bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL STUDY OF ACQUIRED LARGE ABDOMINAL WALL DEFECT REPAIR WITH MULTI-LAYER MESH BRIDGING TECHNIQUE
Authors: Song Z , Yang J , Gu Y 
Published: May 2024

Abstract

Aim
To investigate the clinical efficacy of double-layer mesh (synthetic + biological) and “sandwich” mesh (synthetic + biological + omentum flaps) bridging techniques for the repair of large abdominal wall defect patients.

Methods
The clinical data of patients with large abdominal wall defect after extensive resection of abdominal neoplasms or patients with acquired large abdominal wall defect underwent multi-layer mesh bridging technique were enrolled. Patients were divided into the double-layer group (group A) and the “sandwich” group (group B).

Results
23 patients underwent successful operation without perioperative mortality and serious complications. The mean abdominal wall defect area was 211.50 ± 91.01 cm2 in group A, 359.82 ± 203.96 cm2 in group B. Mean operation time was 6.92 ± 2.19 hours in group A and 5.18 ± 1.17 hours in group B. There were 6 seromas in group A and 1 in group B. Postoperatively, in group A there was 1 infection, and 3 subcutaneous effusions, whereas in group B, there was 1 hematoma, 1 subcutaneous effusion, and 1 incomplete intestinal obstruction. There was a significant difference in the short-term complication rate between the two groups.

Conclusions
The “sandwich” mesh bridging technique based on an omentum flap is novel and safe, and can effectively reduce postoperative complication rate. This technique can be considered as an alternative repair method for large abdominal wall defect repair and reconstruction.
LYMPHOCYTE/CRP LEVELS IN EMERGENCY OPERATED INCARCERATED HERNIAS FOR PREDICTING THE LEVEL OF ISCHEMIA
Authors: Temel R , Gümüş T , Tunalı S , Ersin S 
Published: May 2024

Abstract

Background
A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ through the body wall. Incarcerated or strangulated hernias may present with nausea, vomiting or abdominal pain and emergency surgery may be required.

Method
In our study, 132 patients admitted to the emergency department for incarcerated hernia between the year 2020 and 2022 were retrospectively evaluated. Patients were divided into two groups according to the need for resection; demographic data, WBC, LDH, lactate and Lymphocyte/CRP (L/C) ratios that may be predictive for ischaemia were evaluated.

Results
The mean age of the patients was 67.37 ± 14.52 years, 70 (53%) were male and 62 (47%) were female.47 (35.6%) were operated for incisional hernia; 19 (14.4%) for umbilical hernia, 56 (42.4%) for inguinal hernia and 10 (7.6%) for femoral hernia. Resection was performed in 37 patients (28%); 29 (22%) of them had intestinal resection and 8 (6.1%) had colon resection. Patients were divided into two groups according to resection; no difference was found in WBC, LDH and lactate levels. The mean L/C ratio was 0.30 ± 0.74 in the resection group and 1.43 ± 3.66 in the non-resection group (p &lt;0.001). The L/C ratio was evaluated by ROC analysis. Area under the curve was 70.1% [0.595–0.797]. Cut-off value was calculated and found as 0.0409. Patients were divided into two groups according to cut-off value, it was founded that resection was performed in patients with lower L/C ratio (p &lt;0.001).

Conclusion
In our study, it was statistically shown that the need for resection decreased as the L/C ratio increased. The L/C ratio can be used as a simple, effective and inexpensive method to predict ischaemia in incarcerated hernias.
LONG-TERM OUTCOMES OF TRANSABDOMINAL PREPERITONEAL INGUINAL HERNIA REPAIR USING A SELF-FIXATING MESH
Authors: Tomyak I , Neterdová M , Whitley A , Subrt Z , Bafrnec J 
Published: May 2024

Abstract

Aim
This retrospective study aims to assess the long-term outcomes of transabdominal preperitoneal inguinal hernia repair using a self-fixating mesh in a day surgery setting.

Methods
A retrospective analysis was conducted on patients who underwent transabdominal preperitoneal inguinal hernia repair using a self-fixating mesh between January 2016 and January 2018 at a single surgery center. Patients were contacted via telephone and administered a questionnaire, which included a modified Carolina score, and questions on inguinal pain, hernia recurrence, and complications. Follow-up duration.

Results
The median follow-up duration was 76 months (range 68–92). Recurrence was reported in 3 patients (6%) and chronic groin pain in 4 patients (8%). No cases of mesh migration were reported. Thirty-three patients (66%) returned to their daily activities within 6 weeks, 10 patients (20%) within one week, and 6 patients (12%) after 6 weeks.

Conclusion
Our study shows that transabdominal preperitoneal inguinal hernia repair with a self-fixating mesh is associated with a fast return to normal activities and has excellent long-term results, with a low rate of recurrence and chronic groin pain.
CONTINUOUS DERMIC TRACTION WITH VESSEL-LOOP SHOELACE TECHNIQUE FOR ABDOMINAL WALL DEHISCENCE
Authors: Torres A , Clavell A , Gené C , Segarra A , Malagón P , Carrasco C , Cuadrado M M 
Published: May 2024

Abstract

Background
The aim of this case is to highlight the importance of strict selection criteria and patient optimization for enhancing outcomes in complex abdominal wall surgery.

Methods
A fifty-five year-old woman, with a history of diabetes, hypertension, sigmoidectomy and grade IV obesity (BMI 42.8 kg/m2), was counseled for a midline hernia repair (M2–M4, W3). A posterior separation of components with PVDF and PP mesh placement in the retromuscular space was conducted.
In the immediate postoperative period, the patient developed respiratory failure, due to abdominal compartment syndrome requiring emergent surgery with mesh removal and an open abdomen treated with Abthera® negative pressure therapy (NPT). After two months in the ICU and NPT without aponeurotic retention, the patient was transferred to our center for definitive treatment.

Results
The patient arrived with complete abdominal viscera exposure. While a nutritional and respiratory optimization was performed, continuous and progressive dermic traction using a vessel-loop shoelace technique and NPT were applied in order to achieve a progressive abdominal wound closure.
Finally, when the skin was sufficient, a new surgery was planned to cover the exposed bowels, where only the cutaneous and subcutaneous planes could be closed. A small dehiscence in the M3 region was treated with skin grafting from the thigh. The patient has since returned home with restored quality of life.

Conclusion
Inadequate preoperative selection or optimization can lead to life-threatening consequences for the patient. We should promote intensive nutritional education and firmly avoid performing complex abdominal wall procedures in obese patients.
INGUINAL HERNIA REPAIR: TRANSABDOMINAL PREPERITONEAL (TAPP) VERSUS LICHTENSTEIN HERNIOPLASTY
Authors: Touzi M A , Khefacha F , Saidani A , Belhadj A , Chebbi F 
Published: May 2024

Abstract

Background
Inguinal hernias are one of the most common surgical pathologies in digestive surgery. The classical Lichtenstein repair (LR), long-considered as the gold standard, has been challenged since the 1990s by a minimally-invasive laparoscopic technique (TAPP). The aim of this study was to compare the short- and medium-term postoperative outcomes between LR and TAPP.

Methods
We conducted a cross-sectional study including tunisian patients followed up for inguinal hernia repair in the digestive surgery department, over a period of a year.
The study population was prospectively randomized between January 2020 and December 2020 to receive either LR or TAPP. The main outcome measure was hernia recurrence. Chronic postoperative pain and quality of life were the secondary outcome measures.

Results
Twenty-five patients underwent TAPP repair and 31 underwent LR. The average age of patients was 53.2 years. In the TAPP group, the operative time was significantly longer (p = 0.002) and the recovery was faster (p = 0.005). The LR group had higher visual analogue scale scores in the early postoperative (p &lt;0.001), higher morbidity rate (p = 0.003) and complications such as hematomas (p = 0.022) and seromas (p = 0.043). Chronic postoperative pain was more prevalent in the LR Group than the TAPP group (p = 0.022). Both the LR and TAPP had no recurrences of hernia.

Conclusion
The TAPP procedure, despite the longer operative time, provided patients with postoperative comfort, fast recovery, less complications and reduced postoperative pain.
COMPLEX ABDOMINAL WALL RECONSTRUCTION (CAWR) IN PORT SITE METASTASES (PSM) WITH PERMANENT POLYPROPYLENE REINFORCED TISSUE MATRIX (PPRTM)
Authors: Zanellato A , Ryan N , May J 
Published: May 2024

Abstract

Objective
to report the use of a PPRTM for CAWR after PSMs resection. Our report highlights the possibility of bridging 2 larges defects with a single mesh with no need of myocutaneous flaps that are common reconstructive options for oncologic defects.

Case Report
79F with endometrial cancer presented with several anterior abdominal wall masses. Biopsy confirmed PSMs. Given their isolated nature, the two PSMs on right (9 × 6 cm) and one on left (4 × 3 cm) iliac fossa were resected with a 5 mm margin, resulting in two large bilateral defects. The pre-peritoneal space below acuate to arcuate was dissected to create sufficient space to wrap the abdominal wall with a single piece. On the right side, the gap was significantly bigger, and the therefore a transverse abdominal release (TAR) was performed to create space for overlapping cranially. An 40 × 25 cm was trimmed to cover the space completely. The gaps were partially reapproximated and attached to the mesh. A seroma was drained in the clinic on day 22 post-operatively. Follow-up at six months demonstrated good integrity of abdominal wall with no bulge.

Conclusion
Abdominal wall reconstruction after full thickness PSMs resection is challenging. It can be performed safely and effectively with attention to surgical technique, patients' risk of infection, and type of mesh, avoiding myocutaneous flaps. PPRTM would seem to be an adequate implant to perform the bridging repair, minimize morbidity and recurrence in these high-risk patients.
Biomechanical instability of the brain–CSF interface in hydrocephalus
Authors: Duy Phan Q , Mehta Neel H , Kahle Kristopher T 
Published: May 2024

Abstract
Hydrocephalus, characterized by progressive expansion of the CSF-filled ventricles (ventriculomegaly), is the most common reason for brain surgery. ‘Communicating’ (i.e. non-obstructive) hydrocephalus is classically attributed to a primary derangement in CSF homeostasis, such as choroid plexus-dependent CSF hypersecretion, impaired cilia-mediated CSF flow currents, or decreased CSF reabsorption via the arachnoid granulations or other pathways. Emerging data suggest that abnormal biomechanical properties of the brain parenchyma are an under-appreciated driver of ventriculomegaly in multiple forms of communicating hydrocephalus across the lifespan. We discuss recent evidence from human and animal studies that suggests impaired neurodevelopment in congenital hydrocephalus, neurodegeneration in elderly normal pressure hydrocephalus and, in all age groups, inflammation-related neural injury in post-infectious and post-haemorrhagic hydrocephalus, can result in loss of stiffness and viscoelasticity of the brain parenchyma. Abnormal brain biomechanics create barrier alterations at the brain–CSF interface that pathologically facilitates secondary enlargement of the ventricles, even at normal or low intracranial pressures. This ‘brain-centric’ paradigm has implications for the diagnosis, treatment and study of hydrocephalus from womb to tomb.
Learning of the same task subserved by substantially different mechanisms between patients with body dysmorphic disorder and healthy individuals
Authors: Wang Zhiyan , Tan Qingleng , Frank Sebastian M , Sasaki Yuka , Sheinberg David , Phillips Katharine A , Watanabe Takeo 
Published: May 2024

Abstract
It has remained unclear whether individuals with psychiatric disorders involving altered visual processing employ similar neuronal mechanisms during perceptual learning of a visual task. We investigated this question by training patients with body dysmorphic disorder, a psychiatric disorder characterized by distressing or impairing preoccupation with nonexistent or slight defects in one’s physical appearance, and healthy controls on a visual detection task for human faces with low spatial frequency components. Brain activation during task performance was measured with functional magnetic resonance imaging before the beginning and after the end of behavioral training. Both groups of participants improved performance on the trained task to a similar extent. However, neuronal changes in the fusiform face area were substantially different between groups such that activation for low spatial frequency faces in the right fusiform face area increased after training in body dysmorphic disorder patients but decreased in controls. Moreover, functional connectivity between left and right fusiform face area decreased after training in patients but increased in controls. Our results indicate that neuronal mechanisms involved in perceptual learning of a face detection task differ fundamentally between body dysmorphic disorder patients and controls. Such different neuronal mechanisms in body dysmorphic disorder patients might reflect the brain’s adaptations to altered functions imposed by the psychiatric disorder.
Continuous decision to wait for a future reward is guided by fronto-hippocampal anticipatory dynamics
Authors: Shintaki Reiko , Tanaka Daiki , Suzuki Shinsuke , Yoshimoto Takaaki , Sadato Norihiro , Chikazoe Junichi , Jimura Koji 
Published: May 2024

Abstract
Deciding whether to wait for a future reward is crucial for surviving in an uncertain world. While seeking rewards, agents anticipate a reward in the present environment and constantly face a trade-off between staying in their environment or leaving it. It remains unclear, however, how humans make continuous decisions in such situations. Here, we show that anticipatory activity in the anterior prefrontal cortex, ventrolateral prefrontal cortex, and hippocampus underpins continuous stay–leave decision-making. Participants awaited real liquid rewards available after tens of seconds, and their continuous decision was tracked by dynamic brain activity associated with the anticipation of a reward. Participants stopped waiting more frequently and sooner after they experienced longer delays and received smaller rewards. When the dynamic anticipatory brain activity was enhanced in the anterior prefrontal cortex, participants remained in their current environment, but when this activity diminished, they left the environment. Moreover, while experiencing a delayed reward in a novel environment, the ventrolateral prefrontal cortex and hippocampus showed anticipatory activity. Finally, the activity in the anterior prefrontal cortex and ventrolateral prefrontal cortex was enhanced in participants adopting a leave strategy, whereas those remaining stationary showed enhanced hippocampal activity. Our results suggest that fronto-hippocampal anticipatory dynamics underlie continuous decision-making while anticipating a future reward.
Recognizing ideas generated in a creative task: the roles of the hippocampus and medial prefrontal cortex in facilitating self-generated learning
Authors: Ding Ke , He Ruizhi , Wang Xi , Chen Qunlin , Kenett Yoed N 
Published: May 2024

Abstract
Creative idea generation plays an important role in promoting successful memory formation. Yet, its underlying neural correlates remain unclear. We investigated the self-generated learning of creative ideas motivated by the schema-linked interactions between medial prefrontal and medial temporal regions framework. This was achieved by having participants generate ideas in the alternative uses task, self-evaluating their ideas based on novelty and source (i.e. new or old), and then later being tested on the recognition performance of the generated ideas. At the behavioral level, our results indicated superior performances in discriminating novel ideas, highlighting the novelty effect on memory. At the neural level, the regions-of-interest analyses revealed that successful recognition of novel ideas was associated with greater activations in the hippocampus (HPC) and medial prefrontal cortex (mPFC) during ideation. However, only activation in the right HPC was positively related to the successful recognition of novel ideas. Importantly, the weaker the connection between the right HPC and left mPFC, the higher the recognition accuracy of novel ideas. Moreover, activations in the right HPC and left mPFC were both effective predictors of successful recognition of novel ideas. These findings uniquely highlight the role of novelty in promoting self-generated learning of creative ideas.
JrPHL8-JrWRKY4-JrSTH2L module regulates resistance to Colletotrichum gloeosporioides in walnut
Authors: Mu Yutian , Dong Yuhui , Li Xichen , Gong Andi , Yu Haiyi , Wang Changxi , Liu Jianning , Liang Qiang , Yang Keqiang , Fang Hongcheng 
Published: May 2024

Abstract
Walnut anthracnose (Colletotrichum gloeosporioides) reduces walnut yield and quality and seriously threatens the healthy development of the walnut industry. WRKY transcription factors (TFs) are crucial regulatory factors involved in plant-pathogen interactions. Our previous transcriptome analysis results indicate that JrWRKY4 responds to infection by C. gloeosporioides, but its specific regulatory network and disease resistance mechanism are still unclear. Herein, the characteristics of JrWRKY4 as a transcription activator located in the nucleus were first identified. Gain-of-function and loss-of-function analyses showed that JrWRKY4 could enhance walnut resistance against C. gloeosporioides. A series of molecular experiments showed that JrWRKY4 directly interacted with the promoter region of JrSTH2L and positively regulated its expression. In addition, JrWRKY4 interacted with JrVQ4 to form the protein complex, which inhibited JrWRKY4 for the activation of JrSTH2L. Notably, a MYB TF JrPHL8 interacting with the JrWRKY4 promoter has also been identified, which directly bound to the MBS element in the promoter of JrWRKY4 and induced its activity. Our study elucidated a novel mechanism of the JrPHL8-JrWRKY4-JrSTH2L in regulating walnut resistance to anthracnose. This mechanism improves our understanding of the molecular mechanism of WRKY TF mediated resistance to anthracnose in walnut, which provides new insights for molecular breeding of disease-resistant walnuts in the future.
Ebola Virus–Specific Neutralizing Antibody Persists at High Levels in Survivors 2 Years After Resolution of Disease in a Sierra Leonean Cohort
Authors: Bond Nell G , Shore Kayla R , Engel Emily J , Coonan Erin E , Al-Hasan Foday , Gbakie Michael A , Kamara Fatima K , Kanneh Lansana , Momoh Mambu , Kanneh Ibrahim M , Sandi John D , Elliott Debra , Ficenec Samuel C , Smira Ashley R , Fischer William A , Wohl David A , Robinson James E , Shaffer Jeffrey G , Garry Robert F , Samuels Robert J , Grant Donald S , Schieffelin John S 
Published: May 2024

Abstract
Ebola virus (EBOV) infection results in Ebola virus disease (EVD), an often severe disease with a nonspecific presentation. Since its recognition, periodic outbreaks of EVD continue to occur in sub-Saharan Africa. The 2013–2016 West African EVD outbreak was the largest recorded, resulting in a substantial cohort of EVD survivors with persistent health complaints and variable immune responses. In this study, we characterize humoral immune responses in EVD survivors and their contacts in Eastern Sierra Leone. We found high levels of EBOV IgG in EVD survivors and lower yet substantial antibody levels in household contacts, suggesting subclinical transmission. Neutralizing antibody function was prevalent but variable in EVD survivors, raising questions about the durability of immune responses from natural infection with EBOV. Additionally, we found that certain discrete symptoms—ophthalmologic and auditory—are associated with EBOV IgG seropositivity, while an array of symptoms are associated with the presence of neutralizing antibody.
Mapping model between lateral responses of bridges under random traffic loads based on data-driven approach
Authors: Yang Gan , Chen Shizhi , Wang Junfeng , Zhang Shuying 
Published: May 2024

Abstract
The lateral distribution characteristic of a bridge is one of the important features reflecting its in-service state. Conventional deterministic indicators often struggle to consider this time-varying feature. In this study, a data-driven approach is employed to establish the mapping model among responses at the different lateral positions using the eXtreme Gradient Boosting model optimized by the Bayesian optimization algorithm. The proposed method is validated based on both data from a bridge health monitoring system equipped on an actual bridge and data from numerical simulation. At different lateral positions of the actual bridge, the overall coefficient of determination (R2) of the strain response mapped by the model is above 0.991, and the overall root mean squared error (RMSE) of the strain response mapped by the model are below 1.159 με. The numerical simulation method is used to consider a variety of working conditions with different road surface roughness and different traffic densities. Under different working conditions, the overall R2 of the deflection response mapped by the model is still above 0.961, and the overall RMSE of the deflection response mapped by the model is below 0.249 mm. These indicate that the proposed model can consider time-varying mapping relationships among responses at different lateral positions, and has good accuracy and applicability.
Antibiotic utilization patterns in Tanzania: a retrospective longitudinal study comparing pre- and intra-COVID-19 pandemic era using Tanzania Medicines and Medical Devices Authority data
Authors: Sangeda Raphael Z , William Sahani M , Masatu Faustine C , Bitegeko Adonis , Mwalwisi Yonah H , Nkiligi Emmanuel A , Horumpende Pius G , Fimbo Adam M 
Published: May 2024

Abstract

Background
Antimicrobial resistance (AMR) is a growing public health concern globally, and misuse of antibiotics is a major contributor.

Objective
This study investigated antibiotic utilization patterns before and during the COVID-19 pandemic in Tanzania using data from the Tanzania Medicines and Medical Devices Authority (TMDA).

Methods
This retrospective longitudinal study analysed secondary data. The study compared antibiotics consumption in defined daily doses per 1000 inhabitants per day (DID) in two distinct eras: 2018–2019 as the pre-COVID-19 era and 2020–2021 as the intra-COVID-19 era. A sample t-test was conducted using Statistical Package for the Social Sciences.

Results
The study analysed 10 614 records and found an overall increase in antibiotics consumption from 2018 to 2021. We found that the consumption was 61.24 DID in the intra-COVID-19 era and 50.32 DID in the pre-COVID-19 era. Levofloxacin had the highest percentage increase in use, with a 700% increase in DID during the intra-COVID-19 era. Azithromycin had a 163.79% increase, while cefotaxime had a 600% increase. By contrast, some antibiotics exhibited a decrease in usage during the intra-COVID-19 era, such as nalidixic acid, which had a 100% decrease, and cefpodoxime, which had a 66.67% decrease.

Conclusions
Increased antibiotic consumption during the COVID-19 pandemic highlights the importance of implementing effective antimicrobial stewardship strategies to prevent AMR, especially during pandemics.