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Vascularized lymph node transfer for the treatment of lymphedema: a systematic review and meta-analysis of clinical and patient-reported outcomes
No full textAim: The aim of this systematic review was to summarize clinical and patient-reported outcomes (PROs) for various vascularized lymph node transfer (VLNT) donor sites and identify gaps in the literature to guide future research.Methods: A literature search of five databases was performed for articles related to VLNT that were published prior to November 2021. Studies that included clinical outcomes or PROs from at least five adult patients who received VLNTs to treat lymphedema were included.Results: Sixty-six studies met the study criteria. Most studies reported improved limb circumference/volume, reduction or discontinuation of conservative therapy, infection rate reduction, improved PROs, or postoperative imaging findings reflecting functional lymph nodes. There were significantly lower infection rates (P < 0.05) and a trend towards improved PROs in patients who received intra-abdominal flaps, but overall few studies reported these outcomes. There were no significant differences in complication rates at the donor or recipient site based on VLNT donor sites, or between intra-abdominal vs. extra-abdominal VLNT donor sites, although these outcomes are not uniformly reported.Conclusion: This meta-analysis identified that intra-abdominal donor sites have the potential to reduce postoperative infectious episodes more than extra-abdominal donor sites. Though recent investigations address many understudied VLNT donor sites, larger comparative studies and a standardized methodology are needed to better characterize postoperative outcomes, which can offer more concrete evidence to guide surgical practice
The role of pro-inflammatory components, carcinoma-associated fibroblasts, and tumor-associated macrophages in ovarian cancer progression and metastasis
No full textOvarian cancer (OC) is associated with poor outcomes and challenges scientists and clinicians. It is usually diagnosed in advanced stages when it is frequently aggressive, chemoresistant, and metastatic. The most prevalent form of OC is epithelial ovarian cancer (EOC), which displays significant heterogeneity, enhancing the difficulty in managing the disease. Several factors have been associated with the disease’s development and progression, especially those related to the tumor microenvironment (TME). Here, we highlight components of the ovarian TME in the disease development process, including pro-inflammatory pathways activated by interleukins, cytokines and chemokines, cancer-associated fibroblasts, tumor-associated macrophages, and epithelial-mesenchymal transition. We compiled evidence identifying TME factors promoting the development, chemoresistance, and metastasis, including cytokines, chemokines, growth factors, and tumor-associated cells. We identify potential targets for treatment and improving outcomes. These targets block or alter pathways associated with OC (especially EOC) progression
The effectiveness of the magnetic ring (LINX®) Device in managing reflux after sleeve gastrectomy; long term results: a seven-years’ experience
No full textAim: The magnetic ring (LINX®) system was approved by the FDA in 2012 as a device to augment the lower esophageal sphincter pressure to manage reflux in the general population. It was introduced into the bariatric population in 2014 as an alternative to Roux-en-Y gastric bypass (RYGB) in managing reflux after sleeve gastrectomy (SG).Materials: Between January 2015 and December 2021, Seventeen patients had the Magnetic Ring (MR) device placement to manage their reflux after SG.Methods: The mean age was 54 ± 12 years. Their mean body mass index (BMI) was 31 ± 6 kg/m2. The mean time between the SG and MR device placement was 41 ± 19 months. The mean DeMeester score was 48 ± 26 (normal < 14.72).Results: All seventeen patients underwent a successful laparoscopic placement of the MR device. Two patients had early post-operative dysphagia requiring removal of the device and one patient was lost to follow-up. The mean follow up of the remaining fourteen patients was 65 ± 31 months. Recurrent reflux occurred in 11 (79%). In three of these eleven (27%) patients the recurrent reflux was due to a broken device. None of these patients were interested in conversion to RYGB.Conclusion: The MR device is a valuable tool in treating reflux after SG in spite of its potential risk of recurrence. Our results can be interpreted as being dissatisfying if complete resolution is the goal. Larger studies, with more than 3 year follow up, are needed before a final decision is made on its value in the bariatric population
Neurological complications of COVID-19 and SARS-CoV-2 vaccination: an update
No full textThe respiratory infectious disease COVID-19, which emerged in 2019, has affected the world population over a brief period. In 2020, the disease was declared a pandemic by the World Health Organization. Although most COVID-19 patients primarily develop respiratory symptoms, neurological symptoms have been observed. Neurological symptoms are usually mild and non-specific. However, some patients could experience life-threatening neurological symptoms. With the increase in the incidence of COVID-19, the disease spectrum of patients with central and peripheral nervous system involvement has expanded significantly compared to the previous period. Lack of awareness has caused delays in diagnosis and treatment; therefore, updating the disease spectrum of neurological complications of COVID-19 is necessary. After COVID-19 claimed millions of lives, researchers found that some vaccines may induce autoimmune inflammatory responses in the nervous system via molecular mimicry, leading to SARS-CoV-2 vaccine-related neurological deficits. These neurological complications are often ignored by clinicians, delaying diagnosis and treatment; it is essential to study cases of vaccine-associated neurological complications. Therefore, we summarize the neurological complications of COVID-19 and nervous system adverse reactions caused by SARS-CoV-2 vaccines to help clinicians and public health service personnel understand these rare complications. Avoiding delays in diagnosis and treatment would ensure the safety of COVID-19 patients and SARS-CoV-2 vaccine recipients
Microstructure evolution in laser powder bed fusion-built Fe-Mn-Si shape memory alloy
No full textThe need for specialty powder composition limits the processing of a wide range of alloy products via the laser powder bed fusion (LPBF) technique. This work extends the adaptability of the LPBF technique by fabricating the first-ever Fe-30Mn-6Si (wt.%) product for potential use as a biodegradable shape memory alloy (SMA). Different LPBF processing parameters were assessed by varying the laser power, scan speed, and the laser re-scan strategy to achieve a fully dense part. The microstructure was found to respond to the processing conditions. For example, the microstructure of the parts produced by the high linear energy density (LED) had a columnar and strong crystallographic texture, while in the low LED, the parts were almost equiaxed and had a weak texture. To explain the evolved microstructure, the thermal history of the LPBF products was computed using the finite element analysis (FEA) of the melt pool gathered from a single-track laser scan experiment. The FEA results showed a varying temperature gradient, cooling and solidification rates, and temperature profile as a function of LED. Then, the relationship of hardness between grain size, phases present, and crystallographic misorientation of the LPBF-built alloy was analysed with reference to a control alloy of similar composition but prepared by arc melting. This study validates the LPBF processability of Fe-Mn-Si SMA and provides a new insight into the influence of processing parameters on the formed microstructure and hardness
Recent commentaries on the expected performance, advantages and applications of sodium-ion batteries
No full textReassessment of genes associated with dilated and hypertrophic cardiomyopathy in a Chinese Han population
No full textIntroduction: More than 100 genes are reportedly associated with dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM). However, the situation that many genes lack of reassessment in a large population hinders the interpretations of these genes in genetic diagnostic testing. Moreover, limited genetic data for cardiomyopathy in Chinese patients was reported.Aim: Therefore, here we reassessed an estimated 500 putative genes in the Chinese Han population by whole exome sequencing (WES) to describe the landscape of variants in these genes and to confirm their genetic contribution to DCM and HCM.Methods and Results: WES was performed in 1059 DCM patients, 1175 HCM patients and 514 controls. Approximately 500 candidate genes were selected for evaluation. Truncating variants of TTN and MYBPC3 were the most burdensome for both groups. Gene-based association tests identified 35 and 35 genes associated with DCM and HCM, respectively. Except for the known genes of cardiomyopathy, the top three genes associated with DCM were MUC16, KMT2C, and FBN1, while the top three genes associated with HCM were KMT2C, RYR2, and SCN5A. After filtering for pathogenicity, FBN1 is still significantly associated with DCM and SCN5A and RYR2 remains significantly enriched in HCM patients. However, after adjustment, only TTN with DCM and MYBPC3 and MYH7 with HCM remains significant.Conclusion: We described the genetic landscape of Chinese patients with DCM and HCM and developed a website (www.cardioexome.cn) to enable open access to this information. Furthermore, the gene-based association test confirmed the contribution of TTN to DCM and MYBPC3 and MYH7 to HCM in Chinese Han. In addition, the website, www.cardioexome.cn, was developed to store these sequencing results
Synergizing ontologies and graph databases for highly flexible materials-to-device workflow representations
No full textThe escalating adoption of high-throughput methods in applied materials science dramatically increases the amount of generated data and allows for the deployment and use of sophisticated data-driven methods. To exploit the full potential of these accelerated approaches, the generated data need to be managed, preserved and shared. The heterogeneity of such data calls for highly flexible models to represent the data from fabrication workflows, measurements and simulations. We propose the use of a native graph database to store the data instead of relying on rigid relational data models. To develop a flexible and extendable data model, we create an ontology that serves as the blueprint of the data model. The Python framework Django is used to enable seamless integration into the virtual materials intelligence platform VIMI. The Django framework relies on the Object Graph Mapper neomodel to create a mapping between database classes and Python objects. The model can store the whole bandwidth of the data from fabrication to simulation data. Implementing the database into a platform will encourage researchers to share data while profiting from rich and highly curated data to accelerate their research
Towards the creation of the future fish farm
No full textAim: A fish farm is an area where fish are raised and bred for food. Fish farm environments support the care and management of seafood within a controlled environment. Over the past few decades, there has been a remarkable increase in the calorie intake of protein attributed to seafood. Along with this, there are significant opportunities within the fish farming industry for economic development. Determining the fish diseases, monitoring the aquatic organisms, and examining the imbalance in the water element are some key factors that require precise observation to determine the accuracy of the acquired data. Similarly, due to the rapid expansion of aquaculture, new technologies are constantly being implemented in this sector to enhance efficiency. However, the existing approaches have often failed to provide an efficient method of farming fish.Methods: This work has kept aside the traditional approaches and opened up new dimensions to perform accurate analysis by adopting distributed ledger technology. Our work analyses the current state-of-the-art of fish farming and proposes a fish farm ecosystem that relies on a private-by-design architecture based on the Hyperledger Fabric private-permissioned distributed ledger technology.Results: The proposed method puts forward accurate and secure storage of the retrieved data from multiple sensors across the ecosystem so that the adhering entities can exercise their decision based on the acquired data.Conclusion: This study demonstrates a proof-of-concept to signify the efficiency and usability of the future fish farm
Thrombosis and myocardial infarction: the role of bioresorbable scaffolds
No full textCoronary atherosclerosis is a leading cause of death as a result of coronary thrombosis and acute myocardial infarction. Drug-eluting stents (DES) have dramatically improved the treatment of coronary artery stenosis. However, stent thrombosis (ST) and in-stent-restenosis (ISR) have remained a vexing limitation of the DES. After DES implantation, despite taking dual antiplatelet (DAPT) therapy, very late ST results in myocardial infarction and death. This occurs regardless of the type of polymer or antiproliferative agent used in the contemporary DES. Such adverse events occur at a rate of approximately 2% to 3% per year after the first year, which have been attributed to strut fractures, loss of vessel compliance, and neoatherosclerosis. Bioresorbable scaffolds (BRS) have been introduced to overcome the above shortfalls and to a “leave nothing behind” approach. While BRS are novel and interesting, the initial experience with BRS was hampered by the increased rate of thrombosis compared with DES. Accordingly, in this review, we summarized underlying mechanisms leading to BRS failure and provided insights into optimizing BRS deployment with intravascular imaging. In addition, we outlined the perspectives of new generations of BRS with thinner struts and new designs as well as alternative materials to improve outcomes
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