bluuebunny/crossref_metadata_2025_split huggingface dataset:
Choledocholithiasis: Long‐term follow‐up in patients without stone clearance at first endoscopic retrograde cholangiopancreatography
Authors: Kourounis Georgios , Gall Lewis S. , McArthur Donald , Gibson Simon , Glen Paul 
Published: August 2021

ObjectivesComplete clearance during endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis is not always successful and biliary stenting is commonplace. Strategies vary between temporary stent placement (TSP) with interval ERCP or permanent stent placement (PSP) and watchful waiting for recurrent biliary obstruction (RBO). This study aimed to describe outcomes in these two groups and stent patency rates in PSP.MethodsPatients with incomplete clearance at first ERCP for choledocholithiasis between May 2015 and December 2018 were identified. Clinical outcomes were obtained by retrospective interrogation of the case notes. Median follow‐up duration was 41 months (interquartile range 29‐51 mo).ResultsOf 1263 index ERCP, 199 (15.8%) had no stone clearance, with 53.3% receiving PSP and 46.7% undergoing TSP. The TSP group had repeat ERCP after a median of 8 weeks; 75.3% had clearance on a repeat ERCP. The PSP group was elder than the TSP group (82 y vs 72 y, P < 0.001). The rates of RBO (32.1% vs 16.1%) and emergency readmissions (32.1% vs 19.4%) were higher in the PSP group (both P < 0.05). More patients died without further biliary disease in the PSP group (39.6% vs 12.9%, P = 0.001). PSP stent patency rates at 6, 12, 24, 36, and 61 months were 87.7%, 82.1%, 75.5%, 69.8% and 67.9%, respectively.ConclusionsThough PSP had higher RBO and emergency readmissions, two‐thirds of patients either died or survived without recurrent biliary disease. Stent patency decreased fastest in the first 12 months. Criteria to guide decision‐making for biliary stenting remain unclear.
Coincidental splenic irradiation and risk of functional hyposplenism in oesophageal cancer treatment
Authors: Ellis Rachel , Cole Aidan J , O’Hare Jolyne , Whitten Glenn , Crowther Karen , Harrison Claire 
Published: August 2021

AbstractIntroductionDefinitive chemoradiotherapy (dCRT) and radical radiotherapy are central to the management of distal oesophageal carcinoma. This study sought to establish whether the spleen receives a significant incidental radiation dose when treating distal oesophageal carcinoma with the standardised dCRT or radical radiotherapy doses.MethodsIn this single‐centre retrospective study, all patients (n = 34) with distal oesophageal cancer, treated with either dCRT or radical radiotherapy over an 18‐month period using a volumetric modulated arc therapy (VMAT) planning technique, were included. The median age was 74 years old: 56% were male; 50% (n = 17) had adenocarcinoma and 41% (n = 14) had squamous carcinoma. The majority (79%) received dCRT with a prescribed dose of 50 Gy in 25 fractions while the other 21% of patients were treated with radical radiotherapy alone (55 Gy in 20 fractions). The spleen was retrospectively contoured by one physician, and the V10 Gy and mean splenic dose (MSD) were calculated using Eclipse planning software.ResultsThe median MSD was 14.4 Gy with a range of 0.75–28.3 Gy. The median V10 Gy was 62.7%. Of the cohort, 67.6% received an MSD of more than 10 Gy.ConclusionsTwo‐thirds of the patients received a dose of more than the 10 Gy. A review of the literature suggests that higher splenic radiation doses may increase the long‐term risk of infection and impact on other outcomes. This study provides important evidence that the spleen receives a significant dose of radiation when treating distal oesophageal cancer and should be considered as an organ at risk.
Transposable element annotation in non‐model species: The benefits of species‐specific repeat libraries using semi‐automated EDTA and DeepTE de novo pipelines
Authors: Bell Ellen A. , Butler Christopher L. , Oliveira Claudio , Marburger Sarah , Yant Levi , Taylor Martin I. 
Published: August 2021

AbstractTransposable elements (TEs) are significant genomic components which can be detected either through sequence homology against existing databases or de novo, with the latter potentially reducing the risk of underestimating TE abundance. Here, we describe the semi‐automated generation of a de novo TE library using the newly developed EDTA pipeline and DeepTE classifier in a non‐model teleost (Corydoras fulleri). Using both genomic and transcriptomic data, we assess this de novo pipeline's performance across four TE based metrics: (i) abundance, (ii) composition, (iii) fragmentation, and (iv) age distributions. We then compare the results to those found when using a curated teleost library (Danio rerio). We identify quantitative differences in these metrics and highlight how TE library choice can have major impacts on TE‐based estimates in non‐model species.
Immune‐mediated thrombocytopenia induced with durvalumab after chemoradiotherapy in a non‐small cell lung cancer patient: A case report
Authors: Makiguchi Tomonori , Tanaka Hisashi , Kamata Kosuke , Taima Kageaki , Kurose Akira , Tasaka Sadatomo 
Published: August 2021

AbstractWe describe a case of a 60‐year‐old man with a prolonged thrombocytopenia during a durvalumab maintenance therapy after chemoradiotherapy for locally advanced non‐small cell lung carcinoma. Bone marrow specimen was normoplastic with the marked megakaryocyte depletion, which was assumed to be an acquired amegakaryocytic thrombocytopenic purpura. Although hematological disorders as immune‐related adverse events (irAE) are rare, we should pay more attention to hematological disorders with durvalumab especially after concurrent chemoradiotherapy.
Electromagnetic navigational bronchoscopy‐guided dye marking to identify the subsegmental bronchus in thoracoscopic anatomic subsegmentectomy
Authors: Xu Rongjian , Zhao Min , Zhao Yandong , Xuan Yunpeng , Qin Yi , Jiao Wenjie 
Published: August 2021

AbstractVideo‐assisted thoracoscopic surgery (VATS) subsegmentectomy has been widely used to resect small‐sized lung lesions in clinical practice. Precise identification of the subsegmental bronchus is one of the essential steps in performing thoracoscopic anatomic subsegmentectomy. Here, we report a thoracoscopic right S2a segmentectomy with preoperative electromagnetic navigational bronchoscopy (ENB)‐guided injection of methylene blue to identify the subsegmental bronchus in a 51‐year‐old male. We successfully performed complicated surgery using this method. This ENB‐guided dye marking method may accurately distinguish the subsegmental bronchus to effectively guide surgery.
Atraumatic restorative treatment restorations performed in different settings: systematic review and meta‐analysis
Authors: Garbim Jonathan Rafael , Laux Caroline Mariano , Tedesco Tamara Kerber , Braga Mariana Minatel , Raggio Daniela Prócida 
Published: August 2021

AbstractBackgroundThere are potential barriers to using the atraumatic restorative treatment (ART) approach in conventional dental offices, as many professionals assume that it is only used for field conditions. This systematic review and meta‐analysis evaluated the survival data of ART restorations in permanent and primary teeth when performed in and out of the conventional environment.MethodsSearches were performed on PubMed/MEDLINE, Scopus, Web of Science, and Open Grey databases up to April 2020. Studies that evaluated ART restorations were prospective and had survival rate data were included. The risk of bias was evaluated by Rob 2.0 and ROBINS‐I tools. Meta‐analyses were carried out considering as outcome the survival rate of primary and permanent teeth. Subgroups analysis was performed for setting and type of cavity (occlusal or multi‐surface).ResultsThirty‐four studies were included. For primary teeth, in general, the overall percentage of survival rate was not influenced by setting, ranging up to 71% in 12 months to 65% in 36 months. Similarly, for permanent teeth, the overall percentage of survival rate was not influenced by setting, ranging up to 96% in 12 months to 61% in 36 months.ConclusionART is a feasible approach for field settings as well as conventional dental offices.PROSPERO: CRD42020184680.
A new era of atopic eczema research: Advances and highlights
Authors: Hülpüsch Claudia , Weins Andreas B. , Traidl‐Hoffmann Claudia , Reiger Matthias 
Published: August 2021

AbstractAtopic eczema (AE) is an inflammatory skin disease with involvement of genetic, immunological and environmental factors. One hallmark of AE is a skin barrier disruption on multiple, highly interconnected levels: filaggrin mutations, increased skin pH and a microbiome dysbiosis towards Staphylococcus aureus overgrowth are observed in addition to an abnormal type 2 immune response. Extrinsic factors seem to play a major role in the development of AE. As AE is a first step in the atopic march, its prevention and appropriate treatment are essential. Although standard therapy remains topical treatment, powerful systemic treatment options emerged in the last years. However, thorough endotyping of the individual patients is still required for ideal precision medicine approaches in future. Therefore, novel microbial and immunological biomarkers were described recently for the prediction of disease development and treatment response. This review summarizes the current state of the art in AE research.
Morbidity following thyroid and parathyroid surgery: Results from key performance indicator assessment at a high‐volume centre in New Zealand
Authors: Lin Jin Xin , Wen Daniel , Sharma Avinash , van der Werf Bert , Martin Richard C.W. , Harman Richard 
Published: August 2021

AbstractBackgroundComplications following thyroid/parathyroid surgery include recurrent laryngeal nerve (RLN) injury, hypocalcaemia and return to theatre for haematoma evacuation. Rates of these form the basis of key performance indicators (KPI). An endocrine database, containing results from 1997, was established at the North Shore Hospital in Auckland, New Zealand. We aimed to measure complication rates by procedure (thyroid and parathyroid), explore a temporal change in our unit and compare our results against international literature.MethodsA retrospective review of the database between July 1997 and February 2020 was performed. The results for each KPI were analysed in total and over consecutive time periods. A review of the literature was carried out to find international complication rates for comparison. A cumulative sum (CUSUM) analysis was performed to give visual feedback on performance.ResultsThere were 1062 thyroidectomies and 336 parathyroidectomies from July 1997 to February 2020. Thyroid surgery results found rates of temporary/permanent RLN injury of 1.9%/0.3%, temporary/permanent hypocalcaemia of 22.3/2.5%, and return to theatre for haematoma evacuation of 1.1%. Parathyroid surgery results were, temporary RLN injury of 0.8% (no permanent injury), temporary/permanent hypocalcaemia of 1.7%/0.4%, and return to theatre for haematoma evacuation of 0.3%. CUSUM analysis found KPI results to be comparable with international literature.ConclusionOur unit's KPI results are comparable to published results in the literature. The use of this clinical database will help in future monitoring of performance and help drive improvement in the service. Embedding prospective data collection as routine practice allows for continuous improvement for the unit.
Multicentre evaluation of magnetic technology for localisation of non‐palpable breast lesions and targeted axillary nodes
Authors: McCamley Chere , Ruyssers Natacha , To Henry , Tsao Simon , Keane Holly , Poliness Cathie , Mehta Kirti , Rose Allison , Baker Caroline , Mann Gregory B. 
Published: August 2021

AbstractBackgroundMagseed technology is a recently introduced localisation technique for impalpable breast lesions with possible advantages over traditional techniques. These include improved theatre logistics, flexibility in incision placement and improved patient experience. This multicentre study evaluates the experience of introducing Magseed technology into routine surgical practice.MethodsA prospective multicentre study of Magseed localised procedures was performed. Insertion data were recorded by the radiologist including lesion characteristics and Magseed insertion accuracy. The surgical team recorded time from insertion to operation, operating time and surgical satisfaction. Pathology results were reviewed for specimen weight and margins.ResultsBetween February 2019 and June 2020, 100 patients were enrolled. Magseed localised procedures included 18 excisional biopsies, 23 wide local excisions (WLE), 50 WLE with axillary surgery and four cases of Magseed localised breast WLE with Magseed localised axillary surgery. There were three therapeutic mammoplasties and two cases of Magseed localised targeted axillary node dissection alone. A total of 90% of Magseeds were radiologically placed within 5 mm of the target lesion/node. Time between incision and specimen removal was 17 min (range 6–40 min). All breast and axillary Magseeds were successfully identified and retrieved during surgery. The target lesion was identified in the specimen in all cases. A total of 10% of cases required further surgery for pathologically positive margins. Overall, surgeons reported that Magseed localisation was “easy” or “very easy” in 77% of cases.ConclusionMagseed is a reliable, safe and accurate surgical technique that provides logistical advantages and flexibility of surgical approach. The method was well‐accepted by all users.
Gastric medullary carcinoma: clinicopathological features and prognosis—a single‐center study
Authors: Uprak Tevfik Kıvılcım , Akmercan Ahmet , Coşkun Mümin , Attaallah Wafi 
Published: August 2021

AbstractBackgroundGastric medullary carcinoma (GMC) is a distinct histologic subtype of gastric adenocarcinoma, which prominently associated with Epstein–Barr virus infection. This study aimed to evaluate the clinicopathological features and prognosis of patients with medullary carcinoma in one center.MethodsData regarding patients with gastric cancer were retrospectively analyzed at Marmara University between 2014 and 2019. Demographics, pathological features, and overall survival of patients with GMC were evaluated. The primary outcome of this study was to compare the pathological features of GMC to non‐GMC (NGMC). The secondary outcome was comparing overall survival between the two groups.ResultsA total of 412 patients were enrolled in the study. Of 412 patients, 19 (5%) were diagnosed with medullary cancer. Compared to NGMC, no significant differences were observed in patient age, gender, tumor macroscopic pattern, size, lymphovascular invasion, pathological stage, location and size of the tumors, and the number of metastatic lymph nodes in GMC. However, perineural invasion and Borrmann ulcerated type rates were significantly higher among NGMC. Whereas the microsatellite instability (MSI) rate was significantly higher in the GMC (64% and 11%, respectively, p < 0.001). Multivariate analysis showed that the MSI status was the solely significantly different feature between the two groups.ConclusionThis study showed that GMC was associated with MSI, which could explain the better prognosis of medullary carcinomas.
Procedure‐specific outcomes following gastrectomy for cancer compared by hospital volume and service capability
Authors: Tian Kevin , Baade Peter D. , Aitken Joanne F. , Narendra Aaditya , Smithers B. Mark 
Published: August 2021

AbstractBackgroundInternational literature recommends centralising gastric cancer surgery, however, with volumes that define ‘high‐volume resection’ being higher than those in most major centres in Australia and New Zealand. These reports rarely focus on the difference between total (TG) and partial gastrectomy (PG). We assessed the impact of resection volume and service capability on operative mortality, morbidity and surgical quality in patients who had a PG and TG.MethodsPatients who had gastrectomy for adenocarcinoma, between 2001 and 2015, were collected from the Queensland Oncology Repository. Hospitals were characterised by cases‐per‐annum (high‐volume [HV] ≥ 5 and low‐volume [LV] < 5) and hospital service capability as (high‐service [HS] and low‐service [LS]), giving three hospital groups: HVHS, LVHS and LVLS. Chi‐squared tests were used to compare post‐operative mortality, morbidity, failure to rescue (FTR) from complications and surgical quality between these three groups.ResultsThere were 426 patients who had a TG and 827 having PG. HVHS centres performed 59% of PG with high surgical quality rates of: HVHS = 53%, LVHS = 34% and LVLS = 46% (p < 0.01). Surgical complications were highest in LVLS (LVLS = 19%, LVHS = 11%, HVHS = 11%; p = 0.02). There was no difference in 30‐day mortality nor in FTR. For TG, HVHS performed 67% of these procedures, with lower 30‐day mortality (2%) and FTR rates (5%) compared with LVHS (7%, 22%) and LVLS (12%, 28%; p < 0.01). There was no difference in operative morbidity and surgical quality between hospital groups.ConclusionDespite the ‘high‐volume’ threshold for gastrectomy being the lowest described in the literature, we have shown that centralisation to HVHS centres was associated with lower operative mortality for TG and improved quality of surgery for PG.
Greater risk of all‐cause revisions and complications for obese patients in 3 106 381 total knee arthroplasties: a meta‐analysis and systematic review
Authors: Onggo James Randolph , Ang James Jia Ming , Onggo Jason Derry , de Steiger Richard , Hau Raphael 
Published: August 2021

AbstractBackgroundObesity is a major public health issue and has considerable implications on outcomes of total knee arthroplasty (TKA). However, there has been conflicting evidence and conclusions on the effects of obesity on TKA. This meta‐analysis compares the outcomes, complications, and peri‐operative parameters of TKA in the obese (body mass index [BMI] ≥ 30 kg/m2) versus non‐obese (BMI < 30 kg/m2) population as well as subgroup analysis of morbidly obese (BMI ≥ 40 kg/m2) versus non‐obese population.MethodsA meta‐analysis was conducted with a multi‐database search according to PRISMA guidelines on 12 September 2019. Data from all published literature meeting inclusion criteria were extracted and analysed.ResultsNinety‐one studies were included, consisting of 917 447 obese and 2 188 834 non‐obese TKA. Obese patients had higher risk of all‐cause revisions (odds ratio [OR] = 1.15, 95% CI: 1.08–1.24, p < 0.0001), all complications (OR = 1.21, 95% CI: 1.06–1.38, p = 0.004), deep infections (OR = 1.47, 95% CI: 1.27–1.69, p < 0.0001), superficial infections (OR = 1.59, 95% CI: 1.32–1.91, p < 0.0001), wound dehiscence (OR = 1.46, 95% CI: 1.24–1.72, p < 0.0001) and readmissions (OR = 1.21, 95% CI: 1.05–1.40, p = 0.009). Subgroup analysis of morbidly obese patients revealed greater risks of all‐cause revisions (OR = 1.25, 95% CI: 1.10–1.43, p = 0.0009), deep infections (OR = 1.98, 95% CI: 1.05–3.75, p = 0.04), superficial infections (OR = 2.44, 95% CI: 2.08–2.88, p < 0.0001) and readmissions (OR = 1.33, 95% CI: 1.20–1.47, p < 0.0001). No analysis was performed on patient reported outcome measures due to heterogeneous reporting methods.ConclusionObese and morbidly obese patients have higher risks of revisions and infections post TKA. Surgeons should counsel patients of these risks during the informed consenting process and adopt preventative strategies into clinical practice to reduce risks where possible. In conclusion, obesity is a significant, modifiable risk factor for increased complications following TKA.
Cashew nut shell liquid potentially mitigates methane emission from the feces of Thai native ruminant livestock by modifying fecal microbiota
Authors: Narabe Chiaki , Kamiyama Saki , Saito Mizuki , Boonsaen Phoompong , Khongpradit Anchalee , Sawanon Suriya , Suzuki Yutaka , Koike Satoshi , Kobayashi Yasuo 
Published: August 2021

AbstractThe methane‐mitigating potency of cashew nutshell liquid (CNSL) was evaluated by investigating gas production from batch cultures using feces from Thai native ruminants that had been incubated for different periods. Feces was obtained from four Thai native cattle and four swamp buffaloes reared under practical feeding conditions at the Kasetsart University farm, Thailand. Fecal slurry from the same farm was also included in the analysis. CNSL addition successfully suppressed the methane production potential of feces from both ruminants by shifting short chain fatty acid profiles towards propionate production. Methane mitigation continued for almost 150 days, although the degree of mitigation was more apparent from Day 0 to Day 30. Bacterial and archaeal community shifts with CNSL addition were observed in feces from both ruminants; specifically, Bacteroides increased, whereas Lachnospiraceae and Ruminococcaceae decreased in feces to which CNSL was added. Fecal slurry did not show marked changes in gas production with CNSL addition. The findings showed that the addition of CNSL to the feces of ruminants native to the Southeast Asian region can suppress methane emission. Because CNSL can be easily obtained as a byproduct of the local cashew industry in this region, its on‐site application might be ideal.
Influence of maxillary antrolith on the clinical outcome of implants placed simultaneously with osteotome sinus floor elevation: A retrospective radiographic study
Authors: Chen Hsuan‐Hung , Yi Chieh‐An , Chen Ya‐Chi , Tsai Chia‐Chin , Lin Po‐Yen , Huang Her‐Hsiung 
Published: August 2021

AbstractBackgroundLarge antroliths and those located adjacent to the sinus floor can affect clinical interventions and increase the difficulty of implant placement performed simultaneously with osteotome sinus floor elevation surgery.PurposeThis retrospective study investigated the clinical outcomes of implants placed simultaneously with osteotome sinus floor elevation subjacent to maxillary antroliths.Material and methodsTwenty implants inserted subjacent to or intruding into the antrolith after sinus floor elevation were evaluated in 18 patients. Cone‐beam computed tomography (CBCT) was used to measure antrolith size and membrane thickness at sites of osteotome sinus floor elevation. Periapical radiographs were used to assess the height of grafted bone. Generalized estimating equation (GEE) analysis was performed to correlate the occurrence of antroliths with patient background characteristics and dental outcomes, based on a sample population of 239, among whom 33 presented antroliths.ResultsThe 20 implants remained clinically stable over a mean follow‐up period of 42.4 months. The mean thickness of the sinus membrane at osteotome sites was 5.4 ± 3.3 mm. None of the cases presented sinus membrane perforation or sinus symptoms following osteotome intervention. The mean gain in the height of grafted sinus bone was 4.0 ± 1.4 mm at the last follow‐up. The occurrence of antroliths was higher among females and the elderly (>49 years old). The multivariable GEE analysis showed that the adjusted odds ratio for the occurrence of antroliths with root canal fillings was significantly lower than those without root canal fillings (odds ratio = 0.33; 95% confidence interval = 0.11–0.96).ConclusionOur findings indicate that osteotome sinus floor elevation is a surgical procedure with a risk <17%. Thorough planning based on CBCT and careful management during surgery can eliminate the negative effects of antroliths on implant performance.