bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-L03 The efficacy and safety of controlled low central venous pressure for liver resection: a systematic review and meta-analysis
Authors: Chen Zhong , Sun Dundong , Wang Feiran 
Published: December 2021

Abstract

Background
Partial hepatectomy is an effective treatment for benign and malignant liver diseases . However, intraoperative bleeding is one of the major factors affecting the outcome of hepatectomy. Currently, the most commonly used method of hepatic blood flow occlusion in clinical practice is Pringle method, but this method has a great impact on liver function and can cause hepatic ischemia-reperfusion injury. .Studies have shown that blood loss volume during hepatectomy is related to central venous pressure (CVP) . Intraoperative control of central venous pressure (LCVP) is increasingly popular in hepatectomy, but its effectiveness and safety remain controversial.

Methods
The main result of the analysis was to reduce the blood loss and blood infusion. Secondary outcomes included operative time, fluid infusion, urine volume, ALT, TBIL, BUN, CR, postoperative complication rates and length of hospital stay. Statistical analysis was performed using RevMan 5.3 software (Cochrane Collaboration, Oxford, England). The results of all studies were measured by mean ± standard deviation. If there is significant heterogeneity between the results (P &lt; 0.05), a random-effects model is used. A fixed-effect model was used when there was no significant heterogeneity (P &gt; 0.05). Heterogeneity was assessed using the Cochrane χ2 text .

Results
In total, 10 studies, involving 324 patients undergoing liver resection with controlled low central venous pressure, were identified. Meta-analysis showed that blood loss in the LCVP group was significantly less than that in the control group ( P = 0.0002). blood transfusion in the LCVP group was also significantly less than that in the control group(P = 0.0006). there was no difference between LCVP group and control group in operation time(P = 0.17), fluid infusion( P = 0.46), urinary volume(P = 0.38), ALT( P = 0.23), TBIL(P = 0.86), BUN(P = 0.67), CR(P =0.59), postoperative complication rates( P = 0.01) and hospital stay(P = 0.26).

Conclusions
Compared with the control, controlled low central venous pressure showed comparable efficacy and safety for the treatment during liver resection.
P-O04 The effect of a pre- and post- operative exercise programme versus standard care on physical fitness of patients with oesophageal and gastric cancer undergoing neoadjuvant treatment prior to surgery (The PERIOP-OG Trial): A Randomised controlled trial
Authors: Loughney Lisa , Tully Roisin , Bolger Jarlath. C , Sorensen Jan , McAnena Oliver , Collins Chris. G , Carroll Paul. A , Arumugasamy Mayilone , Murphy Thomas. J , McCaffrey Noel , Robb William. B 
Published: December 2021

Abstract

Background
Neoadjuvant cancer treatment (NCT) reduces physical fitness prior to surgery. Lower levels of fitness pre-operatively are associated with increased risk of post-operative morbidity and prolonged recovery. Exercise prehabilitation can optimise fitness for surgery. There is a paucity of evidence regarding the role of community-based exercise programmes during oncological treatment of oesophagogastric malignancies. The aim of the PERIOP-OG trial was to investigate the effect of a community-based exercise prehabilitation programme on physical fitness and other clinical outcomes in patients undergoing NCT and surgical resection for oesophagogastric malignancies.

Methods
Between March 2019 and December 2020, patients with oesophagogastric cancers requiring NCT and surgery were recruited to a multi-centre randomised controlled trial that compared an exercise prehabilitation group to a usual care control group. The exercise programme commenced following cancer diagnosis. All participants undertook assessments at baseline, end of NCT and pre-surgery. The primary endpoint was improvement in cardiorespiratory fitness, measured by the 6-min walk test (6MWT), from baseline and pre-surgery. Secondary endpoints included upper and lower body strength tests (grip strength and 10-sec sit to stand), EQ-5D-5L Health Questionnaire (EQ-5D-5L), Functional Assessment of Cancer Therapy (FACT-E) Questionnaire and Surgical Fear Questionnaire (SFQ).

Results
Seventy-one patients were randomised (exercise n = 36, control n = 35). Baseline characteristics between groups were comparable: mean age (p = 0.87) and sex (p = 0.24). The difference-in-difference (DID) for the exercise prehabilitation showed a significant improvement in 6MWT pre-surgery compared to the usual care group from baseline to pre-surgery: mean (standard deviation) 522 m (17.4) to 582 m (20.1) vs. 498 m (18.2) to 506 m (28.7), p = 0.050. There was no significant DID in grip strength p = 0.770, 10-sec sit to stand (p = 0.100), EQ-5D-5L (p = 0.311), FACT-E (p = 0.105) or SFQ (p = 0.350).

Conclusions
The PERIOP-OG trial demonstrates that a community-based exercise prehabilitation programme initiated at diagnosis, continued during NCT and up to the time of surgery, significantly improves cardiorespiratory fitness. This community exercise prehabilitation model is feasible and sustainable and may provide a standardised framework for the prescription of exercise in oesophagogastric cancer patients.
P-OGC15 Impact of postoperative systemic treatment on survival for oesophageal adenocarcinoma after preoperative chemotherapy and oesophagectomy
Authors: Rahman Saqib , Thomas Betsan , Maynard Nick , Park Min Hae , Wahedally Muhammed , Trudgill Nigel , Crosby Tom , Cromwell David , Underwood Tim 
Published: December 2021

Abstract

Background
Perioperative chemotherapy is widely used in the treatment of oesophageal cancer with substantial survival benefit over surgery alone. However, the postoperative part of these regimens is given in less than half of cases, reflecting uncertainty about its benefit. This study estimates the effect of postoperative chemotherapy after surgery for oesophageal cancer using a large population-based dataset and modern statistical methods.

Methods
Patients with oesophageal adenocarcinoma diagnosed between 2012 and 2018 and underwent preoperative chemotherapy followed by surgery, were identified from a national level audit in England and Wales (National Oesophagogastric Cancer Audit). Postoperative therapy was defined as the receipt of at least one cycle of systemic chemotherapy within 90 days of surgery. The comparative effectiveness of postoperative chemotherapy compared to observation was estimated using inverse propensity treatment weighting (IPTW).

Results
The study included 2,814 patients, in whom postoperative therapy was given to 1,054 (37.5%). Patients who received postoperative therapy were younger, with a lower ASA grade and were less likely to have surgical complications of any type, including anastomotic leak (all p &lt; 0.001). Tumour characteristics were similar in both groups. Weighted median survival times for patients having no treatment or postoperative chemotherapy were 45.4 months and 57.5 months respectively. There was a life expectancy difference at five years of 2.9 months in favour of postoperative chemotherapy (95%CI 1.1–4.8 months, p &lt; 0.001) with a Hazard Ratio of 0.80 (95%CI 0.70-0.91, p &lt; 0.001).

Conclusions
Among patients with oesophageal adenocarcinoma treated with preoperative chemotherapy and surgery, improved overall survival was observed in those patients who received postoperative chemotherapy. Minimising surgical complications and improving patient fitness could increase the use of postoperative chemotherapy, leading to better outcomes for patients with oesophageal adenocarcinoma.
mTORC1 functional assay revealsSZT2loss-of-function variants and a founder in-frame deletion
Authors: Calhoun Jeffrey D , Aziz Miriam C , Happ Hannah C , Gunti Jonathan , Gleason Colleen , Mohamed Najma , Zeng Kristy , Hiller Meredith , Bryant Emily , Mithal Divakar S , Bellinski Irena , Kinsley Lisa , Grimmel Mona , Schwaibold Eva M C , Smith-Hicks Constance , Chassevent Anna , Scala Marcello , Accogli Andrea , Torella Annalaura , Striano Pasquale , Capra Valeria , Bird Lynne M , Ben-Sahra Issam , Ekhilevich Nina , Hershkovitz Tova , Weiss Karin , Millichap John , Gerard Elizabeth E , Carvill Gemma L 
Published: December 2021

AbstractBiallelic pathogenic variants in SZT2 result in a neurodevelopmental disorder with shared features, including early-onset epilepsy, developmental delay, macrocephaly, and corpus callosum abnormalities. SZT2 is as a critical scaffolding protein in the amino acid sensing arm of the mTORC1 signalling pathway. Due to its large size (3432 amino acids), lack of crystal structure, and absence of functional domains, it is difficult to determine the pathogenicity of SZT2 missense and in-frame deletions, but these variants are increasingly detected and reported by clinical genetic testing in individuals with epilepsy. To exemplify this latter point, here we describe a cohort of 12 individuals with biallelic SZT2 variants and phenotypic overlap with SZT2-related neurodevelopmental disorders. However, the majority of individuals carried one or more SZT2 variants of uncertain significance (VUS), highlighting the need for functional characterization to determine, which, if any, of these VUS were pathogenic. Thus, we developed a novel individualized platform to identify SZT2 loss-of-function variants in the context of mTORC1 signalling and reclassify VUS. Using this platform, we identified a recurrent in-frame deletion (SZT2 p.Val1984del) which was determined to be a loss-of-function variant and therefore likely pathogenic. Haplotype analysis revealed that this single in-frame deletion is a founder variant in those of Ashkenazi Jewish ancestry. Moreover, this approach allowed us to tentatively reclassify all of the VUS in our cohort of 12 individuals, identifying five individuals with biallelic pathogenic or likely pathogenic variants. Clinical features of these five individuals consisted of early-onset seizures (median 24 months), focal seizures, developmental delay and macrocephaly similar to previous reports. However, we also show a widening of the phenotypic spectrum, as none of the five individuals had corpus callosum abnormalities, in contrast to previous reports. Overall, we present a rapid assay to resolve VUS in SZT2, identify a founder variant in individuals of Ashkenazi Jewish ancestry, and demonstrate that corpus callosum abnormalities is not a hallmark feature of this condition. Our approach is widely applicable to other mTORopathies including the most common causes of the focal genetic epilepsies, DEPDC5, TSC1/2, MTOR and NPRL2/3.
Early lysosome defects precede neurodegeneration with amyloid-β and tau aggregation in NHE6-null rat brain
Authors: Lee YouJin , Miller Morgan R , Fernandez Marty A , Berg Elizabeth L , Prada Adriana M , Ouyang Qing , Schmidt Michael , Silverman Jill L , Young-Pearse Tracy L , Morrow Eric M 
Published: December 2021

AbstractLoss-of-function mutations in the X-linked endosomal Na+/H+ exchanger 6 (NHE6) cause Christianson syndrome in males. Christianson syndrome involves endosome dysfunction leading to early cerebellar degeneration, as well as later-onset cortical and subcortical neurodegeneration, potentially including tau deposition as reported in post-mortem studies. In addition, there is reported evidence of modulation of amyloid-β levels in experimental models wherein NHE6 expression was targeted. We have recently shown that loss of NHE6 causes defects in endosome maturation and trafficking underlying lysosome deficiency in primary mouse neurons in vitro. For in vivo studies, rat models may have an advantage over mouse models for the study of neurodegeneration, as rat brain can demonstrate robust deposition of endogenously-expressed amyloid-β and tau in certain pathological states. Mouse models generally do not show the accumulation of insoluble, endogenously-expressed (non-transgenic) tau or amyloid-β. Therefore, to study neurodegeneration in Christianson syndrome and the possibility of amyloid-β and tau pathology, we generated an NHE6-null rat model of Christianson syndrome using CRISPR-Cas9 genome-editing. Here, we present the sequence of pathogenic events in neurodegenerating NHE6-null male rat brains across the lifespan. NHE6-null rats demonstrated an early and rapid loss of Purkinje cells in the cerebellum, as well as a more protracted neurodegenerative course in the cerebrum. In both the cerebellum and cerebrum, lysosome deficiency is an early pathogenic event, preceding autophagic dysfunction. Microglial and astrocyte activation also occur early. In the hippocampus and cortex, lysosome defects precede loss of pyramidal cells. Importantly, we subsequently observed biochemical and in situ evidence of both amyloid-β and tau aggregation in the aged NHE6-null hippocampus and cortex (but not in the cerebellum). Tau deposition is widely distributed, including cortical and subcortical distributions. Interestingly, we observed tau deposition in both neurons and glia, as has been reported in Christianson syndrome post-mortem studies previously. In summary, this experimental model is among very few examples of a genetically modified animal that exhibits neurodegeneration with deposition of endogenously-expressed amyloid-β and tau. This NHE6-null rat will serve as a new robust model for Christianson syndrome. Furthermore, these studies provide evidence for linkages between endolysosome dysfunction and neurodegeneration involving protein aggregations, including amyloid-β and tau. Therefore these studies may provide insight into mechanisms of more common neurodegenerative disorders, including Alzheimer’s disease and related dementias.
Rethinking the everyday domestic sphere: Palestinian women as environmentalist and anti-colonial warriors
Authors: Shqair Manal , Soliman Mahmoud 
Published: December 2021

Abstract
This paper examines the role of rural Palestinian women in the South Hebron Hills (SHH) in fighting back against both Israeli settler colonial practices and environmental destruction resulting from such practices. We contend that Israel is waging a war on the environment as a tool to deprive Palestinians in Area ‘C’ of what sustains life, land and natural resources. Through their everyday practices of defiance, we argue that, rural women wielding an indigenous lifestyle of farming in the SHH create an agro-ecological structure of sumud, or steadfastness through their domestic everyday practices, where they strengthen their attachment to the land and regenerate the environment.
Enterococcus Intestinal Domination Is Associated With Increased Mortality in the Acute Leukemia Chemotherapy Population
Authors: Messina Julia A , Tan Chin Yee , Ren Yi , Hill Lauren , Bush Amy , Lew Meagan , Andermann Tessa , Peled Jonathan U , Gomes Antonio , van den Brink Marcel R M , Chao Nelson J , Surana Neeraj K , Sung Anthony D 
Published: December 2021

Abstract

Background
Enterococcus intestinal domination (EID), a state of dysbiosis wherein enterococci comprise ≥30% abundance within the microbiota, has been associated with Enterococcus bacteremia, graft-versus-host disease, and mortality in the allogeneic hematopoietic stem cell transplant (allo HCT) population. The acute leukemia (AL) chemotherapy population includes patients receiving intensive chemotherapy, but not all patients go on to have an allo HCT. The impact of EID on outcomes including mortality in the AL chemotherapy population is unknown.

Methods
Microbiota composition from weekly stool samples was analyzed using 16S ribosomal RNA gene sequencing. Patients were analyzed in 2 cohorts: AL chemotherapy cohort and allo HCT cohort. α -diversity and richness were calculated. Kaplan-Meier analysis was used to analyze mortality.

Results
A total of 929 stool samples were collected from 139 patients. Both allo HCT and AL cohorts had a decline in α-diversity and richness over the course of treatment that tended not to return to baseline months later. EID was observed in at least 1 sample in 36% of allo HCT patients and 49% of AL patients. Patients with observed EID had lower α-diversity over time. Similar to the HCT cohort, AL patients with EID had reduced overall survival. We identified 4 other genera that were commonly found in ≥30% relative abundance within the microbiota, but none were associated with mortality. In fact, in allo HCT, Bacteroides abundance ≥30% was associated with improved survival.

Conclusions
EID is associated with increased all-cause mortality in HCT and AL cohorts. Unlike EID, relative abundance ≥30% by other genera is not associated with increased all-cause mortality.
On the Longest Common Cartesian Substring Problem
Authors: Faro Simone , Lecroq Thierry , Park Kunsoo , Scafiti Stefano 
Published: December 2021

AbstractA Cartesian tree is associated with a string of numbers and is structured as a heap from which the original string can be recovered. Although Cartesian trees have been introduced 40 years ago, the Cartesian tree matching problem appeared very recently. It consists in finding all substrings of given text, which have the same Cartesian tree as that of a given pattern. In this paper, we address the problem of computing the longest common Cartesian substrings of two strings and present three methods for such problem. Our first method is based on a classical suffix tree construction and solves the problem in randomized linear time and linear space, although the space overhead is quite prohibitive in the case of large strings. Our second solution is based on classical dynamic programming, and our third solution is based on a constructive approach. Both of them run in quadratic worst case time but are more space economical in practice. From our experimental results, it turns out that our second solution runs faster than the standard suffix tree solution for short strings, whereas our third solution is more suitable for large strings, when storing a full suffix tree becomes prohibitive.
Efficacy of new medical therapies in patients with heart failure, reduced ejection fraction, and chronic kidney disease already receiving neurohormonal inhibitors: a network meta-analysis
Authors: Ameri Pietro , De Marzo Vincenzo , Zoccai Giuseppe Biondi , Tricarico Lucia , Correale Michele , Brunetti Natale Daniele , Canepa Marco , De Ferrari Gaetano Maria , Castagno Davide , Porto Italo 
Published: December 2021

Abstract

Aims
We assessed the efficacy of the drugs developed after neurohormonal inhibition (NEUi) in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and concomitant chronic kidney disease (CKD).

Methods and results
The literature was systematically searched for phase 3 randomized controlled trials (RCTs) involving ≥90% patients with left ventricular ejection fraction &lt;45%, of whom &lt;30% were acutely decompensated, and with published information about the subgroup of estimated glomerular filtration rate &lt;60 mL/min/1.73 m2. Six RCTs were included in a study-level network meta-analysis evaluating the effect of NEUi, ivabradine, angiotensin receptor–neprilysin inhibitor (ARNI), sodium–glucose cotransporter-2 inhibitors (SGLT2i), vericiguat, and omecamtiv mecarbil (OM) on a composite outcome of cardiovascular death or hospitalization for HF. In a fixed-effects model, SGLT2i [hazard ratio (HR) 0.78, 95% credible interval (CrI) 0.69–0.89], ARNI (HR 0.79, 95% CrI 0.69–0.90), and ivabradine (HR 0.82, 95% CrI 0.69–0.98) decreased the risk of the composite outcome vs. NEUi, whereas OM did not (HR 0.98, 95% CrI 0.89–1.10). A trend for improved outcome was also found for vericiguat (HR 0.90, 95% CrI 0.80–1.00). In indirect comparisons, both SLGT2i (HR 0.80, 95% CrI 0.68–0.94) and ARNI (HR 0.80, 95% CrI 0.68–0.95) reduced the risk vs. OM; furthermore, there was a trend for a greater benefit of SGLT2i vs. vericiguat (HR 0.88, 95% CrI 0.73–1.00) and ivabradine vs. OM (HR 0.84, 95% CrI 0.68–1.00). Results were comparable in a random-effects model and in sensitivity analyses. Surface under the cumulative ranking area scores were 81.8%, 80.8%, 68.9%, 44.2%, 16.6%, and 7.8% for SGLT2i, ARNI, ivabradine, vericiguat, OM, and NEUi, respectively.

Conclusion
Expanding pharmacotherapy beyond NEUi improves outcomes in HFrEF with CKD.
Contemporary Challenges in Clinical Flow Cytometry: Small Samples, Big Data, Little Time
Authors: Brestoff Jonathan R , Frater John L 
Published: December 2021

AbstractBackgroundImmunophenotypic analysis of cell populations by flow cytometry has an established role in primary diagnosis and disease monitoring of many hematologic diseases. A persistent problem in evaluation of specimens is suboptimal cell counts and low cell viability, which results in an undesirable rate of analysis failure. In addition, the increased amount of data generated in flow cytometry challenges existing data analysis and reporting paradigms.ContentWe describe current and emerging technological improvements in cell analysis that allow the clinical laboratory to perform multiparameter analysis of specimens, including those with low cell counts and other quality issues. These technologies include conventional multicolor flow cytometry and new high-dimensional technologies, such as spectral flow cytometry and mass cytometry that enable detection of over 40 antigens simultaneously. The advantages and disadvantages of each approach are discussed. We also describe new innovations in flow cytometry data analysis, including artificial intelligence-aided techniques.SummaryImprovements in analytical technology, in tandem with innovations in data analysis, data storage, and reporting mechanisms, help to optimize the quality of clinical flow cytometry. These improvements are essential because of the expanding role of flow cytometry in patient care.
An ASP approach for arteries classification in CT scans
Authors: Fabiano Francesco , Dal Palù Alessandro 
Published: December 2021

Abstract
Automated segmentation of computed tomography (CT) scans is the first step in the pipeline for the interpretation and identification of potential pathologies in human organs. Several methods based on machine learning (ML) are currently available, even if their precision is still outperformed by medical doctors. In this field there are some intrinsic limitations to ML approaches, such as the following: cost and time to acquire high-quality annotated scans for training; and a remarkable high variability of organ morphology due to age, conditions, genetics and acquisition. This paper outlines a new methodology based on Answer Set Programming, which returns reliable, easy-to-program and explainable interpretations. In particular, we focus on the CT scan analysis and retrieval of tree-like structure, corresponding to main blood vessels (arteries) arrangement. The structure is compared to the knowledge base of vessels contained in anatomy textbooks. The mapping of vessel names is computed by an Answer Set Programming program. This preliminary step produces a robust input to a reasoner for the multi-organ labelling and localization problem.