bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seven-year periodic variations in the methanol maser line displayed by the massive protostar IRAS 20216+4104
Authors: Szymczak M. , Durjasz M. , Goedhart S. , Wolak P. , Bartkiewicz A. , Caratti o Garatti A. , Kobak A. , Massi F. 
Published: November 2023

Aims. We report the discovery and analysis of a periodic methanol maser in the massive protostar IRAS 20216+4104.
Methods. To obtain the light curve, we used the 6.7 GHz methanol maser spectra collected between 2000–2003 and 2009–2023 with the Hartebeesthoek and Torun radio telescopes, as well as spectra from the literature reported prior to 1992.
Results. The velocity-integrated flux density shows sinusoidal-like variations with a period of 6.9±0.03 yr. All but one of the features show periodic changes with a relative amplitude of 2 up to >89. A slightly variable feature displays a moderate anti-correlation between the flux density and the other significantly variable features. The maser emission appears to follow the continuum emission of the red-shifted outflow cavity. A maximum emission of 3.4 and 4.6 µm precedes the maser peak by 15% of the period and the (infrared) IR light centroids show time-dependent displacement. The periodic behaviour of the maser and IR emission is likely due to the eclipsing effect from a wobbling inner disk.
Über Grenzen hinaus: erste Extrem-Langzeit-Impella-Unterstützung mit transkontinentaler Verlegung
Authors: Fitzner Sebastian , Fühner Thomas , Franke Andreas 
Published: November 2023

ZusammenfassungWir berichten über die erste transkontinentale Ambulanzjet-Verlegung eines 61-jährigen Patienten mit über 76 Tage liegender Impella CP-Pumpe nach kardiogenem Schock infolge eines akuten Myokardinfarkts. Nach initialer, diagnostischer Herzkatheteruntersuchung erfolgte, vor einer Hochrisiko-PCI, zunächst die Implantation einer IABP. 15 Tage später wurde auf eine Impella CP-Pumpe gewechselt, die nach 24 Tagen, aufgrund eines technischen Defekts, gewechselt werden musste. Seitdem befindet sich der Patient seit über 76 Tagen an einer Impella CP, was unserer Erkenntnis nach die weltweit längste dokumentierte Liegedauer ist. Aufgrund einer Kolonblutung unter der heparinversetzten Spülflüssigkeit der Impella und der DAPT musste die Antikoagulation mit Heparin gestoppt und stattdessen eine alternative Spüllösung mit Dextrose 5% und Natriumbicarbonat eingesetzt werden. Nach 3-monatigem stationären Aufenthalt erfolgte die Verlegung des Patienten aus den UAE in die USA zur Implantation
eines dauerhaften LVAD. Dies ist die erste Transkontinentalverlegung eines Impella-Patienten in einem Ambulanzjet mit einer Entfernung > 11000 km.
Is There A Connection Between Primary Hypophysitis and Celiac
Disease?
Authors: Kara Zehra , Eşkazan Tuğçe , Şahin Serdar , Durcan Emre , Sulu Cem , Demir Ahmet Numan , Uysal Serhat , Özkaya Hande Mefkure , Yılmaz Erkan , Hatemi Ali İbrahim , Bolayırlı İbrahim Murat , Kadıoğlu Pınar 
Published: November 2023

Abstract
Aim To investigate the autoimmune and genetic relationship between primary
hypophysitis (PH) and celiac disease (CD).
Methods The study was retrospective and patients with PH followed in our
clinic between 2007 and 2022 were evaluated. Clinical, endocrinologic,
pathologic, and radiologic findings and treatment modalities were assessed.
Patients diagnosed with CD in the Gastroenterology outpatient clinic in
2020–2022 were included in the study as a control group. Information
such as sociodemographic data, year of diagnosis, human leukocyte antigen (HLA)
DQ2/8 information, CD-specific antibody levels, pathologic results of
duodenal biopsy, treatment received, follow-up status, additional diseases,
hormone use, and surgical history was obtained from patient records at PH.In patients diagnosed with PH, a duodenal biopsy was obtained, and the tissue was
examined for CD by experienced pathologists. Anti-pituitary antibody (APA) and
anti-arginine-vasopressin (AAVP) antibody levels of individuals with PH and CD
were measured.
Results The study included 19 patients with lymphocytic hypophysitis, 30
celiac patients, and 30 healthy controls. When patients diagnosed with
lymphocytic hypophysitis were examined by duodenal biopsy, no evidence of CD was
found in the pathologic findings. The detection rate of HLA-DQ2/8 was
80% in celiac patients and 42% in PH (p=0.044). (APA and
AAVP antibodies associated with PH were tested in two separate groups of
patients and in the control group. APA and anti-arginine vasopressin (AAVP)
levels in PH, CD and healthy controls, respectively M [IQR]: 542
[178–607];164 [125–243]; 82 [74–107] ng/dL
(p=0.001), 174 [52–218]; 60 [47–82]; 59 [48–76]
ng/dL (p=0.008) were detected. The presence of an
HLA-DQ2/8 haplotype correlates with posterior hypophysitis and
panhypophysitis (r=0.598, p=0.04 and r=0.657,
p=0.02, respectively).
Conclusion Although patients with PH were found to have significant levels
of HLA-DQ2/8, no CD was found in the tissue. Higher levels of pituitary
antibodies were detected in celiac patients compared with healthy controls, but
no hypophysitis clinic was observed at follow-up. Although these findings
suggest that the two diseases may share a common genetic and autoimmune basis,
the development of the disease may be partially explained by exposure to
environmental factors.
A bibliometric analysis of virtual influencers in the Web of Science
Authors: Vila-López Natalia , Kuster-Boluda Ines , Mora-Pérez Elisabet , Pascual-Riquelme Isabel 
Published: November 2023

AbstractThe role of virtual influencers has risen in popularity. However, the revisions on this are scarce and incomplete. In this framework, two main objectives guide this work: (i) to carry on a performance analysis to measure the visibility/impact of the scientific production on virtual influencers’ marketing (most cited authors, journals, and themes) and (ii) to visually present the scientific structure by topics of research in virtual influencers marketing as well as its evolution along time. A final set of 1740 papers about virtual influencer marketing was retrieved from the ISIWeb of Science (from 1997 to 2021). Three different periods of time were identified (i) from 1997 to 2012 (649 papers), (ii) from 2013 to 2016 (540 papers), and (iii) from 2017 to 2021 (514 papers). Our results have identified seven promising future research lines on this topic, highlighting the role of tourism and sports celebrities.
The survival and outcome of older patients with primary aneurysmal subarachnoid haemorrhage: a 2-year follow-up, multi-centre, observational study
Authors: Wang Bang-Yue , Peng Chao , Jiang Hong-Sheng , Yang Zhong-Hong , Zhao Yan , Song Yun-Fei , Li Jian , Yang Yi-Fan , Wang Zhen , Zhang Heng-Rui , Wu Zhuo-Lin , Cui Jian-Zhong , Yang Xin-Yu , Hu Fu-Guang 
Published: November 2023

Abstract

Background and Purpose
The management of older aneurysmal subarachnoid haemorrhage (aSAH) cases is a clinical challenge. This study aimed to analyse the survival and functional outcomes in older aSAH patients (age ≥ 70 years) to provide evidence for making treatment decisions for such patients.

Methods
We performed a 2-year follow-up analysis of the Chinese Multi-Centre Cerebral Aneurysm Database for older patients suffering from aSAH from 2017 to 2020. A survival analysis was used to investigate the mean survival and hazard ratios for death. Binary logarithmic regression was performed to investigate the odds ratio for independent survival and dependent survival.

Results
A total of 1,136 consecutive older patients with aSAH were assessed in this study, and 944 patients (83.1%) were followed up. The overall mean survival was 37.79 ± 1.04 months. A total of 380 (40.25%) patients died within 2 years after aSAH. In survival analysis, the predictors of mortality were older age, intracerebral haemorrhage (ICH) history, Hunt-Hess (H-H) grade, World Federation of Neurosurgical Societies (WFNS) grade and operative treatment decreased the risk of mortality compared to conservative treatment. In binary logarithmic regression, the predictors of dependent survival were hypertension, diabetes, WFNS grade.

Conclusions
The risk for 2-year mortality after aSAH increases markedly with older age, ICH history, H-H grade and WFNS grade. Risk factors for 2-year dependent survival were associated with hypertension, diabetes and WFNS grade in older patients with aSAH. Operative treatment markedly decreased mortality but did not significantly decrease the morbidity of dependent survival compared to conservative treatment.
We should be screening for benign paroxysmal positional vertigo (BPPV) in all older adults at risk of falling: a commentary on the World Falls Guidelines
Authors: Li Yuxiao , Smith Rebecca M , Whitney Susan L , Seemungal Barry M , Ellmers Toby J 
Published: November 2023

Abstract
Benign paroxysmal positional vertigo (BPPV) is amongst the commonest causes of dizziness and falls in older adults. Diagnosing and treating BPPV can reduce falls, and thereby reduce fall-related morbidity and mortality. Recent World Falls Guidelines recommend formal assessment for BPPV in older adults at risk of falling, but only if they report vertigo. However, this recommendation ignores the data that (i) many older adults with BPPV experience dizziness as vague unsteadiness (rather than vertigo), and (ii) others may experience no symptoms of dizziness at all. BPPV without vertigo is due to an impaired vestibular perception of self-motion, termed ‘vestibular agnosia’. Vestibular agnosia is found in ageing, neurodegeneration and traumatic brain injury, and results in dramatically increased missed BPPV diagnoses. Patients with BPPV without vertigo are typically the most vulnerable for negative outcomes associated with this disorder. We thus recommend simplifying the World Falls Guidelines: all older adults (&gt;60 years) with objective or subjective balance problems, irrespective of symptomatic complaint, should have positional testing to examine for BPPV.
Do honest signals or piercing weapons determine rank in a polygynous ungulate?
Authors: Fattorini Niccolò , Tizzani Paolo , Dematteis Andrea , Lovari Sandro 
Published: November 2023

Abstract
In polygynous ungulates, males are often larger than females and bear more elaborate/larger weapons. Quantifying sexual dimorphism in different traits could provide insights into species-specific evolutionary pathways of sexual selection. Concerning the combination of secondary sexual traits, we found that Himalayan tahr (Hemitragus jemlahicus) is unique among the ~20 species in the tribe Caprini, as its body mass dimorphism is ~2-fold greater than the dimorphism in horn size, whereas horn shape appears to be near-monomorphic. Whilst horns show the same growth rate in both sexes, body mass increases faster in males. Considering age variation, dominant, golden-ruffed males are also heavier than brown-ruffed, lower-ranking males. Unlike most bovids, male–male competition in tahr does not seem to have influenced weapon development, suggesting a lower importance of horns in male–male competition compared to body mass, as their unritualized combat style also suggests. Our study highlights alternative evolutionary pathways occurring in the Caprinae, where intraspecific signals involve different traits, from weapons to pelage features. Accordingly, male tahr use their ruff colour as an ‘honest’ signal of rank.
Formylpeptide receptor 1 contributes to epidermal barrier dysfunction-induced skin inflammation through NOD-like receptor C4-dependent keratinocyte activation
Authors: Shao Shuai , Sun Zhongbin , Chu Mengyang , Chen Jiaoling , Cao Tianyu , Swindell William R , Bai Yaxing , Li Qingyang , Ma Jingyi , Zhu Zhenlai , Schuler Andrew , Helfrich Yolanda , Billi Allison C , Li Zhiguo , Hao Junfeng , Xiao Chunying , Dang Erle , Gudjonsson Johann E , Wang Gang 
Published: November 2023

Abstract

Background
Skin barrier dysfunction may both initiate and aggravate skin inflammation. However, the mechanisms involved in the inflammation process remain largely unknown.

Objectives
We sought to determine how skin barrier dysfunction enhances skin inflammation and molecular mechanisms.

Methods
Skin barrier defect mice were established by tape stripping or topical use of acetone on wildtype mice, or filaggrin deficiency. RNA-Seq was employed to analyse the differentially expressed genes in mice with skin barrier defects. Primary human keratinocytes were transfected with formylpeptide receptor (FPR)1 or protein kinase R-like endoplasmic reticulum (ER) kinase (PERK) small interfering RNA to examine the effects of these gene targets. The expressions of inflammasome NOD-like receptor (NLR)C4, epidermal barrier genes and inflammatory mediators were evaluated.

Results
Mechanical (tape stripping), chemical (acetone) or genetic (filaggrin deficiency) barrier disruption in mice amplified the expression of proinflammatory genes, with transcriptomic profiling revealing overexpression of formylpeptide receptor (Fpr1) in the epidermis. Treatment with the FPR1 agonist fMLP in keratinocytes upregulated the expression of the NLRC4 inflammasome and increased interleukin-1β secretion through modulation of ER stress via the PERK-eIF2α-C/EBP homologous protein pathway. The activation of the FPR1-NLRC4 axis was also observed in skin specimens from old healthy individuals with skin barrier defect or elderly mice. Conversely, topical administration with a FPR1 antagonist, or Nlrc4 silencing, led to the normalization of barrier dysfunction and alleviation of inflammatory skin responses in vivo.

Conclusions
In summary, our findings show that the FPR1-NLRC4 inflammasome axis is activated upon skin barrier disruption and may explain exaggerated inflammatory responses that are observed in disease states characterized by epidermal dysfunction. Pharmacological inhibition of FPR1 or NLRC4 represents a potential therapeutic target.
A O05 Global 30-day morbidity and mortality of surgery for perforated peptic ulcer – GRACE study
Authors: Abouelazayem Mohamed , Jain Rajesh , Wilson Michael , Martinino Alessandro , Balasubaramaniam Vignesh , Biffl Walter , Coccolini Federico , Riera Manel , Wadhawan Himanshu , Wazir Ishaan , Abderaouf Bettahar 
Published: November 2023

Abstract

Background
Perforated peptic ulcer (PPU) is a surgical emergency with a mortality rate of 16-30% and a morbidity rate of 20-50%. All studies reporting on the outcome of surgery for PPU are either local or national. Most of these are based on small cohort sizes. A few larger studies have been reported, but still limited to a single nation, accounting for the wide variations in the literature. There is a lack of global, multicenter data on this topic. We aimed to assess the global 30-day morbidity and mortality of surgery for PPU and the factors influencing it.

Methods
We conducted a global observational cohort study of patients who underwent surgery for PPU between 01/01/2022 and 30/06/2022. Adults (≥18 years) who underwent surgery for PPU and those who had a PPU in a bypassed stomach after bariatric surgery were included. We excluded patients with underlying gastric cancer, and those treated conservatively. Patients were divided into subgroups to study the influence of some variables. These were age (≤50 and &gt;50 years), time from onset of symptoms to hospital presentation (≤24 and &gt;24 hours), and surgical technique (open, laparoscopic, and laparoscopic converted to open).

Results
This is the first global study on this topic and included 1864 patients from 162 centers across 52 countries. Mean age was 49.7 ± 17 years, and males represented 78.3%. The mean hospital stay was 10 ± 9.2 days and the 30-day reoperation rate was 5.4%. The 30-day morbidity rate was 48.5% and mortality rate was 9.3%. On multivariate analysis, age &gt;50 years, presentation &gt;24 hours, female gender, shock on admission, and acute kidney injury were significantly associated with 30-day morbidity. 30-day mortality was significantly associated with age &gt;50 years, female gender, acute kidney injury, and shock on admission.

Conclusions
Surgery for PPU carries high 30-day morbidity and mortality globally. Age &gt; 50 years old, female gender, acute kidney injury, and signs of shock upon admission are independent factors that can increase the likelihood of 30-day mortality. Laparoscopic surgery appears to be underutilized despite lower morbidity and mortality rates.
BS O02 Pancreatic Exocrine Insufficiency after Bariatric Metabolic Surgery: Results from a Systematic Review and Meta-Analysis
Authors: Hall Lewis , Powell-Brett Sarah , Smith James Halle , Ward Liz , Wiggins Tom , Markar Sheraz , Roberts Keith 
Published: November 2023

Abstract

Background
Disruptive gastrointestinal symptoms and malnutrition are common following bariatric metabolic surgery (BMS), and pancreatic exocrine insufficiency (PEI) is a sparsely considered cause of such. Untreated PEI results in substantial patient harm and should be managed with pancreatic enzyme replacement therapy (PERT). The incidence of PEI, its diagnosis and management, is unclear after BMS. The aim of this review was to assimilate the literature on incidence, diagnosis, and management of PEI in patients following BMS.

Methods
A systematic review of PUBMED and Embase databases identified studies investigating PEI following BMS. A pooled analysis was performed to determine prevalence of PEI in each cohort, and benefit of PERT. Meta-analyses were performed using the software package Revman 5.4, in accordance with the recommendation of the Cochrane Collaboration.

Results
12 studies were included in the quantitative synthesis of PEI rate after BMS. The rate of PEI after any BMS was 23.0% (95% CI:14.6% - 32.6%) amongst 1157 patients, and most common after biliopancreatic diversion with duodenal switch (44.0% (95%CI: 9.2-82.1%)). The most common diagnostic test used was faecal-elastase-1 (FE-1) (10/12 studies) reporting &lt;200 µg/g as diagnostic of PEI. Five studies considered management of PEI with 81.7% (95% CI: 73.8% - 88.6%) of patient’s responding positively to PERT when prescribed. One study specifically reported improved Vitamin D, quality of life and FE-1 following PERT, with no effect on weight loss.

Conclusions
PEI is common following BMS, particularly following bypass procedures, and may be a substantial contributor to post-operative malnutrition in these patients. With over 4/5th patients experiencing symptomatic benefit of PERT, and evidence suggesting it does not prohibit weight loss, future research must further illuminate the role of PERT in the post-operative story of BMS patients.
BS O05 Resource impacts of bariatric surgery emergencies on the NHS: a 5-year review from a regional bariatric centre
Authors: Alabdellat Osama Khaled , Nima Bara Abu , Alwani Omneya , Alkhaffaf Bilal 
Published: November 2023

Abstract

Background
Bariatric surgery is a safe and highly effective treatment for obesity. Whilst the risks of surgery are generally low, emergency presentations can be extremely challenging to manage, particularly in a cohort with complex health needs. In the UK, a large proportion of cases are undertaken outside of the NHS. Little is known about the burden that an indeterminate volume of elective cases has on a publicly funded healthcare system which may need to adapt to better care for this group. This study aimed to explore this topic further by understanding the changing trends of emergency care for bariatric surgery patients.

Methods
This was a retrospective review of all consecutive non-elective (NE) attendances and admissions between January 2018 and April 2023. The setting was a regional bariatric and metabolic surgery centre with a dedicated bariatric on-call service serving a regional population in the North-West of England. Patient demographics, data on index procedures, diagnostic and therapeutic interventions as well as length of hospital stay (LOS) and intensive therapy unit (ITU) stay was collected. Changing trends in presentations and resource utilization were explored.

Results
373 NE episodes resulted in 4311 bed day occupancy; 76% had privately funded surgery accounting for 66.5% of total bed days. Median LOS was 5 days (IQR 2-11). 29 episodes resulted in 176 ITU bed days (median 4 days). Band-related complications were the most frequent cause of episodes (167) versus gastric bypass (104) and gastric sleeve (88). Median time from index procedure was 5 years IQR (2-11). 397 fluoroscopies and 365 CT-scans were undertaken in addition to 270 interventions (186 surgical; 30 radiological; 26 bedside deflations and 28 endoscopic). There was a three-fold increase in episodes between 2021 and 2022.

Conclusions
Non-elective episodes related to bariatric surgery can occur many years after the index procedure and result in the use of significant diagnostic, therapeutic and system resource. Our results suggest that the landscape of emergency bariatric surgery is changing with more cases that result in greater complex management needs. Most NE episodes are a result of privately funded surgery (likely as a response to limited access in the NHS) which have contributed to this increased resource use. These changes have serious implications for service delivery and design in the NHS which needs to rapidly adapt to these needs.
BS O06 Robotic-assisted bariatric surgery: a systematic review on learning curves
Authors: Supparamaniam Shreyas , Supparamaniam Sandesh , Lim Jia-Jye , Lee Shiela , Kourounis Georgios 
Published: November 2023

Abstract

Background
Robotic-assisted minimally invasive surgery has improved patient outcomes and experiences in various surgical disciplines, demonstrating reduced complications, postoperative pain, and length of hospital stays. Within the field of bariatric surgery, the integration of robotic systems aims to further enhance patient outcomes compared to traditional laparoscopic procedures. However, the precise learning curve (LC) for robotic bariatric surgery has yet to be clearly defined. Considering this knowledge gap, our review aims to compile and analyse the most up-to-date evidence on LC outcomes in bariatric surgery procedures.

Methods
In this review, we searched PubMed, Embase, and Cochrane Central Library databases up to April 2023 to identify studies reporting LC outcomes for robotic bariatric procedures. The primary outcome was the number of operations required to reach LC stabilization. Secondary outcomes included surgeon characteristics, including the number of training surgeons, their prior laparoscopic and/or robotic experience, exposure to simulated robotic training and outcome measures, including complication rates, surgery duration, and length of stay. Our study is registered on PROSPERO (CRD42023425878), and no specific grants were received from funding agencies.

Results
Of 432 initial results, 18 articles were included. All were observational studies reporting 27 cohorts from 2006 to 2022, involving 2084 patients. There were one to four included surgeons. The overall median number of cases to overcome the LC was 35 (IQR 15-64). For gastric bypass (RGB), the median LC was 25 (IQR 15-69), while for sleeve gastrectomy (RSG), it was 31 (IQR 20-86). The overall operation time was 185 minutes (IQR 124-197), with RGB at 152 minutes (IQR 139-196) and RSG at 98 minutes (IQR 85-110). Five studies used the CUSUM methodology, while others lacked specified LC determination approaches.

Conclusions
Our review highlights that the learning curve for bariatric surgery can be navigated relatively quickly and safely. However, it also reveals that the existing evidence on learning curves for robotic bariatric surgery is derived from a limited number of surgeons with unclear levels of prior surgical experience. Furthermore, the heterogeneity in evaluating learning curves poses challenges for comprehensive analysis. Future studies should aim to outline differences in outcomes between established laparoscopic methods and robotic bariatric procedures, providing further clarity in this field.