Accuracy of 2D and point shear wave elastography-based measurements for diagnosis of esophageal varices: a systematic review and meta-analysis

PURPOSEThe aim of this meta-analysis is to summarize the diagnostic accuracies of point shear wave elas- tography (pSWE) and two-dimensional (2D) SWE for esophageal varices (EV) and varices needing treatment (VNT).METHODSWe conducted a systematic review and meta-analysis of diagnostic accuracy studies. We searched for studies reporting the EV and VNT diagnostic accuracy of pSWE and 2D SWE using PubMed Cen- tral, SCOPUS, MEDLINE, Embase, and Cochrane databases. STATA software“Midas”package was used for meta-analysis.RESULTSA total of 24 studies with 3867 patients were included in the review. Pooled score sensitivities of pSWE were 91% (95% CI, 80%-96%) for EV, and 94% (95% CI, 86%-97%) for VNT. Pooled score sensi- tivities of 2D SWE were 78% (95% CI, 69%-85%) for EV, and 79% (95% CI, 72%-85%) for VNT. Pooled score specificities of pSWE were 70% (95% CI, 60%-78%) for EV, and 59% (95% CI, 40%-75%) for VNT. Pooled score specificities of 2D SWE for EV were 79% (95% CI, 72%-85%) 72% (95% CI, 66%-77%) for VNT. We found significant heterogeneity for all the elastography-based measurements with the chi- square test results and an I2 statistic >75%.CONCLUSIONBoth pSWE and 2D SWE can diagnose EV and VNT with moderate diagnostic accuracy. Further large- scale setting-specific longitudinal studies are required to establish the best modality

Potential Linkage between Heavy Metal Pollution Risk Assessment and Dissolved Organic Matter Spectra in the WWTPs-River Integrated Area-Case Study from Ashi River

Direct sewage discharge can cause severe damage to the water environment of the river. However, the impacts of dissolved organic matter (DOM) in the discharge on the original pattern of DOM and the distribution of heavy metals (HMs) in the river are little known. How to monitor such areas in a long-term and systematic manner also needs to be urgently addressed. In this paper, we characterized the DOM of the sediments in the WWTPs (wastewater treatment plants)-river integrated zone by ultraviolet-visible absorption spectroscopy (UV-vis), three-dimensional excitation-emission matrix (3D-EEM) combined with parallel factor (PARAFAC) method. The effects of WWTP on receiving waters were investigated, and the potential link between DOM and HM pollution was explored. Hg (Igeo: 3.94 ± 0.65; EF: 44.83 ± 31.11), Cd (Igeo: 1.81 ± 0.69; EF: 8.02 ± 2.97), Cu (Igeo: 1.61 ± 0.83; EF: 6.85 ± 2.37), Zn (Igeo: 1.55 ± 0.54; EF: 7.24 ± 3.58), and Ni (Igeo: 1.46 ± 0.56; EF: 6.12 ± 1.99) in rivers were the primary risk sources of HM. The combined pollution risk indicates that the WWTPs-river integrated area is in a high pollution risk state. Moreover, α(254) has a significant correlation with pollution indicators and can be used as a proxy indicator. These results help to understand better the impact of WWTPs on receiving water bodies and the potential connection between DOM and HM pollution and provide new ideas for monitoring the water environment in highly polluted areas

Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review

Abstract Age‐associated obesity and muscle atrophy (sarcopenia) are intimately connected and are reciprocally regulated by adipose tissue and skeletal muscle dysfunction. During ageing, adipose inflammation leads to the redistribution of fat to the intra‐abdominal area (visceral fat) and fatty infiltrations in skeletal muscles, resulting in decreased overall strength and functionality. Lipids and their derivatives accumulate both within and between muscle cells, inducing mitochondrial dysfunction, disturbing β‐oxidation of fatty acids, and enhancing reactive oxygen species (ROS) production, leading to lipotoxicity and insulin resistance, as well as enhanced secretion of some pro‐inflammatory cytokines. In turn, these muscle‐secreted cytokines may exacerbate adipose tissue atrophy, support chronic low‐grade inflammation, and establish a vicious cycle of local hyperlipidaemia, insulin resistance, and inflammation that spreads systemically, thus promoting the development of sarcopenic obesity (SO). We call this the metabaging cycle. Patients with SO show an increased risk of systemic insulin resistance, systemic inflammation, associated chronic diseases, and the subsequent progression to full‐blown sarcopenia and even cachexia. Meanwhile in many cardiometabolic diseases, the ostensibly protective effect of obesity in extremely elderly subjects, also known as the ‘obesity paradox’, could possibly be explained by our theory that many elderly subjects with normal body mass index might actually harbour SO to various degrees, before it progresses to full‐blown severe sarcopenia. Our review outlines current knowledge concerning the possible chain of causation between sarcopenia and obesity, proposes a solution to the obesity paradox, and the role of fat mass in ageing