bluuebunny/crossref_metadata_2025_split huggingface dataset:
Portal vein thrombosis and liver transplantation: management, matching, and outcomes: a retrospective multicenter cohort study
Authors: Di Benedetto Fabrizio , Magistri Paolo , Di Sandro Stefano , Boetto Riccardo , Tandoi Francesco , Camagni Stefania , Lauterio Andrea , Pagano Duilio , Nicolini Daniele , Violi Paola , Dondossola Daniele , Guglielmo Nicola , Cherchi Vittorio , Lai Quirino , Toti Luca , Bongini Marco , Frassoni Samuele , Bagnardi Vincenzo , Mazzaferro Vincenzo , Tisone Giuseppe , Rossi Massimo , Baccarani Umberto , Ettorre Giuseppe Maria , Caccamo Lucio , Carraro Amedeo , Vivarelli Marco , Gruttadauria Salvatore , De Carlis Luciano , Colledan Michele , Romagnoli Renato , Cillo Umberto 
Published: March 2024

Background and aims:
Besides the increased risk of perioperative morbidity, graft failure, and mortality, the majority of PVT are diagnosed at liver transplantation (LT). Improving preoperative management and patient selection may lead to better short-term and long-term outcomes and reduce the risk of a futile LT. The authors aimed to identify predictors of adverse outcomes after LT in patients with nonmalignant portal vein thrombosis (PVT) and improve donor to recipient matching by analyzing the results of the Italian cohort of LT recipients.

Methods:
Adult patients who underwent LT in Italy between January 2000 and February 2020 diagnosed with PVT pre-LT or at time of LT were considered eligible for inclusion. Based on a survey encompassing all 26 surgeons participating in the study, a binary composite outcome was defined. Patients were classified as having the composite event if at least one of these conditions occurred: operative time more than 600 min, estimated blood loss greater than 5000 ml, more than 20 ICU days, 90 days mortality, 90 days retransplant.

Results:
Seven hundred fourteen patients were screened and 698 met the inclusion criteria. The analysis reports the results of 568 patients that fulfilled the criteria to enter the composite outcome analysis.
Overall, 156 patients (27.5%) developed the composite outcome. PVT stage 3/4 at transplant and need for any surgical correction of PVT are independent predictors of the composite outcome occurrence. When stratified by PVT grade, overall survival at 1-year ranges from 89.0% with PVT grade 0/1 to 67.4% in patients with PVT grade 3/4 at LT (P<0.001). Nevertheless, patients with severe PVT can improve their survival when identified risk factors are not present.

Conclusions:
Potential LT candidates affected by PVT have a benefit from LT that should be adequately balanced on liver function and type of inflow reconstruction needed to mitigate the incidence of adverse events. Nonetheless, the absence of specific risk factors may improve the outcomes even in patients with PVT grades 3–4.
Deep learning-based multimodel prediction for disease-free survival status of patients with clear cell renal cell carcinoma after surgery: a multicenter cohort study
Authors: Chen Siteng , Gao Feng , Guo Tuanjie , Jiang Liren , Zhang Ning , Wang Xiang , Zheng Junhua 
Published: March 2024

Background:
Although separate analysis of individual factor can somewhat improve the prognostic performance, integration of multimodal information into a single signature is necessary to stratify patients with clear cell renal cell carcinoma (ccRCC) for adjuvant therapy after surgery.

Methods:
A total of 414 patients with whole slide images, computed tomography images, and clinical data from three patient cohorts were retrospectively analyzed. The authors performed deep learning and machine learning algorithm to construct three single-modality prediction models for disease-free survival of ccRCC based on whole slide images, cell segmentation, and computed tomography images, respectively. A multimodel prediction signature (MMPS) for disease-free survival were further developed by combining three single-modality prediction models and tumor stage/grade system. Prognostic performance of the prognostic model was also verified in two independent validation cohorts.

Results:
Single-modality prediction models performed well in predicting the disease-free survival status of ccRCC. The MMPS achieved higher area under the curve value of 0.742, 0.917, and 0.900 in three independent patient cohorts, respectively. MMPS could distinguish patients with worse disease-free survival, with HR of 12.90 (95% CI: 2.443–68.120, P<0.0001), 11.10 (95% CI: 5.467–22.520, P<0.0001), and 8.27 (95% CI: 1.482–46.130, P<0.0001) in three different patient cohorts. In addition, MMPS outperformed single-modality prediction models and current clinical prognostic factors, which could also provide complements to current risk stratification for adjuvant therapy of ccRCC.

Conclusion:
Our novel multimodel prediction analysis for disease-free survival exhibited significant improvements in prognostic prediction for patients with ccRCC. After further validation in multiple centers and regions, the multimodal system could be a potential practical tool for clinicians in the treatment for ccRCC patients.
Management for degenerative lumbar spondylolisthesis: a network meta-analysis and systematic review basing on randomized controlled trials
Authors: Jia Hao , Zhang Zhuo , Qin Jianpu , Bao Lipei , Ao Jun , Qian Hu 
Published: March 2024

Background:
Consensus on the various interventions for degenerative lumbar spondylolisthesis (DLS) remains unclear.

Materials and methods:
We searched PubMed, Embase, Cochrane Library, Web of Science, and major scientific websites until Nov 01, 2023, to screen eligible randomized controlled trials (RCTs) involving the treatment of DLS. The seven most common DLS interventions (non-surgical [NS], decompression only [DO], decompression plus fusion without internal fixation [DF], decompression plus fusion with internal fixation [DFI], endoscopic decompression plus fusion [EDF], endoscopic decompression [ED], and circumferential fusion [360F]) were compared. The primary (pain and disability) and secondary (complications, reoperation rate, operation time, blood loss, length of hospital stay, and satisfaction) outcomes were analyzed.

Results:
Data involving 3,273 patients in 16 RCTs comparing the efficacy of different interventions for DLS were reported. In terms of improving patient pain and dysfunction, there was a significant difference between surgical and NS. EDF showed the greatest improvement in short-term and long-term dysfunction (probability, 7.1% and 21.0%). Moreover, EDF had a higher complication rate (probability 70.8%), lower reoperation rate (probability, 20.2%), and caused greater blood loss (probability, 82.5%) than other surgical interventions. Endoscopic surgery had the shortest hospitalization time (EDF: probability, 42.6%; ED: probability, 3.9%). DF and DFI had the highest satisfaction scores.

Conclusions:
Despite the high complication rate of EDF, its advantages include improvement in pain, lower reoperation rate, and shorter hospitalization duration. Therefore, EDF may be a good option for patients with DLS as a less invasive surgical approach.
Whether surgical procedure can improve the prognosis of endometrial cancer arising in adenomyosis (EC-AIA)? a systematic review and meta-analysis
Authors: Sun Yi , Lin Shitong , Wu Weijia , Nie Fangfang , Liu Yuchen , Wen Jing , Cheng Xiaoran , Liu Qianwen , Wang Yuanpei , Ren Fang 
Published: March 2024

Purpose:
Endometrial cancer arising in adenomyosis (EC-AIA) is frequently detected accidentally following a general hysterectomy for adenomyosis. Whether supplemental lymphadenectomy in patients with EC-AIA can improve the survival outcome remains inconclusive. Herein, we summarized the data of patients with EC-AIA and further explored the impact of lymphadenectomy on the prognosis of these patients.

Methods:
Five electronic databases, namely MEDLINE, Web of Science, PubMed, Embase, and the Cochrane Library were employed for searching articles from inception to May 2023.

Results:
In total, 38 eligible studies enrolling 56 patients were included. Of these, 44 patients had a traceable prognosis. Kaplan–Meier curves demonstrated that patients who had undergone lymphadenectomy had a better progression-free survival (PFS) compared with those who had not undergone lymphadenectomy (P=0.016), but there was no difference in overall survival (OS). Univariable (P=0.025, HR=0.25, 95%CI=0.08–0.84) and multivariable (P=0.042, HR=0.13, 95%CI=0.020–0.930) Cox regression analyses revealed that lymphadenectomy was an independent protective factor for PFS.

Conclusion:
For patients diagnosed with EC-AIA following hysterectomy for benign disease, further supplementary lymphadenectomy is recommended to improve PFS.
Resuscitating the macro- vs. microcirculation in septic shock
Authors: González Rafael , Urbano Javier , López-Herce Jesús 
Published: March 2024

Purpose of review
This review summarizes current literature about the relationships between macro and microcirculation and their practical clinical implications in children with septic shock.

Recent findings
Current evidence from experimental and clinical observational studies in children and adults with septic shock reveals that the response to treatment and resuscitation is widely variable. Furthermore, there is a loss of hemodynamic coherence, as resuscitation-induced improvement in macrocirculation (systemic hemodynamic parameters) does not necessarily result in a parallel improvement in the microcirculation. Therefore, patient-tailored monitoring is essential in order to adjust treatment requirements during resuscitation in septic shock. Optimal monitoring must integrate macrocirculation (heart rate, blood pressure, cardiac output, and ultrasound images), microcirculation (videomicroscopy parameters and capillary refill time) and cellular metabolism (lactic acid, central venous blood oxygen saturation, and difference of central venous to arterial carbon dioxide partial pressure).

Summary
There is a dire need for high-quality studies to assess the relationships between macrocirculation, microcirculation and tissue metabolism in children with septic shock. The development of reliable and readily available microcirculation and tissue perfusion biomarkers (other than lactic acid) is also necessary to improve monitoring and treatment adjustment in such patients.
Recurrence Patterns and Surveillance Imaging in Pediatric Brain Tumor Survivors
Authors: Cacciotti Chantel , Lenzen Alicia , Self Chelsea , Pillay-Smiley Natasha 
Published: March 2024

Surveillance magnetic resonance imaging (MRI) is routinely used to detect recurrence in pediatric central nervous system (CNS) tumors. The frequency of neuroimaging surveillance varies without a standardized approach. A single-institutional retrospective cohort study evaluated the frequency of recurrences. This study included 476 patients with the majority diagnosed with low-grade glioma (LGG) (n=138, 29%), high-grade glioma (HGG) (n=77, 16%), ependymoma (n=70, 15%), or medulloblastoma (n=61, 13%). LGG, HGG, and ependymoma patients more commonly had multiply recurrent disease (P=0.08), with ependymoma patients demonstrating ≥2 relapses in 47% of cases. Recurrent disease was identified by imaging more often than clinical symptoms (65% vs. 32%; P=<0.01). Patients diagnosed with meningioma demonstrated the longest mean time to first relapse (74.7 mo) whereas those with atypical teratoid rhabdoid tumor and choroid plexus carcinoma tended to have the shortest time to relapse (8.9 and 9 mo, respectively). Overall, 22 patients sustained first relapse >10 years from initial diagnosis. With a higher tendency toward detection of tumor recurrence/progression on MRI surveillance in comparison to clinical progression, surveillance imaging is necessary in routine follow up of pediatric CNS tumor survivors. With some relapses >10 years from initial diagnosis, imaging beyond this time point may be useful in particular tumor types. While the study is limited in outcome analysis, earlier detection of recurrence would lead to earlier initiation of treatment and implementation of salvage treatment regimens which can impact survival and quality of life.
Relationship of Day-by-Day Blood Pressure Variability and Admission Stroke Severity in Acute Ischemic Stroke
Authors: Zhu Yuan , Wu Minghua , Zheng Yawei , Wang Xintong , Xiayang Jingyi , Zhang Tianrui , Wang Shana , Fang Zhuyuan 
Published: March 2024

Objectives:
Research on the association between stroke severity and day-by-day blood pressure variability (BPV) in acute ischemic stroke (AIS) is rare as the majority focus on the blood pressure (BP) or the short-term BPV. Our study aims to explore the exact roles of daily BPV through the 7-day commencement on stroke severity in AIS.

Methods:
The study included 633 patients with AIS, defining AIS as the time from the beginning of symptom up to 7 days with recording BP twice a day as well as calculating the daily BPV, and then matching them to the stroke severity. The logistic regression models were used to evaluate associations between stroke severity and day-by-day BPV. We used the smooth curve fitting to identify whether there was a nonlinear association. In addition, the subgroup analyses were performed using the logistic regression.

Results:
According to the modified National Institutes of Health Stroke Scale score, 301 (47.5%) patients were allocated to the mild stroke group and 332 (52.5%) to the moderate-to-severe stroke group. In terms of stroke categories, we found no significant difference between BP at admission or mean BP. However, the moderate-to-severe stroke group exhibited higher daily BPV. The multiple logistic regression analysis indicated that day-by-day BPV was positively correlated to stroke severity [odds ratio (OR)=1.05, 95% CI:1.01–1.1, P=0.03 for SBP-SD; OR=1.08, 95% CI:1.01–1.15, P=0.03 for SBP-CV; OR=1.04, 95% CI:1.01–1.07, P=0.015 for SBP-SV).

Conclusions:
High day-by-day BPV in AIS was associated with more severe stroke independent of BP levels.
How Much Training Is Enough? Low-Dose, High-Frequency Simulation Training and Maintenance of Competence in Neonatal Resuscitation
Authors: Haynes Joanna C. , Rettedal Siren I. , Ushakova Anastasia , Perlman Jeffrey M. , Ersdal Hege L. 
Published: March 2024

Introduction
Facemask ventilation is a crucial, but challenging, element of neonatal resuscitation.
In a previously reported study, instructor-led training using a novel neonatal simulator resulted in high-level ventilation competence for health care providers (HCPs) involved in newborn resuscitation. The aim of this study was to identify the optimal frequency and dose of simulation training to maintain this competence level.

Methods
Prospective observational study of HCPs training through 9 months. All training was logged. Overall ventilation competence scores were calculated for each simulation case, incorporating 7 skill elements considered important for effective ventilation.
Overall scores and skill elements were analyzed by generalized linear mixed effects models using frequency (number of months of 9 where training occurred and total number of training sessions in 9 months) and dose (total number of cases performed) as predictors. Training loads (frequency + dose) predictive of high scores were projected based on estimated marginal probabilities of successful outcomes.

Results
A total of 156 HCPs performed 4348 training cases. Performing 5 or more sessions in 9 months predicted high global competence scores (>28/30). Frequency was the best predictor for 4 skill elements; success in maintaining airway patency and ventilation fraction was predicted by performing training in, respectively, 2 and 3 months of 9, whereas for avoiding dangerously high inflating pressures and providing adequate mask seal, 5 and 6 sessions, respectively, over the 9 months, predicted success. Skills reflecting global performance (successful resuscitation and valid ventilations) and ventilation rate were more dose-dependent.

Conclusions
Training frequency is important in maintaining neonatal ventilation competence. Training dose is important for some skill elements. This offers the potential for individualized training schedules.
The Effects of Combined Use of Linaclotide and Polyethylene Glycol Electrolyte Powder in Colonoscopy Preparation for Patients With Chronic Constipation
Authors: Song Jian , Xu Yuemei , Chen Changxi , Qi Xufei , Hu Pingping , Ying Xianhao , Li Hongliang 
Published: March 2024

Objective:
The purpose of this study is to evaluate the safety and efficacy of linaclotide and polyethylene glycol (PEG) electrolyte powder in patients with chronic constipation undergoing colonoscopy preparation.

Patients and Methods:
We included 260 patients with chronic constipation who were scheduled to undergo a colonoscopy. They were equally divided into 4 groups using a random number table: 4L PEG, 3L PEG, 3L PEG+L, and 2L PEG+L. The 4 groups were compared based on their scores on the Boston Bowel Preparation Scale (BBPS) and Ottawa Bowel Preparation Quality Scale (OBPQS), adverse reactions during the bowel preparation procedure, colonoscope insertion time, colonoscope withdrawal time, detection rate of adenomas, and their willingness to repeat bowel preparation.

Results:
In terms of the score of the right half of the colon, the score of the transverse colon, the total score using BBPS, and the total score using OBPQS, the 3L PEG (polyethylene glycol)+L group was superior to groups 3L PEG and 2L PEG+L (P<0.05), but comparable to the 4L PEG group (P>0.05). The incidence rate of vomiting was higher in the 4L PEG group than in the 2L PEG+L group (P<0.05). There was no statistically significant difference in the insertion time of the colonoscope between the 4 groups. The colonoscope withdrawal time in the 3L PEG+L group was shorter than in groups 4L PEG and 3L PEG (P<0.05) and comparable to that in the 4L PEG group (P>0.05). There was no statistically significant difference in the rate of adenoma detection among the 4 groups (P>0.05). The 4L PEG group was the least willing of the 4 groups to undergo repeated bowel preparation (P<0.05).

Conclusion:
The 3L PEG+L is optimal among the 4 procedures. It can facilitate high-quality bowel preparation, reduce the incidence of nausea during the bowel preparation procedure, and encourage patients to undertake repeated bowel preparation.
Basal forebrain activation improves working memory in senescent monkeys
Authors: Pennington Kendyl R , Debs Luca , Chung Sophia , Bava Janki , Garin Clément M , Vale Fernando L , Bick Sarah K , Englot Dario J , Terry Alvin V , Constantinidis Christos , Blake David T 
Published: March 2024

AbstractBrain aging contributes to cognitive decline and risk of dementia. Degeneration of the basal forebrain cholinergic system parallels these changes in aging, Alzheimer’s dementia, Parkinson’s dementia, and Lewy body dementia, and thus is a common element linked to executive function across the lifespan and in disease states. Here, we tested the potential of one-hour daily intermittent basal forebrain stimulation to improve cognition in senescent monkeys, and its mechanisms of action. Stimulation in five animals improved working memory duration in 8-12 weeks across all animals, with peak improvements observed in the first four weeks. In an ensuing three month period without stimulation, improvements were retained. With additional stimulation, performance remained above baseline throughout the 15 months of the study. Studies with a cholinesterase inhibitor produced inconsistent improvements in behavior. One of five animals improved significantly. Manipulating the stimulation pattern demonstrated selectivity for both stimulation and recovery period duration. Brain stimulation led to acute increases in cerebrospinal levels of tissue plasminogen activator, which is an activating element for two brain neurotrophins, Nerve Growth Factor (NGF) and Brain-Derived Growth Factor (BDNF). Stimulation also led to improved glucose utilization in stimulated hemispheres relative to contralateral. Glucose utilization also consistently declines with aging and some dementias. Together, these findings suggest that intermittent stimulation of the nucleus basalis of Meynert improves executive function and reverses some aspects of brain aging.HighlightsThe basal forebrain and its cholinergic projections are the sole source of acetylcholine for the cortical mantle in primates and humans.Forebrain function tracks cognitive loss throughout the adult lifespan.One hour per day intermittent stimulation of this region improves executive function behaviors and plausibly reverses some aspects of brain aging, a large risk factor in dementias.This stimulation exceeds impacts of standard pharmacotherapies, is enduring, recruits brain neurotrophic pathways and improves cortical glucose utilization.
Resistance to PSEN1-selective γ-secretase inhibitors in T-cell acute lymphoblastic leukemia
Authors: Vandersmissen Charlien , Demeyer Sofie , Jacobs Kris , Boogaerts Lien , Fernández Sara Gutiérrez , Segers Heidi , Chávez-Gutiérrez Lucía , Cools Jan 
Published: March 2024

AbstractPSEN1-selective gamma-secretase inhibitors (GSI), such as MRK-560, are a potential option for the treatment of T-cell acute lymphoblastic leukemia (T-ALL) with NOTCH1 activating mutations, as these show less toxicity compared to broad-spectrum GSIs. However, an important challenge with targeted therapies for cancer treatment is the rapid development of drug resistance. We therefore investigated ifPSEN1mutations could confer resistance to MRK-560 in T-ALL. We performed a CRISPR-mediated mutagenesis screen in a T-ALL cell line to identify mutations leading to MRK-560 resistance and confirmed these findings in additional cell lines. We identified 3 types of resistance mutations. Mutations at the enzyme-drug interface directly disrupt the interaction of MRK-560 with PSEN1. Mutations at the enzyme-substrate interface cause a shift in relative binding affinities towards drug and/or substrate. The third resistance mechanism involves a mutation at the enzyme-substrate interface that hinders the entrance of MRK-560 to the binding pocket. These findings contribute to the understanding of the PSEN1-selectivity of MRK-560 and can help to design other PSEN1-selective GSIs to overcome resistance in cancer therapy.