bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional anaesthesia quality indicators for adult patients undergoing non‐cardiac surgery: a systematic review
Authors: Hamilton G. M. , MacMillan Y. , Benson P. , Memtsoudis S. , McCartney C. J. L. 
Published: January 2021

SummaryImprovement in healthcare delivery depends on the ability to measure outcomes that can direct changes in the system. An overview of quality indicators within the field of regional anaesthesia is lacking. This systematic review aims to synthesise available quality indicators, as per the Donabedian framework, and provide a concise overview of evidence‐based quality indicators within regional anaesthesia. A systematic literature search was conducted using the databases MEDLINE, Embase, CINAHL and Cochrane from 2003 to present, and a prespecified search of regional anaesthesia society websites and healthcare quality agencies. The quality indicators relevant to regional anaesthesia were subdivided into peri‐operative structure, process and outcome indicators as per the Donabedian framework. The methodological quality of the indicators was determined as per the Oxford Centre for Evidence‐Based Medicine's framework. Twenty manuscripts met our inclusion criteria and, in total, 68 unique quality indicators were identified. There were 4 (6%) structure, 12 (18%) process and 52 (76%) outcome indicators. Most of the indicators were related to the safety (57%) and effectiveness (19%) of regional anaesthesia and were general in nature (60%). In addition, most indicators (84%) were based on low levels of evidence. Our study is an important first step towards describing quality indicators for the provision of regional anaesthesia. Future research should focus on the development of structure and process quality indicators and improving the methodological quality and usability of these indicators.
Robotic colorectal surgery in Australia: evolution over a decade
Authors: Larach José Tomás , Flynn Julie , Kong Joseph , Waters Peadar S. , McCormick Jacob J. , Murphy Declan , Stevenson Andrew , Warrier Satish K. , Heriot Alexander G. 
Published: January 2021

AbstractBackgroundDespite reports of increasing adoption of robotics in colorectal surgery worldwide, data regarding its uptake in Australasia are lacking. This study examines the trends of robotic colorectal surgery in Australia during the last 10 years.MethodsData from patients undergoing robotic colorectal surgery with the da Vinci robotic platform between 2010 and 2019 were obtained. Overall, numbers of specific colorectal procedures across Australia were obtained from the Medicare Benefit Schedule data over the same period. Pearson's correlation analysis was used to determine the statistical trends of overall and specific robotic colorectal procedures over time.ResultsA total of 6110 robotic general surgery procedures were performed across Australia during the study period. Of these, 3522 (57.6%) were robotic colorectal procedures. An increasing trend of overall robotic colorectal procedures was seen over 10 years (Pearson's coefficient of 0.875; P = 0.001). While this applied to both the public and private sectors, 90.7% of the procedures were undertaken in the private sector. Restorative rectal resections, rectopexies, and right hemicolectomies accounted for 82.6% of the robotic colorectal procedures performed during this period with an increasing trend seen over time for each intervention. Moreover, a robotic approach was utilized in 12.5%, 41.0% and 9.0% of all restorative rectal resections, rectopexies and right hemicolectomies undertaken in Australia during 2019, respectively.ConclusionRobotic colorectal surgery has increased dramatically in Australia over the last 10 years, especially in the private sector. Penetration of robotic colorectal surgery in the public healthcare system will require focussed cost–benefit evaluations and governmental investment.
Chest keloids: effect of surgical excision and adjuvant radiotherapy on recurrence, a systematic review and meta‐analysis
Authors: Miles Oliver J. , Zhou Jieyun , Paleri Sarang , Fua Tsien , Ramakrishnan Anand 
Published: January 2021

AbstractBackgroundChest keloids are a difficult sub‐group of scars to treat, likely secondary to the high wound tension in the area that promotes excessive fibroblast proliferation and collagen deposition. Excision and adjuvant radiotherapy has been demonstrated as an efficacious treatment for keloids in general, but no meta‐analysis exists to support the claims for chest keloids. This study aims to identify the rate of recurrence after surgical resection and radiotherapy on patients with chest keloids.MethodsA search was performed using Embase, MEDLINE, Pubmed and Cochrane database on 22 December 2018 for terms ‘radiotherapy’, ‘keloid’ and ‘chest’. Papers included met a prospectively designed inclusion criteria assessed by multiple investigators.ResultsTwelve studies, including 1 randomized controlled trial, were included for a total of 400 patients with a chest keloid scar managed with surgical excision and adjuvant radiotherapy. Overall pooled‐estimate of recurrence rate was 22% (95% CI 12–32%). Meta‐regression did not demonstrate a significant effect for method of wound closure, type of radiotherapy, radiotherapy dose (BED10) and study type.ConclusionExcision and adjuvant radiotherapy represents an effective method of treatment for chest keloids, however sufficient prospective data, including randomized controlled trials, did not yet exist to support these findings. Further studies with sufficient sub‐group analysis for keloid location are required to add to the pool of literature that can be added to this meta‐analysis.
Association of temporal trends in neutrophil lymphocyte ratio on left ventricular assist device patient outcomes
Authors: Solanki Mitesh , Dobson Lucas , Alwair Hazaim , Ghafghazi Shahab , Wysoczynski Marcin , Slaughter Mark S. , Trivedi Jaimin R. 
Published: January 2021

AbstractNeutrophil to lymphocyte ratio (NLR) can predict mortality/complications in left ventricular assist device (LVAD) patients; however, the prognostic value of longitudinal NLR measurements has not been well studied. Here, we examine the mortality/complication incidence in patients with chronically increased NLR verses patients with acutely elevated NLR as a predictor of patient outcomes. This retrospective analysis included 102 patients who underwent LVAD implantation from 2016 to 2018 at a single center. The NLR was calculated at the time of surgery, and at 30 and 90 days after surgery. The NLR values were grouped into categorical data: low, normal (put in range), and high. Patients were classified in 2 groups based on change in their NLR values from surgery to 90 days; the H90 group had sustained increase of NLR over 90‐days and the N90 group had normalization of NLR at 90‐days. Actuarial survival the between study groups was measured using Kaplan–Meier curves. The N90 group had 50 patients (median age 58 (48–66) years, 21% female) at the time of LVAD placement. Group H90 had 52 patients (median age 64 (52–68) years, 16% female). Median age, body mass index (BMI), bilirubin, creatinine, and BNP at time of implant as well as type of device and implant strategy were comparable between the study groups. The post implant survival for N90 group was significantly better than the H90 group at 1 year (93% vs. 80%) and 2 years (90% vs. 67%) (log‐rank P = .001). Early post LVAD survival in patients with elevated NLR over 90 days postoperatively was significantly worse compared to patients who normalized the NLR at 90 days.
Progress in cardiovascular bioprinting
Authors: Quadri Faisal , Soman Soja Saghar , Vijayavenkataraman Sanjairaj 
Published: January 2021

AbstractCardiovascular disease has been the leading cause of death globally for the past 15 years. Following a major cardiac disease episode, the ideal treatment would be the replacement of the damaged tissue, due to the limited regenerative capacity of cardiac tissues. However, we suffer from a chronic organ donor shortage which causes approximately 20 people to die each day waiting to receive an organ. Bioprinting of tissues and organs can potentially alleviate this burden by fabricating low cost tissue and organ replacements for cardiac patients. Clinical adoption of bioprinting in cardiovascular medicine is currently limited by the lack of systematic demonstration of its effectiveness, high costs, and the complexity of the workflow. Here, we give a concise review of progress in cardiovascular bioprinting and its components. We further discuss the challenges and future prospects of cardiovascular bioprinting in clinical applications.
Swept‐source optical coherence tomography objective composite activity score for uveitis
Authors: Llorenç Victor , Serrano Alba R. , Mesquida Marina , Lin Phoebe , Esquinas Cristina , Sainz‐de‐la‐Maza Maite , Metea Christina , Bosch Anna , Calvo Maria , Balter Ariel , Nakamura Yukiko , Molins Blanca , Alba Carmen , Suhler Eric , Adán Alfredo 
Published: January 2021

AbstractPurposeTo develop an objective intraocular inflammation composite score.MethodsCross‐sectional study. Non‐invasive image acquisition and processing were conducted from April 2017 to April 2019. Inflammation‐grade stratified eyes from patients with active, inactive uveitis and healthy controls were recruited. After clinical assessment, four anterior and posterior segment image acquisition protocols per eye, using swept‐source optical coherence tomography (SS‐OCT), were performed at inclusion. Eight imaging biomarkers in three domains: anterior, intermediate and posterior were studied. They were ranked and selected by discriminatory power and correlation with clinical scores. A final SS‐OCT‐derived composite uveitis activity score (SS‐UAS) was developed through multiple linear regression.ResultsWe studied 224 eyes with uveitis (165 active and 59 inactive) from 165 patients (mean age 46.6 SD 15.5 years; 55.3% women) and 38 eyes from 19 healthy controls (mean age 43.6 SD 17.1; 47% women). The selected SS‐OCT‐derived biomarkers to build the final score were anterior chamber hyper‐reflective dots (anterior), high‐definition relative vitreous intensity (intermediate) and the averaged thickened retinal index (posterior). Swept‐source (SS)‐UAS was highly discriminant between active and inactive, and between active and healthy eyes (means 2.06 SD 1.86, 0.93 SD 0.44, and 0.96 SD 0.38, respectively, both p ‐, Mann–Whitney U). Construct validity (Cronbach's alpha = 0.7), internal consistency, criterion validity and reliability (concordance correlation coefficient intra‐rater = 0.99, 95% CI: 0.98–0.99; inter‐rater = 0.98, 95% CI: 0.96–0.99) were favourable.ConclusionsGlobal intraocular inflammation can potentially be staged and scored objectively, continuously, consistently and in a valid manner through the combined processing of SS‐OCT scans.
Quality of vision and vision‐related quality of life after Descemet membrane endothelial keratoplasty: a randomized clinical trial
Authors: Dunker Suryan L. , Dickman Mor M. , Wisse Robert P.L. , Nobacht Siamak , Wijdh Robert H.J. , Bartels Marjolijn C. , Tang N.E. Mei‐Lie , van den Biggelaar Frank J.H.M. , Kruit Pieter J. , Winkens Bjorn , Nuijts Rudy M.M.A. 
Published: January 2021

AbstractPurposeTo compare quality of vision and vision‐related quality of life (QOL) in patients undergoing Descemet membrane endothelial keratoplasty (DMEK) or ultrathin Descemet stripping automated endothelial keratoplasty (DSAEK).MethodsFifty‐four eyes of 54 patients with Fuchs' dystrophy from six corneal clinics in the Netherlands were randomized to DMEK or ultrathin DSAEK and examined preoperatively, and 3, 6 and 12 months postoperatively. Main outcome measures were corneal higher‐order aberrations (HOAs), contrast sensitivity, straylight and vision‐related QOL.ResultsPosterior corneal HOAs decreased after DMEK and increased after ultrathin DSAEK (p ≤ 0.001) 3 months after surgery and correlated positively with best spectacle‐corrected visual acuity (12 months: r = 0.29, p = 0.04). Anterior and total corneal HOAs did not differ significantly between both techniques at any time point. Contrast sensitivity was better (p = 0.01), and straylight was lower (p = 0.01) 3 months after DMEK compared with ultrathin DSAEK; 95% confidence interval [CI] of log(cs) 1.10–1.35 versus 95% CI: 0.84 to 1.12, and 95% CI: log(s) 1.18 to 1.43 versus 95% CI: 1.41 to 1.66, respectively. Both were comparable at later time points. Vision‐related QOL (scale 0–100) did not differ significantly between both groups at any time point and improved significantly at 3 months (β = 12 [95% CI: 7 to 16]; p < 0.001), and subsequently between 3 and 12 months (β = 5 [95% CI: 0 to 9]; p = 0.06).ConclusionsDescemet membrane endothelial keratoplasty (DMEK) results in lower posterior corneal HOAs compared with ultrathin DSAEK. Contrast sensitivity and straylight recover faster after DMEK but reach similar levels with both techniques at 1 year. Vision‐related QOL improved significantly after surgery, but did not differ between both techniques.
What controls salt‐detached contraction in the translational domain of the outer Kwanza Basin, offshore Angola?
Authors: Erdi Aurio , Jackson Christopher A.‐L. 
Published: January 2021

AbstractIt is now well‐established that base‐salt relief drives complex deformation patterns in the mid‐slope domain of salt‐bearing passive margins, in a location classically thought to be dominated by simple horizontal translation. However, due to a lack of detailed studies drawing on high‐quality, 3D seismic reflection data, our understanding of how base‐salt relief controls four‐dimensional patterns of salt‐related deformation in natural systems remains poor. We here use 3D seismic reflection data from, and structural restorations of the Outer Kwanza Basin, offshore Angola to examine the controls on the evolution of variably oriented salt anticlines, rollers, and walls, and related normal and reverse faults. We show that the complex geometries and kinematics of predominantly contractional salt structures reflect up to 22 km of seaward flow of salt and its overburden across prominent base‐salt relief. More specifically, this contractional deformation occurs where the seaward flow of salt is inhibited due to: (a) it flowing being forced to flow up, landward‐dipping ramps; (b) it encountering thicker, slower‐moving salt near the base of seaward‐dipping ramps; or (c) the formation of primary salt welds at the upper hinge of seaward‐dipping ramps. The rate at which salt and its overburden translates seaward varies along strike due to corresponding variations in the magnitude of base‐salt relief and, at a larger, more regional scale, primary salt thickness. As a result of these along‐strike changes in translation rate, overburden rotation accompanies bulk contraction. Our study improves our understanding of salt‐related deformation on passive margins, highlighting the key role of base‐salt relief, and showing contraction, extension and rotation are fundamental processes controlling the structural style of the mid‐slope translational domains of salt basins.
Seed consumption by small fish follows peak seed availability in a tropical dry forest river
Authors: Montes de Oca Vanessa , Wehncke Elisabet V. , Mejía‐Mojica Humberto , Mariano Néstor A. 
Published: January 2021

AbstractWe evaluated seed consumption by fish in an altered tropical dry forest river in Mexico. Non‐natives fishes more than natives ingested significantly more seeds in the rainy season. Fishes follow the peak of seed availability after a flood pulse released them from the soil seed banks.Abstract in spanish is available with online material
Population‐level plant pollination mode is influenced by Quaternary climate and pollinators
Authors: Rech André Rodrigo , Ollerton Jeff , Dalsgaard Bo , Ré Jorge Leonardo , Sandel Brody , Svenning Jens‐Christian , Baronio Gudryan J. , Sazima Marlies 
Published: January 2021

AbstractPatterns in ecology are the products of current factors interacting with history. Nevertheless, few studies have attempted to disentangle the contribution of historical and current factors, such as climate change and pollinator identity and behavior, on plant reproduction. Here, we attempted to separate the relative importance of current and historical processes on geographical patterns of the mating system of the tree speciesCuratella americana(Dilleniaceae). Specifically, we asked the following: (a) How do Quaternary and current climate affect plant mating system? (b) How does current pollinator abundance and diversity relate to plant mating system? (c) How does mating system relate to fruit/seed quantity and quality inC. americana? We recorded pollinators (richness, frequency, and body size) and performed pollination tests in ten populations ofC. americanaspread over 3,000 km in the Brazilian savannah. The frequency of self‐pollination in the absence of pollinators was strongly influenced by historical climatic instability and not by present‐day pollinators. In contrast, seed set from hand‐cross and natural pollination were affected by pollinators (especially large bees) and temperature, indicating the importance of current factors on out‐cross pollination. Two populations at the Southern edge of the species’ distribution showed high level of hand‐cross‐pollination and high flower visitation by large bees, but also a high level of autogamy resulting from recent colonization. Our results indicate that historical instability in climate has favored autogamy, most likely as a reproductive insurance strategy facilitating colonization and population maintenance over time, while pollinators are currently modulating the level of cross‐pollination.
Pathogenicity assessment of variants for breast cancer susceptibility genes based on BRCAness of tumor sample
Authors: Yoshida Reiko , Hagio Taichi , Kaneyasu Tomoko , Gotoh Osamu , Osako Tomo , Tanaka Norio , Amino Sayuri , Yaguchi Noriko , Nakashima Eri , Kitagawa Dai , Ueno Takayuki , Ohno Shinji , Nakajima Takeshi , Nakamura Seigo , Miki Yoshio , Hirota Toru , Takahashi Shunji , Matsuura Masaaki , Noda Tetsuo , Mori Seiichi 
Published: January 2021

AbstractGenes involved in the homologous recombination repair pathway—as exemplified by BRCA1, BRCA2, PALB2, ATM, and CHEK2—are frequently associated with hereditary breast and ovarian cancer syndrome. Germline mutations in the loci of these genes with loss of heterozygosity or additional somatic truncation at the WT allele lead to the development of breast cancers with characteristic clinicopathological features and prominent genomic features of homologous recombination deficiency, otherwise referred to as “BRCAness.” Although clinical genetic testing for these and other genes has increased the chances of identifying pathogenic variants, there has also been an increase in the prevalence of variants of uncertain significance, which poses a challenge to patient care because of the difficulties associated with making further clinical decisions. To overcome this challenge, we sought to develop a methodology to reclassify the pathogenicity of these unknown variants using statistical modeling of BRCAness. The model was developed with Lasso logistic regression by comparing 116 genomic attributes derived from 37 BRCA1/2 biallelic mutant and 32 homologous recombination‐quiescent breast cancer exomes. The model showed 95.8% and 86.7% accuracies in the training cohort and The Cancer Genome Atlas validation cohort, respectively. Through application of the model for variant reclassification of homologous recombination‐associated hereditary breast and ovarian cancer causal genes and further assessment with clinicopathological features, we finally identified one likely pathogenic and five likely benign variants. As such, the BRCAness model developed from the tumor exome was robust and provided a reasonable basis for variant reclassification.
Serum exosomal miR‐638 is a prognostic marker of HCC via downregulation of VE‐cadherin and ZO‐1 of endothelial cells
Authors: Yokota Yuki , Noda Takehiro , Okumura Yuichiro , Kobayashi Shogo , Iwagami Yoshifumi , Yamada Daisaku , Tomimaru Yoshito , Akita Hirofumi , Gotoh Kunihito , Takeda Yutaka , Tanemura Masahiro , Murakami Takashi , Umeshita Koji , Doki Yuichiro , Eguchi Hidetoshi 
Published: January 2021

AbstractHepatocellular carcinoma (HCC) is the second leading cause of cancer‐related death. High recurrence rates after curative resection and the lack of specific biomarkers for intrahepatic metastases are major clinical problems. Recently, exosomal microRNAs (miRNAs) have been reported to have a role in the formation of the pre‐metastatic niche and as promising biomarkers in patients with malignancy. Here we aimed to clarify the molecular mechanisms of intrahepatic metastasis and to identify a novel biomarker miRNA in patients with HCC. A highly intrahepatic metastatic cell line (HuH‐7M) was established by in vivo selection. HuH‐7M showed increased proliferative ability and suppression of apoptosis and anoikis. HuH‐7M and the parental cell (HuH‐7P) showed the similar expression of epithelial‐mesenchymal transition markers and cancer stem cell markers. In vivo, mice treated with exosomes derived from HuH‐7M showed increased tumorigenesis of liver metastases. Exosomes from HuH‐7M downregulated endothelial cell expression of vascular endothelial‐cadherin (VE‐cadherin) and zonula occludens‐1 (ZO‐1) in non‐cancerous regions of liver and increased the permeability of FITC‐dextran through the monolayer of endothelial cells. The miRNAs (miR‐638, miR‐663a, miR‐3648, and miR‐4258) could attenuate endothelial junction integrity by inhibiting VE‐cadherin and ZO‐1 expression. In patients with HCC, higher serum exosomal miR‐638 expression was associated with tumor recurrence. In conclusion, the miRNAs secreted from a highly metastatic cancer cell can promote vascular permeability via downregulation of endothelial expression of VE‐cadherin and ZO‐1. Serum exosomal miR‐638 expression holds potential for serving as a significant and independent prognostic marker in HCC.
Efficacy of intracameral antibiotics following manual small incision cataract surgery in reducing the rates of endophthalmitis: A meta‐analysis
Authors: Rana Khizar , Bahrami Bobak , van Zyl Lourens , Esterman Adrian , Goggin Michael 
Published: January 2021

AbstractBackgroundManual small incision cataract surgery (MSICS) is a widely used technique for cataract surgery in the developing world. Higher rates of postoperative endophthalmitis have been reported with this technique compared with phaco‐emulsification. The purpose of this study was to evaluate the efficacy of prophylactic intracameral (IC) antibiotics in reducing the rates of postoperative endophthalmitis following MSICS.MethodsSystematic review and meta‐analysis of patients undergoing MSICS. A literature search in PubMed and EMBASE databases was performed to identify studies published from October 1992 to April 2020 evaluating MSICS with a minimum of 500 eyes reported. Two authors independently assessed eligibility, extracted data and assessed the risk of bias. Heterogeneity was assessed using the I2 test.ResultsTwelve studies enrolling 1 494 307 eyes were included. IC antibiotics were used in 725 324 (48.5%) eyes. The risk ratio of developing endophthalmitis was 2.94 (95% CI, 1.07‐8.12; P = .037) in eyes that did not receive IC antibiotics.ConclusionsRoutine use of IC antibiotics may help to reduce the rates of endophthalmitis following MSICS and significantly improve the safety of this effective form of cataract surgery.