bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Internal Ring Suturing for the Minimal Invasive Treatment of Pediatric Inguinal Hernia: A 5-Year Single Surgeon Experience
Authors: Pogorelić Zenon , Čohadžić Tin , Jukić Miro , Nevešćanin Biliškov Ana 
Published: November 2020

Purpose:
Percutaneous internal ring suturing (PIRS) is a minimally invasive surgical technique of laparoscopic hernia repair in children under the control of a laparoscope placed in the umbilicus. The aim of this study was to evaluate the management and postoperative outcomes of PIRS for inguinal hernia repair in children.

Patients and Methods:
All children who underwent PIRS for an inguinal hernia, between February 2015 and February 2020, were included in the prospective cohort study. The following parameters were recorded: age, gender, body mass index, lateralization of hernia, surgical and anesthesia times, level of pneumoperitoneum, additional trocar introduction, length of hospital stay, and intraoperative or postoperative complications and recurrences were recorded.

Results:
A total number of 228 PIRS procedures were performed in 188 children [126 (67%) male individuals and 62 (33%) female individuals] with a median age of 4 [interquartile range (IQR), 2 to 6] years and a median follow-up of 46 (IQR, 38 to 52) months. From the total number of hernia repairs there were 99 (52.7%) right, 49 (26.1%) left, and 40 (21.2%) bilateral hernia repairs. Median surgical time was 10 (IQR, 8 to 12) minutes for unilateral and 16 (IQR, 14 to 20) minutes for a bilateral repair. The median hospital stay was 24 (IQR, 8 to 24) hours. Regarding intraoperative complications, only 3 (1.3%) inferior epigastric veins injuries were recorded, without any consequences. During the follow-up period in 3 male children, hydrocele was recorded; in 2 cases, hydrocele resolved spontaneously and 1 required surgical treatment. No cases of other complications including testicular atrophy or recurrence were recorded.

Conclusion:
In a hands of an experienced pediatric laparoscopic surgeon, PIRS is a simple, safe, and effective technique for inguinal hernia repair in children with excellent outcomes, cosmetic results, and a low incidence of complications and recurrence.
Learning Curve in Robotic Primary Ventral Hernia Repair Using Intraperitoneal Onlay Mesh: A Cumulative Sum Analysis
Authors: Kudsi Omar Y. , Gokcal Fahri , Bou-Ayash Naseem , Crawford Allison S. , Chung Sebastian K. , Chang Karen , Litwin Demetrius 
Published: November 2020

Background:
Cumulative sum (CUSUM) learning curves (LCs) are useful to analyze individual performance and to evaluate the acquisition of new skills and the evolution of those skills as experience is accumulated. The purpose of this study is to present a CUSUM LC based on the operative times of robotic intraperitoneal onlay mesh (rIPOM) ventral hernia repair (VHR) and identify differences observed throughout its phases.

Materials and Methods:
Patients who underwent rIPOM repair for elective, midline, and primary hernias were included. All procedures were performed exclusively by one surgeon within a 5-year period. CUSUM and risk-adjusted CUSUM were used to visualize the LC of rIPOM-VHR, based on operative times and complications. Once groups were obtained, univariate comparisons were performed.

Results:
Of the 90 rIPOM repairs, 25, 40, and 25 patients were allocated using a CUSUM analysis to the early, middle, and late phases, respectively. In terms of skin-to-skin times, the middle phase has a mean duration of 23 minutes shorter than the early phase (P<0.001), and the late phase has a mean duration 34 minutes shorter than the early phase (P<0.001). A steep decrease in off-console time was observed, with a 10-minute difference from early to middle phases. A consistent and gradual decrease in operative times was observed after completion of 36 cases, and a risk-adjusted CUSUM revealed improving outcomes after 55 cases.

Conclusions:
This study demonstrates and elucidates interval improvement in operative efficiency in rIPOM-VHR. Consistently decreasing operative times and simultaneous accumulated complication rates were observed after the completion of 55 cases.
Administration of valproic acid in clinically approved dose improves neurologic recovery and decreases brain lesion size in swine subjected to hemorrhagic shock and traumatic brain injury
Authors: Wakam Glenn K. , Biesterveld Ben E. , Pai Manjunath P. , Kemp Michael T. , O’Connell Rachel L. , Williams Aaron M. , Srinivasan Ashok , Chtraklin Kiril , Siddiqui Ali Z. , Bhatti Umar F. , Vercruysse Claire A. , Alam Hasan B. 
Published: November 2020

BACKGROUND
Traumatic brain injury (TBI) and hemorrhage remain the leading causes of death after trauma. We have previously shown that a dose of valproic acid (VPA) at (150 mg/kg) can decrease brain lesion size and hasten neurologic recovery. The current Food and Drug Administration–approved dose of VPA is 60 mg/kg. We evaluate neurologic outcomes and brain lesion size of a single dose of VPA at a level currently within Food and Drug Administration–approved dose in swine subjected to TBI and hemorrhagic shock.

METHODS
Swine (n = 5/group) were subjected to TBI and 40% blood volume hemorrhage. Animals remained in shock for 2 hours before randomization to normal saline (NS) resuscitation alone (control), NS-VPA 150 mg/kg (VPA 150), or NS-VPA 50 mg/kg (VPA 50). Neurologic severity scores (range, 0–32) were assessed daily for 14 days, and brain lesion size was measured via magnetic resonance imaging on postinjury day (PID) 3.

RESULTS
Shock severity and laboratory values were similar in all groups. Valproic acid–treated animals demonstrated significantly less neurologic impairment on PID 1 and returned to baseline faster (PID 1 mean neurologic severity score, control = 22 ± 3 vs. VPA 150 mg/kg = 8 ± 7 or VPA 50 mg/kg = 6 ± 6; p = 0.02 and 0.003). Valproic acid–treated animals had significantly smaller brain lesion sizes (mean volume in mm3, control = 1,268.0 ± 241.2 vs. VPA 150 mg/kg = 620.4 ± 328.0 or VPA 50 mg/kg = 438.6 ± 234.8; p = 0.007 and 0.001).

CONCLUSION
In swine subjected to TBI and hemorrhagic shock, VPA treatment, in a dose that is approved for clinical use, decreases brain lesion size and reduces neurologic impairment compared with resuscitation alone.
Methods of visual assessment in children with cortical visual impairment
Authors: Chang Melinda Y. , Borchert Mark S. 
Published: November 2020

Purpose of review
Cortical visual impairment (CVI) is the leading cause of pediatric visual impairment in developed countries. Currently, there is no standardized method of visual assessment in these children, who usually cannot participate in tests designed for typically developing children. A reproducible method of visual assessment that accurately reflects the multitude of visual deficits in CVI is critical to evaluate proposed therapies for this disorder. This review analyzes current research on methods of visual assessment in children with CVI.

Recent findings
Earlier studies focused on measuring visual acuity in children with CVI. More recent studies have emphasized other aspects of visual function, such as contrast sensitivity, motion detection, and visual search. Current research topics include questionnaires, functional vision assessment (CVI Range), neuropsychological tests of visual perception, and eye tracking. Eye tracking shows promise for visual assessment in both clinical and research settings because it is objective and quantitative, with the ability to assess diverse visual parameters.

Summary
Current research on visual assessment in children with CVI focuses on measuring deficits of visual function beyond visual acuity. This research represents an important step toward designing clinical trials to identify effective therapeutics for this increasingly prevalent disorder with heterogeneous manifestations.
The role of telemedicine in acute stroke treatment in times of pandemic
Authors: Hubert Gordian J. , Corea Francesco , Schlachetzki Felix 
Published: November 2020

Purpose of review
The coronavirus disease 2019 (COVID-19) pandemic challenges many healthcare systems. This review provides an overview of the advantages of telemedicine during times of pandemic and the changes that have followed the outbreak of the COVID-19 disease.

Recent findings
Telemedicine has been utilized during infectious outbreaks for many years. COVID-19 has induced a variety of changes in laws (i.e. data privacy protection) and reimbursement procedures to accelerate new setups of telemedicine. Existing networks provide novel data about teleactivation resulting from social restrictions during the nadir of the lockdown in spring 2020.

Summary
Telemedicine is a safe and ideal expert support system for hospitals during infectious outbreaks. It makes high-quality medical procedures possible, limits potentially contagious interhospital transfers, saves critical resources such as protective gear and rescue/emergency transport services, and offers safe home office work for medical specialists.
Challenges of treatment adherence with direct oral anticoagulants in pandemic
Authors: Dittrich Tolga , Polymeris Alexandros , De Marchis Gian Marco 
Published: November 2020

Purpose of review
Direct oral anticoagulants (DOAC) are crucial for the prevention of thromboembolic events in patients with nonvalvular atrial fibrillation. Drug adherence by the patient but also adherence to guidelines by the physician are suboptimal. This review highlights aspects of DOAC treatment during the coronavirus disease 2019 (COVID-19) pandemic and selected challenging scenarios.

Recent findings
For patients with a newly diagnosed indication for oral anticoagulation, a new interim clinical guidance recommends starting DOAC instead of vitamin K antagonists if DOAC are not contraindicated. The goal is to reduce the potential exposure of patients to severe acute respiratory syndrome coronavirus during the routine coagulation monitoring visits. As COVID-19 can lead to kidney failure, we discuss the challenges of DOAC dosing in kidney failures. Finally, we discuss two common challenges – when to start a DOAC after an ischemic stroke linked to atrial fibrillation, and whether cerebral microbleeds, including their count, are per se a contraindication to DOAC.

Summary
There are still open challenges regarding DOAC treatment on the patient and physician side, both related and unrelated to the pandemic.
Current advances in giant cell arteritis
Authors: Kaushik Megha , Ponte Cristina , Mollan Susan P. 
Published: November 2020

Purpose of review
The aim of this study was to present the latest advances in giant cell arteritis (GCA) care, and recent national and international rheumatology societies guidance which influences clinical practice.

Recent findings
Cranial ultrasound reduces diagnostic delay and improves clinical outcomes. Immediate high dose glucocorticoids remain the standard treatment for GCA. Controlled trial evidence using Tocilizumab, an interleukin-6 receptor antagonist, shows good clinical efficacy with steroid-sparing effects.

Summary
Improved patient outcomes require formalizing pathways to diagnosis and closer liaison with rheumatology for long-term management with second-line therapies.
A repurposed, blood gene signature is associated with poor outcomes in SARS-CoV-2
Authors: Juan-Guardela Brenda M. , Sun Jiehuan , Zhang Tong , Xu Bing , Michaud Gaetane , Herazo-Maya Jose D. 
Published: November 2020

AbstractPoor outcomes after SARS-CoV-2 infection are difficult to predict. Survivors may develop pulmonary fibrosis. We previously identified a 52-gene signature in peripheral blood, predictive of mortality in Idiopathic Pulmonary Fibrosis. In this study, we analyzed this signature in SARS-CoV-2 infected individuals and identified genomic risk profiles with significant differences in outcomes. Analysis of single cell expression data shows that monocytes, red blood cells, neutrophils and dendritic cells are the cellular source of the high risk gene signature.
A Synthetic Defective Interfering SARS-CoV-2
Authors: Yao Shun , Narayanan Anoop , Majowicz Sydney , Jose Joyce , Archetti Marco 
Published: November 2020

Viruses thrive by exploiting the cells they infect but must also produce viral proteins to replicate and infect other cells. As a consequence, they are also susceptible to exploitation by defective versions of themselves that do not produce such proteins. A defective viral genome with deletions in protein-coding genes could still replicate in cells coinfected with full-length viruses, and even replicate faster due to its shorter size, interfering with the replication of the virus. We have created a synthetic defective interfering version of SARS-CoV-2, the virus causing the recent Covid-19 pandemic, assembling parts of the viral genome that do not code for any functional protein but enable it to be replicated and packaged. This synthetic defective genome replicates three times faster than SARS-CoV-2 in coinfected cells, and interferes with it, reducing the viral load of a cell by half in 24 hours. The synthetic genome is transmitted as efficiently as the full-length genome, confirming the location of the putative packaging signal of SARS-CoV-2. A version of such a synthetic construct could be used as a self-promoting antiviral therapy: by enabling replication of the synthetic genome, the virus promotes its own demise.Graphic summary
Lineages of embryonic stem cells show non-Markovian state transitions
Authors: Udomlumleart Tee , Hu Sofia , Garg Salil 
Published: November 2020

AbstractPluripotent embryonic stem cells (ESCs) contain the ability to constitute the cell types of the adult vertebrate through a series of developmental state transitions. In culture, ESCs reversibly transition between states in a manner previously described as stochastic. However, whether ESCs retain memory of their previous states or transition in a memoryless (Markovian) process remains relatively unknown. Here we show lineages of ESCs do not exhibit the Markovian property: their previous states and kin relations influence future choices. In a subset of lineages, related ESCs remain likely to occupy the same state weeks after labeling. Unexpectedly, the distribution of lineages across states away from the equilibrium point predicted by a Markov model remains consistent over time, suggesting a conservation of informational entropy in this system. Additionally, some lineages appear highly dynamic in their ability to switch states but do not dominate the culture, suggesting that state switching is a separable property from growth. Together, these data suggest ESC state transitions are a proscribed process governed by additional variables.
Nucleosome plasticity is a critical element of chromatin liquid–liquid phase separation and multivalent nucleosome interactions
Authors: Farr Stephen E. , Woods Esmae J. , Joseph Jerelle A. , Garaizar Adiran , Collepardo-Guevara Rosana 
Published: November 2020

ABSTRACTLiquid–liquid phase separation (LLPS) of chromatin is an important mechanism that helps explain the membrane-less compartmentalization of the nucleus. Because chromatin compaction and LLPS are collective phenomena, linking their modulation to biophysical features of individual nucleosomes is challenging. Here, we develop a novel multiscale chromatin model that integrates atomistic representations, a chemically-specific coarse-grained model, and a minimal model. In tandem, we devise a transferable Debye-length exchange molecular dynamics approach to achieve enhanced sampling of high-resolution chromatin. We find that nucleosome thermal fluctuations become significant at physiological salt concentrations and destabilize the 30-nm fiber. Nucleosome breathing favors stochastic folding of chromatin and promotes LLPS by simultaneously boosting the transient nature and heterogeneity of nucleosome–nucleosome contacts, and the effective nucleosome valency. Our results put forward the intrinsic plasticity of nucleosomes as a key element in the liquid-like behavior of chromatin, and help reconcile longstanding differences between fiber-based and in vivo chromatin models.
Household-Level Risk Factors forAedes aegyptiPupal Density in Guayaquil, Ecuador
Authors: Ha Thien-An , León Tomás M. , Lalangui Karina , Ponce Patricio , Marshall John M. , Cevallos Varsovia 
Published: November 2020

AbstractBackgroundVector-borne diseases are a major cause of disease burden in Guayaquil, Ecuador, especially arboviruses spread byAedes aegyptimosquitoes. Understanding which household characteristics and risk factors lead to higherAe. aegyptidensities and consequent disease risk can help inform and optimize vector control programs.MethodsCross-sectional entomological surveys were conducted in Guayaquil between 2013 and 2016, covering household demographics, municipal services, potential breeding containers, presence ofAe. aegyptilarvae and pupae, and history of using mosquito control methods. A zero-truncated negative binomial regression model was fitted to data for estimating the household pupal index. An additional model assessed the factors of the most productive breeding sites across all of the households.ResultsOf surveyed households, 610 satisfied inclusion criteria. The final household-level model found that collection of large solid items (e.g., furniture and tires) and rainfall the week of and 2 weeks before collection were negatively correlated with average pupae per container, while bed canopy use, unemployment, container water volume, and the interaction between large solid collection and rainfall 2 weeks before the sampling event were positively correlated. Selection of these variables across other top candidate models with ΔAICc < 1 was robust, with the strongest effects from large solid collection and bed canopy use. The final container-level model explaining the characteristics of breeding sites found that contaminated water is positively correlated withAe. aegyptipupae counts while breeding sites composed of car parts, furniture, sewerage parts, vases, ceramic material, glass material, metal material, and plastic material were all negatively correlated.ConclusionHaving access to municipal services like bulky item pickup was effective at reducing mosquito proliferation in households. Association of bed canopy use with higher mosquito densities is unexpected, and may be a consequence of large local mosquito populations or due to limited use or effectiveness of other vector control methods. The impact of rainfall on mosquito density is multifaceted, as it may both create new habitat and “wash out” existing habitat. Providing services and social/technical interventions focused on monitoring and eliminating productive breeding sites is important for reducing aquatic-stage mosquito densities in households at risk forAe. aegypti-transmitteddiseases.
Transcriptional regulation ofZIPgenes is independent of local zinc status in Brachypodium shoots upon zinc deficiency and resupply
Authors: Amini Sahand , Arsova Borjana , Gobert Sylvie , Carnol Monique , Bosman Bernard , Motte Patrick , Watt Michelle , Hanikenne Marc 
Published: November 2020

AbstractThe biological processes underlying zinc homeostasis are targets for genetic improvement of crops to counter human malnutrition. Detailed phenotyping, ionomic, RNA-Seq analyses and flux measurements with67Zn isotope revealed whole plant molecular events underlying zinc homeostasis upon varying zinc supply and during zinc resupply to starvedBrachypodium distachyon(Brachypodium) plants. Although both zinc deficiency and excess hindered Brachypodium growth, accumulation of biomass and micronutrients into roots and shoots differed depending on zinc supply. The zinc resupply dynamics involved 1893 zinc-responsive genes. Multiple ZIP transporter genes and dozens of other genes were rapidly and transiently down-regulated in early stages of zinc resupply, suggesting a transient zinc shock, sensed locally in roots. Notably genes with identical regulation were observed in shoots without zinc accumulation, pointing to root-to-shoot signals mediating whole plant responses to zinc resupply. Molecular events uncovered in the grass model Brachypodium are useful for the improvement of staple monocots.
Protein interactions between the oral bacteriaFusobacterium nucleatumandPorphyromonas gingivalisin biofilm and planktonic culture
Authors: Mohammed Marwan Mansoor Ali , Pettersen Veronika Kuchařová , Nerland Audun H. , Wiker Harald G. , Bakken Vidar 
Published: November 2020

AbstractThe opportunistic pathogensFusobacterium nucleatumandPorphyromonas gingivalisare Gram-negative bacteria associated with oral biofilm and periodontal disease. Although liquid cultures are often the preferred cultivation method in microbiology, bacterial cells in biofilm adopt a profoundly different phenotype reflecting the close cell-to-cell contact compare to their planktonic counterparts. To investigateF. nucleatumandP. gingivalisinteractions relevant in biofilm formation, we applied liquid chromatography-tandem mass spectrometry to determine the expressed proteome ofF. nucleatumandP. gingivaliscells that were grown either as biofilm or in planktonic culture, and individually or together.The proteomic analyses detected 1,322F. nucleatumand 966P. gingivalisproteins. We statistically compared the proteins label-free quantitative (LFQ) intensities between biofilm and planktonic culture and identified significant changes (p-value ≤0.05) in 0,4%F. nucleatumproteins, 7%P. gingivalisproteins, and more than 14% of all proteins in the dual-species model. For both species, proteins involved in vitamin B2 (riboflavin) metabolic process had significantly increased levels in the biofilm condition. In both mono- and dual-species biofilm models,P. gingivalisincreased the production of proteins functional in translation, oxidation-reduction, and amino acid metabolism, when compared to planktonic cultures. However, when we compared LFQ intensities between mono- and dual-species models, over 90% of the significantly changedP. gingivalisproteins had their levels reduced in biofilm and planktonic settings of the dual-species model.Our findings suggest that the two bacteria interact with each other at the protein level and indicate thatP. gingivalisreduces the production of multiple proteins because of more favourable growth conditions provided byF. nucleatumpresence. The results highlight the complex interactions of bacteria contributing to oral biofilm, which need to be considered in the design of future prevention strategies.
Improving water quality does not guarantee fish health: effects of ammonia pollution on the behaviour of wild-caught pre-exposed fish
Authors: Soler Patricia , Faria Melissa , Barata Carlos , García-Galea Eduardo , Lorente Beatriz , Vinyoles Dolors 
Published: November 2020

AbstractAmmonia is a pollutant frequently found in aquatic ecosystems. In fish, ammonia can cause physical damage, alter its behaviour and even cause death. Exposure to ammonia also increases fish physiological stress, which can be measured through biomarkers. In this study, we analysed the effect of sublethal ammonia concentrations on the behaviour and the oxidative stress ofBarbus meridionalisthat had been pre-exposed to this compound in the wild. Wild-caught fish from a polluted site (pre-exposed fish) and from an unpolluted site (non-pre-exposed fish) were exposed, under experimental conditions, to total ammonia concentrations (TAN) of 0, 1, 5 and 8 mg/L. Swimming activity, feeding behaviour and oxidative stress response based on biomarkers were analysed. Pre-exposed fish showed both an altered behaviour and an altered oxidative stress response in the control treatment (0 mg/L). Differences in swimming activity were also found as pre-exposed fish swam less. Lower feeding activity (voracity and satiety) and altered response to oxidative stress were also observed at ≥ 1 mg/L TAN. Biomarker results confirmed pre-exposed fish suffer from a reduction in their antioxidant defences and, hence, showed increased oxidative tissue damage. In summary, pre-exposed fish showed more sensitivity to ammonia exposure than fish from a pristine site.