bluuebunny/crossref_metadata_2025 huggingface dataset:
The growth and yield of five genotypes of sunflower (Helianthus annuus L.) in the lowland of West Sumatra, Indonesia
Authors: Martinsyah R H , Satria B , Hasibuan S P
Published: May 2023

Sunflower plants have many benefits as food, especially for vegetable oil. The development of sunflower cultivation in Indonesia has not been optimal, especially in sunflower production. Increasing production requires superior seeds. Therefore, it is necessary to conduct field tests to know the growth and yield of sunflower plants in the lowlands before plant assembly. The objective of this study was to determine the growth and yield of five adaptive sunflower genotypes. The research was conducted in July - September 2022 in Pauh Sub-district, Padang City, West Sumatra Province The plant genotypes were Ha1, Ha15, HU1, HU2, and HU3. The observed variables were plant height, stem diameter, flowering age, main flower diameter, the weight of 100 seeds, and the percentage of empty seeds. The research used a Completely Randomized Block Design and data analysis was by analysis of variance and if the F test on the analysis of variance shows a significant effect, then it is continued with Duncan’s Multiple Range Test at 5%The results showed that the genotypes had a significant effect on the variables of plant height, stem diameter, main flower diameter, and weight of 100 seeds. According to the observed variable, HU3, Ha1, and HU1 were more adaptive in lowlands than others.
Effectivity of organic extract of forest betel fruit (Piper aduncum L.) of Riau to fall armyworm (Spodoptera frugiperda JE Smith) in laboratory
Authors: Rustam R , Putra A R , Yudha P A
Published: May 2023

Spodoptera frugiperda is a new pest for maize in Indonesia. The research was aimed to obtain fruit organic extract of forest betel for S. frugiperda mortality in Laboratory. The research was conducted at Pest Laboratory, Faculty of Agriculture, Riau University,Bina Widya Campus, Pekanbaru, Riau Province, Indonesia from February to April 2022. Experiment in completely randomized design was used in the study. There were six treatments and four replicates. 10 larvae instar three of S. frugiperda were infested for each treatment by using spraying method. The treatment was organic extract concentration of forest betel as follows : A0 ( 0 % of organic extract of forest betel), A1 (0.2 % of organic extract of forest betel), A2 (0.4 % of organic extract of forest betel), A3 (0.6 % of organic extract of forest betel), A4 (0.8 % of organic extract of forest betel) and A5 (1.0 % of organic extract of forest betel). The result showed that concentration of 0.8% was the effective one to mortality of S. frugiperda. The total mortality was 82.50% with early lethal time of 2.5 hours after application and lethal time 50 at 31 hours after application. Concentration of 0.32% or 3.2 ml.l−1 was appropriate one to kill 50% of population and concentration of 1.34% or 13.4 ml.l−1 was appropriate to kill 95% of S. frugiperda larvae population
First report of stemphyllium leaf blight diseases on shallots in West Sumatra, Indonesia
Authors: Resti Z , Sulyanti E , Xander D A , Zandini W F
Published: May 2023

Stemphyllium leaf blight (SLB) is one of the diseases that cause losses in shallots. This study aims to detect the presence of SLB disease and determine the percentage of disease incidence and severity in West Sumatra. The study used survey methods, sample collection, and disease measurement in three shallot production centers in West Sumatra districts, namely Solok, Agam, and Tanah Datar. The damage caused by this disease is determined by measuring the percentage of disease incidence and severity. Infected plants were isolated to identify the cause of the diseases. The survey results have found symptoms of SLB which has never been reported before. Symptoms on the leaves are small round spots that coalesce to form a blight which then develops into a brown lesion and turns black in the center of the lesion due to sporulation over time. The disease incidence was 12.15%, and the severity was 5.97%. Based on morphological identification, microscopy, and pathogenicity tests, it was found that the cause of this disease was Stemphyllium sp. It is the first Stemphyllium sp. report on shallots in West Sumatra.
Efficacy of insecticides mixture to brown planthoppers (Nilaparvata lugens) and its effect on natural enemies
Authors: Rahmini  , Iswanto E H , Suparno H , Nuryanto B
Published: May 2023

Insecticides applications are one of the components to control brown planthoppers pest that are applied in large scale by farmers. In the field, some farmers mix different active ingredients of insecticides to control brown planthoppers. This study was aimed to find out the efficacy of mixed insecticides to brown plant hoppers and the effect on natural enemies in the field. The research was carried out in Pemalang Regency, Central Java, in 2016/2017 rice planting season. There were eleven treatments with three replications in 5x8 m2 plots using randomized completed block design. Two successive sprays of selected insecticides were applied with sprayer at 14 days interval. Insecticides Pymetrozine 480 + Imidacloprid 160 (150+50), Pymetrozine 480 + Imidacloprid 160 (75+25), Pymetrozine 185 + Buprofezin 240 (150+194,59), Pymetrozine 185 + Buprofezin 240 (75+97,3), and Buprofezin 240 + Fipronil 40 (100+16,67) effectively controlled the population of brown planthopper with the efficacy as follows 96.78%; 94.27%; 96.45%; 96.71%; and 94.01%. Insecticides mixtures tested did not affect the population of natural enemies such as spiders, Paederus, and C. lividipennis.
Organic amendments and rice sheath blight management
Authors: Nuryanto B , Pratiwi G R , Rahmini
Published: May 2023

Soil amended with rice straw compost significantly reduced rice sheath blight severity. The disease caused by the fungusRhizoctonia solaniKühn is a severe disturbance to rice cultivation in Indonesia.R. solaniis soil borne fungi and highly competitive as saprophyte. In mature compost,R. solanipropagules in the form of sclerotia germination were suppressed by hyperparasites and other biological control agents. Compost maturity level affects the ability of sclerotia to germinate. Initial inoculum reduction as sclerotia in steril soil was studied in glass house which is treated with the addition of variations in the maturity of the compost. Result showed that mature compost added to sterile soil in the pot decreased sclerotia germination for about 14%, otherwise fresh organic matter added to steril soil increased sclerotia germination, this condition leadR. solanigrew and new sclerotia formed in the soil surface. The decomposition levels of organic matter influences disease development, it significantly affected on disease severity. Disease severity of rice sheath blight decreased by about 32.6-39.9 % with mature compost application.
Empowerment in the development of agricultural areas
Authors: Murtiningrum F , Noer M , Wahyuni I , Wahyuni S
Published: May 2023

The development of agricultural areas is carried out in to realize agricultural development for the prosperity of the community, especially farmers. The decreasing control over agricultural land owned by farmers makes it difficult to obtain business efficiency. The effectiveness of farming is also increasingly difficult to achieve with the consequence that the quality of agricultural products is not guaranteed. Various studies have shown that the development of agricultural areas has been carried out but in reality, the success of developing agricultural areas has not met expectations. Success at the farm level is also a question of current conditions, so proper planning is needed in the context of developing agricultural areas. However, the results of a literature study show that the development of agricultural areas is carried out based on regional development plans that have been prepared by a special team who are considered experts in making regional development plans. Meanwhile, on the one hand, farmers, as land owners are questioned about their position and role in the process of developing agricultural areas. This study tries to conduct a literature review on the development of agricultural areas that have been carried out and are developing well using the Systematic Literature Review [SLR] method. The results of the study indicate that the development of agricultural areas requires planning that is compiled and designed together through a process of community empowerment who will receive benefits from agricultural area development activities.
The effect of Arabica coffee farmers’ innovation on good agriculture practice in Solok
Authors: Putri A , Syahni R , Hasnah  , Miko A
Published: May 2023

Coffee is the leading commodity of Indonesian plantations. One of the efforts to increase coffee production and quality requires farmers to implement innovations according to Good Agriculture Practices (GAP). This study aims to see the effect of the characteristics of innovation on the application of GAP by farmers. This research is a survey research with 100 Arabica coffee farmers as respondents. This research was conducted in the Districts of Lembah Gumanti and Pantai Cermin. The variables used are innovation characteristics: relative advantage, compatibility, complexity, trialability, and observability. Data were analyzed quantitatively using multiple regression. The results show that the characteristics of innovation (relative advantage, compatibility, complexity, trialability, and observability) in the application of Good Agriculture Practice Arabica coffee farmers in Solok Regency are in the moderate category where farmers carry out cultivation activities but are still not by the GAP concept. Multiple regression results show that simultaneously all variables affect the application of GAP. However, only the relative advantage, compatibility, and trialability variables affect the GAP implementation partially.
Effect of sugar addition on the enrichment of oligosaccharides in soybean sprouts
Authors: Syukri D , Koja R , Jaswandi  , Thammawong M , Nakano K
Published: May 2023

The soybean contains a high amount of oligosaccharides that will be degraded during germination, however, oligosaccharides are one of the phytochemicals that need by the human body. This study aimed to investigate the effect of sugar addiction (glucose, sucrose and galactose) to enhance the oligosaccharides content in soybean sprouts. It can be assumed that sugar addition could replace the glucose for respiration process of soybean sprouts thus the oligosaccharides degradation for glucose provision was not required. The soybean seeds prior to germination were soaked into sucrose 3%, sucrose 6%, glucose 3 % and fructose 3%. The oligosaccharides in soybean were analyzed by using the high-performance liquid chromatography with the charged aerosol detector. Although the degradation of oligosaccharides produced glucose used for the respiration of germinated soybean sprouts, the addition of sugar in replacing the glucose produced by oligosaccharides was not effective. The oligosaccharides still degraded during the germination process. The higher of glucose concentration, the number of oligosaccharides would be reduced. In the conclusion, the replacement of glucose that is used for the respiration of germinating soybean sprouts could not be conducted by the external addition of sugar. Another approach needs to be considered further.
Validation of MPM method to determine antioxidant content in traditional and hydroponic grown water spinach
Authors: Yefrida  , Zagita R , Fadhil M , Refilda
Published: May 2023

Water spinach (Ipomoea reptans) is Indonesia’s widely used vegetable type. This vegetable has a good taste and contains nutrients that benefit the body. Water spinach is generally grown traditionally, but some are produced with a hydroponic system. This research aims to validate the MPM method and determine the antioxidant content in two growth systems of water spinach samples. The validation parameters are linearity, LoD, LoQ, RSD, and % recovery. The research results show that the MPM method is valid to use. Statistically, the antioxidant content in the two types of water spinach was significantly different, where the antioxidant content in traditionally grown was higher than others.
Real time facility management: assessing the effectiveness of Digital Twin in the Operation and Maintenance phase of building life cycle
Authors: Pomè A P , Signorini M
Published: May 2023

The current scenario of the Architecture, Engineering, Construction and Operation (AECO) industry outlines an accelerating approach to digitalisation which is defined PropTech (abbreviation for Property Technologies). Among all the digital innovation brought to AECO, PropTech companies are introducing digital technologies in the Operation and Maintenance (O&M) phase of the building lifecycle to improve operational efficiency, performance of an asset, and effectiveness of provided services and supplies. Analysing the literature scenario of O&M phase, Building Information Modelling (BIM) and Digital Twin (DT) have resulted in a methodological innovation for the entire industry. Thanks to Internet of Things (IoT), the advent of DT makes its way into the building sector allowing among all to monitor the as-is conditions, detect anomalies before they occur, make diagnosis, and give an added value with respect to the BIM. Although DT is in its early stages, in the real estate market, some PropTech companies have embraced the challenge and applied the digital technology for building management. Therefore, the paper aims to analyse the numerous advantages of DT in the management of buildings. For this objective, the authors referred to two case studies, taken from the Italian PropTech Network ecosystem, that implement DT in management of O&M phase. On one hand the authors present the benefits of facility management digitalisation introduced by DT; on the other, they underline the issues faced by the two companies and the future implementations of DT in the O&M field.
Digitally Transforming Facility Management in Healthcare: A Systematic Review of Key Digital Technologies and Systems
Authors: Schmitter P , Ashworth S
Published: May 2023

The COVID-19 pandemic led to an acceleration of digitalisation in healthcare institutions, not only in the medical field but also within non-medical, which includes facility management (FM). FM organisations are increasingly confronted with the need to digitally transform their operations and to implement new digital technologies. This paper aims at providing scholars and professionals with an overview of the various digital technologies and systems that are relevant in shaping the digital transformation. An integrative literature review has been chosen, as it provides a systematic approach to map, collate and report on key findings and concepts from the literature for researchers and practitioners. Overall, 33 articles were systematically reviewed. 22 different digital technologies and systems were identified in the literature and were added to so-called technology clusters. From all the described technologies, Building Information Modelling (BIM) is most prominently cited. Furthermore, Internet of Things (IoT), Artificial Intelligence (AI) and Machine Learning (ML), Digital Twins (DT), and Blockchain technologies are commonly found. Additional technologies and systems mentioned in the literature, though not further detailed, were also added within a separate cluster. This study also discusses the implications for the digital transformation which is important when introducing novel digital technologies in healthcare organisations. It is argued that FM in healthcare needs to focus on integrating technologies, both at a technological level, and particularly at an organisational and interorganisational level.
The applicability and challenges of implementing Facilities management standards in South Africa
Authors: Molloy S , Adewunmi Y , Nelson M
Published: May 2023

FM is a multi-sector environment where organisations vary in terms of scope, structure and services. The publication of management system standards in the FM environment has created significant challenges in implementation. Few of the World’s top 10 listed FM companies have achieved ISO 41001 certification. This opinion paper discussed the applicability and challenges of the implementation of ISO41001 standard in the South African context. An opinion piece was conducted on applicability and challenges of implementing management system standards in South Africa. The paper found that the challenges of implementing these systems include a lack of awareness, resistance to change, and lack of applicability to some organisations. Also, many organisations spend many human resources, capital, and time but still have inadequate and poorly deployed management systems. The paper recommends that ISO41001 implementation frameworks are developed that consider the varying scope, structure, and services within the FM environment to improve its success in the South African organisations.
Energy poverty in Portugal, Italy, and Norway: awareness, short-term driving forces, and barriers in the built environment
Authors: Ogut O , Bartolucci B , Parracha J L , Bertolin C , Tzortzi J N , Frasca F , Siani A M , Mendes M P , Flores-Colen I
Published: May 2023

Portugal, Italy, and Norway differ by energy performance of buildings and gross domestic product (GDP). Portugal has significantly highest thermal discomfort with harsher winters. In 2021, 80% of Portuguese buildings had a low energy rating, with 75% of buildings without thermal insulation, highly contributing to the energy poverty (EP) of the country. In Italy, despite a generally mild climate, the building stock has low thermal performance. The most affected areas are the suburban and peri-urban ones, with an EP rate in southern regions between 13% and 20% compared to 8.8% at national level. Moreover, 65% of buildings were constructed before the first law on energy saving criteria and a 25% of it has never undergone any work of maintenance or improvement. Norway, despite the limited studies performs well respect to other European Economic Area and European Union countries, in investing and using indicators to enhance and monitor the green energies’ use. Because of energy price growth, seasonal price fluctuations, and different energy tariffs, energy inequality is increasing. EP risk is underestimated, masked by Norway’s high GDP and regional price disparity. Energy inequality is increasing due to energy price growth, seasonal price fluctuations, and energy prices’ geographical inequality. The barriers in reducing EP are the underestimation of risk masked by the high GDP, and the need of homogenized prices in Norway. This study provides an overview to discuss EP awareness and it assesses the drivers and barriers that influence building’s energy efficiency renovation.
Sustainable Electric Vehicle charging scheme: User requirements in designing energy trading algorithm
Authors: Haputhanthirige A C W , Liyanage C L , Yapa R , Udagedara R M U S
Published: May 2023

Promoting Electrical Vehicles (EVs) as a cleaner alternative to traditional Internal Combustion Engine (ICE) vehicles is an important step towards transformation to a sustainable world. However, usage of grid electricity in charging EVs hinders achieving zero carbon emissions, hence, necessitates developing a renewable energy-based model for EV charging. On the other hand, encouraging renewable energy (RE) usage contributes to United Nations 2030 agenda for sustainable development. An energy trading algorithm which facilitates trading excess renewable energy generation of households to charge EVs is a key component in such renewable energy-based EV charging model. However, to design an algorithm beneficial for both stakeholders, i.e., EV users and households with solar power systems, user requirements of both stakeholders should be taken into consideration. This paper investigates the user requirements and specifications for an improved energy trading algorithm from both stakeholders’ point of view. Semi-structured interviews were conducted with 20 EV users and 16 household solar users in the United Kingdom (UK) to explore the above. According to the findings of the interviews, both participant categories highlight renewable energy utilisation as a key requirement, whereas EV users highlight non- financial user- experience related requirements such as improving convenience and selection of preferred charging speed and household solar panel users highlight trading with less time and effort as their requirements. Additionally, households also expect higher returns to cover capital costs of solar panel installations. These findings can be used by practitioners from the industry in developing effective energy trading solutions for end users.
Integrating Facilities Management knowledge in municipal school building: Swedish case studies
Authors: Molén Jessica , Kadefors Anna , Troje Daniella
Published: May 2023

Due to population growth and evolving demands for flexible premises, the design and construction of school facilities is currently a highly prioritized activity for many Swedish municipalities. However, previous research has found that facilities management (FM) knowledge is rarely integrated in the design of schools, resulting in construction deficiencies, high lifecycle costs and lower user functionality. The propensity to integrate FM knowledge in school projects varies greatly across Swedish municipalities, but the underlying factors shaping such organizational capabilities are less studied. In response, this study investigates how Swedish municipalities are currently organizing the integration of FM knowledge in the design phase of schools. The case study includes three municipalities of different sizes, where 18 interviews were performed with 22 representatives from users, operations and maintenance, construction project management, procurement and top management. To analyse the findings, a framework based on knowledge management was applied. The findings showed that FM knowledge is increasingly translated into codified processes and project planning standards and guidelines, but that personalized knowledge still plays an important role. Further, knowledge sharing in this field is complex and municipalities still face challenges despite improvement efforts. Thus, there is considerable potential to strengthen knowledge codification and sharing between municipalities and on the sector level. The study also points at the importance of studying knowledge governance at higher municipal levels, where many key organizational decisions are made.
Clustering of Health Behaviors in Canadians: A Multiple Behavior Analysis of Data from the Canadian Longitudinal Study on Aging
Authors: van Allen Zack , Bacon Simon L , Bernard Paquito , Brown Heather , Desroches Sophie , Kastner Monika , Lavoie Kim L , Marques Marta M , McCleary Nicola , Straus Sharon , Taljaard Monica , Thavorn Kednapa , Tomasone Jennifer R , Presseau Justin
Published: May 2023

Background

Health behaviors such as physical inactivity, unhealthy eating, smoking tobacco, and alcohol use are each leading risk factors for non-communicable chronic disease. Better understanding which behaviors tend to co-occur (i.e., cluster together) and co-vary (i.e., are correlated) may provide novel opportunities to develop more comprehensive interventions to promote multiple health behavior change. However, whether co-occurrence or co-variation-based approaches are better suited for this task remains relatively unknown.

Purpose

To compare the utility of co-occurrence vs. co-variation-based approaches for understanding the interconnectedness between multiple health-impacting behaviors.

Methods

Using baseline and follow-up data (N = 40,268) from the Canadian Longitudinal Study of Aging, we examined the co-occurrence and co-variation of health behaviors. We used cluster analysis to group individuals based on their behavioral tendencies across multiple behaviors and to examine how these clusters are associated with demographic characteristics and health indicators. We compared outputs from cluster analysis to behavioral correlations and compared regression analyses of clusters and individual behaviors predicting future health outcomes.

Results

Seven clusters were identified, with clusters differentiated by six of the seven health behaviors included in the analysis. Sociodemographic characteristics varied across several clusters. Correlations between behaviors were generally small. In regression analyses individual behaviors accounted for more variance in health outcomes than clusters.

Conclusions

Co-occurrence-based approaches may be more suitable for identifying sub-groups for intervention targeting while co-variation approaches are more suitable for building an understanding of the relationships between health behaviors.
Impact of transitioning to an active, noninterruptive CYP2C19/proton pump inhibitor alert on prescribing patterns
Authors: Massmann Amanda , Petry Natasha J
Published: May 2023

Purpose

To compare rates of prescriber acceptance of interruptive and noninterruptive clinical decision support (CDS) alerts regarding potential diminished therapeutic effectiveness and safety risks associated with proton pump inhibitor (PPI) use in carriers of gene variants affecting cytochrome P450 (CYP) isozyme 2C19 metabolism.

Methods

A retrospective study was conducted at a large rural health system to examine different approaches to improving CDS alert acceptance while minimizing alert fatigue. Manual reviews were conducted to identify alerts regarding CYP2C19 metabolizer status displayed at the time of PPI ordering over 30-day periods before and after the transition from interruptive to noninterruptive CDS alert functionality. A chi-square test was conducted to analyze prescriber acceptance of CDS recommendations by alert modality and type of treatment modification.

Results

Overall, interruptive alerts had an acceptance rate of 18.6% (64/344), compared to 8.4% acceptance (30/357 alerts) for noninterruptive alerts (P ≤ 0.0001). Analysis of acceptance criteria ­revealed the noninterruptive alert cohort had higher acceptance, as determined by documented medication dose adjustments, than the interruptive alert cohort (53.3% [16/30] and 4.7% [3/64], respectively). The difference in acceptance rates by CDS modality and treatment modification was statistically significant (P ≤ 0.00001). The predominant indication for PPI use was gastroesophageal reflux disease (GERD) in both cohorts.

Conclusion

Interruptive alerts that actively influenced workflow had higher acceptance rates than noninterruptive alerts that served an informational purpose without a direct disruption of workflow. The study results suggest the utilization of noninterruptive alerts may be a beneficial tool for prompting clinicians to alter dosing regimens rather than transition to an alternative agent.
Standardization of strawberry sourness and sweetness intensities using a taste sensor system and an invariant taste standard solution
Authors: Ujihara Tomomi , Hayashi Nobuyuki , Ishida Yuki , Ikezaki Hidekazu
Published: May 2023

Taste is an essential factor for evaluating the quality of agricultural products. However, it is usually difficult to compare data acquired at different times or by different people because there is no invariant reference and because the evaluation methods are largely subjective. Here, we addressed these problems by developing a method for standardizing strawberry sourness and sweetness intensities using a taste sensor approach with a taste standard solution composed of sour and sweet compounds. This standard solution allows highly efficient sensor measurements because it contains the standard compounds citric acid and sucrose. In addition, we found that polyphenol destabilized the sensor response for strawberry sweetness, and its removal from the sample by appropriate treatment with polyvinylpolypyrrolidone allowed stable evaluation of the sweetness intensity. The taste sensor data obtained using this method were in good agreement with the chemical analysis values related to human sensory evaluation.
Alkane production from fatty alcohols by the combined reactions catalyzed by an alcohol dehydrogenase and an aldehyde-deformylating oxygenase
Authors: Sui Yu-An , Maruyama Satoshi , Okada Natsumi , Ito Masakazu , Muramatsu Masayoshi , Obata Shusei , Ogawa Jun , Kishino Shigenobu
Published: May 2023

PsADH, an alcohol dehydrogenase originating in Pantoea sp. was characterized and found to convert a broad variety of fatty alcohols into their corresponding aldehydes, the substrates of alkane biosynthesis. By coupling PsADH with NpAD, a cyanobacterial aldehyde-deformylating oxygenase, and by optimizing the conditions of the enzyme-catalyzed reactions, we achieved a 52% conversion of 1-tetradecanol to tridecane. We further applied this system to generate alkanes ranging from C5–17. These alkanes can be used as biofuels, suggesting that introducing a suitable alcohol dehydrogenase is an effective strategy to utilize fatty alcohols for alkane production.
CosTaL: an accurate and scalable graph-based clustering algorithm for high-dimensional single-cell data analysis
Authors: Li Yijia , Nguyen Jonathan , Anastasiu David C , Arriaga Edgar A
Published: May 2023

With the aim of analyzing large-sized multidimensional single-cell datasets, we are describing a method for Cosine-based Tanimoto similarity-refined graph for community detection using Leiden’s algorithm (CosTaL). As a graph-based clustering method, CosTaL transforms the cells with high-dimensional features into a weighted k-nearest-neighbor (kNN) graph. The cells are represented by the vertices of the graph, while an edge between two vertices in the graph represents the close relatedness between the two cells. Specifically, CosTaL builds an exact kNN graph using cosine similarity and uses the Tanimoto coefficient as the refining strategy to re-weight the edges in order to improve the effectiveness of clustering. We demonstrate that CosTaL generally achieves equivalent or higher effectiveness scores on seven benchmark cytometry datasets and six single-cell RNA-sequencing datasets using six different evaluation metrics, compared with other state-of-the-art graph-based clustering methods, including PhenoGraph, Scanpy and PARC. As indicated by the combined evaluation metrics, Costal has high efficiency with small datasets and acceptable scalability for large datasets, which is beneficial for large-scale analysis.
Characterizing M-estimators
Authors: Dimitriadis Timo , Fissler Tobias , Ziegel Johanna
Published: May 2023

We characterize the full classes of M-estimators for semiparametric models of general functionals by formally connecting the theory of consistent loss functions from forecast evaluation with the theory of M-estimation. This novel characterization result allows us to leverage existing results on loss functions known from the literature on forecast evaluation in estimation theory. We exemplify advantageous implications for the fields of robust, efficient, equivariant and Pareto-optimal M-estimation.
BJS-02 INCIDENCE AND RISK FACTORS OF METACHRONOUS CONTRALATERAL INGUINAL HERNIA DEVELOPMENT UP TO 25 YEARS AFTER UNILATERAL INGUINAL HERNIA REPAIR: A SINGLE CENTRE COHORT STUDY
Authors: Glorieux R , Van Aerde M , Vissers S , Fieuws S , De Groof P , Miserez M
Published: May 2023

Background

Patients undergoing unilateral inguinal hernia repair (IHR) are at risk of metachronous contralateral inguinal hernia (MCIH) development, requiring reintervention in some cases. We evaluated incidence and risk factors of MCIH development up to 25 years after unilateral IHR to determine possible indications for simultaneous prophylactic surgery of the contralateral groin at the time of index surgery.

Methods

Patients between 18–70 years of age undergoing elective unilateral IHR in our centre from 1995 to 1999 were studied retrospectively using the electronic health records, and prospectively via phone calls. Study aims were MCIH incidence and risk factor determination. Kaplan-Meier curves were constructed and univariable and multivariable Cox regressions were performed.

Results

758 patients were included (91% male, mean age 51 years). Median FU-time was 21.75 years, mean FU-time was 18.3 years. The incidence of operated MCIH after 5 years was 5.6%, after 15 years 16.1%, and after 25 years 24.7%. The incidence of both operated and non-operated MCIH after 5 years was 5.9%, after 15 years 16.7%, and after 25 years 29.0%. MCIH risk was increased with higher age, and decreased in primary right-sided surgery and higher BMI at index surgery.

Conclusion

We believe these data do not provide enough clinical evidence to support prophylactic contralateral repair in all patients to avoid the development of a MCIH. We suggest a patient-specific approach taking into account MCIH risk factors, surgical approach and risk factors for chronic postoperative inguinal pain (CPIP).
BJS-06 LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY (LIRA) TECHNIQUE VERSUS INTRAPERITONEAL ONLAY MESH CLOSING THE DEFECT (IPOM PLUS) FOR VENTRAL HERNIA REPAIR: COMPARATIVE RESULTS AT MEDIUM FOLLOW-UP
Authors: Menchero J Gómez , Balla A , Bohorquez A Gila , Fernandez Y Lara , Bolaños E Licardie , Luque J A Bellido , Morales-Conde S
Published: May 2023

Background

The primary aim of this prospective study is to compare the postoperative outcomes between LIRA technique and IPOM plus, in terms of recurrence and bulging rates at one-year follow-up; the secondary aim is to compare the postoperative complications, seroma and pain at 30 days and one-year after surgery.

Methods

Patients with midline ventral hernia of 4–10 cm in width were included. Seromaand recurrence was evaluated by Computed tomography scan 1 month and 1 year after surgery. Pain was evaluated using the visual analogue scale score.

Results

Forty-five and forty-seven patients underwent LIRA and IPOM plus, respectively. Preoperatively, smoke habitus rate was statistically significantly higher in LIRA group (20 patients, 44.4%) in comparison to IPOM group (5 patients, 10.6%) (p=0.0001). Statistically significant differences were not considering the intraoperative variables. Two bulgings (4.4%) occurred in the LIRA group, while in the IPOM group occurred 10 bulgings (21.3%) and three recurrences (6.4%) (p=0.017 and p=0.085, respectively). Postoperatively, seven (15.6%, Clavien-Dindo I) and four complications (8.5%, two Clavien-Dindo I and two Clavien-Dindo III-b) occurred in the LIRA and in the IPOM group, respectively (p=0.298). One month after surgery, clinical seroma, occurred in five (11.1%) and eight patients (17%) in the LIRA and in the IPOM group, respectively (p=0.416). During follow-up, pain reduction occurred, without statistically significant differences.

Conclusions

LIRA showed lower bulging and recurrence rates in comparison to IPOM plus at one-year follow-up. Further prospective studies, with a large sample of patients and longer follow-up are required to draw definitive conclusions.
BJS-07 COMPARISON OF ENDOSCOPIC ENHANCED-VIEW TOTALLY EXTRAPERITONEAL PROSTHETIC (ETEP) VERSUS OPEN RIVES-STOPPA REPAIR AS TREATMENT OF MIDLINE ABDOMINAL WALL HERNIAS WITH RECTUS DIASTASIS: SINGLE-CENTRE SURGICAL COHORT
Authors: Kinet S , Maes H , Van Cleven S , Brusselaers N , Kuppens E F P
Published: May 2023

Aim

The Rives-Stoppa (RS) procedure is a gold standard in the treatment of midline abdominal wall hernias. Comparability of pain control and outcomes to the less invasive enhanced-view totally extraperitoneal prosthetic (eTEP) repair remain unclear.

Material & Methods

Single centre surgical cohort including 30 RS repairs (January 2019 – November 2021), and 30 consecutive eTEP procedures (September 2021 – August 2022) for midline abdominal wall hernia(s) with rectus abdominis diastasis. Postoperative pain and outcomes were compared.

Results

Presence and median duration of patient-controlled analgesia (PCA) were respectively 90% and 3 nights with RS, versus 30% and 0 nights with eTEP. Median switch to only oral analgesics occurred at postoperative day (POD) 3 after RS and at POD 2 after eTEP. Postoperative analgesics and opioid prescription at discharge were comparable between groups. Median length of hospital stay was 6 nights after RS versus 3 nights after eTEP. Median duration of surgery was 110.5 and 164.5 minutes for RS and eTEP respectively. After RS, 30 patients had a postoperative drain compared to 3 patients after eTEP. Conversion was needed in 3 eTEP procedures. Postoperative complications were comparable. No early recurrences were observed. Minimal residual diastasis was observed at postoperative consultation in 11 patients after eTEP.

Conclusions

eTEP is a feasible minimally invasive alternative to RS for the treatment of midline abdominal wall hernias with rectus abdominis diastasis and is associated with a shorter length of hospital stay, less postoperative pain and a comparable risk of short-term complications.

Registration number: NCT05446675 (ClinicalTrials.gov).
OC-004 CAN AI HELP IN EARLY PREDICTION OF SURGICAL SITE INFECTIONS?
Authors: Bawa A , Kansal R , Kalra V , Rengan V , Sundaram P , Ramana B
Published: May 2023

Background

The use of Artificial Intelligence (AI) in healthcare has the potential to transform medical diagnosis, including the detection of surgical site infections (SSI). Real-time monitoring of surgical sites and early detection of infection through AI can lead to prompt treatment, improving patient outcomes and reducing healthcare costs and spread of infections in healthcare facilities.

Aim

This study aimed to determine the use of AI in the early detection of surgical site infections and its impact on patient recovery.

Materials and methods

The study analysed patients admitted to the hospital over the past year with SSIs. A novel AI device was used to image the wound and detect presence of infection through fluorescence lights that identify bacteria through bioluminescence. Targeted tissue cultures were taken, antibiotics were administered. Some wounds required targeted debridement. Daily dressings were done followed by secondary suturing.

Results

A total of 34 patients were included in the study, with a mean age of 52.4 years and 14 female and 20 male patients. 25 patients reported pus from the wound, 9 had serous discharge, and 19 had slough present. In 85.2% of patients, the AI device's gram stain for bacteria in the wound was similar to the tissue culture report. The mean time for wound healing was 39.52 days.

Conclusion

Our study suggests that AI devices can accurately identify the gram stain of bacteria in a wound, leading to prompt antibiotic treatment for patients with SSIs. This could have significant benefits in improving patient outcomes and healthcare costs.
OC-009 DIASTASIS RECTI. MDT POST-PREGNANCY PROGRAM
Authors: Santilli O , Santilli H , Nardelli N , Poso F , Paolucci P , Scaravonati R
Published: May 2023

Aim

To analyze the results collected by the multidisciplinary program.

Material & Methods

The diastasis post-pregnancy program used a systematic evaluation that included an abdominal wall surgeon, plastic surgeon, physiotherapist, nutritionist, and radiologist. The physiotherapist used tests to analyze the strength, stability, and functionality of the abdominal wall, also evaluating synergy with the diaphragm and pelvic floor. The same tests were used to check up on the treatment, plus the ultrasound evaluation.

We propose a classification, adapting the specific treatment depending on the degree of the patient's condition. Grade I (Increase in Waist): performed physiotherapy; Grade II (Bulge): started physiotherapy plan, with associated surgical treatment due to lack of response; Grade III (Herniation): underwent surgery as the first treatment in addition to physiotherapy protocol.

Endoscopic Rives-Stoppa has been used to repair midline hernias and diastasis.

Results

From January 2017 and June 2022, 1344 patients completed the program. The average age was 42. The most frequent clinical entity for consultation was: cosmesis discomfort (84%). According to the Clinical classification: Grade I: 941 patients (70%)only performed physiotherapy treatment. Grade II: 307 patients (22%), surgical treatments were necessary on 113 patients (36%). Grade III: 96 patients (7%) and 34% require a dermolipectomy. The bulging with functional test deficits is related in all patients. Physiotherapy tests and ultrasound check-ups post-treatment showed improvement in 77% of patients.

Conclusions

The diastasis recti must focus from three points of view: anatomical, functional, and cosmesis. The multidisciplinary approach concept showed good initial results.
OC-011 SARCOPENIA IN COMPLEX ABDOMINAL WALL SURGERY: IMPACT ON THE POSTOPERATIVE COMPLICATIONS
Authors: Santana Valenciano A , Juez Saez L D , Robin A , Porrero B , Muñoz J , Molina J M , Lopez Monclus J , Garcia Ureña M A , Fernandez Cebrian J M , Blazquez Hernando L
Published: May 2023

Aim

Sarcopenia is defined as the skeletal muscle mass loss and is considered as a prognostic factor in oncological surgical patients, liver transplant and trauma surgery. It can be reversed with exercise and diet. Nonetheless there is a lack of evidence of its impact on complex abdominal wall surgery. The aim is to evaluate the impact of sarcopenia in postoperative complications after complex incisional hernia repair.

Material and Methods

Retrospective study of patients undergoing surgery for complex incisional hernias >10cm (W3 of European Hernia Society classification) between 2014–2021. Sarcopenia was stablished as the skeletal muscle index (SMI), measured at L3 transversal section of a preoperative CT-scan. Previously defined literature-based SMI cutoff values were used: men <52,4cm2/m2, women <38,5cm2/m2.

Results

We included 105 patients, of which 29 (27,6%) were sarcopenic. The mean follow-up was 24,11 (19,28) months. The mean age and body mass index was 65,34 (10,98) and 31,85 (5,55), respectively. Sarcopenia was significantly associated with a higher risk of death [OR 11,21 (IC95% 2,76–45,52); p=0,001]. We observed a difference in need of intensive care unit (ICU) stay [OR 2,24 (IC95% 0,88–5,69); p=0,089] and cardiac complications [OR 2,96 (IC95% 0,79–11,11); p=0,108], not reaching statistical significance. Differences in surgical site occurrence or infection were not observed. After analysing by possible cofounding factors (age, comorbidities, ICU stay), sarcopenia remains associated with a higher risk of death [OR 9,08 (IC95% 2,08–39,59); p=0,003].

Conclusions

Given the results of our study sarcopenia might increase the risk of death, independent of age, comorbidities and ICU stay.
OC-015 IMPACT OF DISCLOSURE OF RADIOGRAPHIC TEST RESULTS ON QUALITY OF LIFE AMONG PATIENTS WITH OCCULT HERNIAS: A RANDOMIZED CONTROLLED TRIAL
Authors: Olavarria O , Lyons N , Bernardi K , Dhanani N , Neela N , Arakelians A , Holihan J , Liang M
Published: May 2023

Aim

Ventral and groin hernias are commonly diagnosed using radiographic imaging. We aimed to determine if informing patients of the presence of a clinically apparent or occult hernia on imaging would change their abdominal wall quality of life (AW-QOL).

Materials and Methods

Consecutive patients with a hernia on elective CT abdomen/pelvis were enrolled. Patients underwent standardized abdominal examination by surgeons, and completed the modified Activities Assessment Scale, a validated, hernia-specific AW-QOL survey. On this scale, 1 is poor AW-QOL, 100 is perfect, and the minimally clinically important difference is 7. Patients were randomized to complete the one-year follow-up survey before or after being informed of the presence of a hernia on their imaging results. Primary outcome was change in AW-QOL compared to baseline.

Results

Of 169 patients randomized, 126 (75%) completed follow up at one-year. Among patients with occult hernias, those who completed the follow-up survey after being informed of having a hernia had a lower follow-up AW-QOL (mean difference -7.6, 95% CI = -20.8 to 5.7, p=0.261) compared to those who completed the survey before being informed. Conversely, for patients with clinical hernias, those who completed the survey after being informed had higher adjusted follow-up AW-QOL (mean difference 10.3, 95% CI = -3.0 to 23.6, p = 0.126) than those that completed it after.

Conclusions

Conveying findings of hernias found on CT imaging can influence patients’ AW-QOL. Future research should focus on identifying and addressing patients’ concerns after disclosure of CT results.
OC-016 ASSESSMENT OF PATIENT AND SURGEON PERCEPTIONS ON PROPHYLACTIC MESH: A STANDARD GAMBLE
Authors: Neela N , Lyons N , Nguyen K , Olavarria O , Dhanani N , Bernardi K , Cohen B , Harris H , Hughes T , Kao L , Liang M
Published: May 2023

Aim

Ventral incisional hernia (VIH) is a common complication after abdominal surgery. The use of prophylactic mesh can reduce its incidence however, this also has risks. Our aim was to determine the percent risk of wound complications that surgeons and patients would be willing to accept in the use of prophylactic mesh for a reduced risk of VIH.

Materials and Methods

We performed a cross-sectional standard gamble study with three clinical scenarios: abdominal surgeries at low, medium, and high-risk of VIH and wound complications. Participants were given an option of suture or mesh closure and provided the estimated mean risk of VIH with either technique. In a step-wise fashion, participants were provided increasing risks of wound complications until they chose suture over mesh. Estimated mean risk of VIH and wound complications were compiled through systematic review of randomized controlled trials and ACS-NSQIP risk calculator.

Results

Overall, 35 surgeons and 9 patients were surveyed. For the low, medium, and high-risk scenarios surgeons’ and patients’ maximal accepted risks was 3% and 11%, 11% and 18%, and 23% and 28%, respectively. For all three scenarios, surgeons reported risk-tolerance of prophylactic mesh far below that of the ACS-NSQIP risk calculator while patients were willing to accept more risk than the surgeons.

Conclusions

Surgeons and patients have different risk tolerances for various types of complications. Substantial education is needed for both surgeons and patients prior to widespread adoption of prophylactic mesh.
OC-017 Robotic abdominal wall program surgery: Initial experience of our first 101 cases
Authors: Villalobos R , Maestre Y , González-Barranquero A , Mias C , Escartin A , Olsina J
Published: May 2023

Aim

Minimally invasive surgery in abdominal wall had spread exponentially in the last decade, specially with the robotic surgery appearance. In our hospital, the Abdominal Wall Unit started the robotic program in 2019. The experience of our team in laparoscopic surgery allowed us to introduce the robotic surgery in complex abdominal wall pathologies. The aim of this study is to describe our experience of the progressive evolution that we had in our first 101 cases

Material and Methods

Patients with ventral/incisional hernias with medium and high complexity with no loss of domain, parastomal and inguinal hernias. The surgeries were performed by X or Xi DaVinci robotic platform.

Result

101 patients (115 surgeries) were considered in our study. All of them underwent robotic abdominal wall surgery. Women were 46 (45,5%) and men 55 (54,5%). The mean IBM was 34 (±3,7). The main hernia was in the midline: 53 (52,5%), the more frequent techniques were eTEP 32 (31,7%), RoboTAR (intrabdominal transversus abdominis muscle release) 19 (18,8%), bilateral inguinal TAPP 16 (15,9%) and Pauli 15 (14,9%). Also, we performed 11(10,9%) patients with our protocol with botulinum toxin called Robotox decreasing the TAR procedure. The RoboTAR had the most operating time mean: 315 min (260–350) while eTEP had 225 min (180–269). 4 (3,9%) patients had a recurrence with a follow-up of 26 months (3–37).

Conclusion

The implementation of a robotic program in an abdominal wall surgery unit is possible but it is necessary to standarize a training program to improve progressively the skills.