bluuebunny/crossref_metadata_2025_split huggingface dataset:
136 OUTPATIENT PARATHYROID SURGERY. OPEN ROAD TO THE FUTURE
Authors: Morales D , Soler R , Fernández J L , Guillermo P , Dominguez M D , Pérez L , Adarve A , Ocaña L T 
Published: May 2024

Abstract

Background
Outpatient surgery (OS) is consolidated in many pathologies, but there are still controversies regarding endocrine surgery. The objective of this study was to present the results about OS parathyroid surgery program in a reference hospital.

Methods
The patient selection criteria included those patients with a diagnosis of primary hyperparathyroidism (HPT1°) due to parathyroid adenoma, with two positive localization tests, ages between 18 and 80 years, with an ASA I, II or III pre-anesthetic assessment, who live less than an hour from the hospital center, have a contact telephone number and are accompanied. Histological confirmation is performed through intraoperative biopsy, as well as PTH determinations according to the Miami criteria. After surgery, patients move to the post-anesthetic recovery and readaptation area. If tolerance is correct, postoperative pain is controlled and there is no evidence of clinical hypocalcemia, they are discharged. Next morning a phone call is made.

Results
From March 2019 to March 2023, 143 patients with HPT1° have been operated and 78 have been performed as OS, 11 were male and 67 female, mean age of 60±7 years. The average surgery time was 38±15 minutes. The time spent in the unit from admission in the early morning until discharge was 9.5±2 hours, with no mortality or readmission. Regarding complications, only one case of symptomatic hypocalcemia at 48 hours and a wound seroma.

Conclusions
OS HPT1° surgery, with correct patient selection and in expert teams, can be performed in outpatient surgery with complete safety.
121 TRANSPLANTATION AND NON-INVASIVE LONGITUDINAL IN VIVO IMAGING OF PARATHYROID CELLS – A PROOF-OF-CONCEPT STUDY
Authors: Bränström R , Van Krieken P , Fröbom R , Shabo I , Aspinwall C A 
Published: May 2024

Abstract

Background
The parathyroid cell is a vital regulator of extracellular calcium levels, operating through the secretion of parathyroid hormone (PTH). Despite its importance, the regulation of PTH secretion remains complex and not fully understood, representing a unique interplay between extracellular calcium, intracellular calcium, and hormone secretion. One significant challenge in parathyroid research has been the difficulty in maintaining cells ex vivo for in-depth cellular investigations.

Methods
We introduce a novel platform for parathyroid cell transplantation and non-invasive in vivo imaging using the anterior chamber of the eye as a transplantation site.

Results
We found that parathyroid tissue transplanted into the mouse eye engrafted onto the iris, became vascularized, and retained cellular composition. Transplanted animals exhibited elevated PTH levels, indicating a functional graft. With in vivo confocal microscopy, we were able to repetitively monitor parathyroid graft morphology and vascularization.

Conclusions
In summary, there is a pressing need for new methods to study complex cellular processes in parathyroid cells. Our study provides a novel approach for non-invasive in vivo investigations that can be applied to understand parathyroid physiology and pathology under physiological and pathological conditions. This innovative strategy can deepen our knowledge on parathyroid function and disease.
86 GERMLINE MUTATIONS OF GCM2 CAUSE A NOVEL VARIANT OF HEREDITARY PRIMARY HYPERPARATHYROIDISM WITH MULTIGLANDULAR INVOLVEMENT
Authors: Iacobone M , Fernando-Watutantrige S , Stefania Z , Pellegrini R , Taschin E , Massimiliano Ferrara F , Augenti V , Lizarazo J L C , Torresan F 
Published: May 2024

Abstract

Background
Primary hyperparathyroidism (pHPT) rarely (10%) occurs as hereditary disease. GCM2 germline mutations have been recently described as responsible for the development of a novel variant of hereditary pHPT. This study was aimed to determine the prevalence of GCM2 germline variants in pHPT and evaluate the main features of this variant.

Methods
Demographics, laboratory, surgical data were assessed in a series of 10 index cases carrying GCM2 mutations undergoing surgery for pHPT.

Results
The GCM2 germline pathogenetic variants c.1181A&gt;C p.(Tyr394Ser) was detected in 80% of cases. GCM2-related pHPT affected subjects of both sexes (F/M= 6/4); it was diagnosed at a median age of 60 yrs. (range 49 – 71). Preoperative median calcium and PTH levels were 2.9 mmol/L (range 2.7-3.4) and 215 pg/ml (range 103-459), respectively. Family history of pHPT was absent in 70% of cases; multiglandular involvement was preoperatively suspected because of equivocal preoperative imaging studies (absent, multiple, or discordant localization) in 60% of patients. Complete clinical, surgical and follow-up data were available for 5 patients. Bilateral neck exploration with subtotal parathyroidectomy was performed in 4/5 patients and focused exploration with selective parathyroidectomy in 1 case. All patients undergoing subtotal parathyroidectomy were cured and are disease-free at a median follow up of 4 years (range 3-10), while the patient undergoing selective parathyroidectomy had persistent pHPT.

Conclusions
GCM2 germline mutations may cause hereditary pHPT, even if it may mimic sporadic variant because of the absence of familial history and late onset. The main feature is multiglandular involvement, needing bilateral neck exploration and subtotal parathyroidectomy.
52 DOES CENTRAL NECK DISSECTION NEGATIVELY INFLUENCE HYPOPARATHYROIDISM AFTER ANGIOGRAPHY-GUIDED THYROIDECTOMY?
Authors: Moreno-Llorente P , Barrasa A G , Pascua-Solé M , de Nova J L M 
Published: May 2024

Abstract

Background
Central neck dissection (CND) may have a negative effect on parathyroid glands (PGs) function. Indocyanine-green angiography (ICG) has shown that only one well-vascularized PG is enough to avoid postoperative hypocalcemia. Angiography-guided thyroidectomy (A-GT) was reported to significantly reduce postoperative hypocalcemia by preserving more well-vascularized PGs. We evaluated the effect of CND on postoperative hypocalcemia in patients undergoing A-GT.

Methods
Consecutive patients undergoing total thyroidectomy (TT) + CND from April 2016 to September 2023. A-GT was routinely performed since September 2020. In the Study group, ICG was initially injected to enhance the vascular map supplying PGs, then A-GT was performed. PGs perfusion was evaluated in every single PG after lobectomy+CND in all patients (control and study group) by using the 0-black, 1-gray, 2 white scoring system.

Results
wTT+CND was performed in 97/181 patients (71 bilateral CND, 26 unilateral) therefore 168 “sides” (lobectomies+CND) were included in the study: 97 “sides” (54 patients) in the control group and 71 sides (43 patients) in the study group. Superior PGs were significatively better preserved after A-GT, (p = 0.026) and CND didn’t significatively reduce the quality of their perfusion (p = 0.510). A-GT patients showed a significant reduction of hypoparathyroidism episodes (p = 0.007) minimizing the deleterious effect of CND on inferior PGs function.

Conclusions
1.- A-GT preserved more well-perfused superior PGs reducing the number of hypocalcemic episodes significatively. 2.- After AG-T, CND didn´t have a deleterious effect on hypocalcemic episodes rate.
The Case for an Intersectional Approach to Trauma-Informed Practices in K–12 Schools for Black Girls
Authors: Joseph-McCatty Andrea , Bamwine Patricia , Sanders Jane 
Published: May 2024

Abstract
Black girls are the only group of girls across the United States disproportionally suspended from school. Studies have documented that disproportionality cannot be explained solely by greater misbehavior among students of color. Instead, discipline disparities are also informed by punitive/inequitable discipline policies and practices, less discussed has been the relationship between childhood adversity and school discipline outcomes at the intersection of race and gender. Examining this phenomenon is important and timely as schools are increasingly providing trauma-informed practices to support socioemotional learning. Yet doing so without data-driven practices rooted in an understanding of disproportionate adversity may render these practices insufficient for Black girls. Thus, this study asks, what types of childhood adversities do Black girls have the greatest risk of experiencing? Using 2016–2019 data from the National Survey of Children’s Health (N = 63,674), risk ratios and Pearson’s chi-square test of independence were performed to determine across-race and within-gender group differences by the type of childhood adversity. Analyses demonstrated that Black girls had a greater risk for six out of nine adversities compared with other girls of color and seven out of nine compared with White girls.
Seasonal variation in attraction to plant volatiles by Cacopsylla pyricola (Foerster) (Hemiptera: Psyllidae)
Authors: Cooper W Rodney , Serrano Jacqueline M , Horton David R , Ohler Bonnie J , Waters Tim D 
Published: May 2024

Abstract
Pear psylla, Cacopsylla pyricola (Foerster) (Hemiptera: Psyllidae), occurs as 2 seasonal morphotypes. Summerforms occur on pear (Pyrus communis L.; Rosales: Rosaceae) where they are a significant pest. The larger and darker winterform morphotype develops in response to shortening daylengths and begins winter in reproductive diapause characterized by the absence of ovarian development. Diapausing winterforms often leave pear to overwinter on coniferous shelter plants and then return to pear in late winter and early spring to begin depositing the eggs that produce the first summerform generation. Cacopsylla pyricola adults are attracted to the color of foliage most of the year, but little is known about the role of plant volatiles in host finding and in seasonal dispersal between host and shelter plants by the psyllid. We used a Y-tube olfactometer and choice assays to investigate the response by C. pyricola adults to volatiles emitted by pear and an evergreen tree (cypress) often used as a shelter plant by wintering C. pyricola. Attraction to pear and cypress volatiles varied by season, tree phenology, and psyllid physiology. Cacopsylla pyricola were attracted to cypress volatiles and preferred to settle on cypress shoots during winter and early spring but then shifted to a marked preference for the pear developmental host in late spring and summer. Female C. pyricola exhibited stronger responses to pear volatiles than did males. Our study is the first to show that plant volatiles have a role in host finding by C. pyricola and provides a foundation for research on chemical ecology and management of C. pyricola.
The Clinical Effectiveness of Fidaxomicin Compared to Vancomycin in the Treatment of Clostridioides difficile Infection, A Single-Center Real-World Experience
Authors: Alsoubani Majd , Chow Jennifer K , Rodday Angie Mae , McDermott Laura A , Walk Seth T , Kent David M , Snydman David R 
Published: May 2024

Abstract

Background
The use of fidaxomicin is recommended as first-line therapy for all patients with Clostridioides difficile infection (CDI). However, real-world studies have shown conflicting evidence of superiority.

Methods
We conducted a retrospective single-center study of patients diagnosed with CDI between 2011 and 2021. A primary composite outcome of clinical failure, 30-day relapse, or CDI-related death was used. A multivariable cause-specific Cox proportional hazards model was used to evaluate fidaxomicin compared to vancomycin in preventing the composite outcome. A separate model was fit on a subset of patients with C. difficile ribotypes adjusting for ribotype.

Results
There were 598 patients included, of whom 84 received fidaxomicin. The primary outcome occurred in 8 (9.5%) in the fidaxomicin group compared to 111 (21.6%) in the vancomycin group. The adjusted multivariable model showed fidaxomicin was associated with 63% reduction in the risk of the composite outcome compared to vancomycin (hazard ratio [HR] = 0.37; 95% confidence interval [CI], .17–.80). In the 337 patients with ribotype data after adjusting for ribotype 027, the results showing superiority of fidaxomicin were maintained (HR = 0.19; 95% CI, .05–.77).

Conclusions
In the treatment of CDI, we showed that real-world use of fidaxomicin is associated with lower risk of a composite end point of treatment failure.
Reasons for the Exclusion of Women from Peace Processes: The Case of Georgia
Authors: Vassileva Julia 
Published: May 2024

Abstract
With the Russian invasion of Ukraine in 2022, security perception in the South Caucasus has been impacted considerably and this has highlighted the need for the international community to pay increased attention to unresolved, “frozen” conflicts. Against this background and the call for an effective and inclusive peace process in Georgia, the article focuses in particular on the inclusion of women in the Georgian peace process. By conducting document analysis and triangulating the findings with original interview data from thirty-one semi-structured interviews conducted in Tbilisi in spring 2023, the article argues that women's substantive inclusion in Georgia's peace processes continues to be limited and that the influence of women remains mostly on track II and III channels. It finds that the following reasons explain this continued exclusion: (1) elite-dominated hard power negotiation structures, (2) cultural factors, (3) the need for empowerment and linking the Women, Peace and Security (WPS) and Youth, Peace and Security (YPS) agendas, and (4) insufficient implementation of commitments made to include women under the existing policy and legal framework. Aiming to spell out the multiple reasons underpinning the exclusion, this article speaks to the importance of ensuring more effective, sustainable, and inclusive peace processes in Georgia and beyond.
#1568 Cardiometabolic benefits of low dose zibotentan and dapagliflozin 10 mg in the ZENITH-CKD study
Authors: Ambery Philip , Teruel Jose Luis Górriz , Romeo Maria José Soler , Wijkmark Emma , Lin Annie , Greasley Peter J , Heerspink Hiddo Lambers 
Published: May 2024

Abstract

Background and Aims
Positive effects of endothelin receptor antagonists on blood pressure and urinary albumin excretion have been well described, although their use in a wider population of patients with chronic kidney disease with increased cardiovascular risk has been limited by potential fluid retention. Here we present the effects of low dose zibotentan in combination with dapagliflozin on a range of cardiometabolic risk factors.

Method
In a post-hoc analysis of the ZENITH-CKD trial, a randomized, double-blind, active-controlled trial conducted in 170 clinical sites in 19 countries, adults with a urinary albumin-creatinine ratio (UACR) of 150 to 5000 mg/g and eGFR ≥20 mL/min/1.73 m2 not on SGLT2i were randomized to zibotentan/dapagliflozin, 0.25 mg/10 mg, zibotentan/dapagliflozin, 1.5 mg/10 mg, or placebo/dapagliflozin 10 mg. Effects on fluid retention events, defined as body weight increase from baseline &gt;3% (of which at least 2.5% from total body water) or BNP increase &gt;100% to &gt;200 pg/mL without atrial fibrillation or 100% increase to &gt;400 pg/mL with atrial fibrillation were assessed (NCT04724837).

Results
Data from the full analysis set is presented including 91 participants treated with 0.25 mg zibotentan and 10 mg dapagliflozin, and 177 participants treated with 10 mg dapagliflozin and placebo. UACR reduction for 0.25 mg zibotentan and 10 mg dapagliflozin was −47.7%, for 10 mg dapagliflozin alone it was −28.3%, making an adjusted mean difference for the combination versus dapagliflozin alone of −27.0%. Cardiometabolic markers are shown in the table.

Conclusion
In the ZENITH-CKD study zibotentan used at low dose combined with dapagliflozin had incremental effects versus dapagliflozin alone on a range of cardiometabolic risk markers including blood pressure, LDL cholesterol, HbA1c and uric acid, without a significant increase in fluid retention.
#2978 Formative usability test of a novel device for peritoneal dialysis (WEAKID)
Authors: de Vries Joost , Mathijssen Elke , Trappenburg Jaap , de Lange Wendela , Simonis Frank , Dolmans Helma , Donati Gabriele , Cappelli Gianni , Ligabue Giulia , Rubio María Auxiliadora Bajo , Gilsanz Gloria del Peso , Gerritsen Karin 
Published: May 2024

Abstract

Background and Aims
Chronic kidney disease is a growing problem worldwide with a growing number of patients requiring kidney replacement therapy. In recent years we have developed a novel device for peritoneal dialysis (PD), the WEarable Artificial KIDney (WEAKID); composed of a wearable device connected to a dialysate reservoir. WEAKID uses both sorbent technology and continuous flow PD to improve dialysis efficacy. Formative usability testing aids to the identification of design issues that may interfere with a device's safe and effective use and thus may influence decisions made in the design process. Here, we present the results of an international, multicentre, formative usability study of WEAKID among nurses and patients.

Method
This study used a mixed-methods design and was conducted in hospitals in Italy (Modena University Hospital), Spain (La Paz University Hospital, Madrid), and the Netherlands (University Medical Center Utrecht) between November 2021 and December 2022. An individual, formative usability testing session was conducted with each participant (nurse or patient) under the conditions of simulated use. Participants were asked to perform basic operational procedures (i.e. turning the device on/off, input of dialysis settings, handling an alarm) with the device according to a usability task list. Their performance was observed and use errors (i.e., something that a participant does or fails to do that results in an unexpected or unintended outcome) were noted. Furthermore, participants were asked for feedback, both verbally and by means of completing the system usability scale (SUS), reflecting perceived usability on a scale from 0 (worst) to 100 (best).

Results
We included 14 participants (n = 6 nurses, n = 8 patients) in three participating centres. All nurses were female and had a median experience with PD of 20.5 years (range 0.5-32). Patients were generally highly educated (n = 5, 63%). In total, 22 use errors occurred, 10 in nurses and 12 in patients. These use errors included factors not related to the device, e.g. not taking appropriate hygiene measures. In particular, use errors occurred during the priming/connection of catheter and handling the alarm. Participants’ feedback mainly concerned the small screen (and thus font) size, user interface (e.g. lack of colour-coded soft buttons), and (short) length of the patient line. The mean SUS score was 70 (range 57.5–85) for nurses, and 71.9 (range 55–87.5) for patients.

Conclusion
Despite the slightly above-average perceived usability of the device's current design stage, participants made a lot of suggestions for improvements, and usability must be improved to make the device ready for market introduction.
#2096 A randomized controlled study of telemonitoring in kidney transplantation: interim results of the Ap'TX trial
Authors: Mariat Christophe , Dinic Miriana , Thibaudin Damien , Maillard Nicolas 
Published: May 2024

Abstract

Background and Aims
Telemedicine is a matter of growing interest in transplantation. However, its real added value is uncertain. In 2018, we have started to study the medico-economic impact of a less stringent on-site follow-up of our kidney transplant recipients (KTR) using Ap'Telecare®. We present here a preliminary report focusing on 500 KTR with a 2 years follow-up.

Method
The Ap'Tx study (NCT03750331) is a controlled randomized trial testing the hypothesis that monitoring stable KTR (at least 3 months after transplantation) with Ap'Telecare® is non inferior to a conventional follow-up in terms of the occurrence of graft dysfunction (defined as a decrease in eGFR of 20% or more). On-site consultation scheduling was 2 times less frequent for KTR followed by Ap'Telecare®. Secondary endpoints were the impact of a remote follow-up by Ap'Telecare® on medical workload, economic saving and quality of life.

Results
688 KTR have been randomized so far with 500 of them having completed the 2 years follow-up. Among all KTR approached to participate in the study, 37% were not included mainly due to difficulties with accessing internet (44%) or to masterize the app (36%). After randomization, 27% of KTR were considered as non compliant in adequately using Ap'Telecare®. Over the 2 years study duration, graft dysfunction occurred in 16% and 18% of KTR in the Ap'telecare® and conventional arm, respectively (RR of 0.87 (0.56; 1.39), non-inferiority confirmed, superiority not significant). Medical time dedicated to handling daily lab results was decreased by a factor 3 for KTR using Ap'Telecare®. Rates of unplanned consultations and hospitalisations were reduced by 26% and 32% for patients using Ap'Telecare®, respectively (P &lt; .05).

Conclusion
This preliminary report of Ap'Tx suggest that a partial and reasonable remote follow-up of selected KTR is feasible, safe and logistically beneficial. Determining the nature of factors associated with a wider implementation of Ap'Telecare® is underway.
#1776 Distinct changes in gut microbiota of patients with kidney graft rejection
Authors: Visconti Vanessa , Müller-Deile Janina , Schiffer Mario , Wirtz Stefan 
Published: May 2024

Abstract

Background and Aims
Kidney graft rejection still represents the major cause of graft loss in kidney transplant recipients. Of growing interest is the bidirectional relationship between gut microbiome and immune system suggesting that gut microbiota can affect allograft outcome.

Method
In this cross-sectional case control study, we characterized the gut microbial profile of adult renal transplant recipients with and without graft rejection in order to define a cohort-specific microbial fingerprint through 16S rRNA gene sequencing. We used very strict inclusion and exclusion criteria to address confounder of microbiota composition.

Results
Different relative abundances in several gut microbial taxa were detectable in control patients compared to patients with kidney allograft rejection. Alpha diversity was lower in the rejection group and beta diversity revealed dissimilarity between patients with and without kidney graft rejection (P &lt; .01). When the rejection group was stratified according to different types of allograft rejection, major changes were identified between patients with chronic T cell mediated rejection (cTCMR) and controls. Changes in alpha diversity within the gut microbiome were related to the probability of cTCMR (P &lt; .05). Kidney transplant patients without rejection showed significant enrichment of rather anti-inflammatory taxa whereas in the rejection group bacteria well known for their role in chronic inflammation were increased. For example, ASV 362 belonging to the genus Bacteroides and ASV 312 belonging to Tanerrelaceae were enriched in no rejection (P &lt; .001 and P &lt; .01) whereas ASV 365 was enriched in patients with allograft rejection (P = .04). Looking at metagenomic functions, a higher abundance of genes coding for enzymes involved in bacterial multidrug resistance and processing of short chain fatty acids was found in patients without rejection but an increase in enzymes involved in NADPH production was seen in patients with allograft rejection.

Conclusion
A distinct microbial fingerprint of patients with allograft rejection might serve as non-invasive biomarker in the future.