bluuebunny/crossref_metadata_2025_split huggingface dataset:
RA09.08: EVALUATION OF THE EIGHTH YPTNM CLASSIFICATION SYSTEM IN ESOPHAGEAL CANCER PATIENTS
Authors: Nomura Motoo , Tsunoda Shigeru , Sakanaka Katsuyuki , Tamaoki Masashi , Amanuma Yusuke , Miyamoto Shinichi , Fujii Kohta , Hisamori Shigeo , Obama Kazutaka , Muto Manabu , Sakai Yoshiharu 
Published: September 2018

Abstract

Background
The 7th edition of the Union for International Cancer Control (UICC) TNM staging system is based on pathologic data from esophageal cancers treated by surgery alone. In the 8th edition of UICC-TNM staging system, there is no information available for treatment modality (surgery alone or neoadjuvant therapy [NAC] followed by surgery [NAC-S]), although clinical stage, neoadjuvant pathologic stage, and pathologic stage were analyzed and identified. The objective of this study was to evaluate the prognostic impact of the new staging system on esophageal squamous cell cancer (ESCC) patients treated by NAC-S.

Methods
Database of 140 consecutive ESCC patients in our hospital was retrospectively restaged in 7th and 8th UICC-TNM system. The prognostic impacts of pathologic stage after NAC according to the both staging systems were compared.

Results
The median follow-up period was 4.8 years (range 0.2–9.7), with 49 patients dead at the time of analysis. In 7th edition, the 3-year overall survival rates (3y-OS) of ypStages 0, I, II, III, and IV were 100%, 93.5%, 93.5%, 43.9%, and 0.0%, respectively. In 8th edition, the 3y-OS of ypStages 0, I, II, III, and IV were 100%, 96.5%, 90.2%, 51.7%, and 29.6%, respectively. There were no marked differences between 7th and 8th edition in the prognoses. The both editions poorly distinguish the prognoses of ypStages 0, I, and II. For pathological prognostic group in 7th edition, the 3y-OS of Groups 0, I, II, III, and IV were 100%, 97.0%, 90.6%, 43.9%, and 0.0%, respectively. For pathological prognostic group in 8th edition, the 3y-OS of Groups 0, I, II, III, and IV were 100%, 96.7%, 89.8%, 51.7%, and 29.6%, respectively. For patients with ypStages 0-II, pretreatment higher CEA was poor prognostic factor (HR 7.1, 95% confidence interval 1.9–25.9).

Conclusion
Our study indicates the problem that the ypStage in the 8th TNM staging system poorly distinguish the prognoses of ypStages 0, I, and II in patients undergoing NAC-S. Additional study is needed to evaluate the role of ypStage 0-II incorporation of new prognostic factors.

Disclosure
All authors have declared no conflicts of interest.
VS01.02: MEDIASTINAL LYMPH NODE DISSECTION DURING MINIMAL INVASIVE ESOPHAGECTOMY
Authors: Noshiro Hirokazu , Yoda Yukie 
Published: September 2018

Abstract

Description
As esophageal cancer reveals aggressive characteristics of lymph node metastasis, esophagectomy with extensive lymph node dissection is required as the optimal management in most cases. In spite of improvements in the survival rate, however, the procedure is still associated with significant postoperative morbidity and mortality. As minimally invasive surgery reduces both pain and the systemic inflammatory response, minimally invasive esophagectomy has been developed in an obvious attempt to reduce the incidence of postoperative complications. In addition, the magnified and clear views by thoracoscopy accelerate recognition for the fine and minute surgical anatomy of the mediastinum. Thoracoscopic mobilization of the esophagus and mediastinal lymph node dissection as part of a three-stage procedure was reported in the early 1990s. Recently, thoracoscopic esophageal mobilization and mediastinal dissection in the prone position has been developed. Enhanced visualization and improved ergonomics for surgeons in the prone position provide higher-quality mobilization and lymphadenectomy and contribute to enhancement of the learning curve. Especially, it is favorable during the procedures of upper mediastinal lymph node dissection which are the most complicated ones. During this lymph node dissection, the concept of lymphatic flow is very important. Now, it takes 3 hours and 15 minutes for the thoracic procedure, but the blood loss is less than 100 ml in our recent series. In the presentation, the surgical procedures of thoracoscopic or robotically-assisted esophagectomy in the prone position for esophageal cancer will be demonstrated and our surgical results of over 300 cases will be shown.

Disclosure
All authors have declared no conflicts of interest.
VS01.03: ROBOTIC-ASSISTED D2-LYMPHADENECTOMY IN SURGERY FOR CANCER OF THE ESOPHAGEAL CARDIA
Authors: Dubecz Attila , Giulini Luca , Stein Hubert 
Published: September 2018

Abstract

Description

BACKGROUND
Widespread acceptance of minimally-invasive surgery for adenocarcinoma for the distal esophagus limited by the feasibility of an oncologically correct complete D2-lymphadenectomy which can be facilitated by using robotic-assisted surgery. The aim of this presentation is to describe our technique and short-term results of a series of robotic-assisted esophagectomies with D2-lymphadenectomy for esophageal cancer, using the da Vinci Surgical System.

MATERIALS AND METHODS
Between November 2016 and January 2018, we performed 48 consecutive robotic-assisted esophagectomies with an extended D2-lymphadenectomy for histologically-proven adeno- or squamous-cell-carcinoma of the cardia and distal esophagus. Data were collected in a database and retrospectively analyzed.

RESULTS
Median operative time was 333 min (200–536). Conversion to open technique occured in 10.4% (abdominal 2.1%, thoracic 8.3%). Median intraoperative blood loss was 50 mL. Median number of harvested lymph nodes was 28 (13–68). Resection margins were negative in all cases (91.7% R0, 2.1% Rx, 6.2% R1). Surgery-related morbidity attributed to the extended D2-Lymphadenectomy was 2.1%. The over-all 30 days-mortality for this series was 2.1%.

CONCLUSIONS
Robotic-assisted surgery with modern tissue sealing techiques allows optimal hemostasis and a fast, safe and effective D2-lymphadenectomy with an adequate lymph node harvest with low postoperative morbidity. Technique of the robotic assisted D2-Lymphadenectomy will be presented in the accompanying video.

Disclosure
All authors have declared no conflicts of interest.
VS02.01: FLEXIBLE ENDOSCOPIC CRICOPHARYNGEAL MYOTOMY WITH THULIUM LASER
Authors: Siboni Stefano , Aiolfi Alberto , Sozzi Marco , Ceriani Chiara , Bonavina Luigi 
Published: September 2018

Abstract

Description
Flexible endoscopic treatment of Zenker's diverticulum is feasible, but electrocautery and CO2 laser technology carry the risk of collateral thermal injury. Thulium laser septum incision may overcome this limitation. We describe for the first time the use of thulium laser through flexible endoscopy in a small cohort of patients with Zenker diverticulum.

Methods
Thulium laser septum division was performed via flexible endoscopy under general anesthesia in 11 consecutive symptomatic patients with primary or recurrent Zenker diverticulum. Primary study aims were feasibility and safety of the procedure. To improve exposure and stabilize the septum during the procedure, either a transparent cap or a bivalve soft overtube were used. The laser system used was Opera® (Quanta System SpA, Varese, Italy), emitting a 1.9 μm Thulium wavelength radiation. A continuous laser configuration and an emission power of 5 to 16 W were chosen to allow incision of the mucosa and cricopharyngeal myotomy. Using 272 and 365 μm optical fibres in a non-contact mode, laser incision was performed in the midline of the septum until cricopharyngeal muscle fibers were encountered and a V-shaped myotomy was completed under visual control.

Results
Between May and January 2018, 11 consecutive patients were treated. Four patients presented with recurrent symptomatic diverticulum after previous transoral septum stapling or endoscopic myotomy. Median dysphagia and regurgitation scores were 4.1 ± 0.7 and 3.3 ± 0.8 respectively. Complete division of the septum was achieved in all patients. There was no bleeding nor need of adjunctive electrocautery devices to complete the procedure. The post-operative course was uneventful in all patients; the chest film and gastrographin swallow study on post-operative day one were negative for pneumomediastinum or leaks. All patients were discharged within 48 hours on a soft diet. At the 2-month follow-up visit, all patients were satisfied with the procedure with a post-operative dysphagia score of 2.0 ± 0.6 and a regurgitation score of 1.5 ± 0.4.

Conclusions
Division of Zenker's septum with Thulium laser is feasible and safe through flexible endoscopy. Longer term follow-up is required to establish effectiveness and reproducibility of this novel procedure.

Disclosure
All authors have declared no conflicts of interest.
VS02.03: LAPAROSCOPIC EXCISION OF ESOPHAGEAL FISTULA TRACT (LEEFT) IN A SPONTANEOUS ESOPHAGOCUTANEOUS FISTULA WITH KIKUCHI DISEASE
Authors: Voon Kelvin , Hamidi Osman Mohd , Mohammed Taher Mustafa , Rajan Reynu , Ritza Kosai Nik 
Published: September 2018

Abstract

Description
Spontaneous esophagocutaneous fistula is rare and necrotizing mediastinal lymphadenopathy is one of the causes. We report a case of spontaneous esophagocutaneous fistula in a 38-year-old lady with Kikuchi disease that was treated with laparoscopic excision of esophageal fistula tract (LEEFT). On endoscopy, the fistula opening was located at right posterolateral wall of distal esophagus, 3cm above esophagogastric junction. Esophageal stenting and endoscopic clipping of fistula were attempted but the fistula tract persisted. She then underwent laparoscopic excision of esophageal fistula tract. Laparoscopic excision of esophageal fistula tract (LEEFT) is a novel transhiatal technique as compared to the usual transthoracic aproach. Patient is placed in french position and it is done via 4-laparoscopic port technique with liver retraction. LEEFT is feasible in distally located esophageal fistula. In comparison to transthoracic aproach, the dissection and control of esophagus is easier with this technique as dissection through the chronic inflammatory tissue in the posterior mediastinum is avoided. Moreover, it spares the morbidity associated with single lung ventilation and transthoracic approach.

Disclosure
All authors have declared no conflicts of interest.
VS02.06: ROBOTIC RE-DO GIANT HIATAL HERNIA WITH MESH
Authors: Sallum Rubens , Takeda Flavio , Santo Marco , Cecconello Ivan 
Published: September 2018

Abstract

Description
The authors present a video of reoperation of relapsed giant hiatal hérnia (twice). Tactics of static presentation of 2 robotic arms allowing safe dissection with 2 concomitant energy modalities: ultrasonic scalpel and bipolar. The endowrist movments allow intrathoracic safe dissection. The hiatal repair with barbed suture at different angles was followed by a biological U-shape mesh. Total fundoplication with 3 lines of suture and hiatal fixation are highlighted.

Disclosure
All authors have declared no conflicts of interest.
VS02.07: ROBOTIC RESSECTION OF A GIANT THORACIC ESOPHAGEAL LEIOMYOMA
Authors: Sallum Rubens , Takeda Flavio , Santo Marco , Cecconello Ivan 
Published: September 2018

Abstract

Description
The authors present the video of robotic resection of extensive leiomyoma of the thoracic esophagus. We highlight the use of 4 robotic arms that allow the rotation of the leiomyoma of great proportions, as well as presentation of the contralateral face of the muscular breach to perform the repair of the esophageal wall. The removal of the tumor (in bag peacemeal) is still observed.

Disclosure
All authors have declared no conflicts of interest.
VS03.06: RADICAL OPERATION OF ESOPHAGEAL CANCER UNDER 3D THORACOSCOPE (ABDOMINAL PART)
Authors: Jiang Jie , Yu Xiuyi , Geng Guojun , Liu Hongming 
Published: September 2018

Abstract

Description
To show the main operation procedure of the abdominal part of the radical operation of esophageal carcinoma.

Disclosure
All authors have declared no conflicts of interest.
The Central Nervious System Acts as a Transducer of Stress-Induced Masculinization through Corticotropin-Releasing Hormone B
Authors: Castañeda Cortés DC , Arias Padilla LF , Langlois VS , Somoza GM , Fernandino JI 
Published: September 2018

ABSTRACTExposure to environmental stressors during early development has important implications for rescheduling many cellular and molecular mechanisms. In some fish species, environmental stressors, like high temperatures (HT), cause an increase in cortisol levels. In turn, this mechanism induces sex reversal of genotypic females, overriding genetic factors related to development of the gonad. However, the involvement of the brain in this process is not well clarified. In the present work, we investigated the mRNA levels of corticotropin-releasing hormone b (crhb) and its receptors (crhr1 and crhr2), and found out that they were up-regulated at HT during the critical period of gonadal sex determination in medaka (Oryzias latipes), i.e., when the gonadal primordium is sexually labile. In order to clarify their roles in sex reversal, biallelic mutants for crhr1 and crhr2 were produced by CRISPR/Cas9 technology. Remarkably, biallelic mutant of both loci (crhr1 and crhr2) did not undergo female-to-male sex reversal upon HT exposition, whereas mutants for either crhr1 or crhr2 showed partial, or intersex phenotypes, suggesting that both crh receptors are required for HT-induced masculinization. Inhibition of this process in double crhrs mutants could be successfully rescued through the administration of the downstream effector of the hypothalamic-pituitary interrenal axis, the cortisol. Taken together, these results revealed for the first time the participation of the central nervous system acting as a transducer of masculinization induced by thermal stress.
Sentence processing is modulated by the current linguistic environment and a priori information: An fMRI study
Authors: Weber K. , Micheli C. , Ruigendijk E. , Rieger J.W. 
Published: September 2018

AbstractWords are not processed in isolation but in rich contexts that are used to modulate and facilitate language comprehension. Here, we investigate distinct neural networks underlying two types of contexts. Firstly, the current linguistic environment, presented as the relative frequencies of two syntactic structures (prepositional object (PO) and double-object (DO)), which would either follow everyday linguistic experience or not. Secondly, preference towards one or the other structure depending on the verb; learned in everyday language use and stored in memory. German participants were reading PO and DO sentences in German while brain activity was measured with functional magnetic resonance imaging. Firstly, the anterior cingulate cortex (ACC) showed a pattern of activation that integrated the current linguistic environment with everyday linguistic experience. When the input did not match everyday experience, the unexpectedly frequent structure showed higher activation in the ACC than the other conditions and more connectivity from the ACC to posterior parts of the language network. Secondly, verb-based surprisal of seeing a structure given a verb (PO verb preference but DO structure presentation) resulted, within the language network (left inferior frontal and left middle/superior temporal gyrus) and the precuneus, in increased activation compared to a predictable situation. In conclusion, 1) beyond the canonical language network, brain areas engaged in cognitive control, such as the ACC, might use the statistics of syntactic structures to facilitate language comprehension, 2) the language network is directly engaged in processing verb preferences. These two networks show distinct influences on sentence processing.
Fungal community assembly in soils and roots under plant invasion and nitrogen deposition
Authors: Phillips Michala L. , Weber S□ren E. , Andrews Lela V. , Aronson Emma L. , Allen Michael F. , Allen Edith B. 
Published: September 2018

AbstractAbstract Fungal community composition in the Anthropocene is driven by rapid changes in environmental conditions caused by human activities. This study examines the relative importance of two global change drivers – atmospheric nitrogen (N) deposition and annual grass invasion – on structuring fungal communities in a California chaparral ecosystem, with emphasis on arbuscular mycorrhizal fungi. We used molecular markers, functional groupings, generalized linear statistics and joint distribution modeling, to examine how environmental variables structure taxonomic and functional composition of fungal communities. Invasion of a chaparral ecosystem decreased richness and relative abundance of non-AMF symbionts and rhizophilic AMF (e.g. Glomeraceae) as well as the proportion of edaphophilic AMF (e.g. Gigasporaceae). We found increased richness and the proportion of rhizophilic and edaphophilic AMF with increasing soil NO3. Our findings suggest that invasive persistence may decrease the presence of multiple soil symbionts that native species depend on for pathogen protection and increased access to soil resources.
Marine Fe-oxidizingZetaproteobacteria: Historical, ecological, and genomic perspectives
Authors: McAllister Sean M. , Moore Ryan M. , Gartman Amy , Luther George W. , Emerson David , Chan Clara S. 
Published: September 2018

AbstractTheZetaproteobacteriaare a class of bacteria typically associated with marine Fe oxidizing environments. First discovered in the hydrothermal vents at Loihi Seamount, Hawaii, they have become model organisms for marine microbial Fe oxidation. In addition to deep sea and shallow hydrothermal vents,Zetaproteobacteriaare found in coastal sediments, other marine subsurface environments, steel corrosion biofilms, as well as saline terrestrial aquifers and springs. Isolates from a range of environments all grow by Fe oxidation. Their success lies partly in their microaerophily, which enables them to compete with abiotic Fe oxidation at the low O2concentrations common to Fe(II)-rich oxic/anoxic transition zones. Also,Zetaproteobacteriamake a variety of biomineral morphologies as a repository for Fe(III) waste, and as attachment structures. To determine the known diversity of theZetaproteobacteria, we have used 16S rRNA gene sequences to define 59 operational taxonomic units (OTUs), at 97% similarity. While someZetaproteobacteriataxa appear to be cosmopolitan, various habitats enrich for different sets ofZetaproteobacteria. OTU networks show that certainZetaproteobacteriaco-exist, sharing compatible niches. These niches may correspond with adaptations to O2, H2, and nitrate availability, based on genomic analyses. Also, a putative Fe oxidation gene has been found in diverseZetaproteobacteriataxa, suggesting that theZetaproteobacteriaevolved as specialists in Fe oxidation. In all, culture, genomic, and environmental studies suggest thatZetaproteobacteriaare widespread, and therefore have a broad influence on marine and saline terrestrial Fe cycling.
Polygenic Prediction via Bayesian Regression and Continuous Shrinkage Priors
Authors: Ge Tian , Chen Chia-Yen , Ni Yang , Anne Feng Yen-Chen , Smoller Jordan W. 
Published: September 2018

AbstractPolygenic prediction has shown promise in identifying individuals at high risk for complex diseases, and may become clinically useful as the predictive performance of polygenic risk scores (PRS) improves. Here, we present PRS-CS, a novel polygenic prediction method that infers posterior SNP effect sizes using GWAS summary statistics and an external linkage disequilibrium (LD) reference panel. PRS-CS utilizes a high-dimensional Bayesian regression framework, and is distinct from previous work by placing a continuous shrinkage (CS) prior on SNP effect sizes, which is robust to varying genetic architectures, provides substantial computational advantages, and enables multivariate modeling of local LD patterns. Simulation studies using data from the UK Biobank show that PRS-CS outperforms existing methods across a wide range of effect size distributions, especially when the training sample size is large. We apply PRS-CS to predict six complex diseases and six quantitative traits in the Partners HealthCare Biobank, and further demonstrate the improvement of PRS-CS in prediction accuracy over alternative methods.
Human cortical dynamics during full-body heading changes
Authors: Gramann Klaus , Hohlefeld Friederike U. , Gehrke Lukas , Klug Marius 
Published: September 2018

AbstractThe retrosplenial complex (RSC) plays a crucial role in spatial orientation by computing heading direction and translating between distinct spatial reference frames based on multi-sensory information. While invasive studies allow investigating heading computation in moving animals, established non-invasive analyses of human brain dynamics are restricted to stationary setups. To investigate the role of the RSC in heading computation of actively moving humans, we used a Mobile Brain/Body Imaging approach synchronizing electroencephalography with motion capture and virtual reality. Data from physically rotating participants were contrasted with rotations based only on visual flow. During physical rotation, varying rotation velocities were accompanied by pronounced wide frequency band synchronization in RSC, the parietal and occipital cortices. In contrast, the visual flow rotation condition was associated with pronounced alpha band desynchronization, replicating previous findings in desktop navigation studies, and notably absent during physical rotation. These results suggest an involvement of the human RSC in heading computation based on visual, vestibular, and proprioceptive input and implicate revisiting traditional findings of alpha desynchronization in areas of the navigation network during spatial orientation in movement-restricted participants.
Hyperconnectivity of the default mode network in multiorgan dysfunction syndrome
Authors: Jimenez-Marin Antonio , Rivera Diego , Boado Victoria , Diez Ibai , Labayen Fermin , Garrido Irati , Ramos-Usuga Daniela , Rasero Javier , Cabrera Alberto , Stramaglia Sebastiano , Arango-Lasprilla Juan Carlos , Cortes Jesus M. 
Published: September 2018

AbstractMultiple Organ Dysfunction Syndrome (MODS) is a systemic physiological disorder affecting two or more body organs triggered after an insult complication. Beyond the systemic failure, patients who survive MODS present cognitive and neurological impairments that remain stable even several years after Intensive Care Unit (ICU) discharge. Here, we focus on the specific situation of MODS patients with no apparent brain damage (NABD), where the mechanisms driving cognitive impairment at long term are not well-understood. We recruit N1 = 13 MODS patients with NABD at 6 months after ICU discharge, together with N2 = 13 healthy controls (matched by age, sex and years of education), and acquire functional magnetic resonance imaging at rest to find that, as compared to control, MODS patients with NABD present an overall increase of the functional connectivity (FC) at rest. In particular, we find that the default mode network (DMN) hyperconnects (increasing the node strength of the FC matrix) to three classes of networks: primary sensory (such as auditory, sensory-motor and visual), multimodal integration (such as dorsal attention and salience) and higher order cognition networks (such as fronto-parietal, language and executive control). Therefore, although these patients do not have an apparent structural damage after MODS, at the functional level, we found brain network alterations coexisting with hyperconnectivity of the DMN, that similar to what happens at the onset of other pathologies, might indicate a possible mechanism for brain compensation occurring after MODS.