bluuebunny/crossref_metadata_2025_split huggingface dataset:
Closed Incision Negative Pressure Therapy to Reduce Surgical Site Infection in High-Risk Gastrointestinal Surgery: A Randomized Controlled Trial
Authors: Ceppa Eugene P , Kim Rachel C , Niedzwiecki Donna , Lowe Melissa E , Warren Dana A , House Michael G , Nakeeb Attila , Zani Sabino , Moyer Ashley N , Blazer Dan G ,   for the ciNPT Investigators
Published: February 2023

Background:
Despite institutional perioperative bundles and national infection prevention guidelines, surgical site infection (SSI) after major abdominal surgery remains a significant source of morbidity. Negative pressure therapy has revolutionized care for open wounds but the role of closed incision NPT (ciNPT) remains unclear.

Study Design:
We conducted a multi-institutional randomized controlled trial evaluating SSI after major elective colorectal or hepatopancreatobiliary surgery. Patients were randomized to receive conventional wound care versus ciNPT (PREVENA Incision Management System, KCI USA, Inc, San Antonio, TX). The primary endpoint was postoperative incisional SSI. SSI incidence was evaluated at inpatient day 4-5 and postoperative day 30. With 144 patients studied estimated power was 85% to detect the difference in SSI between 17% and 5%, conventional vs ciNPT (1-sided α=0.1). Secondary endpoints included incidence by SSI type, length of stay, 30-day readmission, and mortality. T-tests were used to compare continuous variables between treatments, similarly chi-square tests were used to compare categorical variables, p<0.05 considered significant, except for primary comparison of incisional and organ SSI.

Results:
164 patients from 2013-2021 were randomized. 138 patients were evaluable (n=63 ciNPT, n=75 conventional). Incisional SSI occurred in 9 (14%) patients in the ciNPT group and in 13 (17%) patients in the conventional group (p= 0.31). Organ space SSI occurred in 7 (11%) patients in ciNPT and 10 (13%) conventional therapy (p=0.35).

Conclusion:
In this multi-institutional, randomized controlled trial among patients undergoing colorectal or hepatopancreatobiliary surgery, the difference in incisional SSI between ciNPT and conventional wound therapy was not statistically significant. Future trials should focus on patient populations undergoing the highest SSI risk procedures with more focus on specific procedure types.
Fluoroscopic Intraoperative Breast Neoplasm and Node Detection
Authors: Weiser Roi , Manno Gabrielle C , Cass Samuel H , Chen Lu , Kuo Yong-fang , He Jing , Robinson Angelica S , Posleman Monetto Flavia , Silva H Colleen , Klimberg V Suzanne 
Published: February 2023

Background:
Preoperative localization is necessary for non-palpable breast lesions. A novel procedure, Fluoroscopic Intraoperative Neoplasm and Node Detection (FIND), obviates the preoperative painful and potentially expensive localization, by using intraoperative visualization of the standard clip placed during diagnostic biopsy. We hypothesized FIND would improve negative margin rates.

Study Design:
This is an IRB-approved retrospective study (9/2016-3/2021). Electronic chart review identified breast and axillary node procedures using wire localization (WL) or FIND. Primary outcome was margin status. Secondary outcomes included re-excision rate, specimen weight, surgery time and axillary node localization rate.

Results:
We identified 459 patients, 116(25.3%) underwent FIND and 343(74.7%) WL. Of these, 68.1% of FIND and 72.0% of WL procedures were for malignant lesions. Final margin positivity was 5.1%(4/79) for FIND and 16.6%(41/247) for WL (p=0.0083). This difference lost statistical significance upon multivariable logistic regression (p=0.6521). Re-excision rates were 7.6% and 14.6% for FIND and WL (p=0.1246), with an equivalent mean specimen weight (p=0.5025), and mean surgery time of 177.5 ± 81.7 and 157.1 ± 66.8 minutes, respectively (p=0.0224). FIND identified all (29/29) targeted axillary nodes, while WL identified only 80.1%(21/26) (p=0.0189).

Conclusion:
FIND has lower positive margin rates and a trend towards lower re-excision rates compared to WL, proving its value in localizing non-palpable breast lesions. It also offers accurate localization of axillary nodes, valuable in the era of targeted axillary dissection. It is a method of visual localization, using a skill and equipment surgeons already have, and saves patients and medical systems an additional schedule-disruptive, painful procedure, especially valuable when using novel localization devices is cost-prohibitive.
Illuminating the Use of Trauma Whole Body CT Scan During the Global Contrast Shortage
Authors: Ramsey Walter A , O’Neil Jr Christopher F , Ramdev Rajan A , Sleeman Ella A , Danton Gary H , Kaufman Joyce I , Pizano Louis R , Meizoso Jonathan P , Proctor Kenneth G , Namias Nicholas 
Published: February 2023

Introduction:
The use of whole-body CT scan (WBCT) is widespread in the evaluation of traumatically injured patients and may be associated with improved survival. WBCT protocols include the use of IV contrast unless there is a contraindication. This study tests the hypothesis that using plain whole-body CT (WBCT) scan during the global contrast shortage would result in greater need for repeat contrast-enhanced CT, but would not impact mortality, missed injuries, or rates of acute kidney injury (AKI).

Methods:
All trauma encounters excluding burns and prehospital cardiac arrests at an academic level-I trauma center from 3/1/22 to 6/24/22 were reviewed. Imaging practices and outcomes before and during contrast shortage (beginning May 3rd) were compared.

Results:
The study population was comprised of 1,109 consecutive patients (72% male), including 890 (80%) blunt and 219 (20%) penetrating traumas. Overall, 53% of patients underwent WBCT, and contrast was administered to 73%. The overall rate of AKI was 6% and the rate of renal replacement therapy (RRT) was 1%. Contrast usage in WBCT was 99% before and 40% during the shortage (p<0.001). There was no difference in the rate of repeat CT scans, missed injuries, AKI, RRT, or mortality.

Conclusions:
Trauma imaging practices at our center changed during the global contrast shortage; the use of contrast decreased despite the frequency of trauma WBCT scans remaining the same. The rates of AKI and RRT did not change, suggesting that WBCT with contrast is insufficient to cause AKI. The missed injury rate was equivalent. Our data suggest similar outcomes can be achieved with selective use of WBCT and IV contrast.
Hypercapnic Tissue Gene Expression and Survival in Early-Stage Pancreatic Ductal Adenocarcinoma
Authors: Nevler Avinoam , Khalilieh Saed , Lavu Harish , Bowne Wilbur , Yeo Charles J 
Published: February 2023

Background:
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive and lethal cancer. Hypercapnic tumor microenvironments were previously shown to promote cancer chemoresistance. In this study, we aimed to investigate the impact of tissue hypercapnia on PDAC prognosis.

Study Design:
PDAC cancer-cell lines were cultured in normocapnic (5%CO2) and hypercapnic conditions (10%CO2). RNA was extracted and whole-exome transcriptome was sequenced. Differentially-expressed genes were identified and used to construct a ‘hypercapnic gene-set’. PDAC transcriptomic patient data from the Tumor Cancer Genome Atlas was used to calculate single-sample gene-set enrichment scores based on each patient’s tissue expression of the ‘hypercapnic gene-set’. Tissue hypercapnic scores (HS) in PDAC patients (TMN Stages Ia-IIb) were determined and correlated with clinico-pathological parameters and overall survival.

Results:
A cohort of 135 resected Stage I-II PDAC patients were assessed in this study. The average age was 65 ± 11.0 years and the male:female ratio was 74:61. Median overall survival was 19.5 ± 1.4 months. High HS were associated with increased tumor stage (P<0.05), and higher lymph-node ratio (P<0.05). In active smokers, high HS also correlated with smoking pack-years (P<0.05). Cox regression analysis revealed high HS to be an independent prognostic factor for overall survival (HR 2.66, P=0.004), along with lymph-node ratio (HR 4.2, P=0.002) and age at diagnosis (HR 2.63, P=0.01).

Conclusions:
The pancreatic tumor microenvironment plays an integral role in tumor aggressiveness and our previous in-vitro data suggests hypercapnia promotes an aggressive, more-resistant phenotype. Herein we show that in early-stage pancreatic cancer, hypercapnic tissue signatures corresponded with a worse overall survival.
Four-Day Robotic Whipple: Early Discharge after Robotic Pancreatoduodenectomy
Authors: Fong Zhi Ven , Lwin Thinzar M , Aliaj Agim , Wang Jiping , Clancy Thomas E 
Published: February 2023

Background:
We aim to assess the safety of an ERAS and early discharge pathway in a robotic pancreatoduodenectomy (PD) program and compare outcomes with an open PD cohort as controls to determine the synergistic effects of robotic surgery and enhanced recovery pathways on length of stay (LOS).

Study Design:
Consecutive patients undergoing open or robotic pancreatoduodenectomy by a single surgeon from analysis from March 2020 to July 2022 was identified. Logistic regression models were used for adjusted analyses of postoperative outcomes.

Results:
There were 134 consecutive patients who underwent PD, of which 40 (30%) were performed robotically. Pancreatic adenocarcinoma was the most common indication in both the open (56%) and robotic (55%, p=0.51) groups, with a similar proportion of them being borderline resectable or locally advanced tumors (78% vs 82% in robotic group, p=0.82). The LOS was significantly shorter in the robotic PD group (median 5 days, IQR 4-7 days) when compared to the open PD group (median 6 days, IQR 5-8 days, p<0.001). A LOS of ≤4 days was observed in 40% of the robotic PD group compared to only 3% of patients in the open PD group (p<0.001), with no differences in the overall readmission rates (10% vs 12% in the robotic PD group, p=0.61). On multivariable logistic regression, robotic PD was independently associated with higher odds of LOS of ≤4 days (OR 22.4, p=0.001) when compared to open PD.

Conclusions:
An enhanced recovery and early discharge pathway could be safely implemented in a robotic PD program. Patients undergoing robotic PD have significantly shorter lengths of stay without increased complication or readmission rates compared to open PD, with 40% of patients undergoing robotic PD achieving a LOS of ≤4 days.
Predicting Futility in Severely Injured Patients: Using Arrival Lab Values and Physiology to Support Evidence-Based Resource Stewardship
Authors: Van Gent Jan-Michael , Clements Thomas W , Lubkin David T , Wade Charles E , Cardenas Jessica C , Kao Lillian S , Cotton Bryan A 
Published: February 2023

Background:
The recent pandemic exposed a largely unrecognized threat to medical resources, including daily available blood products. Some of the most severely injured patients who arrive in extremis consume tremendous resources yet succumb shortly after arrival. We sought to identify cut-points available early in the patient’s resuscitation that predicted 100% mortality.

Study Design:
Cut-points were developed from a previously collected dataset of all level-1 trauma patients admitted 01/10-12/16. Objective values available on or shortly after arrival were evaluated. Once generated, we then validated these variables against (1) a prospective dataset 11/17-10/21 of severely injured patients and (2) a multicenter, randomized trial of hemorrhagic shock patients. Analyses were conducted using STATA 17.0 (College Station, TX), generating positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity.

Results:
The development dataset consisted of 9,509 patients (17% mortality), with 2,137 (24%) and 680 (24%) in the two validation datasets. Several combinations of arrival vitals and labs had 100% PPV. Patients undergoing CPR in the field or on arrival (with subsequent ROSC) required lower fibrinolysis LY-30 (30%) than those with systolic pressures (SBP) of ≤50 (30-50%), ≤70 (80-90%), and ≤90 mmHg (90%). Using a combination of these validated variables, the Suspension of Transfusions and Other Procedures (STOP) criteria were developed, with each element predicting 100% mortality, allowing physicians to cease further resuscitative efforts.

Conclusion:
The use of evidence-based STOP criteria provides cut-points of futility to help guide early decisions for discontinuing aggressive treatment of severely injured patients arriving in extremis.
Effects of Patient Sex on Neurocognitive Decline after Cardiac Surgery
Authors: Stanley Madigan E , Kant Shawn , Raker Chris , Sabe Sharif , Sodha Neel R , Ehsan Afshin , Sellke Frank W 
Published: February 2023

Background:
Neurocognitive decline (NCD) is a common complication of cardiac surgery. Understanding risk factors helps surgeons counsel patients pre- and peri-operatively about risk, prevention, and treatment.

Results:
Eighty-four patients undergoing cardiac surgery utilizing cardiopulmonary bypass underwent pre- and post-operative neurocognitive testing. Neurocognitive data are presented as a change from baseline to either postoperative day four (POD4) or to one month. The score is standardized with respect to age. There was no significant difference in baseline neurocognitive function. NCD was more common in female patients (71%) than male patients (26.4%) on POD4. By one month the incidence of NCD is similar between female (15.0%) and male patients (14.3%). Of note, female patients differed from male patients in preoperative hematocrit, preoperative creatinine, and type of surgery.

Conclusion:
In the acute postoperative period, female patients are both more likely to experience NCD and experience a more severe change from baseline cognitive function. This difference between male and female patients resolves by the one month follow-up point. Female patients had a lower preoperative hematocrit and were more likely to receive intraoperative and perioperative blood transfusions. Lower pre-operative hematocrit appears to mediate the difference in NCD between male and female patients.
Multiplex analysis of cytokines and chemokines in persons aging with or without HIV
Authors: Kroll Kyle W. , Woolley Griffin , Terry Karen , Premeaux Thomas A. , Shikuma Cecilia M. , Corley Michael J. , Bowler Scott , Ndhlovu Lishomwa C. , Reeves R. Keith 
Published: February 2023

AbstractPeople with HIV (PWH) on combined antiretroviral therapy (cART) are living longer lives due to modern cART advances and increased routine medical care. The full landscape of aging with HIV is unclear; given that HIV emerged relatively recently in human history and initially had a high mortality rate, there has not been a substantially aged population to evaluate. In the present study, we set out to perform high throughput plasma analyte profiling by multiplex analysis, focusing on various T helper (Th)-related cytokines, chemokines, and pro- and anti-inflammatory cytokines. The primary goals being to provide reference ranges of these analytes for aging PWH cohorts, as well as testing the utility of high throughput multiplex plasma assays. The cohort used in this study was comprised of age-matched healthy donors (aged 32.6-73.5), PWH on cART (aged 26.7-60.2), and viremic PWH (aged 27.5-59.4). The patients in each group were then stratified across the age span to examine age-related impacts of these plasma biomarkers. Our results largely indicate feasibility of plasma analyte monitoring by multiplex and demonstrate a high degree of person-to-person variability regardless of age and HIV status. Nonetheless, we find multiple associations with age, duration of known infection, and viral load, all of which appear to be driven by either prolonged HIV disease progression or long-term use of cART.
m6A RNA methylation orchestrates transcriptional dormancy during developmental pausing
Authors: Collignon Evelyne , Cho Brandon , Fothergill-Robinson Julie , Furlan Giacomo , Ross Robert L. , Limbach Patrick A. , Ramalho-Santos Miguel 
Published: February 2023

AbstractEmbryos across metazoan lineages can enter reversible states of developmental pausing, or diapause, in response to adverse environmental conditions. The molecular mechanisms that underlie this remarkable dormant state remain largely unknown. Here we show that m6A RNA methylation by Mettl3 is required for developmental pausing in mice by maintaining dormancy of paused embryonic stem cells and blastocysts. Mettl3 enforces transcriptional dormancy via two interconnected mechanisms: i) it promotes global mRNA destabilization and ii) suppresses global nascent transcription by specifically destabilizing the mRNA of the transcriptional amplifier and oncogene N-Myc, which we identify as a critical anti-pausing factor. Our findings reveal Mettl3 as a key orchestrator of the crosstalk between transcriptomic and epitranscriptomic regulation during pausing, with implications for dormancy in stem cells and cancer.
TMS-induced inhibition of the left premotor cortex modulates illusory social perception
Authors: Peylo Charline , Sterner Elisabeth F. , Zeng Yifan ,   the EMPRA students, Friedrich Elisabeth V. C. 
Published: February 2023

AbstractCommunicative actions from one person are used to predict another person’s response. However, in some cases, these predictions can outweigh the processing of sensory information and lead to illusory social perception such as seeing two people interact, although only one is present (i.e., seeing a Bayesian ghost).We applied either inhibitory brain stimulation over the left premotor cortex (i.e., real TMS) or sham TMS. Then, participants indicated the presence or absence of a masked agent that followed a communicative or individual gesture of another agent.As expected, participants had more false alarms (i.e., Bayesian ghosts) in the communicative than individual condition in the sham TMS session and this difference between conditions vanished after real TMS. In contrast to our hypothesis, the number of false alarms increased (rather than decreased) after real TMS.These pre-registered findings confirm the significance of the premotor cortex for social action predictions and illusory social perception.HighlightsSocial predictions can outweigh sensory information and lead to illusory perceptionPremotor cortex is linked to the illusory social perception of a Bayesian ghostTMS over premotor cortex modulates how social predictions influence our perception
An efficient method for viable cryopreservation of hookworms and other gastrointestinal nematodes in the laboratory
Authors: Li Hanchen , Gazzola David , Hu Yan , Aroian Raffi V. 
Published: February 2023

AbstractHookworms (generaAncylostomaandNecator) are amongst of the most prevalent and important parasites of humans globally. These intestinal parasites ingest blood, resulting in anemia, growth stunting, malnutrition, and adverse pregnancy outcomes. They are also critical parasites of dogs and other animals. In addition, hookworms and hookworm products are being explored for their use in treatment of autoimmune and inflammatory diseases. There is thus a significant and growing interest in these mammalian host-obligate parasites. Laboratory research is hampered by the lack of good means of cryopreservation. Here, we describe a robust method for long-term (≥3 year) cryoprotection and recovery of bothAncylostomaandNecatorhookworms that is also applicable to two other intestinal parasites that passages through the infective third larval stage,Strongyloides rattiand Heligmosomoides polygyrus bakeri. The key is the use cryo-preserved first-staged larvae raised to the infective third larval stage using activated charcoal mixed with uninfected feces from a permissive host. This technique will greatly facilitate research on and availability of gastrointestinal parasitic nematodes with great importance to global health, companion animal health, and autoimmune/inflammatory disease therapies.
Open-up or stay closed: the effect of TMT gender diversity on open innovation
Authors: Saeed Abubakr , Ali Ashiq , Riaz Hammad 
Published: February 2023

PurposeDespite the importance of top management team (TMT) gender diversity in a firm's strategic decisions and the high degree of innovation activities that several firms have experienced in recent years, little or no research has examined how TMT gender diversity affects a firm's open innovation decision. The authors examine how TMT gender diversity impacts firms' open innovation activities. The authors further examine how this impact is affected by women executives' personal attributes and institutional conditions.Design/methodology/approachThe sample comprised of 62,745 firm-year observations (9,831 firms) from 25 countries from 1990 to 2010. The authors employed the system generalized method of moments (GMM) estimation technique to estimate the results.FindingsEmploying novel panel data on co-owned patents across 25 economies, the authors find that proportion of women in TMTs has a positive impact on open innovation activities. Moreover, the authors find that women managers' power and institutional gender parity strengthen the association between gender diversity and open innovation.Practical implicationsThe findings of this study indicate that firms committed to optimizing their open innovation policies and practices should include women in TMTs and create such conditions that are supportive for women executives to effectively express their innate inclinations. Importantly, our study supports the business case for gender diversity in top leadership positions by providing a compelling evidence for the positive impact of TMT gender diversity on open innovation.Originality/valueThis study contributes to the gender diversity literature by showing how women leaders' values and character become embedded in their companies' strategy and present empirical evidence that having women in TMTs increase the likelihood of conducting open innovation. Further, the authors show how women executives' power and institutional level gender parity provide boundary conditions that moderate the relationship between TMT gender diversity and open innovation.
Multi-demand supply chain triads and the role of Third-Party Logistics Providers
Authors: Vlachos Ilias , Polichronidou Vasiliki 
Published: February 2023

Purpose Third-party logistics providers (3PLs) have significantly evolved during the last decades, yet their role within a supply chain triad has been overlooked; this study examines empirically the 3PLs' role using four established theories: resource-based view, social capital perspective, agency theory and transaction cost economics.Design/methodology/approachThis study examines the role of 3PLs in four supply chain triads, using the case study approach. Sources of evidence include interviews and secondary data.FindingsThe 3PL had different roles in multi-demand triads as service developer, customer adaptor and customer developer. The 3PL, by offering advanced services, became a service developer. The 3PL as a customer adaptor offered customised services and gain the client's trust. As a customer developer, the 3PL acted on behalf of its client in expanding its operations and meeting competitive needs.Research limitations/implicationsThe results of the case study methodology can only be generalised to similar types of 3PL. Supply chain triads are an emerging research field; theories like the resource-based view and transaction cost economics are established in the dyadic context and require further elaboration when applied in triadic contexts.Practical implicationsThe findings provide practical insights into the role that 3PL can play in supply chain triads, how they can upgrade their role by long-range planning and extending their services to create supply chain efficiency.Social implicationsUnderstanding the 3PL's role in triads can improve how companies and economies respond to crises like the recent pandemic outbreak.Originality/valueIt uncovers three different 3PL roles in supply chain triads by using four established theories.