bluuebunny/crossref_metadata_2025 huggingface dataset:
OC-125 PARASTOMAL HERNIA REPAIR WITH THE MODIFIED RETROMUSCULAR SUGARBAKER TECHNIQUE (PAULI PROCEDURE)
Authors: Gröger C , Kundel L , Adam U , Köckerling F , Riediger H
Published: May 2023

Aim

Parastomal hernia can be treated by retromuscular mesh placement with transversus abdominis release (Pauli procedure). Since then, we established it as our standard procedure and report on our perioperative results and initial follow-up data.

Material & Methods

During a 4-year period (1/2019–12/2022), 20 consecutive patients were treated by Pauli procedure. All patients were prospectively registered in the Herniamed database. Follow up was performed by patient interview or patient review.

Results

Pauli Procedures were mainly (75%, n=15) performed by minimal-invasive techniques (Laparoscopic n=14, open n=4, robotic n=1). Thirteen patients had a urostomy and seven had a colostomy. Median hernia diameter was 5 cm (3–13 cm, EHS classification for parastomal hernia: 9×I, 6×III and 5×IV). Median Mesh size was 310 cm2 (150–750). Perioperative morbidity was 15% (n=3, Clavien Dindo Grade II). Median hospital stay was 4 days (range: 3–17). Median follow up was 13 months (range 6–43) with a recurrence rate of 20% (urostomy n=3, colostomy n=1).

Conclusion

Pauli repair of parastomal hernia can be performed routinely by minimal-invasive techniques. The perioperative risk is low. Further studies are necessary to reduce the recurrence rate.
P-056 ADOPTING ROBOTICS IN A PRIVATE PRACTICE: FIRST EXPERIENCE AND PITFALLS
Authors: Serebrennikov A
Published: May 2023

Aim

Description of the adoption process, first experiences and pitfalls with a surgical robot for hernia surgery in a private practice.

Material & Methods

consecutive experience with the first 30 cases including redo cases for inguinal hernias with previous preperitoneal mesh placemen, previous prostate surgery and incional hernias.

Results

There were no complications. The usage of pain medication was significantly lower in comparison to “conventional” hernia surgery techniques. The preparations of the operating theatre for a robot adoption in a small day case unit was complex and required thorough planning and a talent for improvisation.

Conclusion

Robotic approach to hernia surgery is feasible and safe in a private practice setting with day cases. Using a robot potentially allows to minimize risks and complication rates and raise patient comfort. There are several pitfalls which can be avoided if known in advance.
P-063 Comparison of isokinetic dynamometer and strain gauge as measurement methods of abdominal wall strength in patients with abdominal hernia
Authors: Garcia Moriana A J , Sanchez Arteaga A , Tallon Aguilar L , Tinoco Gonzalez J , Feria Madueño A , Sañudo Corrales B
Published: May 2023

Aim

The goal was to analyse trunk flexion strength in patients undergoing incisional hernia surgery, obtaining the data using both isokinetic dynamometer (gold standard for the measurement of the abdominal wall strenght) and strain gauge.

Methods

Observational cohort study, including patients with incisional hernia (July-December 2022). Collected data were demographic characteristics, clinical characteristics related with the hernia, and measures of the abdominal wall strength using an isokinetic dynamometer and a strain gauge. Comparative analysis was performed using Pearson correlation test adjusted for body composition parameters.

Results

53 patients were enrolled (56,6% female) with a mean age of 57,42 age (SD 10,49). Mean BMI was 30,42 (SD 5,15), and mean maximum diameter of hernia defect was 6,75cm (SD 2,16). Bending force moment measurement was 80,23 N/m (SD 38,17). Results obtained with the strain gauge were: force peak with hip and knee flexion at 90° 171,1 N (SD 52,98), rate of force development (RFD) 523,29 N/s (SD 410,04). Adding 45° trunk rotation, peak force was 158,4 N (SD 42,76) and RFD 376,72 N/s (SD 288,74). Significant Pearson correlation indexes were found exceeding r= 0,641 for peak force and r= 0,305 for RFD (both at 90°), and r= 0,6 for peak force and r= 0,315 for RFD (both at 45°) when compared to isokinetic moment values.

Conclusions

In our group of study, we found a correlation between data obtained using isokinetic dynamometer and strain gauge. Further studies should analyze these associations controlling for other variables such as gender, age or hernia defect size.
P-067 PREHABILITATION IN A LOSS OF DOMAIN BILATERAL INGUINOSCROTAL HERNIA: USE OF BOTULINUM TOXIN AND PREOPERATIVE PROGRESSIVE PNEUMOPERITONEUM
Authors: Orellana León M , Lorenzo Mañas S , Vázquez Beltrán P , Vega Novillo V , Justo Alonso I , Butrón Vila T , Fernández Nöel S , Lavin Montoro L , Bernaldo De Quirós Fernández M , Falcón Bonilla K , Martínez Pozuelo A , Otero Torrón B
Published: May 2023

Aim

Describe the use of botulinum toxin A (BT) and preoperative progressive pneumoperitoneum (PPP) in a loss of domain inguinoscrotal hernia following our hospital's protocol.

Material and methods

Single case report of a 60-year-old male, with loss of domain bilateral inguinoscrotal hernia. We performed prehabilitation with respiratory physiotherapy (RP), BT and PPP. We applied BT 30 days before surgery, injecting a total of 500U in 12 sites of abdominal wall: 4 in the lateral abdominal muscle and 2 of them in each rectus abdominis. We calculated, using the Tanaka index, the ratio between the abdominal cavity volume (ACV) and the hernia volume (HV), which was 32%, as well as the amount of pneumoperitoneum to insufflate, which according to our protocol is HV x3 + 100cc.

The PPP catheter was placed 10 days before repair, insufflating a total of 6.900cc within seven consecutive days of catheter placement.

Results

With the application of prehabilitation (BT, RP, PPP) we achieve a lengthening of 18.5 cm and a decrease of 27 mm of the thickness as well as an increase in the volume of the abdominal cavity of×4.200cc.

Afterwards, a hernioplasty with Stoppa and bilateral Litchenstein technique was performed. as well as a scrotoplasty and circumcision for the patient's phimosis in collaboration with Plastic and Urology services.

The surgical procedure was performed without complications. After 7 months there is no hernia recurrence.

Conclusions

BT and PPP help to repair the inguinoscrotal hernia, avoiding the mayor surgical techniques like component separation diminishing morbidity.
P-071 GIANT INGUINOSCROTAL HERNIA ASSOCIATED WITH PENIS BASALOID CARCINOMA. A PURPOSE OF A CASE
Authors: Jaimes León E , Peña Soria M J , Buendia J , Galante I , García Romero E , López Antoñanzas L , Del Campo Martín M , De La Serna Esteban S , Torres García A J
Published: May 2023

We present a unique case of a patient with a giant bilateral inguinoscrotal hernia associated with a basaloid carcinoma in pennis. A 60 year old male with bilateral inguinoscrotal hernia came to our office because he had a suppurative ulcer around pennis and chronic hidradenitis in perineal and scrotum region. We presented the case in a multidisciplinary session composed by urologists, plastic surgeons and abdominal wall surgeons in order to plan the diagnosis and treatment.

The CT showed us a bilateral inguinoscrotal hernia with a large and small bowel inside them. The multidisciplinary team decided on toxin botulinum.

An infiltration previous hernia repair in order to avoid complications related to the huge volumen. During the infiltration we also scheduled cystoscopy and biopsy of the pennis injury. The cystoscopy showed a urethral fistula. The biopsy was informed as a basaloid invasive carcinoma.

Surgery was scheduled 4 weeks after toxin botulinum infiltration. Surgical team was composed of urologists, plastic surgeons and abdominal wall surgeons.

We performed a hypogastric transverse incision, then opened midline to reduce inguinal hernia contented by a combined maneuvers. Small bowel resection was performed because it was infiltrated by the tumor. Bilateral Liechtenstein repair was done with polypropylene mesh. The midline was closed with intra abdominal mesh and continuous suture. Partial penectomy was done. Scrotum skin was resected. Testicles are left in, in a crossing mode under skin flaps.

Anatomopatologic diagnosis was Pennis Epidermoid carcinoma pT3pN0 pM1. After 1 year follow up no recurrence of tumor or hernias.
V-010 ROBOTIC ASSISTED BILATERAL INGUINOSCROTAL HERNIA REPAIR: STEP BY STEP
Authors: Huerta M , Rodrígues V , Verdaguer M , Bergamini S , Martínez P , Herms D , López Cano M
Published: May 2023

Introduction

Robotic surgery in the field of abdominal wall surgery is exponentially growing. In this video we will present a step by step robotic approach for bilateral inguinoscrotal hernia repair.

Clinical case

A 79 year-old male with history of hypercholesterolemia was diagnosed of bilateral inguinal hernia. On physical examination, a right inguinoscrotal hernia (EHS classification L3P) and left inguinal hernia (EHS classification M1P) were diagnosed. Minimally invasive surgery assisted by DaVinci Xi robot is decided.

Under general anesthesia, a supraumbilical 8-mm trocar is located and 2 other trocars are positioned 8 cm laterally. Monopolar scissors and bipolar grasps are introduced. Laparoscopic examination confirmed the diagnosis.

First, peritoneum is dissected, allowing to access to the preperitoneal space, dissecting the medial and lateral compartiment, reaching the pectineal ligament. Identification and reduction of the hernia sac is performed, individualizing and preserving the inguinal structures. Critical view of the miopectineal orifice is ensured.

Contralateral procedure is performed. 15×15 cm Poplipropilene mesh are located at the preperitoneal space, fixated with 3/0 PDS stitches to the pectineal ligament. Fixation stitches are done at the superior section of the mesh. Peritoneal flaps are closed with V-lock suture.

Conclusion

Robotic surgery is a safe and feasible procedure for inguinal hernia repair in patients specially selected (BMI <30, bilateral hernias). Further studies are needed in order to clarify its role in the field of minimally invasive surgery.
V-013 NEW TECHNIQUE FOR ABDOMINAL WALL GRAFT RETRIEVAL
Authors: Navarro Fajardo D , Jiménez Romero C , Vega Novillo V , Marcacuzco Quinto A , Caso Maestro O , Calvo Pulido J , Manrique Municio A , García Sesma Á , Loinaz Segurola C , Justo Alonso I
Published: May 2023

Aim

show our technique for abdominal wall graft retrieval minimizing warm ischemia time.

Material and methods

a video report of an abdominal wall graft retrieval (full-thickness) from a female brain death donor.

Results

better graft perfusion with a lower picnosis in the studied cells. Lower tissue damage in both full-thickness and isolated fascia grafts.

Surgical technique: An “house-flap” incision is done as opposed to a conventional cross-line laparotomy. The flap is extended until the inguinal ligament, divided afterwards to gain easier access to the femoral vessels. After abdominal organ dissection, the common iliac arteries are dissected from close to the aortic bifurcation up to the femoral vessels, beyond the origin of the inferior epigastric arteries. After cannulation of the aorta, cava vein and inferior mesenteric vein for the intraabdominal organs, both common iliac arteries are cannulated beyond the origin of external iliac artery. To achieve optimal perfusion of the rectus fascia we have to clamp the artery distal to the origin of the inferior epigastric artery (usually at the level of the femoral artery). The abdominal wall graft perfusion is done simultaneously with all the abdominal organs. Afterwards, we cover the graft with cold pads to avoid direct contact between the ice and the graft. A closure of the donor abdominal wall must be ensured after removing the wall graft.

Conclusions

our technique has showed better pathological outcomes than those previously published with a lower warm ischemia time of the abdominal wall graft.
V-020 Botulinum Toxin: not just aesthetics anymore
Authors: Barreira A L , Figueiredo J , Souto R , Branco A
Published: May 2023

Introduction

Surgical repair of recurrent abdominal incisional hernia can be challenging. ﻿The aim should be a tension-free, mesh reinforced midline fascial closure. Different methods have been described to achieve this primary fascial closure. Botulinum toxin (BT) is a neurotoxin that when injected into muscle tissue, causes a temporary flaccid muscle paralysis. This effect can be applied to the lateral abdominal wall muscles, thereby facilitating midline rectus muscles re-approximation and defect closure.

Clinical Case

We present a case of a 58 year old female, with a history of right hemicolectomy and ileostomy, that underwent subsequent stoma closure one year after. She presented with a 12 cm defect width incisional hernia and right rectus muscle atrophy. We demonstrate the preoperative injection of BT using the Zielinski technique in a consultation room with no need for patient monitoring or anesthesia. Four weeks later, the patient underwent open repair with bilateral transversus abdominis release and retromuscular mesh reinforcement. The defect was closed without tension and the postoperative period was uneventful. Patient was discharged on postoperative day 4.

Conclusion

Preoperative BT injection as a selective muscle chemical component paralysis is a safe, easy to perform and effective technique that aims to counteract the chronic muscle retraction observed in large ventral hernias.

BT in combination with advanced ventral hernia repair techniques, may help provide the crucial extra tissue mobility required to achieve primary closure, with the added advantage of less postoperative pain, thereby contributing to early patient discharge.
V-032 UMBILICAL ACCESS AND INFERIOR DOCKING FOR ROBOTIC EXTENDED TOTALLY EXTRAPERITONEAL REPAIR (ETEP) OF UPPER MIDLINE INCISIONAL HERNIA
Authors: Barranquero A G , Villalobos Mori R , Maestre González Y , Sisó E , Codina L , Olsina Kissler J J
Published: May 2023

Aim

Inferior docking for extended totally extraperitoneal repair (eTEP) is the recommended access for the repair of upper midline defects (Belyansky et al. [2018]). However, this access can be challenging due to the proximity of the inferior epigastric vessels. The aim was to show the results of an infraumbilical access for inferior docking in a robotic eTEP.

Material & Methods

Video description of a case report.

The patient was a 59-year-old male who underwent an urgent splenectomy through an upper midline laparotomy and developed an M2 incisional hernia with a defect of 6 cm.

Results

An infraumbilical access was used to place a distension balloon and dissect the preperitoneal space. Then, a Hasson trocar was placed, followed by the first robotic trocar in the inferior midline. The space was dissected to place the other two robotic trocars laterally to the inferior epigastric vessels. After the inferior docking was completed, a sequential bilateral retrorectus dissection was performed, with hernia reduction and an extended dissection under the xiphoid process. Posteriorly, a bilateral partial transversus abdominis muscle release was made to allow a complete suture of the posterior rectus sheath. The image was inverted to perform the plication of the rectus muscle and the closure of the hernia defect. Finally, a polyvinylidene difluoride (PVDF) mesh was placed in the retromuscular space without additional fixation.

Conclusion

The umbilical access facilitates the inferior docking in robotic eTEP, providing an optimal vision of upper midline defects and allowing a symmetric transversus abdominis muscle release.
V-034 SPONTANEOUS EVISCERATION THROUGH AN UMBILICAL HERNIA
Authors: Tuñón-Féquant C , Rodríguez-González D , Casanova-Ramos R , Guil-Ortiz B , Montes-Montero A , Arteaga-González I
Published: May 2023

Aim

Umbilical hernia in the cirrhotic patient is frequently seen in the setting of refractory ascites. Nevertheless, spontaneous evisceration is an unusual and potentially life-threating event. This hernia rupture has a high mortality and morbidity and presents many challenges in medical and surgical management.

Material & Methods

We present a case of a 58 years-old man with personal history of alcoholic cirrhosis with multiple ascites drainages, portal hypertension and hepatic encephalopathy. The patient went to the emergency department suffering from an umbilical hernia with spontaneous rupture and evisceration.

Results

An urgent umbilical hernioplasty was conducted. We performed a hernia sac and suprafascial dissection. We verified that the vascularization of the hernia content was correct. We close peritoneum with double suture (transfixion ligature and continuous suture techniques) and fascia defect. We finally placed an onlay mesh. In the postoperative period, the patient had no complications related to dehiscence of suture or peritoneal fluid leakage, but stayed hospitalized for 25 days due to the decompensation of the cirrhosis. After six months of follow-up, there are no signs of recurrence.

Conclusions

Cirrhotic patients undergoing abdominal surgery are prone to complications, especially in hernias with spontaneous evisceration. One of de most frightening surgical complications in cirrhotic patients is the leakage of peritoneal fluid. In our case, this leakage could not have been produced because we used double suture and transfixion ligation to close peritoneum.
V-039 Combination of Botox & eTEP & hemi-TAR for giant hernia repair in an obese patient
Authors: Gómez López J R , Trujillo Díaz J J , Martínez Moreno C M , Concejo Cútoli P , Montenegro Martín M A , Atienza Herrero J , Martín Del Olmo J C
Published: May 2023

Objective

The possibility of new approaches allows dissecting wide retroperitoneal spaces with minimal tissue damage, make the laparoscopic approach a developing technique. Our purpose is to show how the extended-view totally extraperitoneal (eTEP) approach can be used for giant hernia repair in obese patients.

Material and Methods

34-year-old man, with a history of laparotomy due to traumatic perforation of the colon and BMI: 39.18, presented hernia M2–5W3. Preoperative botox is performed 1 month before.

Results

laparoscopic approach was performed: dissector balloon in the left hypochondrium, 5mm trocars in the right hypochondrium and flank. And 10mm trocar on the right flank. Dissection of the left retrorectal space. Crossover in upper third. Dissection of the right retrorectal space. Hernial sac opening during dissection. Section of the right transverse muscle is completed and that space is released. Plication of the anterior fascia and hernial sac. Closure of the posterior fascia. Measurement and placement of 37×25 cm CICAT mesh fixed with tissucol.

Conclusion

Minimally invasive surgery allows more and more extensive surgeries to be performed, with less aggression to patients and faster recovery. With the technical improvements and the combinations of different tools, we're capable of performing laparoscopic repair of giant hernias. In our case, the preoperative application of botox, eTEP technique, and the combination of one-sided TAR allowed safe and uncomplicated repair of an M2-5W3 hernia defect. eTEP is a safe and reproducible technique that can be used in association with hemi TAR or bilateral TAR for the solution of giant hernias.
Green and Sustainable Analytical Chemistry-Driven Chromatographic Method Development for Stability Study of Apixaban Using Box–Behnken Design and Principal Component Analysis
Authors: Prajapati Pintu , Rajpurohit Pooja , Pulusu Veera Shakar , Shah Shailesh
Published: May 2023

Apixaban (APX) is a novel anti-coagulant drug approved by USFDA. According to referred literature, numerous chromatographic methods such as RP-HPLC and high-performance thin-layer chromatography have been published for the stability study of APX. But these chromatographic methods have been developed using toxic organic solvents that are hazardous to the environment and unsafe for analysts. Hence, green and sustainable analytical chemistry-driven chromatographic method has been developed for the stability study of APX using safe organic solvents for the safety of analysts and the protection of the environment. APX was subjected to forced degradation for the development of a stability-indicating assay method. The method development was carried out by the implementation of chemometric and DoE approaches for minimizing solvent wastage. Principal component analysis was applied for the identification of critical method risk variables (MRVs) and method performance attributes. DoE-based response surface modelling was applied for the optimisation of critical MRVs. The greenness profile scales of published and developed chromatographic methods have been assessed by NEMI and AGREE methods for the estimation of APX. The developed method was found to be more eco-friendly and robust than the published chromatographic methods for the estimation of APX.
Venous excess ultrasound score and acute kidney injury in patients with acute coronary syndrome
Authors: Viana-Rojas Jesús Antonio , Argaiz Eduardo , Robles-Ledesma Mariana , Arias-Mendoza Alexandra , Nájera-Rojas Nitzha Andrea , Alonso-Bringas Alma Paola , De los Ríos-Arce Luis Fernando , Armenta-Rodriguez Jennifer , Gopar-Nieto Rodrigo , Briseño-De la Cruz Jose Luis , González-Pacheco Héctor , Sierra-Lara Martinez Daniel , Gonzalez-Salido Jimena , Lopez-Gil Salvador , Araiza-Garaygordobil Diego
Published: May 2023

Aims

Systemic venous congestion is associated with an increased risk of acute kidney injury (AKI) in critically ill patients. Venous Excess Ultrasound Score (VExUS) has been proposed as a non-invasive score to assess systemic venous congestion. We aimed to evaluate the association between VExUS and AKI in patients with acute coronary syndrome (ACS).

Methods and results

This is a prospective study including patients with the diagnosis of ACS (both ST elevation and non-ST elevation ACS). VExUS was performed during the first 24 h of hospital stay. Patients were classified according to the presence of systemic congestion (VExUS 0/≥1). The primary objective of the study was to determine the occurrence of AKI, defined by KDIGO criteria. A total of 77 patients were included. After ultrasound assessment, 31 (40.2%) patients were categorized as VExUS ≥1. VExUS ≥1 was more frequently found in inferior vs. anterior myocardial infarction/non-ST-segment elevation acute myocardial infarction (48.3 vs. 25.8 and 22.5%, P = 0.031). At each increasing degree of VExUS, a higher proportion of patients developed AKI: VExUS = 0 (10.8%), VExUS = 1 (23.8%), VExUS = 2 (75.0%), and VExUS = 3 (100%; P < 0.001). A significant association between VExUS ≥1 and AKI was found [odds ratio (OR): 6.75, 95% confidence interval (CI): 2.21–23.7, P = 0.001]. After multivariable analysis, only VExUS ≥1 (OR: 6.15; 95% CI: 1.26–29.94, P = 0.02) remained significantly associated with AKI.

Conclusion

In patients hospitalized with ACS, VExUS is associated with the occurrence of AKI. Further studies are needed to clarify the role of VExUS assessment in patients with ACS.
Comparison of machine learning techniques in prediction of mortality following cardiac surgery: analysis of over 220 000 patients from a large national database
Authors: Sinha Shubhra , Dong Tim , Dimagli Arnaldo , Vohra Hunaid A , Holmes Chris , Benedetto Umberto , Angelini Gianni D
Published: May 2023

OBJECTIVES

To perform a systematic comparison of in-hospital mortality risk prediction post-cardiac surgery, between the predominant scoring system—European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, logistic regression (LR) retrained on the same variables and alternative machine learning techniques (ML)—random forest (RF), neural networks (NN), XGBoost and weighted support vector machine.

METHODS

Retrospective analyses of prospectively routinely collected data on adult patients undergoing cardiac surgery in the UK from January 2012 to March 2019. Data were temporally split 70:30 into training and validation subsets. Mortality prediction models were created using the 18 variables of EuroSCORE II. Comparisons of discrimination, calibration and clinical utility were then conducted. Changes in model performance, variable-importance over time and hospital/operation-based model performance were also reviewed.

RESULTS

Of the 227 087 adults who underwent cardiac surgery during the study period, there were 6258 deaths (2.76%). In the testing cohort, there was an improvement in discrimination [XGBoost (95% confidence interval (CI) area under the receiver operator curve (AUC), 0.834–0.834, F1 score, 0.276–0.280) and RF (95% CI AUC, 0.833–0.834, F1, 0.277–0.281)] compared with EuroSCORE II (95% CI AUC, 0.817–0.818, F1, 0.243–0.245). There was no significant improvement in calibration with ML and retrained-LR compared to EuroSCORE II. However, EuroSCORE II overestimated risk across all deciles of risk and over time. The calibration drift was lowest in NN, XGBoost and RF compared with EuroSCORE II. Decision curve analysis showed XGBoost and RF to have greater net benefit than EuroSCORE II.

CONCLUSIONS

ML techniques showed some statistical improvements over retrained-LR and EuroSCORE II. The clinical impact of this improvement is modest at present. However the incorporation of additional risk factors in future studies may improve upon these findings and warrants further study.
Transcriptional Misexpression in Hybrids between Species Linked by Gene Flow Is Associated With Patterns of Sequence Divergence
Authors: Díaz Fernando , Wolf Jason , de Brito Reinaldo A
Published: May 2023

The extent to which hybridization disrupts a gene's pattern of expression likely governs its propensity for introgression, whereas its extent of molecular divergence can itself underlie such disruption. Together, these phenomena shape the landscape of sequence and transcriptional divergence across the genome as species diverge. To understand this process, we characterize gene expression inheritance, regulatory divergence, and molecular divergence in the reproductive transcriptomes of species linked by gene flow: the fruit flies Anastrepha fraterculus and A. obliqua, which show evidence of gene flow despite clear evolutionary divergence. We find that their transcriptional patterns are a mosaic between those typically observed within and between allopatric species. Transcripts showing transgressive expression in hybrids or cis-regulatory divergence between species are associated with greater sequence divergence. This may reflect pleiotropic constraints that make them resistant to gene flow or they may be more likely to experience divergent selection. Although these more divergent gene classes are likely to be important contributors to species differences, they are relatively rare. Instead, most differentially regulated transcripts, including those linked to reproduction, show high degrees of dominance in hybrids and trans-regulated divergence between species, suggesting widespread genetic compatibility that potentially allowed for introgression. These findings provide insights into how postzygotic isolating mechanisms might evolve in the presence of gene flow: regions showing cis-regulatory divergence or transgressive expression contribute to reproductive isolation, whereas regions with dominant expression and trans-regulatory divergence allow for introgression. These patterns create a genomic mosaic of transcriptional regulation that is tied to sequence divergence.
Deficits in Accessibility across Field Research Stations for Scientists with Disabilities and/or Chronic Illness, and Proposed Solutions
Authors: Rudzki Elizabeth N , Kohl Kevin D
Published: May 2023

Synopsis

Equity and inclusivity in STEM research has become a larger topic of discussion in recent years; however, researchers and scientists with disabilities and/or chronic illnesses are often missing from these conversations. Further, while field research is a major research component for some STEM disciplines, it is unclear what accessibility barriers or accommodations exist across the field sciences. Field research can sometimes involve harsh environments, topography, and weather that present challenges to those with disabilities and/or chronic illnesses. A large and coinciding obstacle standing in the way of field research accessibility is the ableism present across science and academia, resulting in and from a lack of prioritization of attention and funding from universities and institutions. Biological field stations have been shown to be valuable not only as infrastructure for field-based research, but also as providing resources toward the scientific education of students and scientific outreach initiatives for the general public. As such, biological field stations are perfectly positioned to reduce barriers in research inclusion and accessibility for students and scientists with disabilities and/or chronic illnesses. The current work presents the results of a survey meant to inventory the presence or absence of accessible infrastructure across field stations, with responses spanning six countries and 24 US states. Our results highlight a number of accessibility deficits in areas such as accessible entrances, kitchens, and bathrooms. Our results suggest that (1) biological field stations have significant variability in accessibility with significant deficits, especially in non-public-facing buildings used primarily by staff and researchers, and (2) field stations would benefit from an increase in federal funding opportunities to expedite their progress toward compliance with Americans with Disabilities Act (ADA) standards. We propose potential solutions to field work infrastructure spanning a range of financial costs, with emphasis on the point that efforts toward accessibility do not require an “all-or-nothing” approach, and that any step toward accessibility will make field stations more inclusive. Additionally, we further suggest that federal funding sources, such as the NSF and NIH, as well as university leadership, should consider broadening diversity initiatives to promote the continuation of, and increased accessibility of, university-affiliated field stations.
A longitudinal study evaluating adverse childhood experiences and obesity in adulthood using the Canadian Longitudinal Study on Aging (CLSA)
Authors: De Rubeis Vanessa , Gonzalez Andrea , Tarride Jean-Éric , Griffith Lauren E , Anderson Laura N
Published: May 2023

Background

Adverse childhood experiences (ACEs) are a risk factor for obesity; however, the causal mechanisms are not well understood. Objectives were to measure the impact of ACEs on adulthood obesity and to investigate whether the association was mediated by nutrition and stress.

Methods

A longitudinal study was conducted using adults aged 46–90 years (n = 26 615) from the Canadian Longitudinal Study on Aging. Participants were asked to recall ACEs from <18 years of age. Body mass index (BMI), waist circumference and per cent body fat were measured (2015–18) and obesity was defined using standard cut points. Nutrition was measured using data from the Short Diet Questionnaire and stress was measured using allostatic load. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% CIs for each obesity measure. Causal mediation methods were used to determine whether nutrition and stress were mediators.

Results

There were 66% of adults who had experienced one or more ACE. The odds of obesity defined by BMI and waist circumference increased in a dose–response manner with increasing number of ACEs (P trend <0.001). For instance, adults with four to eight ACEs, compared with none, had greater odds of obesity, defined by BMI (adjusted OR: 1.54; 95% CI: 1.28–1.75) and waist circumference (adjusted OR: 1.30; 95% CI: 1.15–1.47). There was no evidence of mediation by stress or nutrition.

Conclusions

Adversity experienced in early life is strongly associated with obesity among Canadian adults. Further research is needed to identify other mechanisms for this association to inform obesity prevention strategies.
Output feedback backstepping control for non-linear systems using an adaptive finite time sliding mode observer
Authors: Feng Jiehua , Zhao Dongya , Yan Xing-Gang , Spurgeon Sarah K
Published: May 2023

In this paper, a class of non-linear systems in normal form is considered, which is composed of internal and external dynamics. An adaptive finite time sliding mode observer is first designed so that the system states, unmatched uncertain parameters and matched uncertainties can all be observed in finite time. Then, the systematic backstepping design procedure is employed to develop a novel output feedback backstepping control (OFBC). The proposed OFBC method can stabilize the considered non-linear systems despite the presence of non-linear internal dynamics and unmatched uncertainties. A Lyapunov method is used to ensure that the closed-loop system is asymptotically stable. Two MATLAB simulation examples are used to demonstrate the method.
Effects of mushroom-tobacco rotation on microbial community structure in continuous cropping tobacco soil
Authors: Wang Xianju , Li Zhihua , Jin Honggang , Huang Xiaoming , Xiao Xubin , Zi Shuhui , Liu Tao
Published: May 2023

Aims

Rotation is an effective strategy for controlling crop diseases and improving plant health. However, the effect of a mushroom-tobacco rotation on the composition and structure of microbial communities in continuous cropping soil is unclear.

Methods and results

This study analysed the structure and function of soil bacterial and fungal communities using Illumina MiSeq high-throughput 16S rRNA gene sequencing. The results showed that the physicochemical properties (organic matter, available nitrogen, available phosphorus, and available potassium) and enzymatic activity (phosphatase, catalase, urease and invertase activity) in the rotation treatments (Y1, M1, Y2 and M2) were significantly higher than those in the control (continuous cropping) treatment (CK) and reached peak values in the M2 treatment. PCA showed that the soil microbial community structure in each rotation treatment was different from that in the control. The dominant bacterial phyla of the different soil treatments were Proteobacteria and Actinobacteriota, and the dominant fungal phyla of the different soil treatments were Ascomycota and Basidiomycota. The M2 rotation significantly reduced the relative abundance of harmful fungi (Penicillium and Gibberella) compared to the other treatments. RDA showed that the most abundant bacterial taxa were negatively correlated with pH and positively correlated with physicochemical properties. However, the most abundant fungal taxa were positively correlated with pH and negatively correlated with physicochemical properties.

Conclusions

The mushroom-tobacco rotation can effectively maintain the ecological balance of the substrate microbial environment, and provide a more effective way to prevent the continuous cropping of tobacco.
Monoammonium glycyrrhizinate improves antioxidant capacity of calf intestinal epithelial cells exposed to heat stress in vitro
Authors: Wang Yuexin , Meng Sudan , Wang Shuai , Wang Zhaojun , Dou Xueru , Dou Mengying , Li Yuanxiao , Ma Yanbo , He Lei , Shao Qi , Zhang Cai
Published: May 2023

Dairy calves are highly susceptible to the negative effects of heat stress, which can cause organ hypoxia after blood redistribution, damage the intestinal barrier, and trigger intestinal oxidative stress. This study aimed to investigate the antioxidant effects of monoammonium glycyrrhizinate (MAG) on calf small intestinal epithelial cells under heat stress in vitro. Small intestinal epithelial cells were isolated from a 1-d-old healthy calf and purified by differential enzymatic detachment. The purified cells were divided into seven groups. The control group was cultured with DMEM/F-12 at 37 °C for 6 h, and the treatment groups were cultured with 0, 0.1, 0.25, 0.5, 1, or 5 μg/mL MAG at 42 °C for 6 h. Heat stress causes oxidative damage to cells. Adding MAG to the medium can significantly improve cell activity and reduce cellular oxidative stress. MAG significantly increased the total antioxidant capacity and superoxide dismutase activity caused by heat stress, and significantly decreased malondialdehyde and nitric oxide levels. The MAG treatment also reduced lactate dehydrogenase release, increased mitochondrial membrane potential, and decreased apoptosis under heat stress. MAG also upregulated the expression of the antioxidant-related genes, Nrf2 and GSTT1, in heat-stressed intestinal epithelial cells and significantly downregulated the expression of the heat shock response-related proteins, MAPK, HSP70, HSP90, and HSP27. From the above results, we conclude that 0.25 μg/mL MAG improves the capability of the antioxidant system in small intestinal epithelial cells to eliminate reactive oxygen species by activating antioxidant pathways, improving the oxidant/antioxidant balance, lowering excessive heat shock responses, and reducing intestinal oxidative stress.
Elimination of structural and tree infestations of the Asian subterranean termite, Coptotermes gestroi (Wasmann) (Blattodea: Rhinotermitidae) with noviflumuron baits in above-ground stations
Authors: Su Nan-Yao , Mullins Aaron , Chouvenc Thomas
Published: May 2023

The traditional stake survey and in-ground (IG) monitoring stations have been ineffective in aggregating the Asian subterranean termite, Coptotermes gestroi (Wasmann) in southeastern Florida. In this study, we used both IG and above-ground (AG) Sentricon stations to monitor and bait C. gestroi, and as expected, none of the 83 IG stations was intercepted. Despite this, AG bait stations with 0.5% noviflumuron were successfully used to eliminate C. gestroi colonies. From 2 field experiments, the mean colony elimination time (±SD) using AG baits were 6.4 ± 3.8 wk (n = 4) and 8.0 ± 2.1 wk (n = 12), respectively. Such results were compatible with baiting studies against field colonies of C. gestroi elsewhere, that is, 4–9 wk. The successful rates in monitoring and baiting of C. gestroi with IG stations in other regions also varied, which may be due to the variabilities in tunnel geometry of this species in different environments. In areas with established C. gestroi populations, routine inspection for signs of activity in structures and surrounding trees can be a critical component for pest control providers for early detection of infestation and colony elimination with AG bait stations.
Logics and collaboration
Authors: Sonenberg Liz
Published: May 2023

Since the early days of artificial intelligence (AI), many logics have been explored as tools for knowledge representation and reasoning. In the spirit of the Crossley Festscrift and recognizing John Crossley’s diverse interests and his legacy in both mathematical logic and computer science, I discuss examples from my own research that sit in the overlap of logic and AI, with a focus on supporting human–AI interactions.
The safety profile of nivolumab plus ipilimumab combination therapy in Japanese patients with renal cell carcinoma: results from post-marketing surveillance
Authors: Uemura Hirotsugu , Shinohara Nobuo , Tomita Yoshihiko , Nonomura Norio , Yamada Takako , Yoshida Ai , Komoto Akira
Published: May 2023

Background

Nivolumab and ipilimumab combination therapy is approved in Japan for unresectable or metastatic renal cell carcinoma. Because the clinical trials supporting the approval of nivolumab and ipilimumab combination therapy included relatively few Japanese patients, post-marketing surveillance was implemented to collate further safety data for nivolumab and ipilimumab combination therapy.

Methods

Patients with unresectable or metastatic renal cell carcinoma who started nivolumab and ipilimumab combination therapy between September 2018 and December 2019 were registered in this post-marketing surveillance. The observation period was 13 weeks. Safety data included treatment-related adverse events with a particular emphasis on the gastrointestinal-related (colitis, enteritis, diarrhoea and gastrointestinal perforation) and liver-related (hepatic failure, hepatic function abnormal, hepatitis and cholangitis sclerosing) treatment-related adverse events that are listed in the risk management plan for nivolumab and ipilimumab combination therapy.

Results

Of the 203 patients registered, safety data were available for 159 (119 males/40 females) with a median age of 67 years (range 22–88). Seventy-one patients received nivolumab and ipilimumab combination therapy four times per usual clinical therapy, and 33 continued nivolumab monotherapy thereafter. Any-grade treatment-related adverse events were reported in 102 (64.2%) patients and grade ≥ 3 in 63 (39.6%). Hepatic function abnormalities (13.2%), rash (8.8%) and interstitial lung disease (7.5%) were the most common treatment-related adverse events. Five patients died following treatment-related adverse events. Gastrointestinal-related and liver-related treatment-related adverse events occurred in 10 (6.3%; four with grade ≥ 3 treatment-related adverse events) and 27 (17.0%; 19 with grade ≥ 3 treatment-related adverse events) patients, respectively.

Conclusions

This post-marketing surveillance in patients with unresectable or metastatic renal cell carcinoma revealed a safety profile for nivolumab and ipilimumab combination therapy consistent with CheckMate 214. Furthermore, no new safety concerns were identified including gastrointestinal-related and liver-related treatment-related adverse events.
The various faces of vulnerability: offering neurointerventions to criminal offenders
Authors: Ligthart Sjors , Dore-Horgan Emma , Meynen Gerben
Published: May 2023

In recent years, we have witnessed considerable progress in neurotechnologies that visualize or alter a person’s brain and mental features. In the near future, some of these technologies could possibly be used to change neural parameters of high-risk behavior in criminal offenders, often referred to as neurointerventions. The idea of delivering neurointerventions to criminal justice populations has raised fundamental normative concerns, but some authors have argued that offering neurointerventions to convicted offenders could be permissible. However, such offers raise normative concerns too. One prominent worry that is often emphasized in the literature, relates to the vulnerability of convicted offenders in prison and forensic patients in mental health facilities. In this paper, we aim to show that as far as vulnerability is considered relevant within the context of offering medical interventions to offenders, it could contribute to arguments against as well as in favor of these offers.
Legionella pneumophila-mediated host posttranslational modifications
Authors: Yang Yi , Mei Ligang , Chen Jing , Chen Xiaorong , Wang Zhuolin , Liu Lu , Yang Aimin
Published: May 2023

Legionella pneumophila is a Gram-negative bacterium ubiquitously present in freshwater environments and causes a serious type of pneumonia called Legionnaires’ disease. During infections, L. pneumophila releases over 300 effector proteins into host cells through an Icm/Dot type IV secretion system to manipulate the host defense system for survival within the host. Notably, certain effector proteins mediate posttranslational modifications (PTMs), serving as useful approaches exploited by L. pneumophila to modify host proteins. Some effectors catalyze the addition of host protein PTMs, while others mediate the removal of PTMs from host proteins. In this review, we summarize L. pneumophila effector-mediated PTMs of host proteins, including phosphorylation, ubiquitination, glycosylation, AMPylation, phosphocholination, methylation, and ADP-ribosylation, as well as dephosphorylation, deubiquitination, deAMPylation, deADP-ribosylation, dephosphocholination, and delipidation. We describe their molecular mechanisms and biological functions in the regulation of bacterial growth and Legionella-containing vacuole biosynthesis and in the disruption of host immune and defense machinery.
El Niño Southern Oscillation (ENSO) effects on local weather, arboviral diseases, and dynamics of managed and unmanaged populations of Aedes aegypti (Diptera: Culicidae) in Puerto Rico
Authors: Barrera Roberto , Acevedo Veronica , Amador Manuel , Marzan Melissa , Adams Laura E , Paz-Bailey Gabriela
Published: May 2023

We investigated the effects of interannual El Niño Southern Oscillation (ENSO) events on local weather, Aedes aegypti populations, and combined cases of dengue (DENV), chikungunya (CHIKV), and Zika (ZIKV) viruses in 2 communities with mass mosquito trapping and 2 communities without mosquito control in southern Puerto Rico (2013–2019). Gravid adult Ae. aegypti populations were monitored weekly using Autocidal Gravid Ovitraps (AGO traps). Managing Ae. aegypti populations was done using 3 AGO traps per home in most homes. There were drought conditions in 2014–2015 concurrent with the emergence of a strong El Niño (2014–2016), wetter conditions during La Niña (2016–2018), a major hurricane (2017), and a weaker El Niño (2018–2019). The main factor explaining differences in Ae. aegypti abundance across sites was mass trapping. Populations of Ae. aegypti reached maximum seasonal values during the wetter and warmer months of the year when arbovirus epidemics occurred. El Niño was significantly associated with severe droughts that did not impact the populations of Ae. aegypti. Arbovirus cases at the municipality level were positively correlated with lagged values (5–12 mo.) of the Oceanic El Niño Index (ONI), droughts, and abundance of Ae. aegypti. The onset of strong El Niño conditions in Puerto Rico may be useful as an early warning signal for arboviral epidemics in areas where the abundance of Ae. aegypti exceeds the mosquito density threshold value.
Evaluation of dose perturbations around iodine-125 seed sources in supplemental external beam prostate radiotherapy
Authors: Kanda Daisuke , Hanada Takashi , Yoshida Kayo , Tanaka Tomoki , Eriguchi Takahisa , Yorozu Atsunori , Ohashi Toshio , Shigematsu Naoyuki
Published: May 2023

We investigated dose perturbations caused by 125I seeds in patients undergoing supplemental external beam radiotherapy (EBRT) for prostate cancer. We examined two types of nonradioactive seed models: model 6711 and model STM1251. All experiments were performed using a water-equivalent phantom. Radiochromic film was used to measure the dose distributions adjacent to the seeds upstream and downstream of the external beam source. Single and clusters of multiple seeds were placed in slots in a solid water (SW) slab to measure dose perturbations with separate versus dense seed placement at beam energies of 6 or 10 MV. Monte Carlo simulations (MCSs) were also performed to include the theoretical basis against film dosimetry. Distinct patterns of dose enhancement (buildup [BU]) were upstream, and dose reduction (builddown [BD]) were downstream of the radiation source. Model 6711 with lower photon beam energies produced larger dose perturbations of BU and BD than the model STM1251. The results showed the same tendency with different seed placements and beam energies. However, these differences were not observed in the rotational irradiation measurement, which replicated a clinical plan. Dose perturbations around seeds result in dose enhancement and dose reduction with varying impact depending on the photon beam energy and seed type. This has the potential to cancel out these perturbations using multiple beam direction fields.