bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Surgery in a Large Urban Area Community Hospital During SARS-CoV-2 Pandemic: An Analysis on Acute Appendicitis
Authors: Mazzoni Gianluca , Liotta Gianluca , Lepre Luca , Leonardo Giacomo , Tognoni Valeria , Campa Rossella D. , Fransvea Pietro , Costa Gianluca 
Published: August 2024

Background:
The literature highlights a decrease in surgical treated appendicitis with an increased severity during the COVID-19 pandemic. The aim of this study was to analyze the effect of COVID lockdown on the population with appendicitis comparing clinical-pathologic data and outcome in two matching period (prepandemic and pandemic era).

Methods:
A retrospective analysis of patients admitted to two community urban hospital in Rome with diagnosis of acute appendicitis (AA) before and after the COVID-19 pandemic was performed. We compared patients patients with acute appendicitis in three groups named A (pre-COVID), B (early pandemic), and C (late pandemic). We evaluate the differences between the three groups in terms of onset of symptoms and severity, procedure difficulty, conversion rate, and short-term outcome.

Results:
A total of 310 patients were identified. The time interval from onset of symptoms to arrival in the emergency department was significantly longer in both pandemic group; there was also a significantly longer time to surgery comparing to group A. The risk of complicated AA was higher in both pandemic groups. A significantly higher grade of difficulty was detected in both COVID-groups. However, no differences were observed in conversion rate. Postoperative complications rate showed no significant difference among all three groups. No patients was tested positive for SARS-CoV-2 postoperatively.

Conclusion:
AA treatment was comparable to pre-COVID period in-hospital presurgery stay and early postoperative outcome. With an accurate respect of pandemic protocol is possible to maintain a high and safe standard of care for patients with acute appendicitis.
SPARING VERSUS REMOVAL OF EPIRETINAL PROLIFERATION IN THE SURGICAL REPAIR OF FULL-THICKNESS MACULAR HOLES
Authors: Fukushima Masaki , Tsuboi Kotaro , Akai Ryota , Ishida Yuichiro , Kusaka Shunji , Kamei Motohiro , Hayashi Atsushi , Wakabayashi Taku 
Published: August 2024

Purpose:
To evaluate the efficacy of vitrectomy with epiretinal proliferation (EP) sparing for full-thickness macular hole accompanied by EP.

Methods:
A multicenter, retrospective study. Eyes were divided into two groups: the sparing group (Group S) included eyes in which the EP around the hole was peeled and preserved, whereas the removal group (Group R) included eyes in which the EP was partially or completely removed. The internal limiting membrane was peeling in all eyes.

Results:
Forty-six eyes were included. Twenty-five eyes were in Group S, and 21 eyes were in Group R, with no difference in preoperative best-corrected visual acuity (BCVA) (P = 0.96). After primary surgery, macular holes were closed in all eyes, and there were no complications in either group. Postoperative 12-month BCVA significantly improved in both groups (both P < 0.01), while Group S had better 12-month BCVA than Group R (P = 0.016). In the multivariable analysis, EP sparing was associated with better BCVA at 12 months (P = 0.006) after accounting for the minimal macular hole size and preoperative BCVA.

Conclusion:
Epiretinal proliferation sparing and removal were both safe and effective techniques, while EP sparing may provide a favorable outcome for eyes with full-thickness macular hole and EP.
Regional Summed Corneal Refractive Power Changes in Myopic Orthokeratology and Their Relationships With Axial Elongation
Authors: Zhang Hening , Li Hui , Zou Zongyin , Yang Jing , Zhou Sheng 
Published: August 2024

Purpose:
To determine the relationship between regional summed corneal refractive power changes (CRPCs) in myopic orthokeratology and axial elongation.

Design:
This retrospective study included 70 eyes of 70 patients aged 8 years to 13 years who underwent orthokeratology lens (OK lens) treatment, and all patients underwent regular follow-ups at 1 week, 1 month, 6 months, and 12 months at Zhongshan Ophthalmic Center between January 2019 and May 2021.

Methods:
Axial length (AL) was measured at baseline and 12 months by an IOLmaster 5.0. Refractive error power was measured using cycloplegia. Regional summed CRPCs were calculated by MATLAB software using difference tangential power maps at the sixth month acquired by corneal topography measurements (Medmont E300 Corneal Topographer; Medmont Pty, Victoria, Australia) and defined as changes in corneal refractive power at the sixth month from baseline. The regional summed CRPCs were then subdivided into 4-mm diameter circles, 4- to 5-mm diameter chords, and 5- to 6-mm diameter chords according to the distance from the central of the pupil and into negative, positive, and total according to the values. Pearson correlation, multiple linear regression analysis, and stepwise multiple linear regression analysis were performed to analyze the relationships among these parameters.

Results:
Axial elongation had a negative relationship with positive regional summed corneal refractive power in the central 4-mm diameter circle and age (r=−0.282, P=0.018; r=−0.473, P<0.001, respectively) and a positive relationship with negative regional summed corneal refractive power in the 5- to 6-mm diameter chord (r=0.361, P=0.002). Stepwise multiple linear regression analysis identified age (standardized β=−0.434, P<0.001) and negative regional summed corneal refractive power in the 5- to 6-mm diameter chord (standardized β=0.305, P=0.004) as factors influencing AL elongation.

Conclusion:
Negative regional summed corneal refractive power in a 5- to 6-mm diameter chord after OK lens treatment may be an important index for evaluating the control effects of axial elongation.
Final results of a randomized controlled trial: comparison of the efficacy and safety between totally laparoscopic and laparoscopic-assisted total gastrectomy for advanced Siewert III esophagogastric junction cancer and upper and middle third gastric cancer
Authors: Wang Juan , Liu Shushang , Chen Haixiang , Luo Jialin , Xu Guanghui , Feng Xiangying , Yang Xuewen , Yang Jianjun , Gang Ji 
Published: August 2024

Background:
This study aimed to compare the efficacy and safety of TLTG with the overlap technique to LATG in patients with advanced Siewert III Esophagogastric Junction Cancer and upper and middle third gastric cancer.

Methods:
This single-center RCT enrolled 292 patients with the mentioned cancers, randomly assigned to TLTG overlap (n=146) or LATG (n=146) groups. Data on demographics, pathology, intraoperative variables, postoperative complications, recovery parameters, and 3-year survival were collected. Main outcome: postoperative complications within 30 days. Secondary outcomes: 3-year disease-free and overall survival.

Results:
TLTG versus LATG: TLTG had shorter incision, faster flatus/defecation, reduced analgesia, less opioid use, and shorter hospital stay. Similar operation time, anastomosis time, blood loss, and lymph node harvest. TLTG had a lower overall post-op complication rate (P=0.047) and no significant difference in serious complications (P=0.310). Variances in anastomotic stenosis occurrence at 3 months. No rehospitalization or mortality at 30 days. No significant differences in 3-month disease-free survival (P=0.058) or overall survival (P=0.236).

Conclusion:
The overlap method for anastomosis in TLTG is safe and feasible for advanced middle-upper-third gastric cancer, with positive short-term outcomes. This technique has the potential to be the preferred esophagojejunostomy approach in TLTG.

Trial registration:
This trial has been registered at Chinese Clinical Trial Registry: ChiCTR1900025667 (registration date: 4 September 2019).
Exploring Colorectal Cancer Screening Reach Among United States Veterans: Analyzing Clinical, Sociodemographic, and Social Determinants of Health-Based Patient Factors Across Screening Methods
Authors: Malani Kanika , Loscalzo Kirsten , Elfanagely Yousef , Promrat Kittichai 
Published: August 2024

Introduction:
Mailed fecal immunochemical testing (mFIT), in-clinic FIT (cFIT), and colonoscopy are believed to reach distinct patient populations. This study aims to evaluate this belief.

Methods:
Sociodemographic, clinical, and social determinants of health (SDOH) characteristics of 201 patients completing mFIT, 203 patients completing cFIT, and 74 patients completing colonoscopy at a Northeastern United States Veterans Affairs center from August 2023 to January 2024 were compared using descriptive statistics, χ2, and ANOVA tests.

Results:
Patients completing mFIT (P=0.003) and cFIT (P=0.001) were older than those completing colonoscopy. mFIT patients had more private health insurance as compared with cFIT (P<0.0001) patients. Patients completing colonoscopy had higher average disability ratings as compared with cFIT patients (P<0.0001). mFIT (P<0.0001) and colonoscopy (P<0.0001) patients had more time elapsed since their last primary care visit as compared with cFIT patients. mFIT patients had lower rates of mental health disorders as compared with colonoscopy (P<0.0001) and cFIT (P<0.0001) patients. cFIT patients had higher rates of past stool test use as compared with mFIT (P<0.0001) and colonoscopy (P<0.0001) patients. mFIT patients had lower rates of past colonoscopy completion as compared with cFIT (P<0.0001) and colonoscopy (P<0.0001) patients. There were no significant differences in SDOH domains among patients completing each of the screening methods.

Conclusion:
While each of the screening methods reaches a different patient population, mFIT does not reach a substantially more vulnerable population compared with cFIT and colonoscopy, highlighting the need for improvements in mFIT outreach.
STEP–organizing a major project to tackle significant uncertainty
Authors: Methven P. 
Published: August 2024

This article describes why Spherical Tokamak for Energy Production (STEP) has been launched, what it aims to achieve (benefits) and, principally, how the whole programme will be delivered (strategy). The article draws on the work of major project delivery and organization design (OD) and applies this to the context of STEP, which is dominated by significant uncertainty in all dimensions (technical, financial, commercial and programmatic), where there is embryonic delivery capability, but where there are also global-scale opportunities. This leads to an approach based on securing and organizing the correct capability from both public and private sectors to work in a collaborative arrangement with a single purpose and, critically, in an operating model designed to manage uncertainty and emerging risks and to exploit opportunities. Placing adaptability at the core of the OD, particularly the ability to deliver emergent strategy through guided empowerment in pursuit of an ambitious aim, is a further development beyond much of the current thinking in major projects. The article concludes with an appendix that translates that programme approach into principles for managing the engineering design work.
This article is part of the theme issue ‘Delivering Fusion Energy – The Spherical Tokamak for Energy Production (STEP)’.
Plasma burn—mind the gap
Authors: Meyer Hendrik ,   on behalf of the STEP Plasma Team
Published: August 2024

The programme to design plasma scenarios for the Spherical Tokamak for Energy Production (STEP), a reactor concept aiming at net electricity production, seeks to exploit the inherent advantages of the spherical tokamak (ST) while making conservative assumptions about plasma performance. This approach is motivated by the large gap between present-day STs and future burning plasmas based on this concept. It is concluded that plasma exhaust in such a device is most likely to be manageable in a double null (DN) configuration, and that high core performance is favoured by positive triangularity (PT) plasmas with an elevated central safety factor. Based on a full technical and physics assessment of external heating and current drive (CD) systems, it was decided that the external CD is provided most effectively by microwaves. Operation with active resistive wall mode (RWM) stabilization as well as high elongation is needed for the most compact solution. The gap between existing devices and STEP is most pronounced in the area of core transport, owing to high normalized plasma pressure in the latter which changes qualitatively the nature of the turbulence controlling transport. Plugging this gap will require dedicated experiments, particularly on high-performance STs, and the development of reduced models that faithfully represent turbulent transport at high normalized pressure. Plasma scenarios in STEP will also need to be such that edge localized modes (ELMs) either do not occur or are small enough to be compatible with material lifetime limits. The high current needed for a power plant-relevant plasma leads to the unavoidable generation of high runaway electron beam current during a disruption, where novel mitigation techniques may be needed.
This article is part of the theme issue ‘Delivering Fusion Energy – The Spherical Tokamak for Energy Production (STEP)’.
The magnetic cage
Authors: Nasr E. , Wimbush S. C. , Noonan P. , Harris P. , Gowland R. , Petrov A. 
Published: August 2024

The Spherical Tokamak for Energy Production (STEP) requires high-field magnet designs and has therefore adopted the REBCO-based high-temperature superconductor (HTS) as its current carrier. The HTS enables the toroidal field (TF) coils to be remountable, which unlocks STEP’s vertical maintenance approach; however, remountable joints, approximately 18 GJ of stored energy and limited space down the centre of a spherical tokamak, make the TF coils the most challenging. STEP has pursued a passive approach to TF coil quench protection in order to limit coil terminal voltage. Initial results suggest that a solution may rely on tuning internal coil resistance coupled with actively powered heaters. The pre-conceptual inter-coil structure demonstrates acceptable stresses and deflections under steady-state operating conditions and preliminary fault scenarios, and loads are distributed to limit the tensile force on the TF centre rod. Finally, the HTS must operate reliably in a high radiation environment and endure high neutron fluences, ensuring commercially relevant magnet lifetimes. Initial experiments indicate that instantaneous gamma irradiation of HTS has no negative impact on current carrying capacity. Experimental programmes are underway to cold irradiate HTS to fusion-relevant fluences and to develop a method of assuring tape irradiation tolerance using oxygen ions as an analogue for neutrons.
This article is part of the theme issue ‘Delivering Fusion Energy – The Spherical Tokamak for Energy Production (STEP)’.
Optimizing the cost of the STEP programme
Authors: Lux Hanni , Brown Chris , Butcher Matthew , Chapman Rhian , Foster Jack , Nawal Nousheen 
Published: August 2024

The Spherical Tokamak for Energy Production (STEP) programme is a world-leading fusion power plant programme that has embedded a cost conscience in its design from the early phases. This firmly addresses the attitude of cost complacency of which many major infrastructure projects have historically been accused. While a detailed and highly accurate whole life cycle cost analysis is not possible, or even valuable, during the conceptual design stage, this early design phase is still the most critical programme phase where a focus on costs can drive longer term reductions and impact whole life cycle costs at the high level. Consequently, appropriate estimating methods for these early-stage designs and lessons learned from other industries are used to inform design decisions and ensure cost is part of the overall option analysis. Hence, while the overall programme cost estimate is too immature to be a reliable indicator for the final programme costs, significant effort has been undertaken to understand the major cost drivers and take action to make the STEP design as cost-effective as possible.
This article is part of the theme issue ‘Delivering Fusion Energy – The Spherical Tokamak for Energy Production (STEP)’.
Genetics of posttraumatic stress disorder and cardiovascular conditions using Life’s Essential 8, Electronic Health Records, and Heart Imaging
Authors: Shen Jie , Valentim Wander , Friligkou Eleni , Overstreet Cassie , Choi Karmel , Koller Dora , O’Donnell Christopher J. , Stein Murray B. , Gelernter Joel ,   Posttraumatic Stress Disorder Working Group of the Psychiatric Genomics Consortium, Lv Haitao , Sun Ling , Falcone Guido J. , Polimanti Renato , Pathak Gita A. 
Published: August 2024

AbstractBACKGROUNDPatients with post-traumatic stress disorder (PTSD) experience higher risk of adverse cardiovascular (CV) outcomes. This study explores shared loci, and genes between PTSD and CV conditions from three major domains: CV diagnoses from electronic health records (CV-EHR), cardiac and aortic imaging, and CV health behaviors defined in Life’s Essential 8 (LE8).METHODSWe used genome-wide association study (GWAS) of PTSD (N=1,222,882), 246 CV diagnoses based on EHR data from Million Veteran Program (MVP; N=458,061), UK Biobank (UKBB; N=420,531), 82 cardiac and aortic imaging traits (N=26,893), and GWAS of traits defined in the LE8 (N = 282,271 ∼ 1,320,016). Shared loci between PTSD and CV conditions were identified using local genetic correlations (rg), and colocalization (shared causal variants). Overlapping genes between PTSD and CV conditions were identified from genetically regulated proteome expression in brain and blood tissues, and subsequently tested to identify functional pathways and gene-drug targets. Epidemiological replication of EHR-CV diagnoses was performed in AllofUS cohort (AoU; N=249,906).RESULTSAmong the 76 PTSD-susceptibility risk loci, 33 loci exhibited local rg with 45 CV-EHR traits (|rg|≥0.4), four loci with eight heart imaging traits(|rg|≥0.5), and 44 loci with LE8 factors (|rg|≥0.36) in MVP. Among significantly correlated loci, we found shared causal variants (colocalization probability > 80%) between PTSD and 17 CV-EHR (in MVP) at 11 loci in MVP, that also replicated in UKBB and/or other cohorts. Of the 17 traits, the observational analysis in the AoU showed PTSD was associated with 13 CV-EHR traits after accounting for socioeconomic factors and depression diagnosis. PTSD colocalized with eight heart imaging traits on 2 loci and with LE8 factors on 31 loci. Leveraging blood and brain proteome expression, we found 33 and 122 genes, respectively, shared between PTSD and CVD. Blood proteome genes were related to neuronal and immune processes, while the brain proteome genes converged on metabolic and calcium-modulating pathways (FDR p <0.05). Drug repurposing analysis highlightedDRD2, NOS1, GFAP, and PORas common targets of psychiatric and CV drugs.CONCLUSIONPTSD-CV comorbidities exhibit shared risk loci, and genes involved in tissue-specific regulatory mechanisms.
A Flexible Framework for Assessing the Cumulative Effects of Offshore Wind Energy Activities and Other Pressures on Aerofauna
Authors: Ferguson Megan C. , Williams Kathryn A. , Goodale M. Wing , Adams Evan M. , Knaga Paul , Kingdon Katrien , Avery-Gomm Stephanie 
Published: August 2024

AbstractThe offshore wind energy (OSW) industry is pivotal for renewable energy transition and climate resiliency. However, OSW activities may negatively affect aerofauna, contributing to CE from human activities and natural processes. Cumulative effects assessments (CEA) are vital for informed planning and management of OSW activities during regional assessment, site selection, and site evaluation. To reduce impacts on aerofauna, OSW developments should be sited in areas that avoid or minimize cumulative effects (CE). This study presents a cohesive and flexible framework for assessing the CE from OSW activities, other human activities, and natural processes on aerofauna to support decision-making during the initial OSW planning phases. The framework uses a species-based approach, applicable to various receptors, and adapts to available information on ecology, socioeconomics, and pressures. The analytical strategy uses a CE metric to indicate the presence or magnitude of effects from all pressures on receptors. Spatially explicit optimization methods identify OSW site configurations that minimize a CE metric. The framework accommodates alternative pressure scenarios that include foreseeable future human activities and natural processes and can explore the sensitivity of the result to uncertain parameters. Given sufficient spatial information on receptor density, pressure magnitude, and cause-effect pathways, the spatial optimization algorithm can find solutions that minimize population-level impacts from CE. If this ideal standard cannot be achieved due to information gaps, alternative metrics may be used to inform the immediate decision-making process.
Anin vivoscreen identifies NAT10 as a master regulator of brain metastasis
Authors: Chen Jocelyn F , Xu Peng , Cai Wesley L , Chen Huacui , Wingrove Emily , Li Wenxue , Biancon Giulia , Zhang Meiling , Balabaki Amer , Krop Ethan D , Zhang Yangyi , Yin Mingzhu , Tebaldi Toma , Meier Jordan L , Westbrook Thomas F , Halene Stephanie , Liu Yansheng , Nguyen Don X , Yan Qin 
Published: August 2024

AbstractMetastasis is the major cause of cancer-related deaths. Emerging evidence has shown that epigenetic regulation plays a fundamental role in cancer metastasis. To better understand the epigenetic regulation of metastasis, we conducted an in vivo shRNA screen for vulnerabilities of brain metastasis and identified N-acetyltransferase 10 (NAT10) as a driver of brain metastasis. Knockdown of NAT10 significantly restrains cancer cell proliferation and migrationin vitro, and tumor growth and brain metastasisin vivo. Structure-function analysis of NAT10 showed that its poorly characterized RNA helicase domain is critical for breast cancer cell growthin vitro, while its N-acetyltransferase domain is essential for primary tumor growth and brain metastasisin vivo. Integrative transcriptomic and proteomic analyses revealed key downstream effectors of NAT10, including PHGDH and PSAT1, two catalyzing enzymes for serine biosynthesis implicated in brain metastasis, and HSPA5, known to promote metastasis. We found that distant metastases of breast cancer, especially brain metastases express higher levels of NAT10, PHGDH, PSAT1, and HSPA5. Silencing PHGDH/PSAT1 or HSPA5 in metastatic breast cancer cells inhibits their ability to grow in the serine/glycine-limited condition or migrate, respectively, phenocopying the effects of NAT10 depletion. Moreover, NAT10 promotes the expression of PHGDH, PSAT1, and HSPA5 in its RNA helicase-dependent manner. These findings establish NAT10 as a master regulator of brain metastasis and shed light on the biological functions of its RNA helicase domain, nominating NAT10 as a target for treating metastatic diseases.