bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of learning curve and oncologic feasibility of robotic pancreaticoduodenectomy: A propensity score‐based comparison with open approach
Authors: Kim Hyeyeon , Park Seo Young , Park Yejong , Kwon Jaewoo , Lee Woohyung , Song Ki Byung , Hwang Dae Wook , Kim Song Cheol , Lee Jae Hoon 
Published: October 2020

AbstractBackgroundThough robotic pancreaticoduodenectomy(R‐PD) is gradually adopted, learning curve and its feasibility is still controversial. We analyzed our first 70 R‐PD cases, comparing surgical outcomes and feasibility to those of open pancreaticoduodenectomy (O‐PD).MethodsMedical records of 70 patients of R‐PD and 269 patients of O‐PD between 2015 and 2019 were retrospectively analyzed. Cumulative sum analysis was used to determine learning curve. Surgical outcomes were compared between early(1‐35) and late cases(36‐70). Additional analyses with O‐PD using propensity score‐matching were done.ResultsLearning curve of R‐PD completed after 30 cases. Shorter operative time, lower estimated blood loss, and shorter length of stay were noted in later cases. Complication rate tended to decrease over time. In comparison with O‐PD after matching, R‐PD showed longer operation time(414.5 minutes vs 244.7 minutes; P < .001), with no differences in estimated blood loss, or length of stay. While overall complication rate was higher in R‐PD(45.5% vs 21.8%; P = .010), no statistically significant difference was observed in major complication rates(23.6% vs 10.9%; P = .084). R0 rate was equivalent.ConclusionSurgical performance of R‐PD improved over time. Learning curve of R‐PD completed after 30 cases. R‐PD is a promising modality, based on comparison of perioperative and oncologic feasibilities to those of O‐PD.
Predictors of pancreatic fistula healing time after distal pancreatectomy
Authors: Andrianello Stefano , Marchegiani Giovanni , Bannone Elisa , Vacca Piero , Esposito Alessandro , Casetti Luca , Salvia Roberto , Bassi Claudio 
Published: October 2020

AbstractIntroductionPostoperative pancreatic fistula (POPF) is common after distal pancreatectomy (DP). Whilst extensive investigation into potential predictors has been carried out, there is little evidence regarding POPF healing time.MethodsThis is a retrospective analysis of all consecutive DPs performed at the Department of General and Pancreatic Surgery, University of Verona Hospital Trust, from 2015 to 2019. Perioperative variables were analyzed identifying possible predictors of POPF healing time defined as days between surgery and last drain removal due to POPF.ResultsA total of 496 patients were included. POPF rate was 28.2% and median POPF healing time was 30 days (95% CI 28‐31). Independent predictors of POPF were body mass index (BMI) (OR 1.073, 95% CI 1.010‐1.147, p = 0.040), operative time (OR 95% CI 1.002–1.009, P = .003), and postoperative acute pancreatitis (OR 3.793, 95% CI, 1.852–7.767, P < .001). Independent predictors of POPF healing time were female sex (HR 1.323, 95% CI 1.093–1.998, P = .042), preoperative pancreatic enzyme replacement therapy (HR 2.319, 95% CI 1.195–4.498, P = .013), ASA score 3 (HR 0.278, 95% CI 0.119–0.646, P = .003), pancreatic transection with ultrasonic dissector (HR 0.605, 95% CI 0.404–0.907, P = .015), and positive drain cultures (HR 0.635, 95% CI 0.443–0.910, P = .013).ConclusionPOPF healing after DP is a slow process since only half of patients recover within 30 days of surgery. A longer healing time can be predicted early in the postoperative period with significant implications in therapeutic choices.
Surgical outcomes of 118 complex laparoscopic liver resections: a single‐ center experience
Authors: Hasegawa Yasushi , Nitta Hiroyuki , Takahara Takeshi , Katagiri Hirokatsu , Kanno Shoji , Umemura Akira , Akiyama Yuji , Iwaya Takeshi , Otsuka Koki , Sasaki Akira 
Published: October 2020

AbstractBackgroundIndications for laparoscopic liver resection (LLR) are continuously expanding. The Japanese Society of Hepato‐Biliary‐Pancreatic Surgery defines highly difficult hepatectomy as a procedure involving one or more sections (except for left lateral sectionectomy) or anatomical segmentectomy. This study aimed to assess the outcomes of complex LLR procedures and compare their technical difficulties, about which only a little is known to date.MethodsWe performed a retrospective review of the operative outcomes of 118 consecutive patients who underwent pure laparoscopic complex hepatectomy. The surgical outcomes, including operative times, blood loss amounts, and postoperative morbidity rates, were compared among complex LLR procedures.ResultsThe overall median operative time was 280 minutes, and the median intraoperative blood loss was 86 mL. Two patients required conversion to open laparotomy (1.7%). The postoperative major morbidity rate was 11.0% Posterosuperior segmentectomy, right hemihepatectomy, and anterior sectionectomy required the longest operative times. Anterior and posterior sectionectomy resulted in the highest blood loss, and right hemihepatectomy and anterior sectionectomy resulted in the most complications.ConclusionsThe surgical difficulties associated with complex LLR procedures vary. It is critical to recognize the specific risks and cautionary points to ensure patient safety and provide proper systemic training to surgeons.
Novel bisbenzopyronopyran derivatives: photochemical synthesis and their in‐vitro antimicrobial studies
Authors: Nisa Shehneela , Yusuf Mohamad 
Published: October 2020

AbstractThe present research work describes the productive synthesis of novel bisbenzopyronopyran derivatives 4(a‐h) and 5(a‐h) via the photocyclization reactions of bischromones 3(a‐h) under the inert conditions. The latter compounds have been realized efficiently through the O‐alkylation reactions of the 3‐hydroxychromone 2 with suitable dihalogenated aliphatic/aromatic/heteroaromatic reagents in the presence of dry acetone/anhydrous K2CO3/Bu4N+I− (PTC). The cyclization reaction of chalcone 1 under the Algar‐Flynn‐Oyamada reaction conditions (KOH/H2O2) could results in the formation of compound 2 in the good yield. The structural scaffolds of the newly prepared bischromones and resultant bisbenzopyronopyrans have been certified from the meticulous analysis of their various spectroscopic parameters such as UV‐Vis, IR, 1H/13C‐NMR, and ESI‐MS. It was found that o/m/p‐xylene and pyridine‐linked final symmetrical bistetracycles exhibited higher antimicrobial potencies as compared to alkyl chain‐linked cyclized products. The bischromones 3(a‐h) could be able to endow modest level of antimicrobial behavior.
Development of an automated radiotherapy dose accumulation workflow for locally advanced high‐risk prostate cancer – A technical report
Authors: Ong Ashley , Knight Kellie , Panettieri Vanessa , Dimmock Matthew , Tuan Jeffrey Kit Loong , Tan Hong Qi , Master Zubin , Wright Caroline 
Published: October 2020

AbstractAn automated dose accumulation and contour propagation workflow using daily cone beam computed tomography (CBCTs) images for prostate cases that require pelvic lymph nodes irradiation (PLNs) was developed. This workflow was constructed using MIM® software with the intention to provide accurate dose transformations for plans with two different isocentres, whereby two sequential treatment phases were prescribed. The pre‐processing steps for data extractions from treatment plans, CBCTs, determination of couch shift information and management of missing CBCTs are described. To ensure that the imported translational couch shifts were in the correct orientation and readable in MIM, phantom commissioning was performed. For dose transformation, rigid registration with corrected setup shifts and scaled fractional dose was performed for pCT to daily CBCTs, which were then deformed onto CBCT1. Fractional dose summation resulted in the final accumulated dose for the patient allowing differences in dosimetry between the planned and accumulated dose to be analysed. Contour propagations of the prostate, bladder and rectum were performed within the same workflow. Transformed contours were then deformed onto daily CBCTs to generate trending reports for analysis, including Dice Similarity Coefficient (DSC) and Mean Distance to Agreement (MDA). Results obtained from phantom commissioning (DSC = 0.96, MDA = 0.89 mm) and geometrical analysis of the propagated contours for twenty patients; prostate (DSC: 0.9 ± 0.0, MDA: 1.0 ± 0.3 mm), rectum (DSC: 0.8 ± 0.1, mm, MDA: 1.7 ± 0.6 mm) and bladder (DSC: 0.8 ± 0.1, MDA: 2.8 ± 1.0 mm) were within clinically accepted tolerances for both DSC (>0.8) and MDA (< 0.3 mm). The developed workflow is being performed on a larger patient cohort for predictive model building, with the goal of correlating observed toxicity with the actual accumulated dose received by the patient.
The difference in mortality between adult patients with laboratory documented influenza A and B, a single centre retrospective observational study
Authors: Mabayoje Diana A. , Cutino‐Moguel Teresa , Haigh John , Wilks Mark , Welch Catherine A. , Melzer Mark 
Published: October 2020

AbstractBackgroundSeasonal influenza is an annual occurrence that leads to large community outbreaks and increased hospitalization. A number of studies have suggested that influenza A (FLUAV) is associated with increased rates of hospitalization and mortality compared with influenza B (FLUBV). This study compared demographic and clinical variables in patients diagnosed with FLUAV or FLUBV during the 2017–2018 UK Influenza season.MethodsPatient demographic and clinical information were obtained by accessing medical records of patients testing FLUAV or FLUBV positive using the Cepheid GXP. We used the χ2 test to compare variables in patients with laboratory‐confirmed FLUAV and FLUBV.ResultsOne hundred and twenty‐seven adult patients had confirmed Influenza, 71 (55.9%) had FLUAV, and 56 (44.1%) FLUBV. There was no significant difference between severity at presentation, admission to HDU/ITU or median length of stay. The overall mortality was 6 (4.5%) and 9 (7.1%) at 7 and 30 days, respectively. There was a statistically significant difference in 7‐day mortality between patients with FLUAV and FLUBV, 1 (1.4%) versus 5 (8.9%), respectively, p = .047) although this became nonsignificant at 30 days.ConclusionsWith the exception of mortality, we did not observe significant differences between patients with FLUAV and FLUBV. Seven‐day mortality in patients with FLUBV was significantly higher with FLUAV, although this was was not apparent at 30 days.
Impact on disease mortality of clinical, biological, and virological characteristics at hospital admission and overtime in COVID‐19 patients
Authors: Yazdanpanah Yazdan ,   French COVID cohort investigators and study group
Published: October 2020

AbstractLittle is known on the association between clinical factors and coronavirus disease 2019 (COVID‐19) more than 15 days after diagnosis. We conducted a multicentric prospective cohort of COVID‐19 hospitalized patients to describe clinical, biological, and virological characteristics at hospital admission and over time, according to mortality up to Day 60 after admission. For the analysis of risk factors of survival, analyses assessing associations between mortality and demographic characteristics or comorbidities were performed using a Cox regression model. Between January 24 and March 15, 2020, 246 patients with reverse‐transcriptase polymerase chain reactions virologically confirmed COVID‐19 were enrolled. In multivariate analysis, mortality at Day 60 (n = 42 patients, 17.1% [95% confidence interval, 12.6–22.4]) was associated with older age (adjusted hazard ratio [aHR] for age ≥ 65 years: 5.22 [2.56–10.63, p < .001]), gender (aHR for male: 2.97 [1.47–5.99, p = .002]), chronic pulmonary disease (aHR: 4.84 [2.32–10.07, p < .001]), obesity (aHR: 3.32 [1.70–6.52, p < .001]), and diabetes (aHR: 1.98 [1.01–3.89, p = .048]). The median nasopharyngeal viral load at admission was 6.4 log10 copies/ml and was associated with mortality regardless of clinical risk factors. Viral load decreased with time elapsed since symptoms onset. Our study confirmed that mortality was associated with clinical characteristics at admission. The viral load at admission was significantly lower in patients admitted late after the onset of symptoms in both dead and alive patients. Our results could improve earlier identification of patients with increased risk of mortality and adapted management.
Characterization of daily rainfall variability in Hong Kong: A nonlinear dynamic perspective
Authors: Shu Zhenru , Chan Pak Wai , Li Qiusheng , He Yuncheng , Yan Bowen 
Published: October 2020

AbstractModelling and forecasting of rainfall behaviour are of essential importance in various hydrological and meteorological studies, which depends largely on properly understanding the underlying rainfall dynamics. In this paper, 20‐years (i.e., 2000–2019) measurements of daily rainfall data at 6 rain gauge stations in Hong Kong were analysed in the framework of nonlinear dynamic analysis. Phase space reconstruction (PSR), recurrence plot (RP) and recurrence quantification analysis (RQA) were carried out to identify and characterize the chaotic nature of rainfall dynamics. The results of this study underscore the complex processes and variability that is associated with Hong Kong's rainfall data. The existence of chaos in rainfall process was well recognized across various stations. The rainfall dynamics were further investigated with respect to its inter‐annual and monthly variability. The dependence of rainfall dynamics on different temporal scales was likewise examined, which indicates that the rainfall dynamics at finer resolution are less complex than those at coarser resolution, thus the consequent rainfall variability is less pronounced.
Attenuated total reflection‐cascading nanostructure‐enhanced Raman spectroscopy on flat surfaces: A nano‐optical design
Authors: You En‐Ming , Wang Hai‐Long , Zheng Jun‐Rong , Meng Zhao‐Dong , Zhang Mao‐Xin , Ding Song‐Yuan , Tian Zhong‐Qun 
Published: October 2020

AbstractThe surface‐enhanced Raman scattering (SERS) effect was discovered by Richard Van Duyne et al. in 1977. He and coworkers also first utilized an innovative strategy that used SERS to record spectra on such SERS‐inactive substrate surfaces as n‐gallium arsenide (100) surfaces, which were modified by silver nano‐islands. This nanostructure‐enhanced Raman spectroscopy on flat surfaces (NERSoFS) enabled such SERS applications to be expanded to a variety of materials by virtue of SERS‐active nanostructures such as Au or Ag nanoparticles and shell‐isolated nanoparticles. However, most of such systems, although yielding Raman spectra, produce rather low enhancements, especially when used to record spectra on flat surfaces of SERS‐inactive materials. In this work, along with the direction of Van Duyne's borrowing‐SERS strategy and on the basis of the strategy of cascading optical coupling, we consider a theoretically designed optical configuration, based on an attenuated total reflection‐cascading nanostructure to produce enhanced Raman spectroscopy (ATRc‐NERS) on flat surfaces. This system can effectively harvest the incident light, thereby boosting the local optical field of the incident light and also moderately increasing the radiation field of the Raman‐scattered signals. In this way, one can gain 1–2 additional orders of magnitude in Raman enhancement over present NERSoFS systems both on metallic and nonmetallic flat surfaces, which are otherwise SERS‐inactive. This ATRc‐NERS strategy can potentially be used to develop ultrasensitive and versatile tools for surface science, material science, catalysis, electrochemistry, and micro‐electronics and micro‐LED industries.
The Ending Self‐Stigma for Posttraumatic Stress Disorder (ESS‐P) Program: Results of a Pilot Randomized Trial
Authors: Drapalski Amy L. , Aakre Jennifer , Brown Clayton H. , Romero Erin , Lucksted Alicia 
Published: October 2020

AbstractExperiences of and concerns about encountering stigma are common among veterans with posttraumatic stress disorder (PTSD). One common and serious consequence is self‐stigma, which is when an individual comes to believe that common negative stereotypes and assumptions about PTSD are true of oneself. The current study was a pilot randomized trial that evaluated the feasibility, acceptability, and preliminary outcomes of the Ending Self‐Stigma for PTSD (ESS‐P) program, a nine‐session group intervention that aims to assist veterans with PTSD learn tools and strategies to address stigma and self‐stigma. Veterans (N = 57) with a diagnosis of PTSD who were receiving treatment in U.S. Veterans Health Administration outpatient mental health programs were recruited. Participants were randomized to either ESS‐P or minimally enhanced treatment as usual and assessed at baseline and after treatment on clinical symptoms, self‐stigma, self‐efficacy, recovery, and sense of belonging. Information on mental health treatment utilization for the 3 months before and after group treatment was also collected. Compared to controls, there was a significant decrease in self‐stigma, d = −0.77, and symptoms of depression, d = −0.76, along with significant increases in general and social self‐efficacy, ds = 0.73 and 0.60, respectively, and psychological experience of belonging, d = 0.46, among ESS‐P participants. There were no differences regarding recovery status or changes in treatment utilization. The results of the pilot study suggest that participation in ESS‐P may help reduce self‐stigma and improve self‐efficacy and a sense of belonging in veterans with PTSD.
Predicting Placenta Accreta Spectrum
Authors: Happe Sarah K. , Yule Casey S. , Spong Catherine Y. , Wells C. Edward , Dashe Jodi S. , Moschos Elysia , Rac Martha W. F. , McIntire Donald D. , Twickler Diane M. 
Published: October 2020

ObjectivesThe placenta accreta spectrum (PAS) incidence has risen substantially over the past century, paralleling a rise in cesarean delivery (CD) rates. Prenatal diagnosis of PAS improves maternal outcomes. The Placenta Accreta Index (PAI) is a standardized approach to prenatal diagnosis of PAS incorporating clinical risk and ultrasound (US) findings suggestive of placental invasion. We sought to validate the PAI for prediction of PAS in pregnancies with prior CD.MethodsThis work was a retrospective cohort study of pregnancies with 1 or more prior CDs that received a US diagnosis of placenta previa or low‐lying placenta in the third trimester. Images of third‐trimester US with a complete placental evaluation were read by 2 blinded physicians, and the PAI was applied. Surgical outcomes and pathologic findings were reviewed. Placenta accreta spectrum was diagnosed if clinical evidence of invasion was seen at time of delivery or if any placental invasion was identified histologically. International Federation of Gynecology and Obstetrics criteria were used.ResultsA total of 194 women met inclusion criteria. Cesarean hysterectomy was performed in 92 (47%), CD in 97 (50%), and vaginal delivery in 5 (3%). Of those who underwent hysterectomy, PAS was histologically confirmed in 79 (85%) pregnancies. Of the remaining 13 who underwent hysterectomy, all met International Federation of Gynecology and Obstetrics grade 1 clinical criteria for PAS. With a threshold of greater than 4, the PAI has a sensitivity of 87%, specificity of 77%, positive predictive value of 72%, and negative predictive value of 90% for PAS diagnosis.ConclusionsContemporaneous application of the PAI, a standardized approach to US diagnosis, is useful in the prenatal prediction of PAS.
Critical functions of microRNA‐30a‐5p‐E2F3 in cardiomyocyte apoptosis induced by hypoxia/reoxygenation
Authors: Lv Xiao‐Bing , Niu Qing‐Hui , Zhang Min , Feng Li , Feng Jia 
Published: October 2020

AbstractThe high‐mortality rate of cardiovascular diseases (CVDs) is associated with the myocardial ischemia and reperfusion (I/R). Recent investigations have revealed that microRNAs (miRNAs) exert vital functions in the apoptosis of cardiomyocyte cell. Nevertheless, the potential role of miR‐30a‐5p in the regulation of cardiomyocyte cell apoptosis needs to be illuminated. In the current study, we observed that hypoxia/reoxygenation (H/R) remarkably raised the level of miR‐30a‐5p but reduced the expression of E2F transcription factor 3 (E2F3) in H9c2 cardiomyocytes. In vivo, miR‐30a‐5p was found to be significantly upregulated in the hearts of rats following I/R. Downregulation of miR‐30a‐5p using anti‐miR‐30a‐5p decreased H9c2 cardiomyocytes apoptosis caused by H/R and promoted the proliferation of H9c2 inhibited by H/R. Moreover, E2F3 was a possible target gene of miR‐30a‐5p and upregulation of miR‐30a‐5p reduced the expression level of E2F3 in H9c2 cardiomyocytes. We further identified that E2F3 silencing reversed the effect of anti‐miR‐30a‐5p on the proliferation and apoptosis in H/R treated H9c2 cells. These studies suggested that downregulation of miR‐30a‐5p attenuated the impact of H/R on H9c2 cardiomyocytes through targeting E2F3.
Japanese Familial Cases of Frontotemporal Dementia and Parkinsonism with N279K Tau Gene Mutation
Authors: Oka Yuwa , Saiki Hidemoto , Hashimoto Yasumasa , Terada Yuta , Nakamura Takashi , Ayaki Takashi , Orimo Satoshi , Matsumoto Sadayuki 
Published: October 2020

ABSTRACTBackgroundMutations in the tau gene linked to chromosome 17 cause frontotemporal dementia and parkinsonism (FTDP‐17).ObjectiveThis study presents 3 Japanese familial cases diagnosed with N279K tau gene mutation, including 1 autopsy‐confirmed case.MethodsWe compared the clinical presentations, cognitive functions, and images between the 3 familial cases diagnosed with N279K mutation.ResultsAll 3 patients presented symptoms in their early 40s. One patient showed severe cognitive dysfunction and died in his sixth year after onset. The remaining 2 cases presented with parkinsonism‐dominant clinical features. Among the 2 cases, 1 presented the characteristic symptoms of progressive supranuclear palsy. The pathological features of the dementia‐dominant case showed frontal and temporal lobe‐dominant neuronal loss and gliosis. Tau‐positive neuronal and glial inclusions were found throughout. Further, tufted astrocytes and globose tangles were present whereas there were no Pick bodies and astrocytic plaques, compatible with pathology‐confirmed frontotemporal lobar degeneration (FTLD) ‐tau subtypes.ConclusionsPatients with FTDP‐17 can be classified into the following 2 major groups: dementia and parkinsonism‐plus predominant phenotypes. Among our 3 cases, 1 showed dementia predominance whereas the other 2 showed parkinsonism predominance. Mutations in the microtubule‐associated protein tau (MAPT) present with several pathological features. Clinically, our case presented a behavioral variant frontotemporal dementia (bvFTD). However, morphologically, the observed glial and neuronal pathology met the criteria for progressive supranuclear palsy (PSP). This study highlights the clinical heterogeneity within and between families with same MAPT mutation. Few pathologically confirmed PSP cases have been reported with mutations in MAPT.