bluuebunny/crossref_metadata_2025_split huggingface dataset:
O29 IDENTIFYING PREDICTORS OF VENTRAL HERNIA RECURRENCE: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Parker Samuel , Mallet Sue , Quinn Laura , Wood Christopher , Boulton Richard , Jamshaid Shiraz , Erotocritou Marios , Gowda Siri , Collier William , Plumb Andrew , Windsor Alastair , Archer Lucinda , Halligan Steve 
Published: December 2021

Abstract

Aim
Ventral hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence.

Material and Methods
PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool).

Results
Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m2), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III–IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence.

Conclusions
This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research.
O37 CONCOMITANT INTESTINAL RESECTION DOES NOT NEGATIVELY INFLUENCE LONG TERM OUTCOMES FOLLOWING COMPLEX ABDOMINAL WALL RECONSTRUCTION
Authors: Layfield David , Hagan J. , Wright Danette , Slade Dominic 
Published: December 2021

Abstract

Aim
Simultaneous intestinal resection increases infective risks following abdominal wall reconstruction. We investigated the frequency of those risks and its impact on long-term outcomes.

Material and Methods
Analysis of prospectively accrued data from patients undergoing AWR by a single surgeon (01/01/2014–31/12/2020). Comparison between AWR with (IR-AWR) and without (AWR) concomitant intestinal resection. Clinical review was undertaken 6 monthly for 24 months with ongoing telephone follow-up thereafter.

Results
101 repairs were performed within the study period (46 AWR,55 IR-AWR). IR-AWR patients underwent 129 gastrointestinal procedures including 30 gastrointestinal fistula,33 small bowel,19 colonic and 2 gastric resections.
Both groups were similar in terms of smoking status, diabetes, but obesity (BMI&gt;30) was more prevalent in AWR(23/46(50%)vs.16/55(29%); p=0.03). Hernia defects were the same for both groups; AWR median area (range) 511cm2(47–2171 cm2) and IR+AWR 471cm2(50–2827cm2) (p = 0.7).
Post-operative wound infection was more frequent following IR-AWR (20/55(36%) (Superficial incisional=13,deep incisional=6, cavity=1) vs. 6/46(13%)(N = 5,0,1 respectively);Odds ratio(OR)=3.8 (95% CI1.4-10.6); p=0.01). Patients undergoing IR-AWR were also more likely to experience ileus necessitating short-term postoperative parenteral nutrition (OR 3.3(1–10.8); p=0.05) and Clavien Dindo&gt;2 complications (OR4.4 (1.2–16.7); p=0.03). Within IR-AWR cohort there was a single anastomotic complication requiring re-laparotomy and one mesh infection treated with antibiotics.
Median follow-up= 25.2 months(range 1.2–88.8). 14 patients died during follow-up (AWR 7/46(15%), IR-AWR 7/55(13%); p=0.7). 5 were lost to follow-up (3AWR, 2 IR-AWR).
12(26%) AWR and 8(15%) IR-AWR reported either persistent or delayed onset chronic abdominal wall pain post repair(P = 0.14). Recurrent hernias occurred in 7/46(15%) AWR compared with 10/55(18%)IR-AWR(p = 0.5).

Conclusions
Despite more frequent short-term complications in IR-AWR patient outcomes are comparable at 2 years.
O50 ALTERATIONS IN THE ABDOMINAL WALL MUSCULATURE AFTER ENDOSCOPIC ANTERIOR AND OPEN POSTERIOR COMPONENT SEPARATION
Authors: Oma Erling , Christensen Jan Kim , Daes Jorge , Jorgensen Lars Nannestad 
Published: December 2021

Abstract

Aim
Effects of component separation (CS) on abdominal wall musculature have only been investigated in smaller case series. The study aimed to compare abdominal wall alterations following endoscopic anterior component separation (EACS) or transverse abdominis release (TAR).

Material and Methods
Computed tomography scans were evaluated in patients who underwent open ventral hernia repair with TAR or EACS. Lateral abdominal wall muscle thickness and displacement were compared with preoperative images after bilateral CS and the undivided side postoperatively after unilateral CS.

Results
In total, 105 patients were included. The mean defect width was 12.2 cm. Fifty-five (52%) and 15 (14%) underwent bilateral and unilateral EACS, respectively. Five (5%) and 14 (13%) underwent bilateral and unilateral TAR, respectively. Sixteen (15%) underwent unilateral EACS and contralateral TAR. Complete fascial closure was achieved in 103 (98%) patients. The external oblique and transverse abdominis muscles were significantly laterally displaced with a mean of 2.74 cm (95% CI 2.29-3.19 cm) and 0.82 cm (0.07-1.57 cm) after EACS and TAR, respectively. The combined thickness of the lateral muscles was significantly decreased after EACS (mean decrease 10.5% [5.8-15.6%]) and insignificantly decreased after TAR (mean decrease 2.6% [-4.8-9.5%]), mean reduction difference EACS versus TAR 0.22 cm (-0.01-0.46 cm). One (1%) patient developed an iatrogenic linea semilunaris hernia after EACS. The recurrence rate was 19% after mean 1.7 years follow-up.

Conclusions
The divided muscle was significantly more laterally displaced after EACS compared with TAR. The thickness of the lateral muscles was slightly decreased after EACS and unchanged after TAR.
O52 LAP-T MINI LAPAROSCOPIC TECHNIQUE FOR THE REPAIR OF RECURRENT UMBILICAL HERNIA ON PRIMARILY UNTREATED DIASTASIS
Authors: Pozzi Giuseppe 
Published: December 2021

Abstract

Aim
“This retrospective analysis on 1000 cases of Diatasis Recti (DR) complicated by single/multiple, primary/recurrent hernias, all treated with the Laparoscopic Abdominoplasty Technique (LAP-T), aims at evaluating the possible correlation of higher recurrence rate and complications when DR is left untreated”

Material and Methods
“This review on 1000 patients, &lt;65yrs, BMI&lt;30, 3&gt;IRD&gt;12, based on CT Scan/MRI study, showed 235 (23,5%) of them to be recurrent umbilical/midline hernias engaged on untreated RMD, independently from the surgical technique used for primary repair. Re-operation with LAP-T technique, consisted in removal of recurrent hernia and dislocated mesh when present, closure by self-locking running sutures of the hernia defect and the DR. Repair is consolidated placing an intra-peritoneal mesh”

Results
“In all patients, recurrence was repaired, DR reconstructed and abdominal wall anatomy and physiological functionality successfully restored. No intra operative bleeding, seroma formation, chronic pain, nor mesh infection have been recorded. 98% follow up at 12 months, 91% at 24, no recurrences observed”

Conclusions
“Higher incidence of recurrent umbilical/midline hernias observed in this analysis, compared to average recurrence rate reported in literature, suggest that regardless primary repair technique, the repair of the sole hernia engaged on a DR is likely to lead to a recurrent hernia, further midline hernia defects formation and worsening of the DR. A significant correlation between the recurrency after primary umbilical/midline repair when a concomitant RMD is left untreated is likely to lead to a more invasive and complicated re-intervention, higher complication rate and discomfort for the patient”
OV08 TREATMENT OF THE INGUINAL HERNIA USING THE SHOULDICE REPAIR
Authors: Wiggers Theo , Lorenz Ralph 
Published: December 2021

Abstract

Aim
The Shouldice procedure is a layered reconstruction of the posterior wall in inguinal hernia repair and currently the preferred method if the layers of the abdominal wall are of good quality, the wish of the patient for a non-mesh repair and if a mesh method is not possible or available. The correct performance of the reconstruction of the posterior wall is essential part of the operation.

Material and Methods
A life educational video was made with the four-layer reconstruction in detail.
The first layer of the reconstruction starts at the medial corner and the conjoint tendon is sutured to the caudal flap of the transversalis fascia using a continuous non resorbable suture. The second layer of the reconstruction is made by approximating the cranial flap of the transversalis fascia and the posterior part of the inguinal ligament. The third layer starts at the level of the deep internal inguinal ring and approximates the lower border of the internal oblique muscle with the inguinal ligament. The fourth and final layer approximates the internal oblique muscle again with the inguinal ligament.

Results
The four-layer reconstruction after splitting the transversalis fascia is shown in detail since treatment of the hernia sac is like the other techniques.

Conclusions
The instructional video can be used for the resident training as a start in a hernia course followed by the execution on a model before the actual execution on a patient.
OV13 LAPAROSCOPIC APPROACH IN EMERGENCY HERNIA SURGERY: MANAGEMENT OF ACUTE SMALL BOWEL OBSTRUCTION SECONDARY TO STRANGULATED OBTURATOR HERNIA
Authors: Latif Javed , Bhatti Imran , Awan Altaf 
Published: December 2021

Abstract

Aim
Acute small bowel obstruction secondary to strangulated obturator hernia is a rare condition, with high rates of morbidity and mortality in the absence of prompt diagnosis and intervention. We aim to describe a case with the above presentation, managed using a minimally-invasive approach with positive outcomes.

Material and Methods
We describe a case of an 82-year-old female who presented with acute small bowel obstruction secondary to strangulated obturator hernia on cross-sectional imaging.

Results
The patient underwent emergency surgery using laparoscopic approach for repair of obturator hernia and assessment of obstructed small bowel. Our approach involved identification and reduction of small bowel loop. A transabdominal preperitoneal approach was made to obturator hernia and ischaemic sac was reduced followed by closure of defect with a plug of biologic mesh. A linear segment of ischaemic small bowel was oversewn. Total operative time was 90 minutes.

Conclusions
Minimally-invasive surgery is an important tool in the armamentarium of the acute care surgeon. A laparoscopic approach will reduce the insult of intervention in already physiologically deplete patients. This case demonstrates the feasibility of laparoscopy for small bowel obstruction secondary to strangulated obturator hernia in the acute setting, requiring advanced laparoscopic skill as demonstrated in this video.
OV18 ENDOSCOPIC RETRO-MUSCULAR REPAIR OF PARASTOMAL HERNIA - A TANTALIZING NEW TECHNIQUE
Authors: Lambrecht Jan Roland 
Published: December 2021

Abstract
Development of retro muscular space with transversus abdominis release has reached maturity in endoscopic surgery. Next-level reconstruction is adaptation to parastomal hernia repair alone or in conjunction with another abdominal wall hernia repair.
We aim to present this extraperitoneal modified mesh technique based on the Sugarbaker principle with video demonstration and share clinical data and results from twenty-four patients operated with this technique within two years from the spring of 2019 to the spring of 2021. 77% patients had para-colostomy hernia and 41% of the patients had accessory repairs for midline or opposite flank hernia. 18% had prophylactic mesh at index operation, 27% were recurrent parastomal hernia and ostomies were formed median 32 months prior to parastomal hernia repair. 72% of the patients were operated robotically and 28% laparoscopically. Median follow up at time for presentation will be 17 months.
Within and beyond the visual cortex: brain tumors induce highly sensitive plasticity of visual processing in whole-brain neural functional networks
Authors: Yang Jingwen , Kudulaiti Nijiati , Chen Zelin , Gao Leyan , Hameed N U Farrukh , Feng Rui , Lu Shuo 
Published: December 2021

AbstractVision is a key source of information input for humans, which involves various cognitive functions and a great range of neural networks inside and beyond the visual cortex. There has been increasing observation that the cognitive outcomes after a brain lesion cannot be well predicted by the attributes of the lesion itself but are influenced by the functional network plasticity. However, the mechanisms of impaired or preserved visual cognition have not been probed from direct function-execution conditions and few works have observed it on whole-brain dynamic networks. We used high-resolution electroencephalogram recordings from 25 patients with brain tumors to track the dynamical patterns of functional reorganization in visual processing tasks with multilevel complexity. By comparing with 24 healthy controls, increased cortical responsiveness as functional compensation was identified in the early phase of processing, which was highly localized to the visual cortex and functional networks and less relevant to the tumor position. Besides, a spreading wide enhancement in whole-brain functional connectivity was elicited by the visual word-recognition task. Enhanced early rapid-onset cortical compensation in the local functional networks may contribute to largely preserved basic vision functions, and higher-cognitive tasks are vulnerable to impairment but with high sensitivity of functional plasticity being elicited.
Poor Antibody Response to BioNTech/Pfizer Coronavirus Disease 2019 Vaccination in Severe Acute Respiratory Syndrome Coronavirus 2–Naive Residents of Nursing Homes
Authors: Pannus Pieter , Neven Kristof Y , De Craeye Stéphane , Heyndrickx Leo , Vande Kerckhove Sara , Georges Daphnée , Michiels Johan , Francotte Antoine , Van Den Bulcke Marc , Zrein Maan , Van Gucht Steven , Schmickler Marie Noëlle , Verbrugghe Mathieu , Matagne André , Thomas Isabelle , Dierick Katelijne , Weiner Joshua A , Ackerman Margaret E , Goriely Stanislas , Goossens Maria E , Ariën Kevin K , Desombere Isabelle , Marchant Arnaud 
Published: December 2021

Abstract

Background
Residents of nursing homes (NHs) are at high risk of coronavirus disease 2019 (COVID-19)–related disease and death and may respond poorly to vaccination because of old age and frequent comorbid conditions.

Methods
Seventy-eight residents and 106 staff members, naive to infection or previously infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2), were recruited in NHs in Belgium before immunization with 2 doses of 30 µg BNT162b2 messenger RNA (mRNA) vaccine at days 0 and 21. Binding antibodies (Abs) to SARS-CoV-2 receptor-binding domain (RBD), spike domains S1 and S2, RBD Ab avidity, and neutralizing Abs against SARS-CoV-2 wild type and B.1.351 were assessed at days 0, 21, 28, and 49.

Results
SARS-CoV-2–naive residents had lower Ab responses to BNT162b2 mRNA vaccination than naive staff. These poor responses involved lower levels of immunoglobulin (Ig) G to all spike domains, lower avidity of RBD IgG, and lower levels of Abs neutralizing the vaccine strain. No naive residents had detectable neutralizing Abs to the B.1.351 variant. In contrast, SARS-CoV-2–infected residents had high responses to mRNA vaccination, with Ab levels comparable to those in infected staff. Cluster analysis revealed that poor vaccine responders included not only naive residents but also naive staff, emphasizing the heterogeneity of responses to mRNA vaccination in the general population.

Conclusions
The poor Ab responses to mRNA vaccination observed in infection-naive NH residents and in some naive staff members suggest suboptimal protection against breakthrough infection, especially with variants of concern. These data support the administration of a third dose of mRNA vaccine to further improve protection of NH residents against COVID-19.
Re-Conceptualizing Solitude in the Digital Era: From “Being Alone” to “Noncommunication”
Authors: Campbell Scott W , Ross Morgan Q 
Published: December 2021

Abstract
This article revisits the theoretical terrain surrounding solitude to address conceptual, methodological, and practical challenges manifest in the digital era. First, solitude has been approached from a number of different research traditions, resulting in disconnected streams of theory. Furthermore, these streams were developed before the rise of the Internet and mobile media. As a result, solitude is commonly, if not most commonly, conceptualized and measured as a matter of being physically alone. This article re-conceptualizes solitude as “noncommunication” to offer a more contemporary and inclusive perspective, one that uproots it from ideations of physical aloneness and replants it in social aloneness. Whereas previous theory in this area often ignores mediated interaction, we recognize it as a meaningful way for people to connect, with important implications for solitude. Our framework also calls for interrogation of key contextual factors that condition whether and how solitude is experienced in the digital era.
Spillover Effects of Intellectual Property Protection in the Interwar Aircraft Industry
Authors: Hanlon Walker , Jaworski Taylor 
Published: December 2021

Abstract
Can strengthening intellectual property protection for producers of one good affect innovation in other related goods? To answer this question, we exploit a unique policy experiment in the interwar military aircraft industry. Airframe designs had little intellectual property protection before 1926, but changes passed by Congress in 1926 provided airframe manufacturers with enhanced property rights over new designs. We show that granting property rights to airframe producers increased innovation in airframes, but slowed innovation in aero-engines, a complementary good where there was no change in the availability of intellectual property protection. We propose and test a simple theory that explains these patterns.
A novel method of tracheal anastomosis healing using a single submucosal injection of basic fibroblast growth factor: initial report
Authors: Yokote Fumi , Yamauchi Yoshikane , Komura Hiroko , Tanuma Tadashi , Sakao Yukinori , Kawamura Masafumi , Komura Makoto 
Published: December 2021

Abstract

OBJECTIVES
For the technical management of tracheal anastomosis, developing new and simple methods is required to relieve anastomotic tension. This study aimed to investigate whether basic fibroblast growth factor (bFGF) only once injected immediately before anastomosis promotes cartilage regeneration at the tracheal anastomosis and whether the regenerated cartilage has the effect of reinforcing the anastomosis in a rabbit model.

METHODS
New Zealand white rabbits were anaesthetized, and the cervical trachea was exposed through a cervical midline incision, followed by resection of the 10th tracheal cartilage. The rabbits were categorized into 2 groups: the bFGF group (n = 6) and the control group (n = 6). In the former group, bFGF (25 μg) was administered into the submucosal layer of the cartilage using a 27-G needle immediately before tracheal anastomosis. The animals were sacrificed 4 weeks later. Histological, mechanical and biochemical evaluations were performed on this anastomosed trachea.

RESULTS
At 4 weeks of age, the anastomoses were spindle-shaped and displayed maximum diameter at the injection site compared with those in the control group. Histological evaluation showed that cartilage tissue had regenerated between the 9th and 11th tracheal cartilage rings. Tensile test showed that the anastomoses displayed a significantly high strain/stress ratio (P = 0.035). The collagen type II and glycosaminoglycan levels were significantly increased, and the collagen type I level was significantly decreased (P = 0.019, P = 0.013 and P = 0.045, respectively).

CONCLUSIONS
A new wound-healing concept of airway anastomosis could be provided by the results that single injection of bFGF regenerated tracheal cartilage in rabbits and strengthened the anastomosis by bridging the regenerated and well-matured cartilage. Further investigation of this method will lead to potential clinical applications for reinforcement of tracheal anastomoses.
Natural Disasters and Preferences for Redistribution: The Impact of Collective and Abrupt Disruptions
Authors: Pañeda-Fernández Irene 
Published: December 2021

Abstract
This study investigates the impact on redistributive preferences of one pervasive yet underexplored type of shock: natural disasters. Previous research has focused on smaller, endogenous shocks that do not share two key features of disasters: they are abrupt and collective experiences. The literature on economic shocks suggests they lead to increased demand for redistribution. Nevertheless, disasters are such abrupt ruptures that they could inhibit an increase in demand for redistribution because they may trigger psychological needs to justify the status quo. Further, their collective nature may push people to substitute government-based help for community or religious-based social insurance. In light of these conflicting accounts, I argue that how surprising a disaster is determines whether it is a deterrent or a catalyst of support for redistribution. To test my argument, I link World Values Survey data to information on subnational risk to natural disasters and find that risk of surprising disasters such as earthquakes and tsunamis increases demand for redistribution but risk of predictable disasters does not. The relationship is robust to controlling for a series of individual and sub-national district characteristics. An event study of earthquake incidence shows a similar pattern: more surprising earthquakes—those impacting rarely hit districts—drive increases in demand for redistribution.