bluuebunny/crossref_metadata_2025_split huggingface dataset:
Success of extracorporeal shock wave lithotripsy and ERCP in symptomatic pancreatic duct stones: a systematic review and meta-analysis
Authors: van Huijgevoort Nadine C.M. , Veld Joyce V. , Fockens Paul , Besselink Marc G. , Boermeester Marja A. , Arvanitakis Marianna , van Hooft Jeanin E. 
Published: July 2020

Abstract
Background and study aims Pain is the most frequent and dominant symptom of chronic pancreatitis. Currently, these patients are treated using a step-up approach, including analgesics and lifestyle adjustments, endoscopic, and eventually surgical treatment. Extracorporeal shock wave lithotripsy (ESWL) is indicated after failure of the first step in patients with symptomatic intraductal stones larger than 5 mm in the head or body of the pancreas. To assess the complete ductal clearance rate and pain relief after ESWL in patients with symptomatic chronic pancreatitis with pancreatic duct stones, a systematic review and meta-analysis was performed.
Patients and methods A systematic literature search from January 2000 to December 2018 was performed in PubMed, the Cochrane Library, and EMBASE for studies on ductal clearance rate of ESWL in patients with symptomatic chronic pancreatitis with pancreatic duct stones.
Results After screening 486 studies, 22 studies with 3868 patients with chronic pancreatitis undergoing ESWL for pancreatic duct stones were included. The pooled proportion of patients with complete ductal clearance was 69.8 % (95 % CI 63.8–75.5). The pooled proportion of complete absence of pain during follow-up was 64.2 % (95 % CI 57.5–70.6). Complete stone fragmentation was 86.3 % (95 % CI 76.0–94.0). Post-procedural pancreatitis and cholangitis occurred in 4.0 % (95 % CI 2.5–5.8) and 0.5 % (95 % CI 0.2–0.9), respectively.
Conclusion Treatment with ESWL results in complete ductal clearance rate in a majority of patients, resulting in absence of pain during follow up in over half of patients with symptomatic chronic pancreatitis caused by obstructing pancreatic duct stones.
Utility and safety of balloon-assisted enteroscopy in patients with left ventricular assist devices: a retrospective multicenter study
Authors: Hasan Badar M. , McMahon Charles , Khalid Rumman A. , Colak Yasar , Mayorga Daniel C. , Elkafrawy Ahmed , Tandon Kanwarpreet , Shafiq Muhammad , Hussain Ishtiaq , Erim Tolga , Castro Fernando , Charles Roger , Chhabra Rajiv 
Published: July 2020

Abstract
Objective and study aims Patients with left-ventricular assist devices (LVADs) have an increased risk of gastrointestinal bleeding, especially from the small bowel, often necessitating evaluation with balloon-assisted enteroscopy (BAE). Our study aimed to assess the periprocedural safety and utility of BAE for gastrointestinal bleeding in patients with LVADs.
Patients and methods This was a multicenter retrospective cohort study of adults with LVADs who underwent BAE between January 2007 to December 2018.
Results Thirty-four patients underwent a total of 46 BAEs (9 were single-balloon enteroscopies [SBEs] and 37 were double-balloon enteroscopies [DBEs]). Mean age of patients was 66.4 ± 8.3 years. Patients tolerated anesthesia well, without complications. There were no complications from the BAE itself. One patient required repeat BAE due to a progressive drop in hemoglobin and another patient developed paroxysmal supraventricular tachycardia. One patient died within 72 hours of the procedure due to worsening of LVAD thrombosis. Diagnostic yields were 69.6 % for all procedures, 73.0 % for DBE and 55.6 % for SBE (P = 0.309). Therapeutic yields were 67.4 % overall: 73.0 % for DBE and 44.4 % for SBE (P = 0.102). In those that presented with overt gastrointestinal bleeding, DBE had a higher diagnostic yield compared to SBE (84.2 % vs. 42.9 %; P = 0.057) and a significantly higher therapeutic yield (84.2 % vs. 28.6 %; p = 0.014).
Conclusions This is the largest multicenter study of patients with LVADs who underwent DBE. BAE appears to be a safe and useful modality for the evaluation of gastrointestinal bleeding in these patients.
Management of delayed bleeding after endoscopic mucosal resection of large colorectal polyps: a retrospective multi-center cohort study
Authors: van der Star Simone , Moons Leon M.G. , ter Borg Frank , van Bergeijk Jeroen D. , Geesing Joost M.J. , Groen John N. , Ouwehand Renske J. , Vleggaar Frank P. , de Vos tot Nederveen Cappel Wouter H. , Wolfhagen Frank H.J. , Schwartz Matthijs P. , Didden Paul 
Published: July 2020

Abstract
Background and study aims Delayed bleeding (DB) is the most frequent major adverse event after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps (LNPCPs). Evidence-based guidelines for management of DB are lacking. We aimed to evaluate the clinical presentation, treatment and outcome of patients with DB and to determine factors associated with hemostatic therapy.
Patients and methods Patients with DB were identified by analyzing all consecutive EMR procedures for LNPCPs (≥ 2 cm) from one academic center (2012–2017) and seven regional hospitals (2015–2017). DB was defined as any postprocedural bleeding necessitating emergency department presentation, hospitalization or reintervention. Outcome of DB was assessed for three clinical scenarios: continued bleeding (CB), spontaneous resolution without recurrent bleeding during 24 hours observation (SR), and recurrent bleeding (RB). Variables associated with hemostatic therapy were analyzed using logistic regression.
Results DB occurred after 42/542 (7.7 %) EMR procedures and re-colonoscopy was performed in 30 patients (72 %). Re-colonoscopy and hemostatic therapy rates were 92 % and 75 % for CB (n = 24), 25 % and 8 % for SR (n = 12), and 83 % and 67 % for RB (n = 6), respectively. Frequent hematochezia (≥ hourly) was the only factor significantly associated with hemostatic therapy (RR 2.23, p = 0.01). Re-bleeding after endoscopic hemostatic therapy occurred in 3/22 (13.6 %) patients.
Conclusion Ongoing or recurrent hematochezia is associated with a high rate of hemostatic therapy, warranting re-colonoscopy in these patients. A conservative approach is justified when bleeding spontaneously settles, and without recurrent hematochezia during 24 hours observation patients can be safely discharged without endoscopic re-examination.
Cholangiopancreatoscopy-guided laser dissection and ablation for pancreas and biliary strictures and neoplasia
Authors: Han Samuel , Shah Raj J. 
Published: July 2020

Abstract
Background and study aims Cholangiopancreatoscopy-guided laser dissection or ablation (CPL) is a novel therapeutic modality for refractory benign strictures. Our aim was to describe the safety and efficacy of CPL for pancreaticobiliary disorders.
Patients and methods Patients who underwent CPL using holmium or thulium laser between February 2017 and September 2019 were included. For stricture dissection, gentle strokes of the laser fiber from a distal to proximal approach were applied until luminal patency permitted advancement of the cholangiopancreatoscope. Immediate technical success was defined as ability to traverse the stricture with the cholangiopancreatoscope after CPL. Short-term technical success was defined as > 90 % resolution of the stricture on follow-up pancreatogram.
Results Eleven patients underwent a mean of 3.6 ERCPs (mean total diameter of 14.2 Fr of stenting) prior to CPL. Indications included pancreatic duct stricture (n = 8), pancreaticojejunostomy anastomotic stricture (n = 1), bile duct stricture (n = 1) and pancreatic intraductal papillary mucinous neoplasm ablation (n = 1). Immediate technical success was 94.1 % and short-term technical success rates was 88.2 %. At a mean follow-up of 12.1 months, there have been no stricture recurrences.
Conclusions CPL may be an effective therapy for strictures refractory to conventional dilation and multiple stenting.
Contact-Tracing-Apps als unterstützende Maßnahme bei
der Kontaktpersonennachverfolgung von COVID-19
Authors: Jahnel Tina , Kernebeck Sven , Böbel Simone , Buchner Benedikt , Grill Eva , Hinck Sebastian , Ranisch Robert , Rothenbacher Dietrich , Schüz Benjamin , Starke Dagmar , Wienert Julian , Zeeb Hajo , Gerhardus Ansgar 
Published: July 2020

ZusammenfassungDie Kontaktpersonennachverfolgung ist derzeit eine der wirksamsten
Maßnahmen zur Eindämmung der COVID-19 Pandemie. Digitales
Contact Tracing mittels Smartphones scheint eine sinnvolle zusätzliche
Maßnahme zur manuellen Kontaktpersonennachverfolgung zu sein, um
Personen zu identifizieren, die nicht bekannt oder nicht erinnerlich sind und um
den zeitlichen Verzug beim Melden eines Infektionsfalles und beim
Benachrichtigen von Kontaktpersonen so gering wie möglich zu halten.
Obwohl erste Modellierungsstudien eine positive Wirkung in Bezug auf eine
zeitnahe Kontaktpersonennachverfolgung nahelegen, gibt es bislang keine
empirisch belastbaren Daten, weder zum bevölkerungsweiten Nutzen noch
zum potenziellen Schaden von Contact-Tracing-Apps. Die Beurteilung der
Zweckerfüllung und eine wissenschaftliche interdisziplinäre
Begleitforschung sowohl zur Wirksamkeit, Risiken und Nebenwirkungen als auch zu
Implementierungsprozessen (z. B. Planung und Einbezug verschiedener
Beteiligter) sind wesentliche Bestandteile einer Nutzen-Risiko Bewertung. Dieser
Beitrag betrachtet daher den möglichen Public-Health-Nutzen sowie
technische, soziale, rechtliche und ethische Aspekte einer Contact-Tracing-App
zur Kontaktpersonennachverfolgung im Rahmen der COVID-19-Pandemie. Weiterhin
werden Bedingungen für eine möglichst breite Nutzung der App
aufgezeigt.
Pharmacokinetics and Safety of Mitragynine in Beagle Dogs
Authors: Maxwell Elizabeth A. , King Tamara I. , Kamble Shyam H. , Raju Kanumuri Siva Rama , Berthold Erin C. , León Francisco , Avery Bonnie A. , McMahon Lance R. , McCurdy Christopher R. , Sharma Abhisheak 
Published: July 2020

AbstractMitragynine is the most abundant psychoactive alkaloid derived from the leaves of Mitragyna speciosa (kratom), a tropical plant indigenous to regions of Southeast Asia. Mitragynine displays a moderate affinity to opioid receptors, and kratom is often self-prescribed to treat pain and/or opioid addiction. The purpose of this study was to investigate the safety and pharmacokinetic properties of mitragynine in the dog. Single dose oral (5 mg/kg) and intravenous (0.1 mg/kg) pharmacokinetic studies of mitragynine were performed in female beagle dogs. The plasma concentrations of mitragynine were measured using ultra-performance liquid chromatography coupled with a tandem mass spectrometer, and the pharmacokinetic properties were analyzed using non-compartmental analysis. Following intravenous administration, mitragynine showed a large volume of distribution (Vd, 6.3 ± 0.6 L/kg) and high clearance (Cl, 1.8 ± 0.4 L/h/kg). Following oral mitragynine dosing,
first peak plasma (Cmax, 278.0 ± 47.4 ng/mL) concentrations were observed within 0.5 h. A potent mu-opioid receptor agonist and active metabolite of mitragynine, 7-hydroxymitragynine, was also observed with a Cmax of 31.5 ± 3.3 ng/mL and a Tmax of 1.7 ± 0.6 h in orally dosed dogs while its plasma concentrations were below the lower limit of quantification (1 ng/mL) for the intravenous study. The absolute oral bioavailability of mitragynine was 69.6%. Administration of mitragynine was well tolerated, although mild sedation and anxiolytic effects were observed. These results provide the first detailed pharmacokinetic information for mitragynine in a non-rodent species (the dog) and therefore also provide significant information for allometric scaling and dose predictions when designing clinical studies.
Clinical impact of endoscopic ultrasound-guided through-the-needle microbiopsy in patients with pancreatic cysts
Authors: Kovacevic Bojan , Klausen Pia , Rift Charlotte Vestrup , Toxværd Anders , Grossjohann Hanne , Karstensen John Gásdal , Brink Lene , Hassan Hazem , Kalaitzakis Evangelos , Storkholm Jan , Hansen Carsten Palnæs , Hasselby Jane Preuss , Vilmann Peter 
Published: July 2020

AbstractBackground The limited data on the utility of endoscopic ultrasound (EUS)-guided through-the-needle biopsies (TTNBs) in patients with pancreatic cystic lesions (PCLs) originate mainly from retrospective studies. Our aim was to determine the clinical impact of TTNBs, their added diagnostic value, and the adverse event rate in a prospective setting.Methods This was a prospective, single-center, open-label controlled study. Between February 2018 and August 2019, consecutive patients presenting with a PCL of 15 mm or more and referred for EUS were included. Primary outcome was a change in clinical management of PCLs following TTNB compared with cross-sectional imaging and cytology. Adverse events were defined according to the ASGE lexicon.Results 101 patients were included. TTNBs led to a change in clinical management in 11.9 % of cases (n = 12). Of these, 10 had serous cysts and surveillance was discontinued, while one of the remaining two cases underwent surgery following diagnosis of a mucinous cystic neoplasm. The diagnostic yield of TTNBs for a specific cyst diagnosis was higher compared with FNA cytology (69.3 % vs. 20.8 %, respectively; P < 0.001). The adverse event rate was 9.9 % (n = 10; 95 % confidence interval 5.4 % – 17.3 %), with the most common event being acute pancreatitis (n = 9). Four of the observed adverse events were severe, including one fatal outcome.Conclusions TTNBs resulted in a change of clinical management in about one in every 10 patients; however, the associated adverse event risk was substantial. Further studies are warranted to elucidate in which subgroups of patients the clinical benefit outweighs the risks.
The Effects of Delayed Cord Clamping on 12-Month Brain Myelin Content and Neurodevelopment: A Randomized Controlled Trial
Authors: Mercer Judith S. , Erickson-Owens Debra A. , Deoni Sean C.L. , Dean III Douglas C. , Tucker Richard , Parker Ashley B. , Joelson Sarah , Mercer Emily N. , Collins Jennifer , Padbury James F. 
Published: July 2020

Objective This study aimed to determine if delayed cord clamping (DCC) affected brain myelin water volume fraction (VFm) and neurodevelopment in term infants.
Study Design This was a single-blinded randomized controlled trial of healthy pregnant women with term singleton fetuses randomized at birth to either immediate cord clamping (ICC) (≤ 20 seconds) or DCC (≥ 5 minutes). Follow-up at 12 months of age consisted of blood work for serum iron indices and lead levels, a nonsedated magnetic resonance imaging (MRI), followed within the week by neurodevelopmental testing.
Results At birth, 73 women were randomized into one of two groups: ICC (the usual practice) or DCC (the intervention). At 12 months, among 58 active participants, 41 (80%) had usable MRIs. There were no differences between the two groups on maternal or infant demographic variables. At 12 months, infants who had DCC had increased white matter brain growth in regions localized within the right and left internal capsules, the right parietal, occipital, and prefrontal cortex. Gender exerted no difference on any variables. Developmental testing (Mullen Scales of Early Learning, nonverbal, and verbal composite scores) was not significantly different between the two groups.
Conclusion At 12 months of age, infants who received DCC had greater myelin content in important brain regions involved in motor function, visual/spatial, and sensory processing. A placental transfusion at birth appeared to increase myelin content in the early developing brain.
Key Points
Protecting Breastfeeding during the COVID-19 Pandemic
Authors: Cheema Ritu , Partridge Elizabeth , Kair Laura R. , Kuhn-Riordon Kara M. , Silva Angelique I. , Bettinelli Maria E. , Chantry Caroline J. , Underwood Mark A. , Lakshminrusimha Satyan , Blumberg Dean 
Published: July 2020

The severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2) pandemic has impacted all patient populations including pregnant mothers. There is an incomplete understanding of SARS-CoV-2 pathogenesis and transmission potential at this time and the resultant anxiety has led to variable breastfeeding recommendations for suspected or confirmed mothers with novel coronavirus disease 2019 (COVID-19). Due to the potential concern for transmission of infection from maternal respiratory secretions to the newborn, temporary separation of the maternal-baby dyad, allowing for expressed breast milk to be fed to the infant, was initially recommended but later revised to include breastfeeding by the American Academy of Pediatrics in contrast to international societies, which recommend direct breastfeeding. This separation can have negative health and emotional implications for both mother and baby. Only two publications have reported SARS-CoV-2 in human breast milk but the role of breast milk as a vehicle of transmission of COVID-19 to the newborns still remains unclear and may indeed be providing protective antibodies against SARS-CoV-2 infection even in infected neonates. Other modes of transmission of infection to neonates from infected mothers or any care providers cannot be overemphasized. Symptomatic mothers on hydroxychloroquine can safely breastfeed and no adverse effects were reported in a baby treated with remdesivir in another drug trial. The excretion of sarilumab in human breast milk is unknown at this time. Hence, given the overall safety of breast milk and both short-term and long-term nutritional, immunological, and developmental advantages of breast milk to newborn, breast milk should not be withheld from baby. The setting of maternal care, severity of maternal infection and availability of resources can impact the decision of breastfeeding, the role of shared decision making on breastfeeding between mother and physician needs to be emphasized. We strongly recommend direct breastfeeding with appropriate hygiene precautions unless the maternal or neonatal health condition warrants separation of this dyad.
Key Points
Plastic Surgery in the Time of COVID-19
Authors: Chi David , Chen Austin D. , Dorante Miguel I. , Lee Bernard T. , Sacks Justin M. 
Published: July 2020

Abstract
Background The novel coronavirus disease 2019 (COVID-19) has swept the world in the last several months, causing massive disruption to existing social, economic, and health care systems. As with all medical fields, plastic and reconstructive surgery has been profoundly impacted across the entire spectrum of practice from academic medical centers to solo private practice. The decision to preserve vital life-saving equipment and cancel elective procedures to protect patients and medical staff has been extremely challenging on multiple levels. Frequent and inconsistent messaging disseminated by many voices on the national stage often conflicts and serves only to exacerbate an already difficult decision-making process.
Methods A survey of relevant COVID-19 literature is presented, and bioethical principles are utilized to generate guidelines for plastic surgeons in patient care through this pandemic.
Results A cohesive framework based upon core bioethical values is presented here to assist plastic surgeons in navigating this rapidly evolving global pandemic.
Conclusion Plastic surgeons around the world have been affected by COVID-19 and will adapt to continue serving their patients. The lessons learned in this present pandemic will undoubtedly prove useful in future challenges to come.
Calcium-triggered fusion of lipid membranes is enabled by amphiphilic nanoparticles
Authors: Tahir Mukarram A. , Guven Zekiye P. , Arriaga Laura R. , Tinao Berta , Yang Yu-Sang Sabrina , Bekdemir Ahmet , Martin Jacob T. , Bhanji Alisha N. , Irvine Darrell , Stellacci Francesco , Alexander-Katz Alfredo 
Published: July 2020

Significance
Lipid membrane fusion is a critical component of biological transport, communication, and developmental processes. The fusion reaction is kinetically constrained since it contains multiple large energy barriers, so proteins and ions are used by natural systems to intervene and catalyze the reaction toward biologically relevant timescales. Here, we demonstrate how amphiphilic nanoparticles can prime lipid membranes for fusion so that complete fusion proceeds only upon exposure to an excess of calcium or other stimulus that would stress the outer leaflet. This is a major advance in the nascent field of controlled fusion and may unlock new avenues of research on how nanomaterials can be designed from first principles to perform targeted functional roles in biological systems.
Thermodynamic energetics underlying genomic instability and whole-genome doubling in cancer
Authors: Remacle Francoise , Graeber Thomas G. , Levine R. D. 
Published: July 2020

Significance
Genomic instability is characteristic of the majority of cancers. It includes changes of copy numbers of genes and chromosomes during diverse cell processes, such as genome replication. Genomic instability is a strong biomarker of poor prognosis. An analysis of DNA copy numbers in human tumors across different cancers reveals an instability in an energetic sense: The free energy of the distribution of gene loci copy numbers in each tumor is found to be a monotonically increasing and universal function of the mean chromosome ploidy in that tumor. This relates the biological (genomic instability) with the physicochemical stability criterion. The analysis also shows that it is energetically more favorable for genome doubling to occur from a not-already-fragmented genome.
Specific thylakoid protein phosphorylations are prerequisites for overwintering of Norway spruce (
Picea abies
) photosynthesis
Authors: Grebe Steffen , Trotta Andrea , Bajwa Azfar Ali , Mancini Ilaria , Bag Pushan , Jansson Stefan , Tikkanen Mikko , Aro Eva-Mari 
Published: July 2020

Significance
During overwintering, evergreen conifers of boreal forests must cope with freezing temperatures and high light intensities that often occur simultaneously and expose the photosynthetic apparatus to oxidative damage. To mitigate damage, conifers have developed a specific photoprotection mechanism, called sustained nonphotochemical quenching (sustained NPQ). Here we provide evidence for involvement of unique posttranslational phosphorylations of thylakoid proteins in sustained NPQ of spruce. The triply phosphorylated LHCB1 isoform and phospho-PSBS protein appear as prerequisites for development of sustained NPQ that safely dissipate absorbed light energy as heat. While the induction of Lhcb1 triple phosphorylation requires only freezing temperatures, the triggering of sustained NPQ is additionally dependent on light-induced PSBS phosphorylation, likely in concert with limited photoinhibition of photosystem II.
Co-option of the lineage-specificLAVAretrotransposon in the gibbon genome
Authors: Okhovat Mariam , Nevonen Kimberly A. , Davis Brett A. , Michener Pryce , Ward Samantha , Milhaven Mark , Harshman Lana , Sohota Ajuni , Fernandes Jason D. , Salama Sofie R. , O’Neill Rachel J. , Ahituv Nadav , Veeramah Krishna R. , Carbone Lucia 
Published: July 2020

SignificanceTransposable elements (TEs) are genetic units that can selfishly propagate in a host genome. Despite often being considered “junk,” TEs can occasionally acquire useful functions such as regulating expression of nearby host genes. Here, we study gibbons, small apes whose genome contains a unique TE calledLAVA(LINE-AluSz-VNTR-AluLIKE). We present evidence indicating that several LAVA insertions function as gene regulatory elements in the gibbon genome. Two of these insertions were also favored/preserved by natural selection, further indicating their functional importance for gibbons. Both of these LAVA elements were found inside genes that facilitate correct repair of DNA breaks, suggesting that LAVA’s incorporation in these genes may have influenced the regulation of biological processes that are crucial for maintaining genome integrity.