Background The prevalence and predictors of left atrial appendage thrombus (LAAT) in patients with non-valvular atrial fibrillation (AF) who have been treated with non-vitamin K antagonist oral anticoagulants (NOACs) are not well defined. We aimed to assess the occurrence and predictors of LAAT on transesophageal echocardiography (TOE) in patients with non-valvular AF treated with NOACs for at least 3 weeks. Methods Consecutive patients with non-valvular AF who underwent TOE before catheter ablation or electrical cardioversion in three high-reference centers between 2014 and 2018 were included. Patients on apixaban were excluded from the study due to low numbers in this category. All patients received NOACs for at least 3 weeks before TOE. Results A total of 1148 patients (female, 38.1%; mean age, 62.1 years) referred to our centers for catheter ablation of AF (52.1%) or electrical cardioversion (47.9%) were included. Patients were on rivaroxaban (51.9%) or dabigatran (48.1%). Preprocedural TOE revealed LAAT in 4.4% of all patients. Multivariable logistic regression analysis showed the CHA2DS2-VASc score ≥2 points (OR = 2.11; 95% CI, 1.15-3.88; P = .0161), non-paroxysmal AF (OR = 6.30; 95% CI, 2.22-17.91; P = .0005), and GFR less then 60 mL/min/1.73 m2 (OR = 2.05; 95% CI, 1.14-3.67; P = .0160) were independent predictors of LAAT in patients treated with NOACs. Conclusions In non-valvular AF patients treated with NOACs, the prevalence of LAAT was 4.4% before electrical cardioversion or ablation. In addition to the CHA2DS2-VASc score, the type of AF and renal function should be considered in the stratification of thromboembolism risk in AF patients and qualification for a preprocedural TOE.Objective To investigate the prognostic significance of contact with the renal sinus in patients with clear cell renal cell carcinoma. Methods A total of 787 pT1N0M0 clear cell renal cell carcinoma patients who had undergone radical or partial nephrectomy were reviewed retrospectively. A tumor in contact with the renal sinus was defined as a tumor radiologically attached to the renal sinus. Metastatic-free survival rates were analyzed in the total and propensity score-matched cohorts. A risk score model for metastasis after surgery was developed. Results Of the 787 patients, 411 (52.2%) had tumors in contact with renal sinus. The contact with renal sinus group showed poorer metastatic-free survival in both total and matched cohorts. In multivariate analysis, contact with renal sinus was an independent prognostic factor of metastasis, as well as Fuhrman grade, microvascular invasion and age. The scoring model likewise consisted of Fuhrman grade, microvascular invasion, age and contact with renal sinus. Metastasis-free survival curves were clearly stratified according to risk, with 5-year metastasis-free survival rates of 95.7% and 65.2% in the low- and high-risk groups, respectively (P less then 0.001). Conclusions Contact with the renal sinus is a significant risk factor for metastasis in T1 clear cell renal cell carcinoma after surgery. More intensive follow up should be recommended for patients with renal cell carcinoma that is in contact with the renal sinus.Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocytic, cicatricial alopecias. Clinically, LPP presents with multifocal patchy alopecia, while FFA, considered a variant of LPP, results in hairline recession. Frontal recession in FFA may progress as far as the mid-scalp and infrequently beyond. Treatment to arrest the inflammatory process can be challenging and response variable. We report a case of recalcitrant lichen planopilaris and frontal fibrosing alopecia demonstrating significant clinical improvement after four doses of the interleukin-23 (IL-23) monoclonal antibody tildrakizumab. This article is protected by copyright. All rights reserved.Background Peel color is an economically relevant trait that influences the appearance and quality of red pear, whose red color is due to anthocyanin accumulation. Prohydrojasmon (PDJ), which has similar effects as endogenous jasmonates, was developed as a commercial bioregulator, particularly to improve fruits coloring. However, little information is available about PDJ effect on pears. This study investigated the effects of preharvest PDJ treatments on color development, phenolic compounds accumulation and related gene expression in the red pear cultivar 'Nanhong'. The treatments were performed during the pre-color-change period by spraying 50 or 100 mg. L-1 of PDJ on fruits. Results Preharvest PDJ treatments had a significant effect on color development, without affecting other quality parameters such as total soluble solids and fruit acidity. LC-MS analysis showed that concentrations of anthocyanins and flavonols were enhanced in the peel after PDJ treatments, particularly when a concentration of 100 mg. https://www.selleckchem.com/products/nik-smi1.html L-1 was used, whereas those of hydroxycinnamates and flavanols were decreased. After PDJ application, the transcription levels of anthocyanin biosynthesis genes PAL, CHS, CHI, ANS, F3H, and UFGT were enhanced, especially under the higher PDJ concentration tested. In addition, anthocyanin accumulation in the peels of PDJ-treated fruits was found to be positively correlated with the upregulation of the regulatory gene MYB114. Conclusion Preharvest treatments with PDJ could be a useful tool to improve fruits coloring and increase phenolic content in pear. These findings also improve our understanding of the molecular mechanisms associated with PDJ-regulated anthocyanin accumulation in pear fruits. This article is protected by copyright. All rights reserved.Objective To assess the overall trends in the development and citation impact of high-impact papers in nursing research worldwide to gain insight into the focus areas of nursing research. Background Bibliometric method is proved to be effective in analysing the papers' characteristics, and it gained considerable interest from the scientific community in recent years. An analysis of the characteristics and intrinsic patterns of high-impact papers in nursing research will provide an objective reflection of the research hot spots. Nursing managers can pointedly increase funding amount and strengthen research cooperation in order to put the scientific results into management practice. Methods Bibliometric methods and visualization software were used to comprehensively analyse high-impact papers in nursing research in terms of development trends, countries/regions, distribution of subject areas, research institutes, collaborative networks and subject terms. Results There were 6,886 papers between 2008 and 2018. The number of papers increased from 528 in 2008 to 723 in 2015, and then remained above 600 in 2016 and 2017. |