bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of subclinical atherosclerosis in eosinophilic granulomatosis with polyangiitis
Authors: Bello Federica , Bettiol Alessandra , Silvestri Elena , Mattioli Irene , Urban Maria Letizia , Palermo Adalgisa , Mazzetti Matteo , Malandrino Danilo , Calcaterra Ilenia , Vaglio Augusto , Di Minno Matteo Nicola Dario , Emmi Giacomo , Prisco Domenico 
Published: July 2022

Abstract

Objectives
Patients affected by eosinophilic granulomatosis with polyangiitis (EGPA) display an increased risk of atherothrombotic events compared with the general population. An increased frequency of subclinical markers of atherosclerosis has been observed in other ANCA-associated vasculitis, but no specific study focused on EGPA. We therefore evaluated subclinical atherosclerosis in EGPA patients and in a control population.

Methods
Forty EGPA patients and 80 controls matched by age, sex and traditional cardiovascular risk factors underwent sonographic assessment of common carotid artery (CCA) intima–media thickness (IMT). The presence of plaques of the CCA was also investigated. The correlation between CCA-IMT and clinical and laboratory features was also assessed.

Results
Median CCA-IMT was significantly higher in EGPA patients compared with controls (P = 0.002). Also, the proportion of subjects with increased CCA-IMT and with presence of plaques was significantly higher among EGPA patients (P &lt; 0.001 for both). Moreover, within the EGPA cohort, CCA-IMT tended to increase with disease duration (P = 0.034) and corticosteroid cumulative dose (P = 0.004). No significant associations were found between CCA-IMT, ANCA status, other clinical features and therapeutic regimens. Notably, the prevalence of traditional cardiovascular risk factors was comparable in patients with vs without an increased CCA-IMT.

Conclusion
Ultrasound markers of subclinical atherosclerosis are increased in EGPA patients as compared with controls, independently of traditional cardiovascular risk factors.
A Sustainable Capital Asset Pricing Model (S-CAPM): Evidence from Environmental Integration and Sin Stock Exclusion
Authors: Zerbib Olivier David 
Published: July 2022

Abstract
This article shows how sustainable investing—through the joint practice of exclusionary screening and environmental, social, and governance (ESG) integration—affects asset returns. I develop an asset pricing model with partial segmentation and heterogeneous preferences. I characterize two exclusion premia generalizing Merton’s (1987) premium on neglected stocks and a taste premium that clarifies the relationship between ESG and financial performance. Focusing on US stocks, I estimate the model by applying it to sin stocks as excluded assets and using the holdings of green funds to proxy for environmental integration. The average annual exclusion effect is 2.79% for the period 1999–2019. Although the annual taste effect ranges from –1.12% to + 0.14% across industries for 2007–19, the taste effect spread between the top and bottom terciles of companies within each industry can exceed 2% per year. Finally, I estimate and explain the dynamics of these premia.
Proteomic biomarkers of Kleine–Levin syndrome
Authors: Hédou Julien , Cederberg Katie L , Ambati Aditya , Lin Ling , Farber Neal , Dauvilliers Yves , Quadri Mohammed , Bourgin Patrice , Plazzi Giuseppe , Andlauer Olivier , Hong Seung-Chul , Huang Yu-Shu , Leu-Semenescu Smaranda , Arnulf Isabelle , Taheri Shahrad , Mignot Emmanuel 
Published: July 2022

AbstractStudy ObjectivesKleine–Levin syndrome (KLS) is characterized by relapsing–remitting episodes of hypersomnia, cognitive impairment, and behavioral disturbances. We quantified cerebrospinal fluid (CSF) and serum proteins in KLS cases and controls.MethodsSomaScan was used to profile 1133 CSF proteins in 30 KLS cases and 134 controls, while 1109 serum proteins were profiled in serum from 26 cases and 65 controls. CSF and serum proteins were both measured in seven cases. Univariate and multivariate analyses were used to find differentially expressed proteins (DEPs). Pathway and tissue enrichment analyses (TEAs) were performed on DEPs.ResultsUnivariate analyses found 28 and 141 proteins differentially expressed in CSF and serum, respectively (false discovery rate &lt;0.1%). Upregulated CSF proteins included IL-34, IL-27, TGF-b, IGF-1, and osteonectin, while DKK4 and vWF were downregulated. Pathway analyses revealed microglial alterations and disrupted blood–brain barrier permeability. Serum profiles show upregulation of Src-family kinases (SFKs), proteins implicated in cellular growth, motility, and activation. TEA analysis of up- and downregulated proteins revealed changes in brain proteins (p &lt; 6 × 10−5), notably from the pons, medulla, and midbrain. A multivariate machine-learning classifier performed robustly, achieving a receiver operating curve area under the curve of 0.90 (95% confidence interval [CI] = 0.78–1.0, p = 0.0006) in CSF and 1.0 (95% CI = 1.0–1.0, p = 0.0002) in serum in validation cohorts, with some commonality across tissues, as the model trained on serum sample also discriminated CSF samples of controls versus KLS cases.ConclusionsOur study identifies proteomic KLS biomarkers with diagnostic potential and provides insight into biological mechanisms that will guide future research in KLS.
Beef Quality Assurance national rancher survey: program participation, best management practices, and motivations for joining future sustainability programs
Authors: Klopatek S C , Cantwell A M , Roche L , Stackhouse-Lawson K , Oltjen J W 
Published: July 2022

Abstract
Till date, with over 137,000 certified members, the most successful rancher educational program has been the Beef Quality Assurance (BQA) program. The BQA program was established in the mid-1990’s to improve animal health and welfare with a primary objective to reduce the incidence of injection site lesions by instructing producers to administer injections in the neck only. The present study investigated the drivers of this success to inform future rancher education programs around agricultural sustainability. An online multistate survey was administered to cattle ranchers in collaboration with state cattlemen’s associations to better understand rancher motivations for adopting new practices and to gain insight on current involvement in BQA. In total, the survey consisted of 45 questions and was divided into 3 sections: (1) rancher demographics, (2) BQA participation and current best management practice (BMP) application, and (3) willingness to join new rancher educational programs. Data from 842 respondents are including in this study. Of the survey participants, 70% were currently BQA certified or had been BQA certified at one time, and 30% had never been certified. Ranchers who were BQA certified at any time were less likely to administer injections in areas other than the neck compared to ranchers who were not certified (P &lt; 0.05), demonstrating the effectiveness of the BQA program. More than 80% of survey respondents who joined the BQA program stated they believed the BQA program improved animal health and welfare on their operation (n = 617). Among those who had not joined the BQA program, 40% believed BQA practices did not align with their ranching operation, while 38% had not heard of the BQA program (n = 256). The survey indicated that male ranchers, those with more years ranching, those with a larger percent of income coming from ranching, and ranches with larger total acres grazed were more likely to be BQA certified at any time (P &lt; 0.05). Finally, ranchers who were BQA certified at any time were more likely to state that joining a rancher sustainability program would be beneficial to their operation. In conclusion, not only did the survey provide valuable insight into BQA program adoption but highlighted how BQA pedagogy and program structure may be a suitable framework for creating future rancher sustainability programs.
A randomized controlled trial to evaluate efficacy and safety of early conversion to a low-dose calcineurin inhibitor combined with sirolimus in renal transplant patients
Authors: Zheng Xiang , Zhang Weijie , Zhou Hua , Cao Ronghua , Shou Zhangfei , Zhang Shuwei , Cheng Ying , Chen Xuchun , Ding Chenguang , Tang Zuofu , Li Ning , Shi Shaohua , Zhou Qiang , Chen Qiuyuan , Chen Gang , Chen Zheng , Zhou Peijun , Hu Xiaopeng , Zhang Xiaodong , Na Ning , Wang Wei 
Published: July 2022

Abstract

Background:
The calcineurin inhibitor (CNI)-based immune maintenance regimen that is commonly used after renal transplantation has greatly improved early graft survival after transplantation; however, the long-term prognosis of grafts has not been significantly improved. The nephrotoxicity of CNI drugs is one of the main risk factors for the poor long-term prognosis of grafts. Sirolimus (SRL) has been employed as an immunosuppressant in clinical practice for over 20 years and has been found to have no nephrotoxic effects on grafts. Presently, the regimen and timing of SRL application after renal transplantation vary, and clinical data are scarce. Multicenter prospective randomized controlled studies are particularly rare. This study aims to investigate the effects of early conversion to a low-dose CNI combined with SRL on the long-term prognosis of renal transplantation.

Methods:
Patients who receive four weeks of a standard regimen with CNI + mycophenolic acid (MPA) + glucocorticoid after renal transplantation in multiple transplant centers across China will be included in this study. At week 5, after the operation, patients in the experimental group will receive an additional administration of SRL, a reduction in the CNI drug doses, withdrawal of MPA medication, and maintenance of glucocorticoids. In addition, patients in the control group will receive the maintained standard of care. The patients’ vital signs, routine blood tests, routine urine tests, blood biochemistry, serum creatinine, BK virus (BKV)/ cytomegalovirus (CMV), and trough concentrations of CNI drugs and SRL at the baseline and weeks 12, 24, 36, 48, 72, and 104 after conversion will be recorded. Patient survival, graft survival, and estimated glomerular filtration rate will be calculated, and concomitant medications and adverse events will also be recorded.

Conclusion:
The study data will be utilized to evaluate the efficacy and safety of early conversion to low-dose CNIs combined with SRL in renal transplant patients.

Trial registration:
Chinese Clinical Trial Registry, ChiCTR1800017277.
The Impact of Combined Oral Contraceptives on Adolescents with Macromastia
Authors: Nuzzi Laura C. , Pramanick Tannishtha , Massey Gabrielle G. , Walsh Landis R. , McNamara Catherine T. , Firriolo Joseph M. , DiVasta Amy D. , Labow Brian I. 
Published: July 2022

Background:
The combined oral contraceptive pill (COC), containing both estrogen and progestin, is commonly prescribed to adolescents for numerous health benefits. However, there is concern among patients and providers that its use may exacerbate breast growth. This retrospective, case-control study examined the association between COC use and macromastia-related breast hypertrophy and symptomatology in adolescents.

Methods:
A total of 378 patients undergoing reduction mammaplasty between the ages of 12-21 years were assessed for baseline and postoperative breast symptomatology and COC use. Additionally, the medical records of 378 female controls of the same age range were retrospectively reviewed.

Results:
Although a lower proportion of the macromastia cohort used any hormonal contraception compared to controls (37.8% vs 64.8%; odds ratio, 0.33; 95% confidence interval, 0.24-0.44; P < .001), they were more often prescribed COCs (82.5% vs 52.7%; odds ratio, 1.93; 95% confidence interval, 1.29-2.68; P < .001). Participants with macromastia who used COCs had a smaller median normalized amount of breast tissue resected during reduction mammaplasty than those who never used hormonal contraception (639.5 g/m2 vs 735.9 g/m2
; P = .003). COCs were not associated with breast-related symptomology or clinical impairment, or postoperative breast growth (P > .05, all).

Conclusions:
COC use during adolescence may be associated with developing less severe breast hypertrophy. COCs do not appear to exacerbate macromastia-related symptomatology or impact postoperative growth in young women following reduction mammaplasty. Although additional research is needed, providers are encouraged to consider COCs for their patients with macromastia when indicated and appropriate.
A Statistical Analysis of The Effects of Comorbidities on the Inferior Pedicle Reduction Mammaplasty; Are there premorbid conditions which prohibit this procedure?
Authors: Friedman Harold , Schlub Riley , Durkin Martin , Clark Emily , Gilstrap Jarom , McGreevy Donna 
Published: July 2022

Background:
Multiple studies have analyzed the impact of co-morbidities on breast reduction surgery with mixed results. The purpose of this investigation was to perform a statistical analysis of all complications by a single surgeon, using a single technique for breast reduction

Methods:
Records of patients undergoing breast reduction from 1984 to 2019 with an inferior pedicle were reviewed. Co-morbidities analyzed included hypertension, diabetes, nicotine use, weight of breast tissue resected, pedicle length and basal metabolic index. The literature on the effects of comorbidities on outcomes for breast reconstruction were also reviewed.

Results:
Although increasing BMI significantly increased the rate of fat necrosis, it did not impact those patients requiring reoperation for this complication. BMI greater than 35, weight of tissue resection greater than 1000gm, and nipple to inframammary fold distance greater than 20cm all increased the odds ratio of having a breast with some fat necrosis. Increasing BMI increased the risk of wound healing problems (both major and minor), but not for patients requiring reoperation. BMI greater than 35, breast tissue resection greater than 1000gm, and nipple to fold distance greater than 20 only minimally increased the odds ratio for a major wound complication.

Conclusions:
Patients with increased BMI are at greater risk for fat necrosis and wound healing complications. However, these usually can be managed conservatively in patients undergoing inferior pedicle breast reduction. Patients do not require free nipple grafting. The use of nicotine, presence of diabetes or hypertension does not impact outcome.
Picking the Right Plane: A Comparison of Total Submuscular, Dual-Plane, and Prepectoral Implant-based Breast Reconstruction
Authors: Bekisz Jonathan M , Salibian Ara A , Frey Jordan D , Choi Mihye , Karp Nolan S 
Published: July 2022

Background:
Implant-based breast reconstruction has evolved, with a recent resurgence of prepectoral techniques. Comparative reconstructive outcomes and complications have not been fully elucidated among the total submuscular (TSM), dual-plane (DP), and prepectoral planes of implant placement.

Methods:
All immediate implant-based breast reconstructions from March 2017 through August 2019 were retrospectively reviewed. Cases were divided into TSM, DP, and prepectoral cohorts. Demographics, operative techniques, and reconstructive outcomes and complications were compared among groups.

Results:
826 cases (510 patients) were identified and divided into TSM (n=392), DP (n=358), and prepectoral (n=76) cohorts. Average follow-up for all patients was 27 months. The prepectoral cohort had a higher average BMI and rate of prior reduction/mastopexy. Overall complications were lowest in the TSM group, though this difference was not statistically significant. Major infection occurred more frequently in the DP group compared to the TSM cohort. The prepectoral cohort had a significantly increased incidence of wound dehiscence than the TSM group, while both the dual-plane and prepectoral groups had higher rates of seroma formation and explantation compared to TSM.

Conclusions:
Overall reconstructive complication rates were comparable among the cohorts. Compared to those undergoing TSM reconstruction, the DP cohort was more likely to develop a major infection or require explantation, while the prepectoral group had significantly higher rates of isolated dehiscence, seroma formation, and explantation. This suggest that the absence of overlying vascularized muscle may lead to an inherent inability to tolerate wound healing complications, though further research is needed to clarify these observations.
The Thoracodorsal Artery Perforator Flap: a Powerful Tool in Breast Reconstruction.
Authors: Homsy Christopher , Theunissen Taylor , Sadeghi Alireza 
Published: July 2022

Background:
The use of perforator-based flaps in breast cancer reconstruction has evolved significantly and surgical techniques have undergone major refinements in the last thirty years, making them the flaps of choice in autologous breast reconstruction. However, flap complications may lead to significant breast shape deformity and significant patient dissatisfaction. Restoring breast contour may therefore require multiple revision procedures.
In this study our objective was to review our experience and evaluate the outcomes of the thoracodorsal artery perforator (TDAP) flap in breast reconstruction.

Methods:
We conducted a retrospective chart review of all women undergoing breast reconstruction between 2012 and 2018. Inclusion criteria were patients who underwent a mastectomy (unilateral or bilateral) with immediate or requiring a revision reconstruction with TDAP. Patients with breast reconstruction for non-malignant etiologies were excluded from the study. Patient demographics, risk factors, indications, operative details, complications were extracted from medical records. Complications were divided into major (partial or total flap necrosis, hematoma, and wound breakdown requiring operative management) and minor complications (cellulitis, seroma, minor wound breakdown managed with local wound care).

Results:
One-hundred and thirty-eight charts were reviewed between the years 2012 and 2018. One-hundred and twenty-six patients met the inclusion criteria. Mean age was 52.1. Mean body mass index (BMI) was 29.1. A total of 174 TDAP flaps were performed: 171 pedicled and 3 free flaps. The success rate was 98.3%. There were 3 flap losses (all partial). Operable fat necrosis rate was 3%. Donor-site morbidity was low, accounting for a rate of only 1.2%. There was no difference in complication rate between patients who had a history of radiation to those who did not (16.7% vs. 18.6% respectively; p=0.829).

Conclusion:
Our study is the largest series in the literature that highlights the utility of the TDAP flap in breast reconstruction. The thoracodorsal artery perforator flap is a reproducible and reliable reconstructive tool that may be used to reconstruct breast deformities acquired from wound complications following both implant-based and autologous breast reconstructions. It is a powerful flap that should be considered particularly in patients in whom other major reconstructive options were exhausted or unavailable.
Robotic Distal Pancreatectomy
Authors: Müller Philip C. , Breuer Eva , Nickel Felix , Zani Sabino , Kauffmann Emanuele , De Franco Lorenzo , Tschuor Christoph , Krohn Paul Suno , Burgdorf Stefan K. , Jonas Jan Philipp , Oberkofler Christian E. , Petrowsky Henrik , Saint-Marc Olivier , Seelen Leonard , Molenaar Izaak Quintus , Wellner Ulrich , Keck Tobias , Coratti Andrea , van Dam Jacob L. , de Wilde Roeland , Koerkamp Bas Groot , Valle Valentina , Giulianotti Pier , Ghabi Elie , Moskal David , Lavu Harish , Vrochides Dionisios , Martinie John , Yeo Charles , Sánchez-Velázquez Patricia , Ielpo Benedetto , Ajay Pranay S. , Shah Mihir M. , Kooby David A. , Gao Song , Hao Jihui , He Jin , Boggi Ugo , Hackert Thilo , Allen Peter , Borel-Rinkes Inne H.M. , Clavien Pierre Alain 
Published: July 2022

Background and Objective:Robotic distal pancreatectomy (DP) is an emerging attractive approach, but its role compared with laparoscopic or open surgery remains unclear. Benchmark values are novel and objective tools for such comparisons. The aim of this study was to identify benchmark cutoffs for many outcome parameters for DP with or without splenectomy beyond the learning curve.Methods:This study analyzed outcomes from international expert centers from patients undergoing robotic DP for malignant or benign lesions. After excluding the first 10 cases in each center to reduce the effect of the learning curve, consecutive patients were included from the start of robotic DP up to June 2020. Benchmark patients had no significant comorbidities. Benchmark cutoff values were derived from the 75th or the 25th percentile of the median values of all benchmark centers. Benchmark values were compared with a laparoscopic control group from 4 high-volume centers and published open DP landmark series.Results:Sixteen centers contributed 755 cases, whereof 345 benchmark patients (46%) were included the analysis. Benchmark cutoffs included: operation time ≤300 minutes, conversion rate ≤3%, clinically relevant postoperative pancreatic fistula ≤32%, 3 months major complication rate ≤26.7%, and lymph node retrieval ≥9. The comprehensive complication index at 3 months was ≤8.7 without deterioration thereafter. Compared with robotic DP, laparoscopy had significantly higher conversion rates (5×) and overall complications, while open DP was associated with more blood loss and longer hospital stay.Conclusion:This first benchmark study demonstrates that robotic DP provides superior postoperative outcomes compared with laparoscopic and open DP. Robotic DP may be expected to become the approach of choice in minimally invasive DP.
Using real world data to advance the provision of supportive cancer care: mucositis as a case study
Authors: Wardill Hannah R. , Sonis Steve T. , Blijlevens Nicole M.A. 
Published: July 2022

Purpose of review
For decades, clinical decision making and practice has been largely informed by data generated through randomized clinical trials (RCTs). By design, RCTs are highly restricted in both scope and scale, resulting in narrow indications and iterative advances in clinical practice. With the transition to electronic health records, there are now endless opportunities to utilize these ‘real world’ data (RWD) to make more substantive advances in our understanding that are, by nature, more applicable to reality. This review discusses the current paradigm of using big data to advance and inform the provision of supportive cancer care, using mucositis as a case study.

Recent findings
Global efforts to synthesize RWD in cancer have almost exclusively focused on tumor classification and treatment efficacy, leveraging on routine tumor pathology and binary response outcomes. In contrast, clinical notes and billing codes are not as applicable to treatment side effects which require integration of both clinical and biological data, as well as patient-reported outcomes.

Summary
Cancer treatment-induced toxicities are heterogeneous and complex, and as such, the use of RWD to better understand their etiology and interaction is challenging. Multidisciplinary cooperation and leadership are needed to improve data collection and governance to ensure the right data is accessible and reliable.