bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Colombian Experience in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): The Progression From a Large Caliber to a Low-Profile Device at a Level I Trauma Center
Authors: Ordoñz Carlos A. , Khan Mansoor , Cotton Bryan , Perreira Bruno , Brenner Megan , Ferrada Paula , Horer Tal , Kauvar David , Kirkpatrick Andrew , Priouzram Artai , Roberts Derek , Duchesne Juan 
Published: January 2020

ABSTRACT

Purpose:
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is now performed in many trauma centers, it is used at more than 250 hospitals in the United States and there is an increase rate of publications with the experience in these centers, but there is a gap of knowledge regarding the use of REBOA in Latin-America. This paper endeavors to describe the utilization of REBOA at a high level Latin-American Trauma Center and the transition from a large caliber to a low-profile device with the concomitant reduction in the groin access complications.

Methods:
A prospective, observational, single-center study was conducted. We included all trauma patients who underwent REBOA. We recorded data from admission parameters, complications, and clinical outcomes.

Results:
Fifty patients were included. Most of the REBOA catheters were inserted in the operating room [47 (94%)], and the arterial access was done by surgical cutdown [40 (80%)]. All the complications were associated with the catheter of 11 Fr Sheath used in 36 patients [n = 8/36 (22%) vs. n = 0/14 (0%); P = 0.05].

Conclusion:
REBOA can be used safely in blunt or penetrating thoracic, abdominal, and pelvic trauma. The insertion of a 7 Fr Sheath was associated with lower complications, so its use should be preferred over larger calibers.
Laparoscopic Liver Transplantation
Authors: Dokmak Safi , Cauchy François , Sepulveda Ailton , Choinier Pierre Marie , Dondéro Fédérica , Aussilhou Béatrice , Hego Camille , Chopinet Sophie , Infantes Pauline , Weiss Emmanuel , Francoz Claire , Sauvanet Alain , Paugam-Burtz Catherine , Durand François , Soubrane Olivier 
Published: January 2020

Objective:
To introduce the laparoscopic approach in liver transplant recipients.

Summary of Background Data:
Despite the increasingly frequent use of laparoscopy in living donor hepatectomy, the laparoscopic approach has never been reported in liver transplant recipients.

Methods:
A 52-year-old woman (body mass index: 18.5 kg/m2) with neuroendocrine liver metastases of a digestive origin underwent hybrid liver transplantation by pure laparoscopic total hepatectomy and liver graft implantation using a preexisting midline incision. The hepatic pedicle vessels were dissected after division of the bile duct without a porto-caval shunt. Left lateral sectionectomy and early division of the common trunk allowed near completion of caval dissection with no prolonged inflow occlusion. The liver graft was reduced and latero-lateral caval anastomosis was performed.

Results:
Surgery lasted 400 minutes with 400 mL of blood loss. The anhepatic phase lasted 43 minutes. Warm ischemia time and cold ischemia times were 38 and 466 minutes, respectively. The postoperative course was uneventful.

Conclusions:
This case study suggests that the hybrid approach may be feasible and safe in selected recipients. The decision to use this surgical approach should be made in transplant centers with significant expertise in both laparoscopic liver and pancreatic surgery. Further reducing the size of the abdominal incision is the next step, which may be achieved with the development of vascular anastomoses devices.
Outcomes After Multidisciplinary Management of Primary Mediastinal Germ Cell Tumors
Authors: Caso Raul , Jones Gregory D. , Bains Manjit S. , Hsu Meier , Tan Kay See , Feldman Darren R. , Funt Samuel A. , Reuter Victor E. , Bosl George J. , McHugh Deaglan , Huang James , Molena Daniela , Amar David , Fischer Gregory , Rusch Valerie W. , Jones David R. 
Published: January 2020

Objective:
We examined management strategies, overall survival (OS), and progression-free survival (PFS) among patients with PMNSGCTs undergoing resection and multidisciplinary management at a high-volume institution.

Summary of Background Data:
Outcomes after resection of PMNSGCTs are not well-characterized, with limited data on factors associated with survival.

Methods:
We reviewed patients with PMNSGCT who underwent resection between 1980 and 2019. Median follow-up was 3.4 years. Preoperative therapy (including use of bleomycin), surgical management, recurrence, and survival were examined. Factors associated with survival were analyzed using Cox regression.

Results:
In total, 113 patients were included [median age, 28 years (range, 16–65)]. Preoperative serum tumor markers (STMs) normalized/decreased in 74% of patients. Pathology included necrosis only (25%), teratoma +/− necrosis (20%), viable nonteratomatous germ cell tumor +/− teratoma (41%), and secondary somatic-type malignancy +/− teratoma (20%). Bleomycin chemotherapy was not associated with pulmonary complications or 90-day mortality. Patients receiving second-line chemotherapy followed by resection had significantly worse OS and PFS than patients receiving first-line chemotherapy followed by resection. On multivariable analysis, R1/R2 resection (HR, 3.92; P < 0.001) and increasing postoperative STMs (HR, 4.98; P < 0.001) were associated with shorter PFS; necrosis on pathology (HR, 0.42, P = 0.043) was associated with longer PFS.

Conclusions:
In patients with PMNSGCT undergoing resection, completeness of resection, postoperative pathology, and postoperative STMs were associated with PFS. Induction bleomycin was not associated with pulmonary complications or mortality in patients undergoing resection. Patients undergoing second-line chemotherapy followed by resection have a poor prognosis, with long-term survival of 22%.
Consensus Statement on Robotic Mastectomy—Expert Panel From International Endoscopic and Robotic Breast Surgery Symposium (IERBS) 2019
Authors: Lai Hung-Wen , Toesca Antonio , Sarfati Benjamin , Park Hyung Seok , Houvenaeghel Gilles , Selber Jesse C. , Cheng Fiona Tsui-Fen , Kuo Wen-Ling , Peradze Nickolas , Song Seung Yong , Mok Chi Wei 
Published: January 2020

Objectives:
To achieve a consensus statement on robotic mastectomy.

Background:
Robotic-assisted surgery has gained much attention especially the results of few case series reporting on the technical feasibility, safety and early oncologic outcomes of robotic-assisted mastectomy in a few centers worldwide. The aim of this consensus statement was to develop and provide standardized guidelines on robotic mastectomy based on consensus statement by a panel of experts from indications to outcome measures and indicators, thereby providing a valuable guide for breast surgeons worldwide.

Methodology:
An internationally representative expert panel of 10 surgeons was invited to participate in the generation of a consensus statement. 52 statements were created in 6 domains: indications, contraindications, technical considerations, patient counseling, outcome measures and indicators, training and learning curve assessment. Experts were asked to vote if they agree, disagree or of the opinion that the statement should be rephrased. Two electronic rounds via online survey of iterative rating and feedback were anonymously completed, followed by a final round of in-person meeting during the inaugural International Endoscopic and Robotic Breast Surgery Symposium 2019 from May 24 to 25, 2019. Consensus was reached when there was at least 80% agreement on each statement.

Results:
A total of 53 statements with at least 80% agreement were generated after 3 rounds of voting; 21 statements from first round of voting, 20 statements from second round of voting and 12 statements from the final round of in-person meeting. All experts agreed that the consensus statement served as expert recommendations but not mandatory for a successful and safe practice of robotic mastectomy.

Conclusion:
Robotic mastectomy is a promising technique and could well be the future of minimally invasive breast surgery whereas proving to be safe and feasible. The first consensus statement on robotic mastectomy from an international panel of experts serves as an extremely important milestone and provides recommendations for breast surgeons keen to embark on this technique.
The First Report of Laparoscopic Multivisceral Resection for a Gastrocolic Fistula Secondary to Colon Cancer
Authors: Ammori Basil J. 
Published: January 2020

Background:
Colon cancer rarely presents with a gastrocolic fistula and resection, if feasible, is usually carried out by open surgery. The authors present the first literature case report of laparoscopic multivisceral resection for gastrocolic fistula secondary to locally advanced colon cancer.

Materials and Methods:
A 54-year-old man presented with feculant vomiting, cachexia, and severe iron deficiency anemia. Investigations confirmed a large nonmetastatic splenic flexure colon cancer with fistulation into the stomach. After 10 weeks of nutritional support and laparoscopic defunctioning proximal transverse loop colostomy, we proceeded to laparoscopic extended left hemicolectomy with en bloc sleeve gastrectomy and partial splenectomy.

Result:
The procedure was completed laparoscopically (operating time, 400 min; blood loss, 150 mL). He was discharged on the 6th postoperative day after an uneventful recovery. Histology showed an R0 resection of a pT4N1a (1/45 lymph nodes involved) colon cancer with gastrocolic fistula.

Conclusion:
Laparoscopic multivisceral en bloc R0 resection of locally advanced colon cancer with gastrocolic fistula can be accomplished safely in experienced hands.
Shortened Pattern Electroretinogram Latency and Impaired Autoregulatory Dynamics to Steady-State Stimuli in Patients With Multiple Sclerosis
Authors: Jiang Hong , Gameiro Giovana R. , Hu Huiling , Monsalve Pedro F. , Dong Chuanchui , Hernandez Jeffrey , Delgado Silvia R. , Porciatti Vittorio D. , Wang Jianhua 
Published: January 2020

Background:
The steady-state pattern electroretinogram (PERG) is a sensitive measure of retinal ganglion cell (RGC) function that includes within-test progressive changes—adaptation—reflecting RGC autoregulatory dynamics. Comprehensive PERG assessment in patients with multiple sclerosis (MS) (with or without optic neuritis [ON]) may provide unique information about RGC dysfunction and its progression, as well as a comparison between functional loss and structural loss as measured by optical coherence tomography (OCT). The goal of this project was to measure steady-state PERG components and their associations with intraretinal layer thicknesses in MS.

Methods:
One hundred forty eyes of 70 patients with relapsing-remitting MS and 126 eyes of 63 age- and sex-matched healthy control subjects (HC) were investigated using a new-generation PERG method and ultrahigh-resolution OCT. Of MS eyes, there were 30 eyes with ON (MSON), 22 non-ON fellow eyes (MSFE), and 88 non-ON MS eyes (MSNON). PERG amplitude, phase (latency), and adaptation of amplitude and phase were measured and correlated with OCT-determined thicknesses of intraretinal layers.

Results:
The average PERG amplitude in MSON eyes was significantly lower than MSFE (P = 0.007), MSNON (P = 0.002), and HC (P < 0.001). The PERG amplitude in MSFE eyes was also significantly lower than HC (P = 0.039). The PERG latency in MSON eyes was significantly shorter than in MSFE (P = 0.001), MSNON (P = 0.002), and HC (P < 0.001). The PERG latency in MSFE (P = 0.007) and MSNON (P = 0.002) was significantly shorter than in HC. However, no significant differences were found between MSFE and MSNON (P > 0.05). PERG adaptation of amplitude in MSON was significantly lower than that in MSNON (P = 0.039) and HC (P = 0.037). Both the amplitude and latency in the MS eyes were significantly correlated with the thicknesses of the macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GCIPL).

Conclusions:
Shortened PERG latency and impaired autoregulatory dynamics occurred in MS, suggesting preferential dysfunction of small, slower RGC axons and decreased ability of RGC to autoregulate their gain in response to PERG stimulus. The established relations of PERG measurements with intraretinal thickness measurements suggested that PERG losses were primarily associated with GCIPL and mRNFL thinning.
Trends in Prescriptions of Lithium and Other Medications for Patients with Bipolar Disorder in Office-based Practices in the United States: 1996-2015
Authors: Lin Yian , Mojtabai Ramin , Goes Fernando S , Zandi Peter P 
Published: January 2020

AbstractBackgroundStudies have shown that rates of lithium use for bipolar disorder (BPD) in the United States declined through the 1990s as other mood stabilizing anticonvulsants and second-generation antipsychotics (SGAs) became more popular. We examined recent prescribing trends of medications for BPD over the past two decades.MethodsTwenty years of data (1996-2015) from the National Ambulatory Medical Care Survey (NAMCS) were used. Weighted percentages of prescriptions of lithium, anticonvulsants, SGAs and antidepressants were calculated over two-year intervals. Logistic regression was used to examine factors related to polytherapy.ResultsPrescriptions of lithium declined from 38.1% (95%CI: 29.8% - 46.3%) in 1996-97 to 14.3% (95%CI: 10.6% - 18.1%) in 2006-07 and has remained stable since. During this time, prescriptions of SGAs more than doubled. SGAs and/or anticonvulsants were prescribed in 78.6% (95%CI: 73.0% - 84.2%) of BPD visits in 2014-2015. Polytherapy increased by approximately 4% every two years and in 2014-15 occurred in over 35% of BPD visits. Antidepressants were prescribed in 40-50% of BPD visits, but their prescriptions without other mood stabilizers decreased from 18.2% (95%CI: 11.7% - 24.8%) in 1998-99 to 5.8% (95%CI: 3.0% - 8.6%) in 2014-15.LimitationsThe sample had limited power to study the effect of individual medications or the potential for differing effects in certain subgroups of patients.ConclusionsThis study further documents the declining prescriptions of lithium for BPD, and corresponding increase in prescriptions of anticonvulsants and SGAs, despite the fact that lithium is typically recommended as a first line therapy for BPD.
InStrain enables population genomic analysis from metagenomic data and rigorous detection of identical microbial strains
Authors: Olm Matthew R. , Crits-Christoph Alexander , Bouma-Gregson Keith , Firek Brian , Morowitz Michael J. , Banfield Jillian F. 
Published: January 2020

AbstractCoexisting microbial cells of the same species often exhibit genetic differences that can affect phenotypes ranging from nutrient preference to pathogenicity. Here we present inStrain, a program that utilizes metagenomic paired reads to profile intra-population genetic diversity (microdiversity) across whole genomes and compare populations in a microdiversity-aware manner, dramatically increasing genomic comparison accuracy when benchmarked against existing methods. We use inStrain to profile >1,000 fecal metagenomes from newborn premature infants and find that siblings share significantly more strains than unrelated infants, although identical twins share no more strains than fraternal siblings. Infants born via cesarean section harboredKlebsiellawith significantly higher nucleotide diversity than infants delivered vaginally, potentially reflecting acquisition from hospital versus maternal microbiomes. Genomic loci showing diversity within an infant included variants found in other infants, possibly reflecting inoculation from diverse hospital-associated sources. InStrain can be applied to any metagenomic dataset for microdiversity analysis and rigorous strain comparison.
Epigenetic gene-expression links heart failure to memory impairment
Authors: Islam Rezaul , Lbik Dawid , Sakib Sadman , Hofmann Raoul Maximilian , Berulava Tea , Mausbach Martí Jiménez , Cha Julia , Vakhtang Elerdashvili , Schiffmann Christian , Zieseniss Anke , Katschinski Dörthe Magdalena , Sananbenesi Farahnaz , Toischer Karl , Fischer Andre 
Published: January 2020

AbstractIn current clinical practice care of diseased patients is often restricted to separated disciplines. However, such an organ-centered approach is not always suitable. For example, cognitive dysfunction is a severe burden in heart failure patients. Moreover, these patients have an increased risk for age-associated dementias. The underlying molecular mechanisms are presently unknown and thus corresponding therapeutic strategies to improve cognition in heart failure patients are missing. Using mice as model organisms we show that heart failure leads to specific changes in hippocampal gene-expression, a brain region intimately linked to cognition. These changes reflect increased cellular stress pathways which eventually lead to loss of neuronal euchromatin and reduced expression of a hippocampal gene cluster essential for cognition. Consequently, mice suffering from heart failure exhibit impaired memory function. These pathological changes are ameliorated via the administration of a drug that promotes neuronal euchromatin formation. Our study provides first insight to the molecular processes by which heart failure contributes to neuronal dysfunction and point to novel therapeutic avenues to treat cognitive defects in heart failure patients.
Fusion of Drosophila oocytes with specified germline sister cells
Authors: Ali-Murthy Zehra , Fetter Richard D. , Kornberg Thomas B. 
Published: January 2020

ABSTRACTIn many animals, oocytes develop together with sister germline cells that pass products to the developing oocyte. In Drosophila, fifteen sister germline (nurse) cells in each egg chamber are known to apoptose by stage 12-13, but we discovered that two specific nurse cells that are juxtaposed to the oocyte are eliminated precociously at stage 10B. These nurse cells fuse with the oocyte and their nuclei extrude through an opening that forms in the oocyte. These nuclei extinguish in the ooplasm, and at stage 11, egg chambers have thirteen nucleated nurse cells and the plasma membrane of the oocyte is mostly restored. In infrequent egg chambers in which nurse cells are not eliminated, oocytes do not develop normally and are not fertilized. Precocious elimination is common to other Drosophila species. We conclude that nurse cells are distinguished by position and identity, and that nurse cell dissolution proceeds in two stages.
Unacylated ghrelin and AZP531 suppress the 3D growth of breast cancers
Authors: Au CheukMan C. , Furness John B. , Britt Kara , Oshchepkova Sofya , Ladumor Heta , Soo Kai Ying , Callaghan Brid , Gérard Céline , Inghirami Giorgio , Mittal Vivek , Wang Yufeng , Huang Xin-Yun , Spector Jason A. , Andreopoulou Eleni , Zumbo Paul , Betel Doron , Dow Lukas E. , Brown Kristy A. 
Published: January 2020

ABSTRACTBreast cancer is the most common type of cancer in women and notwithstanding important therapeutic advances, it remains the second leading cause of cancer-related death in the US. Despite extensive research relating to the hormone ghrelin, responsible for the stimulation of growth hormone release and appetite, little is known of the effects of its unacylated form, especially in cancer. One major area of research relates to its reported effects to increase insulin sensitivity in diabetics, this being the basis for the development of unacylated ghrelin analog, AZP531 or livoletide, now in clinical trials for the treatment of Prader-Willi Syndrome. The mechanism of action of unacylated ghrelin is largely uncharacterized, in any system, because it does not bind to or activate the cognate ghrelin receptor, GHSR1a. The present study aimed to characterize effects of unacylated ghrelin on breast cancer cells, define its mechanism of action, and explore the therapeutic potential of unacylated ghrelin or analog AZP531. We report potent effects of unacylated ghrelin, at picomolar doses, on the growth of breast cancer cells, dependent on 3D culture and activation of Gαi. Suppression of MAPK signaling by unacylated ghrelin leads to cell cycle arrest and apoptosis. AZP531 also suppresses the growth of breast cancer cells in vitro and in xenografts, and may be a novel approach for the safe and effective treatment of breast cancer.
High-resolution transcriptional and morphogenetic profiling of cells from micropatterned human embryonic stem cell gastruloid cultures
Authors: Minn Kyaw Thu , Fu Yuheng C. , He Shenghua , George Steven C. , Anastasio Mark A. , Morris Samantha A. , Solnica-Krezel Lilianna 
Published: January 2020

SummaryDuring mammalian gastrulation, germ layers arise and are shaped into the body plan while extraembryonic layers sustain the embryo. Human embryonic stem cells, cultured with BMP4 on extracellular matrix micro-discs, reproducibly differentiate into gastruloids, expressing markers of germ layers and extraembryonic cells with radial organization. Single-cell RNA sequencing and cross-species comparisons with mouse and cynomolgus monkey gastrulae suggest that gastruloids contain seven major cell types, including epiblast, ectoderm, mesoderm, endoderm, and extraembryonic trophoblast- and amnion-like cells. Upon gastruloid dissociation, single cells reseeded onto micro-discs were motile and aggregated with the same but segregated from distinct cell types. Ectodermal cells segregated from endodermal and extraembryonic cells but mixed with mesodermal cells. Our work demonstrates that the gastruloid system supports primate-specific features of embryogenesis, and that gastruloid cells exhibit evolutionarily conserved sorting behaviors. This work generates a resource for transcriptomes of human extraembryonic and embryonic germ layers differentiated in a stereotyped arrangement.
Microbial competition reduces interaction distances to the low µm-range
Authors: van Tatenhove-Pel Rinke J. , Rijavec Tomaž , Lapanje Aleš , van Swam Iris , Zwering Emile , Hernandez-Valdes Jhonatan A. , Kuipers Oscar P. , Picioreanu Cristian , Teusink Bas , Bachmann Herwig 
Published: January 2020

AbstractMetabolic interactions between cells affect microbial community compositions and hence their function in ecosystems. It is well-known that under competition for the exchanged metabolite, concentration gradients constrain the distances over which interactions can occur. However, interaction distances are typically quantified in two-dimensional systems or without accounting for competition or other metabolite-removal, conditions which may not very often match natural ecosystems. We here analyze the impact of cell-to-cell distance on unidirectional cross-feeding in a three-dimensional system with competition for the exchanged metabolite. Effective interaction distances were computed with a reaction-diffusion model and experimentally verified by growing a synthetic consortium of 1 µm-sized metabolite producer, receiver and competitor cells in different spatial structures. We show that receivers cannot interact with producers ∼15 µm away from them, as product concentration gradients flatten close to producer cells. We developed an aggregation protocol and created variants of the receiver cells’ import system, to show that within producer-receiver aggregates even low affinity receiver cells could interact with producers. These results show that competition or other metabolite-removal of a public good in a three-dimensional system reduces the interaction distance to the low micrometer-range, highlighting the importance of concentration gradients as physical constraint for cellular interactions.