bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic Hernia Repair: A Novel Technique for the Repair of Inguinal Hernia in a Cadaver Model
Authors: Gülaydin Nihat , Ersöz Feyzullah , Kalayci Mustafa , Kara Erdoğan 
Published: April 2021

Background:
The techniques of total extraperitoneal and transabdominal preperitoneal hernia repair have been conducted for laparoscopic repair of inguinal hernia since long. However, they offer significant disadvantages of requiring general anesthesia, producing negative cosmetic outcomes, and other serious complications. We examined the feasibility of applying an endoscopic method alternative to total extraperitoneal and transabdominal preperitoneal for laparoscopic repair of inguinal hernia in a cadaver model so as to overcome the disadvantages of the presently available techniques.

Methods:
A total of 4 male and 2 female cadavers [aged 18 y and above, body mass index (BMI) <40 kg/m2], who were planned for a routine autopsy between January 24 and 26, 2020 were selected for the present study conducted at the Forensic Medicine Institute. Twelve laparoscopic repair surgeries of inguinal hernia were performed in 6 of these cadavers using both the inguinal areas.

Results:
We conducted a total of 12 surgeries on 4 male (mean age: 43.25 y; BMI: 29.05 kg/m2) and 2 female cadavers (mean age: 76.50 y; BMI: 26.60 kg/m2). A 7×5-cm-shaped mesh was used for both the sexes. For the fixation of the mesh, a titanium tacker was used in pubic tubercle and tendon conjoint, whereas for the fixation of ligamentum inguinale, 2/0 PDS was used in 3 surgeries, 2/0 15-cm V-Loc was used in another 3 surgeries, and titanium tacker was used in 6 surgeries.

Conclusions:
We demonstrated that the technique of endoscopic surgery that offers the advantages of open inguinal surgery in a cadaver model can be combined with the presently used laparoscopic intervention so as to combine all the advantages, especially for patients who are not suitable for general anesthesia, who are experiencing a recurrence after laparoscopic intervention, and who do not want any visible scares resultant from the surgery. For future studies, we suggest that the proposed technique be applied to inguinal hernia patients to ascertain clearer results.
Predictive Risk Factors for Postoperative Complications and Its Impact on Survival in Laparoscopic Resection for Colon Cancer
Authors: Granero Lucia , Cienfuegos Javier A. , Baixauli Jorge , Pastor Carlos , Sánchez Justicia Carlos , Valentí Víctor , Rotellar Fernando , Hernández Lizoáin José Luis 
Published: April 2021

Background:
Laparoscopic resection is the ideal treatment of colon cancer. The aim of the study was to analyze the predictive factors for postoperative complications and their impact on oncologic outcomes in laparoscopic resections in colon cancer.

Materials and Methods:
In all patients undergoing elective laparoscopic surgery the number and degree of severity of postoperative complications were recorded and classified according to Clavien-Dindo. A univariate analysis was made of the demographic, surgical, and oncologic variables of patients with and without complications. The statistically significant variables were then entered into a multivariate model. In both groups overall and disease-free survival were analyzed using Kaplan-Meier estimates.

Results:
Of 524 patients, 138 (26.3%) experienced some type of complication, 110 less severe (79.7%) and 28 (20.4%) severe. Twenty-nine conversions to open surgery occurred (5.5%) and hospital mortality was 0.2%.
In the multivariate analysis, use of corticosteroids [odds ratio (OR): 3.619], oral anticoagulants (OR: 3.49), blood transfusions (OR: 4.30), and conversion to open surgery (OR: 3.93) were significantly associated with the development of complications. However, sigmoid resections were associated with fewer complications (OR: 0.45).
Overall 5-year and 10-year survival in both groups, was 83.3%, 74.1%, 76.0%, and 67.1%, respectively (P=0.18). Disease-free survival at 5 and 10 years, excluding stage IV tumors, was 88.6% and 90.4%, respectively (P=0.881).

Conclusions:
The use of corticosteroids, oral anticoagulants, blood transfusions, and conversion to open surgery are all independent predictive factors of postoperative complications. Sigmoid resections are associated with fewer complications. In laparoscopic resections of the colon, complications do not negatively affect long-term oncologic outcomes.
Clinical Outcomes of a Multidisciplinary Female Chronic Pelvic Pain Program
Authors: Westbay Lauren C. , Adams William , Kistner Margaret , Brincat Cynthia , Bresler Larissa , Yang Linda C. , Fitzgerald Colleen M. 
Published: April 2021

Objective
The aim of this study was to describe patient-reported longitudinal outcomes in a multidisciplinary female chronic pelvic pain (CPP) program.

Methods
We conducted a retrospective cohort study for women cared for in a tertiary, multidisciplinary, female (CPP) program between 2012 and 2017. Patient demographics were collected from electronic medical records. Patients completed the numerical rating scale for pain, Pain Disability Index (PDI), and Patient Global Impression of Improvement scale at each visit. Mixed-effects models were used to assess change in patient responses over time.

Results
Patients (N = 317) with a mean age of 44.3 years (SD, 14.6) and median duration of symptoms of 3 years (interquartile range, 1.0–7.0) were assessed in this analysis. The primary diagnosis was pelvic floor myofascial pain (67%). On multivariable analysis, numerical rating scale scores decreased by −0.11 point [95% confidence interval (CI), −0.20 to −0.01] every 3 months (P = 0.03). On multivariable analysis, total PDI score decreased by −0.88 point (95% CI, −1.43 to −0.33) (P = 0.003), and PDI sexual subscores decreased by −0.29 point (95% CI, −0.44 to −0.14) (P < 0.001) every 3 months. A higher (worse) Patient Global Impression of Improvement score was associated with a higher (worse) PDI score at follow-up (odds ratio, 1.04; 95% CI, 1.01–1.07; P = 0.01).

Conclusions
Patients in a multidisciplinary CPP program demonstrated improvement over time in pain disability that was associated with an overall global impression of improvement.
The Patient Acceptable Symptom State in Female Urinary Incontinence
Authors: Sanderson Derrick J. , Zavez Alexis , Meekins A. Rebecca , Eddib Abeer , Lee Toy G. , Barber Matthew D. , Duecy Erin 
Published: April 2021

Objective
The objective of this study is to characterize an acceptable health state, using the patient acceptable symptom state (PASS) question, in adult women with urinary incontinence.

Methods
This is a prospective multicenter cohort study determining PASS thresholds from condition-specific measures using an electronic research platform in English-speaking women seeking nonsurgical treatment of urinary incontinence between March 2019 and May 2020. Exclusions included pregnancy, isolated overactive bladder, and pelvic organ prolapse greater than stage II. The cohort was described and then grouped based on achievement of PASS. The PASS thresholds were determined using the 75th percentile and univariate regression methods. Multivariable regression modeling was used to understand the influence of covariates on PASS achievement.

Results
The study was completed by 100 (80%) of the 125 enrolled subjects. Of these, 45% (n = 45) achieved PASS after a median of 7 weeks of treatment (range, 6–13 weeks). The corresponding questionnaire score for PASS was estimated to be 6 for the Incontinence Severity Index, 3 for the Patient Global Impression of Severity and Improvement, 37.5 using the Urinary Distress Inventory 6, and 33.3 using the Incontinence Impact Questionnaire 7. Increasing age was independently associated with achieving PASS after adjusting for treatment adherence and outcomes scores (adjusted odds ratio, 1.05 [95% confidence interval, 1.01–1.10]; P = 0.02).

Conclusions
PASS was achieved in 45% of women after conservative treatment of urinary incontinence. PASS offers a new perspective for analysis and interpretation of outcome measures used in pelvic floor disorders and can serve as a reference for future research and clinical care pathways.
Toxin-associated infectious diseases: tetanus, botulism and diphtheria
Authors: Pfausler Bettina , Rass Verena , Helbok Raimund , Beer Ronny 
Published: April 2021

Purpose of review
The incidence rates of the toxin-related infectious diseases, tetanus, diphtheria and botulism declined dramatically over the past decades mainly because of the implementation of immunization programs also in low-and-middle-income countries (LAMICs) and by improving hygiene conditions. But still, single cases occur, and they need fastest possible recognition and management.

Recent findings
Over the past 20 years, the incidence of neonatal tetanus has declined by more than 90%. This success was achieved by immunizing women in reproductive age in areas of high risk as sub-Saharan Africa and parts of Asia. Larger regional outbreaks of diphtheria have been reported from the former Soviet Union in the 1990s and from India in 2017. Botulism is still rare, mainly seen in infants and, in recent years, in intravenous drug abusers.

Summary
Tetanus, diphtheria and botulism are rarities in high-income countries (HICs) with unlimited access to immunization programs and standard hygiene procedures. The diagnosis of all three diseases is still, even in the 21st century, based upon patient‘s history and clinical signs and symptoms. Neither biochemical bedside tests nor neuroradiological investigations help to confirm the diagnosis in an emergency situation.
Energy and frequency ripple in devices with inertial excitation of oscillations
Authors: Blekhman I. , Blekhman L. I. , Vaisberg L. A. , Vasilkov V. B. 
Published: April 2021

We consider vibration devices that consist of softly vibration-isolated rigid bodies subjected to vibrations transmitted by means of inertial vibration exciters (unbalanced rotors) driven into rotation by electric motors. Typically, when designing such devices, it is assumed that the rotors rotate uniformly with a certain circular frequency and the body performs small harmonic oscillations with the same frequency. The present work, using a second-order approximation of their nonlinear coupled differential equations, shows that the rotor and the oscillating body keep exchanging energy. At the same time, the angular velocity of the rotor oscillates with the working frequency as well as with its multiple frequencies during each revolution. As a result, the acceleration of the oscillating body also acquires harmonics with multiple frequencies. This may cause both unwanted and beneficial resonance phenomena. We obtain formulae describing the magnitudes of these ripples. We show that the magnitude of oscillations of the angular frequency can also be estimated using energy considerations. Such estimates are provided for the three most common schemes of dynamic devices. Available experimental data confirm the main conclusions of the theory. We discuss both the harmful effects of these phenomena as well as their possible applications. The latter include design of bi-harmonic vibration exciters and exciters based on vibrational resonance.This article is part of the theme issue ‘Vibrational and stochastic resonance in driven nonlinear systems (part 2)’.
Impacts of autapse on chaotic resonance in single neurons and small-world neuronal networks
Authors: Baysal Veli , Erkan Erdem , Yilmaz Ergin 
Published: April 2021

Chaotic resonance (CR) is a new phenomenon induced by an intermediate level of chaotic signal intensity in neuronal systems. In the current study, we investigated the effects of autapse on the CR phenomenon in single neurons and small-world (SW) neuronal networks. In single neurons, we assume that the neuron has only one autapse modelled as electrical, excitatory chemical and inhibitory chemical synapse, respectively. Then, we analysed the effects of each one on the CR, separately. Obtained results revealed that, regardless of its type, autapse significantly increases the chaotic resonance of the appropriate autaptic parameter’s values. It is also observed that, at the optimal chaotic current intensity, the multiple CR emerges depending on autaptic time delay for all the autapse types when the autaptic delay time or its integer multiples match the half period or period of the weak signal. In SW networks, we investigated the effects of chaotic activity on the prorogation of pacemaker activity, where pacemaker neurons have different kinds of autapse as considered in single neuron cases. Obtained results revealed that excitatory and electrical autapses prominently increase the prorogation of pacemaker activity, whereas inhibitory autapse reduces or does not change it. Also, the best propagation was obtained when the autapse was excitatory.
This article is part of the theme issue ‘Vibrational and stochastic resonance in driven nonlinear systems (part 2)’.
On some applications of vibrational resonance on noisy image perception: the role of the perturbation parameters
Authors: Morfu S. , Usama B. I. , Marquié P. 
Published: April 2021

In this paper, we first propose a brief overview of nonlinear resonance applications in the context of image processing. Next, we introduce a threshold detector based on these resonance properties to investigate the perception of subthreshold noisy images. By considering a random perturbation, we revisit the well-known stochastic resonance (SR) detector whose best performances are achieved when the noise intensity is tuned to an optimal value. We then introduce a vibrational resonance detector by replacing the noisy perturbation with a spatial high-frequency signal. To enhance the image perception through this detector, it is shown that the noise level of the input images must be lower than the optimal noise value of the SR-based detector. Under these conditions, considering the same noise level for both detectors, we establish that the vibrational resonance (VR)-based detector significantly outperforms the SR-based detector in terms of image perception. Moreover, we show that whatever the perturbation amplitude, the best perception through the VR detector is ensured when the perturbation frequency exceeds the image size.This article is part of the theme issue ‘Vibrational and stochastic resonance in driven nonlinear systems (part 2)’.
Broadly-reactive IgG responses to heterologous H5 prime-boost influenza vaccination are shaped by antigenic relatedness to priming strains
Authors: Wang Jiong , Li Dongmei , Perry Sheldon , Hilchey Shannon P. , Wiltse Alexander , Treanor John J. , Sangster Mark Y. , Zand Martin S. 
Published: April 2021

ABSTRACTPrime-boost vaccinations of humans with different H5 strains have generated broadly protective antibody levels. However, the effect of an individual’s H5 exposure history on antibody responses to subsequent H5 vaccination is poorly understood. To investigate this, we analyzed the IgG response to H5 A/Indonesia/5/2005 (Ind05) vaccination in three cohorts: (1) a double primed group that received two H5 vaccinations: A/Vietnam/203/2004 (Vie04) 5 years ago and A/Hong Kong/156/1997 (HK97) 11 years ago, (2) a single primed group that received Vie04 5 years ago, and (3) an H5-naïve group that received two doses of the Ind05 vaccine 28 days apart. Hemagglutinin (HA)-reactive IgG levels were estimated by multiplex assay against an HA panel that included 21 H5 strains and 9 other strains representing H1, H3, H7, and H9 subtypes. Relative HA antibody landscapes were generated to quantitatively analyze the magnitude and breadth of antibody binding after vaccination. We found that short-interval prime-boosting with the Ind05 in the naïve group generated a low anti-H5 response. Both primed groups generated robust antibody responses reactive to a broad range of H5 strains after boosting with Ind05; IgG antibody levels persisted longer in subjects who had been double primed years ago. Notably, the IgG responses were strongest against the first priming H5 strain, that reflecting influenza virus immune imprinting. Finally, the broad anti-H5 IgG response was stronger against strains having a small antigenic distance to the initial priming strain.IMPORTANCEThe antigenic shift and draft of hemagglutinin (HA) in influenza viruses is accepted as one of the major reasons for immune evasion. The analysis of B cell immune responses to influenza infection and vaccination is complicated by the impact of exposure history and antibody cross-reaction between antigenically similar influenza strains. To assist in such analyses, the influenza “antibody landscape” method has been used to analyze and visualize the relationship of antibody mediated immunity to the antigenic distance between influenza strains. In this study, we describe a “relative antibody landscape” method, calculating the antigenic distance between the vaccine influenza strain and other H5 strains, and using this relative antigenic distance to plot with the anti-H5 IgG levels post-vaccination. This new method quantitatively estimates and visualizes the correlation between the humoral response to a particular influenza strain, and the antigenic distance to other strains. Our findings demonstrate the effect of H5 exposure history on H5 vaccine responses quantified by the relative antibody landscape method.
Inhaled budesonide for COVID-19 in people at higher risk of adverse outcomes in the community: interim analyses from the PRINCIPLE trial
Authors:   PRINCIPLE Collaborative Group, Yu Ly-Mee , Bafadhel Mona , Dorward Jienchi , Hayward Gail , Saville Benjamin R , Gbinigie Oghenekome , Van Hecke Oliver , Ogburn Emma , Evans Philip H , Thomas Nicholas PB , Patel Mahendra G , Berry Nicholas , Detry Michelle A. , Saunders Christina T. , Fitzgerald Mark , Harris Victoria , de Lusignan Simon , Andersson Monique I , Barnes Peter J , Russell Richard EK , Nicolau Dan V , Ramakrishnan Sanjay , Hobbs FD Richard , Butler Christopher C 
Published: April 2021

AbstractBACKGROUNDInhaled budesonide has shown efficacy for treating COVID-19 in the community but has not yet been tested in effectiveness trials.METHODSWe performed a multicenter, open-label, multi-arm, adaptive platform randomized controlled trial involving people aged ≥65 years, or ≥50 years with comorbidities, and unwell ≤14 days with suspected COVID-19 in the community (PRINCIPLE). Participants were randomized to usual care, usual care plus inhaled budesonide (800µg twice daily for 14 days), or usual care plus other interventions. The co-primary endpoints are time to first self-reported recovery, and hospitalization/death related to COVID-19, both measured over 28 days from randomisation and analysed using Bayesian models.RESULTSThe trial opened on April 2, 2020. Randomization to inhaled budesonide began on November 27, 2020 and was stopped on March 31, 2021 based on an interim analysis using data from March 4, 2021. Here, we report updated interim analysis data from March 25, 2021, at which point the trial had randomized 4663 participants with suspected COVID-19. Of these, 2617 (56.1%) tested SARS-CoV-2 positive and contributed data to this interim budesonide primary analysis; 751 budesonide, 1028 usual care and 643 to other interventions. Time to first self-reported recovery was shorter in the budesonide group compared to usual care (hazard ratio 1.208 [95% BCI 1.076 – 1.356], probability of superiority 0.999, estimated benefit [95% BCI] of 3.011 [1.134 – 5.41] days). Among those in the interim budesonide primary analysis who had the opportunity to contribute data for 28 days follow up, there were 59/692 (8.5%) COVID-19 related hospitalizations/deaths in the budesonide group vs 100/968 (10.3%) in the usual care group (estimated percentage benefit, 2.1% [95% BCI −0.7% – 4.8%], probability of superiority 0.928).CONCLUSIONSIn this updated interim analysis, inhaled budesonide reduced time to recovery by a median of 3 days in people with COVID-19 with risk factors for adverse outcomes. Once 28 day follow up is complete for all participants randomized to budesonide, final analyses of time to recovery and hospitalization/death will be published. (Funded by the National Institute of Health Research/ United Kingdom Research Innovation [MC_PC_19079]; PRINCIPLE ISRCTN number, ISRCTN86534580.)
Quantatitive Analysis of Conserved Sites on the SARS-CoV-2 Receptor-Binding Domain to Promote Development of Universal SARS-Like Coronavirus Vaccines
Authors: Wang Siling , Wu Dinghui , Xiong Hualong , Wang Juan , Tang Zimin , Chen Zihao , Wang Yizhen , Zhang Yali , Ying Dong , Lin Xue , Liu Chang , Guo Shaoqi , Tian Weikun , Lin Yajie , Zhang Xiaoping , Yuan Quan , Yu Hai , Zhang Tianying , Zheng Zizheng , Xia Ningshao 
Published: April 2021

SummaryAlthough vaccines have been successfully developed and approved against SARS-CoV-2, it is still valuable to perform studies on conserved antigenic sites for preventing possible pandemic-risk of other SARS-like coronavirus in the future and prevalent SARS-CoV-2 variants. By antibodies obtained from convalescent COVID-19 individuals, receptor binding domain (RBD) were identified as immunodominant neutralizing domain that efficiently elicits neutralizing antibody response with on-going affinity mature. Moreover, we succeeded to define a quantitative antigenic map of neutralizing sites within SARS-CoV-2 RBD, and found that sites S2, S3 and S4 (new-found site) are conserved sites and determined as subimmunodominant sites, putatively due to their less accessibility than SARS-CoV-2 unique sites. P10-6G3, P07-4D10 and P05-6H7, respectively targeting S2, S3 and S4, are relatively rare antibodies that also potently neutralizes SARS-CoV, and the last mAbs performing neutralization without blocking S protein binding to receptor. Further, we have tried to design some RBDs to improve the immunogenicity of conserved sites. Our studies, focusing on conserved antigenic sites of SARS-CoV-2 and SARS-CoV, provide insights for promoting development of universal SARS-like coronavirus vaccines therefore enhancing our pandemic preparedness.
Luminal Flow Actuation Generates Coupled Shear and Strain in a Microvessel-on-Chip
Authors: Dessalles Claire A. , Ramón-Lozano Clara , Babataheri Avin , Barakat Abdul I. 
Published: April 2021

AbstractIn the microvasculature, blood flow-derived forces are key regulators of vascular structure and function. Consequently, the development of hydrogel-based microvessel-on-chip systems that strive to mimic the in vivo cellular organization and mechanical environment has received great attention in recent years. However, despite intensive efforts, current microvessel- on-chip systems suffer from several limitations, most notably failure to produce physiologically relevant wall strain levels. In this study, a novel microvessel-on-chip based on the templating technique and using luminal flow actuation to generate physiologically relevant levels of wall shear stress and circumferential stretch is presented. Normal forces induced by the luminal pressure compress the surrounding soft collagen hydrogel, dilate the channel, and create large circumferential strain. The fluid pressure gradient in the system drives flow forward and generates realistic pulsatile wall shear stresses. Rigorous characterization of the system reveals the crucial role played by the poroelastic behavior of the hydrogel in determining the magnitudes of the wall shear stress and strain. The experimental measurements are combined with an analytical model of flow in both the lumen and the porous hydrogel to provide an exceptionally versatile user manual for an application-based choice of parameters in microvessels-on-chip. This unique strategy of flow actuation adds a dimension to the capabilities of microvessel-on-chip systems and provides a more general framework for improving hydrogel-based in vitro engineered platforms.Abstract Figure