bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Donor Sex in Females Undergoing Repeat Kidney Transplant: Does Prior Donor Sex Matter?
Authors: Craig Stephanie , Tennankore Karthik , Kiberd Bryce , Worthen George , Vinson Amanda 
Published: July 2022

Background.
Female recipients of male donor kidneys are at increased risk for graft failure because of the HY antigen effect. However, whether prior transplant with a male donor impacts subsequent transplant outcomes is unknown. Therefore, the purpose of this study was to determine whether prior male-current male donor sex is associated with an increased risk of graft failure in female recipients.

Methods.
We performed a cohort study of adult female recipients undergoing a second kidney transplant (2000–2017), identified using the Scientific Registry of Transplant Recipients. Using multivariable Cox models, we analyzed the risk of death-censored graft loss (DCGL) if the second transplant was from a male versus female kidney donor, conditional on donor sex at the time of the first transplant. In a secondary analysis, we stratified results by recipient age (>50 or ≤50 y) at the time of retransplant.

Results.
Of 5594 repeat kidney transplants, 1397 (25.0%) developed DCGL. Overall, there was no association between first and second donor sex pairing and DCGL. A prior and current female donor (FD1FD2) posed a higher risk for DCGL in recipients aged >50 y at second transplant (hazard ratio,≤0.67, confidence interval 0.46-0.98, for all other donor combinations), but posed a lower risk if aged ≤50 y at retransplant (hazard ratio, ≥1.37, confidence interval 1.04-1.80, for all other donor combinations).

Conclusions.
Overall, past-current donor sex pairing was not associated with DCGL in female recipients undergoing second kidney transplant; however, the risk with a past and current female donor was increased in older, and decreased in younger, female recipients at retransplant.
Long-Term Outcomes of Mesohepatectomy for Centrally Located Liver Tumors: Two-Decade Single-Center Experience
Authors: Mehrabi Arianeb , Ramouz Ali , Golriz Mohammad , Khajeh Elias , Hackert Thilo , Müller-Stich Beat , Strobel Oliver , Hoffmann Katrin , Büchler Markus W ,   Liver Cancer Center Heidelberg (LCCH)
Published: July 2022

BACKGROUND:
Mesohepatectomy is a viable treatment option for patients diagnosed with centrally located liver tumors (CLLTs). There are several reports from Eastern centers, but few data are available on this topic from Western centers.

STUDY DESIGN:
Data of 128 consecutive patients who underwent mesohepatectomy between September 2000 and September 2020 in our center were analyzed from a prospectively collected database. Patient demographic data, liver tumor characteristics, and intraoperative data were collected. In addition, posthepatectomy bile leakage (PHBL), posthepatectomy hemorrhage (PHH), posthepatectomy liver failure (PHLF), and 90-day mortality after mesohepatectomy were assessed. Long-term outcomes were also reported, and factors that may influence disease-free survival were evaluated.

RESULTS:
Of 128 patients, 113 patients (88.3%) had malignant hepatic tumors (primary and metastatic tumors in 41 [32%] and 72 [56.3%] patients, respectively), and 15 patients suffered from benign lesions (11.7%). Among the relevant surgical complications (grade B or C), PHBL was the most common complication after mesohepatectomy and occurred in 11.7% of patients, followed by PHLF in 3.1% of patients and PHH in 2.3% of patients. Only four patients (3.1%) died within 90 days after mesohepatectomy. The 5-year overall survival and overall recurrence (for malignant lesion) rates were 76.5% and 45.1%, respectively.

CONCLUSION:
Mesohepatectomy is a safe and feasible surgical treatment with low morbidity and mortality for patients with CLLT. Long-term outcomes can be improved by increased surgical expertise.
Surgical Care of Patients Experiencing Homelessness: A Scoping Review Using a Phases of Care Conceptual Framework
Authors: Abel Mary Kathryn , Schwartz Hope , Lin Joseph A , Decker Hannah C , Wu Christopher L , Grant Michael C , Kushel Margot , Wick Elizabeth C 
Published: July 2022

Homelessness is a growing concern across the world, particularly as individuals experiencing homelessness age and face an increasing burden of chronic health conditions. Although substantial research has focused on the medical and psychiatric care of patients experiencing homelessness, literature about the surgical care of these patients is sparse. Our objective was to review the literature to identify areas of concern unique to patients experiencing homelessness with surgical disease. A scoping review was conducted using a comprehensive database for studies from 1990 to September 1, 2020. Studies that included patients who were unhoused and discussed surgical care were included. The inclusion criteria were designed to identify evidence that directly affected surgical care, systems management, and policy making. Findings were organized within a Phases of Surgical Care framework: preoperative care, intraoperative care, postoperative care, and global use.
Our search strategy yielded 553 unique studies, of which 23 met inclusion criteria. Most studies were performed at public and/or safety-net hospitals or via administrative datasets, and surgical specialties that were represented included orthopedic, cardiac, plastic surgery trauma, and vascular surgery. Using the Surgical Phases of Care framework, we identified studies that described the impact of housing status in pre- and postoperative phases as well as global use. There was limited identification of barriers to surgical and anesthetic best practices in the intraoperative phase. More than half of studies (52.2%) lacked a clear definition of homelessness. Thus, there is a marked gap in the surgical literature regarding the impact of housing status on optimal surgical care, with the largest area for improvement in the intraoperative phase of surgical and anesthetic decision making. Consistent use of clear definitions of homelessness is lacking. To promote improved care, a standardized approach to recording housing status is needed, and studies must explore vulnerabilities in surgical care unique to this population.
Is Previous Postoperative Infection an Independent Risk Factor for Postoperative Infection after Second Unrelated Abdominal Operation?
Authors: Feldt Susan L , Keskey Robert , Krishnan Pranav , Hyman Neil H , Shogan Benjamin D 
Published: July 2022

BACKGROUND:
Infections after abdominal surgery remain a significant problem. Although preoperative antibiotic prophylaxis is a primary strategy used to reduce postoperative infections, it is typically prescribed based on standardized protocols, without attention to previous infection or antibiotic history. Patients with a previous infection after surgery may be at higher risk for infectious complications after subsequent operations owing to antibiotic resistance. We hypothesized that a previous postoperative infection is a significant risk factor for the development of infection after a second unrelated surgery.

STUDY DESIGN:
We performed a retrospective study of patients who had undergone 2 unrelated abdominal operations at a tertiary care center from 2012 to 2018. Clinical variables and microbiological culture results were abstracted. Univariate and multivariable regression models were constructed.

RESULTS:
Of 758 patients, 15.0% (n = 114) developed an infection after the first operation. After the second operation, 22.8% (n = 26) of those with a previous infection developed another infection, whereas the incidence of an infection after the second operation was only 9.5% (n = 61) in patients who did not develop an infection after the first operation. Multivariable analysis demonstrated that previous infection (odds ratio 2.49, 95% CI 1.46 to 4.25) was associated with future infection risk. Microbiological analysis found that infections after the second surgery were significantly more likely to be antibiotic resistant than infections after the first surgery (82.3% vs 64.1%; p = 0.036). Strikingly, 49% of infections after the second surgery were resistant to the antibiotic prophylaxis given at the time of incision.

CONCLUSIONS:
Previous postoperative infection is an independent risk factor for a subsequent postoperative infection and is associated with resistance to standard prophylaxis. Individualization of antibiotic prophylaxis in patients with a previous postoperative infection is warranted.
Effect of Lymphaticovenous Anastomosis on Muscle Edema, Limb, and Subfascial Volume in Lower Limb Lymphedema: MRI Studies
Authors: Yang Johnson Chia-Shen , Wu Shao-Chun , Wang Yu-Ming , Luo Sheng-Dean , Kuo Spencer Chia-Hao , Chien Peng-Chen , Tsai Pei-Yu , Hsieh Ching-Hua , Lin Wei-Che 
Published: July 2022

BACKGROUND:
Although satisfactory volume reduction in secondary unilateral lower limb lymphedema after lymphaticovenous anastomosis (LVA) in the affected limb has been well reported, alleviation of muscle edema and the impact of LVA on the contralateral limb have not been investigated.

STUDY DESIGN:
This retrospective cohort study enrolled patients who underwent supermicrosurgical LVA between November 2015 and January 2017. Pre- and post-LVA muscle edema were assessed using fractional anisotropy (FA) and apparent diffusion coefficient (ADC). The primary endpoint was changes in limb/subfascial volume assessed with magnetic resonance volumetry at least 6 months after LVA.

RESULTS:
Twenty-one patients were enrolled in this study. Significant percentage reductions in post-LVA muscle edema were found in the affected thigh (83.6% [interquartile range = range of Q1 to Q3; 29.8–137.1] [FA], 53.3% [27.0–78.4] [ADC]) as well as limb (21.7% [4.4–26.5]) and subfascial (18.7% [10.7–39.1]) volumes. Similar findings were noted in the affected lower leg: 71.8% [44.0–100.1] (FA), 59.1% [45.8–91.2] (ADC), 21.2% [6.8–38.2], and 28.2% [8.5–44.8], respectively (all p < 0.001). Significant alleviation of muscle edema was also evident in the contralateral limbs (thigh: 25.1% [20.4–57.5] [FA]; 10.7% [6.6–17.7] [ADC]; lower leg: 47.1% [35.0–62.8] [FA]; 14.6% [6.5–22.1] [ADC]; both p < 0.001), despite no statistically significant difference in limb and subfascial volumes.

CONCLUSIONS:
Our study found significant reductions in muscle edema and limb/subfascial volumes in the affected limb after LVA. Our findings regarding edema in the contralateral limb were consistent with possible lymphedema-associated systemic influence on the unaffected limb, which could be surgically relieved.
Early vs Delayed Surgery for Esophageal Cancer During the COVID-19 Pandemic
Authors: Bajaj Simar S , Shah Kavya M , Potter Alexandra L , Mayne Nicholas R , Sachdeva Uma M , Lin Mong-Wei , Yang Chi-Fu Jeffrey 
Published: July 2022

BACKGROUND:
During the coronavirus disease 2019 pandemic, national guidelines recommended that elective surgery for esophageal cancer be deferred by 3 months when hospital resources are limited. The impact of this delay on patient outcomes is unknown. We sought to evaluate the survival of patients with stage I and II/III esophageal cancer who undergo early vs delayed treatment.

STUDY DESIGN:
Using the National Cancer Database from 2010 to 2017, multivariable Cox proportional hazards modeling and propensity score–matched analysis were employed to compare survival of patients with stage I esophageal cancer who received early (0 to 4 weeks after diagnosis) vs delayed esophagectomy (12 to 16 weeks) and of patients with stage II/III esophageal cancer who—after receiving timely chemoradiation (0 to 4 weeks after diagnosis)—underwent early (9 to 17 weeks) vs delayed esophagectomy (21 to 29 weeks).

RESULTS:
For stage I esophageal cancer, 226 (41.7%) patients underwent early esophagectomy, and 316 (58.3%) patients underwent delayed esophagectomy. Propensity score matching created 2 groups of 134 patients with early or delayed esophagectomy, whose 5-year survival was comparable (hazard ratio [HR] 65.0% [95% confidence interval (CI) 55.2% to 73.2%] vs HR 65.1% [95% CI 55.6% to 73.1%], p = 0.50). For stage II/III esophageal cancer, 1,236 (86.1%) patients underwent early esophagectomy, and 200 (13.9%) underwent delayed esophagectomy. Propensity score matching created 2 groups of 130 patients; the early esophagectomy group had improved 5-year survival compared with the delayed esophagectomy group (HR 41.6% [95% CI 32.1% to 50.8%] vs HR 22.9% [95% CI 14.9% to 31.8%], p = 0.006).

CONCLUSIONS:
Early esophagectomy was associated with similar survival compared with delayed esophagectomy for patients with stage I esophageal cancer. For patients with stage II/III esophageal cancer, early esophagectomy was associated with improved survival relative to delayed esophagectomy.
Well-Being Intervention in General Surgery: Multicenter Study of Program Director and Resident Perspectives
Authors: Greenberg Anya L , Tenzing Norbu , Ghadimi T Roxana , Tilahun Mekaleya N , Berler Michael H , Lebares Carter C ,   for the General Surgery Research Collaborative on Resident Well-Being
Published: July 2022

BACKGROUND:
Physician well-being is critical for optimal care, but rates of psychological distress among surgical trainees are rising. Although numerous efforts have been made, the perceived efficacy of well-being interventions is not well understood.

STUDY DESIGN:
This qualitative thematic study included online questionnaires to Program Directors (PDs) and residents at 16 ACGME-accredited General Surgery residency programs. PDs reported active well-being interventions for surgical residents or those under consideration at their institutions. Residents shared perspectives of available well-being interventions through open-ended responses. Conventional content analysis was used to analyze responses.

RESULTS:
Fifteen PDs, or their proxies (94% response rate), responded. Responses revealed that a majority of available well-being interventions are focused on changing the individual experience rather than the underlying workplace. PD decision-making around well-being interventions is often not based on objective data. Three hundred residents (34% response rate) responded. Of available interventions, those that increase control (eg advanced and flexible scheduling), increase support (eg mentorship), and decrease demand (eg work hour limits) were consistently identified as beneficial, but interventions perceived to increase demand (eg held during unprotected time) were consistently identified as not beneficial. Group social activities, cognitive skills training, and well-being committees were variably seen as beneficial (increasing support) or not (increasing demand).

CONCLUSIONS:
Our findings underscore the prevalence of individual-based well-being interventions and the paucity of system-level changes. This may explain, in part, the persistence of distress among residents despite abundant effort, highlighting the imperative for system-level transformation.
Optimizing Perioperative Venous Thromboembolism Chemoprophylaxis on a Gynecologic Oncology Service
Authors: Lippitt Melissa H , Johnson Emily S , Frost Anja S , Thompson Sharon D , Kashi Payam K , Beavis Anna L , Fader Amanda N , Ferriss J Stuart , Stone Rebecca L , Wethington Stephanie L 
Published: July 2022

BACKGROUND:
Perioperative venous thromboembolism (VTE) is a significant cause of morbidity and mortality after gynecologic cancer surgery. Here we report a quality improvement intervention to increase perioperative VTE chemoprophylaxis compliance.

STUDY DESIGN:
All operations performed by a gynecologic oncologist at a tertiary urban university medical center admitted to the hospital for at least one midnight were included. Using a pre/post design with a washout period, we sought to increase perioperative VTE chemoprophylaxis compliance from 22% in the historical control (HC) cohort to 90% in the quality improvement (QI) cohort. The perioperative VTE chemoprophylaxis process was standardized by addressing four domains: preoperative VTE chemoprophylaxis, surgical time-out, postoperative VTE chemoprophylaxis, and intervention education and compliance tracking. Pearson’s chi-square test was used to compare HC vs QI cohort compliance.

RESULTS:
There were 130 surgical cases in the HC cohort and 131 in the QI cohort. Forty-two percent underwent laparotomy, and 57% had cancer at the time of operation. VTE chemoprophylaxis compliance improved from 22% in the HC cohort to 82% in the QI cohort (p < 0.001). Preoperative VTE chemoprophylaxis compliance improved from 76% in the HC cohort to 94% in the QI cohort (p < 0.001), and postoperative VTE chemoprophylaxis compliance improved from 27% to 87% (p < 0.001). Thirty-day postoperative VTE occurred in three patients (2%) in the HC cohort and none in the QI cohort (p = 0.08).

CONCLUSIONS:
A low-cost and low-technology QI initiative intervention improved perioperative compliance with VTE chemoprophylaxis.
Minimally Invasive vs Open Pancreatectomy for Pancreatic Neuroendocrine Tumors: Multi-Institutional 10-Year Experience of 1,023 Patients
Authors: Zheng Jian , Pulvirenti Alessandra , Javed Ammar A , Michelakos Theodoros , Paniccia Alessandro , Lee Kenneth K , Ferrone Cristina R , Wei Alice C , He Jin , Zureikat Amer H ,   additional members of the Pancreatic Neuroendocrine Disease Alliance (PANDA)
Published: July 2022

BACKGROUND:
Resection of pancreatic neuroendocrine tumors (PNETs) may be associated with adverse perioperative outcomes compared with pancreatic adenocarcinoma given the high-risk nature of soft glands with small pancreatic ducts. The effect of minimally invasive surgery (MIS) pancreatectomy on outcomes of PNETs remains to be examined, which is the aim of this study.

STUDY DESIGN:
Between 2009 and 2019, 1,023 patients underwent pancreatectomy for PNETs at 4 institutions. Clinicopathologic data and perioperative outcomes of patients who underwent MIS (n = 447) and open resections (n = 576) were compared.

RESULTS:
Of the 1,023 patients, 51% were male, the mean age was 58, the median tumor size was 2.1 cm, and 73% were grade 1 PNETs. There were 318 (31%) pancreatoduodenectomies (PDs), 541 (53%) distal pancreatectomies (DPs), 80 (7.8%) enucleation (ENs), 72 (7%) central pancreatectomies (CPs), and 12 (1.2%) total pancreatectomies. Almost half of the patients (N = 447, 44%) had MIS operations, of which 230 (51%) were robotic and 217 (49%) were laparoscopic. Compared with open operations, MIS PDs had significantly lower operative blood loss (150 vs 400 mL, p < 0.001) and rate of clinically relevant postoperative pancreatic fistulas (CR-POPFs; 13% vs 27%, p = 0.030), and MIS DPs had a shorter length of stay (5 vs 6 days, p < 0.001). Although MIS DPs and ENs had CR-POPFs comparable with open operations, MIS CPs had a higher CR-POPF rate (45% vs 15%, p = 0.013). After adjusting for pathological differences, MIS pancreatectomy was associated with recurrence-free survival and overall survival comparable with open pancreatectomy.

CONCLUSIONS:
MIS pancreatectomy for PNETs is associated with improved outcomes or outcomes comparable with open resection.
BA.4/BA.5 early surge report Austria
Authors: Gamisch Alexander , Mustafa Maria Elisabeth 
Published: July 2022

AbstractMore than two years into the COVID-19 pandemic, the emergence of the Omicron subvariants BA.4 and BA.5 initiated the fifth wave. BA.4/BA.5 share identical spike proteins and are thus difficult to differentiate using standard diagnostic tests. The true frequency and diversity of the two variants in Austria is therefore largely unknown. Aim of this report is to take stock about the frequency and diversity of BA.4 & BA.5 and their subvariants based on whole genome sequencing (WGS) data as deposited at GISAID database. Results show that most sequenced cases belong to BA.5 (c. 86 %) rather than BA.4 (c. 14 %) and that most of the global diversity (24 out of 32 subvariants) of BA.4 and BA.5 in terms of subvariants described is already present in Austria. However, most cases can be attributed to a few subvariants (e.g. BA.5.1, BE.1.1, BA.5.3, BA.5.2.1) with high estimated growth advantage over BA.2 (ranging 103 to 159 %) and may be worth monitoring as the immediate wave unfolds.
The Relation Between Viscous Energy Dissipation And Pulsation For Aortic Hemodynamics Driven By A Left Ventricular Assist Device
Authors: Sahni Akshita , McIntyre Erin E. , Cao Kelly , Pal Jay D. , Mukherjee Debanjan 
Published: July 2022

AbstractLeft ventricular assist device (LVAD) provides mechanical circulatory support for patients with advanced heart failure. Treatment using LVAD is commonly associated with complications such as stroke and gastro-intestinal bleeding. These complications are intimately related to the state of hemodynamics in the aorta, driven by a jet flow from the LVAD outflow graft that impinges into the aorta wall. Here we conduct a systematic analyses of hemodynamics driven by an LVAD with a specific focus on viscous energy transport and dissipation. We conduct a complementary set of analysis using idealized cylindrical tubes with diameter equivalent to common carotid artery and aorta, and a patient-specific model of 27 different LVAD configurations. Results from our analysis demonstrate how energy dissipation is governed by key parameters such as frequency and pulsation, wall elasticity, and LVAD outflow graft surgical anastomosis. We find that frequency, pulsation, and surgical angles have a dominant effect, while wall elasticity has a weaker effect, in determining the state of energy dissipation. For the patient-specific scenario, we also find that energy dissipation is higher in the aortic arch and lower in the abdominal aorta, when compared to the baseline flow without an LVAD. This further illustrates the key hemodynamic role played by the LVAD outflow jet impingement, and subsequent aortic hemodynamics during LVAD operation.
MIADE metadata guidelines: Minimum Information About a Disorder Experiment
Authors: Mészáros Bálint , Hatos András , Palopoli Nicolas , Quaglia Federica , Salladini Edoardo , Van Roey Kim , Arthanari Haribabu , Dosztányi Zsuzsanna , Felli Isabella C. , Fischer Patrick D , Hoch Jeffrey C. , Jeffries Cy M , Longhi Sonia , Maiani Emiliano , Orchard Sandra , Pancsa Rita , Papaleo Elena , Pierattelli Roberta , Piovesan Damiano , Pritisanac Iva , Viennet Thibault , Tompa Peter , Vranken Wim , Tosatto Silvio CE , Davey Norman E 
Published: July 2022

AbstractAn unambiguous description of an experimental setup and analysis, and the subsequent biological observation is vital for accurate data interpretation and reproducible results. Consequently, experimental analyses should be described in a concise, unequivocal, and digestible manner. The aim of minimum information guidelines is to define the fundamental complement of data that can support an unambiguous conclusion on experimental observations. In this document, we present the Minimum Information About Disorder Experiments (MIADE) guidelines to define the minimal fundamental parameters required for non-experts to understand the key findings of an experiment studying intrinsically disordered proteins (IDPs) or intrinsically disordered protein regions (IDRs). MIADE guidelines provide recommendations for data producers to describe the results of their experiments at source, for curators to annotate experimental data to community resources and for database developers maintaining community resources to disseminate the data. We give examples of the application of these guidelines in common use cases and describe the implementation of an update to the DisProt IDP database to allow MIADE-compliant annotation. The MIADE guidelines will improve the interpretability of experimental results for data consumers, facilitate direct data submission, simplify data curation, improve data exchange among repositories and standardise the dissemination of the key metadata on an IDP experiment by IDP data sources.