bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Robotic Versus Laparoscopic Pancreatoduodenectomy After Learning Curves of Surgeons
Authors: Zhang Xiu-Ping , Xu Shuai , Zhao Zhi-Ming , Yu Guang-Sheng , Han Bing , Chen Xiong , Ma Yun-Tao , Xu Zong-Zhen , Liu Zhao , Li En-Shan , Guo Xiang-Feng , Gao Yuan-Xing , Zhao Guo-Dong , Lau Wan Yee , Liu Jun , Liu Rong 
Published: December 2023

Objective:
This study aimed to compare robotic pancreatoduodenectomy (RPD) with laparoscopic pancreatoduodenectomy (LPD) in operative and oncologic outcomes.

Background:
Previous studies comparing RPD with LPD have only been carried out in small, single-center studies with variable quality.

Methods:
Consecutive patients from nine centers in China who underwent RPD or LPD between 2015 and 2022 were included. A 1:1 propensity score matching (PSM) was used to minimize bias.

Results:
Of the 2255 patients, 1158 underwent RPD, and 1097 underwent LPD. After PSM, 1006 patients were enrolled in each group. The RPD group had significantly shorter operative time (270.0 vs 305.0 minutes, P<0.001), lower intraoperative blood transfusion rate (5.9% vs 12.0%, P<0.001), lower conversion rate (3.8% vs 6.7%, P=0.004), and higher vascular reconstruction rate (7.9% vs 5.6%, P=0.040) than the LPD group. There were no significant differences in estimated blood loss, postoperative length of stay, perioperative complications, and 90-day mortality. Patients who underwent vascular reconstruction had similar outcomes between the 2 groups, although they had significantly lower estimated blood loss (300.0 vs 360.0 mL; P=0.021) in the RPD group. Subgroup analysis on pancreatic ductal adenocarcinoma found no significant differences between the 2 groups in median recurrence-free survival (14.3 vs 15.3 mo, P=0.573) and overall survival (24.1 vs 23.7 mo, P=0.710).

Conclusions:
In experienced hands, both RPD and LPD are safe and feasible procedures with similar surgical outcomes. RPD had a perioperative advantage over LPD, especially in vascular reconstruction. For pancreatic ductal adenocarcinoma patients, RPD resulted in similar oncological and survival outcomes as LPD.
Rescue Allocation Modes in Eurotransplant Kidney Transplantation: Recipient Oriented Extended Allocation Versus Competitive Rescue Allocation—A Retrospective Multicenter Outcome Analysis
Authors: Assfalg Volker , Miller Gregor , Stocker Felix , Hüser Norbert , Hartmann Daniel , Heemann Uwe , Tieken Ineke , Zanen Wouter , Vogelaar Serge , Rosenkranz Alexander R. , Schneeberger Stefan , Függer Reinhold , Berlakovich Gabriela , Ysebaert Dirk R. , Jacobs-Tulleneers-Thevissen Daniel , Mikhalski Dimitri , van Laecke Steven , Kuypers Dirk , Mühlfeld Anja S. , Viebahn Richard , Pratschke Johann , Melchior Sebastian , Hauser Ingeborg A. , Jänigen Bernd , Weimer Rolf , Richter Nicolas , Foller Susan , Schulte Kevin , Kurschat Christine , Harth Ana , Moench Christian , Rademacher Sebastian , Nitschke Martin , Krämer Bernhard K. , Renders Lutz , Koliogiannis Dionysios , Pascher Andreas , Hoyer Joachim , Weinmann-Menke Julia , Schiffer Mario , Banas Bernhard , Hakenberg Oliver , Schwenger Vedat , Nadalin Silvio , Lopau Kai , Piros Laszlo , Nemes Balazs , Szakaly Peter , Bouts Antonia , Bemelman Frederike J. , Sanders Jan S. , de Vries Aiko P. J. , Christiaans Maarten H. L. , Hilbrands Luuk , van Zuilen Arjan D. , Arnol Miha , Stippel Dirk , Wahba Roger 
Published: December 2023

Background.
Whenever the kidney standard allocation (SA) algorithms according to the Eurotransplant (ET) Kidney Allocation System or the Eurotransplant Senior Program fail, rescue allocation (RA) is initiated. There are 2 procedurally different modes of RA: recipient oriented extended allocation (REAL) and competitive rescue allocation (CRA). The objective of this study was to evaluate the association of patient survival and graft failure with RA mode and whether or not it varied across the different ET countries.

Methods.
The ET database was retrospectively analyzed for donor and recipient clinical and demographic characteristics in association with graft outcomes of deceased donor renal transplantation (DDRT) across all ET countries and centers from 2014 to 2021 using Cox proportional hazards methods.

Results.
Seventeen thousand six hundred seventy-nine renal transplantations were included (SA 15 658 [89%], REAL 860 [4.9%], and CRA 1161 [6.6%]). In CRA, donors were older, cold ischemia times were longer, and HLA matches were worse in comparison with REAL and especially SA. Multivariable analyses showed comparable graft and recipient survival between SA and REAL; however, CRA was associated with shorter graft survival. Germany performed 76% of all DDRTs after REAL and CRA and the latter mode reduced waiting times by up to 2.9 y.

Conclusions.
REAL and CRA are used differently in the ET countries according to national donor rates. Both RA schemes optimize graft utilization, lead to acceptable outcomes, and help to stabilize national DDRT programs, especially in Germany.
Balloon Rises Above: REBOA at Zone 1 May Be Superior to Resuscitative Thoracotomy
Authors: Brenner Megan , Zakhary Bishoy , Coimbra Raul , Scalea Thomas , Moore Laura , Moore Ernest , Cannon Jeremy , Spalding Chance , Ibrahim Joseph , Dennis Bradley 
Published: December 2023

BACKGROUND:
The use of Zone 1 REBOA for life-threatening trauma has increased dramatically.

STUDY DESIGN:
The Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery database was queried for blunt and penetrating trauma between 2013 and 2021. Outcomes were examined both for mechanisms of injury combined and separately and for combinations of abdominal injury with and without traumatic brain injury and chest injuries (Abbreviated Injury Scale [AIS] score >2).

RESULTS:
A total of 531 patients underwent REBOA (408 with blunt injury and 123 with penetrating injury) and 1,603 (595 with blunt injury and 1,008 with penetrating injury) underwent resuscitative thoracotomy (RT). Mean age was 38.5 ± 16 years and mean injury severity score was 34.5 ± 21; 57.7% had chest AIS score of more than 2, 21.8% had head AIS score of more than 2, and 37.3% had abdominal AIS score of more than 2. Admission Glasgow Coma Scale was 4.9 + 4, and systolic blood pressure at aortic occlusion (AO) was 22 + 40 mmHg. No differences in outcomes in REBOA or RT patients were identified between institutions (p > 0.5). After inverse probability weighting, Glasgow Coma Scale, age, injury severity score, systolic blood pressure at AO, CPR at AO, and blood product transfusion, REBOA was superior to RT in both blunt (odds ratio [OR] 4.7, 95% CI 1.9 to 11.7) and penetrating (OR 4.9, 95% CI 1.7 to 14) injuries, across all spectrums of injury (p < 0.01). Overall mortality was significantly higher for AO more than 90 minutes compared with less than 30 minutes in blunt (OR 4.6, 95% CI 1.5 to 15) and penetrating (OR 5.4, 95% CI 1.1 to 25) injuries. Duration of AO more than 60 minutes was significantly associated with mortality after penetrating abdominal injury (OR 5.1, 95% CI 1.1 to 22) and abdomen and head (OR 5.3, 95% CI 1.6 to 18).

CONCLUSIONS:
In-hospital survival is higher for patients undergoing REBOA than RT for all injury patterns. Complete AO by REBOA or RT should be limited to less than 30 minutes. Neither hospital and procedure volume nor trauma verification level impacts outcomes for REBOA or RT.
Unraveling the Molecular Complexity of Bicuspid Aortopathy: Lessons from Comparative Proteomics
Authors: Pozo-Vilumbrales Bárbara , Martín-Chaves Laura , López-Unzu Miguel A. , Soto-Navarrete María Teresa , Pavón-Morón Javier , Rodriguez-Capitán Jorge , Corujo Borja Fernández 
Published: December 2023

AbstractBackgroundMolecular markers and pathways involved in the etiology and pathophysiology of bicuspid aortopathy are poorly understood. The aim here is to delve into the molecular and cellular mechanisms of the disease and identify potential predictive molecular markers using a well-established isogenic hamster model (T-strain) of bicuspid aortic valve (BAV) and thoracic aortic dilatation (TAD).MethodsComparative quantitative proteomics combined with western blot and morpho-molecular analyses in the ascending aorta of tricuspid aortic valve (TAV) and BAV animals from the T-strain, and TAV animals from a control strain. This strategy allows discriminating between genetic and hemodynamic factors in genetically homogeneous populations.ResultsThe major molecular alteration in the aorta of genetically homogeneous BAV individuals is PI3K/AKT overactivation caused by changes in the EGF, ANGII and TGF-β pathways. PI3K/AKT affects downstream eNOS, MAP2K1/2, NF-κB, mTOR and WNT pathways. Most of these alterations are seen in independent patient studies with different clinical presentations, but not in TAV hamsters from T-strain that mainly exhibit WNT pathway downregulation.ConclusionsWe identify a combination of defective interconnected molecular pathways, directly linked to the central PI3K/AKT pathway, common to both BAV-associated TAD patients and hamsters. The defects indicate smooth muscle cell shift towards the synthetic phenotype induced by endothelial-to-mesenchymal transition, oxidative stress and inflammation. WNT signaling represent one genetic factor that may cause structural aortic abnormalities and aneurysm predisposition, whereas hemodynamics is the main trigger of molecular alterations, probably determining aortopathy progression. We identify twenty-seven novel potential biomarkers with a high predictive value.
Expression Patterns ofMalgenes and its Association with Differential Maltose and Maltotriose Transport rate of TwoSaccharomyces pastorianusYeasts
Authors: Hernández-Vásquez César I. , García-García Jorge H. , Pérez-Ortega Esmeralda R. , Martínez-Segundo Adriana G. , Damas-Buenrostro Luis C. , Pereyra-Alférez Benito 
Published: December 2023

ABSTRACTMicroorganisms play a significant role in fermented food biotechnology by converting raw materials in human edible organoleptic and nutritive components, especially in the beer brewing industry. The lager-style beer is the dominant industrial beer type, and it is fermented bySaccharomyces pastorianus(Sp) whose members encompass two groups. Typically, strains belonging to group I are deficient in maltotriose consumption. The main variables linked to this phenotype are fermentation conditions, the presence of maltotriose transporters, copy number variation of maltose and maltotriose transporters, and differential genetic regulation. This study was aimed to determine that the differences the alpha-glycoside consumption phenotypes of two Sp strains, Sp820 and Sp790, are related with different phylogenetic distribution and gene expression of the transporters ScMalx1, SeMalx1, ScAGT1, SeAGT1,MTT1 andMPHx. Biochemical analyses of the transport rate confirmed that the Sp790 strain transported more maltose and maltotriose, 28% and 32% respectively, than Sp820 strain. In addition, detection of Sp790 transcripts indicated the presence of all theMalgenes analyzed since the first day of fermentation, whereas Sp820 only presented transcripts for the ScMalx1, ScAGT1, andMPHx genes. These results indicate that a multifactorial phenomenon related with phylogenetic distribution, polymorphisms in transmembrane domains and the difference in the genetic expression of maltose and maltotriose transporters are involved in the phenotypic diversity related with maltose and maltotriose consumption in two lager yeast.IMPORTANCEBeer is the third most popular beverage around the world and has roughly 90% market share in the alcoholic beverage industry.Saccharomyces pastorianus(Sp) strains, which are widely used for lager beer production, have a phenotypic diversity involved in maltotriosa consumption. The fermentation of this sugar is fundamental for the flavor landscape produced during lager beer brewing. This phenotypic diversity encompasses lager yeast strain with remarkable ability to consume maltotriose; Sp group II, to poor capacity of consumption for some lager yeast belonging to Sp group I. Research in this field indicate that variables like conditions of fermentation, presence of maltotriose transporter specific genes, and differential gene regulation can cause this diversity. The significance of our study is to approximate and also contribute to the elucidation of mechanistic variables involved in such phenotypic variability that will allow the development of more controlled and efficient biotechnological processes around beer brewing industry.
Tirofiban in Acute Ischemic Stroke Patients Undergoing Endovascular Thrombectomy with Preceding intravenous Thrombolysis
Authors: Wu Yuefei , Zhu Tianrui , Yang Jianhong , Abuduaini Mayila , Liu Feifeng , Zhang Yue , Parsons Mark W. , Li Gang , Lin Longting 
Published: December 2023

AbstractBackgroundThe effectiveness of Tirofiban administration to acute ischemic stroke patients undergoing endovascular thrombectomy (EVT) after intravenous thrombolysis (IVT) remains unclear. This study examined the effect of intraarterial or intravenous tirofiban during endovascular thrombectomy following thrombolysis.MethodsPatients with acute ischemic stroke who received EVT after thrombolysis were selected from the International Stroke Perfusion Imaging Registry, and divided into three groups according to tirofiban administration. Safety outcomes were symptomatic intracerebral hemorrhage (sICH) and parenchymal hematoma type-2 (PH2). Efficacy outcomes included successful recanalization, complete recanalization, functional independence, and death at 3-months. Univariate and multivariate regression estimates are listed as “estimate [95% confidence interval] p-value”.ResultsWe analyzed a total of 682 patients who underwent EVT after IVT. Among them, 53 (7.77%) were treated with intraarterial tirofiban (IA-tirofiban group), 80 (11.73%) were treated with intravenous tirofiban (IV-tirofiban group), while 549 (80.50%) patients were not treated with tirofiban (non-tirofiban group). There were no significant differences between groups in the incidences of PH2 or sICH (P=0.413,P=0.256). There were significant differences in successful recanalization, functional independence, and death at 3-months (P=0.031,P<0.001,P=0.010). There was no difference between IA-tirofiban and non-tirofiban in terms of safety or efficacy outcomes. Compared with non-tirofiban, IV-tirofiban was not associated with PH2 (P=0.111; adjustedP=0.705) or sICH (P=0.263; adjustedP=0.168), but was associated with higher odds of successful recanalization (OR=8.94 [1.22–65.53],P=0.031; adjusted OR=8.24 [1.08–62.59], adjustedP=0.041), 3-month functional independence (OR=3.21 [1.88–5.50],P<0.001; adjusted OR=2.22 [1.21–4.12], adjustedP=0.011) and lower odds of 3-month death (OR=0.20 [0.17–0.27],P=0.007; adjusted OR=0.25 [0.07–0.92], adjustedP=0.039).ConclusionsIn acute ischemic stroke patients undergoing mechanical thrombectomy with preceding intravenous thrombolysis, both intraarterial and intravenous tirofiban could be safe. However, only intravenous tirofiban was associated with clinical benefit. Further randomized clinical trials are needed to confirm these findings.
Peripheral inflammation is associated with structural brain atrophy and cognitive decline linked to mild cognitive impairment and Alzheimer’s disease
Authors: Liang Nuanyi , Nho Kwangsik , Newman John W. , Arnold Matthias , Huynh Kevin , Meikle Peter J. , Borkowski Kamil , Kaddurah-Daouk Rima ,   Alzheimer’s Disease Metabolomics Consortium,   Alzheimer’s Disease Neuroimaging Initiative
Published: December 2023

ABSTRACTMounting evidence points towards inflammation as an important factor in Alzheimer’s disease (AD) pathogenesis. In this study, we investigated the relationship between a key marker of inflammation – glycoprotein acetyls (GlycA) – in blood and cognitive and brain structural changes in over 1500 participants enrolled into the Alzheimer’s Disease Neuroimaging Initiative. We evaluated those associations cross-sectionally at baseline, followed by an evaluation of whether baseline GlycA can inform about future disease progression. Our results support the following findings: 1) GlycA is elevated in participants diagnosed with AD compared to cognitively normal participants; 2) GlycA level correlates negatively with regional brain volumes in females diagnosed with late mild cognitive impairment (LMCI) or AD; 3) baseline GlycA level is associated with executive function decline at 3-9 year follow-up in both male and female participants diagnosed with LMCI at baseline; and 4) baseline GlycA is associated with decline in entorhinal cortex volume at years 2, 4 and 6-8 of follow-up in both male and female participants diagnosed with LMCI at baseline. In conclusion, peripheral inflammation was found to be positively associated with AD diagnosis and future decline in cognition and regional brain volumes. However, we note that the cross-sectional relationship between peripheral inflammation and AD-related brain atrophy is specific to sex and diagnostic status. Our findings point to peripheral inflammation as a risk factor in AD development, which enables the identification of potential markers and therapeutic intervention for participants who are at risk.
Speech-induced suppression and vocal feedback sensitivity in human cortex
Authors: Ozker Muge , Yu Leyao , Dugan Patricia , Doyle Werner , Friedman Daniel , Devinsky Orrin , Flinker Adeen 
Published: December 2023

AbstractAcross the animal kingdom, neural responses in the auditory cortex are suppressed during vocalization, and humans are no exception. A common hypothesis is that suppression increases sensitivity to auditory feedback, enabling the detection of vocalization errors. This hypothesis has been previously confirmed in non-human primates, however a direct link between auditory suppression and sensitivity in human speech monitoring remains elusive. To address this issue, we obtained intracranial electroencephalography (iEEG) recordings from 35 neurosurgical participants during speech production. We first characterized the detailed topography of auditory suppression, which varied across superior temporal gyrus (STG). Next, we performed a delayed auditory feedback (DAF) task to determine whether the suppressed sites were also sensitive to auditory feedback alterations. Indeed, overlapping sites showed enhanced responses to feedback, indicating sensitivity. Importantly, there was a strong correlation between the degree of auditory suppression and feedback sensitivity, suggesting suppression might be a key mechanism that underlies speech monitoring. Further, we found that when participants produced speech with simultaneous auditory feedback, posterior STG was selectively activated if participants were engaged in a DAF paradigm, suggesting that increased attentional load can modulate auditory feedback sensitivity.
Chromothripsis orchestrates leukemic transformation in blast phase MPN through targetable amplification ofDYRK1A
Authors: Brierley CK , Yip BH , Orlando G , Goyal H , Wen S , Wen J , Levine MF , Jakobsdottir G M , Rodriguez-Meira A , Adamo A , Bashton M , Hamblin A , Clark SA , O’Sullivan J , Murphy L , Olijnik AA , Cotton A , Narina S , Pruett-Miller SM , Enshaei A , Harrison C , Drummond M , Knapper S , Tefferi A , Antony-Debré I , Thongjuea S , Wedge DC , Constantinescu S , Papaemmanuil E , Psaila B , Crispino JD , Mead AJ 
Published: December 2023

SummaryChromothripsis, the process of catastrophic shattering and haphazard repair of chromosomes, is a common event in cancer. Whether chromothripsis might constitute an actionable molecular event amenable to therapeutic targeting remains an open question. We describe recurrent chromothripsis of chromosome 21 in a subset of patients in blast phase of a myeloproliferative neoplasm (BP-MPN), which alongside other structural variants leads to amplification of a region of chromosome 21 in ∼25% of patients (‘chr21amp’). We report that chr21amp BP-MPN has a particularly aggressive and treatment-resistant phenotype. The chr21amp event is highly clonal and present throughout the hematopoietic hierarchy.DYRK1A, a serine threonine kinase and transcription factor, is the only gene in the 2.7Mb minimally amplified region which showed both increased expression and chromatin accessibility compared to non-chr21amp BP-MPN controls. We demonstrate thatDYRK1Ais a central node at the nexus of multiple cellular functions critical for BP-MPN development, including DNA repair, STAT signalling and BCL2 overexpression.DYRK1Ais essential for BP-MPN cell proliferationin vitroandin vivo, and DYRK1A inhibition synergises with BCL2 targeting to induce BP-MPN cell apoptosis. Collectively, these findings define the chr21amp event as a prognostic biomarker in BP-MPN and link chromothripsis to a druggable target.
Associations of Alzheimer’s disease with inpatient hospital costs and with quality-adjusted life years: Evidence from conventional and Mendelian randomization analyses in the UK Biobank
Authors: Dixon Padraig , Anderson Emma 
Published: December 2023

ABSTRACTBACKGROUNDAlzheimer’s disease and other dementias are progressive neurodegenerative disorders with profound impacts on cognitive function. There is a shortage of economic evidence relating to the impact Alzheimer’s disease on healthcare costs and quality-adjusted life-years (QALYs).METHODSWe employed two study designs to model the association between Alzheimer’s disease and healthcare costs and QALYs. We first estimated conventional multivariable models of the association between Alzheimer’s disease and these core economic outcomes. However, these types of model may be confounded by diseases, processes, or traits that independently affect Alzheimer’s disease and either or both of healthcare costs and QALYs. We therefore also explored a complementary approach using germline genetic variation as instrumental variables in a Mendelian randomization analysis. We used single nucleotide polymorphisms (SNPs) identified in recent genome-wide association studies of Alzheimer’s disease as instruments. We studied outcome data on inpatient hospital costs and QALYs in the UK Biobank cohort.RESULTSData from up to 310,838 individuals were analyzed. N=55 cases of Alzheimer’s disease were reported at or before recruitment into UK Biobank. A further N=284 incident cases were identified over follow-up. Multivariable observational analysis of the prevalent cases suggested significant impacts on costs (£1,140 in cases, 95% Confidence Interval (CI): £825 to £1,456) and QALYs (−25%, 95% CI: -28% to -21%). Mendelian randomization estimates were very imprecise for costs (£3,082, 95% CI: -£7,183 to £13,348) and QALYs (−32%, 95% CI: -149% to 85%), likely due to the small proportion of variance (0.9%) explained in Alzheimer’s disease status by the most predictive set of SNPs.IMPLICATIONSConventional multivariable models suggested important impacts of Alzheimer’s disease on inpatient hospital costs and QALYs, although this finding was based on very few cases which may have included instances of early-onset dementia. Mendelian randomization was very imprecise. Larger GWAS of clinical cases, improved understanding of the architecture of the disease, and the follow-up of cohorts until old age and death will help overcome these challenges.