bluuebunny/crossref_metadata_2025_split huggingface dataset:
71342 - International differences in selection and outcome of minimally invasive and open distal pancreatectomy: a transatlantic analysis
Authors: Johansen Karin , Augustinus Simone , Wellner Ulrich , Andersson Bodil , Beane Joal , Björnsson Bergthor , Busch Olivier , Davis Catherine , Ghadimi Michael , Gleeson Elizabeth , de Graaf Nine , Koerkamp Bas , Pitt Henry , van Santvoort Hjalmar , Tingstedt Bobby , Uhl Waldemar , Werner Jens , Williamsson Caroline , Besselink Marc , Keck Tobias 
Published: August 2024

Abstract

Introduction
The safety and efficacy of minimally invasive distal pancreatectomy (MIDP) has been confirmed within randomized trials. Information regarding differences in patient selection and outcomes of MIDP and open distal pancreatectomy (ODP) among countries is however lacking. This study compared MIDP and ODP in North America (NA), the Netherlands (NL), Germany (GER) and Sweden (SWE).

Method
Patients registered in the four pancreatic registries of the GAPASURG collaboration who underwent MIDP or ODP from 2014 to 2020 were included.

Result
Overall, 20 158 DPs were included; 7316 (36%) MIDP. Use of MIDP varied from 29% to 54% among registries, of which 13-35% were performed robotically (figure 1). Patients undergoing MIDP tended to be younger (GER and SWE), female (NA, GER), have higher body mass index (NA, NL, GER), lower comorbidity classification (NA, GER, SWE), lower performance status (GER), and lower rate of pancreatic ductal adenocarcinoma (all). Patients in the MIDP group had less vascular resections (all) and lower rates of severe complications and mortality (NA and GER). In the multivariable analysis, country was significantly associated with severe complications but not with 30-day mortality.

Discussion
Considerable disparities in the use and outcome of MIDP were shown among four transatlantic registries of pancreatic surgery. The differences in patient selection and outcomes imply that countries are in different stages of their learning curve.
72215 - Percutaneous hepatic perfusion as treatment for liver-dominant metastatic uveal melanoma: the first results from a Nordic referral center
Authors: Wong Andrew , Huibers Anne , Bagge Roger Olofsson 
Published: August 2024

Abstract

Introduction
Uveal melanoma has a high propensity to metastasize to the liver. Percutaneous hepatic perfusion (PHP) is an effective, minimally invasive treatment that allows selective intrahepatic delivery of high dose cytotoxic melphalan while limiting systemic toxicity through filtration of the hepatic venous outflow. The aim of this study was to investigate the response and safety in patients with liver-dominant metastatic uveal melanoma.

Method
Between December 2023 and April 2024, a total of 6 PHP treatments with melphalan were performed in three patients with liver-dominant metastatic uveal melanoma. Procedures were performed at Sahlgrenska University Hospital; the only referral center within the Nordic countries. Peri- and post-procedural adverse events were registered, as well as tumor response.

Result
Adverse events recorded were: periprocedural anaphylaxis (n=1), temporary leukopenia (n=1), temporary thrombocytopenia (n=6) and acute gout exacerbation (n=1). PHP-treatment resulted in stable disease on imaging in all patients after the first treatment session. All three underwent a successful second session of PHP-treatment. Planned additional follow-up imaging after 3 months is currently not yet available.

Discussion
Despite the very small study population and very preliminary data, these results suggest that PHP with melphalan is a safe treatment for selected patients with liver-dominant metastatic uveal melanoma and potentially offers a good intrahepatic disease control. The reported adverse events seem to be directly related to the melphalan instead of the technical aspects of the procedure itself.
72239 - Cholecystectomy for acute cholecystitis during weekend compared to delayed weekday surgery– a nationwide population study
Authors: Edblom Magnus , Enochsson Lars , Nyström Hanna , Sandblom Gabriel , Arnelo Urban , Hemmingsson Oskar , Gkekas Ioannis 
Published: August 2024

Abstract

Introduction
The optimal timing of surgery for acute cholecystitis has been subject for debate, but the predominant view supports early cholecystectomy. This study investigates the safety of early cholecystectomy during weekends compared to delaying until weekdays.

Method
A population-based cohort study based on data from GallRiks (Swedish National Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreateatography). Data from cholecystectomies 2006-2020 were analysed. Patients operated on during weekends were compared with patients in hospital during weekends and undergoing surgery on any subsequent weekday. Statistical analyses were conducted using logistic regression analysis.

Result
15 730 patients were included, and a complication was registered in 2 246 patients (14.3%). The proportion of complications was equal in both groups (14.0% vs. 14.5%, p= 0.365) and after adjustment for for confounding factors, there still was no significant difference in complications ratio. The proportion of open surgery was higher in the weekend surgery group (29.1% vs. 26.3%), with an odds ratio of 1.32 in multivariate logistic regression analysis (p&lt;0.001). Meanwhile, duration of surgery exceeding 2 hours was less common when surgery was performed on the weekend (32.7% vs. 46.8%, p=&lt;0.001). No difference were seen in the ratio of bile duct injuries.

Discussion
In this study, procedures carried out during weekends had outcomes that did not substantially differ from those performed during weekdays. More procedures were completed with open surgery during weekends, but less procedures had operating time exceeding two hours. The results of our study support performing early cholecystectomies during the weekend without increasing the patients’ risk of complications.
71465 - Reflex CRC Initiative - Advancing Colorectal Cancer Care through Comprehensive Genetic Testing
Authors: Pappas Christoforos , Olauson Hannes , Haglund Felix , Lindberg Johan , Beergrehn Caroline , Tham Emma , Sjövall Annika 
Published: August 2024

Abstract

Introduction
Colorectal cancer management is evolving towards personalized medicine, with genetic testing playing a crucial role in treatment decisions. The Reflex Testing for Colorectal Cancer initiative aimed to integrate comprehensive genetic testing into routine care. Specifically, the aim was to promptly determine treatment predictive genetic factors and hereditary cancer risk syndromes that would lead to potential prophylactic surgery as well as identify DPYD deficiency that affects oncological treatment.

Method
The study, conducted from October 2021 to December 2023, included 370 patients diagnosed with colorectal cancer. Genetic analysis was performed on DNA extracted from blood and from tumor tissue taken from biopsy during endoscopy, using a gene panel of 385 genes (GMCK panel) designed to identify variants relevant to treatment prediction, prognosis, and heredity for all solid tumors.

Result
In the first 100 cases (48 females, 52 males), 7% were diagnosed before 50 years and 18% between 50 and 60 years of age. The tumor localization varied, with 23% in the right colon, 9% in the transverse colon, 27% in the left colon and 41% in the rectum.15% showed high microsatellite instability. Additionally, four patients (4%) were identified with Lynch syndrome (disease-associated variants in MLH1(x2) or MSH6(x2)). Regarding treatment-predictive biomarkers, pathogenic variants were found in KRAS in 44% and in BRAF in 20%.

Discussion
The analysis of paired tumor and blood data can identify both somatic and germline aberrations that are of clinical significance and thus enable personalized therapeutic decisions at diagnosis.
Grants: Regional Cancer Center Stockholm-Gotland funded this project.
72275 - A retrospective review of palliative rectal cancer with no curative surgical intent – comorbidites, local complications and management
Authors: Kejving Gustav , Sandén Gustav , Ljuslinder Ingrid , Vinnars Petrus , Rutegård Martin 
Published: August 2024

Abstract

Introduction
Palliative rectal cancer patients typically retain their primary tumour, as trials have concluded no survival benefit of tumour resections in non-curative patients. This patient group is understudied regarding the natural course of the remaining tumour, in particular concerning the need of surgical management.

Method
This is a retrospective study on rectal cancer patients diagnosed between 2007–2020 in Region Västerbotten, Sweden.
Data were ascertained from the Swedish Colorectal Cancer Registry and chart review. Exclusion criteria comprised curative intent, primary tumour resection, synchronous other tumour, locally recurrent colorectal cancer, or treatment refusal. Patients were followed up from diagnosis until death or end of followup (2023). Indications for palliative treatment, tumour-related complications, and surgical and oncological management were noted. Stratification for study period and patient age was performed.

Result
Some 150 patients remained after applying exclusion criteria. The majority had a metastasized and incurable disease (74%). Almost half suffered local complications (46%). Some 43% underwent surgical intervention due to the unremoved primary tumour. Tumour perforation occurred in 7% with a significantly higher risk for patients younger than 75 years (p&lt;0.01). Mechanical obstruction afflicted 21.3%, while 33% underwent stoma diversion. Almost half of the patients received chemotherapy (49%) and radiotherapy (44%), respectively.

Discussion
There is a significant risk of local complications and surgical intervention due to the unremoved primary tumour in palliative rectal cancer patients. Therefore, considerations of the benefits of surgical resection should be taken, especially for patients with a longer estimated survival. Further research is required to properly select these patients.
72145 - Mesh versus Suture repair for Small umbilical hernias in adults: Early results from a Randomized Controlled multicenter Trial; The SUMMER Trial
Authors: Bergström Mathias , Widhe Björn , Granåsen Gabriel , Granström Anna Löf , Ohlsson Johan , Schult Simone , Dahlstrand Ursula , Österberg Johanna , Loogna Peter , Bringman Sven , Melkemichel Maria 
Published: August 2024

Abstract

Introduction
Mesh repair is recommended for umbilical hernias larger than 1 cm to reduce recurrence rates, yet evidence remains limited. An important question concerns optimal mesh positioning and surgical site occurrences (SSO). This study investigates early SSO in suture versus mesh repair for small umbilical hernias.

Method
A multicenter, randomized, controlled, double-blind trial across six Swedish surgical units compared a 4x4 cm lightweight onlay mesh to conventional suture repair for umbilical hernias ≤2 cm. Intraoperative centralized web-based randomization ensured allocation concealment. Participants and assessment surgeons were blinded for allocation. Primary outcome will be recurrence at 3 years. Secondary outcome was early SSO at 30 days after surgery, assessed through a physical examination and presented in this study. The trial is registered with Clinicaltrials.gov, NCT04231071.

Result
From February 2020 to January 2024, 290 participants were randomly assigned. After exclusion and loss to follow-up, remaining population for intention to treat analysis were n=144 (suture repair) and n=135 (mesh repair). SSO (Clavien-Dindo ≥1) were in the mesh group n=32 (24%) compared to n=26 (18%) in the suture group, without any significant increase for mesh repairs (OR 1.39, CI 0.78-2.52). BMI and defect size weren't significant risk factors. Clinically relevance SSO (Clavien-Dindo ≥2) were fewer in the mesh group n=2 (1.5%) compared to suture group n=4 (2.8%). No recurrences were detected.

Discussion
This randomized trial provides first high-level evidence for mesh repair in umbilical hernias ≤2 cm. Onlay mesh repair is comparable to suture repair regarding early surgical site occurrences and is safe for small umbilical hernias.
72307 - “Are you curious about studying further?” Undergraduate nurses' attitudes towards specialist training in surgical care
Authors: Ferlin Hanna , Hopf Linnea 
Published: August 2024

Abstract

Introduction
The supply of skills is a major challenge for the Swedish healthcare system, with a shortage of specialist nurses and experienced staff. The lack of competence poses a threat to patient safety. Even though efforts are being made to encourage nurses to specialize, not enough are doing so. The aim of this study is to investigate undergraduate nurses' attitudes towards specialist training in surgical care.

Method
A focus group study with a total of 16 participants employed at surgical wards at a university hospital. A qualitative content analysis supported by Graneheim and Lundman (2004) was conducted.

Result
Four main categories emerged, “Knowledge of the education”, “organizational conditions”, “personal conditions” and “the role of the specialist nurse”. Nurses believe that specialist training in surgical care leads to a diffuse professional role. When the specialist nurse receives more administrative tasks, she disappears from the care close to the patient, which is seen as an obstacle to wanting specialist training. Using research and writing a student thesis was also seen as obstacles. Having nurses with post graduate education in the ward was considered to bring security to both nursing staff and patients.

Discussion
The specialist nurse can have an important role in helping to spread knowledge and new research to the unit. If the nurse specialist gets to work closer to the patient, more would be interested in specializing. Hospital management have an important role in informing about what opportunities for specialist training are available and taking advantage of the interest shown by employees.
Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study
Authors: Ohira Masahiro , Aoki Gaku , Orihashi Yasushi , Yoshimura Kenichi , Toshima Takeo , Hatano Etsuro , Eguchi Susumu , Hibi Taizo , Hasegawa Kiyoshi , Umeda Yuzo , Hashimoto Takuya , Hasegawa Yasushi , Nobori Shuji , Ogura Yasuhiro , Nitta Hiroyuki , Egawa Hiroto , Eguchi Hidetoshi , Takada Yasutsugu , Ueda Yoshihide , Kasahara Mureo , Kawachi Shigeyuki , Soejima Yuji , Tokushige Katsutoshi , Nagano Hiroaki , Haga Hironori , Fukumoto Takumi , Mochida Satoshi , Umeshita Koji , Ohdan Hideki ,   the Japanese Liver Transplantation Society, Mizuno Shugo , Kuboki Satoshi , Otsuka Masayuki , Kobayashi Takashi , Wakai Toshifumi , Ishigame Teruhide , Marubashi Shigeru , Watanabe Masaaki , Taketomi Akinobu , Nakamuma Shinichi , Yagi Shintaro , Wakiya Taichi , Ishido Keinosuke , Sawada Yu , Endo Itaru , Goto Yuichi , Hisaka Toru , Uryuhara Kenji , Sakuma Yasunari , Ichida Hirofumi , Saiura Akio , Haruki Koichiro , Ikegami Toru , Iso Yukihiro , Aoki Taku , Takahara Takeshi , Yokoo Hideki , Beck Yoshifumi , Miyagi Shigeto , Tokodai Kazuaki 
Published: August 2024

Abstract

Background
Validating the expanded criteria for living donor liver transplantation for hepatocellular carcinoma using national data is highly significant. The aim of this study was to evaluate the validity of the new Japanese criteria for living donor liver transplantation for hepatocellular carcinoma patients and identify factors associated with a poor prognosis using the Japanese national data set.

Methods
The study population comprised patients who underwent living donor liver transplantation for hepatocellular carcinoma at 37 centres in Japan between 2010 and 2018. In a nationwide survey, the overall survival and recurrence-free survival rates were evaluated based on the new Japanese criteria for applying the 5-5-500 rule when extending the indication beyond the Milan criteria. Prognostic factors within the Japanese criteria were determined using the Cox proportional hazards model.

Results
Patients within (485 patients) and beyond (31 patients) the Japanese criteria exhibited 5-year overall survival rates of 81% and 58% and 5-year recurrence-free survival rates of 77% and 48% respectively. Patients who met the Milan criteria, but not the 5-5-500 rule, had poorer outcomes. Multivariate analysis for 474 patients identified a neutrophil-to-lymphocyte ratio greater than or equal to 5 and a history of hepatectomy as independent risk factors.

Conclusion
This nationwide survey confirms the validity of the Japanese criteria. The poor prognostic factors within the Japanese criteria include a neutrophil-to-lymphocyte ratio greater than or equal to 5 and previous hepatectomy.
Dupilumab treatment in paediatric atopic dermatitis (2–18 years): Spanish multicentre retrospective real-world study
Authors: Iznardo Helena , Roé Esther , Vicente Asunción , Prat Carolina , Casals Miquel , Martín-Santiago Ana , Esteve Altea , Viñas Miguel , Munera-Campos Mónica , Corella Francesca , Mollet Jordi , Figueras-Nart Ignasi , Vila Aina , Soria Xavier , Azón-Masoliver Antoni , Marqués-Martín Laura , Nadal-Lladó Cristina , Bel Susana , Pujol-Montcusí Josep , Bertolín-Colilla Marta , Curto-Barredo Laia , Melé-Ninot Gemma , Evole Montserrat , Berbegal Laura , Puig Lluís , Baselga Eulàlia 
Published: August 2024

Abstract

Background
Moderate-to-severe atopic dermatitis (AD) can be difficult to manage in paediatric patients, and there are few licensed treatments available for this age group. Dupilumab is approved for the treatment of AD in children older than 6 months.

Objectives
To assess the effectiveness and safety of dupilumab in a real-world cohort of paediatric patients with AD in Spain.

Methods
A multicentre, retrospective real-world study on the effectiveness and safety of dupilumab in patients aged 2–18 years with moderate-to-severe AD was conducted. Demographic and clinical characteristics were analysed, and effectiveness (Eczema Area and Severity Index, Investigator’s Global Assessment, Dermatology Life Quality Index, Numerical Rating Scale itch), safety and drug survival measures were assessed. A comparison of our results with other real-world outcomes and with clinical trials was made.

Results
Data from 243 patients from 19 centres were collected, with a mean follow-up of 85 weeks. Dupilumab exhibited significant effectiveness, with marked reductions in severity scores from week 4. By week 16, 79.4% of patients achieved ≥ 75% improvement in Eczema Area and Severity Index (EASI) score (EASI 75) and 40.5% achieved ≥ 90% improvement in EASI score (EASI 90). Mean percentage reduction in EASI was 79.7%. Increasing improvements were observed until week 52, with 85.8% and 49.6% of patients achieving EASI 75 and EASI 90, respectively. Forty-three patients developed adverse events (AEs) (43 of 243, 17.7%). The most frequent AEs were ocular surface diseases (20 of 243, 8.2%), injection site reactions (8 of 243, 3.3%) and facial redness (7 of 243, 2.9%). Drug survival was high (96.9% and 93.1% after 1 and 2 years of follow-up, respectively), with only 19 patients (7.8%) interrupting treatment: 7 (2.9%) owing to AEs; 2 (0.82%) owing to secondary failure; 5 (2.1%) were lost to follow-up; and 5 (2.1%) entered remission and stopped treatment.

Conclusions
Real-world use of dupilumab in paediatric AD demonstrated sustained effectiveness, high drug survival and acceptable safety profiles. Longer-term studies are crucial for AE surveillance and understanding how to manage disease remission.
Anion effects on the structure and stability of 3D domain–swapped cytochrome c dimer
Authors: Fujiwara Kodai , Ryuzaki Michiko , Yamanaka Masaru , Mashima Tsuyoshi , Saotome Tomonori , Kidokoro Shun-ichi , Hirota Shun 
Published: August 2024

Abstract
The structure and stability of proteins are affected by ions. We have previously reported that cytochrome c can form a 3D domain–swapped dimer. The structure of the cytochrome c domain–swapped dimer becomes more compact in the presence of kosmotropic anions, whereas the thermal stability of the dimer decreased with addition of chaotropic anions based on the Hofmeister series. Dimers were formed by incubating cytochrome c at 50 °C in the presence of citrate ions.
Clinical Utility of LC-MS/MS for Blood Myo-Inositol in Patients with Acute Kidney Injury and Chronic Kidney Disease
Authors: Omosule Catherine L , Blair Connor J , Herries Elizabeth , Zaydman Mark A , Farnsworth Christopher , Ladenson Jack , Dietzen Dennis J , Gaut Joseph P 
Published: August 2024

Abstract

Background
Diagnosing acute kidney injury (AKI) and chronic kidney disease (CKD) relies on creatinine, which lacks optimal diagnostic sensitivity. The kidney-specific proximal tubular enzyme myo-inositol oxygenase (MIOX) catalyzes the conversion of myo-inositol (MI) to D-glucuronic acid. We hypothesized that proximal tubular damage, which occurs in AKI and CKD, will decrease MIOX activity, causing MI accumulation. To explore this, we developed an LC-MS/MS assay to quantify plasma MI and assessed its potential in identifying AKI and CKD patients.

Methods
MI was quantified in plasma from 3 patient cohorts [normal kidney function (n = 105), CKD (n = 94), and AKI (n = 54)]. The correlations between MI and creatinine were determined using Deming regression and Pearson correlation and the impact of age, sex, and ethnicity on MI concentrations was assessed. Receiver operating characteristic curve analysis was employed to evaluate MI diagnostic performance.

Results
In volunteers with normal kidney function, the central 95th percentile range of plasma MI concentrations was 16.6 to 44.2 µM. Age, ethnicity, and sex showed minimal influence on MI. Patients with AKI and CKD exhibited higher median MI concentrations [71.1 (25th percentile: 38.2, 75th percentile: 115.4) and 102.4 (77, 139.5) µM], respectively. MI exhibited excellent sensitivity (98.9%) and specificity (100%) for diagnosing CKD. In patients with AKI, MI increased 32.9 (SD 16.8) h before creatinine.

Conclusions
This study unveils MI as a potential renal biomarker, notably elevated in plasma during AKI and CKD. Plasma MI rises 33 h prior to serum creatinine, enabling early AKI detection. Further validation and exploration of MI quantitation in kidney disease diagnosis is warranted.