bluuebunny/crossref_metadata_2025 huggingface dataset:
P-091 IMPROVEMENT OF RESPIRATORY PHYSIOLOGY AFTER POSTERIOR COMPONENT SEPARATION TAR: A PILOT STUDY
Authors: Latham L , Gianazza S , Garbarino S , Coriele S G , Fontana F , Timb Timb F , Facchini A , Marcelli Graziosi B , Rossini G , Ballabio A , Palillo A , Costa J , Inversini D , Ietto G , Carcano G
Published: October 2022

Aim

Patients with incisional hernia with a width greater than 9 centimeters, submitted to Posterior Component Separation Trasversus Abdominis Release, by Department of Emergency and Transplantation Surgery in Varese Hospital, were analyzed to define the modifications in respiratory physiology after surgery.

Material and Methods

Patients that underwent Posterior Component Separation were prospectively analyzed by evaluating: volume of laparocele, volume of abdominal cavity and their ratio. Furthermore Pulmonary Peak pressures and Pulmonary Plateau pressures were measured in three different times: at the induction of the anaesthesia, when the mesh was placed and at the closure of the anterior muscular layer. All patients were submitted to a pre-operative simple spirometry, and re-examinated three months after the surgical procedure with the same procedure to check if modifications in their respiratory function were present.

Results

Primary results of the study will be shown to define how this surgical procedure impacts on the respiratory function of the patients. The expectation is that an improvement of the respiratory physiology happens independently from a pulmonary pressure elevation which is determinated by the re-allocation of the herniated viscera in the abdomen when the anterior muscular fascia is closed.

Conclusions

the aim of this study is to show how, the reconstitution of a functional abdominal wall with an efficient respiratory accessory musculature guaranteed by the laparocele correction with Posterior Component Separation, ensures an improvement of respiratory physiology visible with spirometry, independently from the development of a superior intrathoracic pressure.
P-103 LAPAROSCOPIC MANAGEMENT OF VENTRAL HERNIAS: TRANSPERITONEAL APPROACH FOR POSTERIOR COMPONENT SEPARATION WITH THE AIM OF ABDOMINAL WALL RECONSTRUCTION AND EXTRAPERITONEAL MESH REINFORCEMENT
Authors: Riediger H , Kundel L , Gröger C , Adam U , Adolf D , Köckerling F
Published: October 2022

Aim

The Stoppa-Rives sublay and the transversus abdominis release (TAR) technique are well established in open hernia surgery. The principles are currently being translated into minimally invasive surgery with different concepts. In this study, we investigate initial results of laparoscopic sublay and TAR surgery (LASTAR).

Patients and methodology

Over a 20-month period, 23 consecutive patients with ventral incisional hernias underwent surgery. LASTAR surgery was performed conventionally laparoscopically, transperitoneally with adhesiolysis from the anterior abdominal wall, development of the sublay space and TAR, and midline reconstruction and extraperitoneal mesh reinforcement. Perioperative outcomes were evaluated by unadjusted analyses as part of an initial site assessment in comparison to the Herniamed registry.

Results

Hernias were median in 19 cases, of which 70% (M2-M4) and 60% were W3, respectively. Median patient age was 68 and median BMI was 31. Median operative time was 313 minutes, and hospital length of stay was 4 days. Morbidity was 26% (Dindo Clavien (DC) 1: n=4 and DC 2 + 3a: n=2).

Register comparison (LASTAR: n=23 vs. all others: n=63634) showed that comparable defects were treated with component separation but not in minimal invasive technique. The time required for surgery is significantly greatest compared to all other procedures. However, the length of stay is significantly shorter than with component separation

Conclusion

With the presented surgical technique, a first series of patients with ventral incisional hernias was treated using conventional minimally invasive techniques (LASTAR). The significance of the method should be supplemented by follow-up data.
P-108 MARJOLIN'S ULCER AS A COMPLICATION OF UNRESOLVED OPEN ABDOMEN
Authors: Olona C , Casanova R , Vadillo J , Julià E , Varona A , Ferreres J , Rodrigo M , Jorba R
Published: October 2022

Introduction

Marjolin's ulcer (MU) is a rare cutaneous tumour, commonly associated with chronic wounds with difficult healing.

We present a case of UM diagnosed on a persistent unresolved open abdominal closure wound.

Materials and Methods

80-year-old male with a history of ruptured infrarenal aortic aneurysm (2010) that required aorto-unifemoral repair. Postoperative period requiring decompressive laparotomy for abdominal compartment syndrome and treated with negative pressure therapy, and impossibility of definitive abdominal closure due to abdominal muscle retraction.

Loss of outpatient follow-up for 10 years.

Consultation for worsening of the surgical wound with abdominal pain. Examination revealed abdominal incisional hernia M2–4W3 and large abdominal ulcer. Biopsies positive results for squamous cell carcinoma with infiltrative pattern. A computed tomography describes an abdominal wall mass of 14×6×11cm and space-occupying lesion in the left hepatic lobe. Liver biopsy showed a moderately differentiated hepatocarcinoma.

Surgical management consist in intramuscular injection of botulinum toxin and en bloc resection of granulation and ulcerated tissue and ileal loop attached to the lesion. Wall reconstruction with anterior separation of components and supraponeurotic mesh.

Conclusions

Marjolin's ulcer is associated with squamous cell carcinoma with a high rate of metastasis and mortality. This tumour is considered infrequent, of long-term duration and associated with developing societies.

In our environment, this neoplasia can develop in patients with open abdomen treated partially or with closure by second intention, so we consider it necessary to have a high index of diagnostic suspicion in these cases and to perform biopsies for its detection.
P-121 RETROSPECTIVE REVIEW OF PRACTICE AND OUTCOMES USING A SINGLE BRAND BIOLOGIC MESH AT A DISTRICT GENERAL HOSPITAL
Authors: Pokusevski G , Sodde P , Zeb E , Sabri S , Mihailescu A
Published: October 2022

Aim

A retrospective review of all operated hernia patients in which a single brand of Biologic mesh was used, since it's first introduction in our Trust and to date, has been conducted. During last almost 5 years, twelve patients were identified and included. All patients operated with any other type of Biologic mesh and all patients operated with synthetic meshes were excluded, as the aim of the study was to look at the efficiency of a particular product, which was the cheapest biologic mesh at the time of contract with our Hospital.

Material and Methods

Retrospective review of patient's notes and outcomes, including post-op follow-up and long-term follow-up. The study looked at the following criteria: indication of use as per VHWG (ventral hernia working group) classification of the patients, LOS (length of stay) compared with patients operated with synthetic mesh, any post-op complications including SSO/SSI (surgical site occurrence and/or infection) and outcome at follow-up to date, including recurrence, chronic pain or mesh infection.

Results

The biologic mesh studied proved itself as a reliable product and provided a durable repair in the cases where it was used. It was noticed that majority of the cases were emergency presentations for complicated ventral or inguinal hernias, the complexity of the cases compared with elective cases being higher (higher ASA grade patients, non-optimised etc).

Conclusions

The outcome of the study recommends to continue utilising this product, as efficient and financially competitive.
P-145 LARGE FIBROID TUMOR IN A INGUINO-SCROTAL HERNIA – CASE REPORT
Authors: Ungureanu C , Iordache N
Published: October 2022

Aim

One of the most common benign mass of the spermatic cord is lipoma. More rare are the fibrous tumors described as painless, very mobile extra-testicular tumors, which are called “scrotal mouse”; can accompany inguino-scrotal hernias and sometimes mimicking hernia.

Method

We report a case of a 73 years old male, with no previous medical history, presented to our department with a right large inguino-scrotal hernia.

Intraoperatively, we traced the cord into the scrotum and noticed the presence of a mobile tumor, attached to the cord, having 10/5 cm in size. We dissected and excised it. The testicle and cord structures were normal. Also, an indirect hernia sac was ligated and we performed a modified Lichtenstein procedure. The postoperative evolution was uneventful and patient discharged next day. Histopathology shows the diagnosis of a fibroid tumor. Follow-up did not show any recurrence.

Conclusion

Fibroid tumors arising from the cord are poorly defined. Differential diagnosis with vascular, infectious/inflammatory and lipoma should be made. Malignancies should be ruled out. Also we raise the idea that large lipomas found in hernia cure should be excised and further examined.
P-150 TRANSVERSUS ABDOMINIS RELEASE BY MINIMAL INVASIVE SURGERY. OUR EXPERIENCE IN A TERCIARY HOSPITAL
Authors: Menchero J Gómez , Lara Fernandez Y , Gila Bohorquez A , De La Herranz P , Guerrero J L , García Moreno J , Bellido Luque J , Morales Conde S
Published: October 2022

Aim

We present the experience in the transversus abdominis release (TAR) technique using a minimally invasive approach in our center.

Methods

We expose those W3 defects intervened by laparoscopic TAR(n=6). Step 1:

Releasing adhesions from previous surgeries. Step 2: Bilateral Rives space dissection, as well as the Rossen's space, this one using “down to up” technique. Step 3: Closure of the gap with barbed suture. In all cases, a PVDF mesh has been associated with atraumatic fixation, and 2 drains were placed.

Results

The mean age was 62, 100% men, and their BMI was greater than 25Kg/m2. All underwent scheduled surgery, using a minimally invasive approach, placing the mesh at the retromuscular level. Postoperative stay was 7.6 days. We did not obtain major complications (perforation, bleeding), but a drainage hole wound infection was registered. We had no readmissions or any medical complications.

Follow-up of 12 months, without signs of recurrence or chronic pain.

Conclusions

Although Robotic surgery and Botulinum toxin in surgery seems to be the future, in our experience TAR technique performed by laparoscopy is useful for large midline incisional hernias treatment as well as those associated with a lateral component in a terciary Hospital. We obtain good results in terms of recurrence and restoration of the abdominal wall dynamics. However, further studies are necessary to be carried out by experienced teams to reach conclusions.
P-154 GIANT HIATAL HERNIAS: LAPAROSCOPIC REPAIR WITH OR WITHOUT MESH PLACEMENT; EXPERIENCE OF A SINGLE CENTER IN NORTHERN GREECE
Authors: Symeonidou E , Petras P , Mpallas K , Kambaroudis A
Published: October 2022

Aim

Α giant hiatal hernia is defined as a type III paraesophageal hernia, where more than 30% of the stomach lies within the thoracic cavity, with or without any other abdominal viscera, such as pancreas, spleen, or colon. It suggests a rare clinical entity, accounting for less than 0,3% of all hiatal hernias. As a consequence, the surgical treatment, and in particular the laparoscopic approach, is considered challenging and demanding. The purpose of this study is to prove, through our center's experience, that the laparoscopic approach is a safe and effective method of giant hiatal hernia repair.

Material and Methods

8 patients, 4 men and 4 women, 63,83 years old on average, with giant hiatal hernias, are included in this study. In all cases, laparoscopic hiatal hernia repair was performed, without any conversions, in combination with Nissen fundoplication. In addition, in three cases, a poly-4-hydroxybutyrate mesh (Phasix) was applied.

Results

Two patients were reoperated, one due to persistant dysphagia and one due to ileus. The rest of the patients followed an uneventful postoperative course with a short hospital stay and elimination of their symptoms, during a 12-month follow-up period.

Conclusions

Laparoscopic repair of giant hiatal hernias suggests is a challenging operation, which is accompanied by high morbidity and recurrence rates, up to 12% and 10% respectively, as reported in the literature. However, it is a safe and effective procedure when performed in experienced centers.
V-002 MASSIVE INGUINAL HERNIA REPAIR WITH CHEMICAL COMPONENT RELAXATION AND PREOPERATIVE PROGRESSIVE PNEUMOPERITONEUM
Authors: Sacco J , Tawkaliyar R , Katzen M , Heniford T
Published: October 2022

Inguinal hernias are one of the most common procedures performed worldwide. Conversely, massive or giant inguinal hernias; defined as extending below the midpoint of the inner thigh are very uncommon. They are often associated with loss of domain, posing a different set of challenges for the surgeon, specially creating intra-abdominal space for the displaced organs. Preoperative progressive pneumoperitoneum (PPP) coupled with chemical denervation with botulinum toxin A (BTA) is one way to increase the size of the intrabdominal cavity to aid in reduction of the hernia contents and closure of the defect.

We present a case of a 51-year-old male with a massive right inguinal hernia with complete loss of domain. The hernia sac contained the entirety of his small bowel and colon except for his proximal duodenum and distal rectum which remained intrabdominal. We preformed preoperative BTA chemical denervation and progressive pneumoperitoneum prior to staged open Inguinal hernia repair. 1 month preoperatively BTA injections were performed under ultrasound guidance into the external and internal obliques at 3 locations bilaterally and an intraabdominal catheter was placed under laparoscopic guidance. The patient was insufflated with filter air 3 times a week for 3 weeks. He then underwent open repair with preperitoneal mesh placed and orchiectomy.
V-009 ROBOTIC UMBILICAL HERNIA REPAIR WITH RETRORECTUS SUBLAY MESH AND PLICATION OF RECTUS DIASTASIS VIA THE TRANSABDOMINAL PREPERITONEAL (TAPP) APPROACH
Authors: Lee Y K , Tomey D , Secchi R , Martinino A , Oviedo R
Published: October 2022

Aim

Umbilical hernias and rectus diastasis can greatly reduce patients’ quality of life, especially in this patient who is a professional athlete and coach. We present a robotic umbilical hernia repair with retrorectus sublay mesh and plication of rectus diastasis through the transabdominal preperitoneal (TAPP) approach.

Material & Methods

Video recording from the operating room was included. In the recording, we demonstrate the steps of this robotic approach with clear visualization of anatomic structures.

Results

A 37-year-old male with an enlarging umbilical hernia with intermittent incarceration and associated rectus diastasis presented for repair due to a significant impact on his work and quality of life. The patient underwent a TAPP robotic repair of his umbilical hernia and plication of rectus diastasis with a retrorectus sublay mesh placement. This was a same-day discharge procedure that the patient tolerated without complications.

Conclusions

Umbilical hernias and associated rectus diastasis can effectively be repaired robotically with retrorectus sublay mesh through the TAPP approach.
V-027 2-IN1: LAPAROSCOPIC TAPP REPAIR OF CONCURRENT SPIGELIAN AND INGUINAL HERNIAS
Authors: Ambrazevicius M
Published: October 2022

Aim

Spigelian hernias are rare hernias of the abdominal wall and difficult to diagnose clinically. Our aim is to report a diagnostic and surgical challenge of the combination of inguinal and Spigelian hernias.

Material & Methods

74 year old female presented with pain in right inguinal region and lump in right iliac fossa. The ultrasound scan revealed right sided Spigelian hernia up to 4 cm, right inguinal hernia up to 1 cm and incidentally detected contralateral Spigelian hernia up to 3 cm on the left side.

Results

Laparoscopic transabdominal preperitoneal (TAPP) hernia repair was performed of both right Spigelian and ipsilateral inguinal hernias. The hernia sacs were dissected and 25×15 cm polypropylene mesh was placed, covering both hernia sites. The mesh was fixed using absorbable tacks. The peritoneum was closed using barbed suture. The repair of contralateral Spigelian hernia was planned as a second stage procedure due to the present comorbidities. Operation time was 140 min. The patient was discharged on the next postoperative day. Ultrasound scan performed after 3 weeks did not show any signs of seroma, hematoma or recurrence.

Conclusions

An accurate preoperative diagnosis of Spigelian and inguinal hernias led to the safe and successful laparoscopic repair with preperitoneal mesh placement.
V-032 INTRAOPERATIVE BLEEDING AFTER SUGARBAKER REPARATION: HOW CAN I SOLVE IT ??
Authors: Delgado Morales M M , Ramírez Redondo A , Licardie Bolaños E , Bascuas Rodrigo B , Guadalajara Jurado J F
Published: October 2022

Aims

The parastomal hernia represents a controversial item in the wall surgery field, due to the frequency of occurrence in ostomized patients. Sugarbaker Technique constitutes the gold standard for the reparation of this type of hernia. We present the case of a 66-year-old man with a paraostomal hernia.

Material

We opted for a laparoscopic approach to solve a type III incisional hernia. We found a 6×5cm parastomal hernia, and we performed reduction of the hernial content and section of adhesions, placing a 16×15cm Dynamesh protesis around the defect as the Sugarbaker Technique describes, fixed with Tackers and Cianocrilate. At the end of the intervention, an active bleeding was seen in the hernial wall defect, which does not stop with compression nor with the application of hemostatics. We opened the mesh by cutting it in the middle, exploring the hernia cavity and verifying an active bleeding from an arterial vessel; which was controlled by electrocoagulation. A new Dynamesh protesis was placed on top of the previous one, using the same technique. We ended the intervention.

Results

The patient was discharged at the second day of the intervention without any complications. Follow-up at the first month, sixth months and one year after the intervention does not evidence any signs of recurrence.

Conclusions

We have not found any case in the literature of intraoperative bleeding using Sugarbaker technique prior to the ending of the intervention. We think that the described technique can be a useful way to solve this complication when it occurs.
V-040 LAPAROSCOPIC TRANS-ABDOMINAL PREPERITONEAL PROCEDURE (TAPP) FOR RIGHT INGUINAL HERNIA WITH HANDXTM HOOK AND NEEDLE HOLDER
Authors: Szold A , Ortenzi M
Published: October 2022

AIM HandX™ is a handheld, powered laparoscopic device with interchanging single-patient fully articulating instruments. It is electromechanically controlled, and, as the manual interface is handled by the surgeon, beside the patient's bed, the movements of the surgeon's wrist and fingers are translated to the instrument-articulating tip. This report is to show the feasibility and safety of this technology applied in inguinal hernia repair. MATERIALS AND METHODS We report the case of the laparoscopic repair of a right inguinal hernia using HandXTM instruments. RESULTS The index case was a 55-year-old, otherwise healthy male, with an inguinal right hernia. Three trocars were used: one 10 mm umbilical and two of 5 mm, approximately 4 cm laterally from the umbilicus and 1 cm under the level of the horizontal umbilical line. The dissection started with peritoneal cut, from the antero-superior iliac spine to the medial umbilical ligament, into the preperitoneal avascular plane. The anatomical landmarks (epigastric vessels, Cooper and Gimbernat ligaments, the corona mortis and external iliac vessels) were identified and well exposed. A polypropylene mesh was inserted from the optical trocar, placed in the appropriate position and fixed with three separated stiches handled with the articulating needle holder. The peritoneal flap was closed with a readsorbable running suture handled with the HandX instrumentation. No blood loss nor intraoperative or post-operative complications were recorded CONCLUSIONS The report showed how the HandX technology could be safely adopted to obtain both a safe dissection and an ergonomically advantageous suture in laparoscopic TAPP.
V-043 NEW CONCEPTS IN LIRA TECHNIQUE IN LAPAROSCOPIC VENTRAL HERNIA REPAIR. LIRA -LESS STEP BY STEP
Authors: Gómez Menchero J , Gila Bohorquez A , De La Herranz P , Guerrero J L , Lara Fernandez Y , Bellido Luque J , Garcia Moreno J , Navarro L , Morales Conde S
Published: October 2022

Introduction

LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) described in 2018 by our group showed advantages in preliminary results in terms of recurrence and bulging because a reduced tension in the midline in W2 defects following the EHS Classification. Otherwise permanent fixation in inlay meshes is related with and increase of pain and adhesions. We present LIRA-LESS step to step as an evolution in LIRA technique.

Material and methods

A 58 years old male affected by a M3W2 hernia. A LIRA procedure is proposed.

Step 1: adhesions release and sac content reduced.

Step 2: defect measurement and flap designed following the LIRA Technique principles with the neumoperitoneum deflated and flap mobilized and suture in the midline.

Step 3 An in lay mesh of PVDF is positioned reducing permanent fixation in cardinal points combined with Cianocrilate in a 3:1 way.

Step 4 A TAP-block anesthesia is performed in this case with Ropivacaine 2%.

Results

Operative time was 95 min. VAS 1 day was 3 and was discharge without complications. VAS 7 day in clinical office was 0. There were not recurrence or Bulkging in CT -Scan 1 month after the surgery.

Discussion

LIRA technique is a safe procedure with a low tension in the midline with good reults in terms of recurrence and bulging. LIRA-LESS concept allows a reduction in traumatic permanent fixation with good results in terms of pain and recurrence.
V-045 SAFENESS OF LIQUIBAND FIX8® IN T.A.P.P. PROCEDURE: ANALYSIS OF COSTS, POST-OPERATIVE COMPLICATIONS AND RECURRENCES
Authors: Latham L , Ballabio A , Monti E , Costa J , Marzorati A , Colombo E M , Odeh M , Garbarino S , Gianazza S , Inversini D , Ietto G , Carcano G
Published: October 2022

Aims

We tested the use of LiquiBand®FIX8™ versus standard TAPP procedure comparing costs, surgical time, complications, recurrence rate, chronic pain to check the feasibility of the procedure.

Materials and Methods

LiquiBand®FIX8™is a cyanoacrylic adhesive used to fix the mesh during laparoscopic procedures. It consents the avoidance of plastic or metallic fixing materials that can causes post-operative chronic pain or vascular damage

Discussion

We performer 54 TAPP procedures, 48 with standardized tack technique and 6 with LiquiBand®FIX8™. We checked the results after a 6 months follow-up and we found no difference in recurrence rate or chronic pain between the two techniques. Costs and surgical time were inferior in LiquiBand®FIX8™ group.

Conclusions

The use of LiquiBand®FIX8™is a safe and feasible procedure during TAPP to reduce the surgical time, to limit costs and to avoid intraoperative and postoperative complications that can occur with mechanical fixing materials.
V-049 E-TEP RIVES-STOPPA AND OPEN REVERSE TRANVERSUS ABDOMINIS RELEASE (TAR): A HYBRID APPROACH FOR LARGE LATERAL-INFERIOR INCISIONAL HERNIAS
Authors: García Ureña M Á , Martínez Caballero J , Medina M , Avilés A , Rial X , Robin A , Muñoz J , López-Monclús J , Blazquez-Hernando L A
Published: October 2022

Aim

To present hybrid approach with open/endoscopic extraperitoneal dissection for large lateral-inferior incisional hernias

Material and Methods

64 years-old man who underwent left laparoscopic nephrectomy (2019) due to hypernephroma with specimen extraction by a left oblique iliac incision. He presents L3–4 W3 incisional hernia (14×10 cm)

Technique description

Results

After 48 hours ICU admission patient was discharged to hospital ward. Drainages were removed at 2nd-4thpostoperative day and hospital stay was 5 days.

Conclusion

The hybrid approach to large lateral incisional hernias allowed us to use a large sublay mesh with an increased overlap beyond the hernia defect, trying to reduce hernia recurrence rate.
V-054 LAPAROSCOPIC REPAIR OF TWO CASES WITH OBTURATOR HERNIA; EARLY DAIGNOSED AND SUCCESSFUL RESULTS
Authors: Tirnova İ , Yarbuğ Karakayali F , Karaca A S , Fi̇li A İ
Published: October 2022

Aim

Obturator hernia is a rare type of groin site hernias. Early diagnosis may prevent intervention on gastrointestinal tract. In this report, we present two octogenarian female patients with early diagnosed obturator hernia.

Material & Methods

In first case, 83-year-old female admitted to the Emergency Room(ER) for her left groin site pain. Physical examination was unremarkable except mild tenderness on left groin site. There was no abdominal distention. Ultrasound was negative for surgical aspect. Computerized tomography(CT) scans revealed left sided obturator hernia. Laparoscopic trans abdominal pre-peritoneal (TAPP) repair was planned. Peritoneum was opened about 4–5 cm cranial side of the hernia defect and preperitoneal space was prepared. Cone-shaped 5×5 cm polypropylene mesh have placed in the obturator canal. Afterwards 15×15 cm polypropylene mesh was placed to the groin area, covering all possible hernia sites. The mesh was fixed by tuckers and the peritoneal defect was closed.

Second case, 84-year-old female admitted to ER with left groin and knee. There was no sign of inguinal hernia on physical examinitation except mild tenderness on left groin site. CT proved the intestinal segment within the left-sided obturator hernia sac. TAPP repair with mesh plug was planned. Peritoneum was opened and previously prepared cone-shaped 15×15 cm polypropylene mesh have placed in the obturator canal and fixed by tuckers. The peritoneal defect was closed and operation completed.

Results

Both patients were discharged at postoperative day 2. 60 day-postoperative periods were uneventfull.

Conclusion

The most crucial factor affecting the results is timing of surgery in obturator hernia.
Analysis of a mechanistic model of corals in association with multiple symbionts: within-host competition and recovery from bleaching
Authors: Brown Alexandra Lynne , Pfab Ferdinand , Baxter Ethan C , Detmer A Raine , Moeller Holly V , Nisbet Roger M , Cunning Ross
Published: October 2022

Coral reefs are increasingly experiencing stressful conditions, such as high temperatures, that cause corals to undergo bleaching, a process where they lose their photosynthetic algal symbionts. Bleaching threatens both corals’ survival and the health of the reef ecosystems they create. One possible mechanism for corals to resist bleaching is through association with stress-tolerant symbionts, which are resistant to bleaching but may be worse partners in mild conditions. Some corals have been found to associate with multiple symbiont species simultaneously, which potentially gives them access to the benefits of both stress-sensitive and -tolerant symbionts. However, within-host competition between symbionts may lead to competitive exclusion of one partner, and the consequences of associating with multiple partners simultaneously are not well understood. We modify a mechanistic model of coral-algal symbiosis to investigate the effect of environmental conditions on within-host competitive dynamics between stress-sensitive and -tolerant symbionts and the effect of access to a tolerant symbiont on the dynamics of recovery from bleaching. We found that the addition of a tolerant symbiont can increase host survival and recovery from bleaching in high-light conditions. Competitive exclusion of the tolerant symbiont occurred slowly at intermediate light levels. Interestingly, there were some cases of post-bleaching competitive exclusion after the tolerant symbiont had helped the host recover.
Copy number variation of horse Y chromosome genes in normal equine populations and in horses with abnormal sex development and subfertility: relationship of copy number variations with Y haplogroups
Authors: Castaneda Caitlin , Radović Lara , Felkel Sabine , Juras Rytis , Davis Brian W , Cothran Ernest Gus , Wallner Barbara , Raudsepp Terje
Published: October 2022

Structural rearrangements like copy number variations in the male-specific Y chromosome have been associated with male fertility phenotypes in human and mouse but have been sparsely studied in other mammalian species. Here, we designed digital droplet PCR assays for 7 horse male-specific Y chromosome multicopy genes and SRY and evaluated their absolute copy numbers in 209 normal male horses of 22 breeds, 73 XY horses with disorders of sex development and/or infertility, 5 Przewalski’s horses and 2 kulans. This established baseline copy number for these genes in horses. The TSPY gene showed the highest copy number and was the most copy number variable between individuals and breeds. SRY was a single-copy gene in most horses but had 2–3 copies in some indigenous breeds. Since SRY is flanked by 2 copies of RBMY, their copy number variations were interrelated and may lead to SRY-negative XY disorders of sex development. The Przewalski’s horse and kulan had 1 copy of SRY and RBMY. TSPY and ETSTY2 showed significant copy number variations between cryptorchid and normal males (P < 0.05). No significant copy number variations were observed in subfertile/infertile males. Notably, copy number of TSPY and ETSTY5 differed between successive male generations and between cloned horses, indicating germline and somatic mechanisms for copy number variations. We observed no correlation between male-specific Y chromosome gene copy number variations and male-specific Y chromosome haplotypes. We conclude that the ampliconic male-specific Y chromosome reference assembly has deficiencies and further studies with an improved male-specific Y chromosome assembly are needed to determine selective constraints over horse male-specific Y chromosome gene copy number and their relation to stallion reproduction and male biology.
Rapid cefiderocol NP test for detection of cefiderocol susceptibility/resistance in Enterobacterales
Authors: Nordmann Patrice , Bouvier Maxime , Poirel Laurent , Sadek Mustafa
Published: October 2022

Background

Cefiderocol is among the latest generation of commercialized antibiotics against a large variety of MDR Gram-negative bacteria including carbapenem-resistant Enterobacterales and non-fermenters such as Pseudomonas aeruginosa and Acinetobacter baumannii. Cefiderocol susceptibility testing, a key element for implementing rapidly a cefiderocol-based treatment, might be still challenging.

Objectives

To develop a rapid culture-based test, Rapid Cefiderocol NP test, for the identification of cefiderocol resistance among MDR Enterobacterales.

Methods

The Rapid Cefiderocol NP test is based on glucose metabolization when bacterial growth occurs and the detection of bacterial growth in the presence of cefiderocol at 64 mg/L using iron-depleted CAMHB. Bacterial growth is visually detectable by a red-to-yellow colour change of red phenol, a pH indicator. A total of 74 clinical enterobacterial isolates from various clinical sources and of worldwide origin, among which 42 isolates were cefiderocol resistant, were used to evaluate the test performance.

Results

The sensitivity and specificity of the test were found to be 98% and 91%, respectively, by comparison with the reference broth microdilution (BMD) method. All positive results were obtained within 3 h after incubation at 35°C ± 2°C, that is a gain of time of ca. 18 h (1 day) compared with currently used techniques for susceptibility testing (BMD method).

Conclusions

This novel test is rapid, highly sensitive, specific, easily interpretable, and easy to implement in routine microbiology laboratories. Such a test may rapidly and accurately provide the information needed for the implementation of adequate cefiderocol-based treatment.
Development of an international survey tool to measure confidence and current antimicrobial stewardship practices of hospital pharmacists
Authors: Weier Naomi , Thilly Nathalie , Howard Philip , Demore Béatrice , Patel Rahul , Pulcini Céline , Zaidi Syed Tabish R
Published: October 2022

Background

Pharmacists are identified as key members of hospital antimicrobial stewardship (AMS) teams in international guidelines. Developing an international standardized tool to measure hospital pharmacists’ confidence and practices of AMS will encourage knowledge sharing and better networking between hospital pharmacists internationally.

Objectives

To develop a survey tool that can be used internationally to assess pharmacists’ knowledge, confidence, perceived barriers and current AMS practices.

Methods

A project team was formed to refine the survey tool that was initially used in a previous survey study. Following revision by the project team, a revised survey tool was sent to the ESCMID Study Group for Antimicrobial Stewardship (ESGAP). Feedback from the ESGAP members was considered by the project team to finalize the survey tool.

Results

A total of 88 changes were made to the survey tool after revision by the project team. A total of 43/216 (19.9%) of ESGAP members provided feedback on the survey tool, which led to a further 19 revisions. ESGAP members were agreeable to the questions in the survey tool, with >50% agreeing that each question was suitable. The final survey tool consisted of 42 questions, reduced from 72 questions in the original survey.

Conclusions

An international survey tool to measure hospital pharmacists’ confidence and practices of AMS was developed. This tool will help the wider hospital pharmacy community in conducting local studies on current AMS practices and to identify areas where further support is needed. Use of a standardized survey tool will also allow individual regions/countries to compare their data with other countries to identify potential quality improvement programmes.
Beyond the Victimhood Narrative: A Case Study of Unexpectedly Successful Collectivization in Communist Poland
Authors: Wylegała Anna
Published: October 2022

This article is a micro-historical study of the collectivization of agriculture carried out by the communist authorities in Central and Eastern Europe after 1945. Using the example of the village of Gierczyce in the Kielce region (Central Poland), it shows under what conditions collectivization, resisted in most of the Polish countryside, was able to succeed, and it traces the long-term effects of this process on Gierczyce’s social structure and social relations. It also analyzes this rural community’s contemporary memory of the emergence and functioning of the production cooperative. Thus, it critically engages with, and questions, the “resistance paradigm” dominant in studies of collectivization. Enriched with a broader regional and national comparative context, the article is based on the analysis of archival material from central and regional archives, personal documents, and extensive field research.
Barley endosomal MONENSIN SENSITIVITY1 is a target of the powdery mildew effector CSEP0162 and plays a role in plant immunity
Authors: Liao Wenlin , Nielsen Mads E , Pedersen Carsten , Xie Wenjun , Thordal-Christensen Hans
Published: October 2022

Encasements formed around haustoria and biotrophic hyphae as well as hypersensitive reaction (HR) cell death are essential plant immune responses to filamentous pathogens. In this study we examine the components that may contribute to the absence of these responses in susceptible barley attacked by the powdery mildew fungus. We find that the effector CSEP0162 from this pathogen targets plant MONENSIN SENSITIVITY1 (MON1), which is important for the fusion of multivesicular bodies to their target membranes. Overexpression of CSEP0162 and silencing of barley MON1 both inhibit encasement formation. We find that the Arabidopsis ecotype No-0 has resistance to powdery mildew, and that this is partially dependent on MON1. Surprisingly, we find the MON1-dependent resistance in No-0 not only includes an encasement response, but also an effective HR. Similarly, silencing of MON1 in barley also blocks Mla3-mediated HR-based powdery mildew resistance. Our results indicate that MON1 is a vital plant immunity component, and we speculate that the barley powdery mildew fungus introduces the effector CSEP0162 to target MON1 and hence reduce encasement formation and HR.
Explosion imminent: the appearance of red supergiants at the point of core-collapse
Authors: Davies Ben , Plez Bertrand , Petrault Mike
Published: October 2022

From the early radiation of type II-P supernovae (SNe), it has been claimed that the majority of their red supergiant (RSG) progenitors are enshrouded by large amounts of circumstellar material (CSM) at the point of explosion. The inferred density of this CSM is orders of magnitude above that seen around RSGs in the field, and is therefore indicative of a short phase of elevated mass-loss prior to explosion. It is not known over what time-scale this material gets there: is it formed over several decades by a ‘superwind’ with mass-loss rate $\dot{M} \sim 10^{-3}\, {\rm M_\odot \, yr^{-1}}$; or is it formed in less than a year by a brief ‘outburst’ with $\dot{M}\sim 10^{-1}\, {\rm M_\odot \, yr^{-1}}$? In this paper, we simulate spectra for RSGs undergoing such mass-loss events, and demonstrate that in either scenario, the CSM suppresses the optical flux by over a factor of 100, and that of the near-IR by a factor of 10. We argue that the ‘superwind’ model can be excluded as it causes the progenitor to be heavily obscured for decades before explosion, and is strongly at odds with observations of II-P progenitors taken within 10 yr of core-collapse. Instead, our results favour abrupt outbursts < 1 yr before explosion as the explanation for the early optical radiation of II-P SNe. We therefore predict that RSGs will undergo dramatic photometric variability in the optical and infrared in the weeks-to-months before core-collapse.
Cospatial 21 cm and metal-line absorbers in the epoch of reionization – I. Incidence and observability
Authors: Bhagwat Aniket , Ciardi Benedetta , Zackrisson Erik , Schaye Joop
Published: October 2022

ABSTRACTf

Overdense, metal-rich regions, shielded from stellar radiation might remain neutral throughout reionization and produce metal as well as 21 cm absorption lines. Simultaneous absorption from metals and 21 cm can complement each other as probes of underlying gas properties. We use Aurora, a suite of high-resolution radiation-hydrodynamical simulations of galaxy formation, to investigate the occurrence of such ‘aligned’ absorbers. We calculate absorption spectra for 21 cm, O I, C II, Si II, and Fe II. We find velocity windows with absorption from at least one metal and 21 cm, and classify the aligned absorbers into two categories: ‘aligned and cospatial absorbers’ and ‘aligned but not cospatial absorbers’. While ‘aligned and cospatial absorbers’ originate from overdense structures and can be used to trace gas properties, ‘aligned but not cospatial absorbers’ are due to peculiar velocity effects. The incidence of absorbers is redshift dependent, as it is dictated by the interplay between reionization and metal enrichment, and shows a peak at z ≈ 8 for the aligned and cospatial absorbers. While aligned but not cospatial absorbers disappear towards the end of reionization because of the lack of an ambient 21 cm forest, aligned and cospatial absorbers are associated with overdense pockets of neutral gas that can be found at lower redshift. We produce mock observations for a set of sightlines for the next generation of telescopes like the ELT and SKA1-LOW, finding that given a sufficiently bright background quasar, these telescopes will be able to detect both types of absorbers throughout reionization.
Shedding light on low-mass subhalo survival and annihilation luminosity with numerical simulations
Authors: Aguirre-Santaella Alejandra , Sánchez-Conde Miguel A , Ogiya Go , Stücker Jens , Angulo Raul E
Published: October 2022

In this work, we carry out a suite of specially designed numerical simulations to shed light on dark matter (DM) subhalo survival at mass scales relevant for gamma-ray DM searches, a topic subject to intense debate nowadays. We have employed an improved version of DASH, a GPU N-body code, to study the evolution of low-mass subhaloes inside a Milky-Way-like halo with unprecedented accuracy, reaching solar-mass and sub-parsec resolution. We simulate subhaloes with varying mass, concentration, and orbital properties, and consider the effect of baryons in the host. We analyse the evolution of the bound mass fraction and annihilation luminosity, finding that most subhaloes survive until present, yet losing in some cases more than 99 per cent of their initial mass. Baryons induce a much greater mass-loss, especially when the subhalo orbit is more parallel to the Galactic disc. Many of these subhaloes cross the solar Galactocentric radius, making it easier to detect their annihilation fluxes from Earth. We find subhaloes orbiting a DM-only halo with a pericentre in the solar vicinity to lose 70–90 per cent of their initial annihilation luminosity at present, which increases up to 99 per cent when including baryons. We find a strong relation between subhalo’s mass-loss and the effective tidal field at pericentre. Indeed, much of the dependence on all considered parameters can be explained through this single parameter. In addition to shedding light on the survival of low-mass Galactic subhaloes, our results can provide detailed predictions that will aid current and future quests for the nature of DM.
Exploring the impact of COVID-19 on families of children with developmental disabilities: A community-based formative study
Authors: Filler Tali , Benipal Pardeep Kaur , Minhas Ripudaman Singh , Suleman Shazeen
Published: October 2022

Background

COVID-19 continues to disproportionately impact families of children with developmental disabilities (DD). There is an urgent need to understand these families’ experiences, particularly those that face economic or social marginalization. This qualitative study sought to identify the experiences of families of children with DD during the COVID-19 pandemic.

Methods

Using phenomenology, in-depth interviews (IDIs) were conducted with caregivers and health care providers of children with DD living in a large urban Canadian city. Interviews were recorded, transcribed, and coded using inductive coding methods by two independent coders. Transcripts were analyzed within and across stakeholder groups using thematic analysis.

Results

A total of 25 IDIs were conducted in 2020. 3 main themes and 7 sub-themes emerged related to the experiences of parents and health care providers for children with DD: families reported difficulty adhering to public health measures leading to isolation and increased parental stress; restricted access to in-person services worsened behaviour and development; and worsened household financial security in already marginalized families.

Conclusions

Our study demonstrates that families of children with DD have been negatively impacted by the evolving environment from the COVID-19 pandemic, and even more so in those who face social and economic challenges. Public health restrictions have impaired the daily lives of these families and our study suggests that limitations to accessing in-person services may have long-lasting impacts on the well-being of families of children with DD. It is imperative that the unique needs of these families be considered and centred for future interventions.
Predictors of Persistent Post-Surgical Pain Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Observational Studies
Authors: Ashoorion Vahid , Sadeghirad Behnam , Wang Li , Noori Atefeh , Abdar Meisam , Kim Yechan , Chang Yaping , Rehman Nadia , Lopes Luciane C , Couban Rachel J , Aminilari Mahmood , Malektojari Alireza , Ghazizadeh Sara , Rehman Yasir , Ghasemi Mehdi , Adili Anthony , Guyatt Gordon H , Busse Jason W
Published: October 2022

Objective

Approximately one in four total knee replacement patients develop persistent pain. Identification of those at higher risk could help inform optimal management.

Methods

We searched MEDLINE, EMBASE, CINAHL, AMED, SPORTDiscus, and PsycINFO for observational studies that explored the association between risk factors and persistent pain (≥3 months) after total knee replacement. We pooled estimates of association for all independent variables reported by >1 study.

Results

Thirty studies (26,517 patients) reported the association of 151 independent variables with persistent pain after knee replacement. High certainty evidence demonstrated an increased risk of persistent pain with pain catastrophizing (absolute risk increase [ARI] 23%, 95% confidence interval [CI] 12 to 35), younger age (ARI for every 10-year decrement from age 80, 4%, 95% CI 2 to 6), and moderate-to-severe acute post-operative pain (ARI 30%, 95% CI 20 to 39). Moderate certainty evidence suggested an association with female sex (ARI 7%, 95% CI 3 to 11) and higher pre-operative pain (ARI 35%, 95% CI 7 to 58). Studies did not adjust for both peri-operative pain severity and pain catastrophizing, which are unlikely to be independent. High to moderate certainty evidence demonstrated no association with pre-operative range of motion, body mass index, bilateral or unilateral knee replacement, and American Society of Anesthesiologists score.

Conclusions

Rigorously conducted observational studies are required to establish the relative importance of higher levels of peri-operative pain and pain catastrophizing with persistent pain after knee replacement surgery.
COMPARISON OF AIR VERSUS PERFLUOROPROPANE INTRAOCULAR TAMPONADE COMBINED WITH VITRECTOMY FOR THE TREATMENT OF MACULAR HOLE IN HIGH MYOPIA
Authors: Zhang Ke , Yang Xiaohan , Wang Zengyi , Yu Yanping , Liu Lingzi , Qi Biying , Wu Xijin , Wang Xinbo , Liu Wu
Published: October 2022

Purpose:

To compare the efficacy of air and perfluoropropane (C3F8) with pars plana vitrectomy (PPV) in highly myopic macular holes (HMMHs) and explore the factors related to surgical prognosis.

Methods:

A retrospective comparison of a consecutive series of HMMHs undergone vitrectomy and internal limiting membrane peeling. According to tamponade type, they were divided into air group and C3F8 group, which were further divided into subgroups based on hole diameter or axial length (AXL). Anatomical and functional outcomes were compared between tamponades. Related factors of initial closure rate and postoperative best-corrected visual acuity (BCVA) were analyzed by logistic regression.

Results:

The baseline characteristics in air group (n = 63) and C3F8 group (n = 37) were similar except the age of air was older (P = 0.019). The mean follow-up period was 17.16 ± 17.97 months. After surgery, the initial closure rate of air group was 85.7% and that of C3F8 group was 83.7% (P = 0.780). And the initial closure rate showed no difference between tamponades in the same subgroup classified by hole diameter or AXL (all P > 0.05). Postoperative BCVA improved significantly in both groups (P < 0.001), but no difference between them (P = 0.793). Logistic regression showed that age, minimum linear diameter, and AXL were risk factors of initial closure rate, and preoperative BCVA was the only factor associated with postoperative BCVA (all P < 0.05).

Conclusion:

With a long-term follow-up of HMMH, we found air had a similar tamponade effect anatomically and functionally compared with C3F8. Air may also be a good choice for patients with HMMH.