Survival outcomes of salvage surgery in the watch-and-wait approach for rectal cancer with clinical complete response after neoadjuvant chemoradiotherapy: a systematic review and meta-analysis

Purpose This systematic review and meta-analysis compared the outcomes of the watch-and-wait (WW) approach versus radical surgery (RS) in rectal cancers with clinical complete response (cCR) after neoadjuvant chemoradiotherapy. Methods This study followed the PRISMA guidelines. Major databases were searched to identify relevant articles. WW and RS were compared through meta-analyses of pooled proportions. Primary outcomes included overall survival (OS), disease-free survival (DFS), local recurrence, and distant metastasis rates. Pooled salvage surgery rates and outcomes were also collected. The Newcastle-Ottawa scale was employed to assess the risk of bias. Results Eleven studies including 1,112 rectal cancer patients showing cCR after neoadjuvant chemoradiation were included. Of these patients, 378 were treated nonoperatively with WW, 663 underwent RS, and 71 underwent local excision. The 2-year OS (risk ratio [RR], 0.95; P=0.94), 5-year OS (RR, 2.59; P=0.25), and distant metastasis rates (RR, 1.05; P=0.80) showed no significant differences between WW and RS. Local recurrence was more frequent in the WW group (RR, 6.93; P<0.001), and 78.4% of patients later underwent salvage surgery (R0 resection rate, 97.5%). The 2-year DFS (RR, 1.58; P=0.05) and 5-year DFS (RR, 2.07; P=0.02) were higher among RS cases. However, after adjustment for R0 salvage surgery, DFS showed no significant between-group difference (RR, 0.82; P=0.41). Conclusion Local recurrence rates are higher for WW than RS, but complete salvage surgery is often possible with similar long-term outcomes. WW is a viable strategy for rectal cancer with cCR after neoadjuvant chemoradiation, but further research is required to improve patient selection

Laser hemorrhoidoplasty versus conventional hemorrhoidectomy for grade II/III hemorrhoids: a systematic review and meta-analysis

Purpose This study compared the short- and long-term clinical outcomes of laser hemorrhoidoplasty (LH) vs. conventional hemorrhoidectomy (CH) in patients with grade II/III hemorrhoids. Methods PubMed/Medline and the Cochrane Library were searched for randomized and nonrandomized studies comparing LH against CH in grade II/III hemorrhoids. The primary outcomes included postoperative use of analgesia, postoperative morbidity (bleeding, urinary retention, pain, thrombosis), and time of return to work/daily activities. Results Nine studies totaling 661 patients (LH, 336 and CH, 325) were included. The LH group had shorter operative time (P0.999) and prolapse (P=0.240), and the likelihood of complete resolution at 12 months, were similar (P=0.240). Conclusion LH offers more favorable short-term clinical outcomes than CH, with reduced morbidity and pain and earlier return to work or daily activities. Medium-term symptom recurrence at 12 months was similar. Our results should be verified in future well-designed trials with larger samples

Early childhood caries in preschool children of Kosovo - a serious public health problem

<p>Abstract</p> <p>Background</p> <p>Even though it has been widely studied, early childhood caries (ECC) remains a serious public health problem, especially in countries where there is no national program of oral health assessment and no genuine primary oral health care, such as in Kosovo. The purpose of this study was to assess the prevalence of ECC and analyze caries risk factors.</p> <p>Methods</p> <p>The subjects were 1,008 preschool children, selected by stratified random cluster sampling, in the municipality of Prishtina, capital of Kosovo. Data were collected through clinical examination and interviews. Dmft data were recorded according to WHO criteria. Bacterial examination (CRT bacteria test) and plaque test of Greene-Vermillion were used.</p> <p>Results</p> <p>The mean dmft of preschool children was found to be 5.8. The prevalence of ECC was 17.36%, with a mean dmft of 11 ± 3.6. Streptococcus mutans prevalence in ECC children was 98%. A significant correlation between dmft and S mutans counts (≥10⁵CFU/mL saliva) was demonstrated. A correlation was also found between daily sweets consumption and dmft in children with ECC (<it>P </it>< 0.001). Comparing the dmft of ECC children and duration of bottle feeding showed a statistical correlation (<it>P </it>< 0.001). The mean plaque test was 1.52. None of the examined children had ever used fluoride.</p> <p>Conclusion</p> <p>The prevalence of ECC was high among preschool children in the municipality of Kosovo. We recommend increasing parents' knowledge of proper feeding habits and oral health practices, and increasing preschool children's accessibility to dental services.</p

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Cognitive training and mild cognitive impairment : a review

Mild cognitive impairment (MCI) is largely viewed as a pre-clinical stage in the trajectory of Alzheimer’s disease (AD) where the extent of cognitive decline is relatively mild, thus allowing for the application of earlier, more effective treatment. Cognitive training (CT), a form of cognitive intervention, can be subdivided into memory strategy training and cognitive exercise. While CT has shown promise in its ability to temporarily restore cognitive function and stimulate neuroplasticity in the MCI individual, early research in this area often suffered from poor methodological quality. This review evaluates the efficacy of CT in MCI based on the present research available. Additionally, results from the application of functional magnetic resonance imaging (fMRI) and other neurobiological measures provide evidence for CT-induced neuroplasticity in the MCI individual. However, such findings have yet to be explored cohesively from a theoretical standpoint. This review uses the theory of brain/cognitive reserve (Stern et al., 2018) as a basis for discussing these findings. At the conclusion, this review finds that the present research provides better support for the effectiveness of CT in MCI. For memory strategy training, a multidomain treatment approach appears to be more effective in generating positive results, while in cognitive exercise, more focused and individualised treatments tend to fair better. While present research lacks consensus on predictors of efficacy, this review finds the largely positive results of current studies promising, nonetheless. Potential future directions for research are discussed as well. Keywords: Cognitive Training, Memory Strategy Training, Cognitive Exercises, Mild Cognitive ImpairmentBachelor of Arts in Psycholog

Nutrient-dependent regulation of a stable intron modulates germline mitochondrial quality control

Abstract Mitochondria are inherited exclusively from the mothers and are required for the proper development of embryos. Hence, germline mitochondrial quality is highly regulated during oogenesis to ensure oocyte viability. How nutrient availability influences germline mitochondrial quality control is unclear. Here we find that fasting leads to the accumulation of mitochondrial clumps and oogenesis arrest in Drosophila. Fasting induces the downregulation of the DIP1-Clueless pathway, leading to an increase in the expression of a stable intronic sequence RNA called sisR-1. Mechanistically, sisR-1 localizes to the mitochondrial clumps to inhibit the poly-ubiquitination of the outer mitochondrial protein Porin/VDAC1, thereby suppressing p62-mediated mitophagy. Alleviation of the fasting-induced high sisR-1 levels by either sisR-1 RNAi or refeeding leads to mitophagy, the resumption of oogenesis and an improvement in oocyte quality. Thus, our study provides a possible mechanism by which fasting can improve oocyte quality by modulating the mitochondrial quality control pathway. Of note, we uncover that the sisR-1 response also regulates mitochondrial clumping and oogenesis during protein deprivation, heat shock and aging, suggesting a broader role for this mechanism in germline mitochondrial quality control