bluuebunny/crossref_metadata_2025_split huggingface dataset:
Start of experiments in the design configuration of the GOL-NB multiple-mirror trap
Authors: Postupaev V.V. , Batkin V.I. , Burdakov A.V. , Burmasov V.S. , Ivanov I.A. , Kuklin K.N. , Lykova Yu.A. , Melnikov N.A. , Mekler K.I. , Nikishin A.V. , Polosatkin S.V. , Rovenskikh A.F. , Sidorov E.N. , Skovorodin D.I. 
Published: April 2022

Abstract
A multiple-mirror confinement is an alternative concept in fusion energy development that improves the particle and energy confinement times in open traps (linear magnetic systems). The paper discusses the development progress of the GOL-NB multiple-mirror experiment that was recently commissioned at BINP. The reference description of the GOL-NB hardware is presented. Properties of a low-temperature start plasma are discussed. The first results from test experiments with injection of one 25 keV neutral beam are shown. Methods of plasma stabilization in the non-min-B configuration are discussed. In general, the ongoing commissioning progress and results of the preliminary experiments are modestly optimistic for the expected device performance.
Thermostability and catechol-O-methyltransferase inhibitory activity of acylated anthocyanins from purple yam
Authors: Miyata Ryo , Sano Hitomi , Hoshino Sara , Kumazawa Shigenori 
Published: April 2022

ABSTRACT
The thermostability of purple yam was investigated to be used as natural colorants. In addition, the inhibitory properties of purple yam and its isolated anthocyanins toward human catechol-O-methyltransferase (COMT), a key neurotransmitter involved in Parkinson's disease and depression, were also investigated. The thermostability of purple yam was higher than that of the reference samples (purple sweet potato and purple potato). Quantitative HPLC analysis revealed that alatanin A (2) contributed to the thermostability of purple yam. Methanol extracts of purple yam exhibited the highest COMT inhibitory activity of the tested samples. Alatanin D (1) showed the highest inhibitory activity of the anthocyanins in purple yam (IC50 19 µM). This study revealed the thermostability and COMT inhibitory activity of purple yam and may lead to its use not only as a thermostable natural source of colorants, but also for the prevention and treatment of Parkinson's disease and depression.
Circadian rhythmicity of pain sensitivity in humans
Authors: Daguet Inès , Raverot Véronique , Bouhassira Didier , Gronfier Claude 
Published: April 2022

Abstract
Pain intensity has been reported to fluctuate during the day in some experimental and clinical conditions, but the mechanisms underlying these fluctuations are unknown. Although the circadian timing system is known to regulate a wide range of physiological functions, its implication in pain regulation is largely unknown.
Using highly controlled laboratory constant-routine conditions, we show that pain sensitivity is rhythmic over the 24 h and strongly controlled by the endogenous circadian timing system. We found that the circadian component of pain sensitivity can be modelled with a sinusoidal function, with a maximum in the middle of the night and a minimum in the afternoon. We also found a weak homeostatic control of pain sensitivity, with a linear increase over the 34 h of prolonged wakefulness, which slowly builds up with sleep pressure. Using mathematical modelling, we describe that the circadian system accounts for ∼80% of the full magnitude of pain sensitivity over the 24 h, and that sleep-related processes account for only ∼20%.
Overall, our data reveal the neurobiological mechanisms involved in driving the rhythmicity of pain perception in humans. We show that pain sensitivity is controlled by two superimposed processes: a strong circadian component and a modest homeostatic sleep-related component. Our findings highlight the need to consider time of day in pain assessment, and indicate that personalized circadian medicine may be a promising approach to pain management.
Reframing postconcussional syndrome as an interface disorder of neurology, psychiatry and psychology
Authors: Clark Camilla N , Edwards Mark J , Ong Bee Eng , Goodliffe Luke , Ahmad Hena , Dilley Michael D , Betteridge Shai , Griffin Colette , Jenkins Peter O 
Published: April 2022

AbstractPersistent symptoms following a minor head injury can cause significant morbidity, yet the underlying mechanisms for this are poorly understood. The shortcomings of the current terminology that refer to non-specific symptom clusters is discussed. This update considers the need for a multi-dimensional approach for the heterogenous mechanisms driving persistent symptoms after mild traumatic brain injury. Relevant pathophysiology is discussed to make the case for mild traumatic brain injury to be conceptualized as an interface disorder spanning neurology, psychiatry and psychology. The relevance of pre-injury factors, psychological co-morbidities and their interaction with the injury to produce persistent symptoms are reviewed. The interplay with psychiatric diagnoses, functional and somatic symptom disorder presentations and the influence of the medicolegal process is considered. The judicious use and interpretation of investigations given the above complexity is discussed, with suggestions of how the explanation of the diagnostic formulation to the patient can be tailored, including insight into the above processes, to aid recovery. Moving beyond the one-dimensional concept of ‘postconcussional syndrome’ and reframing the cause of persistent symptoms following mild traumatic brain injury in a bio-psycho-socio-ecological model will hopefully improve understanding of the underlying contributory mechanistic interactions and facilitate treatment.
6: PALLIATIVE GASTRECTOMY FOR METASTATIC GASTRIC ADENOCARCINOMA: A NATIONAL POPULATION-BASED COHORT STUDY
Authors: Kamarajah S , Markar S , Phillips A , Salti G , Dahdaleh F , Griffiths E 
Published: April 2022

Abstract

Background and aim
The impact of palliative gastrectomy for metastatic gastric adenocarcinoma, especially by site of metastasis remains unclear. This study aimed to evaluate the long-term outcomes of palliative gastrectomy for metastatic gastric adenocarcinoma.

Methods
The National Cancer Database (2010–2015) was used to identify patients with clinical metastatic (cM1) gastric adenocarcinoma (n = 19,411) at diagnosis. The main variable was index management for cM1 gastric adenocarcinoma (i.e. no treatment, palliative chemotherapy or palliative gastrectomy). Cox multivariable analyses were used to account for treatment selection bias.

Results
Of 19,411 patients, 10,893 (56%) received palliative chemotherapy, and only 1,101 (6%) received palliative gastrectomy only. The median survival was 6.1 months, and 5-year survival was 4% in the entire cohort. Patients receiving palliative gastrectomy had a significantly longer survival than patients without any treatment or palliative chemotherapy (median: 12.8 vs 1.8 vs 9.5 months, P &lt; 0.001), which remained after multivariable adjustment (HR: 0.30, CI95%: 0.28–0.33, P &lt; 0.001). Stratified analyses by clinical nodal stage (cN) demonstrated survival benefit with palliative gastrectomy: cN0 (HR: 0.28, CI 95%: 0.24–0.32), cN1 (HR: 0.27, CI 95%: 0.23–0.31), cN2 (HR: 0.29, CI 95%: 0.24–0.37), and cN3 (HR: 0.26, CI 95%: 0.20–0.32). Palliative gastrectomy remained superior compared to palliative chemotherapy for metastatic disease limited to liver, bone and peritoneum, but equivalent to lung metastasis and inferior to brain metastasis.

Conclusion
Palliative gastrectomy appears to have a modest survival benefit over palliative chemotherapy alone. Differences in outcomes by site of metastasis warrant further research to understand tumor biology and identify specific subgroups which may benefit from palliative gastrectomy.
8: ARE ELDERLY PATIENTS AT INCREASED PERIOPERATIVE MORBIDITY AND MORTALITY FROM OESOPHAGECTOMY FOR OESOPHAGEAL CANCER? A SYSTEMATIC MAPPING REVIEW AND META-ANALYSIS
Authors: Gujjuri R , Kamarajah S , Elhadi M , Umar H , Subramanya M , Evans R , Griffiths E 
Published: April 2022

Abstract

Background and aim
Oesophagectomy is being increasingly performed in an ageing population that is observing a concomitant growth in the life expectancy. However, the risks are poorly quantified, and this study aims to review current evidence to further quantify the postoperative of oesophagectomy in the elderly population compared to younger patients.

Methods
A systematic electronic search was conducted for studies reporting oesophagectomy in the elderly population. Meta-analysis was performed using random-effects modelling to compute odds ratios (OR) and 95% confidence intervals (CI). Primary outcome was overall complications and secondary outcomes included anastomotic leaks, cardiac complications, pulmonary complications, overall and disease-free survival. Meta-regression was performed to identify study-, hospital- and patient-level factors confounding study findings.

Results
This review included 37 eligible studies involving 61,723 patients. Increasing age was significantly associated with increased rates of overall complications (OR: 1.67, CI95%: 1.42–1.97), cardiac complications (OR: 1.62, CI95%: 1.10–2.40), pulmonary complications (OR: 1.44, CI95%: 1.11–1.87) and decreased 5-year overall survival (OR: 1.36, CI95%: 1.11–1.66) and 5-year disease-free survival (OR: 1.66, CI95%: 1.40–1.97). Rates of anastomotic leaks showed no difference between elderly and younger patients (OR: 1.06, CI95%: 0.71–1.59).

Conclusion
Postoperative outcomes such as overall complications, 5-year overall survival and disease-free survival appear to significantly worse in all age cut-offs in this meta-analysis. Sarcopenia and frailty act as better predictors of postoperative outcomes than chronological age. This study confirms the preconceived suspicions of increased risks in elderly patients following oesophagectomy and will aid future pre-operative counselling and informed consent.
10: INTRATHORACIC VERSUS CERVICAL ANASTOMOSIS AFTER MINIMALLY INVASIVE OESOPHAGECTOMY FOR OESOPHAGEAL CANCER: A RANDOMISED CONTROLLED TRIAL
Authors: Van Workum F , Verstegen M , Klarenbeek B , Bouwense S , Van Berge Henegouwen M , Daams F , Gisbertz S , Hannink G , Haveman J W , Heisterkamp J , Jansen W , Kouwenhoven E , Van Lanschot J , Nieuwenhuijzen G , Van Der Peet D , Polat F , Ubels S , Wijnhoven B , Rovers M , Rosman C 
Published: April 2022

Abstract

Background and aim
Transthoracic minimally invasive oesophagectomy (MIO) is increasingly performed as part of curative multimodality treatment. There is no robust evidence on the preferred location of the anastomosis after transthoracic MIO. The aim of this study was to compare an intrathoracic with a cervical anastomosis in a randomised controlled trial.

Methods
An open multicentre randomised controlled superiority trial was performed. Patients with mid to distal oesophageal or gastro-oesophageal junction cancer planned for curative resection were included. Patients were randomly assigned (1:1) to transthoracic MIO with intrathoracic or cervical anastomosis. The primary endpoint was anastomotic leakage requiring endoscopic, radiologic or surgical intervention. Secondary outcomes were overall anastomotic leak rate, other postoperative complications, length of stay, mortality and quality of life. The ICAN trial is registered in the Dutch trial register under number NTR4333.

Results
Two hundred and sixty-two patients were randomised and 245 were eligible for analysis. Anastomotic leakage necessitating re-intervention occurred in 15 of 122 (12.3%) patients with intrathoracic anastomosis and in 39 of 123 (31.7%) patients with cervical anastomosis (risk difference − 19.4%, 95% CI -29.5%—-9.3%). Overall anastomotic leak rate was 12.3% in the intrathoracic anastomosis group and 34.1% in the cervical anastomosis group (risk difference − 21.9%, 95% CI -32.1%—-11.6%). ICU length of stay, mortality rates and overall quality of life were comparable between groups, but intrathoracic anastomosis was associated with less severe complications, lower incidence of recurrent laryngeal nerve palsy and better quality of life in three subdomains.

Conclusion
Intrathoracic anastomosis is the preferred technique for patients treated with transthoracic MIO for mid to distal oesophageal or gastro-oesophageal junction cancer.
19: CARDIOPULMONARY FUNCTION FOLLOWING NEO-ADJUVANT CHEMOTHERAPY FOR OESOPHAGO-GASTRIC ADENOCARCINOMA
Authors: Penney N , Dirie J , Jeffreys N , Siddig A , Currie A , Kamocka A , Prabhu P , Abbassi-Ghadi N , Singh P , Preston S R 
Published: April 2022

Abstract

Background and aim
The role of perioperative chemotherapy in oesophago-gastric adenocarcinoma is well established. Epirubicin, Cisplatin/Oxaliplatin and Capecitabine (ECX/EOX) based regimens have recently been challenged by Fluoruracil, Leucovorin, Oxaliplatin and Docetaxel (FLOT). We aimed to assess whether these regimens had variable effects on patient cardiopulmonary fitness and subsequent suitability for major surgery following treatment.

Methods
Cardiopulmonary exercise (CPEX) testing was used to provide objective estimation of cardiopulmonary function metrics including peak oxygen consumption (VO₂ max), anaerobic threshold (AT) and ventilatory efficiency (VeVCO₂ slope). Paired CPEX testing was performed in participants undergoing treatment for oesophago-gastric adenocarcinoma pre and post FLOT (n = 26) or ECX/EOX (n = 51) chemotherapy regimens, as selected by the multidisciplinary team. Univariate non-parametric testing was used to assess differences for significance.

Results
Participants undergoing FLOT were younger [median (IQR): 61(12.5) □□. 69(11) years, P = 0.003] and had a higher pre-chemotherapy VO₂ max/m2 [929(231) □□. 838(198) ml/m2/min, P = 0.040] and FEV1 [3.5(0.8) □□. 2.9(0.6), P = 0.017] compared to those undergoing ECX/EOX. Other metrics including BMI, weight, VO₂ max/kg, AT, VeVCO₂ slope, FVC and FEV1 were not significantly different at baseline. There was no difference in time to CPEX testing after completing chemotherapy treatment [median 27 □□. 27 days]. Both FLOT and ECX/EOX significantly reduced VO₂ max/kg [−2.85(4.0) & -1.70(3.5) ml/kg/min], VO₂ max/m2 [−101(193) & -68(155) ml/m2/min] and AT [−1.35(2.7) & -1.1(2.3) ml/kg/min] respectively (all P &lt; 0.001), with no significant absolute or proportional differences found between the groups. Respiratory function was not altered.

Conclusion
A reduction in cardiopulmonary function should be accounted for when planning surgery for oesophago-gastric cancer following neo-adjuvant chemotherapy. We did not find significant differences in cardiopulmonary function reduction between chemotherapy regimens in this cohort. However, there was a trend towards a greater reduction in cardiopulmonary function after FLOT and studies in larger cohorts of patients are needed to clarify this.
30: STRONG IMPACT OF SARCOPENIA AS A RISK FACTOR OF SURVIVAL IN RESECTED GASTRIC CANCER PATIENTS: FIRST REPORT FROM AN ITALIAN CANCER CENTER
Authors: Ricciardolo A A , De Ruvo N , Prampolini F , Pecchi A , Missori G , Sorrentino L , Rossi E G , Fenocchi S , Salati M , Spallanzani A , Cautero N , Serra F , Gelmini R 
Published: April 2022

Abstract

Background and aim
Gastric cancer (GC) accounts for 4% of all cancers in Europe. Sarcopenia is a complex syndrome characterized by a loss of muscle mass and function associated with age, often present in neoplastic diseases. Recently several studies have shown a significant association between sarcopenia and poor prognosis in various pathological conditions.

Methods
This observational retrospective study investigates the association between sarcopenia and outcome, both as RFS and OS, in patients with GC undergoing surgery with curative intent. For 50 patients, 25 male and 25 female, the preoperative CT calculation of the skeletal muscle index (SMI) at L3-level allowed us to identify 34 patients with and 16 without sarcopenia. Kaplan-Meyer and univariable and multivariable Cox regression analysis were performed to determine difference in survival and presence of independent prognostic factors.

Results
A statistically significant difference between the sarcopenic and non-sarcopenic groups was observed in both overall survival (OS) and recurrence-free survival (RFS) (P &lt; 0.023; P &lt; 0.006). Moreover, sarcopenia was strongly correlated to a higher risk of recurrence in univariate and multivariate analysis (P &lt; 0.02).

Conclusion
Sarcopenia can be considered a critical risk factor for survival in patients with resectable GC.
31: UTILITY OF ABDOMINAL DRAIN IN GASTRECTOMY (ADIGE) TRIAL: STUDY PROTOCOL FOR A MULTICENTER NON-INFERIORITY RANDOMIZED TRIAL
Authors: Weindelmayer J , Mengardo V , Veltri A , Baiocchi G L , Giacopuzzi S , Verlato G , De Manzoni G 
Published: April 2022

Abstract

Background and aim
Prophylactic use of abdominal drain in gastrectomy has been questioned in the last 15 years and a 2015 Cochrane meta-analysis on four RCTs concluded that there was no convincing evidence to the routine drain placement in gastrectomy. Nevertheless, the Authors evidenced the moderate/low quality of the included studies and highlighted how 3 out of 4 came from Eastern countries. After 2015 only retrospective studies have been published, all with inconsistent results.

Methods
ADiGe (Abdominal Drin in GastrEctomy) Trial is a multicenter prospective randomized non-inferiority trial with a parallel design. It aimed to verify whether avoiding routine use of abdominal drain is burdened with complications, particularly an increase in postoperative invasive procedures. Patients with gastric cancer, scheduled for subtotal or total gastrectomy with curative intent, are eligible for inclusion, irrespective of previous oncological treatment. The primary composite endpoint is reoperation or percutaneous drainage procedures within 30 postoperative days. The primary analysis will verify whether the incidence of the primary composite endpoint is higher in the experimental arm, avoiding routine drain placement, than control arm, undergoing prophylactic drain placement, in order to falsify or support the null hypothesis of inferiority. Secondary endpoints assessed for superiority are overall morbidity and mortality, Comprehensive Complications Index, incidence and time for diagnosis of anastomotic and duodenal leaks, length of hospital stay, readmission rate.

Trial registration
Prospectively registered (last updated on October 29, 2020) at Clinicaltrials.gov with the identifier NCT04227951, https://clinicaltrials.gov/ct2/show/NCT04227951.

Results
Assuming one-sided alpha of 5%, and cumulative incidence of the primary composite endpoint of 6.4% in control arm and 4.2% in the experimental one, 364 patients allow to achieve 80% power to detect a non-inferiority margin difference between the arm proportions of 3.6%. Considering a 10% drop-out rate, 404 patients are needed. In order to have a balanced percentage between total and subtotal gastrectomy, recruitment will end at 202 patients for each type of gastrectomy. The surgeon and the patient are blinded until the end of the operation, while postoperative course is not blinded to patient and caregivers.

Conclusion
ADiGe Trial could contribute to critically re-evaluate the role of prophylactic drain in gastrectomy, a still widely used procedure.
43: NEOADJUVANT CHEMOTHERAPY OFFERS NO SURVIVAL BENEFIT FOR CT2N0M0 GASTRIC ADENOCARCINOMA. A MULTICENTRIC EUROPEAN STUDY
Authors: Abboretti F , Lambert C , Schäfer M , Le Roy B , Mège D , Demartines N , Pezet D , Gronnier C , Mantziari S 
Published: April 2022

Abstract

Background and aim
According to current international guidelines, the optimal treatment of stage cT2N0M0 gastric adenocarcinoma consists of preoperative chemotherapy followed by surgery. Surgery first may be suggested in selected patients, especially if considered unfit for chemotherapy. The aim of the present study was to assess if cT2N0M0 patients treated with surgery first (S) had inferior overall and disease-free survival compared to those treated with neoadjuvant chemotherapy followed by surgery (CS).

Methods
A retrospective analysis was performed among 32 centers, including all consecutive patients with gastric adenocarcinoma operated between January 2007 and December 2017. Patients with cT2N0M0 stage were divided into two groups, surgery first (S) and neoadjuvant chemotherapy followed by surgery (CS). Clinico-pathological details, overall and disease-free survival were compared between the groups. Cox regression analysis was performed for long-term survival.

Results
Among the 2131 included patients, 202 (9.5%) had cT2N0M0 disease: 68 (33.7%) were placed in the CS group and 134 (66.3%) in the S group. CS patients were younger (mean age 62.7 ± 12.8 vs 69.8 ± 12.1 years, P &lt; 0.001) with WHO status 0 in 60.3% versus 34.5% in S patients (P = 0.006). The CS group had more proximal tumors, undergoing more frequently total gastrectomy (70.6% CS vs 45.5% S, P = 0.001). The median number of resected lymph nodes was similar (22 vs 20.5, P = 0.74). R0 resection margins were obtained in 97.1% CS vs 95.5% S patients (P = 0.72). Adjuvant chemotherapy was more often administered in CS patients (75.8% versus 29.8% in S, P &lt; 0.001). Recurrence occured in 30.9% in CS and 18.1% in S (P = 0.04), predominantly as distant metastases (81% CS vs 75% S, P = 0.76). Overall 5-year survival was similar between CS (74.4%, 95%CI 58.1–85.1) and S groups (66.7%, 95%CI 54.4–76.5, P = 0.73), as was 5-year disease-free survival (DFS) (64.6%, 95%CI 48.4–76.9 for CS vs 62.8%, 95%CI 50.7–72.6 for S, P = 0.82). Perioperative chemotherapy was not associated with OS or DFS in multivariate analysis.

Conclusion
Patients with cT2N0M0 gastric adenocarcinoma did not present a survival or recurrence benefit if treated with CS compared to S. In accordance with esophageal cT2N0 tumors, surgery first might be a valid treatment option for these patients.