bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of recurrence in high-risk T1 colon cancer following endoscopic and surgical resection: registry-based cohort study
Authors: Nilsson Emelie , Wetterholm Erik , Syk Ingvar , Thorlacius Henrik , Rönnow Carl-Fredrik 
Published: June 2024

Abstract

Background
Endoscopic resection of T1 colon cancer (CC) is currently limited by guidelines related to risk of lymph node metastases. However, clinical outcome following endoscopic and surgical resection is poorly investigated.

Method
A retrospective multicentre national cohort study was conducted on prospectively collected data from the Swedish colorectal cancer registry on all non-pedunculated T1 CC patients undergoing surgical and endoscopic resection between 2009 and 2021. Patients were categorized on the basis of deep submucosal invasion (Sm2–3), lymphovascular invasion (LVI), poor tumour differentiation, and R1/Rx into low- and high-risk cases. The primary outcomes of interest were recurrence rates and disease-free interval (DFI, defined as time from treatment to date of recurrence) according to resection methods and risk factors (sex, age at diagnosis, histologic grade, LVI, perineural invasion, mucinous subtype, submucosal invasion, tumour location, resection margin and nodal positivity in the surgical group).

Results
In total, 1805 patients undergoing endoscopic (488) and surgical (1317) resection with 60.0 months median follow-up were included. Recurrence occurred in 18 (3.7%) endoscopically and 48 (3.6%) surgically resected patients. Adjuvant treatment was administered in 7.4% and 0.2% of the cases respectively in the surgical and endoscopically treated patients. Five-year DFI was 95.6% after endoscopic and 96.2% after surgical resection, with no significant difference when adjusting for confounding factors (HR 1.03, 95% c.i. 0.56 to 1.91, P = 0.920). There were no statistically significant differences in recurrence comparing endoscopic (1.7%) versus surgical (3.6%) low-risk and endoscopic (5.4%) versus surgical (3.8%) high-risk cases. LVI was the only significant risk factor for recurrence in multivariate Cox regression (HR 3.73, 95% c.i. 1.76 to 7.92, P &lt; 0.001).

Conclusions
This study shows no difference in recurrence after endoscopic and surgical resection in high-risk T1 CC. Although it was not possible to match groups according to treatment, the multivariate analysis showed that lymphovascular invasion was the only independent risk factor for recurrence.
Dehydroabietylamine exerts antitumor effects by affecting nucleotide metabolism in gastric cancer
Authors: Ma Jingsong , Zhao Jiabao , Wu Zhengxin , Tan Jinshui , Xu Meijuan , Ye Wenjie , Zhong Mengya , Xiong Yubo , Pan Guangchao , Zhou Huiwen , Zhou Shengyi , Hong Xuehui 
Published: June 2024

Abstract
Nucleotide metabolism is the ultimate and most critical link in the self-replication process of tumors, including gastric cancer (GC). However, in clinical treatment, classic antitumor drugs such as 5-fluorouracil (5-FU) are mostly metabolic analogs of purines or pyrimidines, which lack specificity for tumor cells and therefore have significant side effects. It is unclear whether there are other drugs that can target nucleotide metabolism, except for nucleic acid analogs. Here, we found that a natural compound, dehydroabietylamine (DHAA), significantly reduced the viability and proliferation of GC cells and organoids. DHAA disrupts the purine and pyrimidine metabolism of GC cells, causing DNA damage and further inducing apoptosis. DHAA treatment decreased transcription and protein levels of key enzymes involved in the nucleotide metabolism pathway, with significant reductions in the expression of pyrimidine metabolism key enzymes CAD, DHODH, and purine metabolism key enzymes PAICS. We also found that DHAA directly binds to and reduces the expression of Forkhead box K2 (FOXK2), a common transcription factor for these metabolic enzymes. Ultimately, DHAA was shown to delay tumorigenesis in K19-Wnt1/C2mE transgenic mice model and reduce levels of CAD, DHODH, and PAICS in vivo. We demonstrate that DHAA exerts an anticancer effect on GC by targeting transcription factor FOXK2, reducing transcription of key genes for nucleotide metabolism and impairing nucleotide biosynthesis, thus DHAA is a promising candidate for GC therapy.
Oesophago-pericardial fistula after catheter ablation of atrial fibrillation: a case report
Authors: Wu Shaohui , Zou Guangchen , Sun Yuzhang , Jiang Weifeng , Liu Xu 
Published: June 2024

Abstract

Background
Oesophageal fistula is a rare complication of catheter ablation of atrial fibrillation with most fistulas being atrio-oesophageal fistulas, but oesophageal–pericardial fistula can also happen in the absence of atrial perforation.

Case summary
A 68-year-old male patient presented with chest pain 10 days after catheter ablation of paroxysmal atrial fibrillation. He was discharged after an initial negative workup that included a CT chest without contrast. He later presented again with severe chest pain and fever and was found to have an oesophageal–pericardial fistula. He underwent surgical and endoscopic treatment with good recovery.

Discussion
Patients with oesophago-pericardial fistulas often have delayed presentation 1–4 weeks after the ablation procedure. Early diagnosis can be challenging. CT with oral and intravenous contrast is often used for diagnosis. Treatment often includes antibiotics, surgical or interventional drainage of infected spaces with oesophageal repair, clipping or stenting. In contrast to atrio-oesophageal fistulas that carry a high mortality rate, mortality for oesophago-pericardial fistulas appears to be much lower.
Admission and Discharge Practices Among Assisted Living Communities: The Role of State Regulations and Organizational Characteristics
Authors: Hua Cassandra L , Smith Lindsey , Zimmerman Sheryl , Gadkari Gauri , Carder Paula , Sloane Philip D , Wretman Christopher J , Thomas Kali S 
Published: June 2024

Abstract

Background and Objectives
A better understanding of factors associated with assisted living admission and discharge practices can help identify communities that are more likely to allow residents to age in place. This study examined how state regulations and assisted living organizational characteristics related to community admission and discharge practices for bathing, getting out of bed, and feeding.

Research Design and Methods
Using data from a representative sample of 250 assisted living communities in seven states and a database of assisted living state regulations, we employed multilevel logistic regression models to examine regulatory and organizational correlates of assisted living community admission and discharge practices for 3 activities of daily living (bathing, getting out of bed, and feeding).

Results
States’ regulations were not associated with assisted living community admission and discharge practices. However, assisted living communities above the median in the number of personal care staff members per resident were 17% (95% confidence interval [CI]: 6.5%, 27.1%) more likely to admit residents who needed assistance with feeding and 25.4% (95% CI: −37.7, −13.2) less likely to discharge these residents. For-profit communities were more likely to admit residents with bathing and feeding limitations.

Discussion and Implications
Organizational characteristics (e.g., for-profit affiliation, staffing levels) may, in part, drive admission and discharge practices, especially related to different care needs. The ability to house residents with advanced care needs may be influenced more by the organizational resources available to care for these residents than by states’ admission and discharge regulations.
The tryptophan metabolic pathway of the microbiome and host cells in health and disease
Authors: Miyamoto Kentaro , Sujino Tomohisa , Kanai Takanori 
Published: June 2024

Abstract
The intricate and dynamic tryptophan (Trp) metabolic pathway in both the microbiome and host cells highlights its profound implications for health and disease. This pathway involves complex interactions between host cellular and bacteria processes, producing bioactive compounds such as 5-hydroxytryptamine (5-HT) and kynurenine derivatives. Immune responses to Trp metabolites through specific receptors have been explored, highlighting the role of the aryl hydrocarbon receptor in inflammation modulation. Dysregulation of this pathway is implicated in various diseases, such as Alzheimer’s and Parkinson’s diseases, mood disorders, neuronal diseases, autoimmune diseases such as multiple sclerosis (MS), and cancer. In this article, we describe the impact of the 5-HT, Trp, indole, and Trp metabolites on health and disease. Furthermore, we review the impact of microbiome-derived Trp metabolites that affect immune responses and contribute to maintaining homeostasis, especially in an experimental autoimmune encephalitis model of MS.
Sugar transport in thermophiles: Bridging lignocellulose deconstruction and bioconversion
Authors: Tjo Hansen , Conway Jonathan M 
Published: June 2024

Abstract

Biomass degrading thermophiles play an indispensable role in building lignocellulose-based supply chains. They operate at high temperatures to improve process efficiencies and minimize mesophilic contamination, can overcome lignocellulose recalcitrance through their native carbohydrate-active enzyme (CAZyme) inventory, and can utilize a wide range of sugar substrates. However, sugar transport in thermophiles is poorly understood and investigated, as compared to enzymatic lignocellulose deconstruction and metabolic conversion of sugars to value-added chemicals. Here, we review the general modes of sugar transport in thermophilic bacteria and archaea, covering the structural, molecular, and biophysical basis of their high-affinity sugar uptake. We also discuss recent genetic studies on sugar transporter function. With this understanding of sugar transport, we discuss strategies for how sugar transport can be engineered in thermophiles, with the potential to enhance the conversion of lignocellulosic biomass into renewable products.

One-Sentence Summary
Sugar transport is the understudied link between extracellular biomass deconstruction and intracellular sugar metabolism in thermophilic lignocellulose bioprocessing.
(214) RESULTS OF THE FIRST 100 PENILE PROSTHESES
Authors: De Fuentes Dr Núria , Beato Dr Sergi , Alabat Dr Andreu , Etcheverry Dr Begoña , Castells Dr Manel , Vigués Francesc 
Published: June 2024

Abstract

Objectives
The implantation of a penile prosthesis (PP) stands among the most effective treatments with high satisfaction rates for erectile dysfunction. It is the treatment of choice for patients who do not respond to PDE-5 inhibitors or intracavernous injections. We present the results of the first 100 PPs implanted by the same team in our center (3 surgeons with no prior experience), along with the patients' satisfaction levels.

Methods
A prospective study of the outcomes of the first 100 PP implantations by the same team in our center from January 2022 to May 2023. Analysis of the demographic and perioperative variables, complications during follow-up and functional results. Patient satisfaction was assessed through a quality of life and sexuality questionnaire after PP implantation (QoLSPP) in outpatient consultations.

Results
With an average age of 62 years, 41% of the intervened patients had organic erectile dysfunction (ED), 34% following radical prostatectomy, 10% secondary to Peyronie's disease, 7% after cystectomy, 4% following priapism, and 4% due to other causes. The patients had an average BMI 27.8, 33% being diabetic. We implanted 97 three-component PPs and 3 malleable PPs, with a surgery time of 52 minutes. The postoperative visual analog scale at 24 hours averaged 2.3. A complication rate of 13% was reported. 4 intraoperative complications (3 crossover and 1 urethral injury) repaired during the same surgical time. 9 postoperative complications: 67% Clavien-Dindo I (5 scrotal hematoma, 1 reservoir herniation) and 33% Clavien-Dindo IIIb (1 pump extrusion, 1 cylinder herniation, 1 PP infection) requiring reintervention, antibiotic therapy and hyperbaric oxygen therapy. Patients expressed high satisfaction, with an average rating over 4/5 for all parameters except for PP rigidity (3.5).

Conclusions
The initial experience with the first 100 cases of PP implantation is very satisfactory, showing good surgical and follow-up results, a complication rate similar to published rates and high patient satisfaction.

Conflicts of Interest
None.
(213) DOES MEASURING THE DIAMETER OF THE DEEP DORSAL VEIN IN THE FLACCID STATE CONTRIBUTE TO THE OBJECTIVE ASSESSMENT OF ERECTILE DYSFUNCTION?
Authors: Appel Dr Boaz , Greenstein Prof Alexander , Shabataev Dr Valentin , Gruenwald Prof Ilan 
Published: June 2024

Abstract

Objectives
The association between the diameter of the Deep dorsal Vein (DV) in the flaccid penis and the indicators of Color Doppler ultrasonography (CDUS) -Peak Systolic Velocity (PSV). End Diastolic Velocity (EDV).and erection quality (EQ) according to CDUS after PGE1 injection have been scarcely tested. Our aim was to assess the association between the DV diameter (DVd) in the flaccid penis with these blood inflow and outflow indicators and with erection quality (EQ), assessed by CDUS.

Methods
Fifty-five men, mean age 47.4 years, (range 24-70) complaining of ED were included, all underwent CDUS. DVd was measured in a transverse position with the penis in a flaccid state. After intracavernous PGE1 injection (10mcg), arterial and venous blood flow parameters were recorded every 5 minutes. We assessed EQ in the erectile state achieved after injection. The latter was subjectively rated by both the examiner & patient, comparing it to the patient’s best erection in the past (=100%) and was graded accordingly in percent. Pearson correlation coefficient was used to associate the DVd with PSV, EDV, and EQ after injection.

Results
Means of DVd were 0.14±0.1 mm, PSV≤45.3±15.2 cm/s, EDV 5.38±5.5 cm/s, and EQ 71.3±19.5%. The statistical comparison showed that the DVd vs. PSV was r=0.05, vs. EDV-r=0.12, and EQ- r=0.3. No significant direct association was found between the DVd in the flaccid state and the intra-cavernosal blood inflow or outflow or the quality of erection.

Conclusions
Measuring the DV diameter in the flaccid state does not contribute to the objective evaluation of ED and thus cannot replace the invasive CDUS, cannot suffice for obbjective ED evaluation, and does not contribute to the decision on treatment strategies.

Conflicts of Interest
No conflict of interest for all authors.
(176) IS HEMOGLOBIN A1C LEVEL A SIGNIFICANT PREDICTOR OF PENILE PROSTHESIS IMPLANTATION INFECTIONS?
Authors: Alharbi Dr Abdulrahman , Salem Dr Shady , Awwad Dr Afnan , Almuwail Dr Salman , Almutairi Dr Hamad , Alhajeri Dr Faisal 
Published: June 2024

Abstract

Objectives
Diabetes mellitus (DM) is a major risk factor for erectile dysfunction (ED). Penile prothesis implantation is a definitive treatment with good outcomes. However, postoperative infection remains a significant complication. This study investigates the association between Glycated Hemoglobin (HBA1c) levels and penile prosthesis infection rates.

Methods
This study is a multi-center retrospective study including all patients underwent penile prothesis implantation between 2015 and 2023. All procedures were performed by the same specialized surgeon. Preoperative, perioperative and postoperative care and prophylaxis were standardized for all patients.

Results
We retrieved and reviewed the records of 62 patients via patients electronic records. Mean age was 54.7±12.4, mean HBA1c was 6.8±1.5. Thirty-nine (62.9%) patients were diabetic. 56 (90.3%) implants were malleable, and 6 (9.6%) were inflatable devices. 11 (17.7%) patients developed penile prosthesis infection, with only 4 (6.4%) treated conservatively, whereas 7 (11.3%) patients required device removal. Patients who had implant infection had a significantly higher mean HbA1c level 8.4±1.9 vs 6.5±1.1 (P=0.002). Although mean HBA1c level was higher among patients who underwent device removal, it was not statistically significant (8.1± 2.2 vs. 6.7±1.3, P=0.093). Moreover, prosthesis infection patients were younger compared to those without prosthesis infection (45.9 ± 13.3 vs. 56.7 ± 11.5 years p=0.0113). DM, peyronie's disease, prosthesis type, operative time and smoking were not significantly associated with infection rate. On multivariate analysis, both higher HBA1c levels and young age were statistically significant predictors for post penile prosthesis infection.

Conclusions
High HBA1c level is associated with increased risk of infection after penile prosthesis implantation.

Conflicts of Interest
The authors have no conflict of interest to declare.
(1016) PATIENTS SATISFACTION RATE AFTER PENILE IMPLANT SURGERY: A CROSS-SECTIONAL INVESTIGATION IN THE MIDDLE EAST
Authors: Al-Tal Yaman , Karam Abdulrahman M , Alshawabkeh Yara , Alshrouf Mohammad A 
Published: June 2024

Abstract

Objectives
The aim of this study was to assess the patient’s satisfaction rate after penile implant surgery, identify the complications that occurred after the procedure, and identify the factors that are associated with the occurrence of these complications at a tertiary hospital in Jordan.

Methods
This study involved a single-center cross-sectional analysis of 56 patients who underwent penile implant surgery at Abdali Hospital in the period of 2018 and 2023. Patients were contacted and asked to complete the survey, which included demographic information, as well as clinical information including comorbidities, duration of erectile dysfunction, number of preoperative consultations, previous non-surgical treatments used, number of implant surgeries, prosthesis type, late and early complications and the modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) survey.

Results
Fifty-six ED patients, 57.1% (n = 32), were treated with hydraulic penile implants, and 42.9% (n = 24) had malleable penile implants. The mean age of the participants was 56.25 ± 9.17. The mean time for ED before surgery was 5.39 ± 3.62 years. The mean score for the EDITS questionnaire was 69.40 ± 24.48, with 85.7% statisfied and 14.3% unsatisfied with the treatment. Medically free participants were 3.462 times (95% CI 1.033-11.599; p = 0.039 and 4.909 times (95% CI 1.471-16.379; p = 0.007) more likely to not have early or late complications, respectively. The most prevalent postoperative early-term complications was decrease length (39.3%), decrease width (25.0%), and pain (221.4%). The most common postoperative late-term complications decrease length (44.6%), decrease width (32.1%), and disfigurement of the penis (14.3%). There was no significant mean difference between two types of implant surgery in the total EDITS score (p = 0.171).

Conclusions
The study showed insights that underscore the importance of personalized care in penile implant selection, providing crucial guidance for urological practice in the Middle East.

Conflicts of Interest
The authors report no conflicts of interest for this work.
(1009) CARDIAC STRUCTURE AND FUNCTION IN MEN WITH ERECTILE DYSFUNCTION
Authors: Durukan Dr Emil , Jensen Christian FS , Dons Dr Maria , Sengeløv Dr Morten , Landler Nino E , Skaarup Dr Kristoffer G , Østergren Peter B , Sønksen Prof Jens , Biering-Sørensen Prof Tor , Fode Prof Mikkel 
Published: June 2024

Abstract

Objectives
Men with erectile dysfunction (ED) are at elevated risk of heart disease. However, data on the prevalence of abnormal cardiac structure and function in ED is scarce. We utilized echocardiography to assess cardiac characteristics in men with ED.

Methods
In this prospective cohort study of men with ED referred to a tertiary urology clinic, all participants underwent transthoracic echocardiography following a predefined protocol and electrocardiogram. Erectile function was graded according to the International Index of Erectile Function - Erectile Function (IIEF-EF) questionnaire. Participants with neurological disease, a medical history of pelvic surgery or trauma were excluded. Left ventricular (LV) structure was evaluated by ventricular mass index (LVMi). LV diastolic function was evaluated according to early diastolic mitral annular velocity (e'), ratio of early transmitral filling velocity to (E/e’) and left atrial volume index (LAVi). LV systolic function was evaluated by LV ejection fraction (LVEF), and global longitudinal strain (GLS).

Results
We included 100 patients with a median age of 61 yr (IQR 13) and median IIEF-EF was 15 (IQR 14). Comorbidities included hypertension (43%), dyslipidemia (41%), diabetes mellitus (29%), ischemic heart disease (12%), arrhythmia (12%), and heart failure (3%). Regarding cardiac structure, 25 patients had LV hypertrophy. Signs of LV diastolic dysfunction were a common observation; 21 patients had an E/e' ratio &gt; 9, while 30 patients had reduced septal and/or lateral e' velocities with only 1 patient having left atrial dilation (LAVi &gt; 34 ml/m2). Regarding LV systolic dysfunction, 83 patients had reduced GLS (&lt; 16%) with 14 suffering reduced LVEF &lt; 52%. 4 patients were referred for further evaluation, due to previously undiagnosed left bundle branch block, mitral valve regurgitation, aortic valve regurgitation, and incident heart failure, respectively.

Conclusions
A majority of patients with ED demonstrated impairment of cardiac structure and function assessed by measures of diastolic dysfunction and myocardial deformation.

Conflicts of Interest
The authors declare no conflict of interest.
(429) ADHERENCE TO PDE-5 INHIBITORS IN PATIENTS WITH ERECTILE DYSFUNCTION (ED) FOLLOWING SPINAL CORD INJURY (SCI). REAL LIFE DATA AFTER 10 YEARS OF TREATMENT
Authors: Thomas Charalampos , Kratiras Prof Zisis , Samarinas Michael , Diamantis Dr Georgios , Konstantinidis Charalampos 
Published: June 2024

Abstract

Objectives
PDE5Is are an effective treatment for ED in SCI individuals. A real-life cohort study was performed to evaluate the adherence to PDE5Is as well as the dropout rate, almost 10 years after the initiation of treatment.

Methods
97 SCI patients suffering from ED that were treated with PDE5Is were evaluated in 2015. Concomitant cardiovascular diseases, hormonal and psychiatric disorders were excluded. Efficacy was evaluated with IIEF5 and SEP2&3 questions. We re-evaluate our data now in order to assess the adherence to PDE5Is, almost 10 years after.

Results
10 years after we collected data from 81 patients out of the original 87 responders.
From the sildenafil group, 18 out of 31 responders are still on, 6 on daily us tadalafil, 1 on intra-cavernosal injections (ICI), 1 died, 2 were lost in follow up, 2 are off treatment due to lack of sexual partner and 1 stopped the medication due to other comorbidities.
From the vardenafil group 5/13 still are on, 2 on sildenafil, 2 daily tadalafil, 1 on ICI, 1 without partner and 2 stopped due to comorbidities..
From the avanafil group, 3/7 are still on, 1 on sildenafil and 2 on daily tadalafil.
From the on demand tadalafil group, 7/22 are still on, 5 on daily tadalafil, 2 on sildenafil, 2 were lost in follow up, 1 died, 1 on ICI, 2 without partner and 2 stopped due to other comorbidities.
From daily tadalafil group, 9 are still on, 1 died, 1 on ICI, 2 on sildenafil, 1 underwent penile prosthesis implantation and 1 stopped the medication due to other comorbidities..

Conclusions
After almost 10 years of follow up, the majority of our SCI patients remained on PDE5 inhibitors, either the one prescribed initially or a different one. The medication dropout rate, in our cohort, is approximately 20%, while other comorbidities and lack of sexual partner were the major reasons for withdrawal.

Conflicts of Interest
None.