Impact of Donor-Recipient BMI Ratio on Survival Outcomes of Heart Transplant Recipients: A Retrospective Analysis Study.

OBJECTIVE: This study aimed to investigate the impact of the donor-recipient BMI ratio on the survival outcomes of heart transplant recipients. METHODS: A retrospective analysis was conducted on 641 heart transplant patients who underwent surgery between September 2008 and June 2021. The BMI ratio (donor BMI divided by recipient BMI) was calculated for each patient. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed to evaluate survival rates and determine the hazard ratio (HR) for mortality. RESULTS: Significant differences were found in donor age and donor-recipient height ratio between the BMI ratio groups. The BMI ratio ≥ 1 group had a higher mean donor age (37.27 ± 10.54 years) compared to the BMI ratio < 1 group (34.72 ± 11.82 years, p = 0.008), and a slightly higher mean donor-recipient height ratio (1.02 ± 0.06 vs. 1.00 ± 0.05, p = 0.002). The Kaplan-Meier survival analysis indicated that the survival rate in the BMI ratio ≥ 1 group was significantly lower than in the BMI ratio < 1 group. Cox multivariate analysis, adjusted for confounding factors, revealed a HR of 1.50 (95% CI: 1.08-2.09) for mortality in patients with a BMI ratio ≥ 1. No significant differences were observed in ICU stay, postoperative hospitalization days, or total mechanical ventilation time between the groups. CONCLUSION: A higher donor-recipient BMI ratio was associated with an increased risk of mortality in heart transplant recipients.

Development of Prediction Model for 5-year Survival of Colorectal Cancer.

Objectives: This study aims to introduce a prediction model based on a machine learning approach as an efficient solution for prediction purposes to better prognosis and increase CRC survival. Methods: In the current retrospective study, we used the data of 1062 CRC cases to analyse and establish a prediction model for the 5-year CRC survival. The machine learning algorithms were used to develop prediction models, including random Forest, XG-Boost, bagging, logistic regression, support vector machine, artificial neural network, decision tree, and K-nearest neighbours. Results: The current study revealed that the XG-Boost with AU-ROC of 0.906 and 0.813 for internal and external conditions gave us better insight into predictability and generalizability than other algorithms. Conclusion: XG-Boost can be utilised as a knowledge source for implementing intelligent systems as an assistive tool for clinical decision-making in healthcare settings to improve prognosis and increase CRC survival through various clinical solutions that doctors can achieve.

Tenofovir versus entecavir on the prognosis of hepatitis B virus-related hepatocellular carcinoma: a reconstructed individual patient data meta-analysis.

Background: Hepatitis B, often leading to Hepatocellular carcinoma (HCC), poses a major global health challenge. While Tenofovir (TDF) and Entecavir (ETV) are potent treatments, their comparative effectiveness in improving recurrence-free survival (RFS) and overall survival (OS) rates in HBV-related HCC is not well-established. Methods: We conducted an individual patient data meta-analysis using survival data from randomized trials and high-quality propensity score-matched studies to compare the impact of Tenofovir (TDF) and Entecavir (ETV) on RFS and OS in HBV-related HCC patients. Data from six databases and gray literature up to 30 August 2023, were analyzed, utilizing Kaplan-Meier curves, stratified Cox models, and shared frailty models for survival rate assessment and to address between-study heterogeneity. The study employed restricted mean survival time analysis to evaluate differences in RFS and OS between TDF-treated and ETV-treated patients. Additionally, landmark analyses compared early (<2 years) and late (≥2 years) tumor recurrence in these cohorts. Results: This study incorporated seven research articles, covering 4,602 patients with HBV-related HCC (2,082 on TDF and 2,520 on ETV). Within the overall cohort, TDF recipients demonstrated significantly higher RFS (p = 0.042) and OS (p < 0.001) than those on ETV. The stratified Cox model revealed significantly improved OS for the TDF group compared to the ETV group (hazard ratio, 0.756; 95% confidence interval, 0.639-0.896; p = 0.001), a result corroborated by the shared frailty model. Over a follow-up period of 1-8 years, no significant difference was noted in the mean time to death between the TDF and ETV groups. The rates of early recurrence did not significantly differ between the groups (p = 0.735). However, TDF treatment was significantly associated with a reduced risk of late recurrence compared to ETV (p < 0.001). In the HCC resection subgroup, the disparities in OS, early, and late recurrence rates between the two treatments paralleled those seen in the overall cohort. Conclusion: Compared to ETV, TDF may enhance OS and reduce late tumor recurrence risk in HBV-related HCC patients receiving curative treatment. However, there was no statistically significant distinction in the timing of tumor recurrence and mortality between patients administered TDF and those prescribed ETV. Systematic Review Registration: http://www.crd.york.ac.uk/prospero/.

Adherence, clinical benefits, and adverse effects of endocrine therapies among women with nonmetastatic breast cancer in developing countries: A systematic review and meta-analysis.

BACKGROUND: Despite significant advances in breast cancer control and survival with endocrine therapies (ETs), treatment utilization and outcomes in developing countries have not been adequately explored. This review evaluated ET adherence, potential benefits, and harms in populations across developing countries. METHODS: A literature search was conducted through August 2023 in five databases: PubMed, Cochrane Library, Web of Science, Global Health, and WHO Global Index Medicus. Retrieved records were screened to identify observational research presenting at least one outcome in women with nonmetastatic breast cancer in developing countries who received ET (tamoxifen or aromatase inhibitors). A random effects model was used to compute the rates of adherence, discontinuation, adverse events (AEs), disease progression, and death. RESULTS: A total of 104 studies met the inclusion criteria. Risk of bias was low in most studies, and a large portion of the patients involved Asians. The overall heterogeneity between studies was partially attributed to variations in study design or outcome measurement method. Results showed a pooled adherence rate of 75% (95% confidence interval [CI], 67%-81%) and a discontinuation rate of 16% (95% CI, 10%-25%). Treatment side effects and young age consistently emerged as significant predictors of nonadherence. A wide range of AEs was identified in our analysis. The estimated average rates of cancer recurrence and mortality at 5-years were 16% and 8%, respectively. CONCLUSIONS: The findings of this study underscore suboptimal ET use in developing countries and provide comprehensive insights into treatment experiences in the real-world setting. Targeted strategies are warranted to enhance adherence and subsequently optimize treatment benefits.

Effectiveness of treatment of oropharyngeal carcinoma patients.

OBJECTIVE: Aim: To analyze the results of treatment of patients with oropharyngeal carcinoma. PATIENTS AND METHODS: Materials and Methods: 276 patients with oropharyngeal carcinoma were treated in 2008-2021. Neoadjuvant chemotherapy consisted of three to six cycles: paclitaxel 175 mg/m2 and carboplatin 350 mg/m2 (or cisplatin 100 mg/m2) on the first day. The interval between cycles was 21 days. After the cycles, all patients were prescribed a course of radiation therapy in a total focal dose (TFD) of 65 Gy. The outcome of treatment was assessed by the degree of tumor regression according to RECIST criteria one month after the end of combination treatment. Statistical processing was performed using STATISTICA 6.1 software (StatSoftInc). RESULTS: Results: The three- and five-year survival rates of the examined patients with oropharyngeal carcinoma after treatment were 40.8% respectively (95% CI 33.7 - 47.9) and 27.0%, (95% CI 20.6 - 33, 4) with a median survival of 36 months with 95% CI (35.5 - 40.2). Processing was performed using STATISTICA 6.1 software (StatSoftInc). CONCLUSION: Сonclusions: Analysis of treatment of patients with oropharyngeal carcinoma with predominance of squamous cell carcinoma (90.6%), localized primarily in the palatine tonsil (73.2%), with the most common stages T3N1M0 (30.1%) and T3N1M0 %), with regional metastases to the lymph nodes of the neck (89.9%), showed that the effectiveness of treatment of patients is quite high, because in most of the examined in the short term after combined treatment there was complete or partial regression of the tumor (91.7%), no progression of the oncological process was detected in any of them.

Clinical behavior and survival of endodontically treated teeth with or without post placement: a systematic review and meta-analysis.

PURPOSE: Non-vital teeth usually exhibit substantial loss of coronal and radicular tooth structure, and use of posts after root canal treatment is controversial. This review examined whether placement of posts influences clinical behavior and survival probability of endodontically treated teeth (ETT). METHODS: An electronic search, without time restrictions, for publications written in English was undertaken in PubMed, Scopus, and Web of Science. Terms related to four main components (endodontically treated teeth, fixed prosthesis, post restoration, and survival rate) were used for the database search strategies. RESULTS: 57 studies met the inclusion criteria and were included in the qualitative analysis. Of the publications chosen for qualitative analysis, 17 clinical studies (11 prospective and 6 retrospective studies) were found to be suitable for quantitative analysis. These studies included 7,278 patients (7,330 ETT), with a mean age ± standard deviation (SD) of 45.46 ± 12.1 years. There was a statistically significant difference in survival rate between ETT with or without posts (P < 0.001). CONCLUSION: As compared with teeth with no posts, post placement on ETT may improve clinical performance and survival probability of endodontically treated teeth.

The association between initial post-resuscitation diastolic blood pressure and survival after pediatric cardiac arrest: a retrospective study.

BACKGROUND: Limited research has analyzed the association between diastolic blood pressure (DBP) and survival after pediatric cardiopulmonary resuscitation (CPR). This study aimed to explore the association between post-resuscitation diastolic blood pressure and survival in pediatric patients who underwent CPR. METHOD: This retrospective single-center study included pediatric patients admitted to the pediatric intensive care unit of Asan Medical Center between January 2016 to November 2022. Patients undergoing extracorporeal CPR and those with unavailable data were excluded. The primary endpoint was survival to ICU discharge. RESULTS: A total of 106 patients were included, with 67 (63.2%) achieving survival to ICU discharge. Multivariate logistic regression analysis identified DBP within 1 h after ROSC as the sole significant variable (p = 0.002, aOR, 1.043; 95% CI, 1.016-1.070). Additionally, DBP within 1 h demonstrated an area under the ROC curve of 0.7 (0.592-0.809) for survival to ICU discharge, along with mean blood pressure within the same timeframe. CONCLUSION: Our study highlights the importance of DBP within 1-hour post-ROSC as a significant prognostic factor for survival to ICU discharge. However, further validation through further prospective large-scale studies is warranted to confirm the appropriate post-resuscitation DBP of pediatric patients.

Postbiotic derived from Bacillus subtilis ACCC 11025 improves growth performance, mortality rate, immunity, and tibia health in broiler chicks.

Introduction: The objective of this study was to evaluate the effects of dietary supplementation of postbiotics on growth performance, mortality rate, immunity, small intestinal health, tibia characteristics, and hematological parameters of broiler chicks. he postbiotics were derived from Bacillus subtilis ACCC 11025. Methods: A total of 480 day-old Arbor acre broiler chicks (52.83 ± 1.38 g) were used in a 42-day study and were randomly allocated into four groups. Each group comprised 6 replicate cages, each containing 20 birds. Dietary treatments were based on a basal diet, supplemented with postbiotics at concentrations of 0.000%, 0.015%, 0.030%, or 0.045%. Results and discussion: The results demonstrated an improvement in growth performance, antibody titers against avian influenza virus and Newcastle disease virus, serum albumin levels, and serum total protein levels, as well as a reduction in mortality rate among broiler chicks with increasing levels of postbiotic supplementation. The most significant effect were observed in the group receiving 0.015% postbiotics. Furthermore, a dose-dependent enhancement in tibia weight and tibia weight to length ratio, coupled with a reduction in the robusticity index, was noted. The most favorable outcomes for tibia health were observed in the group receiving 0.030% postbiotics. This improvement in tibia health corresponded to a linear increase in serum calcium and inorganic phosphorus contents. In summary, supplementing broiler chicks with 0.015% postbiotics effectively enhances immunity, leading to improved growth performance and reduced mortality rates. Additionally, a postbiotic dose of 0.030% is suitable for optimizing tibia health.

Protective potentials of polymyxin B and honey against bacterial lipopolysaccharide-induced endotoxemia in mice.

Objective: The experiment aimed to determine the effects of lipopolysaccharide (LPS), polymyxin B, and honey on survival rates, hematological parameters, liver and kidney biomarkers, blood glucose levels, serum insulin levels, and histopathology of the liver, kidney, lungs, brain, and pancreas in LPS-challenged mice. Materials and Methods: 50 male Swiss Albino mice (Mus musculus), aged 3 weeks, were randomly assigned into 5 groups (10 mice per group): Control group (A), LPS (2 mg/kg bwt/day IP in NS) treated group (B), polymyxin B (1.2 mg/kg bwt/day IM) pre-treated plus LPS (2 mg/kg bwt/day IP in NS) treated group (C), honey (10 gm/kg bwt/day PO) pre-treated plus LPS (2 mg/kg bwt/day IP in NS) treated group (D), both polymyxin B (1.2 mg/kg bwt/day IM) and honey (10 gm/kg bwt/day PO) pre-treated plus LPS (2 mg/kg bwt/day IP in NS) treated group (E). The LPS was administered intraperitoneally (IP) at 80 µg/mice/day, diluting in normal saline. After 16 weeks, the mice were sacrificed, and blood samples and organs (liver, kidney, lung, brain, and pancreas) were collected for laboratory tests. Results: The results revealed that in LPS-treated mice, the mortality rate was the highest, and hemato-biochemical parameters were altered. Histopathological examination in the group treated with LPS showed disarrangement of hepatocytes, cellular infiltrations in the glomerulus, alveolar congestion in the lungs, several nerve fiber degenerations in the brain, and degenerative changes in pancreatic islets. The mortality rate and hemato-biochemical and histopathological changes were restored by the combined treatment of polymyxin B and honey. Conclusion: LPS has detrimental effects on survival rate and hemato-biochemistry, which are lessened by taking honey and polymyxin B supplements.

Surgical approach of anorectal mucosal melanoma with locoregional disease - a case report.

Anorectal mucosal melanoma is rare entity. There is currently no consensus on optimal surgical treatment for loco-regional anorectal melanoma that has a favourable outcome. Abdominoperineal resection has not shown a survival benefit over wide local excision due to the inevitable distant recurrence. With local excision considered favourable given reduced surgical morbidity and avoidance of permanent stoma. However, anorectal melanomas are often diagnosed late, with an increased tumour size and depth of primary lesions, increasing the risk of local recurrence and subsequent disease morbidity when excised locally. The decision to proceed to local excision versus abdominoperineal resection is complex, it needs to be individualized, based on primary tumour clinicopathological features and driven by multidisciplinary discussion, with the goal to improve quality and quantity of life. We present a case of a 66-year-old female with anorectal mucosal melanoma with locoregional disease and our surgical approach.

Concerns with alumina bipolar hemiarthroplasties compared to metal bipolar hemiarthroplasties when performed for nontraumatic osteonecrosis of the femoral head.

PURPOSE: A nationwide multicenter follow-up cohort study of hip replacement arthroplasties performed for nontraumatic osteonecrosis of the femoral head (ONFH) aimed to answer the following questions: What factors were associated with need for reoperation? Although many modifications were made in bipolar hemiarthroplasties (BPs) to improve their durability, could we find any evidence of their efficacy? METHODS: Excluding 58 infected hips and 43 ABS THAs with very poor survivorship, we analyzed 7393 arthroplasties; 6284 total hip arthroplasties (THAs), 886 BPs, 188 total resurfacing arthroplasties, and 35 hemi-resurfacing arthroplasties (hRSs). In the 886 BPs, 440 hips had a smooth small-diameter prosthetic neck (nBPs), 667 hips had a smooth neck (sBPs), 116 hips had highly cross-linked polyethylene in the outer head (hBPs), and 238 hips had an outer head whose outer surface was alumina ceramic (aBPs) (648 hips had an outer head whose outer surface was metal [mBPs]). Multivariate analyses using a Cox proportional-hazard model analyzed risk factors. RESULTS: Follow-up ranged from 0.1 to 27 (average, 6.9) years, during which 265 hips (3.6%) needed reoperation. Combined systemic steroid use and excessive alcohol consumption and lateral approach were associated with higher risks, aBPs were less durable than THAs or mBPs, and hRSs were inferior to the others. Regarding BPs, the following divisions did not influence their survivorship; nBP or not, sBP or not, and hBP or not. CONCLUSIONS: Factors associated with reoperation risk were identified as described above. The modifications made in BPs did not improve their durability, but aBPs made it worse. LEVEL OF CLINICAL EVIDENCE: Level III, therapeutic cohort study.

Comprehensive survival analysis of oral squamous cell carcinoma patients undergoing initial radical surgery.

OBJECTIVE: This study was designed to evaluate the five-year overall survival (OS) rate and postoperative survival time of patients diagnosed with oral squamous cell carcinoma (OSCC), as well as examine the clinical and pathological factors influencing survival outcomes in OSCC patients. METHODS: Data were collected from OSCC patients who underwent their first radical surgical intervention in the Department of Maxillofacial Surgery at the First Affiliated Hospital of Chongqing Medical University between April 2014 and December 2016. Follow-up was conducted until March 2022. RESULTS: The study included a total of 162 patients. The observed 5-year OS rate was 59.3%. Approximately 45.7% of OSCC patients experienced postoperative recurrence or metastasis, with a 5-year overall disease-free survival rate of 49.4%. There was no significant difference in the impact of sex, age, smoking, alcohol consumption, primary tumour location, depth of invasion or primary tumour size on the 5-year survival rate (p > 0.05). Univariate analysis revealed that clinical stage (Hazard Ratio = 2.239, p = 0.004), perineural invasion (PNI) (Hazard Ratio = 1.712, p = 0.03), lymph node metastasis (pN) (Hazard Ratio = 2.119, p = 0.002), pathological differentiation (Hazard Ratio = 2.715, p < 0.001), and recurrence or metastasis (Hazard Ratio = 10.02, p < 0.001) were significant factors influencing survival. Multivariate analysis further indicated that pathological differentiation (Hazard Ratio = 2.291, p = 0.001), PNI (Hazard Ratio = 1.765, p = 0.031) and recurrence or metastasis (Hazard Ratio = 9.256, p < 0.001) were independent risk factors of survival. Intriguingly, 11 OSCC patients were diagnosed with oesophageal squamous cell carcinoma (ESCC) within 1-4 years following surgery. CONCLUSION: The survival prognosis of OSCC patients is significantly associated with clinical stage, PNI, lymph node metastasis, pathological differentiation, and recurrence or metastasis. Pathological differentiation, PNI and recurrence or metastasis are independent risk factors affecting survival. Routine clinical screening for ESCC may be recommended for OSCC patients with a history of alcohol consumption and tobacco use.

Comparative efficacy of radical prostatectomy and radiotherapy in the treatment of high-risk prostate cancer.

BACKGROUND: Both radical prostatectomy and radiation therapy are effective in controlling the condition of patients with hormone-resistant prostate cancer (HRPCa). However, there is limited research on the prognosis and quality of life of HRPCa patients after different treatment modalities. OBJECTIVE: To explore the efficacy of radical prostatectomy (RP) and radiotherapy (RT), when treating high-risk prostate cancer (HRPCa). METHODS: Overall 103 HRPCa patients were included and were divided into RP group and RT group according to different treatment methods. The propensity score matching method (PSM) was used to balance the baseline data of the two groups and match 34 patients in each group. The prognosis, quality of life, and basic efficacy of patients were compared. RESULTS: After intervention, the disease-free survival rate of the RT group was higher than that of the RP group (79.41% vs. 55.88%, p= 0.038). Quality of life scores between the two treatment methods had no difference before intervention (p> 0.05), but higher in RT group than that of the RP group after intervention (p< 0.05). After treatment, there was no statistically significant difference in total effective rate of treatment between two groups (44.12% vs. 58.82%, p> 0.05), but the disease control rate was significantly higher in RT group (94.12% vs. 76.47%, p= 0.040). CONCLUSION: Radical radiotherapy is effective in the clinical treatment of HRPCa patients, with a higher disease-free survival rate and improved quality of life after treatment, and is worth promoting.

Early diagnosis of esophageal cancer: How to put "early detection" into effect?

This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology, focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving "early detection". The five-year age-standardized net survival for esophageal cancer patients falls short of expectations. Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer. While advancements in endoscopic technology have been significant, there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques. Therefore, it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer, investigate the most cost-effective screening methods suitable for different regions, and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.

Primary Intrahepatic Mesothelioma: Case Series and Systematic Review of Literature.

BACKGROUND: Primary intrahepatic mesothelioma (PIHMM) has been rarely reported. Its typical clinical presentation, radiological features and pathology have not been defined. Here, we aimed to summarize its diagnosis and treatment. METHODS: We conducted a retrospective analysis of three cases of PIHMM in the First Affiliated Hospital of Zhejiang University School of Medicine and reviewed the current literature to investigate the clinical and pathological characteristics and prognosis of PIHMM. RESULTS: Based on our case series and the literature, the mean age of PIHMM was 59.7 (41-83) years. Most patients present with nonspecific symptoms such as abdominal pain, fever, weight loss and weakness. On imaging, PIHMM usually presented as a solid, heterogeneous soft tissue mass with irregular margins and significant enhancement of the margins in the arterial phase. Immunohistochemical markers such as calretinin, cytokeratin (CK)5/6, D2-40, WT-1, mesothelin CK and vimentin may be useful for diagnosis. The 3-year relapse-free survival rate (RFS) was 51.85%, the 3-year overall survival (OS) rate was 83.33% and the 3-year postoperative overall survival rate was 100%. CONCLUSION: PIHMM can only be diagnosed by careful postoperative pathology, because of its nonspecific clinical presentations, serological indicators or imaging features. Immunohistochemical staining is very useful to distinguish this tumor from other liver tumors. Surgery is the mainstay of treatment.

Effects of parity, season of birth, and sex on within-litter variation and pre-weaning performance of F1 Large White × Landrace pigs.

Background and Aim: A piglet's pre-weaning performance significantly influences both animal welfare and profitability in pig production. Understanding piglet pre-weaning performance influencing factors is key to enhancing animal welfare, reducing losses, and boosting profitability. The study aimed to evaluate the impact of parity, season of birth, and sex on within-litter variation and pre-weaning performance of F1 Large White × Landrace pigs. Materials and Methods: Information regarding total litter size, number of born alive, number of stillbirths, piglet weight at birth, mortality, and count of weaned F1 Large White × Landrace piglets was acquired from the farm database (April 2022-February 2023). 2602 females and 2882 males, a total of 5484 piglets were utilized, with records from 360 sows. The coefficient of variation (CV) of birth weights among piglets within a litter was calculated. The general linear model analysis in MiniTab 17 was used to evaluate the data, with Fisher's least significant difference test (p < 0.05) used for mean separation and Pearson's moment correlation coefficient calculated to assess relationships between survival rates, mortality rates, litter size, birth weight, and birth weight CV. Results: Parity had a statistically significant impact on litter size, birth weight, and survival rate (p < 0.05). The sow's parity did not significantly (p > 0.05) impact the number of piglets born alive or weaned. Multiparous sows had a significantly larger litter size (p < 0.05) than primiparous sows at birth. The litter weights for parities 2, 4, and 5 did not significantly differ (p > 0.05), with averages of 20.95, 20.74, and 20.03 kg, respectively. About 91.29% was the highest survival rate recorded in parity 2 (p < 0.05). The 1st week of life recorded an 8.02% mortality rate. The mortality rate in parity 3-5 group was significantly (p < 0.05) higher (11.90%) in week 1 than in the other groups (parity 1: 6.79%, parity 2: 5.74%, parity 3-5: 8.54 and 9.21%). The litter sizes in autumn (17.34) and spring (17.72) were significantly larger (p < 0.05) than those in summer (16.47) and winter (16.83). In autumn and spring, the survival rate (83.15 and 85.84%, respectively) was significantly lower (p < 0.05) compared to summer (88.40%) and winter (89.07%). In all seasons, the litter weights did not significantly differ (p > 0.05). The birth weight CV was significantly (p < 0.05) lower during summer (20.11%) than during spring (22.43%), autumn (23.71%), and winter (21.69%). The season of birth had no significant effect (p > 0.05) on the number of live piglets. Males (1.34 kg) were heavier (p < 0.05) than females (1.30 kg) at birth. Notably, the birth weight CV was similar between males (22.43%) and females (22.52%). Litter size was positively correlated with average litter weight (rp = 0.576, p < 0.001), birth weight CV (rp = 0.244, p < 0.001), and mortality rate (rp = 0.378, p < 0.001). An insignificant relationship was observed between average litter weight and birth weight CV (rp = -0.028, p > 0.05) and survival rate (rp = -0.032, p > 0.05). Conclusion: In F1 Large White × Landrace pigs, birth uniformity among piglets declines as litter size grows larger. In parity 3-5, multiparous sows yield litters with reduced uniformity. With an increase in litter size, uniformity among piglets at birth worsens. A larger litter size and greater piglet birth weight variation are linked to a higher pre-weaning mortality rate. Producers need a balanced selection approach to boost litter size and must cull aging sows carefully to introduce younger, more productive females.

A real-world study on the treatment of extremely preterm infants: a multi-center study in southwest area of Fujian Province in China.

BACKGROUND: Due to regional and cultural differences, the current status of extremely preterm infants(EPIs) treatment across different areas of mainland China remains unclear. This study investigated the survival rate and incidence of major diseases among EPIs in the southwest area of Fujian province. METHOD: This retrospective and multicenter study collected perinatal data from EPIs with gestational ages between 22-27+ 6w and born in the southwest area of Fujian province. The study population was divided into 6 groups based on gestational age at delivery. The primary outcome was the survival status at ordered hospital discharge or correct gestational age of 40 weeks, and the secondary outcome was the incidence of major diseases. The study analyzed the actual survival status of EPIs in the area. RESULT: A total of 2004 preterm infants with gestational ages of 22-27+ 6 weeks were enrolled in this study. Among them, 1535 cases (76.6%) were born in the delivery room but did not survive, 469 cases (23.4%) were transferred to the neonatal department for treatment, 101 cases (5.0%) received partial treatment, and 368 cases (18.4%) received complete treatment. The overall all-cause mortality rate was 84.4% (1691/2004). The survival rate and survival rate without major serious disease for EPIs who received complete treatment were 85.1% (313/368) and 31.5% (116/318), respectively. The survival rates for gestational ages 22-22+ 6w, 23-23+ 6w, 24-24+ 6w, 25-25+ 6w, 26-26+ 6w, and 27-27+ 6w were 0%, 0%, 59.1% (13/22), 83% (39/47), 88.8% (87/98), and 89.7% (174/198), respectively. The survival rates without major serious disease were 0%, 0%, 9.1% (2/22), 19.1% (9/47), 27.6% (27/98), and 40.2% (78/194), respectively. CONCLUSION: The all-cause mortality of EPIs in the southwest area of Fujian Province remains high, with a significant number of infants were given up after birth in the delivery room being the main influencing factor. The survival rate of EPIs who received complete treatment at 25-27 weeks in the NICU was similar to that in developed countries. However, the survival rate without major serious disease was significantly lower compared to high-income countries.

Observed-to-expected lung-area-to-head-circumference ratio on ultrasound examination vs total fetal lung volume on magnetic resonance imaging in prediction of survival in fetuses with left-sided diaphragmatic hernia.

OBJECTIVE: To assess and compare the value of antenatally determined observed-to-expected (O/E) lung-area-to-head-circumference ratio (LHR) on ultrasound examination vs O/E total fetal lung volume (TFLV) on magnetic resonance imaging (MRI) examination to predict postnatal survival of fetuses with isolated, expectantly managed left-sided congenital diaphragmatic hernia (CDH). METHODS: This was a multicenter retrospective study including all consecutive fetuses with isolated CDH that were managed expectantly in Mannheim, Germany, and in five other European centers, that underwent at least one ultrasound examination for measurement of O/E-LHR and one MRI scan for measurement of O/E-TFLV during pregnancy. All MRI data were centralized, and lung volumes were measured by two experienced operators blinded to the pre- and postnatal data. Multiple logistic regression analyses were performed to examine the effect on survival at hospital discharge of various perinatal variables, including the center of management. In left-sided CDH with intrathoracic herniation of the liver, receiver-operating-characteristics (ROC) curves were constructed separately for cases from Mannheim and the other five European centers and were used to compare O/E-TFLV and O/E-LHR in the prediction of postnatal survival. RESULTS: From Mannheim, 309 patients were included with a median gestational age (GA) at ultrasound examination of 29.6 (range, 19.7-39.1) weeks and median GA at MRI examination of 31.1 (range, 18.0-39.9) weeks. From the other five European centers, 116 patients were included with a median GA at ultrasound examination of 26.7 (range, 20.6-37.6) weeks and median GA at MRI examination of 27.7 (range, 21.3-37.9) weeks. Regression analysis demonstrated that the survival rates at discharge were lower in left-sided CDH (odds ratio (OR), 0.349 (95% CI, 0.133-0.918), P = 0.033) and those with intrathoracic liver (OR, 0.297 (95% CI, 0.141-0.628), P = 0.001), and higher with increasing O/E-TFLV (OR, 1.123 (95% CI, 1.079-1.170), P < 0.001), advanced GA at birth (OR, 1.294 (95% CI, 1.055-1.588), P = 0.013) and when birth occurred in Mannheim (OR, 7.560 (95% CI, 3.368-16.967), P < 0.001). Given the difference in survival rate between Mannheim and the five other European centers, ROC curve comparisons between the two imaging modalities were presented separately. For cases of left-sided CDH with intrathoracic herniation of the liver, pairwise comparison showed no significant difference between the area under the ROC curves for the prediction of postnatal survival between O/E-TFLV and O/E-LHR in Mannheim (mean difference = 0.025, P = 0.610, standard error = 0.050), whereas there was a significant difference in the other European centers studied (mean difference = 0.056, P = 0.033, standard error = 0.056). CONCLUSIONS: In fetuses with left-sided CDH and intrathoracic herniation of the liver, the predictive value for postnatal survival of O/E-TFLV on MRI examination and O/E-LHR on ultrasound examination was similar in one center (Mannheim), but O/E-TFLV had better predictive value compared to O/E-LHR in the five other European centers. Hence, in these five European centers, MRI should be included in the diagnostic process for left-sided CDH. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Effects of First Wave of COVID-19 on Colon Cancer Multi-disciplinary Team Performance: A Two-Year Analysis.

BACKGROUND: We investigated the effects of COVID-19-related delay on two-year outcomes of colon cancer treatment during the first wave of the pandemic. MATERIALS AND METHODS: Ninety-two patients were referred for bowel cancer at our National Health Service (NHS) trust between March and July 2020, and 41 patients were treated for colon cancer and followed up (a two-year) through a multidisciplinary team (MDT). Treatment delays and overall survival (OS) were also assessed. RESULTS: Treatment delays were observed in 48% of patients. The average delay was 31 days beyond the 62-day mark (P0.001). Logistic and binary logistic regression models showed that a comorbid diagnosis of respiratory disease had a significant effect on delays in management and two-year outcomes (P=0.04), but without the likelihood of upstaging or a poorer outcome (P=0.942). The overall survival rate was 81.5%. Eight percent of bowel cancer surgeries could have been avoided if endoscopic visualization and biopsy were available, and 8% more surgeries could have been performed laparoscopically without fear of surrounding aerosols. CONCLUSION: The findings showed that oncologic care provided minimal disruption to trust during the COVID-19 pandemic owing to a quick association between the NHS site and a green non-NHS site, resulting in acceptable two-year outcomes for colon cancer patients.

Epidemiology of Colorectal Cancer in Saudi Arabia: A Review.

Colorectal cancer (CRC) is the second leading cause of cancer death in the world, originating from the glandular epithelial cells of the large intestine and the rectum. This article aims to review the epidemiology of CRC in Saudi Arabia, focusing on prevalence, incidence, risk factors, preventive measures, and outcomes. This narrative review utilized the PubMed database for data extraction, including freely accessible studies published in the last 15 years. Sixteen articles from different study designs were included, while awareness and non-English language studies were excluded. In 2020, the incidence and mortality rate of CRC in Saudi Arabia were 14.6% and 1.48% among all cancers, respectively. From 2006 to 2016, the number of colon cancer and rectal cancer cases increased by 8% and 7%, respectively. Risk factors for CRC in Saudi Arabia include low education level, unemployment, physical inactivity, excess weight, poor knowledge of foods rich in fiber, cigarette smoking, reduced serum vitamin D and calcium levels, and certain gene mutations. National guidelines in Saudi Arabia recommend CRC screening for all individuals above 45 years using colonoscopy, flexible sigmoidoscopy, or fecal occult blood test. The 10-year survival rate for CRC in Saudi Arabia is 44.6%. The overall 5-year survival rate for the Ministry of National Guard-Health Affairs is 52.0%. To lower the incidence and mortality of CRC, primary, secondary, and tertiary prevention are all very important. The most crucial aspect is to concentrate on primary prevention, which may involve raising public awareness of CRC risk factors and strategies for reducing or eliminating them.