Several epidemiological studies have been conducted to address the later effect of anesthesia on neurodevelopment in children. However, the results are still inconclusive.
We here conducted a ...systematic review and meta-analysis to summarize the currently available clinical and epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children by searching PubMed, EMBASE, and Web of Science database (from January-1 2000 to February-1, 2013). The evaluation of neurodevelopment includes language and learning disabilities, cognition, behavioral development, and academic performance. Both retrospective and prospective studies were included. Data were abstracted from seven eligible studies. We estimated the synthesized hazard ratios (HR) and 95% confidence interval (CI) according to inter-study heterogeneity.
The pooled HR for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.25 (95% CI, 1.13-1.38, P<0.001; random-effects model) in children undergoing the first anesthesia before the age of 4-year. Then we analyzed the factors for this association using meta-regression method. It showed that it was the number of times of exposure (HR = 1.75, 95% CI 1.31-2.33; P<0.001) rather than the time at exposure before 4-year (HR = 1.08, 95% CI 0.87-1.34 for the effect of per 1-year early exposure; P = 0.47) is a risk factor for neurodevelopmental impairment.
The current clinical evidence suggests modestly elevated risk of adverse neurodevelopmental outcomes in children who were exposed to anesthesia/surgery during early childhood, especially for those with multiple times of exposure. Due to limitation of retrospective studies, prospective investigations are needed to determine whether anesthesia/surgery is causative.
Animal models have shown that regional anesthesia (combined with or without general anesthesia) would attenuate the surgical stress response by preserving immune function and result in better ...long-term outcome. In order to test the hypothesis that cancer patients who had surgery with epidural anesthesia (EA) would have better outcome (either overall survival OS or recurrence-free survival RFS) than those who were general anesthesia (GA), we performed this meta-analysis. By searching relevant literature, a total of 14 studies containing 18 sub-studies (seven in OS analysis and eleven in RFS analysis) were identified and meta-analyzed. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the strength of association. For OS, the random-effects model was used to analyze the data and demonstrated an OS benefit in favor of EA compared with GA alone (HR = 0.84, 95% CI 0.74-0.96, P = 0.013). The influence analysis showed the robustness of the results. Specifically, a significantly positive association between EA and improved OS was observed in colorectal cancer (HR = 0.65, 95% CI 0.43-0.99, P = 0.045). For RFS, the random-effects model was used to analyze the data and no significant relationship between RFS benefit and EA (HR = 0.88, 95% CI 0.64-1.22, P = 0.457) was detected. In conclusion, our meta-analysis suggests that epidural anesthesia and/or analgesia might be associated with improved overall survival in patients with operable cancer undergoing surgery (especially in colorectal cancer), but it does not support an association between epidural anesthesia and cancer control. Prospective studies are needed to determine whether the association between epidural use and survival is causative.
Evidence suggests that fasting exerts extensive antitumor effects in various cancers, including colorectal cancer (CRC). However, the mechanism behind this response is unclear. We investigate the ...effect of fasting on glucose metabolism and malignancy in CRC. We find that fasting upregulates the expression of a cholesterogenic gene, Farnesyl-Diphosphate Farnesyltransferase 1 (FDFT1), during the inhibition of CRC cell aerobic glycolysis and proliferation. In addition, the downregulation of FDFT1 is correlated with malignant progression and poor prognosis in CRC. Moreover, FDFT1 acts as a critical tumor suppressor in CRC. Mechanistically, FDFT1 performs its tumor-inhibitory function by negatively regulating AKT/mTOR/HIF1α signaling. Furthermore, mTOR inhibitor can synergize with fasting in inhibiting the proliferation of CRC. These results indicate that FDFT1 is a key downstream target of the fasting response and may be involved in CRC cell glucose metabolism. Our results suggest therapeutic implications in CRC and potential crosstalk between a cholesterogenic gene and glycolysis.
Objective
To assess the accuracy of dynamic computer‐assisted implant surgery.
Materials and methods
An electronic search up to March 2020 was conducted using PubMed, Embase, and the Cochrane Central ...Register of Controlled Trial to identify studies using dynamic navigation in implant surgery, and additional manual search was performed as well. Clinical trials and model studies were selected. The primary outcome was accuracy. A single‐arm meta‐analysis of continuous data was conducted. Meta‐regression was utilized for comparison on study design, guidance method, jaw, and systems.
Results
Ten studies, four randomized controlled trials (RCT) and six prospective studies, met the inclusion criteria. A total of 1,298 drillings and implants were evaluated. The meta‐analysis of the accuracy (five clinical trials and five model studies) revealed average global platform deviation, global apex deviation, and angular deviation were 1.02 mm, 95% CI (0.83, 1.21), 1.33 mm, 95% CI (0.98, 1.67), and 3.59°, 95% CI (2.09, 5.09). Meta‐regression shown no difference between model studies and clinical trials (p = .295, 0.336, 0.185), drilling holes and implant (p = .36, 0.279, 0.695), maxilla and mandible (p = .875, 0.632, 0.281), and five different systems (p = .762, 0.342, 0.336).
Conclusion
Accuracy of dynamic computer‐aided implant surgery reaches a clinically acceptable range and has potential in clinical usage, but more patient‐centered outcomes and socio‐economic benefits should be reported.
To develop and validate a radiomics nomogram for preoperative prediction of lymph node (LN) metastasis in patients with colorectal cancer (CRC).
The prediction model was developed in a primary cohort ...that consisted of 326 patients with clinicopathologically confirmed CRC, and data was gathered from January 2007 to April 2010. Radiomic features were extracted from portal venous-phase computed tomography (CT) of CRC. Lasso regression model was used for data dimension reduction, feature selection, and radiomics signature building. Multivariable logistic regression analysis was used to develop the predicting model, we incorporated the radiomics signature, CT-reported LN status, and independent clinicopathologic risk factors, and this was presented with a radiomics nomogram. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. Internal validation was assessed. An independent validation cohort contained 200 consecutive patients from May 2010 to December 2011.
The radiomics signature, which consisted of 24 selected features, was significantly associated with LN status (P < .001 for both primary and validation cohorts). Predictors contained in the individualized prediction nomogram included the radiomics signature, CT-reported LN status, and carcinoembryonic antigen level. Addition of histologic grade to the nomogram failed to show incremental prognostic value. The model showed good discrimination, with a C-index of 0.736 (C-index, 0.759 and 0.766 through internal validation), and good calibration. Application of the nomogram in the validation cohort still gave good discrimination (C-index, 0.778 95% CI, 0.769 to 0.787) and good calibration. Decision curve analysis demonstrated that the radiomics nomogram was clinically useful.
This study presents a radiomics nomogram that incorporates the radiomics signature, CT-reported LN status, and clinical risk factors, which can be conveniently used to facilitate the preoperative individualized prediction of LN metastasis in patients with CRC.
Fluoride anion complexation impacts a number of areas ranging from sensing to nucleophilic fluorination chemistry. Described here is a new bidentate Lewis acid consisting of two stiborane units ...connected by a 1,8‐triptycenediyl backbone. This neutral derivative captures fluoride with an unprecedented affinity for a neutral, water‐compatible Lewis acid. Structural, spectroscopic and computational studies demonstrate that fluoride anion binding is assisted by the formation of a C−H⋅⋅⋅F hydrogen bond which involves a methine group of the 1,8‐triptycenediyl backbone.
Fluoride on a trip! A new triptycene‐based bidentate Lewis acid containing two stiborane units sequesters aqueous fluoride to form a complex in which the chelated fluoride anion is further stabilized by a C−H⋅⋅⋅F hydrogen bond. Structural, spectroscopic, and computational studies on the formed complex are discussed.
The development of group 15 Lewis acids is an area of active investigation that has led to numerous advances in anion sensing and catalysis. While phosphorus has drawn considerable attention, ...emerging research shows that organoantimony(III) reagents may also act as potent Lewis acids. Comparison of the properties of SbPh3, Sb(C6F5)3, and SbArF3 with those of their tetrachlorocatecholate analogues SbPh3Cat, Sb(C6F5)3Cat, and SbArF3Cat (Cat=o‐O2C6Cl4, ArF=3,5‐(CF3)2C6H3) demonstrates that the Lewis acidity of electron deficient organoantimony(III) reagents can be readily enhanced by oxidation to the +V state—as verified by binding studies, organic reaction catalysis, and computational studies. The results are rationalized by explaining that oxidation of the antimony center leads to a lowering of the accepting σ* orbital and a deeper carving of the associated σ‐hole.
Taking a dig at the σ‐hole! Oxidation of organoantimony derivatives from the +III to the +V state leads to a more pronounced σ‐hole on antimony, thereby making these main‐group compounds better pnictogen bond donors or better Lewis acids. These results, which can be rationalized using orbital‐based arguments, offer a new strategy for tuning the magnitude of pnictogen bonding and have applications in catalysis.
For comprehensive insights into the effects of multiple disinfection regimes on antibiotic resistome in drinking water, this study utilized metagenomic approaches to reveal the changing patterns of ...antibiotic resistance genes (ARGs) and bacterial community as well as their associations. A total of 297 ARGs within 17 types were detected in the drinking water, and their total relative abundance ranged from 195.49 ± 24.85 to 626.31 ± 38.61 copies of ARGs per cell. The total ARG abundance was significantly increased after the antimicrobial resin and ultraviolet (AR/UV) disinfection while significantly decreased after the ozone and chlorine (O3/Cl2) disinfection and remained stable after AR/Cl2 disinfection. Overall, 18 ARGs including bacA, mexT, and blaOXA-12, mainly affiliated to bacitracin, multidrug, and beta-lactam, were persistent and discriminative during all the disinfection strategies in drinking water, and they were considered as key ARGs that represent the antibiotic resistome during drinking water disinfection. Additionally, possible hosts of 50% key ARGs were revealed based on co-occurrence network. During multiple disinfection processes, the change of Fusobacteriales and Aeromonadaceae in abundance mainly contributed to the abundance shift of bacA, and Pseudomonas mainly increased the abundance of mexT. These findings indicated that bacterial community shift may be the key factor driving the change of antibiotic resistome during disinfection. The strong association between antibiotic resistome alteration and bacterial community shift proposed in this study may enhance our understanding of the underlying mechanism of the disinfection effects on antibiotic resistance and benefit effective measures to improve safety of drinking water.
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•ARGs within bacitracin, multidrug, and beta-lactam were dominant in drinking water.•ARG abundance significantly elevated after AR/UV while decreased after O3/Cl2 unit.•Persistent ARGs accounted for the majority of total ARGs during disinfection.•Bacterial communities shifted significantly after multiple disinfection strategies.•Fate of ARGs may relate to the survival ability of corresponding bacterial hosts.
This study uses both observations and numerical modeling experiments to investigate the lead-lag relationship and the associated physical mechanism of the western North Pacific anomalous anticyclone ...(WNPAC) with sea surface temperature (SST) anomalies over the northern tropical Atlantic (NTA). The results show that the WNPAC from late spring to the middle of autumn has a significant in-phase relationship with the NTA SST anomalies up to two seasons ahead. This relationship reaches a peak when the NTA SST leads by approximately 1–2 months and is nearly independent of the El Niño-Southern Oscillation variability. Diagnosis based on observations and numerical experiments using the Community Atmospheric Model version 5.3 reveals that the NTA warming favors intensified local convection activity during the spring–autumn seasons, causing enhanced low-level convergence and upper-level divergence (i.e., ascending motion) over the NTA and opposite flow anomalies over the central tropical Pacific. The enhanced subsidence over the central tropical Pacific, in turn, triggers an anomalous low-level anticyclone over the western North Pacific. Moreover, the intensity of the anomalous local convection activity that is associated with the NTA SST is closely related to the seasonal migration of the Atlantic intertropical convergence zone (ITCZ). As the Atlantic ITCZ migrates northward, the NTA SST-induced local convection activity extends northward from a narrow band near the equator during early spring to nearly the entire NTA region during the middle of summer, leading to the strongest remote effect of the NTA SST anomalies on the WNPAC during late summer and early autumn.
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