bluuebunny/crossref_metadata_2025_split huggingface dataset:
FA01.02: THE EFFECT OF POSTOPERATIVE COMPLICATIONS AFTER MIE ON LONG-TERM SURVIVAL: A RETROSPECTIVE, MULTI-CENTER COHORT STUDY
Authors: Fransen Laura , Berkelmans Gijs , Asti Emanuele , Van Berge Henegouwen Mark , Berlth Felix , Bonavina Luigi , Brown Andrew , Bruns Christiane , Gisbertz Suzanne , Grimminger Peter , Gutschow Christian , Hölscher Arnulf , Kauppi Juha , Lagarde Sjoerd M , Mercer Stuart , Moons Johnny , Nafteux Philippe , Nilsson Magnus , Palazzo Francesco , Pattyn Piet , Philippron Annouck , Raptis Dimitri , Räsänen Jari , Rosato Ernest , Rouvelas Ioannis , Schmidt Henner , Schneider Paul , Schröder Wolfgang , Wijnhoven Bas P L , Grard A P , Nieuwenhuijzen  , Luyer Misha 
Published: September 2018

Abstract

Background
Esophagectomy has a high incidence of postoperative morbidity. Complications lead to a decreased short-term survival, however the influence of those complications on long-term survival is still unclear. Most of the performed studies are small, single center cohort series with inconclusive or conflicting results. Minimally invasive esophagectomy (MIE) has been shown to be associated with a reduced postoperative morbidity. In this study, the influence of complications on long-term survival for patients with esophageal cancer undergoing a MIE were investigated.

Methods
Data was collected from the EsoBenchmark database, a collaboration of 13 high-volume centers routinely performing MIE. Patients were included in this database from June 1, 2011 until May 31, 2016. Complications were scored according to the Clavien-Dindo (CD) classification for surgical complications. Major complications were defined as a CD grade ≥ 3. The data were corrected for 90-day mortality to correct for the short-term effect of postoperative complications on mortality. Overall survival was analyzed using the Kaplan Meier, log rank- and (uni- and multivariable) Cox-regression analyses.

Results
A total of 926 patients were eligible for analysis. Mean follow-up time was 30.8 months (SD 17.9). Complications occurred in 543 patients (59.2%) of which 39.3% had a major complication. Anastomotic leakage (AL) occurred in 135 patients (14.5%) of which 9.2% needed an intervention (CD grade ≥ 3). A significant worse long-term survival was observed in patients with any AL (HR 1.73, 95% CI 1.29–2.32, P < 0.001) and for patients with AL CD grade ≥3 (HR 1.86, 95% CI 1.32–2.63, P < 0.001). Major cardiac complications occurred in 18 patients (1.9%) and were related to a decreased long-term survival (HR 2.72, 95% CI 1.38–5.35, p 0.004). For all other complications, no significant influence on long-term survival was found.

Conclusion
The occurrence and severity of anastomotic leakage and cardiac complications after MIE negatively affect long-term survival of esophageal cancer patients.

Disclosure
All authors have declared no conflicts of interest.
FA02.03: TIMING OF REFLUX ESOPHAGITIS (RE) AND BARRET’S ESOPHAGUS (BE) DEVELOPMENT IN PATIENTS AFFECTED BY GERD AFTER HELLER MYOTOMY FOR ESOPHAGEAL ACHALASIA
Authors: Tassi Valentina , Lugaresi Marialuisa , Mattioli Benedetta , Daddi Niccolò , Di Simone Massimo , Bassi Francesco , Mattioli Sandro 
Published: September 2018

Abstract

Background
In order to acquire data on development of RE and BE in patients affected by GERD after Heller myotomy, we investigated a group of these patients who had long term endoscopic follow up. Data acquired in this group and in a group of patients affected by primary GERD and BE were compared.

Methods
In 1973 our group established a research protocol and data base to include patients affected by esophageal diseases observed since 1955 and successively, who were followed up according to defined protocols. A semi quantitative Visick modified scale (RS0 absence; RS3 maximal severity) was adopted for evaluation of reflux symptoms. Among 465 achalasia patients submitted to Heller myotomy in the period 1955–2016, 42 (57.14% men, median age 50 years IQR 44–58 years) post operatively complained grade RS2–3 reflux symptoms and had long term endoscopic/histologic follow up; 42 patients affected by typical GERD and Barret's esophagus, selected according to age and sex with the ‘Frequency matching’ process formed the control group.

Results
Twenty-six patients were submitted to Heller myotomy without antireflux procedure between 1955 and 1977, 16 to Heller-Dor successively. Patients experienced moderate-severe (SR2–3) GER symptoms after a median period of 20 months (IQR 10–86.5 months) since myotomy; in 100% RE was detected after a median period of 34.5 months (IQR 19.25–56.5 months), in 47.61% BE after a median period of 80 months (IQR 52–123 months) since GER symptoms onset. In primary GERD group, in the absence of medical therapy all patients complained of SR2–3 GER symptoms, RE was diagnosed after a median period of 72.5 months (IQR 59.25–120 months) and BE after a median period of 128 months (IQR 91–163.75 months) since GER symptoms onset. Time for RE (P < 0.001) and BE (P = 0.002) development in achalasia patients was significantly shorter with respect to timing in GERD population.

Conclusion
In achalasia patients myotomy induced Barret's esophagus occurs much earlier than in typical GERD patients. This information should be considered for the treatment of post Heller GERD and for selection of candidates to POEM.

Disclosure
All authors have declared no conflicts of interest.
FA02.06: VOLUMETRIC LASER ENDOMICROSCOPY GLAND QUANTIFICATION CAN GUIDE EN-BLOC RESECTION IN DYSPLASTIC BARRETT’S ESOPHAGUS
Authors: Kamboj Amrit , Kahn Allon , Sawas Tarek , Lutzke Lori , Wang Kenneth , Leggett Cadman 
Published: September 2018

Abstract

Background
Endoscopic mucosal resection (EMR) can be performed en-bloc in Barrett's esophagus (BE) lesions that are ≤2 cm in size. The true size of a BE lesion may be underestimated under white light endoscopy, limiting the rate of en-bloc resection. Volumetric laser endomicroscopy (VLE) provides high-resolution cross-sectional imaging of BE. A greater number of VLE glands are associated with BE dysplasia and may help predict lesion size. The aim of this study was to determine the association between VLE gland count and outcome of resection.

Methods
EMR specimens from patients with a history of dysplastic BE were imaged with VLE. EMRs performed on BE lesions ≤2cm in size with intent at en-bloc resection were included. Manual quantification of epithelial glands was performed in blinded fashion. Image visualization enhancement software was used to quantify the surface area occupied by epithelial glands on en-face VLE. Histologic en-bloc (R0) and incomplete (R1) resection of the targeted lesion was defined by the absence and presence of dysplasia and/or cancer at the specimen margins respectively.

Results
The study sample consisted of 37 EMRs from 31 patients. The mean (SD) size of EMRs was 1.04 (0.37) cm. Pathology showed low-grade dysplasia (N = 12), high-grade dysplasia (N = 19), and intramucosal cancer (N = 6). The en-bloc resection rate was 37.8% (R0: N = 14; R1: N = 23). The mean (SD) number of epithelial glands was 13.0 (6.7) and 28.8 (23.9) for R0 and R1 specimens, respectively, with a statistically significant mean difference of 15.8 glands (95% CI: 2–29, P = 0.02) between the two groups. A gland count of 28 or higher per EMR specimen predicted R1 with 100% sensitivity and 39% specificity (ROC: 0.69). The mean (SD) surface area occupied by epithelial glands in R0 and R1 specimens was 0.98 (1.1) mm2 and 2.3 (2.4) mm2, respectively. There was strong correlation between manual gland counts and epithelial gland surface area (R2: 0.81, P < 0.001).

Conclusion
A higher number of VLE glands in EMR specimens is associated with a lower en-bloc resection rate suggesting that white-light endoscopy underestimates lesion size and that VLE may have a potential role in lesion margin assessment.

Disclosure
All authors have declared no conflicts of interest.
Carriage of the Toxic Shock Syndrome Toxin Gene by Contemporary Community-Associated Staphylococcus aureus Isolates
Authors: Parrish Katelyn L , Wylie Kristine M , Reich Patrick J , Hogan Patrick G , Wylie Todd N , Kennedy Colleen R , Lainhart William , Hunstad David A , Burnham Carey-Ann D , Fritz Stephanie A 
Published: September 2018

AbstractWe report here the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017, one of which was recovered from a child with MRSA toxic shock syndrome. tst-1 was encoded by 43 (6%) S aureus isolates overall: 42 (16.7%) MSSA isolates and 1 (0.2%) MRSA isolate (P < .001).
Long-Term Outcomes of Endovascular Treatment of Indirect Carotid Cavernous Fistulae: Superior Efficacy, Safety, and Durability of Transvenous Coiling Over Other Techniques
Authors: Alexander Matthew D , Halbach Van V , Hallam Danial K , Cooke Daniel L , Ghodke Basavaraj V , Dowd Christopher F , Amans Matthew R , Hetts Steven W , Higashida Randall T , Meyers Philip M 
Published: September 2018

Abstract

BACKGROUND
Endovascular surgery is the first-line treatment for indirect cavernous carotid fistulae (CCFs). This study compares multiple treatment techniques.

OBJECTIVE
To compare endovascular techniques for indirect CCF treatment.

METHODS
Retrospective analysis was performed of prospectively maintained records at 4 centers, identifying patients undergoing indirect CCF embolization. Demographics, symptoms, and lesion characteristics were recorded. Medical records were reviewed for changes in symptoms, delayed complications, and angiographically proven recurrence. Univariate and multivariate analyses were performed to identify impacts of the above characteristics on outcomes.

RESULTS
Sufficient records were available for 267 patients treated between January 1987 and December 2016. Obliteration was achieved in 86.5% patients, occurring in 86.9% of exclusively transvenous treatments and 79.5% of other treatments. Obliteration rates were highest following transvenous embolization using coils compared to all other materials (likelihood ratio [LR] 5.0, P = .024). Complications were less common with coil embolization compared to other materials (LR 0.070, P < .001). Embolization with liquid embolics resulted in higher complication rates (LR 10.2, P = .002), although risk was reduced when used in conjunction with coils. Angiographically confirmed recurrence was more common following embolization with polyvinyl alcohol (LR 9.9, P = .004) and when multiple embolic agents were used (LR 6.6, P = .018). Delayed development of symptoms following embolization was less common following embolization with coils (LR 0.20, P = .030) and more common following embolization with liquids (LR 6.5, P = .014).

CONCLUSION
To treat indirect CCFs, transvenous coil embolization is the safest and most effective technique. Liquid embolics are less effective and have more complications and should be carefully considered only in extenuating circumstances.
Occult Hepatitis B Virus Infection: An Old Entity With Novel Clinical Involvements
Authors: Malagnino Vincenzo , Fofana Djeneba Bocar , Lacombe Karine , Gozlan Joel 
Published: September 2018

Abstract

Background
Occult hepatitis B infection (OBI) is recognized as a risk factor for cirrhosis and hepato-cellular carcinoma. However, OBI brings together a large spectrum of patients who might harbor different characteristics and prognosis.

Methods
We analyzed the databases of a university hospital in Paris to identify OBI among patients (n = 3966) concomitantly tested for hepatitis B virus (HBV) DNA and serology during a 7-year period. OBI patients were gathered into clinical entities according to their clinical records.

Results
Forty-seven OBIs were identified (1.2%). All patients had detectable anti-HBc, isolated (n = 26) or associated with anti-HBs (n = 21). The proportion of OBIs was 3.4% for patients with isolated anti-HBc and 4.2% for patients with both anti-HBc and anti-HBs. Four clinical categories of OBI patients were identified: patients with a passed HBV infection with HBs Ag clearance (group A, 23.4%); HBV-exposed patients receiving immunosuppressive therapy (group B, 29.8%); HIV/HBV-coinfected patients with therapy discontinuation (group C, 17%); HBV-exposed patients with severe liver conditions (group D, 29.8%). Significant follow-up was available for 32 patients, showing a more deleterious prognosis in group D patients, associated more with their underlying condition than the OBI status.

Conclusions
OBI is a heterogeneous condition with various clinical implications.
Biofilm thickness matters: Deterministic assembly of different functions and communities in nitrifying biofilms
Authors: Suarez Carolina , Piculell Maria , Modin Oskar , Langenheder Silke , Persson Frank , Hermansson Malte 
Published: September 2018

ABSTRACTMicrobial biofilms are important in natural ecosystems and in biotechnological applications. Biofilm architecture influences organisms’ spatial positions, who their neighbors are, and redox gradients, which in turn determine functions. We ask if and how biofilm thickness influences community composition, architecture and functions. But biofilm thickness cannot easily be isolated from external environmental factors. We designed a metacommunity system in a wastewater treatment plant, where either 50 or 400 µm thick nitrifying biofilms were grown simultaneously on biofilm carriers in the same reactor. Model simulations showed that the 50 µm biofilms could be fully oxygenated whereas the 400 µm biofilms contained anaerobic zones. The 50 and 400 µm biofilms developed significantly different communities. due to deterministic factors were stronger than homogenizing dispersal forces in the reactor, despite the fact that biofilms experienced the same history and external conditions. Relative abundance of aerobic nitrifiers was higher in the 50 µm biofilms, while anaerobic ammonium oxidizers were more abundant in the 400 µm biofilms. However, turnover was larger than the nestedness component of between-group beta-diversity, i.e. the 50 µm biofilm was not just a subset of the thicker 400 µm biofilm with reduced taxa richness. Furthermore, the communities had different nitrogen transformation rates. The study shows that biofilm thickness has a strong impact on community composition and ecosystem function, which has implications for biotechnological applications, and for our general understanding of biofilms.IMPORTANCEMicroorganisms colonize all surfaces in water and form biofilms. Diffusion limitations form steep gradients of energy and nutrient sources from the water phase into the deeper biofilm parts, influencing community composition through the biofilm. Thickness of the biofilm will affect diffusion gradients, and is therefore presumably important for biofilm composition. Since environmental factors determine thickness, studies of how thickness influences biofilm functions and community assembly, have been difficult to perform. We studied biofilms for wastewater treatment with fixed thicknesses of 50 and 400 µm during otherwise similar conditions and history. Despite growing in the same wastewater reactor, 16S rRNA gene sequencing and confocal microscopy showed the formation of two different communities, performing different ecosystem functions. Using statistical methods, we show for the first time, how biofilm thickness influences community assembly. The results help our understanding of the ecology of microbial biofilms, and in designing engineered systems based on ecological principles.
Akt kinases are required for efficient feeding by macropinocytosis inDictyostelium
Authors: Williams Thomas D. , Peak-Chew Sew-Yeu , Paschke Peggy , Kay Robert R. 
Published: September 2018

AbstractMacropinocytosis is an actin-driven process of large-scale, non-specific fluid uptake used for feeding by some cancer cells and the macropinocytosis model organismDictyosteliumdiscoideum. InDictyostelium, macropinocytic cups are organised by ‘macropinocytic patches’ in the plasma membrane. These contain activated Ras, Rac and PI(3,4,5)P3 and direct actin polymerisation to their periphery. Here, we show that a classical (PkbA) and a variant (PkbR1) Akt protein kinase acting downstream of PI(3,4,5)P3 are together are near-essential for fluid uptake. This pathway enables the formation of larger macropinocytic patches and macropinosomes, thereby dramatically increasing fluid uptake. Akt targets identified by phosphoproteomics were highly enriched in small G-protein regulators, including the RhoGAP GacG. GacG knockout mutants make few macropinosomes but instead redeploy their cytoskeleton from macropinocytosis to motility, moving rapidly but taking up little fluid. The function of Akt in cell feeding through control of macropinosome size has implications for cancer cell biology.Summary statementDictyosteliumamoebae feed by macropinocytosis in a PIP3 dependent manner. In the absence of PI3-kinases or the downstream Akt protein kinases, cells have smaller macropinosomes and nearly abolished fluid uptake.
T vector velocity: A new ECG biomarker for identifying drug effects on cardiac ventricular repolarization
Authors: Bystricky Werner , Maier Christoph , Gintant Gary , Bergau Dennis , Kamradt Kent , Welsh Patrick , Carter David 
Published: September 2018

AbstractWe present a new family TrX of ECG biomarkers based on the T vector velocity (TVV) for assessing drug effects on ventricular repolarization. Assuming a link between the TVV and the instantaneous change of the cellular action potentials, drugs accelerating repolarization by blocking inward (depolarizing) ion currents cause a relative increase of the TVV, while drugs delaying repolarization by blocking outward ion currents cause a relative decrease of the TVV.Evaluating the published data from two FDA funded studies, the TrX effect profiles indicate increasingly delayed electrical activity over the entire repolarization process for drugs solely reducing outward potassium current (dofetilide, moxifloxacin). For drugs eliciting block of the inward sodium or calcium currents (mexiletine, lidocaine), the TrX effect profiles were consistent with accelerated electrical activity in the initial repolarization phase. For multichannel blocking drugs (ranolazine) or drug combinations blocking multiple ion currents (dofetilide + mexiletine, dofetilide + lidocaine), the overall TrX effect profiles indicate a superposition of the individual TrX effect profiles.The parameter Tr40c allows separating pure potassium channel blocking drugs from multichannel blocking drugs with an area under the ROC curve (AUC) value of 0.90, CI = [0.88 to 0.92]. This is significantly larger than the performance of J-Tpeakc (0.81, CI = [0.78 to 0.84]) using the published data from the second FDA study. Further performance improvement was achieved by combining the ten parameters Tr10c to Tr100c in a logistic regression model, resulting in an AUC value of 0.94.The TVV based approach substantially improves assessment of drug effects on cardiac repolarization, providing a plausible and improved mechanistic link between drug effects on ionic currents and overall ventricular repolarization reflected in the body surface ECG. TVV may contribute to a better assessment of the proarrhythmic risk of drugs beyond QTc prolongation and JTpeakc.
Functional composition has stronger impact than species richness on carbon gain and allocation in experimental grasslands
Authors: Roscher Christiane , Karlowsky Stefan , Milcu Alexandru , Gessler Arthur , Bachmann Dörte , Jesch Annette , Lange Markus , Mellado-Vázquez Perla , Strecker Tanja , Landais Damien , Ravel Olivier , Buchmann Nina , Roy Jacques , Gleixner Gerd 
Published: September 2018

AbstractNumerous experiments have shown positive diversity effects on plant productivity, but little is known about related processes of carbon gain and allocation. We investigated these processes in a controlled environment (Montpellier European Ecotron) applying a continuous 13CO2 label for three weeks to 12 soil-vegetation monoliths originating from a grassland biodiversity experiment (Jena Experiment) and representing two diversity levels (4 and 16 sown species). Plant species richness did not affect community- and species-level 13C abundances neither in total biomass nor in non-structural carbohydrates (NSC). Community-level 13C excess tended to be higher in the 16-species than in the 4-species mixtures. Community-level 13C excess was positively related to canopy leaf nitrogen (N), i.e. leaf N per unit soil surface. At the species level shoot 13C abundances varied among plant functional groups and were larger in legumes and tall herbs than in grasses and small herbs and correlated positively with traits as leaf N concentrations, stomatal conductance and shoot height. The 13C abundances in NSC were larger in transport sugars (sucrose, raffinose-family oligosaccharides) than in free glucose, fructose and compounds of the storage pool (starch) suggesting that newly assimilated carbon is to a small portion allocated to storage. Our results emphasize that the functional composition of communities is key in explaining carbon assimilation in grasslands.
The Synergistic Effect of Antioxidant Interaction between Luteolin and Chlorogenic Acid in Lonicera japonica
Authors: Hsieh Meng Hsuen , Hsieh Meng Ju , Wu Chi-Rei , Peng Wen-Huang , Hsieh Ming-Tsuen , Hsieh Chia-Chang 
Published: September 2018

AbstractLonicera japonica Thunb. is a flower that is used in traditional Chinese medicine to prevent the common cold. The two primary active compounds of the flower bud are luteolin, a flavonoid, and chlorogenic acid, a phenolic acid. Both active compounds have demonstrated antioxidant activity. The interactions between chemicals in a plant heavily influences its total antioxidant activity. We attempted to investigate the antioxidant interactions between the two chemicals in the plant. This study aims to investigate if the antioxidants luteolin and chlorogenic acid have a synergistic effect to inhibit free radicals when combined. A 2,2-diphenyl-1-picrylhydrazyl (DPPH•) assay was performed. The half maximal inhibitory concentration (IC50) of luteolin and chlorogenic acid were first determined and then combined at a 1:1 ratio. The combined inhibition capacity was then compared with the sum of the individual inhibition capacities. The IC50 of luteolin is 26.304 μg·ml-1 ± 0.120 μg·ml-1 while the IC50 of chlorogenic acid is 85.529 μg·ml-1 ± 4.482 μg·ml-1. The combined solution produced a free radical percentage inhibition of 77.617% ± 5.470%, more than the percentage inhibition of the separate solutions. The experiment shows that luteolin and chlorogenic acid have a synergistic effect in inhibiting DPPH free radicals.
On simulating cold stunned turtle strandings on Cape Cod
Authors: Xiaojian Liu , Manning James , Prescott Robert , Huimin Zou , Faherty Mark 
Published: September 2018

AbstractKemp’s ridley turtles were on the verge of extinction in the 1960s. While they have slowly recovered, they are still endangered. In the last few years, the number of strandings on Cape Cod Massachusetts beaches has increased by nearly an order of magnitude relative to preceding decades. This study uses a combination of ocean observations and a well-respected ocean model to investigate the causes and transport of cold-stunned animals in Cape Cod Bay. After validating the model using satellite-tracked drifters and local temperature moorings, ocean currents were examined in the Cape Cod Bay in an attempt to explain stranding locations as observed by volunteers and, for some years, backtracking was conducted to examine the potential source regions. The general finding, as expected, is that sub 10.5°C water temperatures in combination with persistent strong wind stress (>0.4Pa) will result in increased strandings along particular sections of the coast dependent on the wind direction. However, it is still uncertain where in the water column the majority of cold stunned turtles reside and, if many of them are on the surface, considerable more work will need to be done to incorporate the direct effects of wind and waves on the advective processes.