bluuebunny/crossref_metadata_2025_split huggingface dataset:
IBC Oxford University Oral Abstract 41 - Efficacy and safety of laparoscopic conversion of failed vertical banded gastroplasty (VBG) to laparoscopic minigastric bypass (LMGB)
Authors: Amer Y 
Published: February 2025

Abstract

Background/Introduction
Obesity has become one of the most important health issues in developing and developed countries, with dramatic increase over the last decades. Morbid obesity is associated with serious comorbidities, such as type 2 diabetes, hypertension, arthritis, and sleep apnea, which cause an estimated 6 to 12 times greater mortality rate than the normal populations. Bariatric surgery is the only method for sustained weight loss in morbid obesity. However, 10–25% of patients will require re-operation for unsatisfactory weight loss or weight regain after restrictive surgery. Re-operation is associated with higher morbidity and mortality.

Objectives
The objective of the current study is to evaluate the safety and efficacy of laparoscopic mini-gastric bypass (LMGB) as convention surgery for failed vertical banded gastroplasty (VBG).

Methods
From February 2021 to November2023, 43 consecutive patients underwent LMGB for failed VBG. Average age was 32.4 years (range 21 to 49) and average BMI before re-operation was 42.6 kg/m2. There were 18 male and 25 female patients. All the patients underwent complete preoperative work-up, including blood chemistry, endocrine status, abdominal ultrasound, upper gastrointestinal barium studies, and gastroendoscopy. Visits to a psychiatrist and dietician were arranged, and explanations for a clear understanding of the benefits, risks, and long-term consequences of a malabsorptive procedure were done. The LMGBs were essentially the same as described by Rutledge technique. All patients received a quality-of-life questionnaire evaluation at their preoperative and postoperative follow-up at 6 months using the Gastrointestinal Quality of-Life Index (GIQLI).

Results
All the re-operations were completed laparoscopically. Average operative time was 164.5 minutes (range 140 to 280). All the patients were followed regularly every 3 months, and the mean BMI at 1 year after the LMGB was 31.6 kg/m2 (P &lt; 0.001 compared with BMI before revision). Three patients (3.9%) complained of epigastralgia and marginal ulcers were diagnosed by endoscopy. A proton-pump inhibitor was prescribed, and all the ulcers healed on medical treatment

Conclusion
Based on the results of the current study, LMGB is an effective and safe revision operation for patients with failed VBG with excellent weight loss and accepted improvement in other causes of failure of VBG.
IBC Oxford University Poster Abstract 5 - Adding a preoperative dose of LMWH may decrease VTE following bariatric surgery
Authors: Abdelsalam Ahmed Mohammed , ElAnsary Ahmed Mohammed Salah Eldeen , Salman Mohammed Abdallah , Nassef Sahar Abdelrahman , Elfergany Hala Mostafa 
Published: February 2025

Abstract

Introduction
Bariatric procedures are the most effective management for obesity. There is no standard Venous thromboembolism (VTE) prophylaxis for both dosing and duration of anticoagulation following laparoscopic sleeve gastrectomy (LSG).

Aims
To assess the optimum regimen for VTE prophylaxis in bariatric procedures and to reduce the incidence of perioperative bleeding.

Methods
This is a prospective randomized study that involved 100 morbidly obese patients, subdivided into two groups; group A received postoperative low molecular weight heparin (LMWH) prophylaxis alone starting from day one to day 15 in dose 1 mg/kg/day in a maximum dose 120 mg/day, and group B received both pre and postoperative LMWH; at night of surgery 12 hours preoperatively and postoperative starting from day one to day 15 with the same dose. All patients underwent mesenteric and bilateral lower limbs duplex 15 days postoperative using a Philips iU machine and linear (L9-3), convex (C5-1), and sector (S5-1) probes.

Results
The purpose of this study was to evaluate if the addition of a pre-operative regimen of low molecular weight heparin to a standard post-operative regimen decreased the incidence of VTE compared to a post-operative low molecular weight heparin regimen alone.

Conclusion
Preoperative as well as a postoperative prophylactic anticoagulant as LMWH is recommended to prevent perioperative VTE. There was an insignificant increase in postoperative bleeding in patients who received preoperative prophylactic anticoagulants.
IBC Oxford University Poster Abstract 8 - Reflux after bariatric surgery, does LINX bridge the gap?
Authors: Foula M , Shomimi S 
Published: February 2025

Abstract

Introduction
Reflux after bariatric surgery is not uncommon and can negatively impact patients’ quality of life. Laparoscopic sleeve gastrectomy is well known to induce de-novo reflux symptoms. Barrett’s esophagitis has been widely reported after laparoscopic sleeve gastrectomy. Moreover, esophago-gastro-duodenoscopy is not routinely performed for all patient preoperatively to detect patients with silent reflux. In most cases, conversion of sleeve gastrectomy to a low-pressure procedure can solve the issue and relieve the symptoms. However, some patients still experienced these symptoms after gastric bypass. Objectives We aim to present our early experience, as a tertiary university institute, in using LINX device to manage reflux symptoms after different bariatric procedures.

Methods
It is a case series representing our early experience in preforming LINX procedure for patients with intractable reflux after different bariatric procedures.

Results
Ten cases with intractable symptomatic reflux were managed in our hospital using LINX device. Five of them had their reflux after laparoscopic sleeve gastrectomy, three cases had intractable reflux after gastric bypass and two cases after one-anastomosis gastric bypass. All cases were managed successfully using LINX device. All patients were followed up for 9–18 months with good results in terms of reflux symptoms and quality of life.

Conclusion
Reflux after bariatric surgery remains a common cause of patients’ morbidity that negatively impact their quality of life. LINX procedure can present a valid option to tackle postoperative reflux with promising results.
IBC Oxford University Poster Abstract 13 - Single anastomosis duodeno-ileal bypass with gastric plication
Authors: Andraos Y , Saliba K 
Published: February 2025

Abstract

Background
Gastric plications and SADI. are new procedures for which authors describe benefits, results, and complications throughout their studies for patients with high BMI.

Objectives
The aim is to demonstrate the technique we are performing (SADI—P) and to describe its standardization implemented at our bariatric unit and to evaluate safety, efficacy, as well as complications.

Methods
From May 2016 until January 2019, 118 patients underwent Single Anastomosis Duodeno-Ileal Bypass (SADI) of which 84 with primary gastric plication. The procedure was first described by Youssef Andraos M.D. FACS. (the author) and presented as a video presentation at the 24th IFSO WORLD CONGRESS 2019 (V-123). Technical steps presented consist of 1. Gastric Greater Curvature Plication (GGCP) is performed using two rows of running non-absorbable 2/0 sutures starting at the GE Junction to 4 cm from the pylorus, in multiple bites (standard steps of this procedure were presented at the Clinical Congress 2019 of the American College of Surgeons in San Francisco, CA by the author (Session Code: VE303)) 2. GGCP is calibrated over a 40 French Faucher tube. 3. SADI is performed at 3.5 meters from the ileocecal valve. 4. Terminal-lateral hand-sewn duodenal-ileal anastomosis is performed by two anterior and two posterior running absorbable 3/0 sutures. 5. Patent and leak test are performed at the end of the surgery. Data was prospectively collected and analysed.

Results
52 patients were males, mean age being 39.4 ± 11 years, mean operative time duration being 80 ± 13.2 minutes, mean pre-operative BMI. being 46.5 ± 9.75 kg/m2 (36.75 kg/m2–56.25 kg/m2), mean pre-operative weight being 134 ± 26.75 kg (107.25 kg–160.75 kg). Among the 84 patients who underwent SADI—P, there were 21 with type 2 diabetes and 20 with arterial blood hypertension. The mean excess weight loss percentages (%EWL) at 1, 3, 6, 18, 32 months were 24.4 ± 14.07%, 71.1 ± 22.8%, 84.5 ± 23.3%, 85 ± 18.4% , 88 ± 19.52% respectively with a total weight loss (TWL) 11.17 ± 1.9%, 19.65 ± 4%, 30.2 ± 8.3%, 35.2 ± 10.9%, 38.4 ± 10.2% respectively. Obesity-related comorbidities showed favourable resolution: 18 of the diabetic patients as well as 14 of the hypertensive patients became off-treatment. All patients were discharged 56 hours post-operatively. There were no deaths, transfusion, or leak. 2 cases of severe hypo-albuminemia were reversed to normal anatomy at 6 and 26 post-operatively.

Conclusion
SADI-P is a standardized, safe, and efficient procedure at our bariatric unit for high BMI. patients with severe comorbidities. Nevertheless, severe hypo-albuminemia is still an issue to be considered. Longer follow-up and deeper studies are necessary to assess the long-term effect of this procedure.
Vulnerability of fault-tolerant topological quantum error correction to quantum deviations in code space
Authors: Zhao Yuanchen , Liu Dong E 
Published: February 2025

Abstract
Quantum computers face significant challenges from quantum deviations or coherent noise, particularly during gate operations, which pose a complex threat to the efficacy of quantum error correction (QEC) protocols. In this study, we scrutinize the performance of the topological toric code in 2 dimension (2D) under the dual influence of stochastic noise and quantum deviations, especially during the critical phases of initial state preparation and error detection facilitated by multi-qubit entanglement gates. By mapping the protocol for multi-round error detection--from the inception of an imperfectly prepared code state via imperfect stabilizer measurements--to a statistical mechanical model characterized by a 3-dimensional ℤ2 gauge theory coupled with a 2-dimensional ℤ2 gauge theory, we establish a novel link between the error threshold and the model's phase transition point. Specifically, we find two distinct error thresholds that demarcate varying efficacies in error correction. The empirical threshold that signifies the operational success of QEC aligns with the theoretical ideal of flawless state preparation operations. Contrarily, below another finite theoretical threshold, a phenomenon absent in purely stochastic error models emerges: unidentifiable measurement errors precipitate QEC failure in scenarios with large code distances. For codes of finite or modest distance d, it is revealed that maintaining the preparation error rate beneath a crossover scale, proportional to 1/log d, allows for the suppression of logical errors. Considering that fault-tolerant quantum computation is valuable only in systems with large scale and exceptionally low logical error rates, this investigation explicitly demonstrates the serious vulnerability of fault tolerant QEC based on 2D toric codes to quantum deviations in code space, highlighting the imperative to address inherent preparation noise.
Learning Through Teaching: How Physicians Learn Medicine in Authentic Clinical Contexts
Authors: Frija-Gruman Nissim Maxim , Steinert Yvonne , Macdonald Mary Ellen , Sun Ning-Zi 
Published: February 2025

Abstract

Purpose
Little is known about the clinical knowledge and skills that are acquired by physicians through teaching, how such learning occurs, or the factors that influence this process. This study explored how physicians acquire clinical knowledge and skills through clinical teaching and examined the contextual elements that influence this learning.

Method
Two theoretical frameworks informed this interpretive description study: situated learning and cognitive apprenticeship. From March to November 2021, semistructured interviews and follow-up discussions were conducted at McGill University with clinician-teachers who regularly supervise internal medicine residents. Participants were asked to describe how they learned clinical medicine through spontaneous clinical teaching, guided by questions relating to what they learned, memorable teaching moments, and factors influencing this learning. Data were analyzed iteratively, using both a deductive and inductive approach.

Results
Of the 87 contacted physicians, 45 responded, expressing interest (n = 22) or declining participation (n = 23), and 42 did not respond. All 22 clinicians who responded positively were interviewed, with 7 follow-up discussions. Results suggested that clinician-teachers encountered myriad opportunities to learn clinical medicine during spontaneous interactions with trainees. These interactions, embedded in authentic patient care, were influenced by clinician-teacher characteristics, trainee characteristics, and contextual affordances. Clinician-teachers were stimulated to learn by trainee presence and through discrete interactions with trainees. These stimuli often led to feelings of “performative pressure” to role model and teach effectively or “slowing down” in thinking, prompting clinician-teachers to engage in learning processes (e.g., reflection, collaboration, and articulation), which resulted in knowledge acquisition, reinforcement, and refinement.

Conclusions
Learning through teaching is an underappreciated strategy that can help clinician-teachers improve their clinical knowledge and skills. This study uncovered some of the processes through which clinicians learn during spontaneous clinical teaching and the factors that modulate this learning.
Effect of Grifola frondosa polysaccharide on immune function and gut microbiota in mice
Authors: Lin Xiaoliang , Ma Linlin , Liang Ming , Qu Xian , Yu Yi , Zhou Yifa , Cheng Hairong 
Published: February 2025

Objective:

Grifola frondosa, a medicinal mushroom, is widely used to enhance immunity and treat cancer. Polysaccharides are its primary active components. We aimed to investigate the effects of the alkaloid G. frondosa polysaccharide (GFP) extract on immunity and gut microbiota.

Methods:
Alkaloid GFP was extracted using an alkaline extraction method, followed by hollow-fiber microfiltration. The molecular weight of alkaloid GFP was determined by high-performance gel permeation chromatography (HPGPC). Monosaccharide composition was analyzed by pre-column derivatization combined with high-performance liquid chromatography (HPLC). Methylation analysis was performed to characterize glycosidic linkages in alkaloid GFP. The immune function of alkaloid GFP was assessed in a cyclophosphamide (CTX)-induced immunosuppressive mouse model. Splenic lymphocyte proliferation, macrophage phagocytic capacity, and natural killer (NK) cell cytotoxicity were evaluated. The effect of alkaloid GFP on gut microbiota was assessed by 16S rRNA sequencing.

Results:
The molecular weight distribution of alkaloid GFP ranged from 17 to 18 kDa. The alkaloid GFP contained a β-(1→6)-glucan backbone branched at O-3 by β-1,3-D-Glcp. Oral administration of alkaloid GFP mitigated the effects of CTX on spleen index, splenic lymphocyte proliferation, and peritoneal macrophage phagocytosis. Additionally, alkaloid GFP improved the gut microbiota composition of immunosuppressed mice, increasing the relative abundances of Ligilactobacillus and Lactobacillus.

Conclusions:
Alkaloid GFP demonstrated immune-enhancing effects and gut microbiota regulatory activity, providing a basis for developing related health food ingredients.
Graphical abstract: http://links.lww.com/AHM/A156.
PKA signaling-mediated inhibition of the AIM2 inflammasome is involved in the radioprotective effect of Eleutheroside E
Authors: Zhang Liangliang , Hu Changkun , Wu Zekun , Yan Ziqiao , Xiao Chengrong , Tang Xianglin , Liao Zebin , Gao Yue 
Published: February 2025

Objective:
To investigate the protective effect and underlying mechanism of Eleutheroside E (EE), derived from Acanthopanax senticosus, against γ-ray radiation-induced splenic injury.

Methods:
The Cell Counting Kit-8 assay was used to determine the toxicity of the drug. Hematoxylin and eosin, terminal deoxynucleotidyl transferase dUTP nick end-labeling, and live/dead cell double staining assays were used to evaluate the protective effects of EE on the spleen. Immunofluorescence, immunohistochemical, and enzyme-linked immunosorbent (ELISA) assays were used to investigate the underlying mechanisms of EE. Cross-talk between the AIM2 inflammasome and the PKA signaling pathway was clarified using selective inhibitors.

Results:
EE reduced IR-induced splenic injury—the increased apoptosis rates and the levels of γ-H2AX and inflammatory factors in splenic cells were significantly alleviated. ELISA showed that EE reduced the level of IFN-γ, IL-1β, IL-6, IL-18, and TNF-α in irradiated tissues. The radioprotective effects of EE were mediated by inhibition of the AIM2 inflammasome and stimulation of PKA signaling, in which EE inhibited the increased levels of AIM2, ASC, and cleaved caspase-1 proteins upon ionizing radiation damage but rescued the decreased protein levels in PKA signaling. Suppression of AIM2 signaling was dependent on the activation of PKA signaling by EE treatment.

Conclusion:
EE exerts a significant radioprotective effect on the spleen in vitro and in vivo. Activation of the PKA signaling pathway leads to AIM2 inflammasome inhibition, thereby attenuating radiation-induced DNA damage. This was demonstrated to be the mechanism involved in the radioprotective effects of EE. Thus, EE can be used as a potential radioprotective drug in clinical practice.
Graphical abstract: http://links.lww.com/AHM/A157.
Exudative retinal detachment in a pediatric patient with Rubinstein-Taybi syndrome
Authors: Mendoza Sergio , Kozek Lindsay Klofas , Meng Da , Hoyek Sandra , Gonzalez Efren , Patel Nimesh A. 
Published: February 2025

Purpose:
To highlight findings of retinal exudation with exudative retinal detachment in a patient with Rubinstein-Taybi syndrome (RSTS) due to CREBBP mutation, successfully treated with laser, with the goal of adding to the known phenotypic spectrum of ophthalmic manifestations of RSTS.

Methods:
A case report of a pediatric patient evaluated with multimodal imaging including fundus photography and fluorescein angiography.

Results:
A 15-year-old female with RSTS caused by a frameshift mutation in CREBBP was referred for retinal examination under anesthesia. In additional to typical features of RSTS, including developmental delay, microcephaly, and broad thumbs and toes, she had an ocular history of bilateral nasolacrimal duct obstructions and intermittent exotropia. Dilated fundus examination revealed left iris coloboma, bilateral optic nerve colobomas, and exudation of the left temporal retina with associated exudative retinal detachment and inferotemporal hemorrhage. Fluorescein angiography demonstrated leakage and avascularity of both eyes, with diffuse leakage and nonperfusion noted in the left eye. The avascular areas of the right eye were treated prophylactically with laser as well as sub-Tenon’s triamcinolone. The left retinal exudation initially improved with several rounds of laser treatment, however vitreoretinal membranes eventually developed, resulting in a focal tractional detachment requiring vitrectomy and lensectomy.

Conclusion:
Patients with RSTS have a wide spectrum of ophthalmic manifestations. Our patient demonstrated marked peripheral retinal avascularity and vascular leakage, ultimately resulting in a novel finding of sub-retinal exudation. Laser to the avascular retina led to initial regression of the exudation, however the patient ultimately developed a focal tractional detachment requiring surgery.
A series of hydroxychloroquine-associated cardiotoxicity presenting with heart failure
Authors: Nazarenko Natalia , Maliha Maisha , Parker Matthew , Borkowski Pawel , Csecs Ibolya , Tauras James M. , Julia Shin Jooyoung , Pullman James , Sims Daniel , Rochlani Yogita M. 
Published: February 2025

Background:
Hydroxychloroquine (HCQ) is widely used to manage autoimmune conditions such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and Sjogren’s syndrome. However, HCQ can cause cardiotoxicity, a dose-dependent complication linked to the accumulation of metabolites in lysosomes that alters cellular pH. HCQ-induced cardiotoxicity can lead to various cardiac abnormalities, including conduction defects, hypertrophy, and heart failure (HF). Importantly, this toxicity may be reversible with early detection and prompt discontinuation of HCQ.

Case Summary:
Three cases of SLE patients with prolonged HCQ use are presented, all of whom exhibited signs of cardiomyopathy and HF. The first case involved a 70-year-old male with a 30-year history of HCQ use, who presented with Mobitz II A-V block and other cardiac abnormalities. The second case was a 45-year-old female with a 26-year history of HCQ therapy who developed sinus tachycardia and biatrial enlargement. The third case involved a 75-year-old woman with 30 years of HCQ use, presenting with shortness of breath and pulmonary hypertension. In all cases, HCQ was discontinued, and supportive HF therapy was initiated, leading to improved ejection fraction and resolution of symptoms within months.

Discussion:
HCQ cardiotoxicity, although rare, is an important consideration in patients on long-term therapy, particularly as it is potentially reversible. The diagnosis can be challenging due to the nonspecific nature of cardiac symptoms and overlaps with other conditions. Imaging, particularly cardiac magnetic resonance imaging, plays a crucial role in early detection, while endomyocardial biopsy provides a definitive diagnosis. These cases underscore the need for clinicians to be aware of HCQ cardiotoxicity, as early intervention can improve patient outcomes.
Convenient but concerning: patients' experiences of metronomic chemotherapy in metastatic breast cancer
Authors: Larsson Karolina , Linderholm Barbro Kristina , Wärnberg Fredrik , Berbuyk Lindström Nataliya , Ekholm Maria , Liljedahl Matilda 
Published: February 2025

Abstract

Background:
Metronomic chemotherapy (MCT) is an available treatment option in patients with metastatic breast cancer. Since patients' perspectives concerning treatment selection may differ from those of the oncologists, increased knowledge on the patient perspective is needed to facilitate shared decision making. The aim was to explore patients' experiences of metronomic chemotherapy with capecitabine and cyclophosphamide (MCT-CX) with focus on the perceived benefits and drawbacks on everyday life.

Methods:
This is a qualitative descriptive study using individual semistructured interviews for data collection. Ten women in Sweden aged 43–83 years currently or previously treated with MCT were included. Interviews were analyzed using inductive content analysis.

Results:
In general, participants experienced MCT-CX as a convenient and easily manageable treatment with modest side effects. They emphasized that MCT-CX enabled them to live a life as close to normal as possible and valued doing so despite noncurable cancer. Participants valued the freedom of having a treatment at home. Participants raised concerns regarding the potential weaker effect of MCT-CX compared with other treatments but viewed the treatment as their lifeline that may keep them alive for just a little bit longer.

Conclusions and Interpretations:
Our results reveal an ambivalence between participants' satisfaction with the minimal intrusion of MCT-CX on everyday life and the fear of taking a potentially weak and insufficient treatment, something that needs to be addressed in future research and in patient–oncologist communication. From the patients' perspective, MCT-CX is as a feasible treatment option.