bluuebunny/crossref_metadata_2025 huggingface dataset:
P148 LIRA TECHNIQUE AFTER MEDIUM FOLLOW UP. RESULTS OF A NEW MINIMAL INVASIVE PROCEDURE IN VENTRAL HERNIA REPAIR
Authors: Gómez-Menchero Julio , Bohorquez Antonio Gila , Herranz Pablo de la , Ramirez Jose Luis Guerrero
Published: December 2021

Aim

LIRA technique (Laparoscopic Intracorporeal Rectus Aponeuroplasty) was described in 2018 in order to reduce the tension in the midline as an alternative to defect closure (CD) in Laparoscopic Ventral Hernia Repair. We present our results in LIRA series in patients over 1-year follow-up.

Material and Methods

A prospective controlled study was conducted from January 2015 to December 2020 to evaluate an elective new procedure (LIRA) performed on patients with midline ventral hernias w2 (EHS Classification). Data analyzed included patient demographics, operative parameters and complications.

A Tomography was performed preoperatively and postoperatively (1 month and 1 year) to evaluate recurrence, distance between rectus and seroma

Results

49 patients were included. Mean Age was 58± 10.59 years old and BMI 33.11± 6.61 kg/m2. Mean width of the defect was 6.19± 1.49 cm. Average VAS (24 h) was 5.09 ± 5, 0.38(1 month) and 0 (1 year). Mean preoperative distance between rectus was 5.55± 1.61 cm; postoperative was 2.15 ± 0.79 cm (1 month) and 2.20±0.68 cm (1 year). Radiological seroma at first month was detected in 40%. Seroma after 1 year was 4,08% Mean follow-up was 24 months. Bulging was detected only in 1 case (2.04%) of our series after 1 year follow up. No recurrence is data.

Conclusions

LIRA technique could be considered as an alternative to CD for w2 defects with a low rate of complication, and could be related to a low rate of postoperative pain with no recurrence and a low rate of bulging compared to CD, being a safe, feasible and reproducible technique.
P153 CHALLENGES IN MINIMALLY INVASIVE REPAIR OF ILEAL CONDUIT PARASTOMAL HERNIAS
Authors: Dewulf Maxime , Pletinckx Pieter , Nachtergaele Femke , Muysoms Filip
Published: December 2021

Aim

Parastomal hernia after radical cystectomy and ileal conduit urinary diversion is an underestimated and probably undertreated condition with significant impact on quality of life. However, its surgical treatment is challenging and prone to recurrence and complications. Literature on the subject is scarce and of poor quality, and the optimal surgical treatment of this condition remains to be determined.

Material and Methods

In this retrospective patient series, a prospectively maintained database was screened. Data from all patients undergoing surgical treatment for a parastomal hernia after cystectomy and ileal conduit urinary diversion in our center were collected. The incidence of local recurrence was defined as primary endpoint. The rate of in-hospital complications was defined as secondary endpoint.

Results

Between May 2016 and June 2020, 15 patients underwent minimally invasive repair of a parastomal hernia of an ileal conduit at our center. Almost half of the patients had a concomitant midline incisional hernia (7/15; 46,7%). The majority of patients were treated with robotic-assisted laparoscopic surgery (10/15; 66,7%). Median follow-up was 366 days. One patient developed a local recurrence of her parastomal hernia on day 66 postoperatively, this recurrence was treated with intraperitoneal mesh.

Conclusions

The minimally invasive surgical treatment of a parastomal hernia after ileal conduit urinary diversion poses specific perioperative challenges that require a broad surgical armamentarium and a tailored approach. This paper confirms the significant morbidity after this type of surgery and proposes a flow chart to standardize the choice of surgical technique, depending on the presence of a concomitant midline incisional hernia and perioperative findings.
P156 INTERNET USE OF THE HERNIA PATIENTS BEFORE SURGERY: SEARCHING ABOUT THE DISEASE, AND FINDING A PROPER SURGEON
Authors: Ugurlu Celil , Bayar Bahattin , Celasin Haydar , Kulacoglu Hakan
Published: December 2021

Aim

To find out the current status of the internet use of the patients who undergo hernia repair.

Material and Methods

The patients who were diagnosed with abdominal wall hernia and scheduled for elective hernia repair were requested to answer a questionnaire. The age, gender, education status, place of living, health insurance, access to the Internet, the person who did the search, and the hernia type were the recorded parameters at the first stage. Then the answers for three main questions were taken: “Did you make a search about your hernia?”, “Did you make a search about your surgeon?”, “Would you prefer another surgeon if you could?”.

Results

139 patients were included. 86% of all participants were Internet users. 62% of the patients made an Internet search about their hernias. 57% made a search in order to find a proper surgeon. 10% of the patients stated that they would like to go to another surgeon for the hernia repair if it was possible. Internet search rate was significantly higher in younger patients (16-40 y) in comparison with older patients. The higher the education level of the patients the higher the rate of making Internet searches. Patients who live in the cities more frequently made Internet searches than those in towns or villages.

Conclusions

Less than two thirds of the hernia patients make Internet search about their disease. Higher education level, younger age and living in a city positively affect Internet search rates.
O02 THE ROLE OF DEEP LEARNING IN PREDICTING COMPLEXITY AND COMPLICATIONS IN ABDOMINAL WALL RECONSTRUCTION
Authors: Elhage Sharbel , Ayuso Sullivan , Zhang Yizi , Deerenberg Eva , Augenstein Vedra , Colavita Paul , Todd Heniford B
Published: December 2021

Aim

The aim of our study was to evaluate the utility of image-based deep learning models (DLMs) to predict surgical complexity and postoperative outcomes in patients undergoing AWR.

Material and Methods

A prospective, tertiary center, hernia database was queried for open AWR patients with adequate pre-operative CT-scans. An 8-layer convolutional neural network (CNN) analyzed image characteristics in Python utilizing the open source Tensorflow© and OpenCV frameworks. Images were analyzed and batched into a training set (80%) and validation set (20%) used to analyze the model output, which was blinded to the CNN until testing. DLMs were run to assess surgical complexity based on need for component separation, surgical site infection (SSI), and pulmonary failure. The surgical complexity DLM was validated by comparison to 6 expert AWR surgeons.

Results

In total, 369 patient CT scans were utilized. The surgical complexity DLM performed well (ROC=0.744;p<0.0001), and when compared to surgeon prediction on the validation set, performed better with an accuracy of 81.3% compared to 65.0% (p < 0.0001). The SSI DLM was successful with an ROC of 0.898 (p < 0.0001). The DLM for predicting pulmonary failure was less effective with an ROC of 0.545 (p = 0.03).

Conclusions

DLMs were able to successfully predict surgical complexity and were more accurate than expert surgeons using objective, pre-operative imaging. DLMs were also successful in predicting SSI. This breakthrough may allow for enhanced pre-operative planning, including resource utilization and possible need for tertiary center referral. AI appears to be an exciting new management tool in complex AWR.
O17 CHRONIC GROIN PAIN DUE TO OR DESPITE THE HERNIA REPAIR
Authors: Jasbon Fernando Ruiz , Ticehurst Kristina , Kroon Lovisa , Ahonen Jukka , Norrby Jonny
Published: December 2021

Aim

There is a discrepancy between the high frequency of chronic post-operative pain reported in questionnaire-based studies after groin hernia surgery and the clinical experience of many surgeons in which it is infrequent that patients return after surgery because of chronic post-operative pain. This is supported by the Swedish Hernia Registry, where the proportion of patients who are re-operated for chronic post-operative pain is 0.02-0.03% for open methods and less than 0,01% for laparo-endoscopic methods. The aim of this study is to find the incidence of non-surgical causes of chronic groin pain and other patient-reported outcomes after inguinal hernia surgery.

Material and Methods

Prospective cohort observation study of patients evaluated for suspected inguinal hernia-related symptoms at a hernia clinic in Sweden during 1 year. Patients completed validated pain forms before surgery and 6 and 12 months after surgery. Patients were assessed preoperatively about the possible causes of groin pain according to a checklist. For this purpose, a questionnaire of inguinal hernia-related symptoms was used. Patients with moderate or severe chronic groin pain after surgery were offered to participate in a clinical examination where the pain was evaluated for probable cause according to a checklist.

Results

574 patients were included in the study, of which 372 were operated on and answered the post-operative questionnaires. Preliminary results on surgical and non-surgical causes of chronic groin pain after hernioplasty and other patient-reported outcomes will be presented at Hernia 2021 EHS-AHS Joint Congress.

Conclusions

Proportion of patients with chronic groin pain related to groin hernia surgery and other non-surgical pathologies will be reported.
O30 THE INCIDENCE OF INCISIONAL HERNIA AT OSTOMY-REVERSAL SITE
Authors: Gorjanc Jurij , Edlinger Raphael , Rosenkranz Magdalena , Tschmelitsch Jörg
Published: December 2021

Aim

The purpose of this study was to evaluate the rate of incisional hernias at the ostomy site after reversal of the ostomy.

Material and Methods

We used retrospectively compiled database of patients who had undergone ostomy formation and ist reversal. All patients had their surgery performed between Jan. 2011 and December 2019. Patients history, added by clinical examination and CT-scan were performed in order to identify the incidence of incisional hernias. Different variables, like gender, surgical site infection (SSI) and BMI were evaluated as possible risk factors for hernia occurrence.

Results

Among totally included 224 patients in the study, 190 of all patients had reversal after loop-ileostomy (85%) and 34 patients had reversal after loop-colostomy (15%). Among all stoma reversal patients, 12,8 % developed incisional hernia at the stoma reversal site (n = 28). The incisional hernia occurrence at the ostomy reversal site was present in 20,0% in patients with clinically relevant SSI and only in 9,4% in patients where SSI was absent (p = 0,03). There was no statistical significance in hernia occurrence between both genders and among patients with low, normal and high BMI in our cohort of patients.

Conclusions

Incisional hernia after ostomy reversal is a common late surgical complication. All measurements that reduce SSI at the reversal site are important for lower hernia incidence. Prophylactic mesh implantation at stoma reversal sites may be considered in these patients.
O42 SURGICAL REPAIR OF DIASTASIS RECTI ABDOMINIS (DRA) PROVIDES LONG-TERM IMPROVEMENT OF ABDOMINAL CORE FUNCTION AND QUALITY OF LIFE: A THREE-YEAR FOLLOW-UP
Authors: Olsson Anders , Kiwanuka Olivia , Wilhelmsson Sofia , Sandblom Gabriel , Stackelberg Otto
Published: December 2021

Aim

Diastasis Recti Abdominis (DRA) is a condition affecting many post-partum women. The aim of this study was to evaluate long-term results of surgical repair of DRA in a cohort of post-partum women.

Material and Methods

Sixty post-partum women with DRA and training-resistant core dysfunctions were included. Surgical repair was performed with suture plication of the linea alba. Abdominal core function was evaluated with the Abdominal Trunk Function Protocol (ATFP) including a self-report questionnaire and seven functional tests. Urinary incontinence and Quality of Life was evaluated with the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the SF-36 questionnaire. Follow-up was performed at one year and three years’ post-operatively.

Results

Response rate at the three-year follow-up was 86.7 % for the DRI questionnaire; and 71.7% for ATFP, the UDI-6, IIQ-7, and SF-36 questionnaires. All DRI-parameters were improved (p < 0,05) after three-years of follow-up compared to preoperative values. The functional tests in the ATFP showed an improvement (p < 0.05) in core muscle strength and stability, persisting back and abdominal muscle strength compared to preoperative values as well as an improvement compared to the one-year follow-up values (p < 0.05). UDI-6 and IIQ-7 results were improved (p < 0.05) compared to preoperative values and showed consistent values compared to the one-year follow-up. Quality of life measured with SF-36 were improved compared to preoperative values and showed consistent values compared to the one-year follow-up (p < 0.05).

Conclusions

The functional improvement of surgical reconstruction of the DRA persisted for three years in this series of post-partum women with DRA.
O44 ENHANCED RECOVERY AFTER SURGERY (ERAS) IN PATIENTS UNDERGOING COMPLEX ABDOMINAL WALL RECONSTRUCTION (AWR)
Authors: Katzen Michael , Ayuso Sullivan , Aladegbami Bola , Nayak Raageswari , Colavita Paul , Augenstein Vedra , Kercher Kent , Todd Heniford B
Published: December 2021

Aim

Enhanced Recovery After Surgery (ERAS) is often conceptually associated with hospital length of stay (LOS), but its true purpose is the application of best science to achieve best patient outcomes. We hypothesized that the implementation of the ERAS program would improve outcomes while possibly leading to a decreased LOS.

Material and Methods

Prospective institutional hernia database queried for patients who underwent open AWR between 2010–2014 (pre-ERAS) and 2016-2020 (ERAS). Demographics, operative characteristics and postoperative outcomes were compared between pre-ERAS and ERAS patients. Standard descriptive statistics and logistic regression were used.

Results

1713 patients were analyzed (ERAS-802, pre-ERAS-911). ERAS patients were similar in terms of age (58.9±12.1vs58.4±12.5;p=0.29) and diabetes (24.6%vs25.9%;p=0.53) compared to pre-ERAS patients, but ERAS patients had lower BMI (31.2±6.3vs33.3±8.1 kg/m2;p<0.01) and increased smoking history (35.8%vs16.1%;p<0.01). The percentage of ERAS patients with CDC 3 and 4 wound classes was higher (12.7%/11.9%vs10.4%/7.4%;p<0.01) as was the use of biologic mesh (30.0% vs 17.4%; p < 0.01). There were no significant differences in defect (208.3±165.4 cm2 vs 216.4 ±254.2cm2; p=0.16) or mesh size (824.1±477.7 cm2 vs 769.1±426.2cm2; p=0.99). ERAS patients had fewer panniculectomies (21.7%vs28.0%;p=0.02) and shorter operative time (176.3±81.6 vs 186.3±87.5min; p=0.01). Mean LOS shorter for ERAS patients (6.5±4.8vs7.2±7.1;p<0.01). When transversus abdominis plane block was added (2018), LOS decreased further (6.0±6.0 days) and narcotic use decreased by 65.1% (each:p<0.05). ERAS had fewer wound complications (14.1%vs32.3%;p<0.01), mesh infections (0.6 %vs2.5%; p<0.01), and 30-day readmissions (2.5%vs11.4%;p<0.01). In logistic regression, BMI, operation time, and panniculectomy increased risk for wound complications.

Conclusions

ERAS measures improve multiple aspects of AWR patient outcomes including LOS, wound complications and readmissions.
OV04 MASSIVE INGUINAL-SCROTAL HERNIA WITH RETROPERITONEAL CONTENTS AND URETER: VIDEO CASE REPORT OF ROBOTIC REPAIR USING INTRAOPERATIVE FLUORESCENCE IMAGING
Authors: Atwood Rex , Tevar Rahul , Li Kai , Chen Gao
Published: December 2021

Aim

Inguinal hernias containing the ureter and retroperitoneal contents are uncommon. We present a robotic repair of a large inguinal-scrotal hernia containing the ureter as a video case presentation.

Material and Methods

A 66 year old male with no previous abdominal surgical history presents with a large left sided inguinal-scrotal hernia, as well as smaller ventral and right inguinal hernias. On CT imaging the patient was found to have an ectopic pelvic location of the left kidney with evidence of the left ureter coursing into the hernia with a significant amount of retroperitoneal fat. The patient was taken to the operating room for a robotic bilateral inguinal hernia repair and ventral hernia repair.

Results

A ureteral catheter was placed preoperatively and instilled with indocyanine green (ICG). The hernias were successfully repaired, and intraoperative fluorescence imaging was successfully used to visualize the ureter as it was reduced with the hernia sac. The robotic platform significantly aided in dissection of the large volume of retroperitoneal fat, while being able to quickly transition to intraoperative fluorescence to clearly visualize the course of the ureter. The patient did well post operatively with no complications.

Conclusions

We present a video case report of a large ureter-containing inguinoscrotal hernia that was successfully repaired using a robotic preperitoneal approach. Use of the robotic platform and indocyanine green/intraoperative fluorescence imaging were helpful adjuncts in aiding dissection by improving intraoperative visualization of the ureter.
OV07 LAPAROSCOPIC HIATAL HERNIA MESH-SUTURE REPAIR
Authors: Abolmasov Alexey
Published: December 2021

Aim

“A new original laparoscopic operative technique was used to suture paraesophageal hernia (PEH) with the strips of mesh.

Material and Methods

The Mercilen (MercilenTM) mesh suture was used to close large hiatal hernia. The strips of mesh, instead of normal thread, were applied to close the gap between diaphragm’s crura in 12 patients with hernia defect more than 5 cm. Mesh suture were tighten as a simple laparoscopic intracorporeal knot. The surgical technique and surgical outcomes are presented.

Results

12 patients underwent a laparoscopic PEH suturing with Mercilen strips of mesh. We recorded no recurrence or dysphagia at 6 and 12 months follow-up.

Conclusions

Mesh-sutured repairs of diaphragm’s hernia support the concepts of force distribution and resistance to suture pull through. The new original technique avoids using the sheet of mesh and enables to reduce the amount of dangerous complications connected with mesh and its fixation. Mesh-sutured closures of hiatal hernias seem to be safe and effective in tension closure of large hiatal defects. Further investigations are needed to evaluate the results.

Using the mesh suture technique for the closure of large PEH, we protect the cruras from being cutting through. Besides, the mesh stripes and its knots produce tissue scarring around the esophagus making the suture line stronger.
p62/SQSTM1 promotes mitophagy and activates the NRF2-mediated antioxidant and anti-inflammatory response restraining EBV-driven B lymphocyte proliferation
Authors: Gilardini Montani Maria Saveria , Tarquini Greta , Santarelli Roberta , Gonnella Roberta , Romeo Maria Anele , Benedetti Rossella , Arena Andrea , Faggioni Alberto , Cirone Mara
Published: December 2021

Reactive oxygen species (ROS) and DNA repair, respectively, promote and limit oncogenic transformation of B cells driven by Epstein-Barr virus (EBV). We have previously shown that EBV infection reduced autophagy in primary B lymphocytes and enhanced ROS and interleukin 6 (IL-6) release, promoting B-cell proliferation and immortalization. In this study, we explored the role of p62/SQSTM1, accumulated as a consequence of autophagy reduction in EBV-infected B lymphocytes, and found that it exerted a growth-suppressive effect in these cells. At the molecular level, we found that p62 counteracted IL-6 production and ROS increase by interacting with NRF2 and promoting mitophagy. Moreover, p62/NRF2 axis sustained the expression level of H2AX and ataxia-telangiectasia mutated (ATM), whose activation has been shown to have growth-suppressive effects during the first steps of EBV infection, before latency is established. In conclusion, this study shows for the first time that the accumulation of p62 and the activation of p62/axis counteracted EBV-driven proliferation of primary B lymphocytes.
A unique case report of mitral valve endocarditis associated with coronary stent infection
Authors: Doost Ata , Rankin James , Yong Gerald
Published: December 2021

Background

Despite increasing use of percutaneous coronary intervention and stenting, septic complications such as coronary stent infections are rare. We report a unique case of mitral valve infective endocarditis and associated coronary stent infection which emerged 6 months after index stent insertion.

Case summary

A 56-year-old previously healthy man underwent percutaneous coronary intervention and stenting of left circumflex (LCx) coronary artery in the setting of non-ST-segment elevation myocardial infarction. Six months later, he represented with inferior ST-segment elevation myocardial infarction and was found to have a coronary pseudoaneurysm of stented segment of LCx. The pseudoaneurysm was treated with insertion of a covered stent, and immediately following that he developed sepsis with methicillin-sensitive Staphylococcus aureus bacteraemia. Comprehensive work-up resulted in the diagnosis of mitral valve endocarditis complicated by coronary stent infection and myocardial abscess formation. He was managed with initial prolonged systemic antibiotic treatment followed by mitral valve replacement. Post-operative course was uneventful with a short duration of oral antibiotics. At 6-year follow-up, the patient was well with the satisfactory echocardiographic result.

Discussion

This is a very rare case of mitral valve endocarditis with extensive cardiac involvement including coronary stent infection and surrounding myocardial abscess. Stents can act as an ideal vector for bacterial adherence from which bacteria could spread to the arterial wall and adjacent myocardium. This case suggests a potential complication of delayed endothelialization and risk of infective complication due to bacterial seeding or embolization.
Peripartum management of patient with long QT3 after successful implantable cardioverter defibrillator device discharge resulting in device failure: a case report
Authors: Lee Melissa J , Monteil Danielle C , Spooner Michael T
Published: December 2021

Background

Long QT3 syndrome type 3 (LQT3) is a gain of function mutation of the SCN5A gene that is inherited in an autosomal dominant fashion. Long QT3 syndrome type 3 results in an increase in arrhythmic events during rest, sleep, and bradycardia by extending the QT interval and inducing Torsades de pointes and sudden cardiac death. Attempting to block the sodium channel with Class I anti-arrhythmics or blocking adrenergic tone with beta-blockers especially in women has shown to be beneficial. There have been few large-scale studies on treating patients with LQT3 due to its lethality and underreported number of cases. Specifically, the safety and efficacy of pharmacologic treatment in pregnant LQT3 patients are unknown.

Case summary

This case demonstrates the safe use of Mexiletine and Propranolol in a 3rd-trimester pregnant LQT3 patient after a presumed ventricular arrhythmia and device-lead electrical short from therapy rendered her implantable cardioverter defibrillator inoperable in a VVI mode (venticular demand pacing). With appropriate medications, the patient was safely monitored through the remainder of her pregnancy and safely delivered at 36 weeks of pregnancy a healthy baby girl. The daughter, heterozygous for LQT3, showed no evidence of intrauterine growth restriction or other side effects from the medications.

Discussion

There are many variants of the SCN5A gene mutations that can lead to different phenotypes and not all mutations are responsive to the same medications. In this case, Mexiletine and Propranolol, both of which have only recently shown to benefit certain variants or LQT3 respectively, were safely started during the 3rd trimester of pregnancy without harming the foetus.
Screening for subclinical rheumatic heart disease: addressing borderline disease in a real-world setting
Authors: Hunter Luke D , Pecoraro Alfonso J K , Doubell Anton F , Monaghan Mark J , Lloyd Guy W , Lombard Carl J , Herbst Philip G
Published: December 2021

Aims

The World Heart Federation (WHF) criteria identify a large borderline rheumatic heart disease (RHD) category that has hampered the implementation of population-based screening. Inter-scallop separations (ISS) of the posterior mitral valve leaflet, a recently described normal variant of the mitral valve, appears to be an important cause of mild mitral regurgitation (MR) leading to misclassification of cases as WHF ‘borderline RHD’. This study aims to report the findings of the Echo in Africa project, a large-scale RHD screening project in South Africa and determine what proportion of borderline cases would be re-classified as normal if there were a systematic identification of ISS-related MR.

Methods and results

A prospective cross-sectional study of underserved secondary schools in the Western Cape was conducted. Participants underwent a screening study with a handheld (HH) ultrasound device. Children with an abnormal HH study were re-evaluated with a portable laptop echocardiography machine. A mechanistic evaluation was applied in cases with isolated WHF ‘pathological’ MR (WHF ‘borderline RHD’). A total of 5255 participants (mean age 15± years) were screened. A total of 3439 (65.8%) were female. Forty-nine cases of WHF ‘definite RHD’ [9.1 cases/1000 (95% confidence interval, CI, 6.8–12.1 cases/1000)] and 104 cases of WHF ‘borderline RHD’ [19.5 cases/1000 (95% CI, 16.0–23.7 cases/1000)] were identified. Inter-scallop separations-related MR was the underlying mechanism of MR in 48/68 cases classified as WHF ‘borderline RHD’ with isolated WHF ‘pathological’ MR (70.5%).

Conclusion

In a real-world, large-scale screening project, the adoption of a mechanistic evaluation based on the systematic identification of ISS-related MR markedly reduced the number of WHF ‘screen-positive’ cases misclassified as WHF ‘borderline RHD’. Implementing strategies that reduce this misclassification could reduce the cost- and labour burden on large-scale RHD screening programmes.
Mourning sickness: the musical birth of ‘Barbara Allen’
Authors: Duffin Ross W
Published: December 2021

In his encyclopaedic 1966 study, The British broadside ballad and its music, Claude Simpson regretted the absence of tune directions for ‘such familiar traditional ballads as “Barbara Allen”’. Indeed, although it is by far the most collected traditional song in England, Scotland, Ireland and North America, and versions of its lyric date back to the 17th century, the tune most people know for ‘Barbara Allen’ was not notated until 1840. Using both verbal and melodic parallels from an earlier complex of ballads and tunes, this study proposes that ‘Barbara Allen’ had its origins in the early 17th century, if not the late 16th century, and that it was originally sung to one or more of three surviving tunes entitled ‘Sick, sick and very sick’. One of those is then linked to a 1740 tune called ‘Barbra Allan’, the earliest surviving melody to bear the name.
A novel transposable element-based authentication protocol for Drosophila cell lines
Authors: Mariyappa Daniel , Rusch Douglas B , Han Shunhua , Luhur Arthur , Overton Danielle , Miller David F B , Bergman Casey M , Zelhof Andrew C
Published: December 2021

Drosophila cell lines are used by researchers to investigate various cell biological phenomena. It is crucial to exercise good cell culture practice. Poor handling can lead to both inter- and intra-species cross-contamination. Prolonged culturing can lead to introduction of large- and small-scale genomic changes. These factors, therefore, make it imperative that methods to authenticate Drosophila cell lines are developed to ensure reproducibility. Mammalian cell line authentication is reliant on short tandem repeat (STR) profiling; however, the relatively low STR mutation rate in Drosophila melanogaster at the individual level is likely to preclude the value of this technique. In contrast, transposable elements (TEs) are highly polymorphic among individual flies and abundant in Drosophila cell lines. Therefore, we investigated the utility of TE insertions as markers to discriminate Drosophila cell lines derived from the same or different donor genotypes, divergent sub-lines of the same cell line, and from other insect cell lines. We developed a PCR-based next-generation sequencing protocol to cluster cell lines based on the genome-wide distribution of a limited number of diagnostic TE families. We determined the distribution of five TE families in S2R+, S2-DRSC, S2-DGRC, Kc167, ML-DmBG3-c2, mbn2, CME W1 Cl.8+, and ovarian somatic sheath Drosophila cell lines. Two independent downstream analyses of the next-generation sequencing data yielded similar clustering of these cell lines. Double-blind testing of the protocol reliably identified various Drosophila cell lines. In addition, our data indicate minimal changes with respect to the genome-wide distribution of these five TE families when cells are passaged for at least 50 times. The protocol developed can accurately identify and distinguish the numerous Drosophila cell lines available to the research community, thereby aiding reproducible Drosophila cell culture research.
Bayesian multitrait kernel methods improve multienvironment genome-based prediction
Authors: Montesinos-López Osval Antonio , Montesinos-López José Cricelio , Montesinos-López Abelardo , Ramírez-Alcaraz Juan Manuel , Poland Jesse , Singh Ravi , Dreisigacker Susanne , Crespo Leonardo , Mondal Sushismita , Govidan Velu , Juliana Philomin , Espino Julio Huerta , Shrestha Sandesh , Varshney Rajeev K , Crossa José
Published: December 2021

When multitrait data are available, the preferred models are those that are able to account for correlations between phenotypic traits because when the degree of correlation is moderate or large, this increases the genomic prediction accuracy. For this reason, in this article, we explore Bayesian multitrait kernel methods for genomic prediction and we illustrate the power of these models with three-real datasets. The kernels under study were the linear, Gaussian, polynomial, and sigmoid kernels; they were compared with the conventional Ridge regression and GBLUP multitrait models. The results show that, in general, the Gaussian kernel method outperformed conventional Bayesian Ridge and GBLUP multitrait linear models by 2.2–17.45% (datasets 1–3) in terms of prediction performance based on the mean square error of prediction. This improvement in terms of prediction performance of the Bayesian multitrait kernel method can be attributed to the fact that the proposed model is able to capture nonlinear patterns more efficiently than linear multitrait models. However, not all kernels perform well in the datasets used for evaluation, which is why more than one kernel should be evaluated to be able to choose the best kernel.
Evolutionarily conserved genetic interactions between nphp-4 and bbs-5 mutations exacerbate ciliopathy phenotypes
Authors: Bentley-Ford Melissa R , LaBonty Melissa , Thomas Holly R , Haycraft Courtney J , Scott Mikyla , LaFayette Cameron , Croyle Mandy J , Andersen Reagan S , Parant John M , Yoder Bradley K
Published: December 2021

Primary cilia are sensory and signaling hubs with a protein composition that is distinct from the rest of the cell due to the barrier function of the transition zone (TZ) at the base of the cilium. Protein transport across the TZ is mediated in part by the BBSome, and mutations disrupting TZ and BBSome proteins cause human ciliopathy syndromes. Ciliopathies have phenotypic variability even among patients with identical genetic variants, suggesting a role for modifier loci. To identify potential ciliopathy modifiers, we performed a mutagenesis screen on nphp-4 mutant Caenorhabditis elegans and uncovered a novel allele of bbs-5. Nphp-4;bbs-5 double mutant worms have phenotypes not observed in either individual mutant strain. To test whether this genetic interaction is conserved, we also analyzed zebrafish and mouse mutants. While Nphp4 mutant zebrafish appeared overtly normal, Bbs5 mutants exhibited scoliosis. When combined, Nphp4;Bbs5 double mutant zebrafish did not exhibit synergistic effects, but the lack of a phenotype in Nphp4 mutants makes interpreting these data difficult. In contrast, Nphp4;Bbs5 double mutant mice were not viable and there were fewer mice than expected carrying three mutant alleles. In addition, postnatal loss of Bbs5 in mice using a conditional allele compromised survival when combined with an Nphp4 allele. As cilia are still formed in the double mutant mice, the exacerbated phenotype is likely a consequence of disrupted ciliary signaling. Collectively, these data support an evolutionarily conserved genetic interaction between Bbs5 and Nphp4 alleles that may contribute to the variability in ciliopathy phenotypes.
Animal Protein Intake Is Inversely Associated With Mortality in Older Adults: The InCHIANTI Study
Authors: Meroño Tomás , Zamora-Ros Raúl , Hidalgo-Liberona Nicole , Rabassa Montserrat , Bandinelli Stefania , Ferrucci Luigi , Fedecostante Massimiliano , Cherubini Antonio , Andres-Lacueva Cristina
Published: December 2021

Background

In general, plant protein intake was inversely associated with mortality in studies in middle-aged adults. Our aim was to evaluate the long-term associations of animal and plant protein intake with mortality in older adults.

Methods

A prospective cohort study including 1 139 community-dwelling older adults (mean age 75 years, 56% women) living in Tuscany, Italy, followed for 20 years (InCHIANTI study) was analyzed. Dietary intake by food frequency questionnaires and clinical information were assessed 5 times during the follow-up. Protein intakes were expressed as percentages of total energy. Time-dependent Cox regression models adjusted for confounders were used to assess the association between plant and animal protein intake, and mortality.

Results

During the 20 years of follow-up (mean: 12 years), 811 deaths occurred (292 of cardiovascular- and 151 of cancer-related causes). Animal protein intake was inversely associated with all-cause (hazard ratio [HR] per 1% of total energy from protein increase, 95% confidence interval [CI]: 0.96, 0.93–0.99) and cardiovascular mortality (HR per 1% of total energy from protein increase, 95% CI: 0.93, 0.87–0.98). Plant protein intake showed no association with any of the mortality outcomes, but an interaction with baseline hypertension was found for all-cause and cardiovascular mortality (p < .05).

Conclusions

Animal protein was inversely associated with all-cause and cardiovascular mortality in older adults. Further studies are needed to provide recommendations on dietary protein intake for older adults.
Personal Care Aides as Household Employees and Independent Contractors: Estimating the Size and Job Characteristics of the Workforce
Authors: Kim Joy Jeounghee
Published: December 2021

Background and Objectives

Although studies pointed out that the number of personal care aides (PCAs) at risk of being in informal employment arrangements is sizeable, little is known about its size and worker characteristics. This study aimed to estimate the share of PCAs working as household employees or independent contractors. It also aimed to compare their basic job characteristics against the job characteristics of those working as agency and government employees.

Research Design and Methods

Using data from the 2014–2018 American Community Surveys, a sample of 43,287 PCAs working for pay in the home- and community-based service (HCBS) industry was identified, and their job characteristics—full-time weekly work (i.e., working at least 35 hours per week), year-round work (i.e., working at least 50 weeks a year), and annual gross earning—were analyzed by their employment arrangement.

Results

Analyses found that (a) close to a quarter of aides in the HCBS industry work as household employees or independent contractors while their share in the workforce varies by state and that (b) the work hours and earnings of full-time year-round working household employees or independent contractors are greater than those of their agency counterparts. The results shed light on why some aides may work as household employees or independent contractors.

Discussion and Implications

The presence of household employees and independent contractors has important implications for PCAs’ job characteristics and labor shortage in the U.S. home care industry. Considering the potentially negative consequences for both the aides’ economic security and the quality of care that consumers can receive, attention should be paid to ways to bring the aides into a more formal employment arrangement.
An overview of the National COVID-19 Chest Imaging Database: data quality and cohort analysis
Authors: Cushnan Dominic , Bennett Oscar , Berka Rosalind , Bertolli Ottavia , Chopra Ashwin , Dorgham Samie , Favaro Alberto , Ganepola Tara , Halling-Brown Mark , Imreh Gergely , Jacob Joseph , Jefferson Emily , Lemarchand François , Schofield Daniel , Wyatt Jeremy C ,   NCCID Collaborative
Published: December 2021

Background

The National COVID-19 Chest Imaging Database (NCCID) is a centralized database containing mainly chest X-rays and computed tomography scans from patients across the UK. The objective of the initiative is to support a better understanding of the coronavirus SARS-CoV-2 disease (COVID-19) and the development of machine learning technologies that will improve care for patients hospitalized with a severe COVID-19 infection. This article introduces the training dataset, including a snapshot analysis covering the completeness of clinical data, and availability of image data for the various use-cases (diagnosis, prognosis, longitudinal risk). An additional cohort analysis measures how well the NCCID represents the wider COVID-19–affected UK population in terms of geographic, demographic, and temporal coverage.

Findings

The NCCID offers high-quality DICOM images acquired across a variety of imaging machinery; multiple time points including historical images are available for a subset of patients. This volume and variety make the database well suited to development of diagnostic/prognostic models for COVID-associated respiratory conditions. Historical images and clinical data may aid long-term risk stratification, particularly as availability of comorbidity data increases through linkage to other resources. The cohort analysis revealed good alignment to general UK COVID-19 statistics for some categories, e.g., sex, whilst identifying areas for improvements to data collection methods, particularly geographic coverage.

Conclusion

The NCCID is a growing resource that provides researchers with a large, high-quality database that can be leveraged both to support the response to the COVID-19 pandemic and as a test bed for building clinically viable medical imaging models.
Anti-SARS-CoV-2 Vaccination and Antibody Response in Patients With Inflammatory Bowel Disease on Immune-modifying Therapy: Prospective Single-Tertiary Study
Authors: Cerna Karin , Duricova Dana , Lukas Martin , Machkova Nadezda , Hruba Veronika , Mitrova Katarina , Kubickova Kristyna , Kostrejova Marta , Teplan Vladimir , Vasatko Martin , Kastylova Kristyna , Lukas Milan
Published: December 2021

Background

Patients with inflammatory bowel disease (IBD) on immune-modifying treatment could be at an increased risk for severe coronavirus disease 2019 (COVID-19); thus, data on the efficacy and safety of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccines are essential. We conducted a prospective study of IBD patients vaccinated with BNT162b2, CX-024414, and ChAdOx1 nCoV-19 vaccines. The aim was to evaluate the rate and magnitude of seroconversion, assess the effect of different immune-modifying treatment modalities on the magnitude of anti-SARS-CoV-2 IgG antibody levels, and analyze the impact of anti-SARS-CoV-2 vaccination on the inflammatory biomarkers of IBD.

Methods

The study included 602 IBD patients and 168 immunocompetent health care workers serving as controls. Serum anti-SARS-CoV-2 IgG antibodies were measured by chemiluminescent microparticle immunoassay before the vaccination and 8 weeks after the vaccination.

Results

Of IBD patients, 82.2% were receiving biological treatment: most of them were treated with antitumor necrosis factor (TNF)-α inhibitors (48.5%), and just under half of them were treated with concomitant thiopurines or methotrexate, followed by vedolizumab (18.6%) and ustekinumab (15.1%). Only 8.1% of patients were on 5-aminosalicylates, and a minority (2.2%) were treatment-free. The postvaccine seropositivity rate among IBD patients and controls was 97.8% vs 100%. Median anti-SARS-CoV-2 IgG levels were lower among IBD recipients of ChAdOx1 nCoV-19 compared with 2 other vaccines (P < .0001) and control ChAdOx1 nCoV-19 recipients (P = .01). No correlation was found between serum trough levels and anti-SARS-CoV-2 IgG concentrations for any of the biological drugs used. The TNF-α inhibitors with concomitant immunosuppressive treatment but no other treatment modalities were associated with a lower postvaccination antibody response (P < .0001). When evaluating the laboratory activity of IBD by C-reactive protein and fecal calprotectin levels, no significant differences were found before the vaccination and 8 weeks after its completion.

Conclusions

Our findings warrant particular attention to the anti-SARS-CoV-2 vaccination of IBD patients treated with TNF-α inhibitors with concomitant immunomodulators and show the priority of mRNA vaccines in this specific group of patients.
In-hospital outcomes of patients undergoing concomitant aortic and mitral valve replacement in Germany
Authors: Kreibich Maximilian , Kaier Klaus , von zur Mühlen Constantin , Siepe Matthias , Zehender Manfred , Bode Christoph , Beyersdorf Friedhelm , Stachon Peter , Bothe Wolfgang
Published: December 2021

OBJECTIVES

To evaluate in-hospital outcomes of concomitant mitral valve replacement (MVR) in patients undergoing conventional aortic valve replacement due to aortic stenosis in a nationwide cohort.

METHODS

Administrative data from all patients with aortic stenosis undergoing conventional aortic and concomitant MVR (reason for MVR not specified) between 2017 and 2018 in Germany were analysed.

RESULTS

A total of 2597 patients with a preoperative logistic EuroScore of 9.81 (standard deviation: 8.56) were identified. In-hospital mortality was 6.8%. An in-hospital stroke occurred in 3.4%, acute kidney injury in 16.3%, prolonged mechanical ventilation of more than 48 h in 16.3%, postoperative delirium in 15.8% and postoperative pacemaker implantation in 7.6% of the patients. Mean hospital stay was 16.5 (standard deviation: 12.1) days. Age [odds ratio (OR): 1.03; P = 0.019], New York Heart Association class III or IV (OR: 1.63; P = 0.012), previous cardiac surgery (OR: 2.85, P = 0.002), peripheral vascular disease (OR: 2.01, P = 0.031), pulmonary hypertension (OR: 1.63, P = 0.042) and impaired renal function (glomerular filtration rate <15, OR: 3.58, P = 0.001; glomerular filtration rate <30, OR: 2.51, P = 0.037) were identified as independent predictors for in-hospital mortality.

CONCLUSIONS

In this nationwide analysis, concomitant aortic and MVR was associated with acceptable in-hospital mortality, morbidity and length of in-hospital stay. The regression analyses may help to identify high-risk patients and further optimize treatment strategies.
Effects of using cassava as an amylopectin source in low protein diets on growth performance, nitrogen efficiency, and postprandial changes in plasma glucose and related hormones concentrations of growing pigs
Authors: Zhou Junyan , Wang Lu , Zhou Jianchuan , Zeng Xiangfang , Qiao Shiyan
Published: December 2021

This study was aimed to explore the effect of using cassava as an amylopectin source in low protein (LP) diets on growth performance, nitrogen efficiency, and postprandial changes in plasma glucose and related hormones concentrations of growing pigs. Three animal experiments were included in the present study. Treatments included corn-soybean meal LP (Corn LP), corn-cassava-soybean meal LP (Corn + Cassava LP), and cassava-soybean meal LP (Cassava LP). The in vitro digestion proved that Corn + Cassava LP and Cassava LP diets induced more rapid starch digestion and glucose release, compared with Corn LP diet. The results of animal experiments are as follows: Cassava LP diet caused the most rapid changes in plasma glucose and relevant hormones concentrations after a meal. It decreased the concentrations of fasting plasma insulin, glucagon, and leptin concentrations compared with other treatments (P < 0.05). These modulations above led to a strong desire to eat and increased feed intake and then weight gain in growing pigs fed Cassava LP diet. Besides, feeding Cassava LP diet caused diarrhea, increased noxious gas release from feces, and increased concentrations of fecal isobutyrate and isovalerate (P < 0.05). Compared with Corn LP group, Corn + Cassava LP group showed significantly decreased urinary nitrogen (P < 0.05) and improved post-absorptive amino acid utilization efficiency. In conclusion, the use of cassava as an amylopectin source in LP diets could modulate glucose absorption and related gut secreted hormones secretion, subsequently strengthened the desire to eat, improved growth performance, and enhanced nitrogen efficiency in growing pigs.
Can Simple Psychological Interventions Increase Preventive Health Investment?
Authors: John Anett , Orkin Kate
Published: December 2021

Behavioral constraints may explain part of the low demand for preventive health products. We test the effects of two light-touch psychological interventions on water chlorination and related health and economic outcomes using a randomized controlled trial among 3,750 women in rural Kenya. One intervention encourages participants to visualize alternative realizations of the future, and the other builds participants’ ability to make concrete plans. After 12 weeks, visualization increases objectively measured chlorination, reduces diarrhea episodes among children, and increases savings. Effects on chlorination and savings persist after almost 3 years. Effects of the planning intervention are weaker and largely insignificant. Analysis of mechanisms suggests both interventions increase self-efficacy—beliefs about one’s ability to achieve desired outcomes. Visualization also increases participants’ skill in forecasting their future utility. The interventions do not differentially affect beliefs and knowledge about chlorination. Results suggest simple psychological interventions can increase future-oriented behaviors, including use of preventive health technologies.