bluuebunny/crossref_metadata_2025_split huggingface dataset:
SURGICAL MANAGEMENT OF W3 INCISIONAL HERNIAS: EVALUATING THE SUCCESS OF ETEP APPROACH
Authors: Salido S , Guevara-Martínez J , Gutiérrez E , Zapata C , Reinoso F , Georgiades A , Monje B , Fondevila C 
Published: May 2024

Abstract

Aim
Treatment of incisional hernias using the extended totally extraperitoneal (eTEP) approach presents significant technical demands. Mostly eTEP is used for W1 and W2 defects due to the challenges posed by larger defects. This study evaluates outcomes applying eTEP for incisional hernias classified as W3 according to the European Hernia Society (EHS).

Materials and Methods
This prospective observational multicenter study included patients with incisional hernias larger than 10 cm in width, conducted at Fundación Jiménez Díaz and La Paz hospitals in Madrid from September 2019 to January 2024. Surgical intervention was performed through the eTEP approach. Preoperative, intraoperative, and postoperative data were collected.

Results
16 patients were included (7 males and 9 females). The American Society of Anesthesiologists (ASA) classification yielded 13 (81.3%) as ASA-III. The median age was 76 years (64–87), and the median body mass index was 30 (21–40). Seven patients had midline defects and 9 lateral defects. The median width of the defect on computed tomography (CT) was 117 cm (18–176). Botox treatment was administered to 43.8% of the patients. Surgical duration had a median of 171 minutes (92–240), with 7 patients requiring transversus abdominis release and 3 patients need endoscopic fascial traction. Complications were observed in 25% of patients, with no reported recurrences during a median follow-up period of 12 months (6–52).

Conclusions
The eTEP technique demonstrates successful application in selected W3 incisional hernias with low conversion rates, recurrence, and complication rates. However, the use of adjuncts before and during surgery is often necessary in these cases.
DEVELOPING A ROBOTIC ABDOMINAL WALL RECONSTRUCTION SERVICE IN THE UK – SINGLE CENTRE EXPERIENCE
Authors: Sharma A , Simpson G 
Published: May 2024

Abstract

Aim
A minimally invasive approach (MIS) to complex abdominal wall reconstruction (CAWR) is expanding and offers advantages in enhanced recovery. We report our single-centre experience in the introduction of Robotic CAWR.

Methods
A retrospective analysis of a prospectively maintained database was carried out from March 2023 to January 2024. All patients undergoing CAWR using a MIS approach were included. Data was collected for the following: sex, age (years), BMI (kg/m2), length of hospital stay (LOS, days), operative time (hours), and post-operative complications.

Results
30 patients underwent MIS CAWR (22 robotic; 8 laparoscopic). Male to female ratio was 18:12. The median age was 59 years (IQR 47–66) and BMI 36 kg/m2 (IQR 32–37). Operations included eTEP retro-rectus Rives-Stoppa (RS) + diastasis plication +/- TAR repair using macroporous polypropylene non-absorbable synthetic mesh. Three patients (10%) had TAR and another 3 (10%) had simultaneous inguinal hernia repairs. The median operating time for RS was 3.3 hours (IQR 3.1–3.5) whilst 7.5 hours (IQR 7.2–7.8) for RS + TAR. The median LOS was 2 days (IQR 1–2).
Seven (23%) patients developed post-operative urinary retention requiring catheterization. 1 (3%) patient developed a post-operative chest infection. Twenty-two of 27 (82%) patients undergoing MIS Rives Stoppa required oral post-operative analgesia only.
1 (3%) patient had laparoscopic converted to open procedure due to bowel involvement.

Conclusion
MIS/Robotic CAWR is a safe approach and can be performed in a similar length of time to open procedures. However, LOS is significantly reduced and patients can be successfully managed with oral analgesia.
ANTERIOR PREPERITONEAL REPAIR FOR INGUINAL HERNIA: AN UPDATE
Authors: Sinha R 
Published: May 2024

Abstract

Background
A continuing prospective study to compare our anterior Preperitoneal [APP] repair for inguinal hernia[IH], with Lichtenstein repair [LR], Laparoscopic Transabdominal preperitoneal [TAPP] and totally extraperitoneal [TEP] repairs.

Method
IH patients, after exclusions and subsequent matching for age, type, and extent of hernia, were assigned randomly for APP, LR, TAPP and TEP repair. The same surgical team performed all operations. Data of predefined endpoints, for all the three groups were statistically compared.

Results
224 patients underwent APP, 81 patients LR, 281 patients TAPP, and 126 TEP. The operating time for both unilateral and bilateral hernias in the APP group was significantly shorter than in LR and TAPP and TEP groups. APP patients were discharged in significantly less time than LR patients but later than TAPP and TEP patients. The postoperative VAS score at 24 hours in the APP patients was significantly less than LR but at 48 hours the difference was equivocal. But VAS score after APP at 24 and 48 hrs was more than in TAPP and TEP patients. However, the pain score across all the three groups was similar at 7 days. There was no surgical site infection (SSI) or mesh infection in any patient. Chronic postoperative inguinal pain (CPIP) was seen less often after APP than after LR but was even less in TAPP and TEP patients. Recurrence across all the four groups was not much different.

Conclusion
APP is a better choice for open IH repair than LR and matches the advantages of Laparoscopic repairs.
SURGICAL TREATMENT FOR ADVANCED COLORECTAL CANCER WITH ABDOMINAL WALL INVASION AND IMPLANTATION
Authors: Song Z , Yang J , Gu Y , Tang J 
Published: May 2024

Abstract

Aim
The prognosis of abdominal wall invasion and implantation from colorectal cancer (CRC) is not good. With radical resection and abdominal wall reconstruction (AWR) technique, locally advanced CRC patients with resectable abdominal wall invasion and implantation may achieve longer tumor-free survival time and an improved quality of life.

Methods
15 patients were retrospectively analyzed. All patients underwent preoperative three-dimensional visualization reconstruction of the abdominal wall and evaluation with a multidisciplinary team (MDT). Patient information, including tumor size, defect size, operation time, intraoperative bleeding, length of hospital stays, and other factors, was collected.

Results
All 15 locally advanced CRC patients with abdominal wall invasion and implantation underwent radical abdominal wall tumor resection followed by AWR. The average tumor dimension and abdominal wall defects after resection were 98.13 ± 71.70 and 270.07 ± 101.95 cm2 respectively; and accurate abdominal wall classification and zoning were obtained for all patients. The average operation time was 431.7 ± 189.2 min, and the average blood loss was 513.3 ± 244.6 ml. The incidence of incisional hernia and CRC recurrence were 6.0% and 13.3%, respectively.

Conclusions
With comprehensive preoperative evaluation, results of radical resection of abdominal wall invasion and implantation in locally advanced CRC patients is satisfactory and safe.
COMPARATIVE STUDY BETWEEN SUBCUTANEOUS ONLAY LAPAROSCOPIC APPROACH (SCOM/SCOLA) AND LAPAROSCOPIC INTRAPERITONEAL ONLAY REPAIR PLUS OF UMBILICAL AND PARA UMBILICAL HERNIA
Authors: Surya Srikanth Saride N S , Pandian K , Alexander N 
Published: May 2024

Abstract

Aim
To compare the techniques between subcutaneous onlay laparoscopic approach (SCOM/SCOLA) and laparoscopic intraperitoneal onlay repair plus (IPOM plus) in terms of duration of surgery, postoperative pain, seroma, duration of stay and cost of surgery.

Methods
It is a prospective observational study. Basic information of the volunteers satisfying the inclusion criteria- Age, sex, defect size of 5 cm or less, with or without rectus abdominis diastasis, single primary umbilical and paraumbilical hernia was included in the study after informed consent. Patients were divided into two groups- Subcutaneous onlay laparoscopic approach (30) and Laparoscopic intraperitoneal onlay repair plus (30). The duration of stay, postoperative pain, seroma, cost and duration of surgery were compared and analysed between the two groups.

Results
In this study shorter duration of surgery was reported in IPOM plus. The postoperative pain was high in IPOM plus than SCOM/SCOLA. Only 6 patients presented with seroma in SCOM/SCOLA and 1 patient in IPOM plus in 3rd week, with no significant difference. Duration of stay is high in SCOM/SCOLA. Cost of surgery is high in IPOM plus group.

Conclusion
The study concludes that patients undergoing treatment for umbilical or para-umbilical hernia can be benefited from both groups where SCOM/SCOLA proves to be effective due to less incidence of postoperative pain and low cost whereas, IPOM plus technique reports a lower incidence of seroma in 1st week and reduced hospital stay.
TREATMENT STRATEGY AND OUTCOMES FOR MEDIAN VENTRAL HERNIA IN OUR DEPARTMENT
Authors: Ueno N 
Published: May 2024

Abstract

Aim
Retro-rectus mesh repair (e-/MILOS) based surgery is performed for ventral hernias in our department. The treatment strategy and results are reported.

Material and Methods
From April 2020 to October 2023, 104 surgeries were performed on median ventral hernias. Based on the current situation in Japan where BOTOX is not approved for the abdominal wall, we applied prehabilitations (physical therapy and nutritional guidance) before surgery (61 cases).
In addition, because of experience of SSI and cancer dissemination in surgery after mesh repair, reconstruction without a mesh (non-mesh e-/MILOS) with retro rectus component separation and reinforcement of Linea alba around the orifice was performed for the younger (under 60 years) and in cases after malignant tumor surgery who don’t refuse in the informed consent (73 cases).

Results
In the cases with prehabilitations, TAR was performed in 2 cases (3.2%), analgesics was prescribed at 2 weeks after surgery in 4 (6.6%), and recurrence occurred in 2 cases (1.6%) what was significantly lower than those without (13.1%, 14.0% and 7.9%, 3–44 months) (p &lt;0.01).
In the non-mesh group, analgesics were prescribed at 2 weeks after surgery in 4 cases (5.4%) and recurrence occurred in 1 (1.3%), significantly lower than the mesh group (12.9%, 9.7%, 3–44 months) (p &lt;0.01).

Conclusions
Prehabilitations may help reduce postoperative pain and prevent recurrence. Non-mesh not only prevents complications associated with mesh but may be non-inferior in therapeutic effect compared to using mesh.
Prospective trials should be planned.
IMPLEMENTATION OF A LAPAROSCOPIC INGUINAL HERNIA REPAIR PROGRAMME. INTRAOPERATIVE OUTCOMES OF A FOUR-YEAR PROGRAMME
Authors: del Valle Ruiz S R , González Valverde F M , Medina Manuel E , Rodríguez Lucas J M , Valero Soriano M , Jiménez Moreno I M , Hurtado Vázquez A M , Sandoval Marín J , Moreno García C , Candel Arenas M F 
Published: May 2024

Abstract

Background
Laparoscopic inguinal hernioplasty was first described in the early 1980s. However, according to the Spanish national database, only a small number of patients have actually undergone this technique.

Material and Methods
Descriptive and retrospective study of patients who underwent elective Totally Extraperitoneal (TEP) surgery between October 2019 and January 2024. Four surgeons with experience in laparoscopic surgery (1 also with advanced colorectal surgery experience, 2 also with advanced bariatric surgery experience) participated in training courses. Selection criteria were: bilateral hernias, recurrent hernias with previous anterior approach, ASA ≤ III, age ≥18 and primary unilateral hernias in athletic patients or patient's personal preference.

Results
214 patients underwent surgery, 87.4% male, mean age 57.6 (SD 13.07, range: 20–88) years. The body mass index was 25,65 (SD 3.57, range: 17.3–42.1). Of these, 131 had bilateral hernias, and 83 unilateral (30 left side, 53 right side). 345 hernias were operated, 60 (17.39%) were recurrent. The mean operative time was 60 (SD 26.47, range: 20–180) minutes. There were 3 TEP to TAPP conversion and 7 to open approach (2 patients with recurrent hernias). Minor complications were: 1 inferior epigastric artery bleeding, the peritoneum was opened in 72 cases (closed with running sutures in 4 cases and with clips in 32 cases). There were 3 major complications: 1 preperitoneal haematoma reoperated within 12 hours, 1 intraoperative bladder perforation and 1 intraoperative external iliac vein injury.

Conclusions
TEP is feasible and safe, but there are many challenges, particularly in terms of a learning curve.
OBESITY AND HERNIA – ALGORITHM AND EVIDENCE
Authors: Vashistha A 
Published: May 2024

Abstract

Materials and Method
Obesity with abdominal wall hernia is always a concern for the patient and surgeon. BMI is an inflammatory state and very high risk of recurrence, surgical site infection, or Subacute Obstruction, if we decide to do Metabolic surgery and Hernia together or defer the Hernia surgery.
IPOM Plus was done with dual mesh with three port technique by Laparoscopy or Robotic for Hernia and Sleeve Gastrectomy

Conclusion
We compared our data and found that Hernia repair and Metabolic surgery can be done in the same sitting with favourable hernia and favourable obesity.

Data
Concomitant Bariatric with Hernia repair. (January 2008 to December 2021).
Total number of patients: 21.
BMI: 46.26 +/- 6.6.
No. of Sleeve Gastrectomy: 19/ IPOM/ No Recurrence/ No SSI.
No. of Gastric Bypass: 1/ PR/ No Recurrence.
No. of MGB: 1/ PR/ 3 years later IPOM + Repair.
Mean hospital stay: 2.5 days.
No. of Post op Mesh infections: 0.
DEVELOPING A SCORING SYSTEM FOR THE OBJECTIVE ASSESSMENT OF TOTALLY EXTRAPERITONEAL MINIMALLY INVASIVE INGUINAL HERNIA REPAIR SURGERY
Authors: Yeşilsoy M , Halil Özata I , Karahan S N , Sucu S , Tüfekçi T , Bozkurt E , Toprak S , Salim Uymaz D , Özoran E , Ağcaoğlu O , Balık E 
Published: May 2024

Abstract

Background
While existing checklists and scoring systems assess open surgery and TAPP (transabdominal preperitoneal procedure) surgeries, there is currently a lack of evaluation criteria and a dedicated checklist for TEP (totally extraperitoneal procedure) surgery. This study aims to develop a comprehensive checklist for guiding the procedural steps of minimally invasive TEP surgery and to establish a scoring system applicable to resident training.

Methods
This observational study, conducted at a single center, involved the evaluation of 60 unedited surgery videos performed by expert surgeons and 34 videos of residents by two independent experts. İnter-rater reliability between the two evaluators and construct validity of the scoring system assessed.

Results
The study demonstrated a robust level of inter-rater reliability, with a Cronbach's Alpha coefficient of 0.94. The median score (Interquartile Range, IQR) of resident surgeons was significantly lower than that of expert surgeons (17 [14-19] vs. 18.5 [17–19.375], p &lt;0.01). However, the median score of senior resident surgeons did not exhibit a statistically significant difference compared to expert surgeons (17 [16–20] vs. 18.5 [17–19.375], p = 0.192).

Conclusion
The developed scoring system demonstrates efficacy in evaluating TEP surgery and indicates a correlation with experience. Further investigations are needed to assess its applicability in diverse settings.
TEP Checklist Trocar insertion - 4 points Entering the preperitoneal space by taking the rectus muscle laterally 0 1 2 Entering adequately two trocars of 5 mm in the pre-peritoneal space 0 1 2 Creation of the preperitoneal space- 6 points Identifying the pubic symphysis in medially 0 1 2 Developing space laterally to the level of SIAS 0 1 2 Identifying the epigastric vessels and staying below it ventrally 0 1 2 Reduction of hernia sac - 4 points Reduction of hernia sac and cord lipomas 0 1 2 Peeling away the peritoneum down to the Cooper's ligament 0 1 2 Description of anatomy - 4 points Identification of ductus deferens and spermatic vessels 0 1 2 Determining the location of the iliac artery and vein 0 1 2 Mesh deployment - 2 points Closing all the potential hernia defects with an excellent appearance 0 1 2 TOTAL 20
Pain experience reduces social avoidance to others in pain: a c-Fos-based functional connectivity network study in mice
Authors: Li Jiali , Qin Yuxin , Zhong Zifeng , Meng Linjie , Huang Lianyan , Li Boxing 
Published: May 2024

Abstract
Pain experience increases individuals’ perception and contagion of others’ pain, but whether pain experience affects individuals’ affiliative or antagonistic responses to others’ pain is largely unknown. Additionally, the neural mechanisms underlying how pain experience modulates individuals’ responses to others’ pain remain unclear. In this study, we explored the effects of pain experience on individuals’ responses to others’ pain and the underlying neural mechanisms. By comparing locomotion, social, exploration, stereotyped, and anxiety-like behaviors of mice without any pain experience (naïve observers) and mice with a similar pain experience (experienced observers) when they observed the pain-free demonstrator with intraperitoneal injection of normal saline and the painful demonstrator with intraperitoneal injection of acetic acid, we found that pain experience of the observers led to decreased social avoidance to the painful demonstrator. Through whole-brain c-Fos quantification, we discovered that pain experience altered neuronal activity and enhanced functional connectivity in the mouse brain. The analysis of complex network and graph theory exhibited that functional connectivity networks and activated hub regions were altered by pain experience. Together, these findings reveal that neuronal activity and functional connectivity networks are involved in the modulation of individuals’ responses to others’ pain by pain experience.
CAIMP: Cross-Architecture IoT Malware Detection and Prediction Based On Static Feature
Authors: The Dung Luong , Ngoc Toan Nguyen , Nghi Phu Tran 
Published: May 2024

Abstract
IoT malware and cross-platform malware are currently the top threats to information systems. This paper proposes a robust cross-architecture IoT malware detection and prediction model based on machine learning and opcode features using a novel approach. In our method, a feature opcode transformation model between chip architecture platforms is proposed to facilitate the process of building a detection model for cross-architecture malware on IoT devices. The feature transformation model is capable of converting opcodes between different architecture platforms using an unsupervised machine learning approach. In our approach, a machine learning model is used for the detection of cross-platform malware based on the proposed opcode features. Experiments have demonstrated that our method is effective in detecting and predicting cross-platform malware with an accuracy of up to 99.4% and an F1-score of 99.3%. The method is capable of learning on one architecture platform and detecting malware on a different architecture platform. Therefore, the method can be used to develop cross-architecture detection and zero-day malware prediction solutions on IoT devices.
Marx Against Techno-Optimism
Authors: Royle Camilla 
Published: May 2024

Abstract
In the influential new book Marx in the Anthropocene: Towards the Idea of Degrowth Communism, Japanese academic Kohei Saito argues that Karl Marx made a theoretical breakthrough in later life. He abandoned his earlier interest in the development of productive forces and the possibilities raised by this for the realization of socialism. Marx intensively studied a range of topics including soil science and communal societies in this time and became what Saito refers to as a degrowth communist. Relatedly, according to Saito, Marx’s ecological work had a different character to that of Friedrich Engels. Saito bases his analysis on a careful analysis of Marx’s written work, including previously unpublished notebooks as well as theoretical engagements with theories of metabolism and metabolic rift. He shows how this remains relevant today in developing an ecological socialism that is cognizant of natural limits to growth and therefore capable of addressing capitalism’s unsustainable relationship to the natural world. Saito argues strongly that socialists cannot rely on technological solutions to ecological breakdown. His conception of ecological Marxism tends to play down discussions of socialist and working-class strategy. However, it nevertheless contributes much to our understanding of Marx as a non-determinist and non-Eurocentric thinker as well as someone whose work was grounded in materialist ecological thought.
Healthcare professionals’ perspectives on the use of PCSK9 inhibitors in cardiovascular disease: an in-depth qualitative study
Authors: Lee Geraldine A , Durante Angela , Baker Edward E , Vellone Ercole , Caggianelli Gabriele , Dellafiore Federica , Khan Mutiba , Khatib Rani 
Published: May 2024

Abstract

Aims
Injectable medicines such as PCSK9 inhibitors are increasingly used to manage risk factors for cardiovascular events with little information around the perceptions of healthcare professionals (HCPs) on the administrative and clinical practicalities. The aim was to identify the facilitators and barriers on the use of injectable therapies with cardiovascular benefits through interviews with HCPs.

Methods and results
Qualitative interviews were conducted in the UK (London and Leeds) and Italy (Rome and Milan) in 2021. Coding was undertaken using NVivo and thematic analysis performed. A total of 38 HCPs were interviewed, 19 in each country composing of physicians (n = 18), pharmacists (n = 10), nurses (n = 9), and pharmacy technician (n = 1). Four themes emerged: (i) clinicians’ previous experiences with injectable therapies, (ii) challenges with patients’ behaviours and beliefs, (iii) clinicians’ knowledge of injectable therapies and therapeutic inertia, and (iv) organizational and governance issues. The behaviour and beliefs from HCPs focused on facilitating behaviour change as well as the poor interdisciplinary working and collaboration. Therapeutic inertia was raised where physicians either lacked awareness of injectable therapies or were unwilling to prescribe them. The importance of facilitating patient education on injection techniques was highlighted, while organizational and governance issues identified the lack of guidance to inform practice. Clear pathways are required to identify those who were eligible for injectable therapies as well as on how injectables should be prescribed.

Conclusion
If medicine optimization is to be achieved, there need to be structured processes in place to identify eligible patients and the development of educational material.
The Intersection of Successful Aging and Family Caregiving
Authors: Bangerter Lauren R , Kim Yijung , Fields Beth , Wittke Michael Reese , Perepezko Kate 
Published: May 2024

Abstract
For the millions of older adults who rely on the support of a family caregiver, successful aging is not an individual achievement but a cooperative process between a care receiver and a caregiver. Yet, family caregivers are rarely incorporated into theoretical models of successful aging. Family caregivers also play an essential role in recent healthcare delivery movements that seek to better align care delivery with successful aging. Greater reliance on family caregivers by the U.S. healthcare system is occurring as an increasingly vocal constituency is tasking policymakers with developing and implementing federal and state health policies that would help build the national infrastructure needed to support them. This paper provides a critical discussion of how family caregivers actualize successful aging for older adults. We highlight the key role of family caregivers in healthcare delivery innovations aimed at facilitating successful aging and discuss policies that support family caregivers. As successful aging continues to evolve as a dominating framework in the literature, we conclude with key recommendations for how research, policy, and practice efforts in successful aging can be more inclusive and supportive of family caregivers.