bluuebunny/crossref_metadata_2025 huggingface dataset:
V-007 Robotic repair of a bilateral recurrent groin hernia in a kidney transplant patient
Authors: Vierstraete M , Muysoms F
Published: May 2023

Aim

Due to the increased frequency of kidney transplantations and the high incidence of inguinal hernia in men, the coincidence of both features is not uncommon.

Material & Methods

A 58-year-old male patient with a history of a kidney transplantation in the right fossa due to bilateral shrivel kidneys, presented with a bilateral recurrent incisional hernia. Two years before he had an anterior bilateral groin hernia repair; a Liechtenstein repair on the left side and a partial preperitoneal repair with mesh reinforcement on the right side.

Results

The case was approached via a robot assisted TAPP (transabdominal preperitoneal) procedure to perform the preperitoneal dissection of the myopectineal orifices. At the region of the right inguinal hernia, the normal anatomy was distorted, due to the extraperitoneal course of the donor ureter which was freed accordingly. A partial mesh excision of the previous mesh was performed. The preperitoneal dissection area was covered with a self-gripping mesh. The postoperative course was uneventful.

Conclusions

The extraperitoneal course of the ureter in a kidney transplant patient challenges the surgical repair of an inguinal hernia. In primary groin hernias an anterior approach seems best suited, but in case of a recurrence after a previous anterior approach, a laparoscopic approach is a possible though challenging surgical option.
V-012 MADRID-PCS. STEP BY STEP E-TEP APPROACH
Authors: Román García De León L , Muñoz Rodriguez J M , Blazquez Hernando L , Robin Valle De Lersundi Á , Serrano González J , Artés Caselles M , García Ureña M Á , López Monclús J
Published: May 2023

Aim

To show the steps involved in the Madrid Modification of posterior component separation (PCS) by e-TEP approach.

Material and Methods

We present a case of a patient with a lateral incisional hernia (L3W1) associated with primary umbilical hernia and ipsilateral groin hernia. The repair that allows treatment of all defects and wide prosthetic coverage with wall reinforcement is PCS, performed in this case according to the Madrid modification. Due to the presence of risk factors for surgical site occurrences such as obesity, we decided to perform a totally extraperitoneal minimally invasive approach (e-TEP) and the step-by-step procedure is shown.

Conclusions

Minimally invasive surgery has become the standard approach in many abdominal wall pathologies. Since the description of the e-TEP technique in 2017, its growth and development has been exponential, progressively expanding for large defects and other locations; being especially indicated versus open surgery for patients with risk factors for surgical site events.

Likewise, the technique of PCS described in 2012 by Novitsky has been extended in recent years and is now the gold standard in the treatment of complex abdominal wall hernias. From the Madrid group, modifications to this technique have been proposed. We present a video that combines this modification with minimally invasive surgery, visualizing the steps of this technique using the e-TEP approach.
V-014 TIPS AND TRICKS OF INGUINAL HERNIA SURGICAL MANAGEMENT IN SUB-SAHARAN AFRICA COOPERATION CAMPAIGNS
Authors: Roldón Golet M , Muriel Alvarez P , Butron T , Ramírez Plaza C P
Published: May 2023

Introduction and Aim

Inguinal hernia is the most prevalent surgical pathology in every surgery department. However, in the African continent (especially the Sub-Saharan region), the shortage of surgeons and the population's difficulty in accessing medical care have made herniary pathology a very frequent cause of disability in the young population. That is why foundations such as “Hernia International” and “Cirujanos en acción” carry out numerous cooperation campaigns each year, in which surgical treatment of inguinal hernia is the key as it meets the four ideal requirements: high prevalence, high impact of surgical treatment, few serious postoperative complications and the possibility of operating on many patients with few resources.The standard surgery in this setting is the Lichtenstein type hernioplasty with sac ligation for L3EHS type hernias.But we believe that the preperitoneal approach through the anterior access (Berliner technique)also has an indication that the general surgeon should know.

Material and Methods

We present the two surgical approaches that we use in cooperation campaigns, analyzing the technical tricks for the management.

1.They are mostly L3 hernias with large chronic scrotal sacs due to persistent peritoneo-vaginal processes of long evolution; 2.High sac ligation is a resource that will reduce the risk of recurrence; 3.The Lichtenstein technique is the standard approach used when the posterior wall is acceptable and the deep inguinal orifice is less than 3cm; 4.In the rest of the cases,the Berliner technique is a technique with excellent long-term results and that the surgeon who operates hernias on the African continent should master.
V-015 ENDOSCOPIC MANAGEMENT OF AN INCARCERATED SPIGELIAN HERNIA
Authors: Iqbal A , Sarian A , Apthorp C , Sheen A
Published: May 2023

Introduction

Spigelian hernias are abdominal wall hernias (incidence 0.12% to 2%). It is more common in women over the age of 60 years and occurs in individuals with raised intraabdominal pressure or weakening of the abdominal fascial layers. Several studies suggest that about 27% of Spigelian hernia will incarcerate and this will require immediate surgical intervention depending on the presentation.

Presentation

A 76-year-old lady presented with a painful lump at the right lower abdomen since a few days. No other constitutional symptoms were reported.

She denied any comorbidities and was on no medication that would contraindicate a general anaesthetic. On Examination she had a 2cm tender non reducible lump at the right Spigelian line.

A CT scan revealed a break in the right side of the abdominal wall consistent with a Spigelian Hernia.

She underwent a repair using a laparoscopic, totally extraperitoneal technique (TEP). This was undertaken as a day case surgery with the hernia containing extraperitoneal fat only. The video demonstrates surgery with balloon dissection, medial to lateral dissection displaying the ilio-pectineal (cooper's) ligament and reduction of the hernia. The defect was covered with a mesh and fixated with Tisseel fibrin sealant. On her 4th week outpatient follow up she recovered well with only a small seroma at the previous site of the Spigelian hernia.

Conclusion

Our video demonstrates an efficient way to perform a Laparoscopic totally extraperitoneal (TEP) technique for an incarcerated Spigelian Hernia.
V-025 ETEP-RS: EXTENDED TOTALLY EXTRAPERITONEAL RIVES-STOPPA TECHNIQUE FOR SMALL VENTRAL HERNIA
Authors: Avilés Oliveros A , Medina Pedrique M , Morejón Ruiz S , Martínez Caballero J , Cruz Cidoncha A , García Ureña M Á
Published: May 2023

Aim

The aim is to describe the laparoscopic surgical technique of eTEP with 3 trocars from the upper port in a 52-year-old male patient who presented 3 small ventral hernias

Material & Methods

Recently, the surgical technique of ventral hernia repair, Rives-Stoppa e-TEP eventroplasty (eTEP-RS) has been introduced. First, 2 subcostal incisions are made. By introducing the dissector balloon through both retromuscular spaces up to the linea arcuata, the retromuscular space is exposed. Great care must be taken to preserve the neurovascular bundles at semilunar line. A 5mm trocar is placed on the right flank to perfom the epigastric crossover maniobre by incising the medial aspect of rigth posterior sheath. The dissection of the left retromuscular space is performed. The midline dissection is progressed to the retzius, completing the Rives retromuscular space. The hernia sacs are dissected and reduced. Finally, posterior rectus sheaths and the linea alba are sutured with 2/0 absorbable self-locking continuous barb suture and a mesh is placed in the retromuscular space.

Results

The patient was discharged the next postoperative day with good pain control. To date, he does not present data on hernia recurrence.

Conclusions

The repair of abdominal wall defects via endoscopic eTEP Rives-Stoppa with three trocars is a feasible and reproducible technique that meets the criteria of ideal open surgery and is safe for the patient.

In addition, it offers advantages such as less postoperative pain, less need for analgesia, favors rapid and safe recovery, added to an excellent aesthetic result.
V-026 LAPAROSCOPIC TAPP REPAIR: IS IT REALLY FEASIBLE IN A RE-RECURRENT HERNIA?
Authors: Alves D G , Ribas S , Oliveira F
Published: May 2023

Aim

Describe a step by step laparoscopic transabdominal preperitoneal (TAPP) repair of a re-recurrent incisional lumbar hernia.

Material & Methods

This is the case of a 72-year-old man who had a previous traumatic right lumbar hernia initially approached by laparoscopic intra-peritoneal onlay mesh repair (IPOM) and its recurrence approached by open onlay mesh repair. CT-scan revealed a lumbar hernia on the right with a neck size of 40 mm. The hernia sac measured 65 mm and contained part of the right colon inside, without signs of incarceration nor dilated intestinal loops. According to the European Hernia Society classification for incisional abdominal wall hernias, the patient had a lateral hernia (L4 W2).

Results

Lateral incisional hernias are limited by the inguinal region inferiorly, the costal margin superiorly, the lateral margin of the rectal sheath medially and the lumbar region laterally. Due to their low incidence and the resulting lack of expertise in the treatment of this abdominal wall defect, surgical treatment poses a challenge-

Conclusion

The repair of a recurrent hernia is a daunting task, even more so of a re-recurrent one. By choosing to perform a TAPP repair, we were able to prove a laparoscopic re-do repair is feasible even faced with weakened tissues and distorted anatomy.
V-033 MINIMAL INCISION REPAIR OF RECTUS ABDOMINIS MUSCLE DIASTASIS (MIRRAD) AS DAY CASE SURGERY: A PILOT STUDY
Authors: Katawazai A
Published: May 2023

Rectus abdominis muscle diastasis (RAD) is a common condition where the rectus muscles are separated by an abnormal distance causing widening of the linea-alba. This condition usually occurs due to increased abdominal cavity pressure. The most common causes are pregnancy and truncal obesity. There is also an increased risk of hernia in the linea-alba. Some of the patients with RAD can increase the stability with the abdominal wall muscle-training program, while others do not benefit from this type of exercise. There is no consensus yet regarding the preferred surgical treatment. The need for a minimal invasive surgical procedure as a day case surgery in RAD in selected cases is obvious.

The aim of this study is to evaluate the safety and effectiveness of MIRRAD as a day case surgery.

All patients are planned as elective day case surgery. Through a small skin incision on one side of the umbilicus, the subcutaneous fat is undermined and dissected from the external aponeurosis 7–9 cm above and 5 cm below the umbilicus to expose the diastasis. The umbilicus is de-attached from the external fascia. The abdominal rectus muscle diastasis is then plicated with double layer barbed suture. The umbilicus re-attached and skin sutured.

Results

20 patients are repaired with this method, all as a day case surgery, without any immediate complication.

Conclusion

This new, relative simple, method is cost effective and may minimize the postoperative morbidity. The method may preferably appropriate for patients without excessive skin.
V-044 CASE REPORT: RECURRENT AND INCARCERATED VENTRAL HERNIA. ETEP APPROACH
Authors: Zárate Gómez J , Peinado Iríbar B , Álvarez De Sierra Hernández P , Supelano Eslait G , Gil López J M , Fernández Luengas D , Conde Someso S , Merello Godino J
Published: May 2023

Aim

The eTEP approach for ventral hernia is becoming a promising treatment option for obese patients as a scheduled procedure, in specialized high volumen centers. Is it feasible also in emergency surgey?

M&M

We present a case of a 73 year old female patient with an incarcerated ventral hernia, presenting itself as a bowel obstruction on the early postoperative period after a prosthetic knee surgery. The patient had a previous midline laparotomy (Cesarian), two onlay ventral hernia repairs, and body mass index of 32. The CT imaging findings revealed a bowel obstruction close to incarcerated ventral hernia. We performed an endoscopic retromuscular sac exploration, reduced the incarcerated hernia, ruled out bowel damage, completed intraperitoneal adhesiolysis and followed through with an eTEP procedure, closing anterior and posterior rectus sheat running sutures. We began closing supraumbilical abdominal wall using inferior trocars and finished closing infraumbilical part using superior trocars. Then we introduced and deployed a polypropylene 26×15 cm mesh. No mesh fixation or drains were used.

Results

Bowel obstruction was solved after surgery. Oral liquids intake started on the second postoperative day. Despite of knee pain, sedentary lifestyle, depressive disorder and obesity, the patient started walking, assisted by physiotherapist also on second postoperative day. Intravenous naproxen and acetaminophen were used as painkillers. Discharged on postoperative day 10 because of knee wound celulitis.

Conclusions

eTEP approach seams feasible also in emergency surgeries in specialized centers.
V-047 VIDEO OF A LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL(TAPP) REPAIR FOR GIANT INGUINOSCROTAL HERNIA
Authors: Caruso R , Ferri V , Vicente E , Quijano Y , Duran H , Diaz E , Fabra I , Malave L , Ruiz P , Pizzuti G , Naldini C
Published: May 2023

Giant inguinoscrotal (GIS) hernias are rarely encountered in clinical settings and are oftenassociated with mental neglect for many years. This type of hernia is defined as “giant” if it descends belowthe mid-point of the inner thigh of a patient in an upright position. The laparoscopic repair approach of aGIS hernia is technically challenging. It has been claimed that laparoscopic surgery has several advantagesover the open surgical approach, with less pain and an earlier recovery. The aim of this video is to evaluatethe efficacy of TAPP (laparoscopic transabdominal preperitoneal) in order to treat a GIS hernia. A 65-year-old male without a relevant past medical history was admitted to theemergency service with abdominal pain, belching and nausea. He denied any other symptoms, and noprevious surgical operations were recorded. Physical examination showed a large mass in the left scrotumbelow the mid-point of the inner thigh of the patient in an upright position. A CT scan confirmed thediagnosis of a GIS. A laparoscopic TAPP procedure was decided upon as the best course of treatment.

Results

The patient underwent a successful repair procedure. The operation time was 150 min. Nointraoperative blood transfusion was necessary. The patient's diet was resumed on the first day postsurgery, and the postoperative hospital stay was three days. Laparoscopic TAPP repair is a safe and feasible method for surgically managing GIS hernias.
V-049 THE IMPORTANCE OF PROCTORING- MISSING THE “TEN GOLDEN RULES” OF TAPP
Authors: Capoccia Giovannini S , Stabilini C , Muysoms F
Published: May 2023

Claus in 2020 published the “Ten golden Rules” for a minimally Invasive safe approach to the Myopectineal Orifice.

During the first proctoring session of a TAPP procedure for the repair of a left side inguinal hernia we revised the application of the rules by the trainee.

The proctor invited the trainee to study the paper before the session of surgery.

The first and the last 3 rules were followed by the trainee but there was a lack of the 4-5-6-7 rules.

The knowledge of the anatomy of the inguinal region allows the surgeon to create a preperitoneal box for a mesh at least 15×15cm covering all the possible origins for hernia.

In particular we focused our attention to the rule 7. The trainee was missing to check the emptiness of the deep inguinal ring that was covered, in the iliopubic tract, by fat sliding to the scrotal region. After dissection a big cord lipoma was reduced in the abdomen.

Missing this rule should be a problem because the patient could feel,after the inguinal hernia repair, a bulging and discomfort in the inguinal region.

The imaging could not be helpful and the clinical visit could report a “false Positive” for the presence of bulging without a real hernia.

In a similar case we reoperate a man after a TAPP procedures for a bulging in inguinal region, pain and discomfort miming a recurrence but we only found a large cord lipoma that we resected.
V-053 USE OF ABDOMINAL FASCIA TRANSPLANTATION FOR COMPLEX GIANT INCISIONAL HERNIA AFTER LIVER TRANSPLANT
Authors: Vega V , Jiménez C , Justo I
Published: May 2023

Incisional hernias are a well-known complicationafter liver transplantation, with an incidence of up to 15%. Conventional closure techniques such as synthetic or biological meshes do not have proper results, probably due to a variety of factors including tension in a definitive wall closure and the use of immunosuppressive drugs that can cause necrosis and wound infection. Alternative techniques such as a complete abdominal fascia transplantation can sometimes be needed.

We present the case of a 57-year-old man with a history of liver transplantation due to HCV Cirrhosis, Portal Thrombosis and Pulmonary Hypertension.

The patient developed a hernia of the Mercedes scar with a large fascial defect that caused him pain and obstructive symptoms.

Surgical intervention was performed for hernia repair. During surgery, a large aponeurotic defect was identified with a ring of 25×15cm associated with an adhesion syndrome within the hernial sac.

During surgery, the hernial sac was released, followed by release of the anterior aponeurosis and peritoneal closure. An abdominal wall transplant was performed from a 56-year-old donor after the graft had been preserved for 10 days in Celsior® at 4°. The fascial graft was placed to cover the abdominal wall defect and sutured to the edges of the recipient's fascia, using 4 interrupted 2-0 polypropylene non absorbable stitches.

This patient's loss of domain of the abdominal cavity, associated with the existing vascular complications, were more than sufficient reasons to choose this technique.

The patient's postoperative course was uneventful, but developed bulging during follow-up, without any additional complications.
Evaluation of functional and aesthetic outcomes of free dermal fat graft versus superficial musculoaponeurotic system flap after superficial parotidectomy: randomized clinical trial
Authors: Fawzy Ahmed , Balbaa M Ashraf , Hagag Mahmoud
Published: May 2023

Background

Parotidectomy is the standard procedure for treatment of many parotid lesions; however, it has several drawbacks. Facial asymmetry and Frey’s syndrome are the most annoying complications to patients. Insertion of interpositioning grafts into the parotidectomy bed can decrease these complications significantly. Free dermal fat graft (FDFG) and superficial musculoaponeurotic system (SMAS) flap have very promising results. This RCT aimed to compare these two techniques regarding functional and aesthetic outcomes.

Methods

Between February 2016 and October 2021, adult patients undergoing superficial conservative parotidectomy in a single centre for a benign indication were randomized into two equal groups using a closed envelope method. In one group, FDFG was inserted at the parotidectomy bed, whereas, in the other group, SMAS flap was performed. Preoperative, operative, and postoperative data were recorded and analysed. The primary outcome was the development of Frey's syndrome.

Results

Seventy-eight patients were randomized into two equal groups of 39 patients. There was no significant difference between the two groups regarding development of Frey's syndrome. There was no significant statistical difference between study groups regarding demographic data, co-morbidities, parotid pathologies, specimen volumes, total operating time, and postoperative complications. A tendency for over correction was observed in FDFG and under correction in SMAS flap. There was no statistically significant difference between the study groups regarding the patients’ aesthetic satisfaction with the majority displaying excellent satisfaction with no poor results.

Conclusion

FDFG and SMAS flap are simple, rapid, and reliable procedures and are effective in improving both functional and aesthetic outcomes post-parotidectomy. They have comparable results; however, selection of either procedure can be determined according to patient and tumour characteristics.

Registration number: NCT05452837 (http://www.clinicaltrials.gov)
Initial systolic blood pressure associates with systemic inflammation, myocardial injury, and outcomes in patients with acute coronary syndromes
Authors: Winzap Patric A , Kraler Simon , Obeid Slayman , Wenzl Florian A , Templin Christian , Klingenberg Roland , von Eckardstein Arnold , Roffi Marco , Muller Olivier , Räber Lorenz , Lüscher Thomas F ,   SPUM-ACS investigators, Mach F , Matter C , Rodondi N , Nanchen D , Carballo D , Gencer B , Pfisterer Matthias , Kappenberger Lukas , Moccetti Tiziano , Meyer Philippe , Meier Pascal , Iglesias Juan , Rigamonti Fabio , Kälin-Weeke Carola , Peereboom Isabelle , Seiler Monika
Published: May 2023

Aims

Outcomes after acute coronary syndromes (ACS) are determined by baseline risk profiles, including initial systolic blood pressure (sBP) levels. Herein, we aimed to characterize ACS patients stratified by initial sBP levels and study their relation to inflammation, myocardial injury and post-ACS outcomes.

Methods and results

We analysed 4724 prospectively recruited ACS patients according to invasively assessed sBP (<100, 100–139, and ≥140 mmHg) at admission. Biomarkers of systemic inflammation [high-sensitivity C-reactive protein (hs-CRP)] and myocardial injury [high-sensitivity cardiac troponin T (hs-cTnT)] were measured centrally. Major adverse cardiovascular events (MACE; composite measure of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death) were externally adjudicated. Leukocyte counts, hs-CRP, hs-cTnT, and creatine kinase (CK) levels decreased from low to high sBP strata (ptrend < 0.001). Patients with sBP < 100 mmHg developed more often cardiogenic shock (CS; P < 0.001), and had a 1.7-fold increased multivariable-adjusted MACE risk at 30 days (HR 1.68, 95% CI 1.05–2.69, P = 0.031) which did not persist at one year (HR 1.38, 95% CI 0.92–2.05, P = 0.117). Those with sBP < 100 mmHg and CS showed a higher leukocyte count (P < 0.001), an increased neutrophil-to-lymphocyte-ratio (P = 0.031), and higher hs-cTnT and CK levels relative to those without CS (P < 0.001 and P = 0.002, respectively), whereas hs-CRP levels did not differ. Patients who developed CS had a 3.6- and 2.9-fold increased MACE risk at 30 days (HR 3.58, 95% CI 1.77–7.24, P < 0.001) and at one year (HR 2.94 95% CI, 1.57–5.53, P < 0.001), which was intriguingely attenuated after controlling for distinct inflammatory profiles.

Conclusion

In patients with ACS, proxies of systemic inflammation and myocardial injury are inversely associated with initial sBP levels, with highest biomarker levels observed in those <100 mmHg. If linked to high levels of cellular inflammation, these patients are prone to develop CS and are at high MACE and mortality risk.
Beta 2-microglobulin: case report of a rare cause of cardiac amyloidosis
Authors: Haslett Jack J , Patel Jignesh K , Kittleson Michelle M
Published: May 2023

Background

Cardiac amyloidosis is caused by the deposition of misfolded proteins in the myocardium. The majority of cases of cardiac amyloidosis is caused by misfolded transthyretin or light chain proteins. In this case report, we discuss a case of a rare form of cardiac amyloidosis related to beta 2-microglobulin (B2M) in a patient not on dialysis.

Case summary

A 63-year-old man was referred for workup of possible cardiac amyloidosis. Serum and urine immunofixation electrophoresis demonstrated no monoclonal bands, and the serum kappa/lambda light chain ratio was normal, excluding light chain amyloidosis. Bone scintigraphy imaging showed diffuse radiotracer uptake in the myocardium, and genetic testing of the Transthyretin gene was negative for variants. This workup was consistent with wild-type transthyretin cardiac amyloidosis. The patient, however, later underwent endomyocardial biopsy due to factors inconsistent with this diagnosis, including a young age of presentation and a strong family history of cardiac amyloidosis despite no variants in the Transthyretin gene. This showed B2M-type amyloidosis, and genetic testing of the B2M gene showed a heterozygous Pro32Leu (p. P52L) mutation. The patient underwent heart transplantation with normal graft function 2 years post transplant.

Discussion

While contemporary advancements allow for the non-invasive diagnosis of transthyretin cardiac amyloidosis with positive bone scintigraphy and negative monoclonal protein screen, clinicians should be aware of rarer forms of amyloidosis where endomyocardial biopsy is required to make the diagnosis.
eHealth for maintenance cardiovascular rehabilitation: a systematic review and meta-analysis
Authors: Heimer Melina , Schmitz Sandra , Teschler Marc , Schäfer Hendrik , Douma Emma R , Habibovic Mirela , Kop Willem J , Meyer Thorsten , Mooren Frank C , Schmitz Boris
Published: May 2023

Aims

To provide a quantitative analysis of eHealth-supported interventions on health outcomes in cardiovascular rehabilitation (CR) maintenance (phase III) in patients with coronary artery disease (CAD) and to identify effective behavioural change techniques (BCTs).

Methods and results

A systematic review was conducted (PubMed, CINAHL, MEDLINE, and Web of Science) to summarize and synthesize the effects of eHealth in phase III maintenance on health outcomes including physical activity (PA) and exercise capacity, quality of life (QoL), mental health, self-efficacy, clinical variables, and events/rehospitalization. A meta-analysis following the Cochrane Collaboration guidelines using Review Manager (RevMan5.4) was performed. Analyses were conducted differentiating between short-term (≤6 months) and medium/long-term effects (>6 months). Effective behavioural change techniques were defined based on the described intervention and coded according to the BCT handbook. Fourteen eligible studies (1497 patients) were included. eHealth significantly promoted PA (SMD = 0.35; 95%CI 0.02–0.70; P = 0.04) and exercise capacity after 6 months (SMD = 0.29; 95%CI 0.05–0.52; P = 0.02) compared with usual care. Quality of life was higher with eHealth compared with care as usual (SMD = 0.17; 95%CI 0.02–0.32; P = 0.02). Systolic blood pressure decreased after 6 months with eHealth compared with care as usual (SMD = −0.20; 95%CI −0.40–0.00; P = 0.046). There was substantial heterogeneity in the adapted BCTs and type of intervention. Mapping of BCTs revealed that self-monitoring of behaviour and/or goal setting as well as feedback on behaviour were most frequently included.

Conclusion

eHealth in phase III CR is effective in stimulating PA and improving exercise capacity in patients with CAD while increasing QoL and decreasing systolic blood pressure. Currently, data of eHealth effects on morbidity, mortality, and clinical outcomes are scarce and should be investigated in future studies.

Registration

PROSPERO: CRD42020203578.
Using quotients as a mentor to facilitate the success of underrepresented students
Authors: Neikirk Kit , Barongan Taylor , Rolle Tiffany , Garza Lopez Edgar , Marshall Andrea , Beasley Heather K , Crabtree Amber , Spencer Elsie C , Shuler Haysetta , Martinez Denise , Murray Sandra , Vang Chia , Jenkins Felysha , Damo Steven , Vue Zer
Published: May 2023

Choosing a mentor requires a certain level of introspection for both the mentor and the mentee. The dynamics of mentorship may change depending on the academic status of the mentee. Regardless, mentors should help their trainees grow both academically and professionally. The success of an individual in the fields of science, technology, engineering, mathematics, and medicine (STEMM) depends on more than intellectual capacity; a holistic view encompassing all factors that contribute to scientific achievement is all-important. Specifically, one new method scientists can adopt is quotients, which are scales and techniques that can be used to measure aptitude in a specific area. In this paper, we focus on these factors and how to grow one’s adversity quotient (AQ), social quotient (SQ), and personal growth initiative scale (PGIS). We also look at how mentors can better understand the biases of their trainees. In addressing this, mentors can help trainees become more visible and encourage other trainees to become allies through reducing biases.
Effectiveness of Sawdust and Rice Straw Mulch Strips to Control Runoff and Sediment Yield in Skid Trails
Authors: Solgi Ahmad , Cerdà Artemi , Masumian Ali , Rabiee Mohammad Reza Sheykh , Behjou Farshad Keivan , Vojoodi Razieh Ghasemi
Published: May 2023

Mulches can be effective for reducing sediment loss and erosion from forest harvesting activities. This study evaluates the use of rice straw and sawdust as mulch covers for skid trails on clay loam soil. The treatments with three replications each included combinations of two levels of slope gradient (≤ 20% and > 20%), three types of mulch cover (bare soil, sawdust, and rice straw cover), three levels of mulching application schemes (1/3, 2/3, and 3/3 of the plot length), and two levels of surface cover rates (50% and 70%). Increasing levels of mulch cover had significantly lower runoff and sediment yields throughout the trails. The average runoff rates and sediment yield from the machine operating trails treated with sawdust cover (SC) (30.2 l and 2.7 g m-2) were lower than on trails covered with rice straw mulch (RSC) (36.8 l and 3.5 g m-2), which were, in turn, lower than on untreated bare soil (BS) trail sectors (48.80 l and 5.34 g m-2). Overall, mulching was more effective when applied over the entire plot length than over the 1/3 and 2/3 plots length strips, both in terms of runoff and sediment yield.
A workflow reproducibility scale for automatic validation of biological interpretation results
Authors: Suetake Hirotaka , Fukusato Tsukasa , Igarashi Takeo , Ohta Tazro
Published: May 2023

Background

Reproducibility of data analysis workflow is a key issue in the field of bioinformatics. Recent computing technologies, such as virtualization, have made it possible to reproduce workflow execution with ease. However, the reproducibility of results is not well discussed; that is, there is no standard way to verify whether the biological interpretation of reproduced results is the same. Therefore, it still remains a challenge to automatically evaluate the reproducibility of results.

Results

We propose a new metric, a reproducibility scale of workflow execution results, to evaluate the reproducibility of results. This metric is based on the idea of evaluating the reproducibility of results using biological feature values (e.g., number of reads, mapping rate, and variant frequency) representing their biological interpretation. We also implemented a prototype system that automatically evaluates the reproducibility of results using the proposed metric. To demonstrate our approach, we conducted an experiment using workflows used by researchers in real research projects and the use cases that are frequently encountered in the field of bioinformatics.

Conclusions

Our approach enables automatic evaluation of the reproducibility of results using a fine-grained scale. By introducing our approach, it is possible to evolve from a binary view of whether the results are superficially identical or not to a more graduated view. We believe that our approach will contribute to more informed discussion on reproducibility in bioinformatics.
Simulating Timber Harvest to Assess Potential Impacts to Forest Wildlife Habitat on State Lands in Minnesota, USA
Authors: Gifford Tyler S , Zobel John M , Shartell Lindsey M , Hillard Scott C
Published: May 2023

Forest management and planning efforts often account for many resource objectives and benefits, including wildlife habitat. In particular, newly approved management goals and harvest targets on state lands in Minnesota were examined for their potential impact on wildlife habitat. Using a list of stands planned for potential harvest and a regional wildlife habitat model, habitat effects were assessed for 173 native, forest-dependent wildlife species on state lands. Leveraging forest type– and region-specific harvest probabilities and post-examination lag times to harvest, three simulation efforts covering the spectrum of possible outcomes were used to estimate habitat change from 2020 to 2030. In the most realistic simulation, 31.8% of species exhibited statistically significant positive habitat change, 11.6% significant negative change, and 56.6% nonsignificant or no change. Compared with simulations reflecting more extreme levels of harvest, the realistic simulation showed the greatest compromise between negative and positive shifts in habitat. Results reflect tradeoffs in wildlife habitat preferences such that changes in management that positively affect certain species often negatively affect others. Tradeoffs may be addressed by providing flexibility to individual managers where a targeted prescription is justified for a specific species, all while continuing broad statewide forest management goals.
The role of ultrasound quantitative parameters in the assessment of acute radiodermatitis after breast-conserving surgery
Authors: Chen Wenqin , Lu Wenjuan , Yuan Ya , Li Lu , Deng Hongyan , Ye Xinhua
Published: May 2023

This study aimed to assess the severity of acute radiodermatitis (ARD) by ultrasound quantitative parameters and to try to identify the influencing factors of skin toxicity. A total of 55 patients who underwent radiotherapy after unilateral breast-conserving surgery (BCS) were included in the study. The irradiated side of the breast was used as the research object and the quantitative ultrasound parameters (skin thickness, shear wave elasticity) were evaluated before radiotherapy, every week during radiotherapy. Two weeks after radiotherapy, the patients were divided into two groups, according to the World Health Organization scoring standard: mild (0–2 grade) and severe (3–4 grade). The differences in the parameters between the groups and the changes during radiotherapy were compared, and the relationship between these parameters and the severity of ARD was analyzed. In addition, some clinical factors that may affect ARD were also included in our study. Ninety-eight percent of patients developed different degrees of ARD, and Group 2 accounted for ~31%. At the end of 5 weeks of radiotherapy, the difference in thickness between the two groups was statistically significant (P < 0.05). There was no significant change in the elastic modulus of breast skin between the two groups (P > 0.05). Body mass index >25 kg/m2, breast thickness ≥18 mm, skin basic elastic modulus <23 kPa and skin thickness increment >0.3 mm were considered to be associated with severe skin reactions (P < 0.05). Ultrasound can be a useful tool for the non-invasive and objective assessment of skin changes during radiotherapy, documenting quantitative changes in the skin of breast cancer patients following BCS undergoing radiotherapy.
The incidence and prevalence of IgA nephropathy in Europe
Authors: Willey Cynthia J , Coppo Rosanna , Schaefer Franz , Mizerska-Wasiak Malgorzata , Mathur Mohit , Schultz Michaela J
Published: May 2023

Background

This study aimed to determine the incidence and prevalence of immunoglobulin A nephropathy (IgAN) in Europe based on high-quality data from national registries.

Methods

IgAN incidences were obtained from a literature review of European studies of national kidney biopsy registry data in which IgAN diagnosis was biopsy-verified using contemporary techniques. Studies were eligible for the main analysis if published from 1990 to 2020. IgAN point prevalence was defined as the annual IgAN incidence multiplied by the estimated duration of disease. Incidence and prevalence estimates were made for three pooled populations: (i) patients of all ages; (ii) pediatric patients; and (iii) elderly patients.

Results

Across 10 European countries, the estimated annual IgAN incidence was 0.76 per 100 000 in patients of all ages. The corresponding pooled IgAN point prevalence was 2.53 per 10 000 (95% confidence interval: 2.51–2.55), ranging from 1.14 per 10 000 in Spain to 5.98 per 10 000 in Lithuania. Applied to 2021 population estimates, the number of expected prevalent IgAN cases was 47 027 across all 10 countries and ranged from 577 in Estonia to 16 645 in Italy. Among pediatric patients, IgAN incidence was 0.20 per 100 000 children and IgAN point prevalence was 0.12 per 10 000 children. Among elderly patients, IgAN incidence was 0.30 per 100 000 and IgAN point prevalence was 0.36 per 10 000.

Conclusions

Based on high-quality data from European national registries, IgAN point prevalence was estimated at 2.53 per 10 000 in patients of all ages. Prevalence was considerably lower in pediatric and elderly populations.
Comprehensive conservative care: what doctors say, what patients hear
Authors: Hamroun Aghiles , Glowacki François , Frimat Luc
Published: May 2023

The demographic evolution of patients with advanced chronic kidney disease (CKD) has led to the advent of an alternative treatment option to kidney replacement therapy in the past couple of decades. The KDIGO controversies on Kidney Supportive Care called this approach “comprehensive conservative care” (CCC) and defined it as planned holistic patient-centered care for patients with CKD stage 5 that does not include dialysis. Although the benefit of this treatment option is now well-recognized, especially for the elderly, and comorbid and frail patients, its development remains limited in practice. While shared decision-making and advance care planning represent the cornerstones of the CCC approach, one of the main barriers in its development is the perfectible communication between nephrologists and patients, but also between all healthcare professionals involved in the care of advanced CKD patients. As a result, a significant gap has opened up between what doctors say and what patients hear. Indeed, although CCC is reported by nephrologists to be widely available in their facilities, few of their patients say that they have actually heard of it. The objectives of this review are to explore discrepancies between what doctors say and what patients hear, to identify the factors underlying this gap, and to formulate practical proposals for narrowing this gap in practice.
North Atlantic subtropical mode water formation controlled by Gulf Stream fronts
Authors: Gan Bolan , Yu Jingjie , Wu Lixin , Danabasoglu Gokhan , Small R Justin , Baker Allison H , Jia Fan , Jing Zhao , Ma Xiaohui , Yang Haiyuan , Chen Zhaohui
Published: May 2023

The North Atlantic Ocean hosts the largest volume of global subtropical mode waters (STMWs) in the world, which serve as heat, carbon and oxygen silos in the ocean interior. STMWs are formed in the Gulf Stream region where thermal fronts are pervasive and result in feedback with the atmosphere. However, their roles in STMW formation have been overlooked. Using eddy-resolving global climate simulations, we find that suppressing local frontal-scale ocean-to-atmosphere (FOA) feedback leads to STMW formation being reduced almost by half. This is because FOA feedback enlarges STMW outcropping, attributable to the mixed layer deepening associated with cumulative excessive latent heat loss due to higher wind speeds and greater air-sea humidity contrast driven by the Gulf Stream fronts. Such enhanced heat loss overshadows the stronger restratification induced by vertical eddies and turbulent heat transport, making STMW colder and heavier. With more realistic representation of FOA feedback, the eddy-present/rich coupled global climate models reproduce the observed STMWs much better than the eddy-free ones. Such improvement in STMW production cannot be achieved, even with the oceanic resolution solely refined but without coupling to the overlying atmosphere in oceanic general circulation models. Our findings highlight the need to resolve FOA feedback to ameliorate the common severe underestimation of STMW and associated heat and carbon uptakes in earth system models.
Registration, recognition, and freedom of religion or belief
Authors: Taylorian Brandon Reece , Ventura Marco
Published: May 2023

Violations of religious freedom resulting from how states arrange their recognition and registration policies continue to escalate around the world. States might seek to regulate the religious activities of their citizens and recognition and registration are convenient tools in this pursuit. Registration is sometimes made mandatory; groups may be barred from accessing it and what they must do to first obtain and then to maintain registered status can be onerous. Such restrictive policies serve to preserve a religious or political hegemony by filtering out religions and beliefs deemed unfavourable and unworthy of recognition. After surveying the ways recognition and registration are misused, this article contends that more definitive international standards are necessary to supersede ambiguous guidelines. Furthermore, this article deliberates over the plausibility that recognition, as a mode of state–religion relations, might still have the potential to facilitate freedom of religion or belief. This relies on whether a state uses recognition to facilitate all religions and beliefs by reducing deep-set favouritism and any administrative hurdles imposed during registration.
Resurgence in 2-dimensional Yang–Mills and a genus-altering deformation
Authors: Fujimori Toshiaki , Glass Philip
Published: May 2023

We study resurgence in the context of the partition function of 2-dimensional SU(N) and U(N) Yang–Mills theory on a surface of genus h. After discussing the properties of the transseries in the undeformed theory, we add a term to the action to deform the theory. The partition function can still be calculated exactly, and the deformation has the effect of analytically continuing the effective genus parameter in the exact answer so that it is noninteger. In the deformed theory we find new saddle solutions and study their properties. In this context each saddle contributes an asymptotic series to the transseries which can be analyzed using Borel-Écalle resummation. For specific values of the deformation parameter we find Cheshire cat points where the asymptotic series in the transseries truncate to a few terms. We also find new partial differential equations satisfied by the partition function, and a number of applications of these are explained, including low-order/low-order resurgence.
Daytime naps improve afternoon power and perceptual measures in elite rugby union athletes—a randomized cross-over trial
Authors: Teece Angus R , Beaven Christopher M , Argus Christos K , Gill Nicholas , Driller Matthew W
Published: May 2023

Daytime naps are used by elite athletes in both training and match-day settings. Currently, there are limited interventional studies on the efficacy of napping on physical performance in elite team-sport athletes. Therefore, the objective was to investigate the effect of a daytime nap (<1 hour) on afternoon performance of peak power, reaction time, self-reported wellness, and aerobic performance in professional rugby union athletes. A randomized cross-over design was carried out among 15 professional rugby union athletes. Athletes performed nap (NAP) and no nap (CON) conditions on two occasions, separated by 1 week. Baseline testing of reaction time, self-reported wellness, and a 6-second peak power test on a cycle ergometer were completed in the morning, followed by 2 × 45-minute training sessions, after which athletes completed the NAP or CON condition at 1200 hours. Following the nap period, baseline measures were retested in addition to a 30-minute fixed-intensity interval cycle and a 4-minute maximal effort cycling test. A significant group × time interaction was determined for 6-second peak power output (+157.6 W, p < 0.01, d = 1.53), perceived fatigue (−0.2 AU, p = 0.01, d = 0.37), and muscle soreness (−0.1 AU, p = 0.04, d = 0.75) in favor of the NAP condition. A significantly lower perceived exertion rating (−1.2 AU, p < 0.01, d = 1.72) was recorded for the fixed-intensity session in favor of NAP.

This study highlights that utilizing daytime naps between training sessions on the same day improved afternoon peak power and lowered perceptions of fatigue, soreness, and exertion during afternoon training in professional rugby union athletes.
Association Between Activity Pacing and Negative Emotions in Patients With Chronic Pain
Authors: Attali David , Leguay Floriane , Milcent Lola , Baeza-Velasco Carolina
Published: May 2023

Objectives:

Chronic pain is a major health problem given its high prevalence and its multiple consequences on the physical and psychological functioning of patients. It is therefore important to determine the relationship between these consequences and pain management strategies such as activity pacing. This review aimed to examine the association between activity pacing and the level of negative emotions in chronic pain. A second objective was to explore sex differences in this association.

Methods:

A systematic review of the literature was conducted following the PRISMA guidelines. Three independent reviewers used a combination of keywords within four databases to include studies examining the link between pacing and negative emotions in chronic pain.

Results:

Pacing was associated with less negative emotions when measured using multidimensional tools, distinguishing it from avoidance, and highlighting the major components of pacing, such as maintaining a constant activity or conserving energy. Data did not allow examination of sex differences.

Discussion:

Pacing is multidimensional and consists of various strategies of pain management which are not equally associated with negative emotions. It is important to use measures reflecting this conception to strengthen knowledges about the role of pacing in the development of negative emotions.