Adaptive Selection of Cis-regulatory Elements in the Han Chinese.

Cis-regulatory elements have an important role in human adaptation to the living environment. However, the lag in population genomic cohort studies and epigenomic studies, hinders the research in the adaptive analysis of cis-regulatory elements in human populations. In this study, we collected 4,013 unrelated individuals and performed a comprehensive analysis of adaptive selection of genome-wide cis-regulatory elements in the Han Chinese. In total, 12.34% of genomic regions are under the influence of adaptive selection, where 1.00% of enhancers and 2.06% of promoters are under positive selection, and 0.06% of enhancers and 0.02% of promoters are under balancing selection. Gene ontology enrichment analysis of these cis-regulatory elements under adaptive selection reveals that many positive selections in the Han Chinese occur in pathways involved in cell-cell adhesion processes, and many balancing selections are related to immune processes. Two classes of adaptive cis-regulatory elements related to cell adhesion were in-depth analyzed, one is the adaptive enhancers derived from neanderthal introgression, leads to lower hyaluronidase level in skin, and brings better performance on UV-radiation resistance to the Han Chinese. Another one is the cis-regulatory elements regulating wound healing, and the results suggest the positive selection inhibits coagulation and promotes angiogenesis and wound healing in the Han Chinese. Finally, we found that many pathogenic alleles, such as risky alleles of type 2 diabetes or schizophrenia, remain in the population due to the hitchhiking effect of positive selections. Our findings will help deepen our understanding of the adaptive evolution of genome regulation in the Han Chinese.

DeepRisk network: an AI-based tool for digital pathology signature and treatment responsiveness of gastric cancer using whole-slide images.

BACKGROUND: Digital histopathology provides valuable information for clinical decision-making. We hypothesized that a deep risk network (DeepRisk) based on digital pathology signature (DPS) derived from whole-slide images could improve the prognostic value of the tumor, node, and metastasis (TNM) staging system and offer chemotherapeutic benefits for gastric cancer (GC). METHODS: DeepRisk is a multi-scale, attention-based learning model developed on 1120 GCs in the Zhongshan dataset and validated with two external datasets. Then, we assessed its association with prognosis and treatment response. The multi-omics analysis and multiplex Immunohistochemistry were conducted to evaluate the potential pathogenesis and spatial immune contexture underlying DPS. RESULTS: Multivariate analysis indicated that the DPS was an independent prognosticator with a better C-index (0.84 for overall survival and 0.71 for disease-free survival). Patients with low-DPS after neoadjuvant chemotherapy responded favorably to treatment. Spatial analysis indicated that exhausted immune clusters and increased infiltration of CD11b+CD11c+ immune cells were present at the invasive margin of high-DPS group. Multi-omics data from the Cancer Genome Atlas-Stomach adenocarcinoma (TCGA-STAD) hint at the relevance of DPS to myeloid derived suppressor cells infiltration and immune suppression. CONCLUSION: DeepRisk network is a reliable tool that enhances prognostic value of TNM staging and aid in precise treatment, providing insights into the underlying pathogenic mechanisms.

Phylogenomics and plastomics offer new evolutionary perspectives on Kalanchoideae (Crassulaceae).

BACKGROUND AND AIMS: Kalanchoideae is one of three subfamilies within Crassulaceae and contains four genera. Despite previous efforts, the phylogeny of Kalanchoideae remains inadequately resolved with persistent issues including low support, unstructured topologies and polytomies. This study aimed to address two central objectives: (1) resolving the pending phylogenetic questions within Kalanchoideae by using organelle-scale 'barcodes' (plastomes) and nuclear data; and (2) investigating interspecific diversity patterns among Kalanchoideae plastomes. METHODS: To explore the plastome evolution in Kalanchoideae, we newly sequenced 38 plastomes representing all four constituent genera (Adromischus, Cotyledon, Kalanchoe and Tylecodon). We performed comparative analyses of plastomic features, including GC and gene contents, gene distributions at the IR (inverted repeat) boundaries, nucleotide divergence, plastomic tRNA (pttRNA) structures and codon aversions. Additionally, phylogenetic inferences were inferred using both the plastomic dataset (79 genes) and nuclear dataset (1054 genes). KEY RESULTS: Significant heterogeneities were observed in plastome lengths among Kalanchoideae, strongly correlated with LSC (large single copy) lengths. Informative diversities existed in the gene content at SSC/IRa (small single copy/inverted repeat a), with unique patterns individually identified in Adromischus leucophyllus and one major Kalanchoe clade. The ycf1 gene was assessed as a shared hypervariable region among all four genera, containing nine lineage-specific indels. Three pttRNAs exhibited unique structures specific to Kalanchoideae and the genera Adromischus and Kalanchoe. Moreover, 24 coding sequences revealed a total of 41 lineage-specific unused codons across all four constituent genera. The phyloplastomic inferences clearly depicted internal branching patterns in Kalanchoideae. Most notably, by both plastid- and nuclear-based phylogenies, our research offers the first evidence that Kalanchoe section Eukalanchoe is not monophyletic. CONCLUSIONS: This study conducted comprehensive analyses on 38 newly reported Kalanchoideae plastomes. Importantly, our results not only reconstructed well-resolved phylogenies within Kalanchoideae, but also identified highly informative unique markers at the subfamily, genus and species levels. These findings significantly enhance our understanding of the evolutionary history of Kalanchoideae.

Theoretical Study of Electrocatalytic CO2 Reduction Mechanism on Typical MXenes under Realistic Conditions.

MXenes are a revolutionary class of two-dimensional materials that have been recently demonstrated to exhibit promising capability of electrocatalytic CO2 reduction reaction (CO2RR) in theory and experiment. In electrocatalytic reactions, the active phases, the mechanism, and the performance can be greatly influenced by electrochemical conditions such as applied electrode potential, pH, and electrolyte. Therefore, in this first-principles study, the stable surface structures of three typical MXenes (V2C, Mo2C, and Ti3C2) with variation of electrocatalytic conditions were determined by the Pourbaix phase diagrams. Additionally, the reaction mechanism for CO2RR toward C1 products was investigated based on the thermal dynamically stable phases. The computation revealed that surfaces of all three MXenes are dominated by H* termination throughout the practical CO2RR electrochemical condition ranges. Meanwhile, the bicarbonate ions, which serve as the major electrolyte in CO2RR, show thermal dynamic unfavorability to adsorb on the surfaces. Among the three types of MXenes, V2CH exhibits higher activity in generating CO and HCOOH through the CO2RR, while Mo2CH exhibits higher activity in producing HCHO, CH3OH, and CH4. This comprehensive study provides crucial insights into the mechanism of electrocatalytic CO2RR on MXenes under realistic electrochemical conditions.

First Report of Tomato Yellow Mottle-Associated Virus Infecting Tobacco in China.

Tomato yellow mottle-associated virus (TYMaV) belongs to the genus Cytorhabdovirus in the family Rhabdoviridae and has been reported to infect a variety of Solanaceae crops, such as Solanum lycopersicum, S. nigrum, Capsicum annuum and Nicotiana benthamiana (Li et al. 2022, Li et al. 2023, Xu et al. 2017, Zhou et al. 2019). In August 2022, about 500 out of 2000 tobacco (N. tabacum) plants showing leaf distortion, crinkling and mosaic symptoms were found in one tobacco growing field in Xingren City, Guizhou Province, China. To identify the causal pathogen(s), leaves from 20 symptomatic tobacco plants were collected and pooled to perform small RNA deep sequencing (sRNA-Seq) and assembly. Briefly, total RNA was extracted with TRIzol Reagent (Takara, Kusatsu, Japan). A small RNA cDNA library was constructed by the small RNA Sample Pre Kit. sRNA-Seq was performed with an Illumina NovaSeq 6000 platform. About 29 million reads were obtained and 334 contigs generated after removal of host-derived sequences. Among them, 31 unique contigs mapped to the TYMaV genome (NC_034240.1), covering 28.43% of the genome with the mean read coverage of 0.92%. Meanwhile, 226 contigs mapped to the genome of a potyvirus, chilli veinal mottle virus (ChiVMV, NC_005778.1), covering 88.79% of the genome with the mean read coverage of 0.83%. To verify the sRNA-Seq result for TYMaV identification, reverse transcription (RT)- PCR was performed with specific primers TYMaV-F (5'-CTGACGTAGTGTTGGCAGAT-3') and TYMaV-R (5'-AACCTCCATGCAGAACCATGG-3'). The expected-size 936-bp fragment was amplified from total RNA of all 20 samples. Dot enzyme-linked immunosorbent assays (Dot-ELISA) with antibody for TYMaV (kindly provided by Dr. Zhenggang Li from Guangdong Academy of Agricultural Sciences) were performed and further verified TYMaV infection. In addition, five asymptomatic tobacco plants from the same field as controls were used to detect TYMaV by RT-PCR and Dot-ELISA, and all samples showed negative test results. Subsequently, 17 primer pairs (Supplementary Table 1) were used to obtain the full-length sequence of TYMaV from a single positive tobacco sample by RT-PCR, followed by Sanger sequencing at Sangon Biotech (Shanghai, China). The resulting amplicon sequences were assembled into a nearly full-length genome sequence of a TYMaV isolate from tobacco in Guizhou (TYMaV-GZ). BLASTn analysis of the 13, 393 nt-long sequence (GeneBank accession number, PP444718) revealed 84.7% and 87.2% nt sequence identity with the TYMaV tomato isolate (KY075646.1) and the TYMaV S. nigrum isolate (MW527091.1), respectively. Moreover, five S. nigrum plants showing leaf crinkling and mosaic symptoms from tobacco fields tested positive for TYMaV by RT-PCR assay, suggesting a potential spread of TYMaV between tobacco and S. nigrum, which may serve as a reservoir for the virus in the tobacco fields. However, the transmission route of TYMaV remains unknown, and further verification is needed. To our knowledge, this is the first report of TYMaV infecting tobacco crop in China. It will be important to assess the potential economic importance of TYMaV to tobacco production in China and elsewhere, and to elucidate the respective roles of this virus and ChiVMV in the leaf distorting and yellowing symptoms.

GRAVEN: a database of teaching method that applies gestures to represent the neurosurgical approach's blood vessels and nerves.

BACKGROUND: In this era of rapid technological development, medical schools have had to use modern technology to enhance traditional teaching. Online teaching was preferred by many medical schools. However due to the complexity of intracranial anatomy, it was challenging for the students to study this part online, and the students were likely to be tired of neurosurgery, which is disadvantageous to the development of neurosurgery. Therefore, we developed this database to help students learn better neuroanatomy. MAIN BODY: The data were sourced from Rhoton's Cranial Anatomy and Surgical Approaches and Neurosurgery Tricks of the Trade in this database. Then we designed many hand gesture figures connected with the atlas of anatomy. Our database was divided into three parts: intracranial arteries, intracranial veins, and neurosurgery approaches. Each section below contains an atlas of anatomy, and gestures represent vessels and nerves. Pictures of hand gestures and atlas of anatomy are available to view on GRAVEN ( www.graven.cn ) without restrictions for all teachers and students. We recruited 50 undergraduate students and randomly divided them into two groups: using traditional teaching methods or GRAVEN database combined with above traditional teaching methods. Results revealed a significant improvement in academic performance in using GRAVEN database combined with traditional teaching methods compared to the traditional teaching methods. CONCLUSION: This database was vital to help students learn about intracranial anatomy and neurosurgical approaches. Gesture teaching can effectively simulate the relationship between human organs and tissues through the flexibility of hands and fingers, improving anatomy interest and education.

Co-Mutations and Possible Variation Tendency of the Spike RBD and Membrane Protein in SARS-CoV-2 by Machine Learning.

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, SARS-CoV-2 variants capable of breakthrough infections have attracted global attention. These variants have significant mutations in the receptor-binding domain (RBD) of the spike protein and the membrane (M) protein, which may imply an enhanced ability to evade immune responses. In this study, an examination of co-mutations within the spike RBD and their potential correlation with mutations in the M protein was conducted. The EVmutation method was utilized to analyze the distribution of the mutations to elucidate the relationship between the mutations in the spike RBD and the alterations in the M protein. Additionally, the Sequence-to-Sequence Transformer Model (S2STM) was employed to establish mapping between the amino acid sequences of the spike RBD and M proteins, offering a novel and efficient approach for streamlined sequence analysis and the exploration of their interrelationship. Certain mutations in the spike RBD, G339D-S373P-S375F and Q493R-Q498R-Y505, are associated with a heightened propensity for inducing mutations at specific sites within the M protein, especially sites 3 and 19/63. These results shed light on the concept of mutational synergy between the spike RBD and M proteins, illuminating a potential mechanism that could be driving the evolution of SARS-CoV-2.

A clean process for the recovery of rare earth and transition metals from NiMH battery based on primary amine and lauric acid.

A novel rare earth separation system composed of lauric acid (LA) and primary ammonium (RNH2) was studied. Compared with individual LA and RNH2, the mixed extraction system can significantly improve the extraction and separation ability of rare earth (RE). When LA and RNH2 are mixed in an equal molar ratio, the synergistic coefficient for extracting Nd(III) in the system reaches 136.85. Effective separation of Nd from Co and Ni can be achieved, with the separation coefficients of 1503 and 2762 for Nd/Co and Nd/Ni, respectively. The ion association mechanism of developed extraction system can avoid the generation of saponification wastewater. Thus, the negative impact of saponification wastewater on the economy and environment can be reduced. The extraction system is simple to be prepared and easy to be stripped, which helps to reduce acid and alkali consumption. Application of this extraction system can effectively realize the separation of RE elements La, Ce, Pr, Nd and transition metals Co, Ni, Mn in nickel-metal hydride (NiMH) battery. This paper provides a new strategy for the development of ionic liquid saponification technology without saponified wastewater.

Post-synthesis of a titanium-rich magnetic COF nanocomposite with flexible branched polymers for efficient enrichment of phosphopeptides from human saliva and serum.

A Ti4+-functionalized magnetic covalent organic framework material with flexible branched polymers (mCOF@ε-PL@THBA-Ti4+) built via an immobilized metal ion affinity chromatography (IMAC) enrichment strategy was proposed through post-synthesis modification. Hydrophilic ε-poly-L-lysine (ε-PL) rich in amino active groups was first introduced in the fabrication of the phosphopeptide enrichment material to increase the hydrophilicity while providing more functional modification pathways of the material. 2,3,4-Trihydroxy-benzaldehyde (THBA) provides abundant binding sites for the immobilization of numerous Ti4+, which is advantageous for the subsequent efficient phosphopeptide enrichment. The magnetic nanocomposite exhibited outstanding performance of phosphopeptide enrichment with good selectivity (1 : 5000), a low detection limit (2 fmol), and relatively high loading capacity (66.7 mg g-1). What's more, after treatment with mCOF@ε-PL@THBA-Ti4+, 16 endogenous phosphopeptides from fresh saliva of healthy people were recognized by MALDI-TOF MS, and 50 phosphopeptides belonging to 35 phosphoproteins from the serum of uremia patients were detected by nano-LC-MS/MS. Proteomics data analysis for the differential protein selection between uremia and normal controls was conducted using R software, and four down-regulated and three up-regulated proteins were obtained. The results suggested that the prepared material has potential applications in biomarker discovery.

Epidemiological characteristics of paediatric Omicron infection during the outbreak of SARS-CoV-2 infection during March-May in 2022 in Shanghai, China.

This study aims to understand the epidemiological characteristics of SARS-CoV-2 infection in the paediatric population during the outbreak of the Omicron variant in Shanghai. We retrospectively analysed the population-based epidemiological characteristics and clinical outcome of SARS-CoV-2 Omicron variant infection in children in Minhang District, Shanghai, based on the citywide surveillance system during the outbreak period in 2022 (March to May). During this time, a total of 63,969 cases of SARS-CoV-2 infection were notified in Minhang District, out of which 4,652 (7.3%) were children and adolescents <18 years. The incidence rate of SARS-CoV-2 infections in children was 153 per 10,000. Of all paediatric cases, 50% reported to be clinically symptomatic within 1-3 days after PCR confirmation by parents or themselves, with 36.3% and 18.9% of paediatric cases reporting fever and cough. Also, 58.4% of paediatric cases had received at least one dose of the COVID-19 vaccine and 52.1% had received two doses of the COVID-19 vaccination. Our findings are informative for the implementation of appropriate measures to protect children from the threat of SARS-CoV-2 infection.

Biochar/sodium alginate mixed matrix membrane as adsorbent for in-syringe solid-phase extraction towards trace nitroimidazoles in water samples prior to ultra-high-performance liquid chromatography-tandem mass spectrometry analysis.

In the present work, the herb (Poria cocos (Schw.) Wolf) residue, as an environmentally friendly and renewable biomass source, was converted into novel biochar. Biochar/sodium alginate mixed matrix membrane was fabricated. On this basis, a biochar/sodium alginate mixed matrix membrane-based in-syringe solid-phase extraction was developed combined with ultra-high performance liquid chromatography-tandem mass spectrometry to determine nitroimidazoles in water samples. The factors including times of exaction, type, and volume of elution solvent, and sample solution pH were thoroughly optimized. Then the correlation coefficient was 0.9995-0.9997. The limit of detection of four analytes was between 0.006 and 0.014 ng/mL, and the recovery was between 79.02% and 99.1%. Consequently, the established method would provide a new perspective on monitoring nitroimidazoles in water samples.

Clinical application of Magnetic resonance elastography in hepatocellular carcinoma: from diagnosis to prognosis.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a major public health problem worldwide. Liver fibrosis is closely correlated with liver functional reserve and the risk of HCC development. Meanwhile, malignant tumors generally have high cellularity compared to benign tumors, which results in increased stiffness. Magnetic resonance elastography (MRE) has emerged as a new non-invasive technique for assessing tissue stiffness with excellent diagnostic accuracy, not only for assessing liver fibrosis but also for measuring tumor stiffness. Recent studies provide new evidence that MRE may play an important role in the management of patients with HCC and show several novel clinical applications, such as predicting the development of HCC, differentiating between benign/malignant liver lesions (FLL) and HCC pathological grades, assessing treatment response, and predicting recurrence after treatment, although some findings are controversial. Therefore, we conducted this review to summarize these novel applications of MRE in HCC patients and also discuss their limitations and future advancement.

Matrix complete dissolution concatenated biochar magnetic solid-phase extraction of benzotriazole ultraviolet stabilizers in polyester fibers prior to UPLC-MS/MS analysis.

Matrix complete dissolution combined with magnetic solid-phase extraction (MSPE) was applied to extract four benzotriazole ultraviolet stabilizers (BUVSs) from polyester curtains. Ultra-performance liquid chromatography tandem mass spectrometry was coupled to perform the content of trace BUVSs. The procedure was being developed in two steps. The polymer matrix was initially thoroughly dissolved by 1,1,1,3,3,3-hexafluoro-2-propanol (HFIP) followed by the addition of precipitant to separate the target from the dissolved polymer matrix. Next, triiron tetraoxide/biochar magnetic material was prepared and utilized as the sorbent for purification of the extract. Ultrasonic extraction coupled with the MSPE method and the proposed method was compared. Better extraction recovery of four BUVSs was acquired by the novel developed extraction method. The purification effect of the new extraction method was established by comparing the matrix effect of the polymer complete dissolution method and the polymer complete dissolution combined with the MSPE method. The extraction parameters were investigated. Under the optimized conditions, correlation coefficient (r) ranging from 0.9969 to 0.9997, limit of detection of 0.2 to 0.8 ng·g-1, and the recovery varied from 81.5 to 102.7% with RSD smaller than 10.7% were obtained for four BUVSs, respectively. This study provides a potential strategy for the efficient extraction and sensitive determination of BUVSs in polyester fibers samples.

Combination of continuous wavelet transform and genetic algorithm-based Otsu for efficient mass spectrometry peak detection.

Mass spectrometry (MS) data is susceptible to random noises and alternating baseline, posing great challenges to spectral peak detection, especially for weak peaks and overlapping peaks. Herein, an efficient peak detection algorithm combining continuous wavelet transform (CWT) and genetic algorithm-based threshold segmentation (denoted as WSTGA) for mass spectrometry was proposed. Firstly, Mexican Hat wavelet was selected as the mother wavelet by comparing the matching degree between the difference of Gaussian (DOG) and different wavelets. Subsequently, the ridges and valleys were identified from 2D wavelet coefficient matrix. Afterward, an improved threshold segmentation method, Otsu method based on genetic algorithm, was introduced to find optimal segmentation threshold and achieve better image segmentation, overcoming the deficiency of traditional Otsu method that cannot handle long-tailed unimodal histograms. Finally, the characteristic peaks were successfully identified by utilizing the ridge-valley lines in wavelet space and original spectrum. Receiver operating characteristic (ROC) curve, area under curve (AUC) and F1 measure are used as criterions to evaluate performance of peak detection algorithms. Compared with multi-scale peak detection (MSPD) and CWT and image segmentation (CWT-IS) methods, all the results showed that WSTGA can achieve better peak detection. More importantly, the experimental results from MALDI-TOF spectra demonstrated that WSTGA can effectively detect more weak peaks and overlapping peaks while maintaining a lower false peak detection rate than MSPD and CWT-IS methods, indicating its great advantages in characteristic peak identification.

A feature-based approach to predict hot spots in protein-DNA binding interfaces.

DNA-binding hot spot residues of proteins are dominant and fundamental interface residues that contribute most of the binding free energy of protein-DNA interfaces. As experimental methods for identifying hot spots are expensive and time consuming, computational approaches are urgently required in predicting hot spots on a large scale. In this work, we systematically assessed a wide variety of 114 features from a combination of the protein sequence, structure, network and solvent accessible information and their combinations along with various feature selection strategies for hot spot prediction. We then trained and compared four commonly used machine learning models, namely, support vector machine (SVM), random forest, Naïve Bayes and k-nearest neighbor, for the identification of hot spots using 10-fold cross-validation and the independent test set. Our results show that (1) features based on the solvent accessible surface area have significant effect on hot spot prediction; (2) different but complementary features generally enhance the prediction performance; and (3) SVM outperforms other machine learning methods on both training and independent test sets. In an effort to improve predictive performance, we developed a feature-based method, namely, PrPDH (Prediction of Protein-DNA binding Hot spots), for the prediction of hot spots in protein-DNA binding interfaces using SVM based on the selected 10 optimal features. Comparative results on benchmark data sets indicate that our predictor is able to achieve generally better performance in predicting hot spots compared to the state-of-the-art predictors. A user-friendly web server for PrPDH is well established and is freely available at http://bioinfo.ahu.edu.cn:8080/PrPDH.

A novel hydrophilic hydrogel with a 3D network structure for the highly efficient enrichment of N-glycopeptides.

Protein glycosylation is of great significance in various physiological processes. Nevertheless, it remains a huge challenge to identify glycopeptides in complex biosamples by the direct mass spectrometry analysis due to the low ion efficiency and low abundance of glycopeptides. In this study, a novel hydrogel (denoted as ZIF-8/SAP) with a stable three-dimensional (3D) network structure and excellent hydrophilicity was successfully fabricated to capture glycopeptides with high efficiency. Owing to the unique characteristics, ZIF-8/SAP exhibited great selectivity (1 : 1000), great sensitivity (1 fmol µL-1), large binding capacity (300 mg g-1) and satisfactory reusability (seven cycles). Inspired by the great enrichment performance of the as-prepared material toward glycopeptides, ZIF-8/SAP was further applied to capture glycopeptides from a real human serum sample. The experimental results demonstrated that 217 N-glycosylation sites were identified in 283 N-glycopeptides, corresponding to 95 glycoproteins identified from 10 µL human serum by the nano-LC-MS/MS analysis, revealing the great potential of the novel ZIF-8/SAP hydrogel for glycopeptide enrichment and glycoproteomic research.

A novel graphene oxide/chitosan foam incorporated with metal-organic framework stationary phase for simultaneous enrichment of glycopeptide and phosphopeptide with high efficiency.

A novel hydrophilic porous biocomposite was fabricated by incorporating graphene oxide (GO) @chitosan (CS) foam substrate (GO@CS@ZIF-8 foam) with ZIF-8 crystals in situ via a facile stirring method for simultaneous enrichment of glycopeptides and phosphopeptides from complex biological samples. The experimental results demonstrated that GO@CS@ZIF-8 foam exhibited favorable specificity for simultaneous enrichment of N-glycopeptides and phosphopeptides under the same condition for HRP and ß-casein tryptic digest mixtures. The novel material was further applied to enriching both glycopeptides and phosphopeptides simultaneously from 4 µL complex human serum, and 423 N-glycopeptides and 40 phosphopeptides corresponding to 133 glycoproteins and 29 phosphoproteins were identified, respectively.

Predictive Value of Liver Stiffness Measurement by Magnetic Resonance Elastography for Complications after Liver Resection: A Systematic Review and Meta-Analysis.

BACKGROUND AND AIMS: Liver fibrosis has been recognized as a significant risk factor for short-term outcomes after hepatectomy. Magnetic resonance elastography (MRE) showed higher diagnostic performance in staging liver fibrosis than other elastography modalities. This study aimed to assess the accuracy of predicting postoperative complications in patients with malignant liver tumors using liver stiffness measurement (LSM) by MRE. METHODS: After a systematic review of the relevant studies, the sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve (AUC) for the diagnosis of postoperative complications were pooled using bivariate meta-analysis. Meanwhile, the pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the effect. Heterogeneity was explored by sensitivity analysis, univariate meta-regression, and subgroup analysis. The potential publication bias was evaluated by the Deek's funnel plot test. RESULTS: Eight studies comprising a total of 1,154 patients that predicted postoperative outcomes as their purpose were ultimately included in the quantitative analysis. The pooled results of the meta-analysis revealed that the pooled sensitivity, specificity, and AUC were 78% (95% CI: 69-85%, Higgins's inconsistency index [I2] = 43.00), 75% (95% CI: 70-80%, Higgins's inconsistency index [I2] = 72.53), and 0.83 (95% CI: 0.80-0.86), respectively. Preoperative LSM by MRE was significantly associated with the development of overall postoperative outcomes (OR 1.78, 95% CI: 1.49-2.08). Univariate meta-regression showed that advanced fibrosis stage (≥F3), HCC patient proportion and cut-off value significantly influenced the heterogeneity of the included studies. The AUC of several novel prediction models based on LSM by MRE ranged from 0.818 to 0.911. CONCLUSIONS: In conclusion, liver stiffness measured by MRE was a significant predictor of postoperative outcomes in patients undergoing liver resection. Future studies could focus on setting a prognostic model integrated with LSM by MRE in distinguishing patients at high risk of posthepatectomy complications.

Culture medium is associated with the risks of placenta previa and macrosomia in pregnancies after in vitro fertilization.

PURPOSE: The culture medium plays an important role in embryonic development and subsequent pregnancy outcomes of in vitro fertilization (IVF) cycles. The sequential culture media of Vitrolife and Cook are the two most commonly used reagents in China. This study aimed to assess their effects on IVF success rates, obstetric outcomes and neonatal outcomes. METHODS: This was a retrospective cohort study on 6352 patients undergoing first IVF attempts between January 2018 and December 2019, resulting in 3153 clinical pregnancies, 2646 live births, and 2668 babies. Patients were grouped according to the culture media they used. There were 4680 patients in the Vitrolife group and 1672 patients in the Cook group. The primary outcome measures were maternal and neonatal outcomes. ANOVA and Chi-square tests were used for statistical comparison, and multivariate logistic regression and multivariate general linear model were used to adjust for potential confounders. RESULTS: The rates of live birth, clinical pregnancy, monozygotic twins, miscarriage, and ectopic pregnancy were all comparable between the groups of Vitrolife and Cook. The incidence of placenta previa was higher in the Vitrolife group [4.86 vs. 3.09%, adjusted odds ratio = 2.048 (1.146-3.657)]. The incidence of macrosomia was higher in the Cook group [7.51 vs. 5.39%, adjusted odds ratio = 1.445 (1.010-2.069)]. CONCLUSION: The culture media of Vitrolife and Cook are comparably effective in IVF success. Vitrolife is associated with a higher risk of placenta previa, while Cook is associated with a higher risk of macrosomia.

Effect of Stromal Vascular Fraction on Sustained Volume Retention of Five Different Hyaluronic Acid Fillers.

BACKGROUND: The technology of manufacturing hyaluronic acid (HA) fillers is evolving to increase their safety and durability. This study aimed to compare the volume maintenance effect of stromal vascular fraction (SVF) on different types of HA fillers. METHODS: In this controlled experiment, HA fillers mixed with SVF were injected into the right upper back and HA fillers alone were injected into the left upper back of each mouse. A total of 35 mice were separated into five groups according to the type of commercially used HA filler: Juvederm Voluma XC, Restylane Lyft, Restylane Skinboosters Vital, Giselle Ligne Signature 2, and Giselle Ligne Universal. Nodule size inspection was performed on post-injection days 0, 3, and 56. Ultrasonography for maximal two-dimensional area of filler nodule measurement and histology were performed on the last day of the inspection. RESULTS: While most of the groups showed a volume reduction of over 50% on day 56, regardless of SVF administration, significant volume maintenance was observed when Giselle Ligne Signature 2 was injected with SVF. Ultrasonographic measurement of two-dimensional filler nodule size showed no significant difference regarding filler types and SVF injection. When compared with the histological results of other fillers mixed with SVF, Giselle Ligne Signature 2 showed marked increase in cell survival and extracellular matrix components in HA particles. CONCLUSION: SVF showed different efficacies in terms of volume maintenance and cell survival for various HA filler types. The SVF mixture in selective HA filler injections may improve maintenance in clinical settings. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.