bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Mesh Placement During Formation of an End-colostomy
Authors: Brandsma Henk-Thijs , Hansson Birgitta ME. , Aufenacker Theo J. , de Jong Nienke , V Engelenburg Klaas CA. , Mahabier Chander , Donders Rogier , Steenvoorde Pascal , de Vries Reilingh Tammo S. , Leendert van Westreenen Hendrik , Wiezer Marinus J. , de Wilt Johannes H.W. , Rovers Maroeska , Rosman Camiel ,   the Dutch Prevent Study Group
Published: February 2023

Objective:
The aim of this study was to determine if prophylactic mesh placement is an effective, safe, and cost-effective procedure to prevent parastomal hernia (PSH) formation in the long term.

Background:
A PSH is the most frequent complication after stoma formation. Prophylactic placement of a mesh has been suggested to prevent PSH, but long-term evidence to support this approach is scarce.

Methods:
In this multicentre superiority trial patients undergoing the formation of a permanent colostomy were randomly assigned to either retromuscular polypropylene mesh reinforcement or conventional colostomy formation. Primary endpoint was the incidence of a PSH after 5 years. Secondary endpoints were morbidity, mortality, quality of life, and cost-effectiveness.

Results:
A total of 150 patients were randomly assigned to the mesh group (n = 72) or nonmesh group (n = 78). For the long-term follow-up, 113 patients were analyzed, and 37 patients were lost to follow-up. After a median follow-up of 60 months (interquartile range: 48.6–64.4), 49 patients developed a PSH, 20 (27.8%) in the mesh group and 29 (37.2%) in the nonmesh group (P = 0.22; RD: −9.4%; 95% CI: −24, 5.5). The cost related to the meshing strategy was € 2.239 lower than the nonmesh strategy (95% CI: 491.18, 3985.49), and quality-adjusted life years did not differ significantly between groups (P = 0.959; 95% CI: −0.066, 0.070).

Conclusions:
Prophylactic mesh placement during the formation of an end-colostomy is a safe procedure but does not reduce the incidence of PSH after 5 years of follow-up. It does, however, delay the onset of PSH without a significant difference in morbidity, mortality, or quality of life, and seems to be cost-effective.
Discrepancy in Reporting of Perioperative Complications
Authors: Gomes Nuno V. , Polutak Amar , Schindler Christian , Weber Walter P. , Steiner Luzius A. , Rosenthal Rachel , Dell-Kuster Salome 
Published: February 2023

Objective:
To assess the discrepancy between perioperative complications, prospectively recorded during a cohort study versus retrospectively from health records.

Background:
Perioperative adverse events are relevant for patient outcome, but incomplete reporting is common.

Methods:
Two physicians independently recorded all intraoperative adverse events according to ClassIntra and all postoperative complications according to the Clavien-Dindo classification based on all available health records. These retrospective assessments were compared with the number and severity of those prospectively assessed in the same patients during their inclusion in 1 center of a prospective multicenter cohort study.

Results:
Interrater agreement between both physicians for retrospective recording was high [intraclass correlation coefficient: 0.89 (95% CI, 0.86, 0.91) for intraoperative and 0.88 (95% CI, 0.85, 0.90) for postoperative complications]. In 320 patients, the incidence rate was higher retrospectively than prospectively for any intraoperative complication (incidence rate ratio: 1.79; 95% CI, 1.50, 2.13) and for any postoperative complication (incidence rate ratio: 2.21; 95% CI, 1.90, 2.56). In 71 patients, the severity of the most severe intraoperative complication was higher in the retrospective than in the prospective data collection, whereas in 69 the grading was lower. In 106 patients, the severity of the most severe postoperative complication was higher in the retrospective than in the prospective data collection, whereas in 19 the grading was lower.

Conclusions:
There is a noticeable discrepancy in the number and severity of reported perioperative complications between these 2 data collection methods. On the basis of the double-blinded assessment of 2 independent raters, our study renders prospective underreporting more likely than retrospective overreporting.
Robotic Ventral Hernia Repair and Concomitant Procedures
Authors: Kudsi Omar Yusef , Kaoukabani Georges , Bou-Ayash Naseem , Gokcal Fahri 
Published: February 2023

Background:
Ventral hernia remains as one of the most performed procedures worldwide. With the aging of the population and increasing comorbidities, it is common for ventral hernia to coexist with other pathologies that require surgery. Patients may opt for concomitant repairs while undergoing ventral hernia surgery. Therefore, the purpose of this study is to investigate the clinical outcomes of robotic ventral hernia repair (RVHR) in patients undergoing concomitant repairs.

Materials and Methods:
Patients who underwent RVHR with concomitant repairs over a period of 9 years were included in this retrospective study. Pre, intra, and postoperative variables including the patient’s demographics, hernia characteristics, complications, and hernia recurrence were reported. Univariate analysis was performed to evaluate potential variables associated with increased risk of postoperative complications

Results:
A total of 109 (33% females) patients were included in this study. Mean age and body mass index were 59.9±12.7 years and 30.5±5.7 kg/m2, respectively. Concomitant repairs were mostly abdominal wall procedures (inguinal hernia repairs, 88.1%). Other procedures included nonabdominal wall surgeries. Incisional hernia repairs were higher than primary repairs (55% vs 45%, respectively). Median operative time and hospital length of stay were 145 min (102 to 245) and 1 day (0 to 1), respectively. Mean postoperative follow-up was 39.2 (4.1 to 93.6) months. In total, 24 patients had postoperative complications, out of which 16 (14.7%) were Clavien-Dindo grade I and II, and 10 (9.2%) were grade III and IV. Nine patients had surgical site events, and two recurrences were recorded. Postoperative complications were associated with incisional hernias [Odds ratio (OR)=8.4; P=0.003; 95% CI=2.092-33.423], nonabdominal wall concomitant procedures (OR=5.9; P=0.013; 95% CI=1.453-24.451), and history of wound infection (OR=3.473; P=0.047; 95% CI=1.016-11.872).

Conclusions:
This is the first study to report outcomes of concomitant repairs with RVHR, with notable Clavien-Dindo grade III and IV complications of 9%. Incisional hernia repairs, nonabdominal wall procedures, and a history of wound infection were risk factors for postoperative complications.
Tolerability, Attrition Rates, and Survival Outcomes of Neoadjuvant FOLFIRINOX for Non-Metastatic Pancreatic Adenocarcinoma: Intent-to-Treat Analysis
Authors: Fong Zhi Ven , Verdugo Fidel Lopez , Fernandez-del Castillo Carlos , Ferrone Cristina R , Allen Jill N , Blaszkowsky Lawrence S , Clark Jeffrey W , Parikh Aparna R , Ryan David P , Weekes Colin D , Hong Theodore S , Wo Jennifer Y , Lillemoe Keith D , Qadan Motaz 
Published: February 2023

Background:
Neoadjuvant FOLFIRINOX is increasingly utilized in the management of pancreatic ductal adenocarcinoma (PDAC). However, neoadjuvant therapy is associated with toxicity, possible disease progression, and biopsy and biliary-related complications that may preclude operative exploration. Data on the true attrition rate outside of clinical trials or resected surgical series are lacking.

Study Design:
Patients with non-metastatic PDAC who initiated FOLFIRINOX from 2015 to 2020 were identified from our institution’s pharmacy records. Multivariable regression and Cox proportional hazard models were used for adjusted analyses of categorical and survival outcomes, respectively.

Results:
Of 254 patients who initiated first-line neoadjuvant FOLFIRINOX, 199 (78.3%) underwent exploration. Fifty-four (21.3%) patients did not complete their chemotherapy cycles due to poor tolerability (46.3%), poor response (31.5%), and disease progression (14.8%), among other causes (7.4%). A total of 109 (42.9%) patients experienced grade 3/4 FOLFIRINOX-related toxicity, of whom 73 (28.7%) and 100 (39.4%) required an ED visit or inpatient admission, respectively. Finally, not undergoing surgical exploration was associated with impaired overall survival (OS) (HR 7.0, 95% CI 3.8-12.8, p<0.001). Independent predictors of not undergoing exploration were remote history of chemotherapy receipt (OR 0.06, p=0.02), inability to complete FOLFIRINOX cycles (OR 0.2, p=0.003), increase in ECOG score (OR 0.2, p<0.001), and being single or divorced (OR 0.3, p=0.018).

Conclusions:
Among 254 patients with non-metastatic PDAC initiated on FOLFIRINOX, of whom 52% were locally advanced, a total of 199 (78.3%) were explored, 142 (71.4%) underwent successful resection, and 129 (90.8%) were resected with negative margins. Despite 109 (42.9)% of patients experiencing significant toxicity, most patients could be managed through treatment-related complications to complete planned neoadjuvant chemotherapy and undergo planned surgical exploration.
Postoperative Venous Thromboembolism in Colon and Rectal Cancer: Do Tumor Location and Operation Matter?
Authors: McKenna Nicholas P , Bews Katherine A , Behm Kevin T , Habermann Elizabeth B , Cima Robert R 
Published: February 2023

Introduction:
Existing venous thromboembolism (VTE) risk scores help identify patients at increased risk of postoperative VTE who warrant extended prophylaxis in the first 30 days. However, these methods do not address factors unique to colorectal surgery, wherein tumor location and operation performed vary widely. Further, VTE risk may extend past 30 days. Therefore, we aimed to determine the roles of tumor location and operation in VTE development and evaluate VTE incidence through 90 days postoperatively.

Study Design:
Adult patients undergoing surgery for colorectal cancer between January 1, 2005 and December 31, 2021 at a single institution were identified. Patients were then stratified by cancer location and by operative extent. VTEs were identified using diagnosis codes in the electronic medical record and consisted of extremity deep venous thromboses (DVTs), portomesenteric venous thromboses (PMVTs), and pulmonary emboli (PE).

Results:
6,844 operations were identified (72% segmental colectomy, 22% proctectomy, 6% total (procto)colectomy), and tumor location was most commonly in the ascending colon (32%), followed by the rectum (31%), with other locations less common (sigmoid 16%, rectosigmoid junction 9%, transverse colon 7%, descending colon 5%). The cumulative incidence of any VTE was 3.1% at 90 days with a relatively steady increase across the entire 90-day interval. Extremity DVTs were the most common VTE type accounting for 37% of events, while PEs and PMVTs made up 33% and 30% of events respectively. More distal tumor locations and more anatomically extensive operations had higher VTE rates.

Conclusions:
When considering extended VTE prophylaxis following colorectal surgery, clinicians should account for the operation performed and the location of the tumor. Further study is necessary to determine the optimal length of VTE prophylaxis in high-risk individuals.
PARP1 Inhibition and Effect on Burn Injury-Induced Inflammatory Response and Cardiac Function
Authors: Wen Jake J , Dejesus Jana , Radhakrishnan Geetha L , Radhakrishnan Ravi S 
Published: February 2023

Introduction:
Burn injury induces multiple signaling pathways leading to a significant inflammatory storm that adversely affects multiple organs, including the heart. PARP1 inhibition, with specific agents such as PJ34, is effective in reducing oxidative stress and cytokine expression in the heart. We hypothesized that PARP1 inhibition would reduce inflammatory signaling and protect against burn injury induced cardiac dysfunction.

Methods:
Male Sprague-Dawley rats (8-week-old, 300-350 gms) were randomized to Sham injury (Sham), 60% TBSA burn (24hpb), or 60% TBSA burn with IP administration of PJ34 (20mg/kg, 24hpb + PJ34) and sacrificed 24 hours post injury. Cardiac function was determined using Vevo 2100 echocardiography (ECHO). Genetic expression of 84 specific TLR-mediated signal transduction and innate immunity genes were examined using microarray to evaluate cardiac tissue. Qiagen GeneGlobe Data Analysis Center was used to analyze expression and genetic clustering was performed using TreeView V2.0.8 software. Real-time qPCR was utilized to validate identified differentially expressed genes.

Results:
Burn injury significantly altered multiple genes in the TLR signaling, IL-17 signaling, TNF signaling, and NF-κB signaling pathways and led to significant cardiac dysfunction. PARP1 inhibition with PJ34 normalized these signaling pathways to sham levels as well as improved cardiac function to sham levels.

Conclusions:
PARP1 inhibition normalizes multiple inflammatory pathways that are altered after burn injury and improves cardiac dysfunction. PARP1 pathway inhibition may provide a novel methodology to normalize multiple burn injury induced inflammatory pathways in the heart.
Pre-Treatment Health-Related Quality of Life Status and Survival in Pancreatobiliary Surgical Patients
Authors: Manisundaram Naveen , Portuondo Jorge I , Erstad Derek , Silberfein Eric , Hsu Cary , Barakat Omar , Wood Amy , Navarro-Cagigas Martina , Van Buren George , Fisher William E , Camp E Ramsay 
Published: February 2023

Background:
Pancreatobiliary (PB) disorders, especially cancer, negatively impact patients’ health-related quality of life (HRQoL). However, the influence of baseline, pre-intervention HRQoL on peri-operative and oncologic outcomes has not been well-defined. We hypothesized that low baseline HRQoL is associated with worse peri-operative and long-term survival outcomes for PB surgical patients.

Study Design:
Pre-treatment FACT-Hep survey results and clinical data from PB patients (2008-2016) from a single center’s prospective database were analyzed. Survey responses were aggregated into composite scores and divided into quintiles. Patients in the highest quintile of HRQoL were compared to patients in the bottom four quintiles combined. Overall (OS) and disease-free (DFS) were analyzed using the Kaplan-Meier method. Logistic and cox regressions were used to determine associations between quintiles of HRQoL scores and 30-day complications and long-term survival, respectively.

Results:
Of 162 patients evaluated, 99 had malignancy, and 63 had benign disease. Median follow-up was 31 months. Baseline HRQoL scores were similar for benign and malignant disease (p=0.42) and were not associated with the development of any (p=0.08) or major complications (p=0.64). Patients with highest quintile HRQoL scores had longer 3-year OS (84.6 vs 61.7%, p = 0.03) compared to patients in the lowest four quintiles of HRQoL. Among cancer patients only, those with highest quintile scores had longer 3-year OS (81.6 vs 47.4%, p = 0.02). On multivariable analysis, highest quintile HRQoL scores were associated with longer OS and DFS for patients with malignancy.

Conclusions:
Pre-treatment HRQoL was associated with both OS and DFS among PB patients and might have prognostic utility. Future studies are necessary to determine whether patients with poorer HRQoL may benefit from targeted psycho-social interventions.
Low vs Standard-Dose Indocyanine Green in the Identification of Biliary Anatomy Using Near-Infrared Fluorescence Imaging: A Multicenter Randomized Controlled Trial
Authors: Ladd Alexandra D , Zarate Rodriguez Jorge , Lewis Duncan , Warren Curtis , Duarte Sergio , Loftus Tyler J , Nassour Ibrahim , Soma Daiki , Hughes Steven J , Hammill Chet , Zarrinpar Ali 
Published: February 2023

Background:
Near-infrared fluorescence (NIRF) imaging using intravenous indocyanine green (ICG) facilitates intraoperative identification of biliary anatomy. We hypothesize that a much lower dose of ICG than the standard decreases hepatic and background fluorescence and improves bile duct visualization.

Study Design:
In this multicenter randomized controlled trial, 55 adult patients undergoing laparoscopic cholecystectomy were randomized to low dose (0.05 mg) or standard dose (2.5 mg) ICG preoperatively on the day of surgery. A quantitative assessment was performed on recorded videos from the operation using ImageJ software to quantify the fluorescence intensity of the bile duct, liver, and surrounding/background fat. Operating surgeons blinded to ICG dose provided a qualitative assessment of various aspects of the visualization of the extrahepatic biliary tree comparing NIRF to standard visible light imaging using a scale of 1-5 (1=unsatisfactory, 5=excellent). Quantitative and qualitative scores were compared between the groups to determine any significant differences between the doses.

Results:
The bile duct-to-liver and bile duct-to-background fat fluorescence intensity ratios were significantly higher for the low dose group compared to the standard dose group (3.6 vs 0.68; p<0.0001 and 7.5 vs 3.3; p<0.0001, respectively). Low dose ICG had a slightly higher (i.e., better) mean score on the qualitative assessment compared to the standard dose, although the differences were not statistically significant.

Conclusion:
Low dose ICG leads to quantitative improvement of biliary visualization using NIRF imaging by minimizing liver fluorescence; this further facilitates routine use during hepatobiliary operations.
ACS NSQIP Risk Calculator Accuracy Using a Machine Learning Algorithm Compared to Regression
Authors: Liu Yaoming , Ko Clifford Y , Hall Bruce L , Cohen Mark E 
Published: February 2023

Background:
The ACS NSQIP risk calculator (RC) uses regression to make predictions for 14, 30-day surgical outcomes. While this approach provides accurate (discrimination and calibration) risk estimates, they might be improved by machine learning (ML). To investigate this possibility, accuracy for regression-based risk estimates were compared to estimates from an extreme gradient boosting (XGB) ML algorithm.

Methods:
A cohort of 5,020,713 million NSQIP patient records was randomly divided into 80% for model construction and 20% for validation. Risk predictions using regression and XGB-ML were made for 13 RC binary 30-day surgical complications and 1 continuous outcome (length of stay, LOS). For the binary outcomes, discrimination was evaluated using AUROC (area under the receiver operating characteristic curve) and AUPRC (area under the precision recall curve), and calibration was evaluated using Hosmer-Lemeshow (H-L) statistics. Mean squared error (MSE) and a calibration curve analog were evaluated for the continuous LOS outcome.

Results:
For every binary outcome, discrimination (AUROC and AUPRC) was slightly greater for XGB-ML than for regression (mean [across the outcomes] AUROC was 0.8299 versus 0.8251, and mean AUPRC was 0.1558 versus 0.1476, for XGB-ML and regression, respectively). For each outcome miscalibration was greater (larger H-L values) with regression; there was statistically significant miscalibration for all regression-based estimates but only for 4 of 13 when XGB-ML was used. For LOS, MSE was lower for XGB-ML.

Conclusions:
XGB-ML provided more accurate risk estimates than regression in terms of discrimination and calibration. Differences in calibration between regression and XGB-ML were of substantial magnitude and support transitioning the RC to XGB-ML.
Is Chest X-Ray a Reliable Screening Tool for Blunt Thoracic Aortic Injury? Results from the American Association for the Surgery of Trauma/Aortic Trauma Foundation Prospective Blunt Thoracic Aortic Injury Registry
Authors: Crapps Joshua L , Efird Jessica , DuBose Joseph J , Teixeira Pedro G , Shrestha Binod , Brown Carlos VR 
Published: January 2023

Purpose:
Traditional teaching continues to espouse the value of initial trauma CXR as a screening tool for blunt thoracic aortic injury (BTAI). The ability of this modality to yield findings that reliably correlate with grade of injury and need for subsequent treatment, however, requires additional multicenter prospective examination. We hypothesize that CXR is not a reliable screening tool, even at the highest grades of blunt thoracic aortic injury.

Methods:
The ATF / AAST prospective BTAI registry was utilized to correlate initial CXR findings to the Society for Vascular Surgery (SVS) injury grade identified on computed tomographic angiography (CTA).

Results:
708 confirmed BTAI injuries with recorded CXR findings and subsequent CTA injury characterization from February 2015 – August 2021 were analyzed. The presence of any of the classic CXR findings was observed in only 57.6% (408/708) of injuries, with increasing presence correlating with advanced SVS BTAI grade (39.1% [75/192] G1; 55.6% [50/90] G2; 65.2% [227/348] G3; 71.8% [56/78] G4). The most consistent single finding identified was widened mediastinum, but this was only present in 27.7% of all confirmed BTAIs and only 47.4% of G4 injuries (7.8%% G1, 23.3%, G2, 35.3% G3, 47.4% G4).

Conclusions:
CXR is not a reliable screening tool for the detection of BTAI, even at the highest grades of injury. Further investigations of specific high-risk criteria for screening that incorporate imaging, mechanism and physiologic findings are warranted.
Rhizopus homothallicus, an emerging pathogen causing cavitary lung lesions
Authors: Taneja juhi , Chatterjee Kuhu , Sachdeva Ruchi Arora , Abbas S Zafar , Sen MK 
Published: January 2023

Introduction: Rhizopus homothallicus is a new emerging pathogen causing Mucormycosis.
Case Presentation: We report a case of pneumonia caused by Rhizopus homothallicus in a 54 year old type 2 diabetic patient. The organism was isolated from bronchoalveolar lavage fluid and preliminary identified by fungal morphology and finally by sequencing of the internal transcribed spacer region.
Conclusion: Mucormycosis may be associated with cavitary lung lesions in the backdrop of poorly controlled diabetes or other immunosuppressed states. Pulmonary mucormycosis may have variable clinical and radiological presentations. Therefore, strong clinical suspicion and prompt management can prevent high fatality associated with the disease.
Effects of the COVID-19 Pandemic on Individuals with Fibromyalgia – a Systematic Scoping Review Protocol
Authors: Sahar Tali , Jalali Ali , Toupin Sylvie , Verner Maria , Mitrovic Sabrina , Minerbi Amir , Shir Yoram , Fitzcharles Mary-Ann , Pagé M. Gabrielle 
Published: January 2023

AbstractObjectiveThe objectives of this review are to systematically search databases and identify studies that examined the effects of COVID-19 pandemic on symptomatology of adults who had fibromyalgia prior to the pandemic, in order to map the existing knowledge and identify knowledge gaps.IntroductionThe COVID-19 pandemic has affected people worldwide in multiple ways. Some suffered infection of varying severity and many experienced stressors associated with quarantine restrictions, lockdowns, and the consequences of social distancing. An initial literature search indicates that the pandemic had different and sometime contradicting effects on individuals with fibromyalgia; while some people experienced worsening of symptoms, others reported symptom relief because of the reduced pace and demands of daily life.Inclusion criteriaAny studies that explored the experience of adults with fibromyalgia syndrome during the COVID-19 pandemic. We will review only studies with participants who were diagnosed with fibromyalgia prior to the pandemic.MethodsFollowing a pilot search, we developed a full search strategy for Medline, Embase, CINAHL and PsycInfo. The reference list of all included sources of evidence will be screened for additional studies. Sources of unpublished studies to be searched: clinical trial.gov, OPENGREY.EU and MedRxiv. Studies in any language will be included. Abstracts will be screened for inclusion by two reviewers. Similarly, two independent reviewers will systematically extract the data from the included articles. Disagreements in any stage will be resolved through consensus. The results will be presented in tables and will be accompanied by a narrative analysis.