bluuebunny/crossref_metadata_2025_split huggingface dataset:
HPB SO68 - Evaluating the Outcome of Laparoscopic Cholecystectomy Against Key Performance Indicator (KPI) of the British Benign Upper GI Surgical Society (BBUGSS)
Authors: Zubair Farhan , Di Rollo Domenic , Khan Khurram Shahzad 
Published: November 2024

Abstract

Background
Laparoscopic cholecystectomy (LC) presents inherent challenges and potential for significant complications, influenced by both patient factors and surgical expertise. Recognizing this variability, the British Benign Upper GI Surgical Society (BBUGSS) has established Key Performance Indicators (KPIs) aimed at enhancing LC outcomes. This study conducts an audit of LC outcomes in a single centre district general hospital (DGH) in accordance with BBUGSS KPIs and thus aims to determine if quality LC by modern standards is achievable in a DGH.

Method
The present retrospective observational study examined all adult LC conducted between August 2022 and June 2024 by two specialized biliary surgeons at a single surgical unit within a DGH, which also serves as a referral center of biliary cases from affiliated hospitals. The analysis encompassed preoperative assessments, intraoperative observations, and postoperative outcomes, with a focus on aligning these findings against the benchmarks established by the BBUGSS KPIs.

Results
141 patients were included; median age was 54 years (IQR 41-64) and 59.6% were female. 37.6% were emergency cases, 44.2% were for acute cholecystitis, 22.7% for gallstone pancreatitis and 63.1% underwent intra-operative cholangiogram. KPIsBBUGSS StandardOur resultDay case for elective cases50%42%Readmission (within 30 days)&lt;10%4.3%Laparoscopic cholecystectomy for acute cholecystitis (within 7 days)&gt;35%97%Laparoscopic cholecystectomy for gallstone pancreatitis (within 2 weeks)&gt;95%100%Conversion to open&lt;5%0.7%Morbidity&lt;10%1.4%Bile leak after elective surgery&lt;1.5%0%Retained bile duct stones&lt;2.5%0%Bile duct injury&lt;0.3%0%Mortality&lt;0.1%0%

Conclusion
This study shows that with the exception of day-case rate in elective LC, all KPIs were satisfactorily achieved, indicating that high quality LC is achievable within a DGH. The majority of readmissions within 30 days were related to inadequate postoperative analgesia. We have since enhanced pain management pathways. It is hoped that this will also improve same day discharge for elective cases to achieve BBGUGS standard. We are committed to conducting annual audits to monitor and optimize surgical outcomes and would encourage other centers to consider adopting the same approach.
HPB SO70 - Evaluating the Outcome of Laparoscopic Common Bile Duct Exploration Against Key Performance Indicator (KPI) of the British Benign Upper GI Surgical Society (BBUGSS)
Authors: Zubair Farhan , Di Rollo Domenic , Khan Khurram Shahzad 
Published: November 2024

Abstract

Background
Treatment of common bile duct (CBD) stone(s) can be challenging with a risk of significant complications. Laparoscopic common bile duct exploration (LCBDE) displays superior outcomes when compared to endoscopic retrograde cholangiopancreatography (ERCP). Acknowledging the impact of patient variables and surgical proficiency, the British Benign Upper GI Surgical Society (BBUGSS) developed Key Performance Indicators (KPIs) to optimize LCBDE outcomes. The present study comprises an audit of LCBDE outcomes with respect to the BBUGSS KPIs and aims to determine the feasibility and quality of LCBDE that can be achieved in a district general hospital (DGH) with a recently developed LCBDE service.

Method
This retrospective observational study examined all adult patients who underwent LCBDE between August 2022 and June 2024 by two specialized biliary surgeons at a single surgical unit within a DGH. This DGH also serves as a referral center for biliary cases from affiliated hospitals. The preference in our surgical unit is single stage management (laparoscopic cholecystectomy and simultaneous LCBDE) of CBD stones in surgically fit patients. The analysis included preoperative assessments, intraoperative observations, and postoperative outcomes, with respect to the published BBUGSS KPIs for LCBDE.

Results
60 patients were eligible for inclusion; median age was 56 years (IQR 40-67) and 40 (66.7%) were female. 33 (55%) were emergency cases. 52 (86.7%) were transcystic exploration; of these 8 (15.4%) utilised basket-in-catheter and 44 (84.6%) utilised choledochoscopes. Median post-operative stay for transcystic exploration was 1 day (IQR 0-2) and for cholechodotomy 8 days (IQR 5-9). Key Performance IndicatorBBUGSS StandardOur outcomeConversion rates&lt;10%0%Bile duct clearance rates&gt;85%91.7%Bile Leak Rates&lt;5%0%Returns to theatre&lt;5%0%Readmission rates (within 30 days)&lt;15%6.7%Overall Morbidity&lt;15%3.3%Overall Mortality&lt;1%0%

Conclusion
This study indicates that the BBUGSS KPIs for LCBDE are satisfactorily achieved in our centre. Adequate ductal clearance with minimal morbidity was achieved. Our outcomes are likely attributed to the recent commencement of a specialist biliary service and utilisation of predominantly transcystic approach, with the aid of electrohydraulic lithotripsy where needed, as opposed to choledochotomy. Furthermore, the present study suggests a high quality LCBDE service is feasible in a DGH setting if there is sufficient clinical and managerial motivation. We suggest that single stage management of bile duct stones model should be considered in other similar centres.
HPB SO79 - Dropped Gallstones After Laparoscopic Cholecystectomy: An Umbrella Review
Authors: Abu Abduelraheim , Almoshantaf Mohammad 
Published: November 2024

Abstract

Background
The enduring presence of gallstones after laparoscopic cholecystectomy (LC) presents a substantial clinical obstacle, potentially resulting in morbidity and diagnostic intricacies, frequently leading to delayed identification.
This umbrella systematic review aims to investigate the available body of literature regarding the symptoms, signs, etiology, management strategies, and associated complications of retained gallstones.

Method
We performed an extensive search of the academic literature spanning several databases, namely PubMed, Embase, Scopus, Web of Science, and Google Scholar. Inclusion criteria for this research encompassed systematic reviews, with or without meta-analysis, focusing on the examination of spilled gallstones in terms of signs, symptoms, diagnosis, imaging, and management. The assessment of potential bias in the final study selection was undertaken utilizing the R-AMSTAR and Risk of Bias in Systematic Reviews (ROBIS) assessment tools.

Results
The most sites for lost gallstones were the subhepatic, perihepatic, retroperitoneal, right flank and pelvic regions. A higher proportion of patients underwent emergency laparoscopic cholecystectomy compared to those who underwent elective procedures. complications included intra-abdominal abscesses, foreign body granulomas, parietal wall abscesses or pelvic abscesses. Multiple stones more common than single stones. Various clinical presentations have been documented, including the presence of abdominal masses simulating malignancy, intestinal obstruction, pelvic pain or fistula formation. Surgical intervention emerged as the primary treatment approach. Computed tomography was the most frequently employed diagnostic modality for stone identification (70.2%), ultrasonography (US) (63.2%) and X-ray (42.9%).

Conclusion
Our study highlights the overlooked issue of spilled gallstones post-laparoscopic cholecystectomy, posing diagnostic challenges and potential complications. Surgeons and patient education regarding this is lacking, stressing the need for increased awareness. Comprehensive studies with larger cohorts are essential for understanding risk factors and developing effective interventions.
Pangenome Reveals Gene Content Variations and Structural Variants Contributing to Pig Characteristics
Authors: Du Heng , Zhuo Yue , Lu Shiyu , Li Wanying , Zhou Lei , Sun Feizhou , Liu Gang , Liu Jian-Feng 
Published: November 2024

Abstract
Pigs are among the most essential sources of high-quality protein in human diets. Structural variants (SVs) are a major source of genetic variants associated with diverse traits and evolutionary events. However, the current linear reference genome of pigs limits the presentation of position information for SVs. In this study, we generated a pangenome of pigs and a genome variation map of 599 deep-sequenced genomes across Eurasia. Moreover, a section-wide gene repertoire was constructed, which indicated that core genes were more evolutionarily conserved than variable genes. Subsequently, we identified 546,137 SVs, their enrichment regions, and relationships with genomic features and found significant divergence across Eurasian pigs. More importantly, the pangenome-detected SVs could complement heritability estimates and genome-wide association studies based only on single nucleotide polymorphisms. Among the SVs shaped by selection, we identified an insertion in the promoter region of the TBX19 gene, which may be related to the development, growth, and timidity traits of Asian pigs and may affect the gene expression. Our constructed pig pangenome and the identified SVs provide rich resources for future functional genomic research on pigs.
Confronting Rifles with Words: The High Islamic Council of Mali and Non-State Armed Groups
Authors: Parisi Piergiuseppe 
Published: November 2024

Abstract
Since the 2012 Tuareg rebellion and the takeover of large areas in the north of Mali by Islamic fundamentalist groups, Muslim religious leaders in the country have spearheaded important negotiation initiatives under the auspices of the High Islamic Council of Mali (HCIM). On more than one occasion, these initiatives have led to the liberation of detainees or the possibility of humanitarian convoys reaching communities caught in the midst of the armed conflict. Why were these initiatives successful (or unsuccessful)? How did religious leaders convince non-state armed groups to adopt conduct that complies with basic humanitarian norms? Drawing on desk-based and fieldwork research conducted as part of the Generating Respect Project, this article seeks to answer these questions and to identify the endogenous and contextual factors that contributed to the successes of the HCIM and its negotiators.
Association between physical activity patterns of working-age adults and social jetlag, depressive symptoms, and presenteeism
Authors: Seol Jaehoon , So Rina , Murai Fumiko , Matsuo Tomoaki 
Published: November 2024

Abstract
Objectives: This study aimed to evaluate the association of physical activity with social jetlag, depressive symptoms, and presenteeism.
Methods: This cross-sectional study included 8247 working-age adults (females, 44.6%; age, 20-64 years). Social jetlag was defined as the absolute difference between the midpoint of bedtime and wake time on workdays and free days. Depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and presenteeism was evaluated using the Work Functioning Impairment Scale. Exercise habits were classified into 4 groups based on the World Health Organization guidelines: nonactive (NA; n = 4223), insufficiently active (IA; n = 3009: exercise below guideline levels), weekend warriors (WW; n = 220: exercise 1-2 times per week meeting guideline levels), and regularly active (RA; n = 793: exercise at least 3 d/wk meeting guideline levels). Using multiple and Poisson regression analyses, we examined the association between exercise habits and each outcome.
Results: Social jetlag, depression, and presenteeism were more favorable with shorter sedentary times and longer durations of moderate- and vigorous-intensity exercise. Compared with the RA group, the NA group had a significantly higher prevalence of social jetlag (prevalence ratio [PR] = 1.30), depression (PR = 1.31), and presenteeism (PR = 1.35). The IA group had a significantly higher prevalence of depression (PR = 1.33) and presenteeism (PR = 1.38).
Conclusions: Exercising with a certain frequency and intensity may help prevent symptoms of depression and social jetlag, and consequently prevent presenteeism.
Goals of care conversations and advance care planning for paediatric patients living with serious illness
Authors: Rapoport Adam 
Published: November 2024

Abstract
Goals of care discussions and advance care planning aim to align the values and wishes of patients and their families with the care received. All paediatric health care practitioners who care for fetuses, infants, children or adolescents with serious illnesses have an ethical responsibility to educate themselves about these aspects of care. This statement assists care providers with important conversations. Effective communication is essential to clarify the goals of care and establish agreement on appropriate treatments for achieving those goals, including resuscitative and palliative measures.
Evaluation of a complex intervention: the Latch On randomized controlled trial of multicomponent breastfeeding support for women with a raised body mass index
Authors: McNestry Catherine , Hobbins Anna , Donnellan Niamh , Gillespie Paddy , McAuliffe Fionnuala M , O’Reilly Sharleen L ,   Latch On Consortium, McGuinness Denise , Killeen Sarah Louise , Mehegan John , Coughlan Barbara , O’Brien Eileen C , Conway Marie , O'Brien Denise , Szafranska Marcelina , Brosnan Mary , Sheehy Lucille , Murtagh Rosie , O'Hagan Lorraine , Corbett Marie , Walsh Michelle , Keogh Regina , Power Paula , Woodcock Marie , Phelan Mary , Carroll Amy , Murray Stephanie , Scallan Charmaine , Dunn Elizabeth 
Published: November 2024

Abstract

Background
Latch On’s objective was to achieve improved breastfeeding rates in women with raised body mass indices using a multicomponent breastfeeding support intervention.

Methods
A hybrid type 1 implementation-effectiveness trial with mixed-methods process and health economics analyses were conducted. Data collection included stakeholder questionnaires, interviews, focus groups, fidelity data, participant and health system costs.

Results
The intervention was delivered with fidelity but the high breastfeeding rates at 3 months were not different between intervention and usual care. Participants receiving the minimum intervention dose were more likely to initiate breastfeeding (P = 0.045) and be breastfeeding at hospital discharge (P = 0.01) compared with participants below the threshold. Participant exit interview themes highlighted the importance of improving breastfeeding support to women, the effect of COVID-19 on the breastfeeding experience, and found that the intervention improved the experience of establishing breastfeeding. The intervention cost €157 per participant, with no other cost difference between groups. Process analysis found that follow-up breastfeeding services continued in half of sites after study completion.

Conclusions
This low-cost intervention resulted in a more enjoyable breastfeeding experience for participants and changed practice in some study sites. The intervention dose received may impact effectiveness, but further research is needed to provide definitive evidence of clinical and cost effectiveness.
Mitochondrial Dysfunction and Cognitive Impairment in Schizophrenia: The Role of Inflammation
Authors: Wang Guanyu , Liu Senqi , Fan Xiaoyun , Li Jinming , Xue Qianzi , Liu Kang , Li Xue , Yang Yongfeng , Wang Xiujuan , Song Meng , Shao Minglong , Li Wenqiang , Han Yong , Lv Luxian , Su Xi 
Published: November 2024

Abstract

Background and Hypothesis
The complex immune-brain interactions and the regulatory role of mitochondria in the immune response suggest that mitochondrial damage reported in schizophrenia (SZ) may be related to abnormalities observed in immune and brain functions.

Study Design
Mitochondrial DNA copy number (mtDNA CN), a biomarker of mitochondrial function, was assessed in peripheral blood leukocytes (PBLs) of 121 healthy individuals and 118 SZ patients before and after 8 weeks of antipsychotic treatment, and a meta-analysis related to blood mtDNA CN was conducted. Plasma C-reactive protein (CRP) levels in SZ patients were obtained from the medical record system. Spearman correlation analysis and hierarchical linear regression were used to analyze the relationships among mtDNA CN, CRP levels, and cognitive function. A mediation model was constructed using the PROCESS program.

Study Results
Our results revealed the decreased mtDNA CN in PBLs from SZ patients (P = .05). The meta-analysis supported the decreased blood mtDNA CN in SZ patients (P &lt; .01). The mtDNA CN in PBL was positively correlated with working memory (P = .02) and negatively correlated with plasma CRP levels (P = .039). Furthermore, a lower mtDNA CN in PBL in SZ patients was a significant predictor of worse working memory (P = .006). CRP acted as a mediator with an 8.0% effect.

Conclusions
This study revealed an association between peripheral mitochondrial dysfunction and cognitive impairment in SZ, with inflammation acting as a mediating effect. Therefore, mitochondrial dysfunction might provide novel targets for new treatments for cognitive impairment in SZ.
What is ‘high-risk research’? Comparing the social sciences and humanities and the natural sciences
Authors: Hamann Julian , Stein Daniel 
Published: November 2024

Abstract
Although high-risk research is a key concern for research policy and science studies, there is little knowledge about what funding agencies or researchers mean by risks. This paper draws on 80 grant proposals from the social sciences and humanities (SSH) and the natural sciences (NSC) that have been submitted to the Reinhart Koselleck funding program of the German Research Foundation. The qualitative analysis shows both similarities and differences in how applicants in the two fields claim risks: in both fields, the most prominent notions refer to results and methodologies. While results at risk are interpreted similarly, methodological risks differ between the two fields. The analysis also reveals a greater variety of different risks in the SSH compared to the NSC. The paper suggests that research policy and science studies should avoid treating “riskiness” as a given and consider different notions of risk across a disciplinary spectrum that includes the SSH.
Proteomics reveals that nanoplastics with different sizes induce hepatocyte apoptosis in mice through distinct mechanisms involving mitophagy dysregulation and cell cycle arrest
Authors: Lu Yan-Yang , Hua Weizhen , Sun Yiqiong , Lu Lu , Ren Hongyun , Huang Qingyu 
Published: November 2024

Abstract
Nanoplastics (NPs) can penetrate the intestinal barrier of organisms and accumulate in the liver, thereby inducing hepatocyte apoptosis. However, the underlying mechanisms remain incompletely elucidated. This study examined the effects of PS-NPs exposure on hepatocyte apoptosis and revealed the role of cell cycle arrest and mitophagy. The C57BL/6 mice were administered a diet containing 100 nm and 500 nm PS-NPs at a concentration of 0.1 g/kg for 180 days, respectively. TUNEL staining confirmed that 100 nm PS-NPs induced more pronounced apoptosis compared to 500 nm PS-NPs in mouse liver. Mechanistically, proteomic analysis revealed that Pdcd2l, associated with the S phase of cell cycle and apoptosis, exhibited the highest fold changes among all detected proteins in 100 nm and 500 nm PS-NPs exposure groups. Notably, the expression of Tbc1d17, Bcl2l13, and Pgam5 involved in mitophagosome formation in mouse liver was upregulated by 100 nm PS-NPs but not by 500 nm PS-NPs; moreover, mitophagosomes were observed in HepG2 cells exposed to 100 nm PS-NPs. Additionally, 100 nm PS-NPs internalized by HepG2 cells could penetrate lysosomes. The protein levels of Igf2r and Rab7a were altered, and p62 mRNA expression was increased in mouse liver, suggesting 100 nm PS-NPs, but not 500 nm PS-NPs, impaired lysosomal function and subsequently inhibited mitophagy degradation. Collectively, 500 nm PS-NPs induced Pdcd2l-mediated cell cycle arrest, thereby exacerbating hepatocyte apoptosis; while 100 nm PS-NPs not only triggered similar levels of cell cycle arrest as 500 nm PS-NPs, but also disrupted mitophagy, which was also associated with hepatocyte apoptosis.
Plant Viral Synergism: Co-expression of P1 and NIaPro Cistrons of Wheat Streak Mosaic Virus and Triticum Mosaic Virus Is Required for Synergistic Interaction in Wheat
Authors: Wong Chi Hzeng , Alexander Jeffrey , Tatineni Satyanarayana 
Published: November 2024

Synergistic interactions among unrelated viruses in mixed infections can cause significant yield losses, and viral determinants of these interactions are poorly understood. Wheat ( Triticum aestivum L.) co-infection with wheat curl mite-transmitted wheat streak mosaic virus (WSMV) and Triticum mosaic virus (TriMV) results in disease synergism with a drastically increased symptom phenotype of stunted growth, leaf bleaching, and enhanced titers of both viruses compared with individual virus infections. In this study, we examined the viral determinants responsible for WSMV-TriMV disease synergism through transient expression of select cistrons of WSMV in wheat through TriMV and vice-versa. We found that expression of WSMV P1, NIa, or NIaPro in wheat through TriMV or vice-versa elicited moderate to severe symptoms with a moderate or no increase in virus titer. However, co-expression of P1 and NIaPro of WSMV in wheat through TriMV or vice-versa exhibited a WSMV-TriMV disease synergism-like phenotype with enhanced accumulation of genomic RNA copies and coat protein. Additionally, we found that the P3 of both viruses is dispensable for synergism. HCPro and NIaVPg of WSMV and TriMV are not the primary determinants but might have a minor role in efficient synergism. In co-infected wheat, the accumulation of virus-specific small interfering RNAs (vsiRNAs) was increased, similar to viral genomic RNA copies, despite the presence of two viral RNA-silencing suppressors (VRSS), which function through sequestration of vsiRNAs. Our findings revealed that WSMV-TriMV disease synergism is not caused by the suppression of host posttranscriptional gene silencing by two VRSS proteins in co-infected wheat, and the P1 and NIaPro of both viruses collectively drive synergistic interactions between WSMV and TriMV in wheat. [Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2025.
Ciprofloxacin Dosage Optimization in Cystic Fibrosis Through Therapeutic Drug Monitoring
Authors: Sayadi Hamza , Fromage Yeleen , Monchaud Caroline , Languepin Jeanne , Masson-Rouchaud Alexandra , Labriffe Marc , Woillard Jean-Baptiste 
Published: November 2024

Background:
Ciprofloxacin (CIP) is effective against many Gram-negative pathogens and penetrates well into respiratory secretions and pulmonary tissues, thus making it useful for treating respiratory infections in patients with cystic fibrosis (CF).

Methods:
A 13-year-old patient with severe CF and an acute respiratory exacerbation from multidrug-resistant Pseudomonas aeruginosa was treated with 700 mg of CIP every 8 hours. Bronchial secretions confirmed that P. aeruginosa was sensitive to high doses of CIP. Pharmacokinetic monitoring using 2 blood samples estimated the AUC24 at 50 hours*mg/L. This led to an increase in CIP dosage to 850 mg three time a day (TID), then to 1000 mg TID, and finally to 1200 mg every 6 hours.

Results:
CIP pharmacokinetics can vary significantly, particularly in patients with CF due to increased clearance, ultimately resulting in shorter half-lives and higher risks of therapeutic failure and resistance. Therapeutic drug monitoring helps when adjusting dosages to maintain effective blood concentrations.

Conclusions:
This case underscores the role of therapeutic drug monitoring in optimizing CIP dosing for patients with CF and highlights the necessity for close collaboration between clinicians and pharmacologists to ensure effective antibiotic exposure.