Griffin Hospital

Colonoscopies reduce colorectal cancer incidence and mortality, but challenges remain in detecting all precancerous lesions. Operator fatigue, technique variability, and subtle lesions can lead to missed adenomas, highlighting the need for tools that standardize detection quality. Computer-aided detection (CADe) systems use artificial intelligence to enhance lesion detection and improve screening colonoscopy quality. This study evaluates the impact of CADe on key quality and efficiency metrics in a clinical setting. A single-center retrospective study at an academic tertiary center analyzed 4,028 colonoscopies from October 2022 to December 2023. The CADe system was used in 4 of 8 endoscopy suites, creating a CADe and control group. Propensity matching accounted for age, sex, indication, and physician. Primary outcomes included adenoma detection rate (ADR) and polyp detection rate (PDR). Adenomas per colonoscopy (APC) and polyps per colonoscopy (PPC) were also measured. Per-polyp analyses were performed as a tertiary outcome. ADR was significantly higher in the CADe group (38.6%) vs control (34.2%) (rate ratio [RR] = 1.127, P < 0.05). PDR was significantly higher in the CADe group (67.2%) vs control (59.4%) (RR = 1.130, P < 0.05). APC was significantly higher in the CADe group (M = 0.406, SD 0.637) vs control (M = 0.359, SD 0.599) (RR = 1.131, P < 0.05). PPC was significantly higher in the CADe group (M = 1.297, SD 1.188) vs control (M = 1.046, SD 1.002) (RR = 1.240, P < 0.05). The increase in polyp resection with CADe was driven predominantly by ≤5 mm lesions, with comparatively smaller differences for larger polyps. Implementing CADe in clinical practice significantly improved ADR, PDR, APC, and PPC. However, the increase in ADR seems inflated by the detection of polyps ≤5 mm, whose clinical significance in reducing colorectal cancer remains uncertain.

Maize, as the global highest-yield grain crop, can impact social stability and security based on its annual yield. Given that maize viruses have caused up to 91% yield reductions, investigating maize virus diseases is of the utmost importance. In July 2020, a suspected maize yellow mosaic virus (MaYMV) was discovered in a maize field, and a MaYMV detection protocol was established. The MaYMV isolate MA70, discovered in a maize plant from Wuri District, Taiwan, in November 2022, was shown to infect both maize 42 days post-inoculation (dpi) and wheat (35 dpi), causing mosaic symptoms, through aphid transmission with corn leaf aphid (Rhopalosiphum maidis). To determine the whole genome sequence of MA70, a 5642 bp sequence was obtained using RT-PCR and Sanger sequencing. Sequencing results indicated a 94.8–96.8% nucleotide sequence similarity with 54 MaYMV isolates from GenBank and with amino acid sequence identities exceeding 90% for all MaYMV proteins. Phylogenetic analysis showed the relationship of MA70 is closest to the Chinese isolate. The nucleotide sequence identity was lower among isolates of more distinct geographical clusters. Between October 2023 and January 2024, survey results indicated that MaYMV prevalence in corn fields across six areas in Taichung reached 17.5% (130/743 plants) and was present in all the sampled fields. MaYMV was present in all sampled fields affirming its ubiquitous presence. This study establishes the first documented case of MaYMV in Taiwan; however, survey findings hint at a potential pre-existing presence in Taiwanese maize fields. Therefore, this research also develops a practical diagnostic tool for field monitoring of MaYMV prevalence, which is crucial for informing future disease management strategies, including the critical need for cross-strait between Taiwan and China collaboration on viral disease surveillance.

Clopidogrel is a widely used agent in the management of cardiovascular disease. However, there have been reports of liver injury associated with its use, some of which have resulted in death. The atypical presentation of this liver injury has often led to delayed diagnosis and inappropriate treatment. We conducted a systematic review of reported cases to summarize the clinical characteristics, diagnostic approaches, and recovery durations associated with clopidogrel-induced liver injury. Electronic databases, including MEDLINE, OVID, and EMBASE, were used to identify eligible studies from inception to December 2024. Eligible cases were required to have a clear diagnosis of clopidogrel-induced liver injury. Descriptive analysis and Kaplan-Meier analysis were used to explore the clinical features and survival durations. Our systematic review included 29 eligible studies, comprising 29 cases of hepatic abscess with a mean age of 67 years (58% male). Patients presented with abdominal pain in only 24% of cases, fever in 17%, but jaundice in 55%. The median recovery time was 25 days after the final diagnosis. A hepatocellular pattern was reported in 37% of cases. Diagnostic criteria were proposed and summarized based on these findings. Clinicians should be aware of clopidogrel-induced liver injury, as patients can present with a wide range of symptoms. Implementing our proposed diagnostic criteria is recommended to facilitate prompt diagnosis and treatment of clopidogrel-induced liver injury.

Intracorporeal anastomosis (ICA) for minimally invasive (MIS) right hemicolectomy is associated with lower rates of postoperative ileus, pain, and future ventral incisional hernia when compared to extracorporeal anastomosis (ECA). However, the rate of adoption of ICA has been slow. This may be attributed to the advanced minimally invasive intracorporeal suturing technical skills required for ICA. A survey was distributed among SAGES and EAES members to assess the current level of adoption of ICA into clinical practice. An anonymous 13 question survey was distributed to SAGES and EAES members in 2023-2024 via email, SAGES Facebook, and SAGES Twitter/X. Response inclusion criteria included performing at least 20 minimally invasive segmental colectomies annually. Questions included year of surgical training completion, ICA vs. ECA preference with rationale, and ICA type of training and/or mentorship. A Chi-square test was used to compare the association between decade of training completion and use of ICA vs ECA. 902 respondents participated and 796 performed at least 20 minimally invasive segmental colectomies per year. 457 (57%) were currently performing ICA for right hemicolectomies in over 80% of cases. Of these 457 respondents, over half reported several benefits when performing ICA vs ECA including less subjective pain (281, 64%) and lower rate of surgical site infections (274, 63%). When asked about the biggest hurdle to performing ICA, the 339 (43%) ECA preferred respondents selected added time and/or cost in the OR. There was no statistically significant association between the decade of training and choice of surgical technique (p = 0.829). Adoption of ICA for minimally invasive right hemicolectomy is on the rise in this predominantly advanced MIS group of surgeons, as it is routinely performed by over half of the SAGES and EAES membership. Operative time, cost, and additional training and mentorship are the barriers for wider adoption.

ABSTRACTBackgroundAs alcohol consumption continues to rise rapidly in Asia, research into its significant consequences, alcohol‐related liver disease (ALD), and alcohol use disorder (AUD) is still limited.ObjectiveThis study examines the burden of alcohol‐related liver disease and alcohol use disorder in Asia from 2000 to 2021.MethodsWe analyzed data from the global burden of disease (GBD) Study 2021 to assess age‐standardized prevalence, incidence, and mortality rates for alcohol‐related liver disease and alcohol use disorder in Asia from 2000 to 2021.ResultsIn 2021, there were approximately 1.40 million cases of ALD, resulting in 175,370 deaths and 53.18 million cases of AUD, with 57,110 deaths. Asia accounted for 46.35% of the global prevalence of ALD (an increase of 6.87% since 2000) and 47.86% of the global prevalence of AUD (an increase of 0.82% since 2000). A 91.2% increase in crude ALD prevalence, incidence, and mortality from 2000 to 2021 in Asia was observed. South Asia exhibited the highest crude burden of ALD, while Central Asia had the highest age‐standardized rate. Notably, ALD prevalence increased in South Asia (Annual Percent Change [APC]: 0.10%, 95% CI: 0.08–0.13) and Central Asia (APC: 0.88%, 95% CI: 0.79–0.97), even as other regions experienced declines.ConclusionsThis study reveals a disproportionately increasing burden of ALD and AUD in Asia compared with global trends, with significant variability across subregions. Central and South Asia are identified as the primary drivers of the burden associated with ALD and AUD in this region.

ABSTRACTIntroductionWhile gastrointestinal involvement is a common manifestation of systemic lupus erythematosus (SLE), the association between gastroparesis and SLE remains unclear.MethodsWe analyzed data from the National Inpatient Sample (NIS) database from 2016 to 2021. Patients with gastroparesis were categorized into SLE and non‐SLE groups. Similarly, patients with SLE were categorized into gastroparesis and nongastroparesis groups. Clinical characteristics, comorbidities, hospitalization data, and outcomes were compared. The primary outcome was the association between SLE and primary gastroparesis. Secondary outcomes were clinical impacts of gastroparesis in patients with or without SLE.ResultsA total of 12 538 228 patients were included from the NIS database. Of these, 1 165 925 patients (9.3%) were diagnosed with gastroparesis during hospitalization, while 11 372 303 patients (90.7%) did not have gastroparesis. SLE was significantly more common in patients with gastroparesis compared to those without (1.6% vs. 0.7%, p &lt; 0.001; aOR 1.87 [95% CI: 1.80–1.95]). Among patients hospitalized with gastroparesis, those with SLE had a longer length of stay, with a β‐coefficient of 0.31 (95% CI: 0.07–0.55, p = 0.009), lower hospitalization charges, with mean differences of $4761 (95% CI: 442–9080, p = 0.031), and a higher rate of intervention needs, with odds ratios of 1.31 (95% CI: 1.09–1.56, p = 0.003). After propensity‐score matching (1:1), SLE patients aged ≥ 65 had higher hospital charges, with mean differences of $7287 (95% CI: 2928–11 646, p = 0.01), compared to non‐SLE patients.ConclusionGastroparesis is associated with SLE, contributing to longer hospitalizations, higher costs, and increased need for invasive interventions. These findings underscore the importance of evaluating gastroparesis in SLE patients to enable early management and reduce potential complications.