bluuebunny/crossref_metadata_2025_split huggingface dataset:
O36 LOD (LOSS-OF-DOMAIN) HERNIA TREATMENT WITH INTRAOPERATIVE FASCIA TRACTION. DOES THIS TECHNIQUE MAKE RELEASE OPERATIONS SUPERFLUOUS?
Authors: Niebuhr Henning , Aufenberg Thomas , Dag Halil , Reinpold Wolfgang , Peiper Christian , Schardey Hans Martin , Renter Marc Alexander , Aly Mohamed , Eucker Dietmar , Köckerling Ferdinand , Eichelter Jakob 
Published: December 2021

Abstract

Aim
Measurable and controlled stretching of the fascia for 30 minutes during surgery to achieve primary tension-free abdominal wall closure in LOD hernias. This prospective observational study aimed to clarify the extent to which this traction method can function as an alternative to component separation methods.

Material and Methods
We have already applied this technique in &gt; 50 procedures of LOD hernias. We published the data of first 21 patients treated with intraoperative fascia stretching in seven specialized hernia centers between November 2019 and August 2020. The average patient age was 58 years with a gender ratio of 2.5 males: 1 female. ASA scores were III in 66.7% and II in 33.3%. The body mass index (BMI) averaged 32.5 kg/m2. Thirteen patients were treated with BTA 4 weeks before surgery.

Results
Intraoperatively-measured fascial distance averaged 17.3 cm (range 8.5–44 cm). After application of diagonal-anterior traction &gt;10 kg for an average duration of 32.3 min (range 30–40 min), the fascial distance decreased by 9.8 cm (1–26 cm) to an average 7.5 cm (range 2–19 cm), which is a large effect (r = 0.62). The fascial length increase (average 9.8 cm) after applied traction was highly significant. All hernias were closed under moderate tension after the traction phase. In 19 patients, this closure was reinforced with mesh using a sublay technique.

Conclusions
This method allows primary closure of complex LOD hernias and is potentially less prone to complications than component separation methods.
O39 ASSOCIATION OF DIFFERENT MESH AND MESH FIXATION COMBINATIONS WITH REOPERATION RISK AFTER LAPAROSCOPIC GROIN HERNIA SURGERY. A SWEDISH HERNIA REGISTRY STUDY OF 25,190 TEP AND TAPP REPAIRS
Authors: Novik Bengt , Sandblom Gabriel , Ansorge Christoph , Thorell Anders 
Published: December 2021

Abstract

Aim
The HerniaSurge guidelines concerning mesh and fixation options in laparoscopic totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) groin hernia repair are based on studies focusing on either mesh or fixation. We hypothesized that the value of such recommendations is limited by lacking knowledge on how mesh and fixation interact. The present registry-based nationwide cohort study compared different mesh/fixation combinations regarding relative risks for reoperation after TEP and TAPP.

Material and Methods
All TEP and TAPP with standard polypropylene (StdPPM) or lightweight (LWM) flat meshes, combined with either tacks, fibrin glue, or no fixation, registered in the Swedish Hernia Registry 2005-2017 were included. Endpoint was reoperation due to recurrence as of December 31, 2018. Multivariable Cox regression rendered relative risk differences between the exposures, expressed as hazard ratios (HR) with 95% confidence intervals (CI).

Results
Of 25 190 repairs, 924 (3.7%) were later reoperated for recurrence.
The lowest, mutually equivalent, reoperation risks were associated with StdPPM without fixation (HR 1), StdPPM with metal tacks (HR 0.8, CI 0.4-1.4), StdPPM with fibrin glue (HR 1.1, CI 0.7-1.6), and LWM with fibrin glue (HR 1.2, CI 0.97-1.6). LWM correlated otherwise with increased risk, whether without fixation (HR 2.0, CI 1.6-2.6), or affixed with metal (HR 1.7, CI 1.1-2.7), or absorbable tacks (HR 2.4, CI 1.8-3.1).

Conclusions
With StdPPM, fixation seems not to improve outcomes, despite being costlier. Thus, for this mesh category, we recommend non-fixation. With LWM, we recommend fibrin glue fixation, which was the only LWM alternative on par with non-affixed StdPPM.
O43 INTRA-ABDOMINAL PRESSURE VARIATIONS IN HUMANS DURING PHYSICAL EXERCISES AND DAILY LIFE BY INTRAGASTRIC WIRELESS SENSOR
Authors: Soucasse Andréa , Jourdan Arthur , Edin Lauriane , Gillion Jean-François , Masson Catherine , Bege Thierry 
Published: December 2021

Abstract

Aim
The conflict between the intra-abdominal pressure (IAP) applied to the abdominal wall and its resistance determines the occurrence of ventral hernia. Knowledge about IAP variation in everyday life is limited and mainly obtained by invasive methods. The objective of the study is to propose a comprehensive evaluation of IAP based on a limited risk and discomfort method.

Material and Methods
A prospective study was carried out in 20 healthy volunteers. The intragastric pressure, validated for estimating IAP, was assessed by an ingestible pressure sensor*. Volunteers realized a set of supervised exercises, including breathing, apnea after calm exhalation and seven muscle contraction stereotyped exercises in three different positions (supine, sitting, standing). Then the volunteers resumed their daily activities with the pressure continuously recorded until gastric emptying. Pressure variations and rates were computed.

Results
The highest IAP levels were reached during coughing and jumping. Maximum peaks were respectively 65 ± 35 and 67 ± 31 mmHg with pressure rates of 121 and 114 mmHg.s−1 for these two exercises. The position did not affect the IAP variation. Men had significantly higher pressure values for pushing against a wall (P &lt; 0.01), Valsalva maneuver and legs raising (P &lt; 0.05) exercises. During daily life, peaks greater than 50, 100, and 150 mmHg occurred on average five times, twice, and once per hour, respectively.

Conclusions
This study provides a real-life characterization of IAP allowing the quantification of mechanical solicitation applied to the abdominal wall and the identification of risk situations for the occurrence of ventral hernias.
* (SmartPill™, Medtronic, Minneapolis, MN, U.S.A)
OV06 EXTENDING THE INDICATIONS OF TRANSVERSUS ABDOMINIS RELEASE: SUBLAY MESH REPAIR FOR A RARE CASE OF ACQUIRED DIAPHRAGMATIC HERNIA
Authors: Bertoglio Camillo Leonardo , Quagli Oscar , Morini Lorenzo , Grimaldi Simona , Ferrari Giovanni 
Published: December 2021

Abstract

Aim
Acquired diaphragmatic hernia (ADH) is rare and its treatment is challenging. Posterior component separation (PCS) with transversus abdominis release (TAR) is gaining wide acceptance for the repair of complex abdominal hernia, including those located in proximity of the abdominal borders. In this view the central tendon of the diaphragm could be intended as the rooftop border of the peritoneal sac. We describe an original application of TAR for the treatment of an unusual case of ADH.

Material and Methods
a 54 year-old man was referred to our department for an ADH, following two previous sternotomies for an aortic aneurysm, conditioning respiratory symptoms. A thoraco-abdominal contrast enhanced CT-scan confirmed an anterior left diaphragmatic defect with a transverse diameter of 8.5 cm and a huge sac containing the great omentum and the distal transverse colon, with atelectasis of the inferior lobe of the lung. A subxiphoid M1W2L2 incisional hernia was also detected. The patient underwent a midline xipho-umbilical laparotomy and a repair by partial TAR with posterior rectus sheath release and progressive dissection of the diaphragmatic muscular fibers far beyond the DH. A sublay repair with a large dual layer PVDF mesh was then accomplished.

Results
Postoperative course was uneventful and no recurrence was recorded at 6 months follow up.

Conclusions
partial-TAR could be a good option for repair of anteriorly placed ADH, ensuring a stable anatomical repair with an overlap that is usually wider than after laparoscopic IPOM repair. This novel indication confirms the extreme versatility of TAR for the repair of complex ventral hernia
Management of acute type A aortic dissection in the elderly: an analysis from IRAD
Authors: Hemli Jonathan M , Pupovac Stevan S , Gleason Thomas G , Sundt Thoralf M , Desai Nimesh D , Pacini Davide , Ouzounian Maral , Appoo Jehangir J , Montgomery Daniel G , Eagle Kim A , Ota Takeyoshi , Di Eusanio Marco , Estrera Anthony L , Coselli Joseph S , Patel Himanshu J , Trimarchi Santi , Brinster Derek R ,   the IRAD Investigators
Published: December 2021

Abstract

OBJECTIVES
We sought to examine management and outcomes of (Stanford) type A aortic dissection (TAAAD) in patients aged &gt;70 years.

METHODS
All patients with TAAAD enrolled in the International Registry of Acute Aortic Dissection database (1996–2018) were studied (n = 5553). Patients were stratified by age and therapeutic strategy. Outcomes for octogenarians were compared with those for septuagenarians. Variables associated with in-hospital mortality were identified by multivariable logistic regression.

RESULTS
In-hospital mortality for all patients (all ages) was 19.7% (1167 deaths), 16.1% after surgical intervention vs 52.1% for medical management (P &lt; 0.001). Of the study population, 1281 patients (21.6%) were aged 71–80 years and 475 (8.0%) were &gt;80 years. Fewer octogenarians underwent surgery versus septuagenarians (68.1% vs 85.9%, P &lt; 0.001). Overall mortality was higher for octogenarians versus septuagenarians (32.0% vs 25.6%, P = 0.008); however, surgical mortality was similar (25.1% vs 21.7%, P = 0.205). Postoperative complications were comparable between surgically managed cohorts, although reoperation for bleeding was more common in septuagenarians (8.1% vs 3.2%, P = 0.033). Kaplan–Meier 5-year survival was significantly superior after surgical repair in all age groups, including septuagenarians (57.0% vs 13.7%, P &lt; 0.001) and octogenarians (35.5% vs 22.6%, P &lt; 0.001).

CONCLUSIONS
When compared with septuagenarians, a smaller percentage of octogenarians undergo surgical repair for TAAAD, even though postoperative outcomes are similar. Age alone should not preclude consideration for surgery in appropriately selected patients with TAAAD.
Novel carotenogenic gene combinations from red yeasts enhanced lycopene and beta-carotene production in Saccharomyces cerevisiae from the low-cost substrate sucrose
Authors: Watcharawipas Akaraphol , Sansatchanon Kitisak , Phithakrotchanakoon Chitwadee , Tanapongpipat Sutipa , Runguphan Weerawat , Kocharin Kanokarn 
Published: December 2021

ABSTRACT
Carotenoids (C40H56) including lycopene and beta-carotene are relatively strong antioxidants that provide benefits to human health. Here, we screened highly efficient crt variants from red yeasts to improve lycopene and beta-carotene production in Saccharomyces cerevisiae. We identified that crt variants from Sporidiobolus pararoseus TBRC-BCC 63403 isolated from rice leaf in Thailand exhibited the highest activity in term of lycopene and beta-carotene production in the context of yeast. Specifically, the phytoene desaturase SpCrtI possessed up to 4-fold higher in vivo activity based on lycopene content than the benchmark enzyme BtCrtI from Blakeslea trispora in our engineered WWY005 strain. Also, the geranylgeranyl pyrophosphate (GGPP) synthase SpCrtE, the bifunctional phytoene synthase-lycopene cyclase SpCrtYB, and SpCrtI when combined led to 7-fold improvement in beta-carotene content over the benchmark enzymes from Xanthophyllomyces dendrorhous in the laboratory strain CEN.PK2-1C. Sucrose as an alternative to glucose was found to enhance lycopene production in cells lacking GAL80. Lastly, we demonstrated a step-wise improvement in lycopene production from shake-flasks to a 5-L fermenter using the strain with GAL80 intact. Altogether, our study represents novel findings on more effective crt genes from Sp. pararoseus over the previously reported benchmark genes and their potential applications in scale-up lycopene production.
Randomized sparse grid algorithms for multivariate integration on Haar wavelet spaces
Authors: Wnuk M , Gnewuch M 
Published: December 2021

Abstract
The deterministic sparse grid method, also known as Smolyak’s method, is a well-established and widely used tool to tackle multivariate approximation problems, and there is a vast literature on it. Much less is known about randomized versions of the sparse grid method. In this paper we analyze randomized sparse grid algorithms, namely randomized sparse grid quadratures for multivariate integration on the $D$-dimensional unit cube $[0,1)^D$. Let $d,s \in {\mathbb {N}}$ be such that $D=d\cdot s$. The $s$-dimensional building blocks of the sparse grid quadratures are based on stratified sampling for $s=1$ and on scrambled $(0,m,s)$-nets for $s\ge 2$. The spaces of integrands and the error criterion we consider are Haar wavelet spaces with parameter $\alpha $ and the randomized error (i.e., the worst case root mean square error), respectively. We prove sharp (i.e., matching) upper and lower bounds for the convergence rates of the $N$th minimal errors for all possible combinations of the parameters $d$ and $s$. Our upper error bounds still hold if we consider as spaces of integrands Sobolev spaces of mixed dominated smoothness with smoothness parameters $1/2&lt; \alpha &lt; 1$ instead of Haar wavelet spaces.
Modelling the functional dependency between root and shoot compartments to predict the impact of the environment on the architecture of the whole plant: methodology for model fitting on simulated data using Deep Learning techniques
Authors: Masson Abel Louis , Caraglio Yves , Nicolini Eric , Borianne Philippe , Barczi Jean-Francois 
Published: December 2021

AbstractTree structural and biomass growth studies mainly focus on the shoot compartment. Tree roots usually have to be taken apart due to the difficulties involved in measuring and observing this compartment, particularly root growth. In the context of climate change, the study of tree structural plasticity has become crucial and both shoot and root systems need to be considered simultaneously as they play a joint role in adapting traits to climate change (water availability for roots and light or carbon availability for shoots). We developed a botanically accurate whole-plant model and its simulator (RoCoCau) with a linkable external module (TOY) to represent shoot and root compartment dependencies and hence tree structural plasticity in different air and soil environments. This paper describes a new deep neural network calibration trained on simulated data sets computed from a set of more than 360 000 random TOY parameter values and random climate values. These data sets were used for training and for validation. For this purpose, we chose VoxNet, a convolutional neural network designed to classify 3D objects represented as a voxelized scene. We recommend further improvements for VoxNet inputs, outputs and training. We were able to teach the network to predict the value of environment data well (mean error &lt; 2 %), and to predict the value of TOY parameters for plants under water stress conditions (mean error &lt; 5 % for all parameters), and for any environmental growing conditions (mean error &lt; 20 %).
Comparison of electronic versus manual abstraction for 2 standardized perinatal care measures
Authors: Schmaltz Stephen , Vaughn Jocelyn , Elliott Tricia 
Published: December 2021

Abstract

Objective
Given that electronic clinical quality measures (eCQMs) are playing a central role in quality improvement applications nationwide, a stronger evidence base demonstrating their reliability is critically needed. To assess the reliability of electronic health record-extracted data elements and measure results for the Elective Delivery and Exclusive Breast Milk Feeding measures (vs manual abstraction) among a national sample of US acute care hospitals, as well as common sources of discrepancies and change over time.

Materials and Methods
eCQM and chart-abstracted data for the same patients were matched and compared at the data element and measure level for hospitals submitting both sources of data to The Joint Commission between 2017 and 2019. Sensitivity, specificity, and kappa statistics were used to assess reliability.

Results
Although eCQM denominator reliability had moderate to substantial agreement for both measures and both improved over time (Elective Delivery: kappa = 0.59 [95% confidence interval (CI), 0.58–0.61] in 2017 and 0.84 [95% CI, 083–0.85] in 2019; Exclusive Breast Milk Feeding: kappa = 0.58 [95% CI, 0.54–0.62] in 2017 and 0.70 [95% CI, 0.67–0.73] in 2019), the numerator status reliability was poor for Elective Delivery (kappa = 0.08 [95% CI, 0.03–0.12] in 2017 and 0.10 [95% CI, 0.05–0.15] in 2019) but near perfect for Exclusive Breast Milk Feeding (kappa = 0.85 [0.83, 0.87] in 2017 and 0.84 [0.83, 0.85] in 2019). The failure of the eCQM to accurately capture estimated gestational age, conditions possibly justifying elective delivery, active labor, and medical induction were the main reasons for the discrepancies.

Conclusions
Although eCQM denominator reliability for the Elective Delivery and Exclusive Breast Milk Feeding measures had moderate agreement when compared to medical record review, the numerator status reliability was poor for Elective Delivery, but near perfect for Exclusive Breast Milk Feeding. Improvements in eCQM data capture of some key data elements would greatly improve the reliability.
Using a certified electronic health record technology platform to screen, test and refer patients with prediabetes
Authors: Kirley Kate , Khan Tamkeen , Aquino Gina , Brown Ameldia , Meier Scott , Chambers Nadene , O’Connell Christopher 
Published: December 2021

Abstract
The objective of this study was to determine if certified electronic health record technology (CEHRT) can be used to identify and refer patients with prediabetes to lifestyle change programs (LCPs) recognized by the National Diabetes Prevention Program (DPP). This pilot utilized a prediabetes registry, patient portal, and clinical decision support to increase referrals. Data from 36 primary care providers showed 4930 patients were eligible for DPP LCP, 293 referrals were generated, compared to 20 referrals in the baseline period, and 116 patients enrolled. Referral to enrollment conversion rates were 41% in the study period and 69% in the post-study 1-year period. CEHRT functionalities can support systematic identification and management of prediabetes. The referral rate increased 7-fold compared to the baseline period, with high referral to enrollment conversion rates. CEHRT coupled with active provider engagement can serve as a tool to identify prediabetes patients and facilitate LCP referrals and enrollment.
Phenotypic and genetic associations between feeding behavior and carcass merit in crossbred growing cattle
Authors: Kelly David N , Sleator Roy D , Murphy Craig P , Conroy Stephen B , Berry Donagh P 
Published: December 2021

Abstract
In growing cattle, the phenotypic and genetic relationships between feeding behavior and both live animal ultrasound measures and subsequent carcass merit are generally poorly characterized. The objective of the current study was to quantify the phenotypic and genetic associations between a plethora of feeding behavior traits with both pre-slaughter ultrasound traits and post-slaughter carcass credentials in crossbred Bos taurus cattle. Carcass data were available on 3,146 young bulls, steers, and heifers, of which 2,795 and 2,445 also had records for pre-slaughter ultrasound muscle depth and intramuscular fat percentage, respectively; a total of 1,548 steers and heifers had information on all of the feeding behavior, ultrasound, and carcass traits. Young bulls were fed concentrates, while steers and heifers were fed a total mixed ration. Feeding behavior traits were defined based on individual feed events or meal events (i.e., individual feed events grouped into meals). Animal linear mixed models were used to estimate (co)variance components. Phenotypic correlations between feeding behavior and both ultrasound and carcass traits were generally weak and not different from zero, although there were phenotypic correlations of 0.40, 0.26, and 0.37 between carcass weight and feeding rate, energy intake per feed event, and energy intake per meal, respectively. Genetically, cattle that had heavier carcass weights, better carcass conformation, or a higher dressing percentage fed for a shorter time per day (genetic correlations [±SE] of −0.46 ± 0.12, −0.39 ± 0.11, and −0.50 ± 0.10, respectively). Genetic correlations of 0.43 ± 0.12 and 0.68 ± 0.13 were estimated between dressing difference (i.e., differential between live weight pre-slaughter and carcass weight) and energy intake per feed event and energy intake per meal, respectively. Neither intramuscular fat percentage measured on live animals nor carcass fat score (i.e., a measure of subcutaneous fat cover of the carcass) was genetically associated with any of the feeding behavior traits. The genetic associations between some feeding behavior traits and both ultrasound and carcass traits herein suggested that indirect responses in the feeding behavior of growing cattle from selection for improved carcass merit would be expected. Such changes in feeding behavior patterns in cattle may be reduced by measuring and including feeding behavior in a multiple-trait selection index alongside carcass traits.
Effects of feeding lubabegron on gas emissions, growth performance, and carcass characteristics of beef cattle housed in small-pen environmentally monitored enclosures during the last 3 mo of the finishing period
Authors: Teeter J Scott , Werth Samantha J , Gruber Sandra L , Kube John C , Hagenmaier Jacob A , Allen Janet B , Herr Cory T , Brown Michael S , Boler Dustin , Dilger Anna C , Zhao Yongjing , Pan Yuee , Mitloehner Frank M 
Published: December 2021

Abstract
The development of technologies that promote environmental stewardship while maintaining or improving the efficiency of food animal production is essential to the sustainability of producing a food supply to meet the demands of a growing population. As such, Elanco (Greenfield, IN) pursued an environmental indication for a selective β-modulator (lubabegron; LUB). LUB was recently approved by the United States Food and Drug Administration (FDA) to be fed to feedlot cattle during the last 14 to 91 d of the feeding period for reductions in gas emissions/kg of unshrunk final BW and HCW. A 4 × 2 factorial arrangement of treatments was used with the factors of dose (0.0, 1.38, 5.5, or 22.0 mg·kg−1 DM basis) and sex (steers or heifers). Three 91-d cycles were conducted (112 cattle/cycle) with each dose × sex combination being represented by a single cattle pen enclosure (CPE; 14 cattle/CPE) resulting in a total of 168 steers and 168 heifers (n = 6 replicates/dose). There were no interactions observed between dose and sex for any variable measured in the study (P ≥ 0.063). Five gases were evaluated for all pens based on CPE concentrations relative to ambient air: NH3, CH4, N2O, H2S, and CO2. Cumulative NH3 gas emissions were reduced by feeding cattle 5.5 and 22.0 mg·kg−1 LUB (P ≤ 0.023) and tended (P = 0.076) to be lower for the cattle fed 1.38 mg·kg−1 LUB compared with the negative controls (CON). The cumulative NH3 gas emission reductions of 960 to 1032 g, coupled with HCW increases (P ≤ 0.019) of 15 to 16 kg for all LUB doses vs. CON, led to reductions in NH3 gas emissions/kg HCW for all three LUB treatments (P ≤ 0.004). Similar to HCW, reductions in NH3 gas emissions/kg of unshrunk final BW were observed for all LUB doses (P ≤ 0.009) and were attributable to both decreases in NH3 gas emissions and numerical increases in BW. Dose had no effect on cumulative emissions or emissions standardized by BW or HCW for the other four gases (P ≥ 0.268). LUB is a novel tool to reduce emissions of NH3 gas per kilogram of unshrunk live BW and hot carcass weight.