bluuebunny/crossref_metadata_2025_split huggingface dataset:
IBC-Ox32 Streamlining preoperative risk assessment: counterintuitive results in the Bariatric patient
Authors: Silveira F C , Mitchell F G , Maranga G , Jenkins M , Pachter H L , Ren-Fielding C 
Published: November 2022

Abstract

Background
Bariatric surgical operations continue to be performed in high numbers nationally, thus it is important to identify factors associated with post-surgical complications. This study aims to identify preoperative risk factors associated with bariatric surgery mortality.

Methods
A retrospective analysis was conducted on the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database to determine the strength of association between pre-operative exposures and 30-day mortality following bariatric surgery. A total of 701,265 primary bariatric operations were registered between the years of 2015 and 2017, consisting of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), adjustable gastric band (AGB), and duodenal switch (DS)

Results
From the 701,265 surgeries registered in the database, 636,286 had complete data points for the variables of interest and therefore were included in this analysis. The mean age of the cohort was 45.01 (SD= 11.96) years, mean BMI was 45.54 kg/m2 (SD=7.72), and 80.07% were female. Overall 30-day mortality was 0.10% (n=629). The association between the following preoperative variables and mortality within 30 days of bariatric surgery was not statistically significant: hyperlipidemia, history of pulmonary embolism, oxygen dependence, obstructive sleep apnea and history of venous stasis. Smoking status (AOR=1.38), insulin dependent diabetes (AOR=1.37) and the use of more than 3 hypertensive medications (AOR=1.30) were weakly associated with postoperative mortality (p&lt;0.05; CI=95%). History of chronic obstructive pulmonary disease (COPD; AOR=2.00), partial functional dependency (AOR=2.09), renal insufficiency (AOR=1.63), dialysis (AOR=3.15), history of deep venous thrombosis (AOR=1.78), history of myocardial infarction (AOR=1.65) and history of cardiac surgery (AOR=1.87) were strongly associated with mortality (P&lt;0.05; c.i. = 95%)

Conclusion
Bariatric surgery continues to be safe. Many factors that have traditionally been thought to contribute to mortality, such as diabetes, hypertension, smoking, and oxygen dependence may have little impact. Other variables such as previous heart surgery, functional dependency status and COPD may play a bigger role in adverse outcomes. While these associations do not determine causality, understanding the strength of them can guide physicians on preoperative risk assessment and care.
IBC-Ox34 Transit bipartition improves serum total testosterone levels in overweight and obese type-2 diabetic men and cures erectile dysfunction: short-term preliminary results
Authors: Taskin H E , Al M , Ozbek E 
Published: November 2022

Abstract

Introduction
In males, erectile dysfunction (ED) secondary to obesity is one of the most common cause of male sexual dysfunction, in our study we investigated the effect of bariatric surgery on male sex hormone, testosterone and sexual status of 99 overweight and obese men with type II diabetes who underwent a laparoscopic transit bipartition.

Methods
Ninety-nine patients with type-II diabetes mellitus (T2DM) and obesity who underwent transit bipartition in Hospital X were prospectively evaluated before and 6 months after the surgery for the serum total testosterone levels. Also, the erectile dysfunction was evaluated by using International Index of Erectile Function (IIEF) scoring system. In addition, all the patients had been evaluated in BMI categories of overweight (BMI 25-29), Class 1 Obese (30-35), Class 2 Obese (35-40) and morbidly obese (&gt;40 kg/m2).

Results
Serum total testosterone (T) levels were assessed before and 6 months after TB in 99 male patients. Mean age was 45.7 and median serum total testosterone (T) levels before and after 6 months were 3.03 nmol/L (range: 0.38-8.44) and, 4.43 nmol/L (range 0.34-9.70) (min-max) respectively. Also, the patient's pre-operative and post-operative testosterone values and IIEF scores were calculated in every category of obesity (Table 1). Before and after bariatric surgery serum T levels were statistically significant (p&lt;0.005).

Conclusion
In conclusion serum T levels and IIEF scores significantly improved after 6 months following bariatric surgery. This condition may explain improvement of erectile dysfunction following bariatric surgery. Larger and long-term studies are required to investigate these beneficial effects of surgery in patients with obesity and T2DM.
IBCOx_1 Do we really need to use staple line reinforcement to prevent leaks after sleeve gastrectomy?
Authors: Alhamdani A , Sufi P , Parmar C 
Published: November 2022

Abstract

Introduction
While some of systematic reviews inform us about the superiority of the stapler line reinforcement (SLR) over no reinforcement to prevent leaks in sleeve gastrectomy, the First Report from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) with 188,000 patients contradicts this with higher leak rates associated with SLR. The objective is to understand why the variation in the literature about the SLR in preventing leaks or not and how this relates to surgeon experience.

Methods
Literature review was performed and analysed to identify the type of the SLR used or not. This was compared with the leak site, stomach thickness and type of stapler thickness height used. The surgeon experience was also taken into account.

Results
The leak rates were mainly due to inappropriate use of the stapler colour (thickness) in relation to the SLR type and the stomach thickness. In one systematic review higher leak rates were found when inappropriate low staple height (blue stapler 1.8mm closure height) was used to include bovine SLR (1mm thickness) to staple the fundal area (1.5mm thickness). In another meta-analysis less leaks rates were noticed using the same buttressing material with a larger stapler (green or gold). Increase in surgeon experience was associated with decreased leak rate.

Conclusion
The inappropriate use of the stapler height with the SLR contributes to the leak and can explain the variation in the literature. The surgeon experience associated with decrease leak rates.
IBCOx-8 Bile reflux after laparoscopic mini-gastric bypass; Is it really a major concern?
Authors: Foula M S 
Published: November 2022

Abstract

Background
Laparoscopic mini gastric bypass MGB, first performed in late 1990s, become a popular bariatric procedure with proven comparable efficiency. Its popularity can be explained by many factors including: its technical simplicity and efficacy in weight loss compared to RYGB, its superiority in controlling metabolic syndrome compared to restrictive procedures and its efficacy as revision surgery for failed restrictive procedures. However, many debates still exist among bariatric surgery experts regarding its complications; mainly bile reflux and its consequences.
We presented our experience, as a tertiary university institute in dealing with bile reflux complications after laparoscopic mini gastric bypass that necessitated endoscopic and/or operative interventions.

Methods
This is a retrospective study of all cases who were admitted in a tertiary hospital because of bile reflux related complications in one year duration.

Results
Three cases were admitted because of bile reflux complications. The first case presented by hemorrhagic shock due to massive hemorrhage at a marginal ulcer after 26 days of mini gastric bypass. The second case was re-operated electively because of intractable bile reflux after failure of medical treatment. The third case presented with peritonitis on top of perforated marginal ulcer seven month after mini gastric bypass.

Conclusion
Despite its claimed safety and efficacy, laparoscopic mini gastric bypass is not the procedure of no-morbidities. Incidence of postoperative bile reflux is under-estimated. All patients should undergo a regular endoscopy to assess it even if asymptomatic.
IBC-Ox22 Greater Adherence to Mediterranean Diet leads to longer term weight loss
Authors: Simpson T , Billy H 
Published: November 2022

Abstract

We were able to obtain dietary data of 134 weight loss surgery patients with an average follow up of five years with annual scoring of the 9 point Mediterranean Diet. The closer adherence to the MD showed more weight loss than those who had not.

Background
The Mediterranean Diet has been associated with decreased all cause mortality for those who adhere strongly to it, as well as decreased risk of heart disease, and cancer. The diet is rich in polyphenols with fruits, vegetables, legumes, fish, mono-unsaturated fats, whole grains, while minimizing dairy, meat and poultry, and some moderate alcohol consumption.

Methods
Pre operatively all bariatric patients patients were counseled about the Mediterranean diet, how to score the diet, and adherence to the diet was reemphasized at their follow ups. Annually they were asked to fill out their scores. We looked at other diet plans that some of the patients reported (low carbohydrate, weight watchers) and the results were not significant.

Results
Of the 134 patients there were 65 which had scores of 5 points or more and showed an absolute reduction in weight of 54% total weight loss on average, vs those of 1-3 who had 32% total weight loss (total of 60 patients). The remaining 9 patients who escorted 4 points had a wide spread of weight loss that could not be calculated (these patients predominantly followed a self-described low-carbohydrate diet). There was no difference in weight loss regarding the type of surgery that the patient had (Lap-Band (N=74) vs Gastric Sleeve (N=50) vs Gastric bypass (N=10). Nor was there any difference in weight loss when measuring physical activity.
Using the 9 point scale of the Mediterranean Diet those who had greater than 5 of the 9 points on the MD had greater weight loss over five years than those who were 0-3. Those who scored 4 points were indeterminate.

Conclusions
The Mediterranean Diet scale provides a quick and easy guide, providing targets for patients (example, less than 4 ounces per day of poultry or meat is a point, more is 0 points). The emphasis on a post operative diet for health, as opposed to weight loss, inadvertently provided a good model for post operative weight loss.
Comparison of CRISPR-Cas9-mediated megabase-scale genome deletion methods in mouse embryonic stem cells
Authors: Miyata Masayuki , Yoshida Junko , Takagishi Itsuki , Horie Kyoji 
Published: November 2022

Abstract
The genome contains large functional units ranging in size from hundreds of kilobases to megabases, such as gene clusters and topologically associating domains. To analyse these large functional units, the technique of deleting the entire functional unit is effective. However, deletion of such large regions is less efficient than conventional genome editing, especially in cultured cells, and a method that can ensure success is anticipated. Here, we compared methods to delete the 2.5-Mb Krüppel-associated box zinc finger protein (KRAB-ZFP) gene cluster in mouse embryonic stem cells using CRISPR-Cas9. Three methods were used: first, deletion by non-homologous end joining (NHEJ); second, homology-directed repair (HDR) using a single-stranded oligodeoxynucleotide (ssODN); and third, HDR employing targeting vectors with a selectable marker and 1-kb homology arms. NHEJ-mediated deletion was achieved in 9% of the transfected cells. Inversion was also detected at similar efficiency. The deletion frequency of NHEJ and HDR was found to be comparable when the ssODN was transfected. Deletion frequency was highest when targeting vectors were introduced, with deletions occurring in 31–63% of the drug-resistant clones. Biallelic deletion was observed when targeting vectors were used. This study will serve as a benchmark for the introduction of large deletions into the genome.
Exploring the structure of internal combustion engine and battery electric vehicles: implications for the architecture of the automotive industry
Authors: Murmann Johann Peter , Schuler Benedikt Alexander 
Published: November 2022

Abstract
How will the technological shift from internal combustion engine vehicles (ICEVs) to battery electric vehicles (BEVs) change the architecture of the automotive industry? To explore this question, we systematically compare the technological structure of ICEVs and BEVs using data from large incumbent automobile companies and start-ups. While our analysis based on technical descriptions and design structure matrices suggests that the power train of BEVs is structurally simpler compared to the power train of ICEVs, BEVs are slightly less modular than ICEVs. We discusss important strategic implications of this finding for incumbent firms and start-ups.
An exotic allele of barley EARLY FLOWERING 3 contributes to developmental plasticity at elevated temperatures
Authors: Zhu Zihao , Esche Finn , Babben Steve , Trenner Jana , Serfling Albrecht , Pillen Klaus , Maurer Andreas , Quint Marcel 
Published: November 2022

Abstract
Increase in ambient temperatures caused by climate change affects various morphological and developmental traits of plants, threatening crop yield stability. In the model plant Arabidopsis thaliana, EARLY FLOWERING 3 (ELF3) plays prominent roles in temperature sensing and thermomorphogenesis signal transduction. However, how crop species respond to elevated temperatures is poorly understood. Here, we show that the barley ortholog of AtELF3 interacts with high temperature to control growth and development. We used heterogeneous inbred family (HIF) pairs generated from a segregating mapping population and systematically studied the role of exotic ELF3 variants in barley temperature responses. An exotic ELF3 allele of Syrian origin promoted elongation growth in barley at elevated temperatures, whereas plant area and estimated biomass were drastically reduced, resulting in an open canopy architecture. The same allele accelerated inflorescence development at high temperature, which correlated with early transcriptional induction of MADS-box floral identity genes BM3 and BM8. Consequently, barley plants carrying the exotic ELF3 allele displayed stable total grain number at elevated temperatures. Our findings therefore demonstrate that exotic ELF3 variants can contribute to phenotypic and developmental acclimation to elevated temperatures, providing a stimulus for breeding of climate-resilient crops.
Household Composition and Smoking Behavior in a Prospective Longitudinal Australian Cohort
Authors: Saxby Karinna , Ireland Andrew , Ghijben Peter , Sweeney Rohan , Sia Kah-Ling , Chen Esa , Farrell Michael , McRobbie Hayden , Courtney Ryan , Petrie Dennis 
Published: November 2022

AbstractIntroductionThis study estimates the extent to which individuals’ smoking cessation and relapse patterns are associated with the smoking behavior of their household members.Aims and MethodsLongitudinal data on household members’ smoking behavior was sourced from a representative sample of 12 723 Australians who ever reported smoking between 2001 and 2019. Controlling for a rich set of confounders, multivariate regression analyses were used to predict the likelihood of smoking cessation and relapse given other household members’ smoking status and their relationship type. The models were then used to forecast smoking prevalence over 10 years across different household types.ResultsIndividuals living with a smoking spouse were less likely to quit (OR 0.77 [95% CI 0.72;0.83]) and more likely to relapse (OR 1.47 [95% CI 1.28;1.69]) compared to those living with nonsmoking spouses. Subsequently, the proportion of smokers living with other smoking household members increased by 15% between 2011 and 2019. A 10-year forecast using the smoking cessation and relapse models predicts that, on average, smokers living with nonsmokers will reduce by 43%, while those living alone or with a smoking partner will only reduce by 26% and 28% respectively.ConclusionsOver time, those who are still smoking are more likely to live with other smokers. Therefore, the current cohort of smokers is increasingly less likely to quit and more likely to relapse. Smoking projection models that fail to account for this dynamic risk may overstate the downstream health benefits and health cost savings. Interventions that encourage smoking cessation at the household level, particularly for spouses, may assist individuals to quit and abstain from smoking.ImplicationsThe current and future paradigm shift in the smoking environment suggests that smoking cessation and relapse prevention policies should consider household structure. Policies designed to affect smoking at the household level are likely to be particularly effective. When estimating the long-term benefits of current smoking policies intrahousehold smoking behavior needs to be considered.
The intracellular immune receptor like gene SNC1 is an enhancer of effector-triggered immunity in Arabidopsis
Authors: Wang Zhixue , Yang Leiyun , Hua Jian 
Published: November 2022

Abstract
Plants contain many nucleotide-binding leucine-rich repeat (NLR) proteins that are postulated to function as intracellular immune receptors but do not yet have an identified function during plant–pathogen interactions. SUPPRESSOR OF NPR1-1, CONSTITUTIVE 1 (SNC1) is one such NLR protein of the Toll-interleukin 1 receptor (TIR) type, despite its well-characterized gain-of-function activity and its involvement in autoimmunity in Arabidopsis (Arabidopsis thaliana). Here, we investigated the role of SNC1 in natural plant–pathogen interactions and genetically tested the importance of the enzymatic activities of its TIR domain for its function. The SNC1 loss-of-function mutants were more susceptible to avirulent bacterial pathogen strains of Pseudomonas syringae containing specific effectors, especially under constant light growth condition. The mutants also had reduced defense gene expression induction and hypersensitive responses upon infection by avirulent pathogens under constant light growth condition. In addition, genetic and biochemical studies supported that the TIR enzymatic activity of SNC1 is required for its gain-of-function activity. In sum, our study uncovers the role of SNC1 as an amplifier of plant defense responses during natural plant–pathogen interactions and indicates its use of enzymatic activity and intermolecular interactions for triggering autoimmune responses.
The top 10 research priorities in psoriatic arthritis: a James Lind Alliance Priority Setting Partnership
Authors: Hailey Louise , Bundy Chris , Burstow Helen , Chandler David , Cowper Russ , Helliwell Philip , Joannes Lucille , Kelly Andy , Kennedy Bronagh , Kinsella Suzannah , McAteer Helen , Mukherjee Sandeep , Packham Jon , Wise Elspeth , Young Helen , Coates Laura C 
Published: November 2022

Abstract

Objectives
To identify and prioritize the top 10 research questions for PsA.

Methods
The British Psoriatic Arthritis Consortium (BritPACT) formed a Priority Setting Partnership (PSP) comprising of people living with PsA, carers and clinicians, supported by the James Lind Alliance (JLA). This PSP followed the established three-stage JLA process: first, an online survey of people living with PsA, carers and clinicians to identify PsA questions, asking, ‘What do you think are the most important unanswered questions in psoriatic arthritis research?’ The questions were checked against existing evidence to establish ‘true uncertainties’ and grouped as ‘indicative questions’ reflecting the overarching themes. Then a second online survey ranked the ‘true uncertainties’ by importance. Finally, a workshop including people living with PsA and clinician stakeholders finalized the top 10 research priorities.

Results
The initial survey attracted 317 respondents (69% people living with PsA, 15% carers), with 988 questions. This generated 46 indicative questions. In the second survey, 422 respondents (78% people living with PsA, 4% carers) prioritized these. Eighteen questions were taken forward to the final online workshop. The top unanswered PsA research question was ‘What is the best strategy for managing patients with psoriatic arthritis including non-drug and drug treatments?’ Other top 10 priorities covered diagnosis, prognosis, outcome assessment, flares, comorbidities and other aspects of treatment (https://www.jla.nihr.ac.uk).

Conclusion
The top 10 priorities will guide PsA research and enable PsA researchers and those who fund research to know the most important questions for people living with PsA.
A Mixed-Methods Analysis of Gender and Career Status Differences in the Impact of the COVID-19 Pandemic on Underrepresented Postdoctoral Fellows and Early-Career Faculty
Authors: White Gretchen E. , Proulx Chelsea N. , Morone Natalia E. , Thakar Maya S. , Murrell Audrey J. , Althouse Andrew D. , Rubio Doris M. 
Published: November 2022

Purpose
The lack of racial and ethnic diversity in the biomedical workforce is pronounced and those from underrepresented backgrounds encounter more challenges than their majority counterparts. The extent of the impact of the COVID-19 pandemic on early-career investigators from underrepresented backgrounds is not yet fully understood. To examine the impact of the pandemic on underrepresented early-career biomedical researchers, this study evaluated differences in productivity, research, and psychological well-being by gender and career status.

Method
This was a cross-sectional analysis of preintervention data, collected in September–October 2020, from 220 participants enrolled in the Building Up a Diverse Biomedical Research Workforce study. Participants were from 25 academic medical centers in the United States and were underrepresented early-career researchers. The primary outcomes were agreement on a 5-point Likert scale with pandemic impact statements (e.g., “The COVID-19 pandemic has impacted my ability to conduct research”). Thematic analysis was conducted on responses to 2 open-ended questions assessing the pandemic’s impact.

Results
Most participants were female (79.9%), of non-Hispanic/Latinx/Spanish origin Black/African American (33.2%) or Hispanic/Latinx/Spanish origin (34.1%), and early-career faculty (53.4%). Over half of participants agreed or strongly agreed that the COVID-19 pandemic impacted their ability to work (55.7%) and conduct research (70.7%). Themes from qualitative analysis suggested lower research productivity, concerns about the academic job market and funding, and psychological distress due to the pandemic. Women were more likely to attribute lost productivity and psychological distress to homeschooling and childcare responsibilities. Postdoctoral fellows were concerned about more competition for fewer academic positions.

Conclusions
In this study of early-career underrepresented biomedical researchers, the impact of the COVID-19 pandemic was widely felt by participants, varying by gender and career status. For those postdoctoral fellows and early-career faculty who are underrepresented, it is critical for institutions to offer flexibility in their positions.