bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infant Feeding, Gut Permeability, and Gut Inflammation Markers
Authors: Koivusaari Katariina , Niinistö Sari , Nevalainen Jaakko , Honkanen Jarno , Ruohtula Terhi , Koreasalo Mirva , Ahonen Suvi , Åkerlund Mari , Tapanainen Heli , Siljander Heli , Miettinen Maija E. , Alatossava Tapani , Ilonen Jorma , Vaarala Outi , Knip Mikael , Virtanen Suvi M. 
Published: March 2023

Objectives:
Increased gut permeability and gut inflammation have been linked to the development of type 1 diabetes. Little is known on whether and how intake of different foods is linked to these mechanisms in infancy. We investigated whether the amount of breast milk and intake of other foods are associated with gut inflammation marker concentrations and permeability.

Methods:
Seventy-three infants were followed from birth to 12 months of age. Their diet was assessed with structured questionnaires and 3-day weighed food records at the age of 3, 6, 9, and 12 months. Gut permeability was assessed with the lactulose/mannitol test and fecal calprotectin and human β-defensin-2 (HBD-2) concentrations were analyzed from stool samples at the age of 3, 6, 9, and 12 months. The associations between foods and gut inflammation marker concentrations and permeability were analyzed using generalized estimating equations.

Results:
Gut permeability and gut inflammation marker concentrations decreased during the first year of life. Intake of hydrolyzed infant formula (P = 0.003) and intake of fruits and juices (P = 0.001) were associated with lower intestinal permeability. Intake of fruits and juices (P < 0.001), vegetables (P < 0.001), and oats (P = 0.003) were associated with lower concentrations of HBD-2. Higher intake of breast milk was associated with higher fecal calprotectin concentrations (P < 0.001), while intake of fruits and juices (P < 0.001), vegetables (P < 0.001), and potatoes (P = 0.007) were associated with lower calprotectin concentrations.

Conclusions:
Higher intake of breast milk may contribute to higher calprotectin concentration, whereas several complementary foods may decrease gut permeability and concentrations of calprotectin and HBD-2 in infant gut.
Combination of Plasma Exchange and Adsorption Versus Plasma Exchange in Pediatric Acute Liver Failure: A Multicenter Cohort Study
Authors: Gao Qian , Chen Jie , Zhao Chun , Li Jing , Song Aiqin , Zhang Zhaohua , Lin Xia , Dong Shengying , Xin Meiyun , Hou Jian , Han Mingying , Li Xiaomei , Yang Xinli , Jin Youpeng , Zhang Yucai 
Published: March 2023

Objectives:
This study aimed to compare the efficacy of double plasma molecular adsorption system (DPMAS) with half-dose plasma exchange (PE) to that of full-dose PE in pediatric acute liver failure (PALF).

Methods:
This multicenter, retrospective cohort study was conducted in 13 pediatric intensive care units in Shandong Province, China. DPMAS+PE and single PE therapies were performed in 28 and 50 cases, respectively. The patients’ clinical information and biochemical data were obtained from the patients’ medical records.

Results:
The severity of illness did not differ between the 2 groups. At 72 hours after treatment, comparing with PE group, the rates of decline of Pediatric model for End-stage Liver Disease and Pediatric Sequential Organ Failure Assessment scores as well as total bilirubin blood ammonia and interleukin-6 were significantly higher, while the short-term effective rate (75.0% vs 44.0%, P = 0.008) was significantly higher in the DPMAS+PE group. The volume of plasma consumption (26.5 vs 51.0 mL/kg, P = 0.000) and the rate of adverse events (3.6% vs 24.0%, P = 0.026) were lower in the DPMAS+PE group than in the PE group, respectively. However, there was no statistical difference in the 28-day mortality between the 2 groups (21.4% vs 40.0%, P > 0.05).

Conclusions:
For PALF patients, both DPMAS + half-dose PE and full-dose PE could improve the liver function, while DPMAS + half-dose PE could significantly reduce plasma consumption without obvious adverse effects in contrast with full-dose PE. Thus, DPMAS + half-dose PE may be a suitable alternative method for PALF in the context of the increasingly tight blood supply situation.
Enhancing Functional Recovery after Segmental Nerve Defect using Nerve Allograft treated with Plasma-Derived Exosome
Authors: Wang Yicun , Shi Guidong , Huang Tony C.T. , Li Jialun , Long Zeling , Reisdorf Ramona , Shin Alexander Y. , Amadio Peter , Behfar Atta , Zhao Chunfeng , Moran Steven L. 
Published: March 2023

Background:
Nerve injuries can result in detrimental functional outcomes. Currently, autologous nerve graft offers the best outcome for segmental peripheral nerve injury. Allografts are alternatives, but do not have comparable results. This study evaluated if plasma-derived exosome can improve nerve regeneration and functional recovery when combined with decellularized nerve allografts.

Methods:
The effect of exosomes on Schwann cell proliferation and migration were evaluated. A rat model of sciatic nerve repair was used to evaluate the effect on nerve regeneration and functional recovery. A fibrin sealant was used as the scaffold for exosome. 84 Lewis rats were divided into Autograft, Allograft, and Allograft with exosome groups. Gene expression of nerve regeneration factors were analyzed on postoperative day 7. At 12 and 16 weeks, rats were subjected to maximum isometric tetanic force (ITF) and compound muscle action potential (CMAP). Nerve specimens were then analyzed via histology and immunohistochemistry.

Results:
Exosomes were readily taken up by Schwann cells (SCs) that resulted in improved SCs viability and migration. Treated allograft group had comparable functional recovery (CMAP, ITF) as the autograft group. Similar results were observed in gene expression analysis of nerve regenerating factors. Histological analysis showed no statistically significant differences between treated allograft and autograft groups in terms of axonal density, fascicular area, and myelin sheath thickness.

Conclusion:
Plasma-derived exosome treatment of decellularized nerve allograft may provide comparable clinical outcomes to that of an autograft. This can be a promising strategy in the future as an alternative for segmental peripheral nerve repair.
“Calling on Sponsorship – Analysis of Speaker Gender Representation at Hand Society Meetings.”
Authors: Jacobson Lauren A , Zhong Shuting S , Mackinnon Susan E , Novak Christine B , Patterson J Megan M 
Published: March 2023

Background:
The paucity of leadership diversity in surgical specialties is well documented. Unequal opportunities for participation at scientific meetings may impact future promotions within academic infrastructures. This study evaluated gender representation of surgeon speakers at hand surgery meetings.

Methods:
Data were retrieved from the 2010 and 2020 meetings of the American Association for Hand Surgery (AAHS) and American Society for Surgery of the Hand (ASSH). Programs were evaluated for invited and peer reviewed speakers excluding keynote speakers and poster presentations. Gender was determined from publicly available sources. Bibliometric data (h-index) for invited speakers was analyzed.

Results:
In 2010 at the AAHS (n=142) and ASSH meetings (n=180), female surgeons represented 4% of the invited speakers and in 2020 increased to 15% at AAHS (n=193) and 19% at ASSH (n=439). From 2010 to 2020, female surgeon invited speakers had a 3.75-fold increase at AAHS and 4.75-fold increase at ASSH. Representation of female surgeon peer reviewed presenters at these meetings was similar (2010 AAHS 26%, ASSH 22%; 2020 AAHS 23%, ASSH 22%). The academic rank of women speakers was significantly lower (p<0.001) than males. At the assistant professor level, the mean h-index was significantly lower (p<0.05) for female invited speakers.

Conclusion:
Although there was a significant improvement in gender diversity in invited speakers at the 2020 meetings compared to 2010, female surgeons remain underrepresented. Gender diversity is lacking at national hand surgery meetings and continued effort and sponsorship of speaker diversity is imperative to curate an inclusive hand society experience.

Level of Evidence:
3
Decreased Length of Stay and Opioid Usage After Liver Cancer Surgery With Enhanced Recovery Pathway Implementation
Authors: Nguyen Yvonne , Fernandez Leopoldo , Trainer Brooke , McNulty Marilyn , Kazior Michael R. 
Published: March 2023

Background and Objectives:
Enhanced recovery after surgery (ERAS) pathways are associated with better postoperative recovery; however, evidence is lacking in liver cancer surgery. This study aimed to evaluate the impact of an ERAS pathway in US veterans undergoing liver cancer surgery.

Methods:
We initiated an ERAS pathway for liver cancer surgery with preoperative, intraoperative, and postoperative interventions, which included a novel regional anesthesia technique, erector spinae plane block, for multimodal analgesia management. A retrospective quality improvement study was conducted with patients undergoing elective open hepatectomy or microwave ablation of liver tumors before and after ERAS pathway implementation.

Results:
With 24 patients in the post-ERAS group and 23 patients in the pre-ERAS group, we found a significant decreased length of stay in the ERAS group (4.1 days ± 3.9) compared with traditional care (8.6 days ± 7.1, P = .01) and decreased perioperative opioid consumption including intraoperative opioids (post-ERAS 49.8 mg ± 28.5 vs pre-ERAS 98 mg ± 42.3, P = 4.1E-5), postoperative opioids (post-ERAS 65.3 mg ± 59.9 vs pre-ERAS 175.7 mg ± 210.6, P = .018), and patient-controlled analgesia requirements (post-ERAS 0% vs pre-ERAS 50%, P < .001).

Conclusion:
The implementation of ERAS for liver cancer surgery in our veteran population translates into decreased length of stay and perioperative opioid consumption. Although this study is limited as a quality improvement project implemented at one institution with a small sample size, our results are clinically and statistically significant and sufficient to warrant further investigation into the efficacy of ERAS as the surgical needs of the US veteran population increase.
Are Surgical Approaches Correlated With BREAST-Q Score Improvements After Reduction Mammoplasty? A Systematic Review
Authors: Liao Christopher D. , Xia Joyce , Zhao Kelley , Wang Katherine , Glickman Laurence T. , Agrawal Nikhil A. 
Published: March 2023

Background
Despite the commonly recognized benefits and drawbacks of each surgical technique for reduction mammoplasty, data on the influence of each surgical approach on patient quality of life and satisfaction remains limited. Our study aims to evaluate the association between surgical factors and BREAST-Q scores for reduction mammoplasty patients.

Methods
A literature review through August 6, 2021, was conducted using the PubMed database to select publications that used the BREAST-Q questionnaire to evaluate outcomes after reduction mammoplasty. Studies examining breast reconstruction, breast augmentation, oncoplastic reduction, or breast cancer patients were excluded. The BREAST-Q data were stratified by incision pattern and pedicle type.

Results
We identified 14 articles that met selection criteria. Among 1816 patients, the mean age ranged from 15.8 to 55 years, mean body mass index ranged from 22.5 to 32.4 kg/m2, and bilateral mean resected weight ranged from 323 to 1845.96 g. Overall complication rate was 19.9%. On average, satisfaction with breasts improved by 52.1 ± 0.9 points (P < 0.0001), psychosocial well-being improved by 43.0 ± 1.0 points (P < 0.0001), sexual well-being improved by 38.2 ± 1.2 points (P < 0.0001), and physical well-being improved by 27.9 ± 0.8 points (P < 0.0001). No significant correlations were observed when mean difference was modeled against complication rates or prevalence of superomedial pedicle use, inferior pedicle use, Wise pattern incision, or vertical pattern incision. Complication rates were not correlated with preoperative, postoperative, or mean change in BREAST-Q scores. A negative correlation was noted between the prevalence of superomedial pedicle use and postoperative physical well-being (Spearman rank correlation coefficient [SRCC], −0.66742; P < 0.05). The prevalence of Wise pattern incision was negatively correlated with postoperative sexual well-being (SRCC, −0.66233; P < 0.05) and physical well-being (SRCC, −0.69521; P < 0.05).

Conclusions
Although either preoperative or postoperative BREAST-Q scores may be individually influenced by pedicle or incision type, there was no statistically significant effect of surgical approach or complication rates on the average change of these scores, and overall satisfaction and well-being scores improved. This review suggests that any of the main surgical approaches to reduction mammoplasty provide equally substantial improvements in patient-reported satisfaction and quality of life, but more robust comparative studies would strengthen this area of research.
Anatomical Reconstruction of Extensive Inferomedial Blow-Out Fractures Involving the Inferomedial Orbital Strut Using a Single Fan-shaped Titanium-Reinforced Porous Polyethylene Plate
Authors: Jeong Seong-Ho , Moon Kyung-Chul , Namgoong Sik , Dhong Eun-Sang , Han Seung-Kyu 
Published: March 2023

Extensive inferomedial blow-out fractures involving the inferomedial orbit strut frequently result in severe ophthalmic complications. Therefore, anatomical reconstruction is essential but is still technically challenging. Thus, the authors have used a novel technique using a combination of single fan-shaped titanium-reinforced porous polyethylene (TR-PPE) implants and a bidirectionally extended transconjunctival approach. Herein, the authors describe our surgical technique and discuss its effectiveness. First, the transconjunctival approach was performed and was subsequently extended medially using the transcaruncular approach and laterally using lateral blepharotomy. After the origin of the inferior oblique muscle was identified, a trimmed fan-shaped TR-PPE implant was inserted into the orbital floor. It was subsequently rotated and bent at the site of origin of the IO muscle and moved upward to cover the superior bony ledge of the medial wall. Finally, the implant was fixed to the orbital rim. Anatomical orbital reconstruction was confirmed by a computed tomographic scan. The preoperative diplopia in 19 patients, resolved within 1 week in 16 patients and in 3 to 6 months in the remaining 3 patients. Preoperative enophthalmos >2 mm in all patients improved to <2 mm in 67 patients and 3 mm in 2 patients (>7 mm preoperatively). The postoperative course was uneventful, and no severe complications were observed. The authors believe that the placement of a fan-shaped TR-PEE implant into the orbit through the bidirectionally extended transconjunctival approach could be a viable option for the anatomical reconstruction of extensive inferomedial blow-out fractures involving the inferomedial orbital strut.
Beyond the Surgical Safety Checklist
Authors: Ramjaun Aliya , Hammond Mobilio Melanie , Wright Nicole , Masella Maria , Snyman Adam , Serrick Cyril , Moulton Carol-anne 
Published: March 2023

Background:
The surgical safety checklist (SSC) has been credited with improving team situation awareness (SA) in the operating room. Although the SSC may support team SA at the outset of the operative case, intraoperative handoff provides an opportunity for either SA breakdown or, more preferably, SA reinforcement. High-functioning surgical teams demonstrate a high level of continued SA, whereas teams deficient in SA are more likely to be affected by surgical errors and adverse events. To date, no interprofessional intraoperative tools exist to support team SA beyond the SSC.

Methods:
This study was divided into 2 phases. The first used qualitative methods to (1) characterize intraoperative handoff processes across surgery, nursing, anesthesia, and perfusion, and (2) identify cultural factors that shaped handoff practices. Data for phase one were collected over 38 observation days and 41 brief interviews. Phase 2, informed by phase 1, used a modified Delphi process to create a tool for use during intraoperative handoff. Data were analyzed iteratively.

Results:
Handoff practices were not standardized and rarely involved the entire team. In addition we uncovered cultural factors—specifically assumptions held by participants—that hindered team communication during handoff. Assumptions included: (1) team members are interchangeable, (2) trained individuals are able to determine when it is appropriate to handoff without consulting the OR team. Despite claims of improved teamwork resulting from the SSC, many participants held a fragmented view of the OR team, resulting in communication challenges during handoff. Findings from both phases of our study informed the development of multidisciplinary intraoperative handoff tools to facilitate shared team situation awareness and a shared mental model.

Conclusions:
Intraoperative handoff occurs frequently, and offers the opportunity for either renewed or fractured team SA beyond the SSC.
Surgical Outcomes in Patients With Low-risk Papillary Thyroid Microcarcinoma From MAeSTro Study
Authors: Hwang Hyeonuk , Choi June Young , Yu Hyeong Won , Moon Jae Hoon , Kim Ji-hoon , Lee Eun Kyung , Kim Yeo Koon , Lee Chang Yoon , Cho Sun Wook , Chung Eun-Jae , Ryu Chang Hwan , Ryu Junsun , Yi Ka Hee , Park Do Joon , Lee Kyu Eun , Park Young Joo , Kim Su-jin , Jung Yuh-Seog 
Published: March 2023

Objective:
To investigate surgical, and clinical outcomes in patients with low-risk papillary thyroid microcarcinoma (PTMC) according to treatment options [immediate operation (IOP) vs delayed operation after active surveillance (AS) (DOP)].

Background:
AS has been adopted as an alternative to immediate surgery in patients with low-risk PTMC. Although some patients undergo surgery during AS, there is little information on surgical, and clinical outcomes after delayed operation after AS.

Methods:
A multicenter prospective cohort study including 1177 patients was conducted at 3 tertiary hospitals in Korea from June 2016 to January 2020. Patients with low-risk PTMC were enrolled. The participants were self-assigned into AS or IOP, and during AS, the patients underwent surgery if there were signs of disease progression or if the patient’s choice changed.

Results:
A total of 516 patients underwent operation; 384 (74.4%) in the IOP group and 132 (25.6%) in the DOP group. Compared with the IOP group, the DOP group was significantly associated with a larger tumor size (P=0.002), higher rates of lymphatic invasion (P=0.002), and multifocality (P=0.008). However, the rates of total thyroidectomy, postoperative hypoparathyroidism and vocal cord palsy did not differ significantly between the groups (P= 0.283, P=0.184, and P=0.284, respectively). Of the 132 patients in the DOP group, disease progression was present in 39 (29.5%) patients. The DOP group with disease progression had a significantly higher rate of lymph node metastasis (P=0.021) and radioiodine therapy (P=0.025) than the DOP group without disease progression.

Conclusions:
These results suggest that AS might be considered an alternative treatment option for patients with low-risk PTMC regarding the extent of thyroidectomy and postoperative complications in the DOP group. To assess oncologic outcomes, long-term follow-up will be needed.

Trial registration:
ClinicalTrials.gov Identifier: NCT02938702.
Early mitochondrial dysfunction proceeds neuroinflammation, synaptic alteration, and autophagy impairment in hippocampus ofAppknock-in Alzheimer mouse models
Authors: Naia Luana , Shimozawa Makoto , Bereczki Erika , Li Xidan , Liu Jianping , Jiang Richeng , Leal Nuno Santos , Pinho Catarina Moreira , Berger Erik , Falk Victoria Lim , Dentoni Giacomo , Ankarcrona Maria , Nilsson Per 
Published: March 2023

ABSTRACTIncreased amyloid β-peptide (Aβ) level is one of the drivers of Alzheimer’s disease (AD). Amyloid precursor protein (App) knock-in mice recapitulate the human Aβ pathology, allowing the elucidation of the downstream effects of Aβ and their temporal appearance upon disease progression. Here we have investigated the sequential onset of AD-like pathologies in theAppNL-FandAppNL-G-Fknock-in mouse models by time-course transcriptome analysis of the hippocampus, a region severely affected in AD. Energy metabolism emerged as one of the most significantly altered pathways at an early stage of the development of the pathologies. Functional experiments in mitochondria isolated fromAppNL-G-Fbrain subsequently identified upregulation of oxidative phosphorylation driven by the activity of mitochondrial complexes I, IV and V, combined with higher susceptibility to Ca2+-overload. This was followed by a strong neuroinflammatory response and impaired autophagy. Accumulation of autophagosomes and reduced number of mitochondria content in presynaptic terminals could account for the altered synapse morphology including increased number of synaptic vesicles and lowered thickness of post synaptic density inAppNL-G-Fmice. This shows that Aβ-induced pathways in theAppknock-in mice recapitulate some key pathologies observed in AD brain, and our data herein contributes to the understanding of their timewise appearance and potential role in new therapeutic approaches.
Post-progression survival in advanced non-small cell lung cancer treated with anti-PD-1/PDL-1 monotherapy: progression after durable clinical benefit versus primary resistance
Authors: Pourmir Ivan , Elaidi Reza , Maaradji Zineb , de Saint Basile Hortense , Ung Monivann , Gazeau Benoit , Fournier Laure , Rance Bastien , Gibault Laure , Ismaili Mohammed , Fabre Elizabeth 
Published: March 2023

ABSTRACTAimsAnti-PD-1/PD-L1 can face the issue of tumor resistance in advanced non-small cell lung cancer (aNSCLC), mostly as primary resistance to the treatment. Still, disease progression (PD) also occurs after prior durable clinical benefit (DCB). Comparison of both situations and tools to evaluate residual benefit of PD-1/PD-L1 blockade are needed to understand and manage resistance.MethodsWe reviewed aNSCLCs with anti-PD-1/PD-L1 monotherapy, and disease progression per RECIST 1.1 (PD) in our center. Primary objective was comparison of post-progression survival (PPS) in primary resistance versus PD after DCB. Secondary objectives were to characterize patterns of PD after DCB; assess the feasibility and relevance of Tumor Growth Rate (TGR) in PD after DCB.Results148 patients were included. Median PPS were 5.2months (95% CI: 2.6-6.5) and 21.3months (95% CI: 18.5-36.3) (p<0.0001) for primary resistance and PD after DCB respectively. Multivariable hazard ratio for death in PD after DCB versus primary resistance was 0.14 (95% CI: 0.07-0.30). 76.7% of PD after DCB occurred in ≤3 lesions; 72.1% occurred only in preexisting lesions. TGR suggested a persistent benefit of PD-1/PD-L1 blockade in at least 44.2% of cases.ConclusionsPD after DCB was an independent factor of longer post-progression survival, with specific patterns of progression. TGR is a promising tool to assess residual benefit of immunotherapy.HighlightsAnti-PD-(L)1 immunotherapy still faces the problem of resistance in lung cancerResistance can be classified as primary or secondary (acquired)Outcomes and mechanisms of both situations need to be characterizedThis unique comparative study reveals diverging survival and progression patternsPrior durable clinical benefit associates with longer post-progression survivalThis data benefits our understanding and management of resistance to anti-PD-(L)1