bluuebunny/crossref_metadata_2025_split huggingface dataset:
The catalytic role of glutathione transferases in heterologous anthocyanin biosynthesis
Authors: Eichenberger Michael , Schwander Thomas , Hüppi Sean , Kreuzer Jan , Mittl Peer R. E. , Peccati Francesca , Jiménez-Osés Gonzalo , Naesby Michael , Buller Rebecca M. 
Published: August 2023

AbstractAnthocyanins are ubiquitous plant pigments used in a variety of technological applications. Yet, after over a century of research, the penultimate biosynthetic step to anthocyanidins attributed to the action of leucoanthocyanidin dioxygenase has never been efficiently reconstituted outside plants, preventing the construction of heterologous cell factories. Through biochemical and structural analysis, here we show that anthocyanin-related glutathione transferases, currently implicated only in anthocyanin transport, catalyse an essential dehydration of the leucoanthocyanidin dioxygenase product, flavan-3,3,4-triol, to generate cyanidin. Building on this knowledge, introduction of anthocyanin-related glutathione transferases into a heterologous biosynthetic pathway in baker’s yeast results in >35-fold increased anthocyanin production. In addition to unravelling the long-elusive anthocyanin biosynthesis, our findings pave the way for the colourants’ heterologous microbial production and could impact the breeding of industrial and ornamental plants.
Retirement and Mental Health: A Contemporary Review of the Literature
Authors: Kanade Ashwini , Strother-Garcia Kristina , Rogers Nicole L. 
Published: August 2023

Purpose:
The purpose of this literature review is to summarize the current understanding of the impact retirement has on mental health. We identify gaps in the literature with the intent of encouraging new perspectives and stimulating innovative research in service of better supporting older adults through an oft overlooked and challenging phase of life.

Method:
To produce a review representing a depth and breadth of quality research, articles were retrieved through a systematic search of current scholarly sources published from 2000 to the present. Well-defined inclusion and exclusion criteria were followed to complete the review.

Results:
A total of 513 articles were identified for initial review, but only 14 articles met the inclusion criteria. Results from these articles are mixed with respect to the mental health effects of retirement.

Conclusions:
The findings of this review highlight the scarcity of recent research examining the impact of retirement on mental health in the United States. Retirement is an important transition, and better preparation for the many changes that accompany it could help older adults make a smoother transition to their new walk of life. Quality research on the mental health effects of retirement is needed to help drive changes in social policy to support individuals nearing (or at) retirement age. This research will also help clinicians who work with older adults to better support their patients during a particularly challenging adjustment in life.
Transition Rates from Benign Paroxysmal Positional Vertigo to Persistent Postural-Perceptual Dizziness
Authors: Masaki Yoshio 
Published: August 2023

AbstractPersistent postural-perceptual dizziness (PPPD) is a chronic dizziness disorder that is newly listed in the World Health Organization (WHO)'s International Classification of Diseases (ICD-11) revised in 2018. In this study, I selected definite cases of the first occurrence of benign paroxysmal positional vertigo (BPPV) among vertigo patients who visited our clinic in the past 1 year, and retrospectively reviewed the age at the first visit, gender, affected side, previous medical conditions, type of BPPV, and their tendency toward transition to PPPD. Eligible patients were new first-ever cases of BPPV who visited our clinic during the 1-year period from June 1, 2020, to May 31, 2021, and who met the diagnostic criteria for BPPV established by the Japan Society for Equilibrium Research. There were 311 cases, including 120 men and 191 women, with a male:female ratio of 1:1.6; hence, the majority of patients were women. The mean age ± standard deviation was 60.7 ± 17.8 years. Men ranged in age from 14 to 88 years, with a mean age of 64.2 ± 16.3 years. Women ranged in age from 11 to 90 years, with a mean age of 58.5 ± 18.5 years. Thus, the average age of the men was higher. As for the type of BPPV, there were 172 cases of posterior semicircular canal-type BPPV (canalolithiasis), 79 cases of lateral semicircular canal-type BPPV (canalolithiasis), and 60 cases of lateral semicircular canal-type BPPV (cupulolithiasis), with the posterior semicircular canal-type BPPV (canalolithiasis) being the most common. In regard to the affected side, the right side was affected in 164 cases and the left side in 147 cases; thus, involvement of the right side was more common. The time to remission was less than 0.5 months in 86 cases, less than 1 month in 69 cases, less than 2 months in 50 cases, less than 3 months in 22 cases, and more than 3 months in 57 cases. Remission was achieved in less than 3 months in 72.9% of cases. The course remained unknown in 27 cases, as the patients discontinued their clinic visits. There was only one case of a 75-year-old man and one case of a 70-year-old woman who transitioned to PPPD. Both cases had left-sided posterior semicircular canal-type BPPV (canalolithiasis). The man had underlying hypertension, while the woman had underlying hypertension and diabetes mellitus. The rate of transition from BPPV to PPPD was 0.6% when cases with an unknown course were included, and the rate was as low as 0.7% when cases with an unknown course were excluded. Thus, the frequency of transition from BPPV to PPPD is low.
The Synergistic Role of Integrated Computed Tomography and Magnetic Resonance Cholangiopancreatography in Disorders of the Pancreatobiliary System
Authors: Rai Santosh , Srivastava Saubhagya , Gopal Sandeep , Tiku Anika 
Published: August 2023

Abstract
Objective The aim of the study was to evaluate the synergistic role and advantages of integrating noncontrast computed tomography (NCCT) and magnetic resonance cholangiopancreatography (MRCP) in disorders of the pancreatobiliary (PB) system.
Methods In this cross-sectional and retrospective record-based study, radiological (NCCT and MRCP) data were collected retrospectively for a period of 3 years (June 2018–August 2020) from 52 patients. The results were compared to the final diagnosis on endoscopic retrograde cholangiopancreatography (ERCP) findings (gold standard). The data collected were analyzed by measuring the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and p-value for NCCT, MRCP, and integrated NCCT plus MRCP at different cutoff points. Subsequently, a receiver operating characteristic (ROC) curve was plotted to analyze different thresholds for NCCT, MRCP, and integrated NCCT plus MRCP.
Results The most common pathologies identified were biliary dilations (18.4%), common bile duct (CBD) calculi (13.6%), and biliary strictures (12.0%). Overall, MRCP provided a higher percentage of correct diagnoses (81.6%) compared to CT (56.0%). Integrating NCCT with MRCP showed a significant increase in sensitivities and specificities when compared to NCCT or MRCP alone. Integrated NCCT plus MRCP showed excellent performance with an area under the curve (AUC) of ROC analysis of 0.937.
Conclusion Our study showed that integrating NCCT and MRCP can prove to be an excellent tool in establishing a detailed diagnosis of PB disorders, better than either NCCT or MRCP alone. Due to the concurrent nature of PB disorders, it may be worth considering integrating NCCT and MRCP, given that there is an absence of contraindications to either modality.
Outlandish creatures and genre crossover in young adult liminal fantasy: a Deleuzian perspective
Authors: You Chengcheng 
Published: August 2023

AbstractThis study employs Deleuze’s concept of “deterritorialisation” to examine how young adult liminal fantasy can blend genre expectations and engage in environmental enquiry for a young adult audience. The term “outlandish creatures” is introduced to denote these improbable nonhuman characters that inhabit imaginary worlds in YA liminal fantasy where they exist intrinsically in young protagonists’ daily lives, exemplifying the genre’s propensity to transcend boundaries between species, genres, and reality. By conducting a Deleuzian analysis of Sonya Hartnett’s The Midnight Zoo (2011), Patrick Ness’s A Monster Calls (2011), and Shaun Tan’s Tales from the Inner City (2018), this study reveals that the depictions of encounters between youth and outlandish creatures not only reflect environmental anxieties in the Anthropocene era, but also contribute to the enrichment of narrative explorations within the genre. The study concludes that YA liminal fantasy has the capacity to address identity issues faced by contemporary young adults and foster ethical directionality through the productive fusion of genres and species.
Improving the design of public health infographics using a motion graphic educational resource to enhance design principle application
Authors: Baxter Matthew , Lonsdale Maria dos Santos 
Published: August 2023

Abstract
Infographics are commonly used in public health to disseminate key messages to wide audiences. Although health organisations are making increasing use of infographics, their designs are of variable quality. The research reported here aimed to develop an educational tool that could improve public health infographic design, using motion graphics to teach users with limited design experience how to apply research-based design principles. Results were positive, with significant improvements in performance (including information location time, memorability, and user perception) observed for the infographics designed after the resource was used, compared to the infographics created before.
12. NEUROKININ A AND SUBSTANCE P SERUM CONCENTRATIONS CORRELATE WITH MOTILITY METRICS PREDISPOSING TO REFLUX, BUT NOT WITH ESOPHAGITIS PRESENCE IN GERD
Authors: Morozov Sergey , Isakov Vasily , Vorozhko Ilya 
Published: August 2023

Abstract

Background
Neurokinin A (NKA) and substance P (SP) may be responsible for airway hyper-reactivity and hypersensitization. Animal studies showed an increase of their blood concentration in response to acid installation into the esophagus, suggesting the presence of neurogenic inflammation in pathogenesis of asthma and chronic cough. Association between serum concentration of these cytokines and esophageal function testing parameters in patients with gastroesophageal reflux disease (GERD) is poorly studied.
Aim of the study was to assess serum concentration of neurokinin A and substance P in patients with erosive esophagitis and non-erosive form of GERD and perform correlation analysis between concentrations of these substances and data of multichannel esophageal pH-impedance (MII-pH) and high-resolution esophageal manometry (HREM).

Methods
The data of examination of 88 subjects (31 with erosive esophagitis (EE); 57 with non-erosive form of GERD (NERD)) served as a source for the study. Diagnosis of GERD was established per Lyon criteria. Subjects with autoimmune disorders, receiving some medications able to affect esophageal motility were not eligible. Patients underwent HREM with the use of 36-channel solid-state catheters and MII-pH with 2-pH, 6-impedandce sensors. Serum concentrations of NKA and SP were measured with ELISA kits and biochemistry analyzer.

Results
Acid exposure time (AET), and number of high gastroesophageal refluxes were higher in EE compared to NERD, while number of refluxes and concentrations of NKA and SP were similar. Mean, minimal and residual lower esophageal sphincter resting pressures were lower in EE compared to NERD. There was direct correlation between serum concentration of SP and number of gastroesophageal refluxes (Spearman rank R = 0.26), AET (R = 0.25), and number of refluxes lasting &gt;5 min (R = 0.35). NKA concentration correlated directly with number of refluxes &gt;5 min long (R = 0.28), and inversely with levels of integrated relaxation pressure (R = –0.32), and contractile front velocity (R = –0.38).

Conclusions
In patients with GERD, serum concentrations of Neurokinin A and Substance P do not depend on the presence of esophagitis and probably are not caused by the influence of reflux content to sensory neurons of esophageal mucosa. Established correlations may support the involvement of Neurokinin A and Substance P in pathogenesis of gastroesophageal reflux disease.
25. THE ROLE OF ADJUVANT THERAPY FOR PATIENTS WITH ESOPHAGEAL ADENOCARCINOMA UNDERGOING NEOADJUVANT THERAPY AND ESOPHAGECTOMY
Authors: Li Xiaokun , Yuan Yong , Shen Yi 
Published: August 2023

Abstract

Background
The use of adjuvant therapy after neoadjuvant therapy followed by esophagectomy is controversial due to limited studies. The aim of this study was to investigate the role of adjuvant therapy for patients with esophageal adenocarcinoma (EAC) after neoadjuvant therapy and esophagectomy and to provide a basis for clinical decision-making.

Methods
Patients who were diagnosed as EAC and underwent neoadjuvant therapy followed by surgery were included in this study. The data of the patients in training group are derived from Surveillance, Epidemiology, and End Results (SEER) database. Patients from two institutions (West China Hospital and Nanjing Jinling Hospital) were used to validate the results.

Results
A total of 3445 EAC patients were identified from the SEER database according to the eligibility criteria. No significant difference was found between adjuvnat therapy and non-adjuvant therapy group (5-year overall survival (OS): 35.7 and 37.2%, p = 0.920; 5-year cancer-specific survival (CSS): 39.5 and 43.2%, p = 0.520). Meanwhile, 130 patients were identified from West China Hospital (n = 84) and Jinling Hospital (n = 46). The results showed that patients undergoing adjuvant therapy group had a better OS than non-adjuvant therapy group (p = 0.031).

Conclusion
On the basis of the SEER database, this study revealed no survival benefit of adjuvant therapy for patients with EAC after neoadjuvant therapy and surgery. However, the analysis results of patients from two institutions in China show that patients with EAC may benefit from adjuvant therapy after neoadjuvant therapy and esophagectomy.
31. MULTICENTER RANDOMIZED CLINICAL TRIAL OF CRT VS DCF AS INITIAL TREATMENT FOR SUBSEQUENT CONVERSION SURGERY FOR CLINICAL T4B ESOPHAGEAL CANCER
Authors: Sugimura Keijiro , Miyata Hiroshi , Tanaka Koji , Makino Tomoki , Takeno Atsushi , Shiraishi Osamu , Motoori Masaaki , Yamasaki Makoto , Hirao Motohiro , Fujitani Kazumasa , Yasuda Takushi , Yano Masahiko , Doki Yuichiro 
Published: August 2023

Abstract

Backgroud
Although induction followed by conversion surgery (CS) is potentially curative for T4b esophageal cancer, the optimal initial induction treatment is unclear. We conducted a multicenter randomized prospective phase 2 trial of chemoradiotherapy (CRT) versus chemotherapy (CT) as initial induction therapy for CS in clinical T4b esophageal cancer. We compared treatment effects, adverse events and survival.

Methods
Ninety-nine patients with T4b esophageal cancer were randomly allocated to chemoradiotherapy (Group A, n = 49) or CT (Group B, n = 50) as initial induction treatment. CRT consisted of radiation (50.4 Gy) with cisplatin and 5-fluorouracil. CT consisted of 2 cycles of docetaxel plus cisplatin and 5-fluorouracil (DCF). CRT or CT was followed by CS if resectable. If unresectable, the patient received the other treatment as secondary treatment. CS was performed if resectable after secondary treatment. The primary end point was 2-year overall survival. The Japan Registry of Clinical Trials (s051180164).

Results
In Group A, CS was performed in 34 (69%) and 7 patients (14%) after initial and secondary treatment. In Group B, CS was performed in 25 (50%) and 17 patients (34%) after initial and secondary treatment. The R0 resection rate after initial and secondary treatment was similar (78% vs 76%, P = 1.000). Adverse events including leukopenia, neutropenia, febrile neutropenia, and diarrhea were significantly more frequent in Group B. Group A had better histological complete response of the primary tumor (40% vs 17%, P = 0.028) and histological nodal status (P = 0.038). The 2-year survival rate was 55.1% (95% CI 41.1–68.3%) in the CRT group and 34.7% (95% CI 22.8–48.9%) in the CT group, although the difference was not significant (p = 0.11). Local and regional lymph node recurrence in patients undergoing R0 resection was significantly higher in CT group than CRT group (30% versus 8%, p = 0.03 and 37% versus 8%, p = 0.002, respectively).

Conclusions
The results of the present trial showed that upfront CRT was superior to upfront CT in terms of adverse effects, pathological effects and 2 year-overall survival as initial induction therapy for CS in clinical T4b esophageal cancer.
136. IMPACT OF SKELETAL MUSCLE LOSS AND SARCOPENIA ON OUTCOMES OF LOCALLY ADVANCED ESOPHAGEAL CANCER
Authors: Xiao Xin , Yuan Yong 
Published: August 2023

Abstract

Background
The impact of change in skeletal muscle and the sarcopenia on outcomes during neoadjuvant chemoradiotherapy (NACR) for patients with esophageal cancer remains controversial.

Methods
We retrospectively analyzed the data of patients with locally advanced esophageal squamous cell cancer who received NACR followed by esophagectomy between June 2013 and December 2021. The images at third lumbar were analyzed to measure the cross-sectional area and calculate skeletal muscle index (SMI) before and after neoadjuvant chemoradiation. The SMI less than 52.4 cm2/m2 for men and less than 38.5 cm2/m2 for women were defined as sarcopenia. The nonlinearity of the effect of percent change in SMI (ΔSMI%) to survival outcomes was assessed by restricted cubic splines.

Results
Overall, data of 367 patients were analyzed. The survival outcomes between sarcopenia and non-sarcopenia groups had no significant differences before NACR. However, patients in post-NACR sarcopenia group showed poor overall survival (OS) benefit (P = 0.016) and poor disease-free survival (DFS) (P = 0.043). Severe postoperative complications rates were 11.9% in post-NACR sarcopenia group and 5.0% in post-NACR non-sarcopenia group (P = 0.019). The association of ΔSMI% with survival outcomes was nonlinear significantly. On the multivariate analysis of OS, ΔSMI % &gt; 12% was the independent prognostic factor (HR = 1.76, 95%CI: 1.03–2.99, P = 0.039) and significant difference was also found on DFS analysis (P = 0.025).

Conclusion
Patients with post-neoadjuvant chemoradiotherapy sarcopenia have worse survival and adverse short-term outcomes. Moreover, additional skeletal muscle index loss increases risk of death and disease progression during neoadjuvant chemoradiotherapy, and max significant difference was reached when it loss over 12%.
137. THE COMPARISON OF UNIPORTAL VERSUS MULTIPORTAL VIDEO-ASSISTED THORACIC SURGERY FOR ESOPHAGEAL CANCER: A PROPENSITY-WEIGHTED ANALYSIS
Authors: Yuan Yong , Xiao Xin 
Published: August 2023

Abstract

Background
Uniportal video-assisted thoracoscopic surgery (VATS) has been widely used, however, there are few studies on uniportal VATS for esophagectomy.

Methods
Data from patients with clinical stage T1–3/N0/M0 thoracic esophageal cancer who underwent surgery between January 2017 and December 2020 were prospectively enrolled and retrospectively analyzed. Inverse probability of treatment weighting (IPTW) analysis was performed to assess the outcomes.

Results
Overall, 55 patients who underwent uniportal, and 212 patients who underwent multiportal, VATS were identified. Surgery-related postoperative complications (Clavien-Dindo grades 1–2) occurred less frequently after uniportal than multiportal VATS in both crude and IPTW models (8.1% versus 29.3%, respectively; P = 0.009). The median postoperative length of stay was 9 (9–10) days in the uniportal VATS and 10 (9–14) days in the multiportal VATS group (P = 0.025 after IPTW). Upon IPTW analysis, in uniportal and multiportal VATS groups, the rates of pneumonia were 10.6% and 26.9% (P = 0.040), while the rates of anastomotic fistulae (grade 2) were 1.0% and 6.6% (P = 0.036), respectively. The visual analog scale (VAS) was administered on postoperative first 7 days and were significantly lower in the uniportal VATS group (P &lt; 0.001). No surgical mortality was observed in the uniportal VATS group, and the survival benefit between the two groups was comparable before (P = 0.732) and after IPTW (P = 0.542).

Conclusions
Uniportal VATS for esophagectomy resulted in a lower rate of postoperative complications with less postoperative pain, and is practical for treating patients with esophageal cancer.
164. INTRAOPERATIVE LYMPHATIC FLOW MAPPING USING INDOCYANINE GREEN PREDICTS LYMPH NODE METASTASIS IN ESOPHAGEAL CANCER PATIENTS NOT TREATED WITH NEOADJUVANT CHEMOTHERAPY
Authors: Shiomi Shinichiro 
Published: August 2023

Abstract

Background
Lymphatic flow mapping using near-infrared fluorescence (NIR) imaging with indocyanine green (ICG) has been used for the intraoperative prediction of lymph node metastasis (LNM) in various cancers. Previous studies examined the feasibility of applying this technique to patients with esophageal cancer. However, a consistent method that yields sufficient diagnostic quality has yet to be confirmed. This study explored the diagnostic utility of our established lymphatic flow mapping protocol for predicting LNM in esophageal cancer.

Methods
We injected 0.5 mL of ICG (500 μg/mL) into the submucosal layer at four peritumoral points on the day before surgery for 54 patients. We performed lymphatic flow mapping intraoperatively using NIR imaging. After determining the NIR status and presence of metastases, evaluable lymph node stations on intraoperative NIR imaging and all resected lymph nodes were divided into four categories: ICG + meta+ (true positive), ICG + meta− (false positive), ICG − meta+ (false negative), and ICG − meta− (true negative). Logistic regression models were used to investigate the characteristics of patients with LNs or LN stations associated with high false-negative rates.

Results
The distribution of ICG+ and meta+ lymph node stations differed according to the primary tumor site. Sensitivity and specificity for predicting meta+ lymph nodes among ICG+ ones were 50% and 75%, respectively. Predicting meta+ lymph node stations among ICG+ stations improved these values to 66% and 77%, respectively. Undergoing neoadjuvant chemotherapy was an independent risk factor for having meta+ lymph nodes with false-negative diagnoses (odds ratio: 4.82; 95% confidence interval: 1.28–18.19). The sensitivity of our technique for predicting meta+ lymph nodes and meta+ lymph node stations in patients who did not undergo neoadjuvant chemotherapy was 79% and 83%, respectively.

Conclusion
Our NIR imaging protocol potentially helps to predict lymph node metastasis intraoperatively in patients with esophageal cancer undergoing esophagectomy who had not undergone neoadjuvant chemotherapy. This technique may effectively serve as a parameter for assessing the need for dissecting LNs in each station and determining whether it is applicable to reduce the extent of lymphadenectomy.