bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil Extracellular Trap Formation and Syndecan-1 Shedding Are Increased After Trauma
Authors: Goswami Julie , MacArthur Taleen , Bailey Kent , Spears Grant , Kozar Rosemary A. , Auton Matthew , Dong Jing-Fei , Key Nigel S. , Heller Stephanie , Loomis Erica , Hall Nathan W. , Johnstone Andrea L. , Park Myung S. 
Published: February 2021

ABSTRACT

Background:
Damage-associated molecular patterns (DAMPs) stimulate endothelial syndecan-1 shedding and neutrophil extracellular traps (NET) formation. The role of NETs in trauma and trauma-induced hypercoagulability is unknown. We hypothesized that trauma patients with accelerated thrombin generation would have increased NETosis and syndecan-1 levels.

Methods:
In this pilot study, we analyzed 50 citrated plasma samples from 30 trauma patients at 0 h (n = 22) and 6 h (n = 28) from time of injury (TOI) and 21 samples from healthy volunteers, for a total of 71 samples included in analysis. Thrombin generation was quantified using calibrated automated thrombogram (CAT) and reported as lag time (LT), peak height (PH), and time to peak (ttPeak). Nucleosome calibrated (H3NUC) and free histone standardized (H3Free) ELISAs were used to quantify NETs. Syndecan-1 levels were quantified by ELISA. Results are presented as median [interquartile range] and Spearman rank correlations.

Results:
Plasma levels of H3NUC were increased in trauma patients as compared with healthy volunteers both at 0 h (89.8 ng/mL [35.4, 180.3]; 18.1 ng/mL [7.8, 37.4], P = 0.002) and at 6 h (86.5 ng/mL [19.2, 612.6]; 18.1 ng/mL [7.8, 37.4], P = 0.003) from TOI. H3Free levels were increased in trauma patients at 0 h (5.74 ng/mL [3.19, 8.76]; 1.61 ng/mL [0.66, 3.50], P = 0.002) and 6 h (5.52 ng/mL [1.46, 11.37]; 1.61 ng/mL [0.66, 3.50], P = 0.006). Syndecan-1 levels were greater in trauma patients (4.53 ng/mL [3.28, 6.28]; 2.40 ng/mL [1.66, 3.20], P < 0.001) only at 6 h from TOI. H3Free and syndecan-1 levels positively correlated both at 0 h (0.376, P = 0.013) and 6 h (0.583, P < 0.001) from TOI. H3NUC levels and syndecan-1 levels were positively correlated at 6 h from TOI (0.293, P = 0.041). TtPeak correlated inversely to H3 NUC (−0.358, P = 0.012) and syndecan-1 levels (−0.298, P = 0.038) at 6 h from TOI.

Conclusions:
Our pilot study demonstrates that trauma patients have increased NETosis, measured by H3NUC and H3Free levels, increased syndecan-1 shedding, and accelerated thrombin generation kinetics early after injury.
Synchronization of Pupil Dilations Correlates With Team Performance in a Simulated Laparoscopic Team Coordination Task
Authors: He Wenjing , Jiang Xianta , Zheng Bin 
Published: February 2021

Background
Modern surgery crucially relies on teamwork between surgeons and assistants. The science of teamwork has been and is being studied extensively although the use of specific objective methodologies such as shared pupil dilations has not been studied as sufficiently as subjective methods. In this study, we investigated team members' shared pupil dilations as a surrogate for surgeon's team performance during a simulated laparoscopic procedure.

Methods
Fourteen subjects formed dyad teams to perform a simulated laparoscopic object transportation task. Both team members' pupil dilation and eye gaze were tracked simultaneously during the procedure. Video analysis was used to identify key event movement landmarks for subtask segmentation to facilitate data analysis. Three levels of each teams' performance were determined according to task completion time and accuracy (object dropping times). The determined coefficient of determination (R
2) was used to calculate the similarity in pupil dilations between 2 individual members' pupil diameters in each team. A mixed-design analysis of variance was conducted to explore how team performance level and task type were correlated to joint pupil dilation.

Results
The results showed that pupil dilations of higher performance teams were more synchronized, with significantly higher similarities (R
2) in pupil dilation patterns between team members than those of lower performance teams (0.36 ± 0.22 vs. 0.21 ± 0.14, P < 0.001).

Conclusions
Levels of pupil dilation synchronization presented among teams reflect differences in performance levels while executing simulated laparoscopic tasks; this demonstrated the potential of using joint pupil dilation as an objective indicator of surgical teamwork performance.
Simulation for Neonatal Endotracheal Intubation Training
Authors: Soghier Lamia M. , Walsh Heather A. , Goldman Ellen F. , Fratantoni Karen R. 
Published: February 2021

Introduction
Neonatal endotracheal intubation is a critical skill that is difficult for learners to acquire even with simulation-based training (SBT). Trainees prefer clinical experiences over SBT. The objective of the study was to explore the differences between SBT and clinical practice in acquiring neonatal intubation skills to inform mannequin design and to improve fidelity.

Methods
A basic qualitative study using semistructured interviews was conducted to determine the experience of newly competent trainees (second- and third-year neonatal-perinatal medicine fellows) and their instructors in developing intubation skills. Participants were asked to compare learning through SBT with clinical practice in terms of context, equipment, and environment. Their responses were analyzed using an inductive approach.

Results
Thirty-two participants (20 fellows and 12 faculty) indicated that SBT does not equal the real experience. Specifically, the look, feel, and function of the simulators differ enough from the real patient and the clinical environmental that they do not elicit the desired learning responses. The clinical environment prompted heightened emotions and had a chaotic atmosphere that was not fully captured by SBT. Participants suggested that programs use SBT in the initial phases of training only to gain basic skills and they provided several solutions for mannequin and SBT session design.

Conclusions
Simulation-based training does not fully prepare neonatal-perinatal medicine fellows for neonatal intubation. Mannequins with unique active features, such as multiple airway configurations, slipperiness, secretions, and softer textures should be developed. Realistic environments that replicate the interprofessional nature and stressors of the clinical environment might better prepare learners for the complexity of clinical practice.
Long-term Outcomes of a Randomized Controlled Trial of Single-incision Versus Multi-port Laparoscopic Colectomy for Colon Cancer
Authors: Watanabe Jun , Ishibe Atsushi , Suwa Hirokazu , Ota Mitsuyoshi , Fujii Shoichi , Kubota Kazumi , Kunisaki Chikara , Endo Itaru 
Published: February 2021

Objective:
The aim of this study was to evaluate the long-term outcomes that were the secondary endpoints of a RCT of multi-port laparoscopic colectomy (MPC) versus SILC in colon cancer surgery.

Summary of Background Data:
The actual long-term outcomes, such as the 5-year RFS, OS, and recurrence patterns after surgery, have not been evaluated by a RCT.

Methods:
Patients with histologically proven colon carcinoma located in the cecum, ascending, sigmoid or rectosigmoid colon clinically diagnosed as stage 0-III were eligible for this study. Patients were preoperatively randomized and underwent complete mesocolic excision. The 5-year RFS, OS, and recurrence patterns were analyzed (UMIN-CTR 000007220).

Results:
Between March 1, 2012, and March 31, 2015, a total of 200 patients were randomly assigned to either the MPC arm (n = 100) or SILC arm (n = 100). The median follow-up for all patients was 61.0 months. An intention-to-treat analysis showed that the 5-year RFS was 91.0% [95% confidence interval (CI) 85.1%–96.9%] in the MPC arm and 88.0% (95% CI 82.1%–93.9%) in the SILC arm (hazard ratio: 1.37; 95% CI 0.58–3.24; P = 0.479). The 5-year OS was 95.0% (95% CI 91.1%–98.9%) in the MPC arm and 93.0% (87.1%–98.9%) in the SILC arm (hazard ratio: 1.39; 95% CI 0.44–4.39; P = 0.568). There were no significant differences in the recurrence patterns between the 2 arms.

Conclusions:
Even though the results of the 5-year OS and RFS in this trial were exploratory and underpowered, there were no statistically significant differences between the SILC and MPC arms. SILC may be an acceptable treatment option for select patients with colon cancer.
Genital Hiatus Size as a Predictor of Progression of Pelvic Organ Prolapse
Authors: Woll Abbigail , Mbaye Marieme , Edenfield Autumn , Swift Steven 
Published: February 2021

Objective
This study aimed to determine if genital hiatus (GH) size is a predictor of worsening pelvic organ prolapse and a preference for a therapeutic intervention in women with pelvic organ prolapse who opt for expectant management over therapeutic intervention at their initial encounter.

Methods
This was a retrospective cohort study analyzing the GH size of women who opted for expectant management in the initial treatment of pelvic organ prolapse at one academic institution from 2002 to 2015. Participants were divided into 2 groups: (1) large GH was defined as ≥4 cm and (2) normal GH was defined as <4 cm. The primary outcome was women opting for therapeutic intervention for their prolapse at a later visit, defined as pessary insertion or surgical intervention. Secondary measures evaluated GH as a predictor of worsening anatomy or symptoms.

Results
One hundred eleven participants were enrolled. Fifty-two women had a large GH, and 59 women had a normal GH. Median length of follow-up was 24 months (range, 6–110 months). Of the 52 with a large GH, 22 (42%) opted for intervention; of the 59 women with a normal GH, 16 (27%) opted for intervention. There was no statistically significant difference between groups in the number who eventually chose intervention (P = 0.09). There was no difference in secondary outcomes between groups with respect to worsening bother, worsening pelvic organ prolapse quantification stage, or an increase in the prolapse leading edge of ≥2 cm.

Conclusions
Women with a large GH, when compared with those with a normal GH, were not more likely to choose intervention over continued observation.
Characterization of Gut Microbiome in Liver Transplant Recipients With Nonalcoholic Steatohepatitis
Authors: Satapathy Sanjaya K. , Banerjee Pratik , Pierre Joseph F. , Higgins Daleniece , Dutta Soma , Heda Rajiv , Khan Sabrina D. , Mupparaju Vamsee K. , Mas Valeria , Nair Satheesh , Eason James D. , Kleiner David E. , Maluf Daniel G. 
Published: February 2021

Background.
Nonalcoholic fatty liver disease (NAFLD) and its progressive form nonalcoholic steatohepatitis (NASH) are a growing problem globally and recur even after liver transplant (LT). We aim to characterize the gut dysbiosis in patients who developed recurrent NAFLD compared with patients without recurrence following LT.

Methods.
Twenty-one patients who received LT for NASH and had a protocol liver biopsy performed beyond 1-y post-LT were included prospectively (January 2018–December 2018). Genomic DNA extraction, next-generation sequencing, and quantitative PCR analysis were performed on stool samples collected within 1.1 ± 1.6 y from time of liver biopsy.

Results.
Recurrent NAFLD was noted in 15 of the 21 included patients. Stool microbiome analysis at the genus level showed significant loss of Akkermansia and increasing Fusobacterium associated with NAFLD recurrence. Quantitative PCR analysis revealed significantly decreased relative abundance of Firmicutes in patients with NAFLD activity scores (NASs) ≥5 as compared with patients with lower NAS scores, whereas Bacteroidetes were significantly increased with higher NAS (P < 0.05). Firmicutes (P = 0.007) and Bifidobacterium group (P = 0.037) were inversely correlated, whereas Bacteroidetes (P = 0.001) showed a positive correlation with higher hepatic steatosis content. The Firmicutes/Bacteroidetes ratios were higher in patients without NAFLD or NASH as compared with patients diagnosed with NAFLD or NASH at the time of sample collection.

Conclusions.

Akkermansia, Firmicutes, and Bifidobacterium may play protective roles in the development of recurrent NAFLD in LT recipients, whereas Fusobacteria and Bacteroidetes may play pathogenic roles. These findings highlight the potential role of the “gut-liver” axis in the pathogenesis of NAFLD recurrence after LT.
A Novel Preservation Solution Containing Quercetin and Sucrose for Porcine Kidney Transplantation
Authors: Gochi Mikako , Kato Fuminori , Toriumi Asuka , Kawagoe Tomoko , Yotsuya Shuichi , Ishii Daisuke , Otani Masahide , Nishikawa Yuji , Furukawa Hiroyuki , Matsuno Naoto 
Published: February 2021

Background.
In organ transplantation, the University of Wisconsin (UW) solution has been the gold standard for organ preservation. Quercetin (Que) has numerous antioxidant and anti-inflammatory activities, and sucrose (Suc) may be effective for cold storage (CS). This study aimed to investigate the in vitro protective effect of Que and Suc on cold injury to the kidney and to determine whether Que + Suc could improve ischemia-reperfusion injury during CS and hypothermic oxygenated perfusion (HOPE) in autologous transplantation models.

Methods.
BHK-21 cells were stored at 4°C for 3 days in UW solution for CS/machine perfusion (CS/MP-UW) with Que (33.1 μM, 3.3 μM, 0.33 μM) and Suc (0.1 M). In a porcine model of renal autologous transplantation, left kidney grafts were preserved under 3 conditions: group 1, CS preservation for 24 hours; group 2, CS preservation for 22 hours and HOPE with CS/MP-UW solution for 2 hours; and group 3, identical preservation as group 2, with Que and Suc added to the solution. Animals were euthanized on day 7 after autologous transplantation.

Results.
After 3 days of CS preservation, the CS/MP-UW solution with Que (33.1 μM, 3.3 μM) and Suc showed significant cell protection against cold injury. In the porcine model of renal autologous transplantation, the last blood Cre level and the blood lipid hydroperoxide on posttransplantation day 2 were significantly different between group 1 and group 3. Moreover, the total endothelial, glomerular, tubular, interstitial (EGTI) histology score in the kidney tissue was also significantly different. Regarding the change in renal resistance in HOPE, the decrease observed in group 3 was significantly larger than that in group 2.

Conclusions.
Our results suggest that the addition of Que and Suc to a UW solution can improve kidney preservation and could potentially enhance the outcome of kidney transplantation.
CD94 Ex Vivo Cultures in a Bone Marrow Transplantation Setting
Authors: Abrams Kraig , Graves Scott S. , Parker Maura H. , Storb Rainer 
Published: February 2021

Background.
Complementary, marrow donor-derived peripheral blood T-lymphocyte infusions enable consistent hematopoietic engraftment in lethally irradiated dog leukocyte antigen (DLA)-haploidentical littermate recipients, but at the cost of severe graft versus host disease (GVHD). Here, we explored whether CD94-selected and in vitro-expanded natural killer (NK) cells could be substituted for T-lymphocytes for enhancing marrow engraftment without causing severe GVHD.

Methods.
Five dogs were conditioned with 700 cGy total body irradiation followed by infusion of DLA-haploidentical donor marrow and CD94-selected, in vitro-expanded NK cells. NK cells were infused at a median of 140 000 (range 78 000–317 000) cells/kg.

Results.
Four dogs rejected their marrow grafts, whereas 1 dog fully engrafted and developed GVHD. We observed an increase in peripheral blood NK cells after infusion of CD94-selected, ex vivo-expanded NK in 2 dogs. Peripheral blood lymphocyte counts peaked at day 7 or 8 posttransplant in the 4 rejecting dogs, whereas in the fully engrafted dog, lymphocyte counts remained stable at suboptimal levels.

Conclusions.
Our study indicates NK cells can be expanded in vitro and safely infused into DLA-haploidentical recipients. Within the range of CD94-selected and expanded cells infused we concluded that they failed to both uniformly promote engraftment and avert GVHD.
Differences in Liver Graft Survival by Recipient Sex
Authors: De Simone Alexia I. , Zhang Xun , Dahhou Mourad , Sapir-Pichhadze Ruth , Cardinal Heloise , Ng Vicky , Foster Bethany J. 
Published: February 2021

Background.
We aimed to characterize patterns of differences in liver graft failure rates by recipient sex, accounting for the modifying effects of donor sex and recipient age.

Methods.
We evaluated 144 212 first deceased donor liver transplant recipients [1988–2019; Scientific Registry of Transplant Recipients (SRTR)]. We used multivariable time-varying Cox models, considering a recipient sex by donor sex by recipient age (0–12, 13–24, 25–44, ≥45 y) interaction.

Results.
Among recipients of male donors, females <45 y had higher graft failure rates than males of the same age, but none of these differences were statistically significant [0–12 y: adjusted hazard ratio (aHR) 1.17 (0.98, 1.40); 13–24 y: aHR 1.18 (0.96, 1.46); 25–44 y: aHR 1.11 (0.96, 1.28)]; there was no material or statistically significant difference between female and male recipients ≥45 y [aHR 1.01 (0.97, 1.06)]. When the donor was female, recipients <45 y showed no statistically significant differences in graft outcomes by recipient sex [0–12 y: aHR 0.91 (0.74, 1.11); 13–24 y: aHR 0.98 (0.77, 1.25); 25–44 y: aHR 0.86 (0.73, 1.01)], whereas female recipients ≥45 y had significantly lower graft failure rates [aHR 0.85 (0.81, 0.89)] than males of the same age.

Conclusions.
Among recipients of female donors, female recipients ≥45 y had significantly better outcomes than males of the same age; there were no clear differences by recipient sex in younger recipients. When the donor was male, there was no material or statistically significant difference in graft failure rates between males and females ≥45 y; among younger recipients point estimates suggested higher failure rates in females than males recipients, but confidence intervals were wide making firm conclusions impossible. Larger studies combining multiple datasets are needed.
Outcomes of Liver Transplantation in Treated Portopulmonary Hypertension Patients With a Mean Pulmonary Arterial Pressure ≥35 mm Hg
Authors: DuBrock Hilary M. , Runo James R. , Sadd Corey J. , Burger Charles D. , Cartin-Ceba Rodrigo , Rosen Charles B. , Taner Timucin , Nyberg Scott L. , Heimbach Julie K. , Findlay James Y. , Krowka Michael J. 
Published: February 2021

Background.
Portopulmonary hypertension (POPH), pulmonary arterial hypertension (PAH) that develops in the setting of portal hypertension, affects 5%–6% of patients with liver disease and is associated with significant morbidity and mortality. A mean pulmonary arterial pressure (mPAP) threshold of 35 mm Hg is used to stratify perioperative risk and liver transplant eligibility in treated POPH patients but does not take into account the specific factors that contribute to the pressure elevation.

Methods.
In this case series, we describe the characteristics and posttransplant outcomes of patients with treated POPH and an mPAP ≥35 mm Hg and pulmonary vascular resistance (PVR) <250 dynes-s-cm−5 at or just before liver transplantation (LT). We also describe the effect of PAH therapy on pulmonary hemodynamics in patients with POPH.

Results.
Sixteen patients were included. All patients were on PAH therapy at the time of LT. PAH therapy resulted in a decrease of mPAP (median 18.4%; interquartile range [IQR] 8.9%–27.0%) with a reduction in PVR (median 50.5%; IQR, 45.4%–70.7%), and an increase in both cardiac output (CO) (median 28.1%; IQR 5.7%–63.8%) and PAWP (median 50.0%; IQR 16.7%–108.3%) before LT. One year posttransplant survival was 69% (11/16); however, only 1 death was attributed to POPH. At 1-year posttransplant, 63.6% (7/11) of patients were weaned off all PAH therapy with clinical and echocardiographic resolution of POPH.

Conclusions.
In treated POPH patients with an mPAP ≥35 mm Hg and PVR < 250 dynes-s-cm−5 before LT, 1-year posttransplant survival was 69% and the majority of patients were able to discontinue PAH therapy.
Time of day influences psychophysical measures in women with burning mouth syndrome
Authors: Sosa Janell S. Payano , Da Silva Joyce T. , Burrowes Shana A.B , Yoo Soo Y. , Keaser Michael L. , Meiller Timothy F. , Seminowicz David A. 
Published: February 2021

AbstractBurning mouth syndrome (BMS) is a chronic orofacial pain condition that mainly affects postmenopausal women. BMS type I patients report little to no spontaneous pain in the morning and increases in pain through the day, peaking in the afternoon. Quantitative sensory testing (QST) findings from BMS type 1 patients are inconsistent as they fail to capture this temporal variation. We examined how QST in BMS type 1 compared to healthy participants was affected by time of day. QST of the face and forearm included warmth detection threshold (WDT), cold detection threshold (CDT), and heat pain thresholds (HPT), ratings of suprathreshold heat, and pressure pain thresholds (PPT), and was performed twice: once in the morning and once in the afternoon. BMS patients reported: no differences in morning and afternoon comparisons of the orofacial region between groups and no differences in PPTs in either orofacial or arm regions between groups; lower within group PPTs of the masseter in the afternoon; higher WDTs, and lower CDTs of the forearm in the morning compared to healthy participants; lower CDTs and higher pain intensity ratings to heat stimuli at low temperatures on the forearm in the afternoon compared to healthy participants. The findings indicate that compared to healthy participants, BMS Type I patients had altered thermal sensitivity, which depended on body area tested (forearm vs orofacial region), and higher pain sensitivity, which was slightly more pronounced in the afternoon plausibly due to a hypervigilance.PerspectiveSomatosensory profiles in BMS type 1 can be affected by time of day, possibly as an effect of spontaneous burning pain that increases throughout the day. Our findings highlight the cyclical effect of BMS pathophysiology across a day, which may further help clinicians choose appropriate treatment strategies for BMS patients.