bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of EUS-directed transgastric ERCP (EDGE) versus laparoscopic-assisted ERCP: A systematic review and meta-analysis
Authors: Gangwani Manesh Kumar , Haghbin Hossein , Priyanka Fnu , Hadi Yousaf , Dahiya Dushyant Singh , Kamal Faisal , Lee-Smith Wade , Nawras Ali , Aziz Muhammad , Adler Douglas G. 
Published: January 2024

ABSTRACT

The altered anatomy in Roux-en-Y gastric bypass (RYGB) makes conventional endoscopic retrograde cholangiopancreatography (ERCP) a technically challenging procedure. EUS–directed transgastric ERCP (EDGE) and laparoscopic-assisted ERCP (LA-ERCP) are alternative modalities used with comparable efficacy and adverse events in such patients. We conducted a meta-analysis comparing EDGE and LA-ERCP to assess the efficacy and safety in patients with RYGB. We conducted a comprehensive literature search from inception to July 7, 2022, on MEDLINE, EMBASE, Cochrane Register of Controlled Trials, and Web of Science databases using the core concepts of EDGE and LA-ERCP. We excluded case reports, case series (<10 patients), and review articles. Relative risk (RR) was calculated when comparing dichotomous variables, whereas mean difference was calculated for continuous outcomes. A 95% confidence interval (CI) and P values (<0.05 considered significant) were also generated. The search strategy yielded a total of 55 articles. We finalized 4 studies with total 192 patients (75 EDGE and 117 LA-ERCP). The rates of technical success were not significantly different for LA-ERCP and EDGE (RR, 0.994; 95% CI, 0.939–1.051; P = 0.830, I
2 = 0%) Similarly, no difference in adverse events was noted between the 2 groups (RR, 1.216; 95% CI, 0.561–2.634; P = 0.620, I
2 = 10.67%). Shorter procedure time was noted for EDGE compared with the LA-ERCP group (mean difference, 91.53 min; 95% CI, 69.911–113.157 min; P < 0.001, I
2 = 8.32%). EDGE and LA-ERCP are comparable in terms of efficacy and safety. In addition, EDGE has overall lower procedural time. Our study suggests that EDGE should be considered as a first-line therapy if expertise available.
Revolution of hands-on model for interventional EUS: How to make a training model
Authors: Chantarojanasiri Tanyaporn , Siripun Aroon , Pinyotheppratarn Ratchamon , Kongkam Pradermchai , Pausawasdi Nonthalee , Ratanachu-ek Thawee 
Published: January 2024

Abstract
EUS interventions have an increasing role in the treatment for hepatobiliary-pancreatic diseases. However, the procedure itself is not frequently performed, needs expertise, and carries a high risk of complications. With these limitations, the hands-on practice model is very important for the endoscopist in training for EUS intervention. There have been various hands-on models for EUS interventions, ranging from in vivo living pig model to all-synthetic model. Although a living model provides realistic sensation, the preparation is complex and increases concerns for zoonotic issues. All-synthetic models are easier to prepare and store but not realistic and still need the room for improvement. Hybrid ex vivo model is more widely available and provides various training procedures but still needs special preparation for the porcine tissue.
The current status and challenges of perioperative management of patients with a BMI of greater than or equal to 50 kg/m2 undergoing bariatric surgery in China: a multicenter cross-sectional study
Authors: Yang Ningli , Hua Hongxia , Liu Shaozhuang , Zhang Songhai , Zhao Xiangwen , Zhang Peng , Zhang Pin , Wang Yong , Shen Jiajia , Lin Shibo , Guan Wei , Liang Hui 
Published: January 2024

Background:
Performing bariatric surgery on patients with a BMI of over 50 kg/m2 is challenging. This study aimed to explore the status and challenges related to the perioperative management of such patients in China.

Materials and methods:
A prospective survey was designed to investigate the perioperative management of patients with a BMI of greater than or equal to 50 kg/m2 undergoing bariatric surgery in China. The questionnaire of our survey included general information, preoperative management measures, surgical procedures performed, technical details regarding anaesthesia, and postoperative management measures. A response from only one attending physician per bariatric centre was accepted.

Results:
Physicians from a total of 101 hospitals responded to the questionnaire, and the questionnaire data from 98 hospitals were complete. These centres had completed a total of 44 702 bariatric surgeries since the launch of such surgery to December 2021. A total of 3280 patients had a BMI exceeding 50 kg/m2. The preferred surgical procedures for patients with super obesity were sleeve gastrectomy by 62 centres, Roux-en-Y gastric bypass by 11 centres, sleeve gastrectomy plus jejunojejunal bypass by 19 centres, one anastomosis gastric bypass by 1 centre, and duodenal switch by 1 centre. The most worrying issues were cardiopulmonary failure and difficulty in extubation. 91 centres believed that preoperative weight loss was beneficial. A low-calorie diet was the specific measure mainly implemented, only three centres considered using intragastric balloon placement. Postoperative management measures varied greatly.

Conclusion:
Bariatric surgery has seen rapid development. Chinese physicians show significant differences regarding the perioperative management for patients with a BMI of over 50 kg/m2. The perioperative risks of these patients remain relatively high, making further development of clinical pathways is necessary.
Three-dimensional printed mold for neovaginal cavity maintenance in vaginal agenesis: A case report
Authors: Lim Chul Kwon , Yang Jung Bo , Lee Jin Yu , Ha Joong Gyu , Choi Won Kyu , Kim Seung Hyun , Hwang In Taek 
Published: January 2024

Rationale:
Vaginal agenesis is a congenital anomaly that causes physical and psychosocial problems for women. Many surgical procedures for neovaginal reconstruction have been described in the literature. Using an appropriate vaginal mold is crucial for a successful surgical outcome. Here, we present an effective solution for neovaginal cavity maintenance involving the use of a customized three-dimensional (3D) printed vaginal mold created using thermoplastic polyurethane material.

Patient concerns:
Here, we present a case of non-syndromic agenesis of the lower vagina in an 18-year-old girl and the postsurgical management.

Diagnosis:
After a thorough evaluation, the patient was diagnosed with Mayer–Rokitansky–Küster–Hauser syndrome or Müllerian agenesis.

Interventions:
After drainage of the pus during acute infection of a patient with vaginal agenesis, a condom and alginate were used to create a mold. The mold was then used to create a permanent, customized mold with a 3D printer.

Outcomes:
This report is the first to suggest using a 3D printer to create molds to maintain vaginal dilation after the creation of a neovagina.

Lessons:
This approach can be applied for patients with vaginal agenesis and stenosis and can be used as a novel method for maintaining the neovaginal structure without affecting the patient’s quality of life.
Predictive Insights Into Exocrine Pancreatic Insufficiency in Chronic Pancreatitis and Autoimmune Pancreatitis
Authors: Tanaka Tomoyuki , Kimura Takefumi , Wakabayashi Shun-ichi , Okamura Takuma , Shigeto Shohei , Tanaka Naoki , Kondo Shohei , Horiuchi Ichitaro , Kuraishi Yasuhiro , Nakamura Akira , Ashihara Norihiro , Kanai Keita , Nagaya Tadanobu , Watanabe Takayuki , Umemura Takeji 
Published: January 2024

Objective
Exocrine pancreatic insufficiency (EPI) is a common manifestation of chronic pancreatitis (CP) and autoimmune pancreatitis (AIP). This study aimed to estimate the presence of EPI in patients with CP or AIP using alternative clinical markers.

Materials and Methods
A machine learning analysis employing a decision tree model was conducted on a retrospective training cohort comprising 57 patients with CP or AIP to identify EPI, defined as fecal elastase-1 levels less than 200 μg/g. The outcomes were then confirmed in a validation cohort of 26 patients.

Results
Thirty-nine patients (68%) exhibited EPI in the training cohort. The decision tree algorithm revealed body mass index (≤21.378 kg/m2) and total protein level (≤7.15 g/dL) as key variables for identifying EPI. The algorithm's performance was assessed using 5-fold cross-validation, yielding area under the receiver operating characteristic curve values of 0.890, 0.875, 0.750, 0.625, and 0.771, respectively. The results from the validation cohort closely replicated those in the training cohort.

Conclusions
Decision tree analysis revealed that EPI in patients with CP or AIP can be identified based on body mass index and total protein. These findings may help guide the implementation of appropriate treatments for EPI.
Evidence-Based Performance Measures for Reconstruction after Skin Cancer Resection: A Multidisciplinary Performance Measure Set
Authors: Chen Andrew , Ray Peter , Rogers Howard , Bialowas Christie , Butala Parag , Chen Michael , Daveluy Steven D. , Davidson Caryn , Faringer Paul , Guarda Helena , Kantor Jonathan , Kaweski Susan , Lawrence Naomi , Lickstein David , Lomax John , Parra Sylvia , Retson Nicholas , Suryadevara Amar , Smith Ryan , Tollefson Travis T. , Wisco Oliver J. 
Published: January 2024

Background:
The American Society of Plastic Surgeons commissioned the multidisciplinary Performance Measure Development Work Group on Reconstruction after Skin Cancer Resection to identify and draft quality measures for the care of patients undergoing skin cancer reconstruction. Included stakeholders were the American Academy of Otolaryngology–Head and Neck Surgery, the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Dermatology, the American Society of Dermatologic Surgery, the American College of Mohs Surgery, the American Society for Mohs Surgery, and a patient representative.

Methods:
Two outcome measures and five process measures were identified. The outcome measures included the following: (1) patient satisfaction with information provided by their surgeon before their facial procedure, and (2) postprocedural urgent care or emergency room use. The process measures focus on antibiotic stewardship, anticoagulation continuation and/or coordination of care, opioid avoidance, and verification of clear margins.

Results:
All measures in this report were approved by the American Society of Plastic Surgeons Quality and Performance Measures Work Group and Executive Committee, and the stakeholder societies.

Conclusion:
The work group recommends the use of these measures for quality initiatives, Continuing Medical Education, Continuous Certification, Qualified Clinical Data Registry reporting, and national quality reporting programs.
Cerebral and Aortic Aneurysms in Electroconvulsive Therapy Patients
Authors: Ullrich Heiko , Sartorius Alexander , Karl Sebastian 
Published: January 2024

Introduction
Theoretically, the procedural risk of electroconvulsive therapy (ECT) could be increased in the presence of undetected aneurysms due to the hemodynamic changes associated with ECT. However, empirical evidence is limited to few individual case reports and case series.

Methods
We performed a systematic review of available evidence on ECT treatment in patients with intracranial aneurysms and untreated aortic aneurysms and we retrospectively analyzed data from 252 consecutive patients referred for ECT at the Department of Psychiatry, Psychotherapy and Psychosomatics of Siegen Hospital, Germany, who received magnetic resonance angiographies and abdominal sonographies as part of their routine pre-ECT workup.

Results
Of 252 patients referred for ECT, 5 (2.0%) were found to have an intracerebral aneurysm and 1 (0.4%) was found to have an abdominal aortic aneurysm. These cases are reported in detail together with 2 additional cases of aortic aneurysms from the Central Institute of Mental Health, Mannheim, Germany. Electroconvulsive therapy was performed without complications in all 8 cases.

Conclusions
Aneurysms might occur in ECT patients at a similar rate as in the general population. The number of ECTs performed annually in mostly unscreened patients suggests that there might be a significant number of patients with undetected aneurysms in whom ECT is performed without reported complications.
Beta-cell adaptation to metabolic stresses requires prolactin receptor signaling
Authors: Lee Daniel , Kahlon Raneet , Kola-Ilesanmi Darasimi , Rahman Mahir , Huang Carol 
Published: January 2024

AbstractThe role of prolactin receptor (PRLR) signaling in β-cell adaptation to maternal insulin resistance of pregnancy has been well demonstrated. Using transgenic mice with an inducible β-cell-specific Prlr deletion (βPrlr-/-), we found that intact PRLR, as found in βPrlr+/+mice, were protected from developing glucose intolerance during pregnancy, and the main mechanism responsible for this PRLR-mediated effect is the up regulation of β-cell proliferation and insulin synthesis. Interestingly, studies in male mice and humans have found a link between diminished PRLR signaling and abnormal β-cell function. We aimed to determine whether PRLR has a role in regulating β-cell function outside of pregnancy, protecting β-cell against exposure to metabolic stressors.In this study, we found that β-cell-specific PRLR reduction resulted in impaired glucose tolerance in multiparous female mice challenged with a 12-week course of high-fat diet (HFD). Unlike in pregnancy, where PRLR signaling up regulates β-cell proliferation resulting in a greater β-cell mass, we observed no difference in β-cell mass between the wild type (βPrlr+/+) and mutant (βPrlr-/-) mice. In vitro glucose-stimulated insulin secretion using isolated islets from wild type (βPrlr+/+) and mutant (βPrlr-/-) mice showed comparable insulin response, but βPrlr-/-mice showed blunted first-phase insulin release in vivo, although only when challenged with glucose orally and not intraperitoneally, suggesting an impairment of the incretin effect. In support of the observed defect in incretin action, we found a reduction in expression of both incretin hormone receptors,GiprandGlp-1r, and several of their upstream regulators, such asE2f1, Nkx6.1, Pax6, Pparγ, andTcf7l2. Islets from the mutant mice also have a lower insulin content and reduced levels of genes that regulate glucose metabolism. Together, these results suggested that PRLR signaling plays an important role in preserving β-cell function in mice exposed to metabolic stress by maintaining incretin receptor expression and insulin secretory capacity in β cells.
Sifting Through the Noise: A Computational Pipeline for Accurate Prioritization of Protein-Protein Binding Candidates in High-Throughput Protein Libraries
Authors: Mondal Arup , Singh Bhumika , Felkner Roland H. , De Falco Anna , Swapna GVT , Montelione Gaetano T. , Roth Monica J. , Perez Alberto 
Published: January 2024

AbstractIdentifying the interactome for a protein of interest is challenging due to the large number of possible binders. High-throughput experimental approaches narrow down possible binding partners, but often include false positives. Furthermore, they provide no information about what the binding region is (e.g. the binding epitope). We introduce a novel computational pipeline based on an AlphaFold2 (AF) Competition Assay (AF-CBA) to identify proteins that bind a target of interest from a pull-down experiment, along with the binding epitope. Our focus is on proteins that bind the Extraterminal (ET) domain of Bromo and Extraterminal domain (BET) proteins, but we also introduce nine additional systems to show transferability to other peptide-protein systems. We describe a series of limitations to the methodology based on intrinsic deficiencies to AF and AF-CBA, to help users identify scenarios where the approach will be most useful. Given the speed and accuracy of the methodology, we expect it to be generally applicable to facilitate target selection for experimental verification starting from high-throughput protein libraries.Table of Contents
Full resolution HLA and KIR genes annotation for human genome assemblies
Authors: Zhou Ying , Song Li , Li Heng 
Published: January 2024

AbstractThe HLA (Human Leukocyte Antigen) genes and the KIR (Killer cell Immunoglobulin-like Receptor) genes are critical to immune responses and are associated with many immune-related diseases. Located in highly polymorphic regions, they are hard to be studied with traditional short-read alignment-based methods. Although modern long-read assemblers can often assemble these genes, using existing tools to annotate HLA and KIR genes in these assemblies remains a non-trivial task. Here, we describe Immuannot, a new computation tool to annotate the gene structures of HLA and KIR genes and to type the allele of each gene. Applying Immuannot to 56 regional and 212 whole-genome assemblies from previous studies, we annotated 9,931 HLA and KIR genes and found that almost half of these genes, 4,068, had novel sequences compared to the current Immuno Polymorphism Database (IPD). These novel gene sequences were represented by 2,664 distinct alleles, some of which contained non-synonymous variations resulting in 92 novel protein sequences. We demonstrated the complex haplotype structures at the two loci and reported the linkage between HLA/KIR haplotypes and gene alleles. We anticipate that Immuannot will speed up the discovery of new HLA/KIR alleles and enable the association of HLA/KIR haplotype structures with clinical outcomes in the future.
Development and optimization of a diluted whole blood ELISpot assay to test immune function
Authors: Ungaro Ricardo F. , Xu Julie , Kucaba Tamara A. , Rao Mahil , Brakenridge Scott C. , Efron Philip A. , Gould Robert W. , Hotchkiss Richard S. , Mazer Monty B. , McGonagill Patrick W. , Moldawer Lyle L. , Remy Kenneth E. , Turnbull Isaiah R. , Caldwell Charles C. , Badovinac Vladimir P. , Griffith Thomas S. 
Published: January 2024

ABSTRACTBackgroundSepsis remains a leading cause of death worldwide with no proven immunomodulatory therapies. Stratifying Patient Immune Endotypes in Sepsis (‘SPIES’) is a prospective, multicenter observational study testing the utility of ELISpot as a functional bioassay specifically measuring cytokine-producing cells after stimulation to identify the immunosuppressed endotype, predict clinical outcomes in septic patients, and test potential immune stimulants for clinical development. Most ELISpot protocols call for the isolation of PBMC prior to their inclusion in the assay. In contrast, we developed a diluted whole blood (DWB) ELISpot protocol that has been validated across multiple laboratories.MethodsHeparinized whole blood was collected from healthy donors and septic patients and tested under different stimulation conditions to evaluate the impact of blood dilution, stimulant concentration, blood storage, and length of stimulation onex vivoIFNγ and TNFα production as measured by ELISpot.ResultsWe demonstrate a dynamic range of whole blood dilutions that give a robustex vivocytokine response to stimuli. Additionally, a wide range of stimulant concentrations can be utilized to induce cytokine production. Further modifications demonstrate anticoagulated whole blood can be stored up to 24 hours at room temperature without losing significant functionality. Finally, we showex vivostimulation can be as brief as 4 hours allowing for a substantial decrease in processing time.ConclusionsThe data demonstrate the feasibility of using ELISpot to measure the functional capacity of cells within DWB under a variety of stimulation conditions to inform clinicians on the extent of immune dysregulation in septic patients.
The lifetime accumulation of multimorbidity and its influence on dementia risk: a UK Biobank Study
Authors: Patel R. , Mackay C.E. , Griffanti L. , Gillis G. , Ebmeier K.P. , Suri S. 
Published: January 2024

AbstractThe number of people living with dementia worldwide is projected to reach 150 million by 2050, making prevention a crucial priority for health services1. The co-occurrence of two or more chronic health conditions, termed multimorbidity, occurs in up to 80% of dementia patients2, raising the potential of multimorbidity as an important risk factor for dementia. However, precise understanding of which specific conditions, as well as their age of onset, drive the link between multimorbidity and dementia is unclear. We defined the patterns of accumulation of 46 chronic conditions over their lifetime in 282,712 individuals from the UK Biobank. By grouping individuals based on their life-history of chronic illness, we show here that risk of incident dementia can be stratified by both the type and timing of their accumulated chronic conditions. We identified several distinct clusters of multimorbidity, and their associated risks varied in an age-specific manner. Compared to low multimorbidity, cardiometabolic and neurovascular conditions acquired before 55 years were most strongly associated with dementia. Acquisition of mental health and neurovascular conditions between the ages of 55 and 70 was associated with an over two-fold increase in dementia risk compared to low multimorbidity. The age-dependent role of multimorbidity in predicting dementia risk could be used for early stratification of individuals into high and low risk groups and inform targeted prevention strategies based on a person’s prior history of chronic disease.
ChronicToxoplasma gondiiinfection curtails the cytotoxic potential of acute T cell responses to West Nile virus in the brain
Authors: Uhrlaub Jennifer L. , McGovern Kathryn E. , Merritt Emily F. , Kuhns Michael S. , Koshy Anita A. , Nikolich Janko Ž. 
Published: January 2024

ABSTRACTToxoplasma gondii (T. gondii), a common brain-tropic parasite, chronically infects the central nervous system (CNS) of up to a third of the world’s population. Constant immune surveillance interrupts cyst reactivation within the CNS and dramatically alters the immune landscape of the brain. West Nile virus (WNV) is a mosquito-borne infection with a clinical spectrum ranging from asymptomatic to mild flu-like symptoms to severe neuroinvasive disease. In a cohort of WNV infected people, we discovered a positive correlation between WNV disease severity andT. gondiiseropositivity. In a mouse model pairing chronicT. gondiiwith acute WNV infection, we found an increased susceptibility of mice to WNV, with reduced granzyme B expression in WNV-specific T cells and increased regulatory T cell (Treg) numbers in the brain, but not the periphery. This demonstrates that theT. gondii-infected tissue microenvironment impairs immune defense against other brain infections by blunting local T cell responses.