bluuebunny/crossref_metadata_2025_split huggingface dataset:
RA03.07: LEARNING CURVE FOR ROBOTIC AND VIDEO-ASSISTED THORACOSCOPIC ESOPHAGECTOMY: A MULTIDIMENSIONAL ANALYSIS
Authors: Chao Yin-Kai 
Published: September 2018

Abstract

Background
Lymph node dissection (LND) along the left recurrent laryngeal nerve (RLN) is a technically challenging part of esophageal cancer surgery, especially after chemoradiotherapy (CRT). Robotic surgery holds promise to increase its safety and feasibility.

Methods
Patients who underwent minimally invasive esophagectomy and RLN dissection following CRT were dichotomized according to the use of robotic surgery (robotic esophagectomy [RE] versus video-assisted thoracoscopic esophagectomy [VATE]). Comparisons were made in terms of 1) number of dissected nodes, 2) rates of RLN palsy, 3) rates of perioperative complications, and 4) learning curves. Analysis of learning curves was performed with the cumulative sum (CUSUM) method (target failure rate for left RLN palsy: 15%).

Results
The RE and VATE groups consisted of 39 and 67 patients, respectively. The intraoperative identification of the left RLN was more common in the RE group (97.4%) than in the VATE group (68.7%, P < 0.001). Postoperative left RLN palsy was significantly more frequent in the VATE group (26.9%) than in the RE group (10.3%, P = 0.042), with a higher rate of pneumonia in the former (16.4% versus 2.6%, P = 0.03). CUSUM analysis revealed a longer learning curve when left RLN LND was performed through VATE. Left RLN palsy rates did not decrease below the target rate with the use of VATE, whereas RE allowed achieving the predefined target rate after 12 operations.

Conclusion
In the current study, we compared for the first time the learning curves of traditional and robotic surgery for RLN LND (which can be considered as one of the most technically challenging parts of esophageal cancer surgery). Our goal was to determine the minimum number of treated cases required to achieve an acceptable technical competency. Our data indicate that RE significantly facilitated a complex procedure like left RLN LND, resulting in a shorter learning curve compared with VATE. Notably, the left RLN was more easily identifiable with the use of RE, which in turn resulted in lower post-procedural left nerve palsy rates. Although MA analysis revealed that robotic surgery was initially more time-consuming than VATE, RE procedural times improved rapidly and became shorter than those of VATE after treatment of 26 cases.

Disclosure
All authors have declared no conflicts of interest.
RA10.04: POSTOPERATIVE PNEUMONIA IS ASSOCIATED WITH SHORT-TERM AND LONG-TERM MORTALITY OF DEFINITIVE CHEMORADIOTHERAPY FOLLOWED BY SALVAGE ESOPHAGECTOMY FOR ESOPHAGEAL CANCER
Authors: Takeuchi Masashi , Kawakubo Hirofumi , Mayanagi Shuhei , Fukuda Kazumasa , Nakamura Rieko , Suda Koichi , Wada Norihito , Kitagawa Yuko 
Published: September 2018

Abstract

Background
Although definitive chemoradiotherapy (CRT) with salvage esophagectomy has improved overall survival (OS) for esophageal cancer, it is a more invasive approach than neoadjuvant CRT followed by surgery or surgery alone, and causes high mortality after surgery. The purpose of this study was to investigate the short and long-term outcomes of salvage esophagectomy, to determine their prognostic factors, and to create a prediction model for OS using a classification and regression tree (CART).

Methods
Ninety patients who had undergone CRT followed by esophagectomy for thoracic esophageal cancer at Keio University Hospital, Tokyo, Japan, between June 1994 and August 2014 were identified for this study. We divided the 90 patients into two groups—the salvage group and the neoadjuvant group—according to the dose of irradiation of CRT. Forty-four patients who underwent CRT with radiation dose less than 50 Gy, followed by planned esophagectomy, were allocated to the neoadjuvant group. Forty-six patients with salvage esophagectomy for locally recurrent or residual cancer after definitive CRT (greater than 50 Gy) were allocated to the salvage group.

Results
Patients from the salvage group tended to have a lower OS (median survival: Salvage, 25 months vs neoadjuvant, 50 months, P = 0.149). In the salvage group, pneumonia and age were identified as factors predictive of in-hospital mortality. OS was significantly lower in patients with postoperative pneumonia and female gender. We set the prediction model for OS in the salvage group using survival CART. The group of R1/2 resection aged ≥ 56.5 years and the group suffering from postoperative pneumonia were the groups at highest risk; the area under the curve was 0.72.

Conclusion
The present study demonstrates the short-term and long-term prognostic factors of salvage esophagectomy after definitive CRT for esophageal cancer. Achieving improvement in OS after salvage surgery requires increased R0 resection rates and decreased pulmonary complications. Both informed decision making in the adoption of salvage surgery and specific plans to reduce pneumonia through means such as pulmonary rehabilitation are required.

Disclosure
All authors have declared no conflicts of interest.
Impact of Aging and HIV Infection on the Function of the C-Type Lectin Receptor MINCLE in Monocytes
Authors: Zapata Heidi J , Van Ness Peter H , Avey Stefan , Siconolfi Barbara , Allore Heather G , Tsang Sui , Wilson Jean , Barakat Lydia , Mohanty Subhasis , Shaw Albert C 
Published: September 2018

AbstractBoth aging and HIV infection are associated with an enhanced pro-inflammatory environment that contributes to impaired immune responses and is mediated in part by innate immune pattern-recognition receptors. MINCLE is a C-type lectin receptor that recognizes trehalose-6,6ʹ-dimycolate or “cord factor,” the most abundant glycolipid in Mycobacterium tuberculosis. Here, we evaluated MINCLE function in monocytes in a cohort of HIV-infected and uninfected young (21–35 years) and older adults (≥60 years) via stimulation of peripheral blood mononuclear cells with trehalose-6,6-dibehenate, a synthetic analog of trehalose-6,6ʹ-dimycolate and measurement of cytokine production (interleukin [IL]-10, IL-12, IL-6, tumor necrosis factor-α) by multicolor flow cytometry. Our studies show an age- and HIV-associated increase in cytokine multifunctionality of monocytes both at the population and single cell level that was dominated by IL-12, IL-10, and IL-6. These findings provide insight into the host response to M. tuberculosis and possible sources for the pro-inflammatory environment seen in aging and HIV infection.
C-type natriuretic peptide improves growth retardation in a mouse model of cardio-facio-cutaneous syndrome
Authors: Inoue Shin-ichi , Morozumi Naomi , Yoshikiyo Kazunori , Maeda Hiroaki , Aoki Yoko 
Published: September 2018

Abstract
Cardio-facio-cutaneous (CFC) syndrome, a genetic disorder caused by germline mutations in BRAF, KRAS, MAP2K1 and MAP2K2, is characterized by growth retardation, heart defects, dysmorphic facial appearance and dermatologic abnormalities. We have previously reported that knock-in mice expressing the CFC syndrome-associated mutation, Braf Q241R, showed growth retardation because of gastrointestinal dysfunction. However, other factors associated with growth retardation, including chondrogenesis and endocrinological profile, have not been examined. Here, we show that 3- and 4-week-old BrafQ241R/+ mice have decreased body weight and length, as well as reduced growth plate width in the proximal tibiae. Furthermore, proliferative and hypertrophic chondrocyte zones of the growth plate were reduced in BrafQ241R/+ mice compared with Braf+/+ mice. Immunohistological analysis revealed that extracellular signal-regulated kinase (ERK) activation was enhanced in hypertrophic chondrocytes in BrafQ241R/+ mice. In accordance with growth retardation and reduced growth plate width, decreased serum levels of insulin-like growth factor 1 (IGF-1) and IGF binding protein 3 (IGFBP-3) were observed in BrafQ241R/+ mice at 3 and 4 weeks of age. Treatment with C-type natriuretic peptide (CNP), a stimulator of endochondral bone growth and a potent inhibitor of the FGFR3-RAF1-MEK/ERK signaling, increased body and tail lengths in Braf+/+ and BrafQ241R/+ mice. In conclusion, ERK activation in chondrocytes and low serum IGF-1/IGFBP-3 levels could be associated with the growth retardation observed in BrafQ241R/+ mice. Our data also suggest that CNP is a potential therapeutic target in CFC syndrome.
The contribution of ice algae to the winter energy budget of juvenile Antarctic krill in years with contrasting sea ice conditions
Authors: Bernard Kim S , Gunther Lacey A , Mahaffey Sean H , Qualls Katelyn M , Sugla Monisha , Saenz Benjamin T , Cossio Anthony M , Walsh Jennifer , Reiss Christian S 
Published: September 2018

AbstractKrill overwintering strategies vary with ontogeny and year; understanding this variability is essential to predicting how the species will respond to climate change in the future. Overwintering studies have focused on larval and adult krill, but we know little about how juvenile krill overwinter. The late winter diet of juvenile krill is important because it will determine their growth and development rates and consequently their reproductive potential the following spring. A diet rich in ice algae would promote growth and reproductive development. The Bransfield Strait (northern Antarctic Peninsula, AP) is an important overwintering ground for krill; it has been proposed this region offers a food-rich winter environment. We examined the contribution of ice algae to the energy budget of overwintering juvenile krill during 2 years with contrasting sea ice conditions. Grazing on ice algae contributed ∼146% to their winter energy budget in 2015, even though ice concentrations were ≤50% and consisted of newly formed pancake ice. However, when sea ice advanced late in the Bransfield Strait (2016), ice algae contributed significantly less (∼16%) to the winter energy budget of juvenile krill. Delayed sea ice advance may negatively affect growth and reproductive development of overwintering juvenile krill.
Should a fistula first policy be revisited in elderly haemodialysis patients?
Authors: Lomonte Carlo , Basile Carlo , Mitra Sandip , Combe Christian , Covic Adrian , Davenport Andrew , Kirmizis Dimitrios , Schneditz Daniel , van der Sande Frank 
Published: September 2018

Abstract
Life-sustaining haemodialysis requires a durable vascular access (VA) to the circulatory system. The ideal permanent VA must provide longevity for use with minimal complication rate and supply sufficient blood flow to deliver the prescribed dialysis dosage. Arteriovenous fistulas (AVFs) have been endorsed by many professional societies as the VA of choice. However, the high prevalence of comorbidities, particularly diabetes mellitus, peripheral vascular disease and arterial hypertension in elderly people, usually make VA creation more difficult in the elderly. Many of these patients may have an insufficient vasculature for AVF maturation. Furthermore, many AVFs created prior to the initiation of haemodialysis may never be used due to the competing risk of death before dialysis is required. As such, an arteriovenous graft and, in some cases, a central venous catheter, become a valid alternative form of VA. Consequently, there are multiple decision points that require careful reflection before an AVF is placed in the elderly. The traditional metrics of access patency, failure and infection are now being seen in a broader context that includes procedure burden, quality of life, patient preferences, morbidity, mortality and cost. This article of the European Dialysis (EUDIAL) Working Group of ERA-EDTA critically reviews the current evidence on VA in elderly haemodialysis patients and concludes that a pragmatic patient-centred approach is mandatory, thus considering the possibility that the AVF first approach should not be an absolute.
Parenting Desires Among Individuals Living With Human Immunodeficiency Virus in the United States
Authors: Cohn Susan E , Haddad Lisa B , Sheth Anandi N , Hayford Christina , Chmiel Joan S , Janulis Patrick F , Schmandt Justin 
Published: September 2018

Abstract

Background
In 1988, 1 of 3 women (W) and heterosexual men living with human immunodeficiency virus (HIV) reported wanting children, but little is known about parenting desires of men who have sex with men (MSM) living with HIV. We examined parenting desires among persons initiating antiretroviral therapy (ART).

Methods
Of 1809 participants in the AIDS Clinical Trials Group (ACTG) Study 5257, 1425 W aged ≤45 years or men completed questionnaires about parenting desires at baseline and 96 weeks after initiating ART. Self-reported desires for children in the future (yes/unsure vs no) and associations between baseline sociodemographics and parenting desires at 96 weeks were examined using multivariable logistic regression, overall and within subgroups.

Results
The 1425 participants were as follows: 36% white, 39% black, 22% Hispanic; median age 36 (interquartile range, 28–44); 70% MSM, 13% men reported sex only with W (MSW), 17% W. At baseline, 42% may want children in the future (42% MSM, 37% MSW, 43% W); at 96 weeks, 41% may want children (41% MSM, 37% MSW, 43% W). At follow-up, approximately 10% of responses changed in each direction. In multivariable analyses, education greater than high school, &lt;30 years, and having no children were significantly associated with future parenting desires among all subgroups. Among MSM, being black was associated with desiring children.

Conclusions
Approximately 40% of MSM, W, and MSW with HIV may want children, both at baseline and 96 weeks after ART initiation. These results highlight the need to regularly assess parenting goals, provide access to comprehensive reproductive services, and address prevention of vertical and heterosexual HIV transmission.
Validation of an Antimicrobial Stewardship-Driven Verigene Blood-Culture Gram-Negative Treatment Algorithm to Improve Appropriateness of Antibiotics
Authors: Claeys Kimberly C , Schlaffer K E , Heil E L , Leekha S , Johnson J K 
Published: September 2018

Abstract
Rapid diagnostic testing (RDT) allows for early adjustment of antibiotic therapy. This study examined the potential impact of a stewardship-driven antibiotic treatment algorithm, incorporating RDT into the management of Gram-negative bacteremia. The proposed algorithm would have resulted in 88.4% of cases receiving appropriate antibiotic therapy versus 78.1% by standard of care (P = .014).
Human Thelaziasis: Emerging Ocular Pathogen in Nepal
Authors: Sah Ranjit , Khadka Shusila , Adhikari Mahesh , Niraula Reema , Shah Apoorva , Khatri Anadi , Donovan Suzanne 
Published: September 2018

Abstract
Thelaziasis is an ocular arthropod-borne, zoonotic disease of the eye infecting the conjunctival sac, lacrimal duct, and lacrimal gland caused by a nematode of the genus Thelazia. We report the first case of human ocular thelaziasis in Nepal in a 6-month-old child from a Rukum district, Nepal. The infant presented with conjunctivitis, and his visual acuity and dilated fundal examination were normal. A total of 6 worms were removed for identification. Collected nematodes were identified based on morphological keys as Thelazia callipaeda. The patient’s symptoms improved after removal of the nematodes.
Middle Cerebral Artery Aneurysm “Neck Overhang”: Decreased Postclipping Residual Using the Intersecting Clipping Technique
Authors: Dimitriadis Stavros , Qeadan Fares , Taylor Christopher L , Yonas Howard , Carlson Andrew P 
Published: September 2018

Abstract

BACKGROUND
Middle cerebral artery (MCA) aneurysms continue to be viewed by many as primarily surgical entities.

OBJECTIVE
To introduce a new, easily measurable dimension termed “neck overhang,” defined as the amount of the aneurysm that extends proximal to the 2 dimensionally defined “neck” and to evaluate the utility of the intersecting clipping technique (use of straight clip and intersecting fenestrated clip) to adapt to this overhanging segment's specific dimensions and achieve better obliteration of the MCA aneurysms.

METHODS
We reviewed retrospectively 100 MCA aneurysms treated surgically over the last 10 yr at our institution. We identified the clipping technique that was performed (intersecting vs “standard” technique) and we evaluated the presence of a postoperative remnant. We then correlated these with the aneurysm's overhanging neck length.

RESULTS
Forty-three aneurysms were treated with the intersecting clipping technique. The overall rate of remnant was 16%. In the standard group, the rate of remnant was 23%, whereas with intersecting clipping that was 7% (P = .029). Within the standard clipping group, we found that the optimum threshold for length of the neck overhang was ≥1.9 mm in order to predict the occurrence of residual. Applying this threshold to the intersecting clipping technique group resulted in a reduction in remnant from 35% in the standard group to 9%.

CONCLUSION
Neck overhang >1.9 mm is associated with a higher chance of postclipping residual aneurysm in MCA aneurysms. The intersecting clipping technique is a versatile technique that can conform to various aneurysms’ geometry and can reduce the rate of post clipping residual for aneurysms with high neck overhang.
Spectral Contrast Optical Coherence Tomography Angiography Enables Single-Scan Vessel Imaging
Authors: Winkelmann James A. , Eid Aya , Spicer Graham , Almassalha Luay M. , Nguyen The-Quyen , Backman Vadim 
Published: September 2018

AbstractOptical coherence tomography angiography relies on motion for contrast and requires at least two data acquisitions per pointwise scanning location. We present a method termed spectral contrast optical coherence tomography angiography using visible light that relies on the spectral signatures of blood for angiography from a single scan using endogenous contrast. We demonstrate the molecular sensitivity of this method, which enables lymphatic vessel, blood, and tissue discrimination.
Generalization via superposition: Combined effects of mixed reference frame representations for explicit and implicit learning in a visuomotor adaptation task
Authors: Poh Eugene , Taylor Jordan A. 
Published: September 2018

AbstractStudies on generalization of learned visuomotor perturbations has generally focused on whether learning is coded in extrinsic or intrinsic reference frames. This dichotomy, however, is challenged by recent findings showing that learning is represented in a mixed reference frame. Overlooked in this framework is how learning is the result of multiple processes, such as explicit re-aiming and implicit motor adaptation. Therefore the proposed mixed representation may simply reflect the superposition of explicit and implicit generalization functions, each represented in different reference frames. Here, we characterized the individual generalization functions of explicit and implicit learning in relative isolation to determine if their combination could predict the overall generalization function when both processes are in operation. We modified the form of feedback in a visuomotor rotation task to isolate explicit and implicit learning, and tested generalization across different limb postures to dissociate the extrinsic and intrinsic representations. We found that explicit generalization occurred predominantly in an extrinsic reference frame but the amplitude was reduced with postural changes, whereas implicit generalization was phase-shifted according to a mixed reference frame representation and amplitude was maintained. A linear combination of individual explicit and implicit generalization functions accounted for nearly 85% of the variance associated with the generalization function in a typical visuomotor rotation task, where both processes are in operation. This suggests that each form of learning results from a mixed representation with distinct extrinsic and intrinsic contributions, and the combination of these features shape the generalization pattern observed at novel limb postures.New and noteworthyGeneralization following learning in visuomotor adaptation tasks can reflect how the brain represents what it learns. In this study, we isolated explicit and implicit forms of learning, and showed that they are derived from a mixed reference frame representation with distinct extrinsic and intrinsic contributions. Furthermore, we showed that the overall generalization pattern at novel workspaces is due to the superposition of independent generalization effects developed by explicit and implicit learning processes.
Fast temporal dynamics and causal relevance of face processing in the human temporal cortex
Authors: Schrouff Jessica , Raccah Omri , Baek Sori , Rangarajan Vinitha , Salehi Sina , Mourão-Miranda Janaina , Helili Zeinab , Daitch Amy L. , Parvizi Josef 
Published: September 2018

ABSTRACTRecordings with a large number of intracranial electrodes in eight neurosurgical subjects offered a unique opportunity to examine the fast temporal dynamics of face processing simultaneously across a relatively large extent of the human temporal cortex (TC). Measuring the power of slow oscillatory bands of activity (θ, α, β, and γ) as well as High-Frequency Broadband (HFB, 70-177 Hz) signal, we found that the HFB showed the strongest univariate and multivariate changes in response to face compared to non-face stimuli. Using the HFB signal as a surrogate marker for local cortical engagement, we identified recording sites with selective responses to faces that were anatomically consistent across subjects and responded with graded strength to human, mammal, bird, and marine animal faces. Importantly, the most face selective sites were located more posteriorly and responded earlier than those with less selective responses to faces. Using machine learning based methods, we demonstrated that a sparse model focusing on information from the human face selective sites performed as well as, or better than, anatomically distributed models of face processing when discriminating faces from non-faces stimuli. Lastly, we identified the posterior fusiform (pFUS) site as causally the most relevant node for inducing distortion of face perception by direct electrical stimulation. Our findings support the notion of face information being processed first in the most selective sites - that are anatomically discrete and localizable within individual brains and anatomically consistent across subjects – which is then distributed in time to less selective anterior temporal sites within a time window that is too fast to be detected by current neuroimaging methods. The new information about the fast spatio-temporal dynamics of face processing across multiple sites of the human brain provides a new common ground for unifying the seemingly contradictory modular and distributed models of face processing in the human brain.
NetWheels: A web application to create high quality peptide helical wheel and net projections
Authors: Mól A.R. , Castro M.S. , Fontes W. 
Published: September 2018

AbstractHelices are one of the most common secondary structures found in peptides and proteins. The wheel and net projections have been proposed to represent in two dimensions the tridimensional helical structures and facilitate the observation of their properties, especially in terms of residues polarity and intramolecular bonding. Nevertheless, there are few software options to create these projections. We have developed a web-based application that has several futures to create, customize and export these projections and is freely available athttp://lbqp.unb.br/NetWheels.