bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suture Cruroplasty Versus Mesh Hiatal Herniorrhaphy for Large Hiatal Hernias (HHs): An Updated Meta-Analysis and Systematic Review of Randomized Controlled Trials
Authors: Memon Muhammed A. , Siddaiah-Subramanya Manjunath , Yunus Rossita M. , Memon Breda , Khan Shahjahan 
Published: March 2019

Background:
To explore the clinical outcomes, safety and effectiveness of suture cruroplasty versus mesh repair for large hiatal hernias (HHs) by an updated meta-analysis.

Material and Methods:
Randomized controlled trials evaluating the effects of these 2 treatment modalities were searched from PubMed and other electronic databases between January 1991 and July 2018. The outcome variables analyzed included operating time, complications, recurrence of HH or wrap migration, reoperation, hospital stay and quality of life.

Results:
Five randomized controlled trials totaling 478 patients (suture=222, mesh=256) were analyzed. For reoperation variable, the odds ratio was significantly 3.26 times higher for the suture group. For recurrence of HH, the odds ratio for the suture group was nonsignificantly 1.65 times higher compared with the mesh group. Comparable effects were noted for all other variables.

Conclusions:
Mesh repair seems to be superior to suture cruroplasty for large HH repair. Therefore, the routine use of mesh may be advantageous in selected cases.
Complications After Endoscopic Stenting for Malignant Gastric Outlet Obstruction: A Cohort Study
Authors: Sterpetti Antonio V. , Fiori Enrico , Sapienza Paolo , Lamazza Antonietta 
Published: March 2019

Background:
Gastric stenting has become a common place in clinical practice. The aim of our study was to evaluate the factors influencing the clinical outcome in patients who received endoscopic stenting for malignant gastric outlet obstruction (GOO).

Materials and Methods:
We prospectively evaluated the clinical course of 87 patients who presented to our attention with malignant GOO.

Results:
There was neither mortality nor major morbidity after endoscopic stenting. Survival was reduced (average, 2 mo) in patients with an obstruction due to no resectable pancreatic cancer. In patients with primary no resectable pyloric adenocarcinoma, the crude survival was >1 year. Almost half of the patients required a new endoscopy. Food obstruction was common after 6 months from stent placement, limiting the quality of life of the patients.

Conclusions:
Endoscopic stenting represents a valid treatment in patients with symptoms of GOO from metastatic cancer. Patients with metastatic pyloric adenocarcinoma and normal liver function tests have survival rates longer than 1 year. In this selected group of patients, laparoscopic surgical gastrojejunostomy can be a valid alternative to avoid a close and exhausting follow-up, with the possibility of a better quality of life (res Registry 808).
Pelvic Organ Prolapse Recurrence and Patient-Centered Outcomes Following Minimally Invasive Abdominal Uterosacral Ligament and Mesh-Augmented Sacrohysteropexy
Authors: Davidson Emily R.W. , Casas-Puig Viviana , Paraiso Marie Fidela R. , Ridgeway Beri , Ferrando Cecile A. 
Published: March 2019

Objectives
The objective of this study was to compare outcomes after minimally invasive uterosacral ligament hysteropexy (USLH) and mesh-augmented sacrohysteropexy (MSH) for women with uterovaginal prolapse including prolapse recurrence and long-term patient satisfaction.

Methods
This was a retrospective cohort study with a cross-sectional survey component. The medical record was queried for perioperative data for patients undergoing USLH and MSH between 2004 and 2016. Pelvic organ prolapse (POP) recurrence was defined as bulge symptoms and/or retreatment with a pessary or surgery. A cross-sectional survey assessed for adverse events and used validated questionnaires to assess symptoms and improvement.

Results
Ninety-seven patients met the inclusion criteria: 42 MSH and 55 USLH. Mean age was 48 ± 14 years. Patients undergoing MSH were older, had more advanced POP, and were less likely to undergo concurrent procedures. There were no differences in perioperative complications between groups; 22.7% (n = 22) of patients experienced POP recurrence with 8.3% (n = 8) undergoing repeat surgery. After controlling for preoperative differences, there was no difference in POP recurrence between groups. The incidence of sacrohysteropexy mesh exposure was 7% (n = 3). Sixty-one percent (n = 59) of patients completed the survey; median follow-up time was 104 (46–164) months. Forty-one percent of respondents reported bothersome pelvic floor symptoms. Bulge symptoms were more common after MSH (41% vs 10%, P = 0.006). Ninety-three percent of all patients reported improvement after surgery, which was not different between groups.

Conclusions
One in 5 patients experienced POP recurrence with fewer than 10% undergoing repeat surgery for recurrence. There does not seem to be a significant difference in the incidence of recurrence between MSH and USLH.
Assessment of safety and bleeding risk in the use of extracorporeal membrane oxygenation for multitrauma patients: A multicenter review
Authors: Kruit Natalie , Prusak Michal , Miller Matthew , Barrett Nicholas , Richardson Carla , Vuylsteke Alain 
Published: March 2019

BACKGROUND
Respiratory failure is the most common form of organ failure following traumatic injury. Previously, there have been concerns regarding extracorporeal membrane oxygenation (ECMO) use in the trauma setting because of the increased risk of bleeding and thrombotic complications. We sought to examine the management of trauma patients with ECMO and to assess the safety and outcome of its use.

METHODS
Data of all patients who experienced a traumatic injury and were supported with ECMO were collected from the five National Respiratory ECMO centers in the United Kingdom over the period from December 2011 to May 2017. Primary outcome variables included 30-day and 6-month mortality and exacerbation of underlying traumatic injury after ECMO commencement. Secondary outcome variables included duration of ECMO support, thrombotic complications, and worsening of intracranial injury.

RESULTS
Fifty-two patients were identified. The overall hospital mortality was 15%. The incidence of bleeding complications was 50%, the majority of these not requiring intervention. Forty patients underwent surgical management prior to ECMO commencement; only four patients required take-back to the operating theater. There was no significant difference between the bleeding and nonbleeding groups in time of injury to ECMO commencement (median difference, 4.5 days; 95% CI, −3 to 3 days; p = 0.75). There was no statistically significant difference between the bleeding and nonbleeding groups in regard to time to anticoagulation commencement after starting ECMO (median difference, − 1 hour; 95% CI, −48 to 2 hours; p = 0.29) or after trauma (median difference, − 1 day; 95% CI, −4 to 2 days; p = 0.41). Nineteen patients were diagnosed with significant neurological injury. Twelve of these patients were anticoagulated. Two patients died as a direct result of worsening neurological injury.

CONCLUSIONS
Our findings suggest that the use of ECMO in trauma patients does not exacerbate primary traumatic injury regardless of anticoagulation commencement and may confer a survival benefit. Neurological injury should not be seen as an absolute contraindication to ECMO.

LEVEL OF EVIDENCE
Therapeutic/Care Management, Level V.
Antibody-suppressor CD8+ T Cells Require CXCR5
Authors: Zimmerer Jason M. , Ringwald Bryce A. , Elzein Steven M. , Avila Christina L. , Warren Robert T. , Abdel-Rasoul Mahmoud , Bumgardner Ginny L. 
Published: March 2019

Background.
We previously reported the novel activity of alloprimed CD8+ T cells that suppress posttransplant alloantibody production. The purpose of the study is to investigate the expression and role of CXCR5 on antibody-suppressor CD8+ T-cell function.

Methods.
C57BL/6 mice were transplanted with FVB/N hepatocytes. Alloprimed CD8+ T cells were retrieved on day 7 from hepatocyte transplant recipients. Unsorted or flow-sorted (CXCR5+CXCR3− and CXCR3+CXCR5−) alloprimed CD8+ T-cell subsets were analyzed for in vitro cytotoxicity and capacity to inhibit in vivo alloantibody production following adoptive transfer into C57BL/6 or high alloantibody-producing CD8 knock out (KO) hepatocyte transplant recipients. Alloantibody titer was assessed in CD8 KO mice reconstituted with naive CD8+ T cells retrieved from C57BL/6, CXCR5 KO, or CXCR3 KO mice. Antibody suppression by ovalbumin (OVA)-primed monoclonal OVA-specific t-cell receptor transgenic CD8+ T cells (OT-I) CXCR5+ or CXCR3+ CD8+ T-cell subsets was also investigated.

Results.
Alloprimed CXCR5+CXCR3−CD8+ T cells mediated in vitro cytotoxicity of alloprimed “self” B cells, while CXCR3+CXCR5−CD8+ T cells did not. Only flow-sorted alloprimed CXCR5+CXCR3−CD8+ T cells (not flow-sorted alloprimed CXCR3+CXCR5−CD8+ T cells) suppressed alloantibody production and enhanced graft survival when transferred into transplant recipients. Unlike CD8+ T cells from wild-type or CXCR3 KO mice, CD8+ T cells from CXCR5 KO mice do not develop alloantibody-suppressor function. Similarly, only flow-sorted CXCR5+CXCR3− (and not CXCR3+CXCR5−) OVA-primed OT-I CD8+ T cells mediated in vivo suppression of anti-OVA antibody production.

Conclusions.
These data support the conclusion that expression of CXCR5 by antigen-primed CD8+ T cells is critical for the function of antibody-suppressor CD8+ T cells.
APRIL/BLyS Blockade Reduces Donor-specific Antibodies in Allosensitized Mice
Authors: Wilson Nancy A. , Bath Natalie M. , Verhoven Bret M. , Ding Xiang , Boldt Brittney A. , Sukhwal Adarsh , Zhong Weixiong , Panzer Sarah E. , Redfield Robert R. 
Published: March 2019

Background.
Highly sensitized candidates on the transplant waitlist remain a significant challenge, as current desensitization protocols have variable success rates of donor-specific antibody (DSA) reduction. Therefore, improved therapies are needed. A proliferation-inducing ligand (APRIL) and B-lymphocyte stimulator (BLyS) are critical survival factors for B-lymphocytes and plasma cells, which are the primary sources of alloantibody production. We examined the effect of APRIL/BLyS blockade on DSA in a murine kidney transplant model as a possible novel desensitization strategy.

Methods.
C57BL/6 mice were sensitized with intraperitoneal (IP) injections of 2 × 106 BALB/c splenocytes. Twenty-one days following sensitization, animals were treated with 100 μg of BLyS blockade (B-cell activating factor receptor-immunoglobulin) or APRIL/BLyS blockade (transmembrane activator and calcium modulator and cyclophilin ligand interactor-immunoglobulin), administered thrice weekly for an additional 21 days. Animals were then euthanized or randomized to kidney transplant with Control Ig, BLyS blockade, or APRIL/BLyS blockade. Animals were euthanized 7 days posttransplant. B-lymphocytes and DSA of BLyS blockade only or APRIL/BLyS blockade-treated mice were assessed by flow cytometry, immunohistochemistry, and enzyme-linked immunospot.

Results.
APRIL/BLyS inhibition resulted in a significant reduction of DSA by flow crossmatch compared with controls (P < 0.01). APRIL/BLyS blockade also significantly depleted IgM- and IgG-secreting cells and B-lymphocyte populations compared to controls (P < 0.0001). APRIL/BLyS blockade in transplanted mice also resulted in decreased B-lymphocyte populations; however, no difference in rejection rates were seen between groups.

Conclusions.
APRIL/BLyS blockade with transmembrane activator and calcium modulator and cyclophilin ligand interactor-immunoglobulin significantly depleted B-lymphocytes and reduced DSA in this sensitized murine model. APRIL/BLyS inhibition may be a clinically useful desensitization strategy for sensitized transplant candidates.
Tactile sensory channels over-ruled by frequency decoding system that utilizes spike pattern regardless of receptor type
Authors: Birznieks Ingvars , McIntyre Sarah , Nilsson Hanna M , Nagi Saad S , Macefield Vaughan G , Mahns David A , Vickery Richard M 
Published: March 2019

AbstractThe established view is that vibrotactile stimuli evoke two qualitatively distinctive cutaneous sensations, flutter (frequencies < 60 Hz) and vibratory hum (frequencies > 60 Hz), subserved by two distinct receptor types (Meissner’s and Pacinian corpuscle, respectively) which may engage different neural processing pathways or channels and fulfill quite different biological roles. In psychological and physiological literature those two systems have been labelled as Pacinian and non-Pacinian channels. However, we present evidence that low-frequency spike trains in Pacinian afferents can readily induce a vibratory percept with the same low frequency attributes as sinusoidal stimuli of the same frequency thus demonstrating a universal frequency decoding system. We achieved this using brief low-amplitude pulsatile mechanical stimuli to selectively activate Pacinian afferents. This indicates that spiking pattern, regardless of receptor type, determines vibrotactile frequency perception. This mechanism may underlie the constancy of vibrotactile frequency perception across different skin regions innervated by distinct afferent types.
Determining the Minimal Background Area for Species Distribution Models: MinBar PACKAGE
Authors: Rotllan-Puig Xavier , Traveset Anna 
Published: March 2019

AbstractOne of the crucial choices when modelling species distributions using pseudo-absences approaches is the delineation of the background area to fit the model. We hypothesise that there is a minimum background area around the centre of the species distribution that characterizes well enough the range of environmental conditions needed by the species to survive. Thus, fitting the model within this area should be the optimal solution in terms of both quality of the model and execution time.MinBAR is an R package that calculates the optimal background area. The version 1.0.0 is implemented for MaxEnt and uses Boyce Index as a metric to assess models performance.Two case studies are presented to assess the hypothesis and to illustrate the package.Partial models trained with part of the species distribution often perform better than those fitted on the entire extension. MinBAR is a versatile tool that helps modellers to objectively define the optimal solution.
Automated and Manual Quantification of Tumour Cellularity in Digital Slides for Tumour Burden Assessment
Authors: Akbar Shazia , Peikari Mohammad , Salama Sherine , Panah Azadeh Y. , Nofech-Mozes Sharon , Martel Anne L. 
Published: March 2019

AbstractAimsThe residual cancer burden index is an important quantitative measure used for assessing treatment response following neoadjuvant therapy for breast cancer. It has shown to be predictive of overall survival and is composed of two key metrics: qualitative assessment of lymph nodes and the percentage of invasive or in-situ tumour cellularity (TC) in the tumour bed (TB). Currently, TC is assessed through eye-balling of routine histopathology slides estimating the proportion of tumour cells within the TB. With the advances in production of digitized slides and increasing availability of slide scanners in pathology laboratories, there is potential to measure TC using automated algorithms with greater precision and accuracy.MethodsWe describe two methods for automated TC scoring: 1) a traditional approach to image analysis development whereby we mimic the pathologists’ workflow, and 2) a recent development in artificial intelligence in which features are learned automatically in deep neural networks using image data alone.ResultsWe show strong agreements between automated and manual analysis of digital slides. Agreements between our trained deep neural networks and experts in this study (0.82) approach the inter-rater agreements between pathologists (0.89). We also reveal properties that are captured when we apply deep neural network to whole slide images, and discuss the potential of using such visualisations to improve upon TC assessment in the future.ConclusionsTC scoring can be successfully automated by leveraging recent advancements in artificial intelligence, thereby alleviating the burden of manual analysis.
Time-course of population activity along the dorsoventral extent of the superior colliculus during delayed saccade tasks
Authors: Massot Corentin , Jagadisan Uday K. , Gandhi Neeraj J. 
Published: March 2019

AbstractThe superior colliculus (SC) is an excellent substrate to study functional organization of sensorimotor transformations. We used linear multi-contact array recordings to analyze the spatial and temporal properties of population activity along the SC dorsoventral axis during delayed saccade tasks. During the visual epoch, information appeared first in dorsal layers and systematically later in ventral layers. In the ensuing delay period, the laminar organization of low-spiking rate activity matched that of the visual epoch. During the pre-saccadic epoch, spiking activity emerged first in a more ventral layer, ∼100ms before saccade onset. This buildup of activity appeared later on nearby neurons situated both dorsally and ventrally, culminating in a synchronous burst across the dorsoventral axis, ∼28ms before saccade onset. Stimulation of individual contacts on the laminar probe produced saccades of similar vectors. Collectively, the results reveal a principled spatiotemporal organization of SC population activity underlying sensorimotor transformation for the control of gaze.
Event segmentation reveals working memory forgetting rate
Authors: Jafarpour Anna , Buffalo Elizabeth A , Knight Robert T , Collins Anne GE 
Published: March 2019

SummaryWe encounter the world as a continuous flow and effortlessly segment sequences of events into episodes. This process of event segmentation engages working memory (WM) for tracking the flow of events and impacts subsequent memory accuracy. WM is limited in how much information is retained (i.e., WM capacity) and for how long the information is retained (i.e., forgetting rate). It is unclear which aspect of WM limitations affects event segmentation. In two separate experiments with multiple tasks, we estimated participants’ WM capacity and forgetting rate in a dynamic context and evaluated their relationship to event segmentation. The results across tasks show that individuals who reported more movie segments than others (fine-segmenters) have a faster decaying WM. A separate task assessing long-term memory retrieval reveals that the coarse-segmenters have better recognition of temporal order of events in contrast to the fine-segmenters who performed better at free recall. The findings show that event segmentation employs dissociable memory strategies and depends on how long information is retained in WM.
Recent and rapid colonization of the Lesser Sundas Archipelago from adjacent Sundaland by seven amphibian and reptile species
Authors: Reilly Sean B. , Stubbs Alexander L. , Karin Benjamin R. , Arida Evy , Iskandar Djoko T. , Mcguire Jimmy A. 
Published: March 2019

AbstractThe Lesser Sundas Archipelago is comprised of two parallel chains of islands that extend between the Asian continental shelf (Sundaland) and Australo-Papuan continental shelf (Sahul). These islands have served as stepping-stones for taxa dispersing between the Asian and Australo-Papuan biogeographic realms. While the oceanic barriers have prevented many species from colonizing the archipelago, a number of terrestrial vertebrate species have colonized the islands either by rafting/swimming or human introduction. Here we examine phylogeographic structure within the Lesser Sundas for three snake, two lizard, and two frog species that each have a Sunda Shelf origin. These species are suspected to have recently colonized the archipelago, though all have inhabited the Lesser Sundas for over 100 years. We sequenced mtDNA from 230 samples to test whether there is sufficiently deep genetic structure within any of these taxa to reject human-mediated introduction. Additionally, we tested for genetic signatures of population expansion consistent with recent introduction, and estimated the ages of Lesser Sundas clades, if any exist. Our results show little to no genetic structure between populations on different islands in five species, and moderate structure in two species. Nucleotide diversity is low for all species, and the ages of the most recent common ancestor for species with monophyletic Lesser Sundas lineages date to the Holocene or late Pleistocene. These results support the hypothesis that these species entered the archipelago relatively recently and either naturally colonized or were introduced by humans to most of the islands within the archipelago within a short time span.
Intercellular positive-feedback loops promote the evolutionary stability of microbial cooperative behaviors
Authors: Ben-Zion Ishay , Eldar Avigdor 
Published: March 2019

AbstractMicrobial cooperation enables groups of conspecific cells to perform tasks that cannot be performed efficiently by individual cells, such as utilization of various secreted ‘public-good’ molecules, communication via quorum-sensing, or the formation of multicellular structures. Cooperation is often costly and therefore susceptible to exploitation by ‘cheater’ cells, which enjoy the benefit of cooperation without investing in it. While population structure is key to the maintenance of cooperation, it remains unclear whether other mechanisms help in stabilizing microbial cooperation. Like other microbial traits, cooperation is often governed by complex regulatory networks, and one reoccurring motif is an ‘intercellular positive-feedback loop’, where a secreted molecule, e.g. a public-good or a quorum-sensing signaling molecule, activates its own production in all surrounding cells. Here we investigate the role of intercellular feedbacks in the maintenance of bacterial cooperation. We combine theory with a synthetic-biology approach, using swarming motility ofBacillus subtilisengineered variants, to compare the response of ‘open-loop’ and feedback cooperators to the presence of cheaters. We find that positive feedbacks on cooperative behaviors – either directly or through a feedback on quorum-sensing – maintain cooperation in a broader range of environments, relieving the requirement for a strong population structure. Our results directly demonstrate the stabilizing effect of intercellular positive feedbacks on cooperative behaviors, and suggests an explanation for their abundance in regulatory networks of bacterial cooperation.