bluuebunny/crossref_metadata_2025 huggingface dataset:
402 A Systematic Review and Meta-Analysis of Autologous vs Titanium Cranioplasty Implants
Authors: Capitelli-McMahon H , Kahlar N , Rahman S
Published: May 2021

Aim: There is currently no gold standard reconstructive material for cranioplasty, with autologous and numerous synthetic materials currently in use. The emerging role of titanium due to its strength and biocompatibility has made it a good option. Titanium has been compared in numerous studies with autologous bone for cranioplasty however there is currently no meta-analysis within the literature to guide craniofacial surgeons on the optimal method.

Method

A systematic review and meta-analysis was performed as per the PRISMA guidelines and a search of electronic information was conducted to identify all randomised control trials and observational studies comparing autologous implants vs. titanium implants in cranioplasty following craniectomy. Re-operation rates and cosmesis were the primary outcome measures and incidence of complications such as bone resorption and infection were the secondary outcome measures.

Results

Six studies (n = 1909) were identified. Autologous cranioplasty using bone had a higher re-operation rate (p > 0.007), due to higher bone reabsorption seen in this group. There was no significant difference between the two groups in cosmetic outcome. Both had comparable infection rates (p > 0.18) and costs involved.

Conclusions

Titanium implants for cranioplasty offer lower re-operation rates compared to autologous based reconstruction without significantly increasing adverse outcomes such as post-operative infection rates or cost.
441 Intravenous Tranexamic Acid Given at Femoral Fragility Fracture Surgery Reduces Blood Transfusion Requirements Four-Fold
Authors: Powell-Bowns M , Olley R , McCann C , Balfour J , Brennan C , Scott C
Published: May 2021

Introduction

Tranexamic acid (TXA) is proven to reduce blood loss in several surgical fields, but its use in femoral fragility fracture (FFF) management is ill defined. This study examined the effect of intraoperative TXA on the rate of postoperative blood transfusion following FFF.

Method

A prospective non-randomized case-control study of 361 consecutive patients admitted to the study centre with FFFs over a 4-month period was performed. Intravenous TXA 1g was administered intraoperatively at the discretion of the operating team: 178 patients received TXA and 183 did not.

Results

Patients given TXA required fewer blood transfusions: 15/178 (8.4%) vs controls 58/183 (31.7%), (p < 0.001). Calculated blood loss (mean difference -222ml (-337 to -106, 95%CI), p < 0.001) and percentage drop in Hb (mean difference -4.3% (-6.3 to -2.3, 95%CI), p < 0.001) were significantly lower in the TXA group. The difference in CBL was greatest following intramedullary nail (n = 49: mean difference -394ml, p = 0.030) and DHS (n = 101, mean difference -216ml, p = 0.032). There was no significant difference in complication rates: venous thromboembolism TXA 2/178 vs control 1/182 (p = 0.620); MI/stroke/TIA 2/178 vs 0/182 (p = 0.244)

Conclusions

Intraoperative intravenous TXA significantly reduced calculated blood loss and blood transfusion requirements following femoral fragility fracture surgery without increasing the rate of complications.
469 Evaluating the Use of Laparoscopic-Assisted Gastrostomy Tube Insertion in Children with Epidermolysis Bullosa: A Retrospective Observational Study
Authors: Mughal A , Subramanian T , Jones R , James D , Ogboli M , Soccorso G
Published: May 2021

Introduction

Nutritional management of children with epidermolysis bullosa (EB) presents multiple challenges including reduced oral intake and mucosal fragility. Laparoscopic-assisted gastrostomy (LAG) tube feeding is effective in improving nutritional status. We aim to review the effectiveness and morbidity of our minimally invasive laparoscopic-assisted approach in EB patients.

Method

A retrospective, observational cohort study was conducted on all EB patients who underwent LAG tube insertion between 2009 and 2019. Patient demographics, admission details and 12-month clinical outcomes were reported.

Results

31 EB patients underwent LAG placement. Median age at insertion was 7.2 (IQR ± 6.5) years, with 8 (25.8%) and 3 (9.7%) of patients requiring oesophageal dilatation and fundoplication, respectively. 71.4% patients experienced minor complications including: overgranulation (35.7%), gastrostomy infection (32.1%), pain (21.4%), mild gastrostomy leakage (17.9%), blockage (10.7%) and late displacement (3.6%). 6 patients (21.4%) developed major complications with extensive gastrostomy site leakage. Only one patient required laparoscopic refashioning for stoma prolapse six years post-insertion. No cases of gastrostomy-related mortality were recorded and an improvement in both mean weight and height Z-scores was observed.

Conclusions

LAG is well-tolerated in EB patients with improvements in growth and minimal morbidity 12-months post-gastrostomy insertion. An extended follow-up period is required to ascertain long-term impacts of gastrostomy feeding.
679 Anxiety and Depression Impacts on The Correlation Between Symptom and Radiological Severity in Patients with Chronic Rhinosinusitis
Authors: Ranford D , Surda P
Published: May 2021

Introduction

Previous studies have reported little correlation between sino-nasal outcome test (SNOT-22) in chronic rhinosinusitis (CRS) and objective radiological scoring. We investigated whether anxiety and depression, which are highly prevalent in patients with CRS may cause symptom amplification and account for the lack of correlation in previous studies.

Method

100 patients with CRS were evaluated using the General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), SNOT-22 and Lund Mackay Score (LMS).

Results

Overall correlation analysis did not show a significant relationship between SNOT-22 and LMS. Subgroup analysis of patients without anxiety or depression showed a significant correlation between SNOT-22 and LMS. We also observed a significant difference in both median SNOT-22 and LMS between patients who suffered with both anxiety and depression and patients without either.

Conclusions

When CRS patients who do not have anxiety and depression are analysed in isolation, or when these conditions are controlled in a multivariable regression, there is a significant correlation between radiological findings and symptom score. This correlation is absent in patients with anxiety and depression. Anxiety and depression should be considered in patients in whom there is a mismatch in symptom and radiological disease severity as it is associated with symptom amplification.
712 Gastric Emptying Procedure in Oesophagectomy: Meta-Analysis of Surgical Pyloroplasty vs Nil Intervention
Authors: Maleyko I , Nevins E J , Brown S , Nauzan M , Nazeer M , Sangheli A , Kanakala V
Published: May 2021

Introduction

Surgical pyloroplasty is often performed to reduce the rate of delayed gastric emptying. However, the clinical significance of this is not clear. The aim of this meta-analysis is to compare the rates of delayed gastric emptying, anastomotic leak, pulmonary complications, need for further pyloric intervention, and mortality in those patients undergoing pyloroplasty following oesophagectomy and those who do not.

Method

Relevant Randomised Control Trials and Cohort Studies were identified. The first group had no drainage procedure following oesophagectomy, whereas the second group underwent a drainage procedure (pyloroplasty). A random effects meta-analysis model was used to compare the outcomes.

Results

12 papers were utilised in the analysis, comprising a total 2567 patients. No significant differences were found between the two groups with regards to delayed gastric emptying (RR 0.87 [95% CI: 0.47 – 1.62], p = 0.66), anastomotic leak (RR 1.20 [95% CI: 0.82 – 1.74], p = 0.34), pulmonary complications (RR 1.04 [95% CI: 0.79 – 1.37], p = 0.79), need for further pyloric intervention (RR 1.44 [95% CI: 0.87 – 2.37], p = 0.16), and mortality (RR 1.18 [95% CI: 0.43 – 3.23], p = 0.75).

Conclusions

Surgical pyloric drainage procedures do not improve outcomes for patients undergoing oesophagectomy, nor does omitting the procedure worsens the outcomes.
914 A Comparison of Mortality, Indicators of Treatment Success and Complications of Resuscitative Endovascular Balloon Occlusion of Aorta (REBOA): A Systematic Review and Meta-Analysis
Authors: Ko H J , Koo H F , Froghi S , Al-Saadi N
Published: May 2021

Introduction

This study aims to provide an updated review on in-hospital mortality rates in patients who underwent Resuscitative Endovascular Balloon Occlusion of Aorta (REBOA) versus Resuscitative thoracotomy (RT) or standard care without REBOA, to identify potential indicators of REBOA use and complications.

Method

Cochrane and PRISMA guidelines were used to perform the study. A literature search was done from 01 January 2005 to 30 June 2020 using EMBASE, MEDLINE and COCHRANE databases. Meta-analysis was conducted using a random effects model and the DerSimonian and Laird estimation method.

Results

25 studies were included in this study. The odds of in-hospital mortality of patients who underwent REBOA compared to RT was 0.18 (p < 0.01). The odds of in-hospital survival of patients who underwent REBOA compared to non-REBOA was 1.28 (p = 0.62). There was a significant difference found between survivors and non-survivors in terms of their pre-REBOA systolic blood pressure (SBP) (19.26 mmHg, p < 0.01), post-REBOA SBP (20.73 mmHg, p < 0.01), duration of aortic occlusion (-40.57 mins, p < 0.01) and ISS (-8.50, p < 0.01). Common complications of REBOA included acute kidney injury, multi-organ dysfunction and thrombosis.

Conclusions

Our study demonstrated lower in-hospital mortality of REBOA versus RT. Prospective multi-centre studies are needed for further evaluation of the indications, feasibility, and complications of REBOA.
957 Comparison of Inguinodynia In Patients Undergoing Prophylactic Ilioinguinal Neurectomy vs No Neurectomy In Lichtenstein Mesh Hernioplasty
Authors: Hashmi Z , Ahmed R , Ahmed M , Yousaf N , Zafar T , Chaudhary K , Islam R , Aljarad F , Madanu M
Published: May 2021

Objective

The objective of this study is to compare the frequency of inguinodynia in ilioinguinal neurectomy VS no neurectomy in patients undergoing Lichtenstein mesh hernioplasty.

Method

200 male patients with unilateral, primary, reducible inguinal hernia were randomly distributed in to two groups by using lottery method to undergo Lichtenstein’s hernia repair i.e., with and without ilioinguinal neurectomy. All the operation were carried out under local anesthesia. Pain score was calculated using the VAS system at 3rd month and inguinodynia was labelled if it is more than 1 on VAS scale.

Results

200 male patients with mean age of 53.25 ± 6.768 were included. 42 (21%) had Inguinodynia after surgery. When we cross tabulated both groups with inguinodynia, results came up significant (p = 0.001). In neurectomy group 10 patients had inguinodynia while in no neurectomy group, 32 patients were having Inguinodynia. There was no effect of malnutrition on outcome. Younger age group benefitted more from procedure.

Conclusions

It is concluded that there is difference in frequency of inguinodynia in ilioinguinal neurectomy versus no neurectomy in patients undergoing Lichtenstein hernia repair. Patients with ilioinguinal neurectomy had reduced incidence of inguinodynia.
181 Comparison of Synthetic Mesh Erosion and Chronic Pain Rates After Surgery for Pelvic Organ Prolapse and Stress Urinary Incontinence: A Systematic Review
Authors: MacCraith E , Cunnane E , Joyce M , Forde J , O'Brien F , Davis N
Published: May 2021

Background

The aim of this study is to systematically compare rates of erosion and chronic pain after mesh insertion for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) surgery.

Method

A systematic electronic search was performed on studies that evaluated the incidence of erosion and chronic pain after mesh insertion for POP or SUI. The primary outcome measurement was to compare mesh erosion and chronic pain rates for POP and SUI surgery.

Results

Twenty-six studies on 292,606 patients (n = 9077 for POP surgery and n = 283529 for SUI surgery) met inclusion criteria. The POP group were older (p < 0.0001) and had a lower BMI (p < 0.0001). Mesh erosion rates were significantly greater in the POP group compared to the SUI group (4% versus 1.9%) [OR 2.13; 95% CI 1.91-2.37; p < 0.0001]. The incidence of chronic pain was significantly greater in the POP group compared to the SUI group (6.7% versus 0.6%) [OR 11.02; 95% CI 8.15-14.9; p < 0.0001].

Conclusions

The risk of mesh erosion and chronic pain is significantly higher after surgery for POP compared to SUI. Since a higher volume of mesh is typically used for POP surgery this supports evidence for a dose-response relationship between the volume of mesh used and the erosion risk.
10 Complete Mesocolic Excision Produces Favorable Survival Outcomes Compared to Conventional Colectomy
Authors: Ow Z G W , Sim W , Nistala K R Y , Ng C H , Chong C S
Published: May 2021

Introduction

Conventional colectomy, and the Japanese Society for Cancer of the Colon and Rectum (JSCCR) D2 Lymphadenectomy (LND2), are the standards of care for the surgical management of colon cancer. Colectomy with complete mesocolic excision (CME) and JSCCR D3 Lymphadenectomy (LND3) are alternative, and more radical procedures, that provide greater lymph nodal clearance. However, controversy exists over the long-term survival benefits of CME/LND3 over non-CME colectomies (NCME)/LND2.

Method

In this study, we performed a meta-analysis to compare the survival outcomes of CME/LND3 with NCME/LND2. Medline and Embase databases were searched for articles reporting survival outcomes of both CME/LND3 and NCME/LND2, with comparisons presented using odds ratios (OR).

Results

Ten studies were included in this analysis. Overall and disease-free survival favored CME/LND3 (3-year OS: OR = 1.56; CI 1.22-2.00; p = 0.0004, 5-year OS: OR = 1.29; CI 1.02-1.64, p = 0.03, 3-year DFS: OR = 1.45; CI 1.12-1.88; p = 0.005, 5-year DFS: OR = 1.61; CI 1.14-2.28; p = 0.007). Overall and disease-free survival rates at five years were 79.8% and 85.9%, and 74.6% and 78.0%, in the CME/LND3 and NCME/LND2 groups respectively.

Conclusions

This is the first meta-analysis to demonstrate that CME/LND3 has superior long-term survival outcomes compared to NCME/LND2, hence a strong case can be made for incorporating CME/LND3 into standard care practice.
302 Is Age Just A Number in Cardiac Surgery? Evaluating Outcomes of An Octogenarian Cohort at A Single Cardiac Centre
Authors: Argyriou A , Hasan R , Abunasra H , McLaughlin K , Bilal H , Sogliani F , Datta S
Published: May 2021

Introduction

Cardiac surgery in octogenarians contains many age-specific perioperative risk factors and outcomes yet to be fully understood.

Method

All adults (N = 4957) undergoing cardiac surgery between 2011-2017 at our institution were retrospectively studied, encompassing 312 octogenarians. Data was evaluated with univariate and multivariate testing and mortality with Kaplan-Meier and cox-regression analyses.

Results

Compared to septuagenarians, octogenarians revealed more patients having previous surgery (p = 0.016), less diabetic patients (p = 0.034), lower BMI (0.002), and longer hospital stay (p < 0.000). Compared to rest of study, octogenarians contained more females (p = 0.012), a greater Euroscore (p < 0.000), spent longer in ITU (p = 0.001) and contained more ITU readmissions (p = 0.023). The octogenarians did not contain significant 30- and 90-day mortality but revealed significant mortality at 1-year versus septuagenarians (p = 0.039) and rest of study (p = 0.001). Variables testing significant in a multivariate regression were inserted into a cox-regression that found octogenarian group-membership to be insignificant (p = 0.051) in a 12-covariate model. Independent risk factors for mortality included emergency surgery (p = 0.04), reoperation (p < 0.000), cardiac procedure (p = 0.007), ITU time (p = 0.041) and diabetes (p = 0.023).

Conclusions

We report specific differences for octogenarians in perioperative characteristics along with promising short- and medium-term survival. Such outcomes must constantly be monitored so that cardiac surgery can be further tailored to this elderly cohort.
41 Diagnosing Bone Metastases in Breast Cancer – CT Vs Nuclear Medicine Bone Scan
Authors: Hiddema L , Muthusami A , Brookes P , Green M , Kasana I
Published: May 2021

Introduction

Guidelines advise use of CT or MRI to detect bone metastasis in breast cancer. Bone-scintigraphy (BS) is not routinely indicated. However, our patients with new node positive breast cancer, or symptoms suggestive of bone metastases, undergo both CT and BS. We aimed to evaluate discrepancies between CT and BS results, and assess whether CT is more accurate in diagnosing bone metastases in breast cancer patients.

Method

Over a 2-year period, breast cancer patients who underwent CT and BS within 28 days of each other, were included. Scan reports were reviewed, and where unclear, MDT outcome was consulted.

Results

Of 149 patients, 15 (10.1%) had discordant scan results. Where CT was negative, and BS suspicious (n = 6) or positive (n = 3), patients were either found to have visceral metastases on CT, BS was found to be a false positive, or MDT concluded there were no bone metastases. Where CT was positive and BS negative (n = 4), MDT confirmed metastases.

Conclusions

CT is as good as BS in demonstrating bone metastases, and also detects visceral metastases. Using CT only would reduce radiation exposure, costs, and burden on service provision. We advise a change in local policy, with CT scan as the primary investigation for breast cancer staging.
377 Global Recruitment for The RESECT Study (Transurethral Resection and Single-Instillation Intravesical Chemotherapy Evaluation in Bladder Cancer Treatment): An International Observational Cohort Study Aiming to Improve the Quality of Surgery for Non-Muscle Invasive Bladder Cancer
Authors: Light A , Gallagher K , Bhatt N , Clement K , Kulkarni M a , Khadhouri S , Zimmermann E , Gao C , Lam C , Anbarasan T , Chan V , Rossi S , Jayaraajan K , Asif A , Shah T , Kasivisvanathan V
Published: May 2021

Introduction

Non-muscle invasive bladder cancer (NMIBC) can be curatively treated with ‘good quality’ transurethral resection of the bladder tumour (TURBT). However, despite evidence-based international guidelines, there is anecdotal evidence that practice varies widely, and this may affect oncological outcomes. Launching in 2020, RESECT aims to measure and report variation in TURBT quality globally, and determine if outcome reporting improves outcomes.

Method

RESECT was advertised internationally through social media, mailing lists, websites, and in person. Collaborators at each registered site will collect data about current practice and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators.

Results

As of August 27, 508 collaborators have registered to participate. Collaborators represent 321 centres from 54 countries, with the highest number from the United Kingdom (54.5%), Spain (5.9%), and Argentina (3.7%). 51.2% are trainees, 29.9% consultants, and 17.5% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power.

Conclusions

RESECT has attracted a large number of collaborators globally and from all training levels. Therefore, the RESECT study has the potential to improve the quality of TURBT surgery across the world.
927 Efficacy of Surgical Helmet Systems for Protection Against COVID-19: A Double-Blinded Randomised Control Study
Authors: Erotocritou M , Schaller G , Nayar S , Overton A , Stelzhammer T , Berber O
Published: May 2021

Introduction

This study assesses whether sterile surgical helmet systems (SSHS) provide additional protection from aerosol pathogens alongside protecting against splash. There has been debate on whether to use such systems in orthopaedic surgery during the COVID-19 pandemic.

Method

Thirty-five participants were enrolled in a double-blinded randomised controlled study investigating efficacy of the Stryker Flyte Surgical Helmet (Stryker Corporation, Kalamazoo, MI, USA) as protection against respiratory droplets. Wearing the SSHS in a fit testing hood, subjects were randomised to nebulised saccharin solution or placebo. Twenty were allocated to the saccharin group with 15 to placebo. Positive sweet taste represented test failure. Taste tests were performed with the helmet fan turned on and off.

Results

SSHS did not prevent saccharin taste (p < 0.0001). Within the saccharin cohort, 40% recorded a positive taste with the fan on and 100% with the fan off. There was a statistically significant difference in mean time-to-taste saccharin (p = 0.049) comparing fan on (123.5 s) vs. off (62.6 s).

Conclusions

SSHS do not protect against aerosol particulate and therefore are not efficacious in protection against COVID-19. The fan system employed may even increase risk by drawing in particulates and delaying recognition of intraoperative cues that point to respirator mask leak.
724 Improving the Lives of Patients with Large Amelobastomas In Ethiopia: Long-Term Outcomes of Mandibular Reconstruction for Ameloblastoma Using Non-Vascularised Rib Grafts
Authors: de Berker H , Patel V , Honeyman C , Yonis E , Eshete M , Martin D , McGurk M
Published: May 2021

Background

Ameloblastomas are odontogenic tumours that often require radical excision and mandibular reconstruction. This is challenging in resource-limited settings where access to microsurgery is limited. Non-vascularised rib-grafts can be used as an alternative, however robust long-term outcomes are lacking.

Method

Adult patients with large ameloblastomas underwent hemimandibulectomy and autologous rib graft reconstruction on short-term surgical missions to Ethiopia between 2012 and 2015. Long-term follow-up was conducted over a two-week period in rural Ethiopia in 2017.

Results

Follow-up was possible for seven patients (58% of those treated). Mean post-operative follow-up time was 42.9 months (SD 11.7; range 24-60 months). Early complications were four superficial surgical site infections. Late complications were two cases of wire extrusion and one of keloid scarring. There were no graft failures. Patients reported reduced social stigma (p = 0.04), excellent function and 100% satisfaction.

Conclusions

When situational factors preclude the use of microsurgery, bundle rib-grafts offer a reliable alternative for partial or total mandibular reconstruction for patients after ameloblastoma resection. Mild complications were experienced by most patients, but these were straightforward to manage and the bundle rib-grafts still took well, being surprisingly resistant to infection. Importantly, this technique is associated with long-term improvements in social stigma and quality of life for patients.
Radiomics modelling in rectal cancer to predict disease-free survival: evaluation of different approaches
Authors: Tibermacine H , Rouanet P , Sbarra M , Forghani R , Reinhold C , Nougaret S ,   the GRECCAR Study Group, Rullier E , Lelong B , Maingon P , Tuech J.-J , Pezet D , Rivoire M , Meunier B , Loriau J , Valverde A , Fabre J.-M , Prudhomme M , Cotte E , Portier G , Quero L , Gallix B , Lemanski C , Ychou M , Bibeau F
Published: May 2021

Background

Radiomics may be useful in rectal cancer management. The aim of this study was to assess and compare different radiomics approaches over qualitative evaluation to predict disease-free survival (DFS) in patients with locally advanced rectal cancer treated with neoadjuvant therapy.

Methods

Patients from a phase II, multicentre, randomized study (GRECCAR4; NCT01333709) were included retrospectively as a training set. An independent cohort of patients comprised the independent test set. For both time points and both sets, radiomic features were extracted from two-dimensional manual segmentation (MS), three-dimensional (3D) MS, and from bounding boxes. Radiomics predictive models of DFS were built using a hyperparameters-tuned random forests classifier. Additionally, radiomics models were compared with qualitative parameters, including sphincter invasion, extramural vascular invasion as determined by MRI (mrEMVI) at baseline, and tumour regression grade evaluated by MRI (mrTRG) after chemoradiotherapy (CRT).

Results

In the training cohort of 98 patients, all three models showed good performance with mean(s.d.) area under the curve (AUC) values ranging from 0.77(0.09) to 0.89(0.09) for prediction of DFS. The 3D radiomics model outperformed qualitative analysis based on mrEMVI and sphincter invasion at baseline (P = 0.038 and P = 0.027 respectively), and mrTRG after CRT (P = 0.017). In the independent test cohort of 48 patients, at baseline and after CRT the AUC ranged from 0.67(0.09) to 0.76(0.06). All three models showed no difference compared with qualitative analysis in the independent set.

Conclusion

Radiomics models can predict DFS in patients with locally advanced rectal cancer.
Nonparametric panel data regression with parametric cross-sectional dependence
Authors: Soberon Alexandra , Rodriguez-Poo Juan M , Robinson Peter M
Published: May 2021

In this paper, we consider efficiency improvement in a nonparametric panel data model with cross-sectional dependence. A generalised least squares (GLS)-type estimator is proposed by taking into account this dependence structure. Parameterising the cross-sectional dependence, a local linear estimator is shown to be dominated by this type of GLS estimator. Also, possible gains in terms of rate of convergence are studied. Asymptotically optimal bandwidth choice is justified. To assess the finite sample performance of the proposed estimators, a Monte Carlo study is carried out. Further, some empirical applications are conducted with the aim of analysing the implications of the European Monetary Union for its member countries.
Clinical and electrophysiological predictors of device-detected new-onset atrial fibrillation during 3 years after cardiac surgery
Authors: Bidar Elham , Zeemering Stef , Gilbers Martijn , Isaacs Aaron , Verheule Sander , Zink Matthias D , Maesen Bart , Bramer Sander , Kawczynski Michal , Van Gelder Isabelle C , Crijns Harry J G M , Maessen Jos G , Schotten Ulrich
Published: May 2021

Aims

Postoperative atrial fibrillation (POAF) after cardiac surgery is an independent predictor of stroke and mortality late after discharge. We aimed to determine the burden and predictors of early (up to 5th postoperative day) and late (after 5th postoperative day) new-onset atrial fibrillation (AF) using implantable loop recorders (ILRs) in patients undergoing open chest cardiac surgery.

Methods and results

Seventy-nine patients without a history of AF undergoing cardiac surgery underwent peri-operative high-resolution mapping of electrically induced AF and were followed 36 months after surgery using an ILR (Reveal XT™). Clinical and electrophysiological predictors of late POAF were assessed. POAF occurred in 46 patients (58%), with early POAF detected in 27 (34%) and late POAF in 37 patients (47%). Late POAF episodes were short-lasting (mostly between 2 min and 6 h) and showed a circadian rhythm pattern with a peak of episode initiation during daytime. In POAF patients, electrically induced AF showed more complex propagation patterns than in patients without POAF. Early POAF, right atrial (RA) volume, prolonged PR time, and advanced age were independent predictors of late POAF.

Conclusions

Late POAF occurred in 47% of patients without a history of AF. Patients who develop early POAF, with higher age, larger RA, or prolonged PR time have a higher risk of developing late POAF and may benefit from intensified rhythm follow-up after cardiac surgery.

Clinicaltrials.gov number

NCT01530750.
Growth and Wood Quality Traits in aDipteryx alataVog. (Fabaceae) Progeny and Provenance Test
Authors: Santos T S , Martins K , Aguiar A V , Baptista Filho M J , Menucelli J R , Faria R F P , Moura R D , Machado J A R , Longui E L
Published: May 2021

Dipteryx alata Vog. presents an excellent economic potential because of its multiple uses. However, it is currently threatened as a result of the degradation of the biome in which it occurs, the Brazilian Cerrado. Therefore, our goal was to provide subsidies for future breeding and ex situ conservation programs of D. alata. We evaluated genetic variation in growth, stem form, and wood quality traits in a progeny and provenance test planted in a random complete block design. The traits were measured in 37-year-old trees. Significant effect for provenance was obtained for all evaluated traits except bifurcation, but progeny effect was significant only for acoustic wave velocity (AWV). The estimates of individual narrow sense heritability were of low magnitude for all traits except AWV (0.24 ± 0.09). Eleven groups were formed based on Mahalanobis genetic distance with 83.1% of progenies allocated to one group. Dipteryx alata has genetic variability between progenies and provenances that can be explored to obtain genetic gain, especially for AWV. We also recommend the use of multi-trait selection index to obtain gains for both growth and wood quality traits. Controlled pollination between individuals from different progeny groups would increase variability in next generation breeding.
Whole-genome assembly of Corylus avellana cv “Tonda Gentile delle Langhe” using linked-reads (10X Genomics)
Authors: Pavese Vera , Cavalet-Giorsa Emile , Barchi Lorenzo , Acquadro Alberto , Torello Marinoni Daniela , Portis Ezio , Lucas Stuart James , Botta Roberto
Published: May 2021

The European hazelnut (Corylus avellana L.; 2n = 2x = 22) is a worldwide economically important tree nut that is cross-pollinated due to sporophytic incompatibility. Therefore, any individual plant is highly heterozygous. Cultivars are clonally propagated using mound layering, rooted suckers, and micropropagation. In recent years, the interest in this crop has increased, due to a growing demand related to the recognized health benefits of nut consumption. C. avellana cv “Tonda Gentile delle Langhe” (“TGdL”) is well-known for its high kernel quality, and the premium price paid for this cultivar is an economic benefit for producers in northern Italy. Assembly of a high-quality genome is a difficult task in many plant species because of the high level of heterozygosity. We assembled a chromosome-level genome sequence of “TGdL” with a two-step approach. First, 10X Genomics Chromium Technology was used to create a high-quality sequence, which was then assembled into scaffolds with cv “Tombul” genome as the reference. Eleven pseudomolecules were obtained, corresponding to 11 chromosomes. A total of 11,046 scaffolds remained unplaced, representing 11% of the genome (46,504,161 bp). Gene prediction, performed with Maker-P software, identified 27,791 genes (AED ≤0.4 and 92% of BUSCO completeness), whose function was analyzed with BlastP and InterProScan software. To characterize “TGdL” specific genetic mechanisms, Orthofinder was used to detect orthologs between hazelnut and closely related species. The “TGdL” genome sequence is expected to be a powerful tool to understand hazelnut genetics and allow detection of markers/genes for important traits to be used in targeted breeding programs.
Draft nuclear genome and complete mitogenome of the Mediterranean corn borer,Sesamia nonagrioides, a major pest of maize
Authors: Muller Héloïse , Ogereau David , Da Lage Jean-Luc , Capdevielle Claire , Pollet Nicolas , Fortuna Taiadjana , Jeannette Rémi , Kaiser Laure , Gilbert Clément
Published: May 2021

The Mediterranean corn borer (Sesamia nonagrioides, Noctuidae, Lepidoptera) is a major pest of maize in Europe and Africa. Here, we report an assembly of the nuclear and mitochondrial genome of a pool of inbred males and females third-instar larvae, based on short- and long-read sequencing. The complete mitochondrial genome is 15,330 bp and contains all expected 13 and 24 protein-coding and RNA genes, respectively. The nuclear assembly is 1021 Mb, composed of 2553 scaffolds and it has an N50 of 1105 kb. It is more than twice larger than that of all Noctuidae species sequenced to date, mainly due to a higher repeat content. A total of 17,230 protein-coding genes were predicted, including 15,776 with InterPro domains. We provide detailed annotation of genes involved in sex determination (doublesex, insulin-like growth factor 2 mRNA-binding protein, and P-element somatic inhibitor) and of alpha-amylase genes possibly involved in interaction with parasitoid wasps. We found no evidence of recent horizontal transfer of bracovirus genes from parasitoid wasps. These genome assemblies provide a solid molecular basis to study insect genome evolution and to further develop biocontrol strategies against S. nonagrioides.
Perceived Gratitude, Role Overload, and Mental Health Among Spousal Caregivers of Older Adults
Authors: Nah Suyoung , Martire Lynn M , Zhaoyang Ruixue
Published: May 2021

Objectives

We investigated whether spousal caregivers’ greater perception of being appreciated by their partner for their help was associated with caregivers’ better mental health and whether caregivers’ higher role overload was related to their poorer mental health. We further evaluated whether spousal caregivers’ greater perceived gratitude buffered the association between their role overload and mental health.

Methods

We examined 306 spousal caregivers of older adults with chronic illness or disability, drawn from the 2011 National Health and Aging Trends Study and National Study of Caregiving. We defined mental health as better psychological well-being and less psychological distress (i.e., fewer depressive and anxiety symptoms). Hierarchical regression models were estimated to test hypotheses.

Results

Greater perceived gratitude was associated with better psychological well-being, and higher role overload was related to poorer psychological well-being and greater psychological distress. In addition, greater perceived gratitude buffered the associations between role overload and anxiety symptoms as well as psychological well-being.

Discussion

Findings suggest that spousal caregivers’ role overload may be a strong risk factor for their poorer mental health, especially when caregivers feel less appreciated by their partner. Couple-oriented interventions to improve spousal caregivers’ mental health could be aimed at reducing their role overload and enhancing perceived gratitude.
Report on the Kyoto Guidelines of the ILA Committee on Intellectual Property and Private International Law
Authors: Sutterer Moritz
Published: May 2021

In 2010 the International Law Association (ILA) formed a committee to develop a new set of rules on intellectual property and private international law. In 2020 the committee presented its work at the 79th Kyoto Conference of the ILA. The ‘Kyoto Guidelines’ cover all areas of IP and all aspects of private international law. This report presents the Kyoto Guidelines and particularly looks at four questions of private international law: initial ownership; jurisdiction and applicable law in cases of multi-state infringements; validity claims of registered rights which arise incidentally; and cross-border collective copyright management.
178 Relationships Between Sow Blood Glucose Levels on Day of Farrowing and Sow and Litter Parameters
Authors: Yeich Brian P , Rivas Rafael Ovidio Bautista , Willard Naomi C , Vande Pol Katherine D , Morris Jenny R , Espinal Alicia Olivo , Moest Nicole K , Shull Caleb M , Ellis Michael
Published: May 2021

Low blood glucose levels at the start of farrowing have been associated with increased farrowing duration and stillbirth rate. This study evaluated changes in sow blood glucose (BG) on the day of farrowing and investigated relationships between sow and litter parameters and BG. The study was carried out over 12 h from 0600h (time of last feeding) on the day sows were induced to farrow (d 115 of gestation) as a cross-sectional survey using 42 sows/gilts of which 32 farrowed. Blood samples (1.2 μL) were collected from an ear vein of each sow every 2 h from 0600 h; glucose was measured using a glucometer (Accuchek Aviva; Roche Diabetes Care, Inc., Indianapolis, IN). Sow parameters recorded included parity, body condition score (BCS: 1 = extremely thin to 5 = extremely fat), number of piglets born, total litter birth weight, and farrowing duration. Linear relationships between sow parameters and BG were developed using PROC REG of SAS. Sows that farrowed had similar (P > 0.05) BG to those that did not (84.4 vs. 86.8 mg/dL; SEM 1.76). Regression relationships between sow parameters and BG were generally weak (adjusted R2 ≤ 0.20). There was no effect (P > 0.05) of time after feeding, time after start of farrowing, or time interval between piglet births on BG. Average BG levels increased linearly (P < 0.05) with sow BCS (7.6 mg/dL/BCS; SE 2.63) but decreased linearly (P < 0.05) with sow parity (-2.5 mg/dL/litter; SE 0.96), litter size (-0.8 mg/dL/piglet; SE 0.28), litter weight (-0.06 mg/dL/kg; SE 0.26), and farrowing duration (-1.8 mg/dL/h; SE 0.82). In contrast to previous research, changes in BG from last feed to start of farrowing (which ranged from 0 to 9 h) and relationship with other sow and litter parameters were relatively limited.
90 Comparing Methods of Raising Twin Beef Calves
Authors: Bortoluzzi Eduarda M Mazzardo , Aubuchon Kolton , Robben Nicole D , Goering Mikayla , Bronkhorst Claiborn , Odde John A , Breiner Clay , Fike Karol E , Hulbert Lindsey E , Odde Kenneth G
Published: May 2021

Twinning has shown promise as a means of increasing reproductive efficiency in beef cattle. The objective of this study was to compare the performance of 1) twin calves raised by their dam (twin born-twin raised; TT); 2) twin calves where one calf was grafted to another cow that lost her calf and one calf was left with their dam (twin born-single raised; TS); and 3) single born calves that were raised by their dams (single born-single raised; S). To achieve twinning, sixty-three Angus-cross cows were estrus synchronized and artificially inseminated. Seven days later, an embryo was placed into the uterine horn contralateral to the corpus luteum. Fourteen twin pairs and 11 singleton calves were produced from the described technique. Three natural twin pairs were added to the study. Birth order was recorded for twin calves (1=first calf; 2=second calf). Birth weights (BW) and blood samples for measuring serum total protein, IgG1, and IgM were collected 24 h post-calving. Calves were weighed at approximately six months of age, and a 200-d adjusted weight was calculated using the following equation: [(ADG x 200 d) + BW=A200dW]. Calf behavior data collected included interval to standing and first nursing, duration of dam nursing, and duration of non-dam nursing. Single calves had greater (P < 0.001) BW compared to TT and TS. Adjusted 200-d weights were greater (P < 0.05) for S compared to TS. There was a positive correlation between BW and A200dW (r=.32; P < 0.05). Behavior data did not differ among raising methods. Twin-single calves had lower (P < 0.05) serum IgG1 concentrations compared to S calves. Twin-Twin calves had a combined A200dW of 185 kg more than single born-single raised calves.
86 Effect of Post-metaphylactic Interval on Health and Performance of Steers Administered Tildipirosin for the Control of Bovine Respiratory Disease
Authors: Streeter Marshall N , Szasz Josh , Bryant Tony C
Published: May 2021

Crossbred beef steers (n = 8160; 294 + 10.4 kg) were used in a randomized complete block designed study to determine the effects of post-metaphylactic interval (PMI) on health, live and carcass performance. Steers were administered tildipirosin for the control of bovine respiratory disease (BRD) before being randomly allocated to PMI treatments (4-, 7-, 10-, or 13-day PMI). Treatments were replicated in forty - 204 head pens with each treatment represented within 10 arrival blocks. Blocks ranged from 4 to 15 unique sources of cattle representing five states (AR, FL, GA, LA, TX). Steers were observed daily (217 + 14 d) by trained pen riders with steers suffering from BRD receiving a common antibiotic therapy across PMI treatment. Data were evaluated using linear, quadratic and cubic contrasts. First pull BRD morbidity decreased linearly (P < 0.01) and tended to decrease quadratically (P = 0.08) as PMI increased with the greatest BRD morbidity at 7 days (12.9%) and the least at 13 days (9.5%). First pull BRD relapses tended to decrease linearly (P = 0.10) with increasing PMI. Total first pull morbidity, for all causes, decreased quadratically (P = 0.02) as PMI increased with the greatest morbidly occurring with a 7-day PMI (15.8%) and the least with a 13-day PMI (11.5%). Mortality caused by BRD (0.73%; P > 0.70) and all causes (1.41%; P > 0.20) or chronicity (1.60%; P > 0.15), resulting from failure to respond to therapy, were not affected by PMI. Final body weight, ADG, DMI, Gain:Feed, and HCW were not affected (P > 0.20) by PMI. Total and BRD morbidity can be reduced by increasing PMI up to 13 days in cattle at moderate risk of developing BRD (15% morbidity, 1% mortality, 1% chronicity) without adversely affecting mortality, chronicity or live and carcass performance.
88 Foundational Investigations of Tissue Dimensions and Their Relation to Captive Bolt application Sites on Cadaver Heads from Mature Swine–A Preliminary Report
Authors: Anderson Karly N , Baysinger Angela , Benjamin Madonna , Claus James , O’Brien Brett , Ramirez Alejandro , Reyes Arquimides , Vogel Kurt D
Published: May 2021

The objective of this study was to contrast the soft tissue thickness, cranial thickness, total tissue thickness, and cross-sectional brain area from the common frontal captive bolt placement for the captive bolt euthanasia of swine with the alternative temporal and caudal to pinna placements. One hundred and fifty-seven cadaver heads from sows and boars with estimated body weights greater than 200 kg were collected from a regional slaughter establishment following electrical stunning and assigned to the FRONTAL, TEMPORAL, or CAUDAL to pinna captive bolt placement treatments after cooling at 2–4°C for approximately 64 h. In sows, soft tissue thickness was different (P ˂ 0.0001) between the three placements (FRONTAL: 13.9±1.1 mm, TEMPORAL: 45.93±1.1 mm, CAUDAL TO PINNA: 53.8±1.1 mm), cranial thickness was different (P ˂ 0.0001) between the three placements (FRONTAL: 47.1±1.4 mm, TEMPORAL: 17.6±1.4 mm, CAUDAL TO PINNA: 30.2±1.4 mm), total tissue thickness was different (P < 0.0001) between the three placements (FRONTAL: 61.03±1.4 mm, TEMPORAL: 63.49±1.4 mm, CAUDAL TO PINNA: 84.05±1.4 mm), and cross-sectional brain area was different (P < 0.0001) between the three placements (FRONTAL: 4509.0±238.0 mm2, TEMPORAL: 1964.4±238.0 mm2, CAUDAL TO PINNA: 2767.5±238.0 mm2). In boars, soft tissue thickness was different (P < 0.0001) between the three placements (FRONTAL: 12.9±1.7mm, TEMPORAL: 45.3±1.7 mm, CAUDAL TO PINNA: 54.7±1.7 mm), cranial thickness was different (P = 0.0193) between the FRONTAL and TEMPORAL treatments (FRONTAL: 34.8±3.2mm, TEMPORAL: 22.1±3.2 mm, CAUDAL TO PINNA: 31.7±3.2 mm), total tissue thickness was different (P < 0.0001) between the three placements (FRONTAL: 47.7±3.2 mm, TEMPORAL: 67.4±3.2 mm, CAUDAL TO PINNA: 86.4±3.2mm), and cross-sectional brain area was different (P < 0.0001) between the three placements (FRONTAL: 4031.9±153.2mm2, TEMPORAL: 1241.8±153.2 mm2, CAUDAL TO PINNA: 2467.5±153.2 mm2). Overall, the preliminary data indicated that the FRONTAL placement appears to have the greatest likelihood for successful euthanasia and may present less risk than the alternative TEMPORAL or CAUDAL TO PINNA placements.
85 Vaccination Mitigates Performance Losses During a Lawsonia Intracellularis Experimental Challenge
Authors: Helm Emma T , Burrough Eric R , Leite Fernando L , Gabler Nicholas K
Published: May 2021

Lawsonia intracellularis is endemic to swine herds worldwide. Currently, vaccination is one of the few strategies available to mitigate L. intracellularis. Thus, this study aimed to characterize the impact of vaccination on growth performance and disease severity during experimental challenge. Thirty-six L. intracellularis negative barrows were assigned to treatment groups as follows (n = 12/trt): 1) nonvaccinated, L. intracellularis negative (NC); 2) nonvaccinated, L intracellularis challenged (PC); and 3) L. intracellularis challenged, vaccinated (Enterisol® Ileitis, Boehringer Ingelheim) at 1 week postweaning (VAC). On days post inoculation (dpi) 0 (7 weeks post-weaned) PC and VAC pigs were inoculated with L. intracellularis. Individual feed disappearance and BW were recorded weekly and all pigs were euthanized at dpi 21. Post-inoculation, ADG was reduced in PC (P < 0.001) and VAC (P = 0.001) pigs compared with NC pigs. Average daily gain was additionally reduced in PC pigs compared with VAC pigs (P < 0.001). Similarly, ADFI was reduced in PC (P < 0.001) and VAC (P = 0.029) pigs compared with NC pigs, and further reduced in PC pigs compared with VAC pigs (P = 0.032). Overall G:F was reduced in PC pigs compared with NC (P < 0.001) and VAC (P = 0.015) pigs, which did not differ. For antibody response and fecal shedding, NC pigs remained negative. Antibody responses and fecal shedding were lower in VAC pigs compared with PC pigs (P < 0.05). Ileal gross lesion severity was greater in PC pigs compared with VAC (P = 0.018) and NC (P = 0.003) pigs, which did not differ. Similarly, ileal lesion length was greater in PC pigs compared with NC (P = 0.007) and VAC (P = 0.045) pigs. Microscopic lesion severity was greater in PC pigs compared with both PC and VAC pigs (P < 0.05). Taken together, these data characterize the impact L. intracellularis has on growth performance of pigs and highlight the importance of vaccination to prevent disease associated performance losses.