bluuebunny/crossref_metadata_2025_split huggingface dataset:
118: PROGNOSTIC SIGNIFICANCE OF EXTRACAPSULAR LYMPH NODE INVOLVEMENT AFTER GASTRECTOMY FOR GASTRIC ADENOCARCINOMA
Authors: Prasad P , Chmelo J , Wahed S , Navidi M , Phillips A 
Published: April 2022

Abstract

Background and aim
Lymph node involvement is a key prognostic indicator in gastric adenocarcinoma. Little is known of the impact of extracapsular lymph node involvement (LNI) upon the prognosis of patients undergoing curative resection of gastric cancer. The aim of this study was to assess the incidence and prognostic significance of extracapsular LNI in patients undergoing a gastrectomy for gastric adenocarcinoma.

Methods
Consecutive patients who underwent a subtotal or total gastrectomy with curative intent for adenocarcinoma of the stomach or gastro-oesophageal junction in a single, high-volume U.K. centre between 2010 and 2018 were identified from contemporaneously maintained database. Patients with a pN0 status on final histology and those who died in-hospital were excluded from analysis. Factors associated with survival were studied with univariable and multivariable cox regression analysis. A P value of &lt;0.05 was deemed significant.

Results
The study included 235 patients. A median (IQR) of 32 (24–43) lymph nodes were resected and median (IQR) 4 (1–9) lymph nodes were positive. Of them, extracapsular LNI was identified in 123 (52%) of patients. Factors associated with survival on univariable analysis were R1 resection (P = 0.001), p/ypT stage (P &lt; 0.001), p/ypN stage (P &lt; 0.001) and extracapsular LNI (P = 0.001). Median survival among patients who had extracapsular LNI was 19 months versus 49 months among patients who did not (P &lt; 0.001). Extracapsular LNI was not an independent predictor of survival on multivariable analysis (P = 0.535).

Conclusion
Extracapsular LNI is associated with poor prognosis among patients undergoing a curative gastrectomy. However, it is not an independent predictor of survival among this patient cohort.
119: METASTASECTOMY OR STEREOTACTIC BODY RADIATION THERAPY FOR OLIGOMETASTATIC ESOPHAGOGASTRIC CANCER: A NATIONWIDE POPULATION-BASED COHORT STUDY
Authors: Kroese T , Jorritsma N , Haj Mohammad N , Mook S , Ruurda J , Verhoeven R , Van Rossum P , Van Laarhoven H , Van Hillegersberg R 
Published: April 2022

Abstract

Background and aim
This nationwide population-based study analyzed the outcome of local treatment for oligometastatic esophagogastric cancer in The Netherlands.

Methods
Patients with synchronous or metachronous oligometastasis (i.e. distant metastasis in 1 organ/extra-regional lymph node station) from esophagogastric cancer were eligible for inclusion from Netherlands Cancer Registry. Patients who underwent local treatment (i.e. metastasectomy or stereotactic body radiation therapy [SBRT]) for oligometastasis were included. The overall survival (OS) after diagnosing oligometastasis was determined. Independent prognostic factors for OS were analyzed using a multivariable Cox proportional hazard model.

Results
Between 2015–2016, some 2,336 eligible patients with oligometastasis were identified of whom 103 (4%) underwent local treatment for oligometastasis. This portion was higher in academic hospitals (10%) compared to non-academic hospitals with esophagogastric resections (5%) or without esophagogastric resections (3%, P &lt; 0.001). The 103 included patients were predominantly diagnosed with esophageal cancer (85%) with adenocarcinoma histology (80%) and with metachronous oligometastasis (59%). The oligometastasis were located in a distant organ (79%), an extra-regional lymph node station (12%), or the peritoneum (9%). Treatment for oligometastasis included metastasectomy (45%), SBRT (40%), or both (15%), and 21% of patients received additional systemic therapy. Median OS was 18.1 months (95% confidence interval [CI]: 13.9–22.7). The OS rate at 2-year was 36% and at 3-year 23%. Improved OS was independently associated with additional systemic therapy (hazard ratio [HR] 0.47, 95% CI: 0.23–0.96) and better performance scores (HR 0.55, 95% CI: 0.29–0.92).

Conclusion
A minority of patients underwent local treatment for oligometastatic esophagogastric cancer, which was dependent on the type of hospital of diagnosis. Local treatment for oligometastasis resulted in a median OS of 1.5 years. Systemic therapy combined with local treatment for oligometastasis improved OS.
131: THE EFFECT OF PANCREATIC ENZYME REPLACEMENT THERAPY ON COMPLAINTS OF MALABSORPTION AFTER ESOPHAGECTOMY FOR CANCER
Authors: Blonk L , Zwolsman M , Wierdsma N , Van Der Peet D , Straatman J 
Published: April 2022

Abstract

Background and aim
Pancreatic enzymes are often prescribed in clinical practice to treat complaints of maldigestion and malabsorption after esophagectomy for cancer, but knowledge regarding the effect of this treatment on malabsorption related complaints is lacking. Aim of this study is to evaluate the presence of malabsorption related complaints after esophagectomy and to determine whether treatment with pancreatic enzymes is effective.

Methods
This single-center, retrospective cohort study included patients after esophagectomy for cancer between 2014 and 2019 at Amsterdam UMC location VU medical center. Medical charts of patients with a postoperative follow-up period of at least 6 months were screened. Endpoints of this study were (1) patient reported signs of malabsorption, defined as; steatorrhea or diarrhea alone, or in combination with weight loss, abdominal pain, flatulence or abdominal bloating, and (2) the effect of treatment with pancreatic enzymes on these complaints.

Results
This cohort included 184 patients. Median postoperative follow-up was 24 months (range 6–78 months). Complaints of postoperative malabsorption were present in 38.6%. Of all patients suffering from malabsorption related complaints, 59.2% received an empirical trial with pancreatic enzymes. The majority of patients (85.7%) reported a positive effect of treatment with pancreatic enzymes, varying from a complete resolution, to a mild reduction of symptoms. Median period between surgery and starting pancreatic enzymes was 7 months (range 0–53 months).

Conclusion
Based on these data, pancreatic enzymes seem to be effective in the treatment of malabsorption related complaints after esophagectomy for cancer and should therefore be considered in postoperative patients reporting malabsorption related complaints.
170: SHORT AND LONG TERM OUTCOMES IN ELDERLY PATIENTS WITH ESOPHAGEAL CANCER: UPFRONT ESOPHAGECTOMY COMPARED TO SURGERY AFTER NEOADJUVANT TREATMENTS
Authors: Moletta L , Capovilla G , Pierobon E S , Carrillo L , Ciccioli E , Zanchettin G , Provenzano L , Salvador R , Costantini M , Merigliano S , Valmasoni M 
Published: April 2022

Abstract

Background and aim
The current standard of care in treating locally-advanced esophageal cancer has been established after the publication of the landmark CROSS trial and several others, which demonstrated an overall survival benefit from preoperative chemoradiation prior to esophagectomy in this setting. However, elderly patients have been generally excluded from randomized study protocols, so literature regarding the choice of the best treatment approach for resectable esophageal cancer in patients older than 75 years old is limited. The aim of this study was to characterize outcomes associated with neoadjuvant chemoradiation prior to esophagectomy, compared to esophagectomy alone, in older patients with esophageal cancer.

Methods
We conducted a retrospective study in patients ≥75 years with locally-advanced esophageal cancer (both adenocarcinoma -EAC and squamous cell carcinoma -SCC) undergoing esophagectomy ± neoadjuvant chemoradiation at our Center between 2000 and 2020.

Results
A total of 141 patients were included in the study. Patients were subcategorized into two groups: patients undergoing upfront surgery (SURG, n = 97) and patients undergoing neoadjuvant therapy before surgery (NAT, n = 44). Patients in the NAT group experienced a significantly higher postoperative morbidity when compared to the SURG group. Overall survival (21 months and 25 months, p = 0.8883) and cancer-related survival (20 and 25 months, p 0.8052) were not statistically different between the SURG and the NAT group. When looking to the histology, OS for EAC and for SCC did not significantly differ between the 2 groups. We subcategorized patients according to their final pathological stage into patients with pTNM stage I and II, and patients with stage III and IV. Among patients with EACs stage III-IV, the NAT group experienced a significant benefit in OS when compared to the SURG group. Univariate analysis for risk factors for postoperative morbidity showed a significant association between NAT and postoperative complications (p 0,0336). Multivariate analysis confirmed neoadjuvant therapy as an independent prognostic factor for morbidity (P 0,0226).

Conclusion
In our study, patients undergoing NAT before surgery experienced a higher postoperative morbidity when compared to patients undergoing upfront esophagectomy. Further studies are needed to identify which older patients are most suitable for neoadjuvant therapy before esophagectomy.
213: IMPACT OF ROUTINE FEEDING VIA JEJUNOSTOMY AFTER OESOPHAGECTOMY
Authors: Khaw R A , Macdonald J , Munro S , Phillips A W 
Published: April 2022

Abstract

Background and aim
Oesophageal cancer is the 8th most common cancer worldwide, with oesophagectomy remaining the mainstay curative treatment, despite significant associated morbidity and mortality. Postoperative weight loss remains a significant problem and is directly correlated to poor prognosis. Measures such as the Enhanced Recovery After Surgery (ERAS) programme and intraoperative jejunostomy feed placement have looked to tackle this. Our aim was to investigate the impact of supplemental jejunostomy feed in practice on mortality, length of hospital stays and postoperative weight loss in a high-volume regional centre.

Methods
Patients undergoing oesophagectomy between January 2012–December 2014 and January 2016–December 2019 in a national tertiary oesophagogastric unit were included retrospectively. Variables measured included comorbidities, operation, histopathology, weights (pre- and post-operatively), length of hospital stay, postoperative complications and mortality. Survival data were analysed using R Studio, Inc.

Results
566 patients were included. Median age at diagnosis was 66 years (30–85). Majority of cases were adenocarcinoma (72.6%), or squamous cell carcinoma (22.3%). Severe weight loss &gt;10% of pre-operative weight was seen in 38.6% and 47.6% of patients discharged without jejunostomy feed, and 4.87% and 0.64% of those discharged with jejunostomy feeds at 3- and 6-months respectively. Median length of stay was 15 days (7–92) and 12 days (6–338) for patients discharged without and with jejunostomy feeds, respectively. Overall median survival in patients discharged without jejunostomy was 52 months (P = 0.035), and in those discharged with jejunostomy, 48 months (P = 0.044).

Conclusion
Postoperative malnutrition has associated poor outcomes. Perioperative nutritional support, to include postoperative jejunal feeding post-discharge can reduce weight loss, and influence survival as well as length of hospital stay. Further randomised trials are needed in order to optimise recovery and morbidity in patients post-oesophagectomy.
Multi-level correlates of received social support among heart transplant recipients in the international BRIGHT Study: a secondary analysis
Authors: Abshire Saylor Martha , Denhaerynck Kris , Mielke Juliane , Davidson Patricia M , Dobbels Fabienne , Russell Cynthia L , De Geest Sabina 
Published: April 2022

Abstract

Aims
Social support is critical in follow-up of patients after heart transplant (HTx) and positively influences well-being and clinical outcomes such as medication adherence. The purpose of this study was to (i) explore received social support variation (emotional and practical) in HTx recipients at country and centre level and (ii) to assess multi-level correlates.

Methods and results
Secondary data analysis of the multi-level cross-sectional BRIGHT study was conducted in 36 HTx centres in 11 countries. Received social support related to medication adherence was measured with emotional and practical sub-scales. The Conceptual Model of Social Networks and Health guided selection of patient, micro (interpersonal and psychosocial), meso (HTx centre) and macro-level (country health system) factors. Descriptive statistics, intraclass correlations, and sequential multiple ordinal mixed logistic regression analysis were used. A total of 1379 adult HTx recipients were included. Patient level correlates (female sex, living alone, and fewer depressive symptoms) and micro-level correlates (higher level of chronic disease management and trust in the healthcare team) were associated with better emotional social support. Similarly, patient level (living alone, younger age, and male sex), micro-level and meso-level (patient and clinician-rated higher level of chronic disease management) were associated with better practical social support. Social support varied at country and centre levels for emotional and practical dimensions.

Conclusions
Social support in HTx recipients varies by country, centre, and was associated with multi-level correlates. Qualitative and longitudinal studies are needed to understand influencing factors of social support for intervention development, improvement of social support, and clinical outcomes.
Protection by Vaccines and Previous Infection Against the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2
Authors: Šmíd Martin , Berec Luděk , Přibylová Lenka , Májek Ondřej , Pavlík Tomáš , Jarkovský Jiří , Weiner Jakub , Barusová Tamara , Trnka Jan 
Published: April 2022

Abstract

Background
The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) evades immunity conferred by vaccines and previous infections.

Methods
We used a Cox proportional hazards model and a logistic regression on individual-level population-wide data from the Czech Republic to estimate risks of infection and hospitalization, including severe states.

Results
A recent (≤2 months) full vaccination reached vaccine effectiveness (VE) of 43% (95% confidence interval [CI], 42%–44%) against infection by Omicron compared to 73% (95% CI, 72%–74%) against Delta. A recent booster increased VE to 56% (95% CI, 55%–56%) against Omicron infection compared to 90% (95% CI, 90%–91%) for Delta. The VE against Omicron hospitalization of a recent full vaccination was 45% (95% 95% CI, 29%–57%), with a recent booster 87% (95% CI, 84%–88%). The VE against the need for oxygen therapy due to Omicron was 57% (95% CI, 32%–72%) for recent vaccination, 90% (95% CI, 87%–92%) for a recent booster. Postinfection protection against Omicron hospitalization declined from 68% (95% CI, 68%–69%) at ≤6 months to 13% (95% CI, 11%–14%) at &gt;6 months after a previous infection. The odds ratios for Omicron relative to Delta were 0.36 (95% CI, .34–.38) for hospitalization, 0.24 (95% CI, .22–.26) for oxygen, and 0.24 (95% CI, .21–.28) for intensive care unit admission.

Conclusions
Recent vaccination still brings substantial protection against severe outcome for Omicron.
A transfer learning-based particle swarm optimization algorithm for travelling salesman problem
Authors: Zheng Rui-zhao , Zhang Yong , Yang Kang 
Published: April 2022

Abstract
To solve travelling salesman problems (TSPs), most existing evolutionary algorithms search for optimal solutions from zero initial information without taking advantage of the historical information of solving similar problems. This paper studies a transfer learning-based particle swarm optimization (PSO) algorithm, where the optimal information of historical problems is used to guide the swarm to find optimal paths quickly. To begin with, all cities in the new and historical TSP problems are clustered into multiple city subsets, respectively, and a city topology matching strategy based on geometric similarity is proposed to match each new city subset to a historical city subset. Then, on the basis of the above-matched results, a hierarchical generation strategy of the feasible path (HGT) is proposed to initialize the swarm to improve the performance of PSO. Moreover, a problem-specific update strategy, i.e. the particle update strategy with adaptive crossover and clustering-guided mutation, is introduced to enhance the search capability of the proposed algorithm. Finally, the proposed algorithm is applied to 20 typical TSP problems and compared with 12 state-of-the-art algorithms. Experimental results show that the transfer learning mechanism can accelerate the search efficiency of PSO and make the proposed algorithm achieve better optimal paths.
Hip arthroscopic management for treating a rhythmic gymnast with a large bone cyst at the femoral head in the setting of hip dysplasia—a case report
Authors: Fujiike Akira , Murata Yoichi , Hatakeyama Akihisa , Takada Shinichiro , Sakai Akinori , Uchida Soshi 
Published: April 2022

ABSTRACT
Recent literature lacks a clear understanding of how to manage bone cysts associated with hip dysplasia. This article aimed to report a case of hip dysplasia in a rhythmic gymnast surgically managed with arthroscopic retrograde bone grafting, labral repair, cam osteoplasty, double shoelace capsular closure and endoscopic shelf acetabuloplasty. A 20-year-old female college rhythmic gymnast presented complaining of right hip pain and discomfort for the past 2 months. This case report describes the use of the CROSSTRAC guide system to perform retrograde bone grafting to treat the bone cyst at the femoral head arthroscopically. Hip arthroscopic retrograde bone grafting, labral repair, cam osteoplasty, double shoelace capsular closure and endoscopic shelf acetabuloplasty are less invasive and beneficial for the treatment of bone cysts of the femoral head associated with hip dysplasia in symptomatic rhythmic gymnasts.
Identifying an Optimal Screen Mesh to Enable Augmentorium-Based Enhanced Biological Control of the Olive Fruit FlyBactrocera oleae(Diptera: Tephritidae) and the Mediterranean Fruit FlyCeratitis capitata(Diptera: Tephritidae)
Authors: Desurmont G A , Tannières M , Roche M , Blanchet A , Manoukis N C 
Published: April 2022

AbstractThe augmentorium is a cost-effective screened enclosure designed to receive fruits infested with insect pests, retain the pests inside but let their natural enemies escape to enhance biological control of pest populations. Screen selection is critical to ensure that an augmentorium is effective for a particular system. Here we tested five types of screens with a mini-augmentorium design and measured the escape of four insect species under laboratory conditions: the pests olive fruit fly Bactocera oleae (Rossi) (Diptera: Tephritidae) and Mediterranean fruit fly Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), and the parasitoids Psyttalia lounsburyi (Silvestri) (Hymenoptera: Braconidae) and Psyttalia ponerophaga (Silvestri) (Hymenoptera: Braconidae). The sex ratio of insects that escaped the screens was compared to the sex ratio of insects that could not escape. Results showed that one screen type (‘crystal mesh’) was the best for the purpose of designing a functional augmentorium: it retained 90% of B. oleae adults and 100% of C. capitata adults while letting 72% of Psyttalia lounsburyi adults and 94% of P. ponerophaga adults escape. The other screen types tested were suboptimal, either because they let too many flies freely escape or because they retained too many parasitoids. Sex ratio was almost always similar for insects that managed to escape the screens and insects that were retained, except for P. ponerophaga and the screen type ‘light mesh’. These results are promising for the development of a functional augmentorium against the olive fruit fly and further implementation against Mediterranean fruit fly.
Realization and optimization of a binary cycle power generating system using a low-grade heat source
Authors: Yang Wun-Hao , Hou Pin-Cheng , Shih Wei-Hung , Hsu Sung-Wei , Chen Yu-Bin 
Published: April 2022

Abstract
The low-grade heat source thermoelectric system generates electricity using a working fluid at temperature lower than 100°C or gas at temperature lower than 250°C. The system is usually composed of binary (1 + 0.5 × 2) cycles. Positive net output power or high efficiency of the system can only be feasible after optimization. Most works focused on the cycle of working fluid and treated the power consumptions of the other cycles as constants. However, both cycles should be comprehensively considered in optimization, especially when power consumptions vary with working conditions. This research selected an organic Rankine cycle thermoelectric system for demonstration. A thermodynamic model conforming to the target system was built. The temperature of the heat source and the pressure at expander inlet were tailored using the genetic algorithm. The best efficiency is 1.89%, and the largest net output power is 5.80 kW. Both results are better than those (efficiency = 1.59% and net output power = 5.34 kW) from benchmarks under the highest temperature of heat source and inlet pressure among possible working conditions. Experimental results are provided for both validation of the model and confirmation of the superiority of optimization results.
Investigation of the value of precipitins in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with a positive marker for Aspergillus species
Authors: Bellanger A P , Lallemand S , Tumasyan Horikian A , Navellou J C , Barrera C , Rouzet A , Scherer E , Reboux G , Piton G , Millon L 
Published: April 2022

Abstract

Although a high prevalence of COVID-19-associated pulmonary aspergillosis has been reported, it is still difficult to distinguish between colonization with Aspergillus fumigatus and infection. Concomitantly, similarities between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and hypersensitivity pneumonitis were suggested. The objective of this study was to investigate retrospectively if precipitin assays targeting A. fumigatus could have been useful in the management of SARS-CoV-2 patients hospitalized in an Intensive Care Unit (ICU) in 2020. SARS-CoV-2 ICU patients were screened for Aspergillus co-infection using biomarkers (galactomannan antigen, qPCR) and culture of respiratory samples (tracheal aspirates and bronchoalveolar lavage). For all these patients, clinical data, ICU characteristics and microbial results were collected. Electrosyneresis assays were performed using commercial A. fumigatus somatic and metabolic antigens. ELISA were performed using in-house A. fumigatus purified antigen and recombinant antigens.
Our study population consisted of 65 predominantly male patients, with a median ICU stay of 22 days, and a global survival rate of 62%. Thirty-five patients had at least one positive marker for Aspergillus species detection. The number of arcs obtained by electrosyneresis using the somatic A. fumigatus antigen was significantly higher for these 35 SARS-CoV-2 ICU patients (P 0.01, Welch's t-test). Our study showed that SARS-CoV-2 ICU patients with a positive marker for Aspergillus species detection more often presented precipitins towards A. fumigatus. Serology assays could be an additional tool to assess the clinical relevance of the Aspergillus species in respiratory samples of SARS-CoV-2 ICU patients.

Lay Summary
This study showed retrospectively that precipitin assays, such as electrosyneresis, could be helpful to distinguish between colonization and infection with Aspergillus fumigatus during the management of severe acute respiratory syndrome Coronavirus-2 (SARS CoV-2) patients in an intensive care unit.