bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of centralization and regionalization of pancreatic surgery on resection rates and survival
Authors: Latenstein A E J , Mackay T M , van der Geest L G M , van Eijck C H J , de Meijer V E , Stommel M W J , Vissers P A J , Besselink M G , de Hingh I H J T ,   the Dutch Pancreatic Cancer Group
Published: January 2021

Abstract

Background
Centralization of pancreatic surgery in the Netherlands has been ongoing since 2011. The aim of this study was to assess how centralization has affected the likelihood of resection and survival of patients with non-metastatic pancreatic head and periampullary cancer, diagnosed in hospitals with and without pancreatic surgery services.

Methods
An observational cohort study was performed on nationwide data from the Netherlands Cancer Registry (2009–2017), including patients diagnosed with non-metastatic pancreatic head or periampullary cancer. The period of diagnosis was divided into three time intervals: 2009–2011, 2012–2014 and 2015–2017. Hospital of diagnosis was classified as a pancreatic or non-pancreatic surgery centre. Analyses were performed using multivariable logistic and Cox regression models.

Results
In total, 10 079 patients were included, of whom 3114 (30.9 per cent) were diagnosed in pancreatic surgery centres. Between 2009–2011 and 2015–2017, the number of patients undergoing resection increased from 1267 of 3169 (40.0 per cent) to 1705 of 3566 (47.8 per cent) (P for trend &lt; 0.001). In multivariable analysis, in 2015–2017, unlike the previous periods, patients diagnosed in pancreatic and non-pancreatic surgery centres had a similar likelihood of resection (odds ratio 1.08, 95 per cent c.i. 0.90 to 1.28; P = 0.422). In this period, however, overall survival was higher in patients diagnosed in pancreatic surgery than in those diagnosed in non-pancreatic surgery centres (hazard ratio 0.92, 95 per cent c.i. 0.85 to 0.99; P = 0.047).

Conclusion
After centralization of pancreatic surgery, the resection rate for patients with pancreatic head and periampullary cancer diagnosed in non-pancreatic surgery centres increased and became similar to that in pancreatic surgery centres. Overall survival remained higher in patients diagnosed in pancreatic surgery centres.
Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis
Authors: Heil J , Korenblik R , Heid F , Bechstein W O , Bemelmans M , Binkert C , Björnsson B , Breitenstein S , Detry O , Dili A , Dondelinger R F , Gerard L , Giménez-Maurel T , Guiu B , Heise D , Hertl M , Kalil J A , Klein J J , Lakoma A , Neumann U P , Olij B , Pappas S G , Sandström P , Schnitzbauer A , Serrablo A , Tasse J , Van der Leij C , Metrakos P , Van Dam R , Schadde E 
Published: January 2021

Abstract

Background
The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability.

Methods
All centres of the international DRAGON trials study collaborative were asked to provide data on patients who had PVE/HVE or PVE on 2016–2019 (more than 5 PVE/HVE procedures was a requirement). Liver volumetry was performed using OsiriX MD software. Multivariable analysis was performed for the endpoints of resectability rate, FLR hypertrophy and major complications using receiver operating characteristic (ROC) statistics, regression, and Kaplan–Meier analysis.

Results
In total, 39 patients had undergone PVE/HVE and 160 had PVE alone. The PVE/HVE group had better hypertrophy than the PVE group (59 versus 48 per cent respectively; P = 0.020) and resectability (90 versus 68 per cent; P = 0.007). Major complications (26 versus 34 per cent; P = 0.550) and 90-day mortality (3 versus 16 per cent respectively, P = 0.065) were comparable. Multivariable analysis confirmed that these effects were independent of confounders.

Conclusion
PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.
Selective impact of COVID-19 in patients presenting with non-specific abdominal pain
Authors: Alsaoudi T , Slavin D , Khasawneh F , Chung W Y , Eltweri A , Sahloul M , Bhardwaj N , Malde D , Dennison A R , Garcea G 
Published: January 2021

The effect of COVID on surgical admissions was investigated by comparing such admissions from March to August 2020 with those in the same period in 2019. A significant reduction was noted in surgical admissions. The majority of this reduction was seen in the group with non-specific abdominal pain. It is presumed that public adherence to authorities’ message and effective ambulatory care are behind this decrease.
we investigated the COVID effect on surgical admissions by comparing surgical admissions to the same period in 2019. significant reduction was noted of surgical admissions. interestingly, the majority of this reduction was seen in the non specific abdominal pain group. it is presumed that public adherence to authorities message and effective ambulatory care are behind this decrease.
Oncological outcomes of laparoscopic versus open rectal cancer resections: meta-analysis of randomized clinical trials
Authors: Creavin B , Kelly M E , Ryan É J , Ryan O K , Winter D C 
Published: January 2021

Abstract

Background
The role of laparoscopic rectal cancer surgery has been questioned owing to conflicting reports on pathological outcomes from recent RCTs. However, it is unclear whether these pathological markers and the surgical approach have an impact on oncological outcomes. This study assessed oncological outcomes of laparoscopic and open rectal cancer resections.

Methods
A meta-analysis of RCTs was performed. Primary endpoints included oncological outcomes (disease-free survival (DFS), overall survival (OS), local recurrence). Secondary endpoints included surrogate markers for the quality of surgical resection.

Results
Twelve RCTs including 3744 patients (2133 laparoscopic, 1611 open) were included. There was no significant difference in OS (hazard ratio (HR) 0.87, 95 per cent c.i. 0.73 to 1.04; P = 0.12; I2 = 0 per cent) and DFS (HR 0.95, 0.81 to 1.11; P = 0.52; I2 = 0 per cent) between laparoscopic and open rectal resections. There was no significant difference in locoregional (odds ratio (OR) 1.03, 95 per cent c.i. 0.72 to 1.48; P = 0.86; I2 = 0 per cent) or distant (OR 0.87, 0.70 to 1.08; P = 0.20; I2 = 7 per cent) recurrence between the groups. Achieving a successful composite score (intact mesorectal excision, clear circumferential resection margin and distal margin) was significantly associated with improved DFS (OR 0.55, 0.33 to 0.74; P &lt; 0.001; I2 = 0 per cent). An intact or acceptable mesorectal excision (intact mesorectal excision with or without superficial defects) had no impact on DFS. Finally, a positive CRM was associated with worse DFS.

Conclusion
Well performed surgery (laparoscopic or open) achieves excellent oncological outcomes with very little difference between the two modalities. The advantage and benefit of minimally invasive surgery should be assessed on an individual basis.
Cost-effectiveness of radioguided occult lesion localization using 125I seeds versus hookwire localization before breast-conserving surgery for non-palpable breast cancer
Authors: Wright C M , Moorin R E , Saunders C , Marinovich M L , Taylor D B ,   the ROLLIS study group, Bourke A G , Westcott E J , Chong C Y L , Liang R , Hughes R L , Elder E 
Published: January 2021

Abstract

Background
The aim was to determine the cost-effectiveness of radioguided occult lesion localization using 125I-labelled seeds (125I seeds) versus hookwire localization in terms of incremental cost per reoperation avoided for women with non-palpable breast cancer undergoing breast-conserving surgery.

Methods
This study was based on a multicentre RCT with eight study sites comprising seven public hospitals and one private hospital. An Australian public health system perspective was taken. The primary effectiveness outcome for this study was reoperations avoided. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were used to explore uncertainty. The willingness to pay (additional cost of localization using 125I seeds justified by reoperation cost avoided) was set at the weighted, top-down cost of reoperation. Costs were in 2019 Australian dollars ($1 was equivalent to €0.62).

Results
The reoperation rate was 13.9 (95 per cent confidence interval 10.7 to 18.0) per cent for the 125I seed group and 18.9 (14.8 to 23.8) per cent for the hookwire localization group. The ICER for 125I seed versus hookwire localization was $4474 per reoperation averted. The results were most sensitive to uncertainty around the probability of reoperation. Accounting for transition probability and cost uncertainty for 125I seed localization, there was a 77 per cent probability that using 125I seeds would be cost-effective, with a willingness to pay of $7693 per reoperation averted.

Conclusion
Radioguided occult lesion localization using 125I seeds is likely to be cost-effective, because the marginal (additional) cost compared with hookwire localization is less than the cost of reoperations avoided.
Double prevalence of appendicular peritonitis during COVID times
Authors: Riveros S , Artigas G , Inzunza M , Rebolledo R , Brañes A , Crovari F , Achurra P 
Published: January 2021

International recommendations during the COVID-19 change favoring medical management and open surgical approach of acute appendicitis.
During COVID times, the presence of appendicular peritonitis was doubled.
The collateral damage of the COVID pandemic has not yet been fully evaluated.
Initiating Antiretroviral Treatment Early in Infancy Has Long-term Benefits on the Human Immunodeficiency Virus Reservoir in Late Childhood and Adolescence
Authors: Avettand-Fenoel Véronique , Lechenadec Jérôme , Diallo Mariama Sadjo , Fillion Marine , Melard Adeline , Samri Assia , Dollfus Catherine , Blanche Stéphane , Faye Albert , Amokrane Kahina , Autran Brigitte , Buseyne Florence , Warszawski Josiane , Frange Pierre ,   ANRS-EP59-CLEAC Study Group, Courcoux Mary-France , Dollfus Catherine , Tabone Marie-Dominique , Vaudre Geneviève , Fourcade Corinne , Warsazawski Josiane , Lechenadec Jérôme , Dialla Olivia , Nailler Laura , Selmi Lamya Ait Si , Leymarie Isabelle , Wack Thierry , Hoctin Alexandre , Feraon-Nanache Razika , Hau Isabelle , Gakobwa Cécile , Avettand-Fenoël Véronique , Blanche Stéphane , Fillion Marine , Frange Pierre , Mahlaoui Nizar , Mélard Adeline , Veber Florence , Mourey Marie-Christine , Marcou Valérie , Faye Albert , Lévine Martine , Richard Sandrine , Autran Brigitte , Samri Assia , Diallo Mariama , Caillat-Zucman Sophie , Amokrane Kahina , Ivanova-Derin Rayna , Chacé Anne , Buseyne Florence , Montange Thomas , Batalie Damien , Fert Ingrid , Saez-Cirion Asier , Monceaux Valérie , Scott-Algara Daniel , Marchand Lucie , Lebrasseur Delphine , Levier Axel 
Published: January 2021

AbstractBackgroundEarly combined antiretroviral therapy (cART) limits the total HIV-DNA load in children. However, data on its impact in older children and adolescents remain scarce. This study compares HIV reservoirs in children (5–12 years) and adolescents (13–17 years) who started cART &lt;6 months (early [E-] group) or &gt;2 years (late [L-] group).MethodsThe ANRS-EP59-CLEAC study prospectively enrolled 76 patients perinatally infected with HIV-1 who reached HIV-RNA &lt;400 copies/mL &lt;24 months after cART initiation, regardless of subsequent viral suppression (E-group: 27 children, 9 adolescents; L-group: 19 children, 21 adolescents). Total and integrated HIV-DNA were quantified in blood and in CD4+ T-cell subsets. A substudy assessed HIV reservoir inducibility after ex vivo peripheral blood mononuclear cell (PBMC) stimulation.ResultsTotal HIV-DNA levels were lower in early- versus late-treated patients (children: 2.14 vs 2.87 log copies/million PBMCs; adolescents: 2.25 vs 2.74 log; P &lt; .0001 for both). Low reservoir was independently associated with treatment precocity, protective HLA, and low cumulative viremia since cART initiation. The 60 participants with undetectable integrated HIV-DNA started cART earlier than other patients (4 vs 54 months; P = .03). In those with sustained virological control, transitional and effector memory CD4+ T cells were less infected in the E-group than in the L-group (P = .03 and .02, respectively). Viral inducibility of reservoir cells after normalization to HIV-DNA levels was similar between groups.ConclusionsEarly cART results in a smaller blood HIV reservoir until adolescence, but all tested participants had an inducible reservoir. This deserves cautious consideration for HIV remission strategies.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Encephalitis Is a Cytokine Release Syndrome: Evidences From Cerebrospinal Fluid Analyses
Authors: Pilotto Andrea , Masciocchi Stefano , Volonghi Irene , De Giuli Valeria , Caprioli Francesca , Mariotto Sara , Ferrari Sergio , Bozzetti Silvia , Imarisio Alberto , Risi Barbara , Premi Enrico , Benussi Alberto , Focà Emanuele , Castelli Francesco , Zanusso Gianluigi , Monaco Salvatore , Stefanelli Paola , Gasparotti Roberto , Zekeridou Anastasia , McKeon Andrew , Ashton Nicholas J , BlennoW Kaj , Zetterberg Henrik , Padovani Alessandro 
Published: January 2021

AbstractBackgroundRecent findings indicated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related neurological manifestations involve cytokine release syndrome along with endothelial activation, blood brain barrier dysfunction, and immune-mediated mechanisms. Very few studies have fully investigated the cerebrospinal fluid (CSF) correlates of SARS-CoV-2 encephalitis.MethodsPatients with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection and encephalitis (COV-Enc), encephalitis without SARS-CoV-2 infection (ENC), and healthy controls (HC) underwent an extended panel of CSF neuronal (neurofilament light chain [NfL], T-tau), glial (glial fibrillary acidic protein [GFAP], soluble triggering receptor expressed on myeloid cells 2 [sTREM2], chitinase-3-like protein 1 [YKL-40]) and inflammatory biomarkers (interleukin [IL]-1β, IL-6, Il-8, tumor necrosis factor [TNF] α, CXCL-13, and β2-microglobulin).ResultsThirteen COV-Enc, 21 ENC, and 18 HC entered the study. In COV-Enc cases, CSF was negative for SARS-CoV-2 real-time PCR but exhibited increased IL-8 levels independently from presence of pleocytosis/hyperproteinorracchia. COV-Enc patients showed increased IL-6, TNF- α, and β2-microglobulin and glial markers (GFAP, sTREM2, YKL-40) levels similar to ENC but normal CXCL13 levels. Neuronal markers NfL and T-tau were abnormal only in severe cases.ConclusionsSARS-CoV-2-related encephalitis were associated with prominent glial activation and neuroinflammatory markers, whereas neuronal markers were increased in severe cases only. The pattern of CSF alterations suggested a cytokine-release syndrome as the main inflammatory mechanism of SARS-CoV-2-related encephalitis.
Trust-aware Task Allocation in Collaborative Crowdsourcing Model
Authors: Donglai Fu , Yanhua Liu 
Published: January 2021

Abstract
Task allocation plays a vital role in crowd computing by determining its performance. The power of crowd computing stems from a large number of workers potentially available to provide high quality of service and reduce costs. An important challenge in the crowdsourcing market today is the task allocation of crowdsourcing workflows. Task allocation aims to maximize the completion quality of the entire workflow and minimize its total cost. Trust can affect the quality of the produced results and costs. Selecting workers with high levels of trust could provide better solution to the workflow and increase the budget. Crowdsourcing workflow needs to balance the two conflicting objectives. In this paper, we propose an alternative greedy approach with four heuristic strategies to address the issue. In particular, the proposed approach aims to monitor the current status of workflow execution and use heuristic strategies to adjust the parameters of task allocation. We design a two-phase allocation model to accurately match the tasks with workers. T-Aware allocates each task to the worker that maximizes the trust level, while minimizing the cost. We conduct extensive experiments to quantitatively evaluate the proposed algorithms in terms of running time, task failure ratio, trust and cost using a customer objective function on WorkflowSim, a well-known cloud simulation tool. Experimental results based on real-world workflows show that T-Aware outperforms other optimal solutions on finding the tradeoff between trust and cost, which is 3 to 6% better than the best competitor algorithm.
Continual Leakage-Resilient Hedged Public-Key Encryption
Authors: Huang Meijuan , Yang Bo , Zhou Yanwei , Hu Xuewei 
Published: January 2021

Abstract
Hedged public-key encryption (HPKE), introduced by Bellare et al. (ASIACRYPT 2009), provides useful security when the per-message randomness fails to be uniform due to faulty implementations or adversarial actions. The HPKE scheme achieves IND-CPA (chosen plaintext attack) security when the randomness they used is of high quality, but, when the randomness is poor quality, rather than breaking completely, it achieves a weaker but a useful notion of security called IND-CDA (chosen distribution attack) as long as the message and randomness together have sufficient min-entropy. However, little research on HPKE in the presence of key leakage was done. In this paper, we study HPKE featuring key leakage-resilience and formulate appropriate security notion for key leakage-resilient HPKE. We work in the continual key leakage model where the secret key is refreshed periodically and an adversary can learn arbitrary but bounded leakage on the secret key between the updates. We present two generic constructions of continual leakage-resilient HPKE in the standard model by using a continual leakage-resilient all-but-one lossy trapdoor function. Finally, we give an instantiation of leakage-resilient HPKE under the linear assumption in bilinear groups.
Association between β-blocker dose and cardiovascular outcomes after myocardial infarction: insights from the SWEDEHEART registry
Authors: Mars Katarina , Wallert John , Held Claes , Humphries Sophia , Pingel Ronnie , Jernberg Tomas , Olsson Erik M G , Hofmann Robin 
Published: January 2021

Abstract

Aims
Dose-dependent effects of β-blockers on survival and cardiovascular outcomes after myocardial infarction (MI) are not well understood. We investigated the long-term risk of cardiovascular events in patients with different doses of β-blockers after MI.

Methods and results
This was a nationwide observational study linking morbidity, mortality, socioeconomic, and medication data from Swedish national registries. Between 2006 and 2015, 97 575 unique patients with first-time MI were included. In total, 33 126 (33.9%) patients were discharged with ≥50% of the target β-blocker dose and 64 449 (66.1%) patients with &lt;50% of the target β-blocker dose used in previous randomized trials. The primary composite endpoint was re-infarction or all-cause death within 1 year from discharge. Multivariable adjusted 1-year follow-up estimates using mixed effects Cox regression [HR (95% CI)] showed that patients treated with ≥50% of the target dose had a similar risk of the composite endpoint [1.03 (0.99–1.08)] and a somewhat higher risk when stroke, atrial fibrillation, or heart failure hospitalization were added to the composite endpoint [1.08 (1.04–1.12)], compared with patients on &lt;50% of the target β-blocker dose. Results remained similar up to 5 years of follow-up and consistent across relevant patient subgroups, including patients who developed heart failure during the index hospitalization.

Conclusions
In contrast to doses of β-blockers used in previous trials, ≥50% of the target β-blocker dose was not associated with superior cardiovascular outcomes up to 5 years as compared with &lt;50% of the target dose. Contemporary randomized clinical trials are needed to clarify the optimal dose of β-blockers after MI.
Hospitalization-related economic impact of patients with cardiogenic shock in a high-complexity reference centre
Authors: Collado Elena , Luiso Daniele , Ariza-Solé Albert , Lorente Victoria , Sánchez-Salado José Carlos , Moreno Ramon , Alsina Maria , Tapia Javier , González-Costello José , Comin-Colet Josep 
Published: January 2021

AbstractAims Cardiogenic shock (CS) is associated with high mortality. Current guidelines strongly recommend centralizing the care of these patients in high-complexity centres. We described the hospitalization-related economic cost and its main determinants in patients with CS in a high-complexity reference centre.Methods and results This is a single-centre, retrospective study. All patients with CS (2015–17) were included. Hospitalization-related cost per patient was calculated by analytical accountability method, including hospital stay-related expenditures, interventions, and consumption of devices. Expenditure was expressed in 2018 euros. All-cause mortality during follow-up was registered. Ratio of cost per life-year gained (LYG) was also calculated. A total of 230 patients were included, with mean age of 63 years. In-hospital mortality was 88/230 (38.3%). Hospital stay was longer in patients surviving after the admission (21.7 vs. 7.5 days, P &lt; 0.001). Total economic cost for the overall cohort was 3 947 118€ (mean/patient 17 161€). Most of this cost was attributable to hospital stay (81.1%). The rest of the expenditure was due to in-hospital procedures (13.1%) and the use of devices (5.8%). Most of hospital stay-related costs (79.8%) were due to Critical Care Unit stay. Mean follow-up was 651 days. Total LYG was 409.77 years for the whole series. The observed ratio of cost per LYG was 9632.52 €/LYG.Conclusions Management of CS in a reference centre is associated to a significant economic cost, but with a low ratio of cost per LYG. Most of this cost is attributable to hospital stay, specifically in critical care units.