bluuebunny/crossref_metadata_2025_split huggingface dataset:
The assessment of postoperative cholangitis in malignant biliary obstruction: a real-world study of nasobiliary drainage after endoscopic placement of self-expandable metal stent
Authors: Jin Hengwei , Fu Chang , Sun Xu , Fan Changqing , Chen Junhong , Zhou Hao , Liu Kai , Xu Hongji 
Published: November 2024

ObjectivesEndoscopic retrograde cholangiopancreatography(ERCP) with endoscopic metallic biliary endoprosthesis(EMBE) serves as a crucial palliative treatment for advanced malignant biliary obstruction(MBO). While endoscopic nasobiliary drainage(ENBD) effectively reduces post-ERCP cholangitis (PEC) incidence, its impact on PEC in MBO patients is unclear. This study evaluates ENBD’s effects on PEC in patients undergoing EMBE and identifies risk factors.MethodsThis retrospective cohort study at the First Hospital of Jilin University involved MBO patients who underwent EMBE from September 2011 to September 2022. Propensity score matching (PSM) was applied to minimize selection bias. Primary and secondary outcomes included the incidence and recovery rate/time of PEC, biliary drainage success, and hospitalization duration. Univariate, multivariate, and Lasso regression analyses identified independent risk factors.ResultsIn this study of 1,008 patients, 730 were analyzed after PSM(365 each in the EMBE+ENBD and EMBE groups). No significant differences were observed in PEC incidence(10.7% vs 11.2%, p=0.9057) or recovery rates(48.7% vs 31.7%, p=0.1855). However, PEC recovery time was shorter in the EMBE+ENBD group(4.0 days [3.0, 6.0] vs 5.0 days [4.0, 7.5], p=0.0240), as was hospitalization duration(6.0 days [4.0, 8.0] vs 7.0 days [5.0, 10.0], p=0.0146), and a higher success rate of biliary drainage(54.0% vs 43.3%, p=0.0049). Tumor location(HR 1.10, 95% CI 1.00-1.20) and preoperative total bilirubin(HR 2.13, 95% CI 1.66-2.73) were identified as independent risk factors.ConclusionIn this large-scale PSM study, ENBD did not reduce PEC incidence but expedited recovery and shortened hospital stays. Patients with hilar MBO of Bismuth III-IV or high preoperative bilirubin were more prone to PEC.
Potential shared gene signatures and molecular mechanisms between recurrent pregnancy loss and ovarian cancer
Authors: Wang Yan , Cai Yan , Chen Jiadong , Shen Wenzhe , Zhu Jianqing , Wang Qiming 
Published: November 2024

BackgroundOvarian cancer (OV) is the second most prevalent gynecological tumor. Recurrent pregnancy loss (RPL) refers to two or more spontaneous abortions. However, the molecular mechanisms underlying both OV and RPL remain poorly understood. This article focuses on the exploration of the common genetic characteristics of OV and RPL and their molecular mechanisms.MethodsThe 71 differentially expressed genes associated with RPL and 1427 genes associated with OV survival were analyzed, among which 7 common genes were both important in the pathogenesis of RPL and OV. Then stepAIC analysis was performed to simplify the model and decrease the number of genes, which yielded a final set of 5 prognostic genes with coefficients to construct a prognostic risk scoring system. Univariate and multivariate Cox analyses were conducted to verify the independent prognostic factor for OV patients. GSEA and GO analysis results showed enriched biological pathways in the high/low risk groups, thereby revealing their biological characteristics. The effect of immunotherapy is better in LR patients. There was a significantly higher enrichment score of stemness and higher tumor aneuploidy score in the HR group.ResultsA five-gene prognostic risk model provided a more accurate prognosis for OV, and this prognostic score system was validated using two external cohorts. The risk score was an independent prognostic index for OV patients. Based on levels of ICs, immune cell infiltration, and predicted response, low risk OV patients were more likely to benefit from immunotherapies.ConclusionsThe 5-gene risk model can predict the prognosis of OV patients, which can draw the attention of clinicians and help stratify patients into high and low risk groups for management.
Anterior retroperitoneal approach in constructing thymokidney organs in swine for xenotransplantation
Authors: Gunes M. Esad , Wolbrom Daniel H. , Fujiwara Sho , Qudus Susan , Cadelina Alexander , Nowak Greg 
Published: November 2024

IntroductionThymokidneys (TK) have been constructed to transplant life-supporting kidney grafts containing donor thymic tissue to induce transplant tolerance. Historically, TKs were constructed by inserting pieces of thymus tissue under the kidney capsule using an intra-abdominal or posterior retroperitoneal (lateral/flank) approach. The intra-abdominal approach is technically easier but causes intra-abdominal adhesions and makes kidney procurement more challenging. The posterior retroperitoneal approach causes fewer complications, but thymus tissue implantation is technically demanding due to limited visibility and exposure of the kidney. We herein describe the anterior retroperitoneal approach that overcomes these challenges.Methods8-week-old GalTKO-swine (n = 2) were sedated, intubated, and draped. Cervical thymus lobes were isolated and excised. Via a small midline abdominal incision, the peritoneum was dissected bilaterally from the abdominal muscles, identifying both kidneys without entering the peritoneal cavity. Multiple thymus pieces were inserted under the kidney capsule. After 8 weeks, TKs were recovered for flow cytometric and histopathological analysis.ResultsIn all kidneys, we successfully constructed TKs with functional thymus tissue under the kidney capsule, verified by histopathology and flow cytometry. No surgical complications were observed, and no adhesions were observed intra-abdominally nor around the kidney, as the peritoneum covered the implanted tissue.ConclusionThe anterior retroperitoneal approach to constructing thymokidneys is easy to perform, offers excellent kidney exposure, allows a larger volume of thymus tissue to be implanted, and decreases the risk of intra-abdominal adhesions. Such constructed TKs are easy to procure with minimal risk of injury to the vascularized thymus as the prerenal peritoneum covers it.
Diagnostic Capacity for Fungal Infections in Tertiary Hospitals in Nigeria and Ghana - An Onsite Baseline Audit of 9 Sites
Authors: Akinlawon Damilola , Osaigbovo Iriagbonse , Yahaya Mohammed , Makanjuola Olufunmilola , Udoh Ubong A. , Nwajiobi-Princewill Philip , Nwafia Ifeyinwa , Peter Jonah , Asamoah Isabella , Peters Folake , Okafor Obiora , Okwor Tochi , Osibogun Akin , Ogunsola Folashade , Jordan Alexander , Chiller Tom , Oladele Rita 
Published: November 2024

ObjectivesTo assess diagnostic mycology capacity and available fungal diagnostic services of microbiology laboratories in eight tertiary hospitals in Nigeria and one in Ghana.MethodsOn-site audits were performed in the microbiology laboratories of nine tertiary hospitals using a structured observation checklist.ResultsA total of nine tertiary hospitals' laboratories in Nigeria and Ghana were assessed between June 2022 and December 2023. The majority of audited laboratories lacked basic infrastructure and materials needed for fungal diagnostic testing, with less than half of the labs having a dedicated mycology bench, space or room, 3/9 (33.3%), appropriate bench workflow 1/9 (11.1%), functional biosafety cabinet type two 2/9 (22.2%), dedicated incubators 3/9 (33.3%), standard operating procedures 1/9 (11.1%), mycology atlases 2/9 (22.2%). Trained laboratory personnel for mycology were also lacking with only one of the laboratories 1/9 (11.1%) observed to have a designated trained personnel for the mycology bench.ConclusionThe audit revealed deficits in basic infrastructure, material resources, dedicated human resources, and laboratory capacity to detect serious fungal infections.
Mitochondrial Genome Instability in W303-SK1 Yeast Cytoplasmic Hybrids
Authors: Epremyan Khoren K. , Burlaka Arteom A. , Markova Olga V. , Galkina Kseniia V. , Knorre Dmitry A. 
Published: November 2024

Unlike most animals, some fungi, including baker’s yeast, inherit mitochondrial DNA (mtDNA) from both parents. When haploid yeast cells fuse, they form a heteroplasmic zygote, whose offspring retain one or the other variant of mtDNA. Meanwhile, some mutant mtDNA (rho−), with large deletions in the nucleotide sequence, can displace wild-type (rho+) mtDNA. Consequently, offspring of zygotes with such rho− mtDNA predominantly carry the mutant variant. This phenomenon is called suppressivity. In this study, we investigated how the suppressivity of rho− mtDNA depends on the mitochondrial and nuclear genomes of the rho+ strain during crossing. Comparing two diverged laboratory strains, SK1 and W303, we measured suppressivity in crosses with four rho− strains. One rho− strain showed significantly higher suppressivity when crossed with SK1 than with W303. We then created cytoplasmic hybrids by swapping mtDNAs between these strains. Surprisingly, we found that the mtDNA of the rho+ strain, rather than its nuclear DNA, determines high suppressivity in crosses of SK1 rho+ with the rho− strain. Additionally, mtDNA replacement reduced respiration rate and growth rate on non-fermentable substrates while increasing the likelihood of functional mtDNA loss. Our data demonstrate that a mutant mtDNA variant’s ability to displace another mitochondrial DNA variant in a heteroplasmic cell depends more on mtDNA sequences than on the biochemical and structural context created by the nuclear genome background.
Skull base-cranio-facial trauma with dura mater repair after subsequent CSF leaking, diagnosis treatment and outcomes
Authors: Encarnación Santos Daniel , Chmutin Gennady , Chaurasia Bipin 
Published: November 2024

Background. Since there is a chance of serious neurological consequences, it is critical to demonstrate the diagnosis and treatment of craniofacial trauma with aetiologies such as extreme sports, motor vehicle accidents, and social trauma. Examining the effectiveness of methods for restoring the Dura after severe craniofacial and skull-base damage made worse by rhinorrhea and CSF leakage is our goal.
Methodology. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews) criteria, a systematic review was conducted. The following search terms were used: "Articles criticizing the analysis of open penetrating craniofacial injury with concurrent CSF leakage from the cranial cavity were examined and included, and associated pathologies, especially severe trauma of the upper and middle regions of the anterior cranial fossa." Rayyan - Intelligent Systematic Review Software A thorough search was conducted in databases like ScienceDirect and PubMed/MEDLINE before employing IBM SPSS Statistics for Windows, Version 26.0 (Released 2020; IBM Corp., Armonk, New York, United States), and EXCEL criteria for the statistical analysis.
Results. A total of 1584 patients with cerebrospinal fluid leaks were included in this investigation. Additionally, 698 patients were shown in Table 1 figure 2 and 886 patients in Table 2, figure 3-4-5. Rhinorrhea following trauma to the base of the skull, or craniofacial, was corrected by transnasal endoscopy in most cases and extracranial approach or craniotomy in fewer cases.
Conclusion. A thorough analysis of the outcomes within the context of healthcare reveals: 1. The efficacy of polyoxybutyrate membrane-based multilayer D-plasty. 2. This evaluation clarified that the inferred further planning for surgical suture material development was made.
THE ROLE OF DYNAMIC MYELOGRAPHIC TECHNIQUES IN IDENTIFYING SPINAL DURAL LEAKS IN INTRACRANIAL HYPOTENSION SYNDROME
Authors: Radu Razvan Alexandru , Dorobat Bogdan 
Published: November 2024

Spontaneous intracranial hypotension (SIH) presents a unique diagnostic and therapeutic challenge due to its varied symptomatology, which often includes orthostatic headaches, nausea, and neurological deficits. Recent advancements in dynamic myelographic techniques have significantly improved the ability to identify spinal dural leaks, a key causative factor in SIH.

This presentation will provide an in-depth review of the clinical manifestations of SIH, emphasizing the importance of accurate and timely diagnosis. We will explore modern dynamic myelographic techniques, including digital subtraction myelography and dynamic CT myelography, which have enhanced the detection of dural breaches and spinal cerebrospinal fluid (CSF) leaks.

The technical aspects of performing dynamic myelography will be discussed, highlighting the procedural steps and imaging protocols that optimize the identification of dural leaks. Comparative data will be presented to illustrate the superiority of these dynamic techniques over traditional imaging methods, particularly in terms of diagnostic accuracy and the ability to pinpoint the exact location of CSF leaks.

Additionally, the presentation will address the implications of these diagnostic advancements for neurosurgery. Identifying spinal dural leaks early can significantly impact the management and outcomes of patients with SIH. The role of neurosurgeons in the surgical repair of these leaks, as well as the potential benefits of minimally invasive techniques, will be explored.

We will also discuss the critical need for healthcare professionals to recognize potential SIH patients and refer them promptly for advanced imaging investigations. Early identification and intervention can prevent chronic disability and improve quality of life for affected individuals.

This presentation aims to provide a comprehensive overview of the role of dynamic myelographic techniques in the diagnosis and management of SIH, offering valuable insights for neurosurgeons, radiologists, and clinicians involved in the care of patients with this condition.
BRACHIAL PLEXOPATHY DUE TO THE ONCOLOGICAL RADIATION TREATMENT RELATED TO MALIGNANCY?
Authors: Savić Andrija , Lepić Milan , Mićić Aleksa , Grujić Jovan , Rasulić Lukas 
Published: November 2024

Radiation-induced brachial plexopathy is a rare but well-known late complication of radiotherapy, typically manifesting several years after treatment. While its incidence is low, it is becoming more prevalent due to improved long-term cancer survival rates, predominantly affecting females. This condition is devastating, significantly altering the quality of life, as it often results in chronic disability that is progressive and usually irreversible. This study aims to present a 38-year single centre experience in the surgical treatment of radiation-induced brachial plexopathy.

The study involved 92 female patients referred for potential surgical treatment of radiation-induced brachial plexopathy. Surgical candidates typically experienced progressive worsening of symptoms 4-6 months after onset, despite exhaustive conservative treatment. Diagnostic criteria included evident fibrosis on MRI or ultrasound and confirmation of plexopathy through electromyography. In total 37 patients were included, all females. Out of 92 cases, 37 were surgically treated due to plexopathy, all underwent external neurolysis, with 25 treated infraclavicularly and 12 both infraclavicular and supraclavicular. The overall functional recovery following surgery was useful, with a median outcome of M3. Post-surgery, 25 patients reported weakness, 31 experienced pain, 5 had lymphedema, and 23 had improved range of motion.

Successfully treating patients with radiation-induced brachial plexopathy poses a significant challenge due to the progressive and often irreversible nature of the condition. Despite surgical interventions, achieving meaningful functional recovery is complex, with many patients continuing to experience persistent symptoms such as weakness and pain.
THE LONG-TERM SEQUELAE OF TBI IN SURGICAL AND NONSURGICAL CASES
Authors: Steudel Wolf-Ingo , Rickels E. , Repschläger U. , Schulte C. , Weissgärber H. , Wende D. 
Published: November 2024

Background
The acute effects of traumatic brain Injury (TBI) are well documented but there is no systematic quantification of its long-term sequelae in German-language literature. The purpose of this study is to compare the frequency of conditions linked to prior TBI with their frequency in the non-brain-injured population.

Methods
A matched cohort study was carried out on the basis of routine data from the BARMER statutory health insurance carrier. The exposure group consisted of patients treated over the period 2006-2009 for TBI at a variety treatment intensities. The control group consisted of BARMER insurees without prior TBI who were matched with the patients in the exposure group for age, sex, and preexisting diseases. Late sequelae were sought in the routine data for a period of ten years after the injury. The outcome rates of the exposure and control groups were compared with Kaplan-Meier estimators and Poisson regression.

Results
114,296 persons with TBI in the period of 2006-2009 were included. The mortality within ten years of TBI was 305 per 1000 individuals. The relative mortality in the exposure group was higher than that in control individuals of the same age and sex, with an incidence rate ratio (IRR) of 1,67 (95% confidence interval (1.60;1.74). Immobility, dementia, epilepsy, endocrine disorders, functional disorders, depression, anxiety, cognitive deficits, headache, and sleep disorders were also more common in the exposure group. Person with TBI requiring high-intensity treatment including surgery displayed the highest relative incidence rates of the conditions studied over 10 years of follow-up.

Conclusion
Adverse sequelae of TBI can still be seen ten years after the exposure. These patients die earlier than person without TBI and suffer earlier and more frequently from associated conditions.
RISK FACTORS ASSOCIATED WITH STEREOTACTIC RADIOSURGERY FOR LARGE SKULL BASE BENIGN MENINGIOMAS
Authors: Stoica Fery , Perin Radu , Neamtu Daniela 
Published: November 2024

Purpose
Skull base meningiomas represent a very challenging pathology due to relatively difficult surgical access. In contrast, stereotactic radiosurgery (SRS) proved to be an effective and more secure treatment technique based on the greater accuracy in delivering precise focused radiation into the target, sparing at the same time healthy surrounding tissues.

Methods and Results
Our study, based on almost 20 years of experience in delivering SRS treatments using various models of Leksell Gamma-Knife units, reports a high tumor control rate for complex-shaped skull base meningiomas close to critical structures. We retrospectively evaluated the risk factors and complications after high-dose irradiation in patients undergoing single-fraction radiosurgery combined with clinical imaging criteria established using MRI scans (in T1 weighted imaging with gadolinium and the edema in T2 weighted sequences).

The mean volume of the tumors was 18.6 cubic centimetres (only tumors with a volume in excess of 15 cubic centimetres were included in the study). The median administered marginal dose was 12.5 Gy. Mean imaging follow-up was 112 months. Tumor control rate was not influenced by sex, age, tumor site, neurological status of the patient or irradiated volume, even though larger meningiomas are associated with poor long-term local control in most published series.

The long-term follow-up data indicates tumor control in 88,5% of patients after 10 years, with low incidence of complications.

Conclusions
Current practice shows a slight potential increase in the incidence of meningiomas, the superiority of the individual techniques needing to be confirmed in prospective and methodologically rigorous studies with at least 20 years of follow-up.
NEUROSURGICAL PERSPECTIVE ON NON-FUNCTIONING PITUITARY NEUROENDOCRINE TUMORS MANAGEMENT
Authors: Tataranu Ligia Gabriela , Ciubotaru Vasile , Solomon Adriana , Dricu Anica , Kamel Amira 
Published: November 2024

Introduction
Pituitary Neuroendocrine Tumors (PitNETs), formerly designated as „pituitary adenomas” (PA), represent a relatively common pathology in the neurosurgical field, accounting for approximately 5.1 cases per 100,000 population yearly. The term “non-functioning” defines all PitNETs that do not induce a hormonal syndrome, and they account for up to 30%. Notwithstanding many aspects regarding non-functional PitNETs that are controversial, like the management of remnants or recurrences, the neurosurgical approach is indisputably indicated in cases of tumoral syndrome.

Material and Methods
The authors of this study aimed to assess patients presenting with non-functioning PitNETs and their outcomes after surgery in the 3rd Neurosurgical Department of the Clinical Emergency Hospital “Bagdasar-Arseni”, Bucharest, for a period of 8 years, between 2016 and 2023. This study is based on a thorough appraisal of the patient’s demographic and clinicopathological data while focusing on the strategic role of the neurosurgical approach.

Results
A total of 325 patients were identified with non-functioning PitNETs, that were treated in our department between the 1st of January 2016 and the 31st of March 2024, of which 193 (59.38%) were male and 132 (40.61%) were female. The mean age at admission was 50.70 years in the male group and 53.44 years in the female group, and the clinical manifestations were mostly those related to the tumoral mass effect, while more than half of the patients also presented with hypopituitarism. All of the patients included in this study underwent neurosurgery via a transnasal trans-sphenoidal approach and a gross-total resection was performed in 79% of cases (N=257). Surgical complications were described. Gamma-knife surgery was a postoperative neurosurgical option for 33 cases (48.5% of the patients with tumor remnants).

Conclusion
Non-functioning PitNETs usually have a slow development, which allows them to grow until the mass effect syndrome sends the patients to the doctor. Trans-sphenoidal surgery is greatly effective in providing symptomatic relief and if grosstotal resection is performed, the chances of recurrence are smaller. However, the intervention should be performed by a neurosurgeon with extensive experience in trans-sphenoidal surgery, to raise the odds of success and minimize the risks of complications.