bluuebunny/crossref_metadata_2025_split huggingface dataset:
Success rates and outcomes of laparoscopic mesh sacrohysteropexy
Authors: Daniels Samuel , Robson Danielle , Palacz Magdalena , Howell Stuart , Nguyen Tran , Behnia‐Willison Fariba 
Published: December 2019

BackgroundUterovaginal prolapse is a prevalent gynaecological issue, which can have a negative impact on the quality of life of women. Hysterectomy and vaginal repair are conventional treatments to address apical prolapse; however, women are increasingly requesting uterine‐preserving alternatives.AimsThis study aimed to evaluate the impact of laparoscopic mesh sacrohysteropexy on symptomatic prolapse from an Australian experience.Materials and MethodsThis retrospective cohort study presents outcomes of 157 patients who underwent laparoscopic mesh sacrohysteropexy at a private practice in South Australia during 2007–2017. Primary outcome is the success rate according to the pelvic organ prolapse quantification (POP‐Q) system. Secondary measures included complication rates and patients identified as having Stages III‐IV prolapse and their outcomes.ResultsThe median age was 58 years (27–86 years), median parity was 2 (0–6), and median body mass index was 26.8 (23–29.9). One hundred and thirty‐four women had a laparoscopic hysteropexy and concurrent vaginal prolapse repair and four women had an isolated laparoscopic hysteropexy. The mean pre‐operative point C was 0.60. The mean change from pre‐operative point C to post‐operative point C was 7.6 cm (P < 0.01). Of the 136 patients (98.6%) seen at post‐operative 4–6 weeks, all had Stage 0 POP‐Q scores. Prolapse recurrence was observed in 22 patients, while 116 patients remained cured at their last follow‐up. Prolapse recurrence was associated with anterior vaginal mesh, previous prolapse surgery, pre‐operative Stage III‐IV disease and number of vaginal deliveries.ConclusionsLaparoscopic mesh sacrohysteropexy is an effective and safe procedure with a high success rate comparable to available international data.
Clinical utility of the Quantra® point‐of‐care haemostasis analyser during urgent cardiac surgery
Authors: Zghaibe W. , Scheuermann S. , Munting K. , Blaudszun G. , Besser M. , Ortmann E. , Klein A. A. 
Published: December 2019

SummaryCoagulopathic bleeding during and after cardiac surgery is associated with increased morbidity and mortality. Viscoelastic testing is increasingly used instead of laboratory testing. Our aim was to compare a new viscoelastic point‐of‐care device, the Quantra® System, with thromboelastography and standard laboratory testing. After ethical approval and with written informed consent, we prospectively recruited adult patients undergoing urgent cardiac surgery at increased risk of bleeding. Clot time and clot stiffness values were compared before, during and after cardiopulmonary bypass. We prospectively recruited 52 patients, of whom 34 (65%) were transfused with red blood cells. Our usual transfusion thresholds for fibrinogen (1.5 g.l−1), platelets (100,000.μl−1), prothrombin time (20 s), activated partial thromboplastin time (48 s) and maximum amplitude on thromboelastography (50 mm) corresponded to Quantra values of fibrinogen clot stiffness 2.0 hPa, platelet clot stiffness 13.5 hPa, clot time 159 s, clot time 183 s and clot stiffness 17.0 hPa, respectively. These Quantra thresholds showed high negative predictive value for low platelets (platelet clot stiffness, 97.4%), prolonged activated partial thromboplastin time (clot time, 92.6%) and reduced maximum amplitude on thromboelastography (clot stiffness, 93.6%). The Quantra predicted clinical need for transfusion of platelets (area under the curve 0.71, p = 0.001) but all tests performed poorly at predicting the need for fresh frozen plasma transfusion. We have shown that point‐of‐care testing using the novel Quantra system provides useful data for guiding transfusion management.
Novel ADGRG2 truncating variants in patients with X‐linked congenital absence of vas deferens
Authors: Pagin Adrien , Bergougnoux Anne , Girodon Emmanuelle , Reboul Marie‐Pierre , Willoquaux Christelle , Kesteloot Maryse , Raynal Caroline , Bienvenu Thierry , Humbert Mathilde , Lalau Guy , Bieth Eric 
Published: December 2019

AbstractBackgroundCongenital absence of vas deferens (CAVD) represents a major cause of obstructive azoospermia and is mainly related to biallelic alteration of the CFTR gene, also involved in cystic fibrosis. Using whole exome sequencing, we recently identified hemizygous loss‐of‐function mutations in the Adhesion G Protein‐coupled Receptor G2 gene (ADGRG2) as responsible of isolated CAVD in the absence of associated unilateral renal agenesis.ObjectivesThe objective of this study was to retrospectively perform ADGRG2 sequencing on a large cohort of patients with CAVD, and 0 or only 1 CFTR defective allele identified after comprehensive testing in order to (a) define more precisely the spectrum and the frequency of ADGRG2 mutations within Caucasian population (b) explore the possibility of co‐occurrence of CFTR and ADGRG2 mutations.Materials and methodsWe collected 53 DNA samples from CAVD patients with 0 (n = 23) or 1 (n = 30) alteration identified after comprehensive CFTR testing in order to perform ADGRG2 sequencing. Twenty patients had normal ultrasonographic renal examination, and renal status was not documented for 33 patients.ResultsWe identified six new truncating ADGRG2 mutations in 8 patients including two twin brothers: c.251C > G (p.Ser84*), c.1013delC (p.Pro338Hisfs*4), c.1460delG (p.Gly487Alafs*9), c.2096dupT (p.Phe700Ilefs*29), c.2473C > T (p.Arg825*), and c.1731_1839 + 373del (p.Asn578Thrfs*12), which is a 596 base pair deletion affecting the last five bases of exon 21 and the whole exon 22. Five of the eight patients also harbored an heterozygous CFTR mutation which we consider as incidental regarding the high penetrance expected for ADGRG2 truncating variants. The frequency of ADGRG2 truncating mutation was 26% (5/19 unrelated patients) when presence of both kidneys was attested by ultrasonography and 6.1% (2/33) among patients with unknown renal status.Discussion & ConclusionOur results confirm the interest of ADGRG2 sequencing in patients with CAVD not formerly related to CFTR dysfunction, especially in the absence of associated unilateral renal agenesis.
Survival outcomes of hepatic resections in Bismuth‐Corlette type IV cholangiocarcinoma
Authors: Ku Dominic , Tang Reuben , Pang Tony , Pleass Henry , Richardson Arthur , Yuen Lawrence , Lam Vincent 
Published: December 2019

AbstractBackgroundSurgical resection for Bismuth‐Corlette type IV (BC‐IV) hilar cholangiocarcinomas, also termed Klatskin tumours are technically challenging and were once considered unresectable tumours. Following advances in hepatobiliary imaging and surgical techniques, emerging evidence suggests that surgical resection is a viable avenue for long‐term survival. We aimed to identify factors affecting survival outcomes of hepatic resections for BC‐IV cholangiocarcinomas.MethodA systematic review was performed across multiple databases and several clinical trial registries. Two reviewers independently screened and selected papers that contained survival data on BC‐IV cholangiocarcinoma after hepatic resections.ResultsOf 13 499 papers from our search result, 21 papers satisfied the inclusion criteria. The median post‐operative survival was 30.8 months. The average 1‐ and 5‐year post‐operative survivals were 61.6 and 33.3%, respectively. Predictors of long‐term survival included achievement of R0 margins, minimisation of operative time and reduction intra‐operative blood loss.ConclusionOur analysis demonstrates improving post‐operative outcomes and survival in surgical resection of BC‐IV cholangiocarcinoma and suggests that radical surgical resection is a valid treatment option for the disease.
Statin therapy does not influence the outcome of patients undergoing surgery for pancreatic cancer
Authors: Karavias Dimitrios , Thomas Paul , Koh Amanda , Irving Glen , Navarro Alex P. , Cameron Iain C. , Gomez Dhanny ,   the Nottingham HPB Surgery Group
Published: December 2019

AbstractBackgroundRecently, statins have been associated with improved survival in certain cancers. The aim of this study was to evaluate the impact of statins on the outcome of patients undergoing surgery for pancreatic cancer. In addition, the effect of statins on the histopathological characteristics of the disease was assessed.MethodsA retrospective review of the prospectively maintained hepato‐pancreatico‐biliary database was performed and patients with pancreatic cancer who underwent surgery between January 2014 and December 2017 were included. Statistical analysis was performed to assess the impact of statins on histopathological characteristics and survival outcome.ResultsA total of 151 patients were included, of whom 71 underwent pancreatic resections and 80 underwent trial dissection and bypass procedures. In the operated group, 20 patients were on statin therapy preoperatively. With respect to disease‐free survival, tumour size (P = 0.023) and lymphatic invasion (P = 0.015) were significant variables on univariate analysis. Gender (P = 0.022), adjuvant chemotherapy (P < 0.001), lymphatic invasion (P = 0.021) and tumour size (P = 0.041) were significant variables on univariate analysis with respect to overall survival. Multivariate analysis identified adjuvant chemotherapy as the only independent predictor of overall survival (P < 0.001). No correlations between the use of statins and the histopathological characteristics were identified.ConclusionAdjuvant chemotherapy is an independent predictor of overall survival in patients undergoing surgery for pancreatic cancer. Statin therapy does not influence survival outcomes and histopathological characteristics following surgery for pancreatic cancer.
Acute cholecystitis or simple biliary colic after an emergency presentation: why it matters
Authors: Nguyen Chu Luan , van Dijk Aafke , Smith Garett , Leibman Steven , Mittal Anubhav , Albania Maria , de Reuver Philip , Hugh Thomas J. 
Published: December 2019

AbstractBackgroundLaparoscopic cholecystectomy (LC) is often performed during the index admission after emergency presentation for acute biliary pain. Many patients have acute cholecystitis (AC) that may increase operative difficulty and complications. Our primary aim was to assess the validity of Tokyo Guidelines (TG18) for diagnosing AC by comparison with the admitting team diagnosis, operative findings and histopathology. The secondary aim was to assess outcomes after same‐admission or delayed LC.MethodsRetrospective analysis of patients who underwent LC after presenting to a tertiary hospital emergency department over a 12‐month period was conducted.ResultsA total of 139 patients underwent LC with no mortality or bile duct injury. A diagnosis of AC made by the admitting surgical team had sensitivity of 84% and specificity of 57%. The TG18 diagnosis had sensitivity of 84% and specificity of 53%. A diagnosis of AC by the admitting surgical team correlated well with TG18 criteria diagnosis. There was poor correlation between clinical and histopathological diagnoses. Nine percent of patients had complications and 4% required conversion to open procedure. Patients with a clinical diagnosis of AC had longer post‐operative length of stay and more complications compared with those who had non‐AC diagnosis. There was no difference in outcomes between same‐admission LC or delayed LC.ConclusionTG18 diagnosis of AC does not improve accuracy of diagnosis or predictability of a poor outcome over the admitting surgical team diagnosis. Same‐admission LC for patients with AC is associated with similar outcomes compared to those who undergo delayed LC.
Tissue‐dependent differences in Bardet–Biedl syndrome gene expression
Authors: Patnaik Sarita Rani , Farag Aalaa , Brücker Lena , Volz Ann‐Kathrin , Schneider Sandra , Kretschmer Viola , May‐Simera Helen Louise 
Published: December 2019

Background InformationPrimary cilia are highly conserved multifunctional cell organelles that extend from the cell membrane. A range of genetic disorders, collectively termed ciliopathies, is attributed to primary cilia dysfunction. The archetypical ciliopathy is the Bardet–Biedl syndrome (BBS), patients of which display virtually all symptoms associated with dysfunctional cilia. The primary cilium acts as a sensory organelle transmitting intra‐ and extracellular signals thereby transducing various signalling pathways facilitated by the BBS proteins. Growing evidence suggests that cilia proteins also have alternative functions in ciliary independent mechanisms, which might be contributing to disease etiology.ResultsIn an attempt to gain more insight into possible differences in organ specific roles, we examined whether relative gene expression for individual Bbs genes was constant across different tissues in mouse, in order to distinguish possible differences in organ specific roles. All tested tissues show differentially expressed Bbs transcripts with some tissues showing a more similar stoichiometric composition of transcripts than others do. However, loss of Bbs6 or Bbs8 affects expression of other Bbs transcripts in a tissue‐dependent way.Conclusions and SignificanceOur data support the hypothesis that in some organs, BBS proteins not only function in a complex but might also have alternative functions in a ciliary independent context. This significantly alters our understanding of disease pathogenesis and development of possible treatment strategies.
Loneliness and friendlessness among adolescents in 25 countries in Latin America and the Caribbean
Authors: Sauter Sydney R. , Kim Loan P. , Jacobsen Kathryn H. 
Published: December 2019

BackgroundLoneliness is a common health problem among the elderly but is not well understood in the adolescent population, especially in low‐ and middle‐income countries (LMICs). Adolescent loneliness can have adverse impacts on short‐ and long‐term health status.MethodsThis study examined rates of self‐reported loneliness and friendlessness among 76,982 secondary school students in 25 LMICs in Latin America and the Caribbean who participated in the Global School‐based Student Health Survey (GSHS). After calculating the rates of reported loneliness and lack of close friends separately for nationally representative samples of boys and girls from each country, we used meta‐analysis to pool results for prevalence rates and associations across all 25 countries and territories.ResultsAbout 1 in 6 students (18.1% [95% CI: 16.4%, 20.0%]) reported being lonely most or all of the time and/or having no close friends, including 19.9% of girls and 16.2% of boys. Girls were more likely than boys to report being lonely most or all of the time (14.6% vs. 9.2%, p < .05), but boys were more likely than girls to report that they had zero close friends (8.7% vs. 7.2%, p < .05). However, the majority of students who reported being lonely did not report having no close friends, and the majority of students who reported having no close friends did not report being lonely most or all of the time.ConclusionsAsking adolescents about both loneliness and friendships may capture the burden of social isolation among males and females better than a single question about loneliness. Successful interventions for reducing social isolation must be rooted in communities and integrated into comprehensive school and community health plans.
Spatial and temporal expansion of intrahepatic metastasis by molecularly‐defined clonality in multiple liver cancers
Authors: Yamamoto Shogo , Midorikawa Yutaka , Nagae Genta , Tatsuno Kenji , Ueda Hiroki , Moriyama Mitsuhiko , Takayama Tadatoshi , Aburatani Hiroyuki 
Published: December 2019

AbstractMultiple hepatocellular carcinoma (HCC) is divided into two categories: intrahepatic metastasis (IM), which is a true relapse of HCC, and multicentric origin (MO), which is a second primary tumor. Clinical diagnosis of multiple HCC is usually made based on tumor location and/or time to recurrence; however, it is often difficult to distinguish the two types of multiple HCC. Using 41 matched pairs of multiple HCC specimens, we confirmed the accuracy of clinical diagnoses using exome sequence data and investigated the importance of discriminating the type of multiple HCC. Genomic analysis revealed that 18 (43.9%) patients diagnosed as having genomic IM had common mutations in a pair of HCC tumors with the main tumor of these patients being more progressive compared to those with genomic MO. The accuracy of clinical diagnosis based on lobe (Definition 1) and segment (Definition 2) were 68.3% and 78.0%, respectively. Intriguingly, recurrence ≥2 years after initial surgery for 3 patients was IM. The survival of patients with clinical IM was significantly shorter than for those with clinical MO based on both Definition 1 (P = 0.045) and Definition 2 (P = 0.043). However, mean survival was not different between the patients with genomic IM and those with MO (P = 0.364). Taken together, genomic analysis elucidated that liver cancer may spread more extensively and more slowly than previously thought. In addition, distinguishing multiple HCC as IM or MC may have provided biological information but was not of clinical importance with respect to patient prognosis.
Executive function in children with and without developmental coordination disorder: A comparative study
Authors: Sartori Rodrigo Flores , Valentini Nadia Cristina , Fonseca Rochele Paz 
Published: December 2019

AbstractBackgroundChildren with motor impairments also show poor performance in some executive functions' components. However, there is no consensus on which specific executive subdomain is more impacted.AimThe objective of this study was to compare executive functions in children with developmental coordination disorder (DCD), at risk for DCD (r‐DCD), and in typically developing (TD) children.Methods and ProceduresA sample of 397 children was assessed using the MABC‐2. Two groups of children were identified; DCD (n = 63) and at r‐DCD (n = 31). A third matched group of children with TD (n = 63) was formed. The MABC‐2 checklist and the WASI tests were used as screening tools. Measures of executive function including verbal and nonverbal tasks for working memory, inhibitory control, and cognitive flexibility were tested. Multivariate analysis of variance followed by analyses of variance and Bonferroni tests were used to verify group effects on executive functions.ResultsA significant group effects were found for Working Memory, Λ = .78, F(4, 360) = 10.12, p ≤ .001, ηp2 = .12; Inhibitory Control, Λ = .59, F(16, 294) = 5.48, p ≤ .001, ηp2 = .23; and Cognitive Flexibility and Inhibitory Control, Λ = .60, F(22, 288) = 3.74, p ≤ .001, ηp2 = .22, with moderate effect sizes. The DCD group showed lower scores compared with the TD group on the visuospatial and verbal working memory; inhibitory control and in tasks of cognitive flexibility; the r‐DCD group showed lower scores compared with the TD group for visuospatial working memory and for cognitive flexibility.Conclusions and ImplicationsPoor performance in several measures of executive functions in children with DCD emphasized the need of motor/executive task‐specific interventions. Furthermore, children at r‐DCD showed low scores in several executive functions; therefore, preventive services should also be provided for this subclinical group.
Maternal psychological distress before birth influences gut immunity in mid‐infancy
Authors: Kang Liane J. , Vu Khanh N. , Koleva Petya T. , Field Catherine J. , Chow Angela , Azad Meghan B. , Becker Allan B. , Mandhane Piushkumar J. , Moraes Theo J. , Sears Malcolm R. , Lefebvre Diana L. , Turvey Stuart E. , Subbarao Padmaja , Lou Wendy Y. W. , Scott James A. , Kozyrskyj Anita L. 
Published: December 2019

AbstractBackgroundMaternal pre‐postnatal psychosocial distress increases the risk for childhood allergic disease. This may occur through a host immunity pathway that involves intestinal secretory immunoglobulin A (sIgA). Experimental animal models show changes in the gut microbiome and immunity of offspring when exposed to direct or prenatal maternal stress, but little is known in humans.ObjectiveWe determined the association between maternal depression and stress symptom trajectories and infant fecal sIgA concentrations.Methods1043 term infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort were studied. Trajectories of maternal perceived stress and depression were based on scored scales administered in pregnancy and postpartum. sIgA was quantified in infant stool (mean age 3.7 months) with Immundiagnostik ELISA. Linear regression and logistic regression were employed to test associations.ResultsVery low fecal sIgA concentrations were more common in infants of mothers in the antepartum and persistent depression trajectories (6% and 2% of women, respectively). Independent of breastfeeding status at fecal sampling, infant antibiotic exposure or other covariates, the antepartum depressive symptom trajectory was associated with reduced mean infant sIgA concentrations (β=−0.07, P < .01) and a two fold risk for lowest quartile concentrations (OR, 1.86; 95% CI: 1.02, 3.40). This lowering of sIgA yielded a large effect size in older infants (4‐8 months)—breastfed and not. No associations were seen with postpartum depressive symptoms (7% of women) or with any of the perceived stress trajectories.Conclusion and clinical relevanceDespite improved mood postpartum and independent of breastfeeding status, mothers experiencing antepartum depressive symptoms delivered offspring who exhibited lower fecal sIgA concentrations especially in later infancy. The implications of lowered sIgA concentrations in infant stool are altered microbe‐sIgA interactions, greater risk for C difficile colonization and atopic disease in later years.
Balloon dilatation for paediatric airway stenosis: Evidence from the UK Airway Intervention Registry
Authors: Powell Steven , Keltie Kim , Burn Julie , Cole Helen , Donne Adam , Morrison Gavin , Stephenson Kate , Daniel Mat , Gupta Sanjeev , Wyatt Michelle , Patrick Hannah , Sims Andrew 
Published: December 2019

AbstractObjectivesTo assess the safety and efficacy in routine clinical practice of balloon dilatation procedures in the treatment of paediatric airway stenosis.DesignObservational data collection in prospective online research database.SettingAcute NHS Trusts with ENT department undertaking complex paediatric airway work.ParticipantsChildren (<18) undergoing balloon dilatation treatment for airway stenosis.Main outcome measuresAirway diameter, complications, hospital resource usage.ResultsFifty‐nine patients had 133 balloon procedures during 128 visits to 10 hospitals. Sixty‐nine (52%) of balloon procedures were conducted with a tracheostomy. Intra‐operative Cotton‐Myer grade decreased in 43 (57%). The mean pre‐balloon subglottic diameter was 4.2 [95% CI: 3.8 to 4.5] mm, and its rate of increase was 0.8 [0.5 to 1.2] mm per year modelled on 30 patients' long‐term data. As the primary treatment of stenosis, the procedural success rate of balloon dilatation (n = 52) was 65% (22% with tracheostomy, 88% without tracheostomy), and 71% as an adjunct to open reconstructive surgery (n = 7). In the 64 hospital visits where a balloon procedure was conducted with a tracheostomy in place, only one in‐hospital complication (lower respiratory tract infection) occurred. For those without a tracheostomy in place, in‐hospital complications occurred in seven of 64 balloon hospital visits, all related to ongoing or worsening stenosis. Six out‐of‐hospital complications were deemed related to ongoing or worsening stenosis following the procedure, and two complications were a combination of lower respiratory infection and ongoing or worsening stenosis.ConclusionsBalloon dilation increases the size of the airway intraoperatively and is associated with long‐term increase in airway diameter. Safety outcomes mostly relate to ongoing or worsening stenosis and are more common in patients without a tracheostomy.