bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous nephrolithotomy with suction: is this the future?
Authors: Liu Yang , Zhu Wei , Zeng Guohua 
Published: January 2021

Purpose of review
The armamentarium of percutaneous nephrolithotomy (PCNL) and the strategy to perform the procedure is constantly evolving. The innovation and development in techniques lead to further miniaturization in PCNL devices and change the lithotripsy and stone removal strategy. Suctioning in PCNL offers urologist a new conception in renal stone management. The present review evaluates the latest results on efficacy, safety and feasibility of suctioning PCNL techniques.

Recent findings
Recent literature reported the outcomes of different suctioning PCNL techniques. Most of these studies demonstrated good efficacy when comparing conventional PCNL. Suctioning PCNL improving the lithotripsy efficiency to enhance the stone-free rate (SFR) and reducing renal pelvic pressure to attenuate postoperative infectious complications. The advantage of suction also helps overcome the limitation of potentially higher intrarenal pressure and prolonged operative time in Mini-PCNL.

Summary
PCNL with suctioning represents a valuable new tool in the armamentarium of modern endourologists. This innovative approach can offer improved safety and efficacy with lower complications rates and higher cost effectiveness than the traditional PCNL technique.
Incisional Hernia Incidence, Repair Techniques, and Outcomes Based on 1600 Consecutive Patients Receiving Abdominally Based Autologous Breast Reconstruction
Authors: Rhemtulla Irfan A. , Mauch Jaclyn T. , McCarty E. Berryhill , Broach Robyn B. , Serletti Joseph M. , Kovach Stephen J. 
Published: January 2021

Background
As the number of postmastectomy patients who receive abdominally based autologous breast reconstruction (ABABR) increases, the frequency of unique paramedian incisional hernias (IHs) at the donor site is increasing as well. We assessed incidence, repair techniques, and outcomes to determine the optimal treatment for this morbid condition.

Methods
A total of 1600 consecutive patients who underwent ABABR at the University of Pennsylvania between January 1, 2009, and August 31, 2016, were retrospectively identified. Preoperative and operative information was collected for these patients. Incisional hernia incidence was determined by flap type and donor site closure technique. Repair techniques and postoperative outcomes for all patients receiving IH repair (IHR) after ABABR at our institution were also determined. Univariate and multivariate analyses were conducted.

Results
The incidence of IH after ABABR in our health system was 3.6% (n = 61). Fifteen additional patients were referred from outside hospitals for a total of 76 patients who received IHR. At the time of IHR, mesh was used in 79% (n = 60) of cases (13 biologic and 47 synthetic), with synthetics having significantly lower recurrent IH incidence (10.6% vs 38.5%, P = 0.017) when compared with biologics. Mesh position did not have any statistically significant effect on outcomes; however, sublay mesh position had zero adverse outcomes.

Conclusions
Mesh should be used in all cases when possible. Although retrorectus repair with mesh is optimal, this plane is often nonexistent or too scarred in after ABABR. Thus, intraperitoneal underlay mesh with primary fascial closure or primary closure with onlay mesh placement should then be considered.
Two-Stage, Prepectoral Breast Reconstruction
Authors: Kumbla Pallavi Archana , Ananthasekar Shivani , Denney Brad David 
Published: January 2021

Goals
Prepectoral breast reconstruction is seeing a resurgence in popularity as advances in breast oncology and breast reconstruction continue to occur. This study seeks to describe a simple, reproducible method for prepectoral breast reconstruction and analyzes patient demographics and outcomes after the first stage of prepectoral breast reconstruction.

Methods
After institutional review board approval was obtained, a retrospective chart review was performed to identify patients who underwent 2-stage prepectoral reconstruction by the senior author from January 2019 to February 2020. Patient demographics including body mass index, nicotine use, diabetes mellitus, neoadjuvant chemotherapy, and adjuvant radiation were analyzed. Type of mastectomy (nipple vs skin sparing), unilateral versus bilateral reconstruction, and use of intraoperative angiography were also assessed. Complications including excision of ischemic skin, delayed mastectomy flap ischemia, seroma, hematoma, axillary cellulitis, expander infection, and reconstructive failure were analyzed. χ2 Analysis was used to identify any association between the above demographics and infection, and P values were generated with a statistical significance being denoted by a P < 0.05.

Results
One hundred five breast reconstructions were included in this study. A statistically significant association was found between nicotine use, diabetes mellitus, excision of ischemic skin, and expander infection. No significant association was found between other demographics and infection risk. Expander infection occurred in 2.86% of all reconstructions with an overall reconstructive failure rate of 2.86%.

Conclusions
This study demonstrates that our technique is reproducible and can be used for all types of mastectomies and incisions. Our data analysis demonstrates that this is a reliable method of breast reconstruction if performed correctly in the properly selected patient. Future studies will assess outcomes following the second stage of reconstruction.
Long-term (18 Years) Results of Patients With Long-segment Barrett Esophagus Submitted to Acid Suppression-duodenal Diversion Operation
Authors: Csendes Attila , Orellana Omar , Figueroa Manuel , Lanzarini Enrique 
Published: January 2021

Objective:
To determine late results of AS-DD procedure in long-segment (LSBE) and extralong-segment BE (ELSBE) using subjective and objective measurements to ascertain the histological impact over intestinal metaplasia (IM) and progression to EAC.

Summary of Background Data:
Barrett esophagus (BE) is a known precursor of esophageal adenocarcinoma (EAC), and Nissen fundoplication has proven to be unable to stop mixed reflux among them. Our group proposed a surgical procedure that handles pathophysiological changes responsible for BE.

Methods:
This prospective study included 127 LSBE and ELSBE subjects submitted to clinical and functional analyses. They were presented to selective vagotomy, fundoplication, partial gastrectomy with Roux-en-Y reconstruction. The changes in IM were determined in both groups.

Results:
Follow-up was completed at a mean of 18 years in 81% of the cases. Visick I-II scores were seen in 88% of LSBE and 65% in ELSBE (P < 0.01). There was significant healing of erosive esophagitis and esophageal peptic ulcers, and strictures were resolved in 71%. There was 38% of IM regression in LSBE. Two cases in each group progressed to EAC at a mean of 15 years. Pathologic acid reflux was abolished in 91% and duodenal in 100%. There was a regression of low-grade dysplasia to IM in 80%.

Conclusions:
AS-DD permanently eliminates pathologic refluxate to the esophagus. The progression to HGD/EAC is lower compared to medical treatment, with an 8-fold reduction in LSBE and 2.2-fold in ELSBE. AS-DD seems to influence IM behaviors, and it is a tool that could reduce and delay progression to EAC.
Exercise for the prevention and treatment of neurocognitive disorders: new evidence and clinical recommendations
Authors: Chan Wai Chi , Lee Allen T.C. , Lam Linda C.W. 
Published: January 2021

Purpose of review
As current pharmacological treatments of dementia have only modest effects, nonpharmacological treatments like exercise interventions have attracted much research interest. This review summarizes recent evidence regarding the efficacy of exercise in preventing and treating neurocognitive disorders.

Recent findings
Recent evidence suggests that exercise may prevent cognitive impairment in older adults with normal cognition. Besides, it may slow down the deterioration in older adults who have mild cognitive impairment (MCI) and dementia. But inconsistent findings have been reported, and larger randomized controlled trials are required to confirm its treatment value. This article also reviews existing evidence-based clinical guidelines advising on the optimal format and intensity of exercise interventions for older adults with different cognitive functions.

Summary
There is a growing body of evidence supporting the cognitive benefits of exercise for older adults with normal cognition, MCI, and dementia. Exercise is a relatively safe and low-cost lifestyle intervention and should be recommended for older adults to prevent dementia and treat cognitive impairment. However, as the factors affecting the efficacy of exercise in improving cognition are complex, exercise prescription should be individually tailored.
Optimal Size of COVID-19 Testing Pools
Authors: Cohen Jon 
Published: January 2021

AbstractThis research note investigates the optimal size of pools for pooled, COVID-19 testing when positive pools will be followed up by individual tests of pool members. Formulae for the optimum are derived and provided. The analysis indicates thatoptimal pool sizes are unlikely to exceed about 20 individuals in realistic situations,optimal pool size is influenced by prevalence in the population and the extent to which infection is clustered within the population, and,pools are most efficiently comprised of people with homogeneous risk, with heterogeneity across pools.
Origin of HIV/AIDS and Vaccine Failure: Simulation of the Role of the Adjuvant Activation Hypothesis
Authors: Grassi H.C. , Andrades E.D.J. , Andrades-Grassi V.J. 
Published: January 2021

ABSTRACTHuman Immunodeficiency Virus (HIV) is the etiological agent for Acquired Immunodeficiency Syndrome (AIDS). It is possible that vaccine failure could be related to the events involved at the origin of HIV/AIDS. In this work the role of the adjuvant activation hypothesis on the origin and on the failure of vaccines, as well as other effects is evaluated by means of a simulation using a mathematical analysis, differential equations and an Excel spreadsheet. The results show that the adjuvant activation alters the viral load and the cellular and humoral Immune Response. Under certain conditions it was possible to show how the adjuvant activation could have promoted the origin of the HIV/AIDS pandemic and also, as a consequence of the SIV adaptation to human beings at the origin, the failure of present day vaccine trials. Other effects such as Immunotolerance and Antibody Dependent Enhancement (ADE) were shown. This study provides a means to examine other effectors in order to suggest therapeutic alternatives. In this case passive immunization in combination with anti-retroviral therapy showed an acceptable adaptation to the conditions tested. It is concluded that the methodological strategy of this work may be useful for the analysis of the adjuvant activation hypothesis as well as other effects, interactions and new proposals, such as thermodynamics of HIV infections.
Ecological correlates of reproductive status in a guild of Afrotropical understory trees
Authors: Drager Andrea P. , Weylandt Michael , Chuyong George , Kenfack David , Thomas Duncan W. , Dunham Amy E. 
Published: January 2021

ABSTRACTThe relative abundance patterns of tropical trees have been of interest since the expeditions of Alfred Russel Wallace, but little is known about how differences in relative abundance relate to reproductive patterns. Flowering is resource-dependent and fitness differences as well as differences in the quality of the abiotic and biotic neighborhood may contribute to the variation in reproductive status responsible for population-level flowering patterns. This variation determines the density and distance between flowering conspecifics and may alter relative abundance extremes among species during reproduction, factors known to influence pollination success. We collected flowering status data for a guild of twenty-three co-occurring tree species that flower in the understory of the Korup Forest Dynamics Plot in Cameroon. We examined how the occurrence and location of reproductive events were related to spatial patterns of adult abundance, focal tree size, neighborhood crowding, and habitat, while accounting for the influence of shared ancestry. Across species, the probability of flowering was higher for individuals of rarer species and for larger individuals but was unrelated to neighborhood crowding or habitat differences. Relative abundance extremes were reduced when only flowering individuals were considered, leading to a negative relationship between plot abundance and flowering probability at the species level that was not structured by shared ancestry. Spatially, flowering conspecifics tended to be overdispersed relative to all adult conspecifics. Rare species are predicted to suffer Allee effects or reduced fitness due to the difficulty of finding mates at low densities and frequencies. Here, however, rare species appear to maximize the size of their mate pool, compared to abundant species. If this partial ‘leveling of the playing field’ during reproduction is typical, it has consequences for our understanding of biodiversity maintenance and species coexistence in tropical forests.
Lower statistical support with larger datasets: insights from the Ochrophyta radiation
Authors: Di Franco Arnaud , Baurain Denis , Glöckner Gernot , Melkonian Michael , Philippe Hervé 
Published: January 2021

AbstractIt is commonly assumed that increasing the number of characters has the potential to resolving radiations. We studied photosynthetic stramenopiles (Ochrophyta) using alignments of heterogeneous size and origin (6,762 sites for mitochondrion, 21,692 sites for plastid and 209,105 sites for nucleus). While statistical support for the relationships between the six major Ochrophyta lineages increases when comparing the mitochondrion and plastid trees, it decreases in the nuclear tree. Statistical support is not simply related to the dataset size but also to the quantity of phylogenetic signal available at each position and our ability to extract it. Here, we show that proper signal extraction is difficult to attain, as demonstrated by conflicting results obtained when varying taxon sampling. Even though the use of a better fitting model improved signal extraction and reduced the observed conflicts, the plastid dataset provided higher statistical support for the ochrophyte radiation than the larger nucleus dataset. We propose that the higher support observed in the plastid tree is due to an acceleration of the evolutionary rate in one short deep internal branch, implying that more phylogenetic signal per position is available to resolve the Ochrophyta radiation in the plastid than in the nuclear dataset. Our work therefore suggests that, in order to resolve radiations, beyond the obvious use of datasets with more positions, we need to continue developing models of sequence evolution that better extract the phylogenetic signal and design methods to search for genes/characters that contain more signal specifically for short internal branches.
Data proliferation, reconciliation, and synthesis in viral ecology
Authors: Gibb Rory , Albery Gregory F. , Becker Daniel J. , Brierley Liam , Connor Ryan , Dallas Tad A. , Eskew Evan A. , Farrell Maxwell J. , Rasmussen Angela L. , Ryan Sadie J. , Sweeny Amy , Carlson Colin J. , Poisot Timothée 
Published: January 2021

AbstractThe fields of viral ecology and evolution have rapidly expanded in the last two decades, driven by technological improvements, and motivated by efforts to discover potentially zoonotic wildlife viruses under the rubric of pandemic prevention. One consequence has been a massive proliferation of host-virus association data, which comprise the backbone of research in viral macroecology and zoonotic risk prediction. These data remain fragmented across numerous data portals and projects, each with their own scope, structure, and reporting standards. Here, we propose that synthesis of host-virus association data is a central challenge to improve our understanding of the global virome and develop foundational theory in viral ecology. To illustrate this, we build an open reconciled mammal-virus database from four key published datasets, applying a standardized taxonomy and metadata. We show that reconciling these datasets provides a substantially richer view of the mammal virome than that offered by any one individual database. We argue for a shift in best practice towards the incremental development and use of synthetic datasets in viral ecology research, both to improve comparability and replicability across studies, and to facilitate future efforts to use machine learning to predict the structure and dynamics of the global virome.
Geographical variability of bacterial communities of cryoconite holes of Andean glaciers
Authors: Pittino Francesca , Seeger Michael , Azzoni Roberto , Ambrosini Roberto , Franzetti Andrea 
Published: January 2021

AbstractCryoconite holes, ponds full of melting water with a sediment on the bottom, are hotspot of biodiversity of glacier surface. They host a metabolically active bacterial community that is involved in different dynamics concerning glacier ecosystems. Indeed, they are responsible of organic matter production and with other microorganisms establish a real microecosystem. Cryoconite holes have been described in different areas of the world (e.g., Arctic, Antarctic, Alps, Himalaya), and with this study we will provide the first description of bacterial communities of cryoconite holes of the Andes in South America. We collected samples on three high elevation glaciers of the Andes (Iver, Iver East and Morado glaciers) and two Patagonian glaciers located at sea level (Exploradores glacier and Perito Moreno). Results show that the most abundant orders are Burkholderiales, Cytophagales, Sphingobacteriales, Actinomycetales, Pseudomonadales, Rhodospiarillales, Rhizobiales, Sphingomonadales and Bacteroidales, which have been reported on glaciers of other areas of the world, Bacterial communities change from one glacier to another and both water pH and O2 concentration affect bacterial communities composition.
Identifying priority areas for research and conservation of the largetooth sawfishPristis pristisin Colombia and Panama
Authors: López-Angarita Juliana , Cubillos-M. Juan Camilo , Villate-Moreno Melany , Del Cid Annissamyd , Díaz Juan M , Cooke Richard , Tilley Alexander 
Published: January 2021

AbstractSawfishes are considered one of the most endangered families of fishes in the world. Their diadromous ecology and vulnerability to fishing nets have brought most populations to the brink of collapse. Conservation of the surviving populations is hindered by the paucity of historic and contemporary catch and observational records, and assessments of suitable coastal and riverine habitats. Colombia and Panama are two of 14 countries considered as a high priority for the development of species-specific national legal protection of the critically endangered largetooth sawfish (Pristis pristis). To construct a baseline for the temporal and spatial distribution of the largetooth sawfish in Colombia and Panama, we collected historical records from museum databases and from literature over the past century, analysed available small-scale fisheries landings databases, and conducted interviews with fish workers in 38 locations across both countries. We found 257 records of sawfish occurrences across both countries between 1896 and 2015, with 69% of the records before the year 2000. The declining trend in the frequency of observations was corroborated by fishers, who reported fewer sawfish catches over the last 20 years. Using kernel density estimation of recent encounter locations, we identify potential hotspots that may represent extant populations of sawfish. These locations are broadly characterized by their remoteness and high mangrove forest cover. Given the length and cultural diversity of the Pacific coastlines of Colombia and Panama, and the inaccessibility of many of the communities, our findings provide important guidance to target rapid conservation and fisheries interventions to priority areas. We suggest that the relative success of community-managed fishing areas in the region makes this a valuable platform on which to build local stewardship of marine resources, while raising awareness of the need to safeguard critically endangered largetooth sawfish.
Opioid withdrawal produces sex-specific effects on fentanyl-vs.-food choice and mesolimbic transcription
Authors: Townsend E. Andrew , Kim R. Kijoon , Robinson Hannah L. , Marsh Samuel A. , Banks Matthew L. , Hamilton Peter J. 
Published: January 2021

AbstractBackgroundOpioid withdrawal is a key driver of opioid addiction and an obstacle to recovery. However, withdrawal effects on opioid reinforcement and mesolimbic neuroadaptation are understudied and the role of sex is largely unknown.MethodsMale (n=10) and female (n=9) rats responded under a fentanyl-vs.-food “choice” procedure during daily 2h sessions. In addition to the daily choice sessions, rats were provided extended access to fentanyl during 12h sessions. After two weeks of this self-administration regimen, the nucleus accumbens (NAc) and ventral tegmental area (VTA) of a subset of rats were subjected to RNA sequencing. In the remaining rats, a third week of this self-administration regimen was conducted, during which methadone effects on fentanyl-vs.-food choice were determined.ResultsPrior to opioid dependence, male and female rats similarly allocated responding between fentanyl and food. Abstinence from extended fentanyl access elicited a similar increase in somatic withdrawal signs in both sexes. Despite similar withdrawal signs and extended access fentanyl intake, opioid withdrawal was accompanied by a maladaptive increase in fentanyl choice in males, but not females. Behavioral sex differences corresponded with transcriptional hyperfunction in the NAc and VTA of opioid-withdrawn females relative to males. Methadone blocked withdrawal-associated increases in fentanyl choice in males, but failed to further decrease fentanyl choice in females.ConclusionsThese results provide foundational evidence of sex-specific neuroadaptations to opioid withdrawal, which may be relevant to the female-specific resilience to withdrawal-associated increases in opioid choice and aid in the identification of novel therapeutic targets.
The effect of handrail cross-sectional design and age on applied handrail forces during reach-to-grasp balance reactions
Authors: Gosine Philippa , Komisar Vicki , Novak Alison C. 
Published: January 2021

AbstractHandrails have been shown to reduce the likelihood of falls. Despite common use, little is known about how handrail shape and size affect the forces that people can apply after balance loss, and how these forces and the corresponding ability to recover balance depend on age. Following rapid platform translations, 16 older adults and 16 sex-matched younger adults recovered their balance using seven handrail cross-sections varying in shape and size. Younger adults were able to withstand higher perturbations, but did not apply higher forces, than older adults. However, younger adults achieved their peak resultant force more quickly, which may reflect slower rates of force generation with older adults. Considering handrail design, the 38mm round handrails allowed participants to successfully recover from the largest perturbations and enabled the highest force generation. Conversely, tapered handrails had the poorest performance, resulting in the lowest force generation and withstood perturbation magnitudes. Our findings suggest that the handrail cross-sectional design affects the magnitude of force generation and may impact the success of recovery. Our findings can inform handrail design recommendations that support effective handrail use in demanding, balance recovery scenarios.