bluuebunny/crossref_metadata_2025_split huggingface dataset:
4. ULTRASOUND STUDY OF TROCAR HERNIA IN POST-OPERATED PATIENTS OF BARIATRIC SURGERY: MEDIUM AND LONG-TERM FOLLOW-UP
Authors: López-Negrete Cueto E , Rodicio Miravalles J L , Suárez Sánchez A , Amoza Pais S , Moreno Gijón M , Noriega Menéndez P , Montes García A , Sanz Álvarez L 
Published: February 2024

Abstract

Introduction
Patients undergoing bariatric surgery have comorbidities and risk factors that increase the likelihood of incisional hernias. Bladeless trocars are safe and not very harmful, so we opted not to close them due to the difficulty they present in these patients.

Methods
Observational, descriptive, longitudinal, and retrospective study in patients who underwent bariatric surgery by laparoscopy with 12mm trocars without a blade or fascial closure between January 2015 and July 2016. Data on risk factors, pain scale, and ultrasound of ports by an expert radiologist in 2018 and 2022.

Results
A total of 45 patients, with a mean age of 49.9 years and an initial BMI of 45.5 kg/m², were included in the study. The majority (88.9%) underwent gastric bypass, while the rest underwent vertical gastrectomy. In 2018, 45 abdominal wall ultrasounds were conducted, revealing 7 trocar hernias out of 225 explored ports (3.1%). All hernias were located in the epigastric port and were asymptomatic. In 2022, 32 ultrasound scans were performed with findings of 7 hernias (4.4%), 3 new and 4 known, with 2 symptomatic patients at the site of the hernia with mild symptoms not consulted.

Conclusion
The incidence of trocar hernia in the medium and long term following bariatric surgery with 12mm ports, without blade or fascial closure, is notably low, with all cases located in the midline (p&lt;0.00001). These findings lead us to question the necessity of closing transmuscular accesses and assess the closure or lateralization of the midline trocar.
9. OPEN ABDOMEN: ANALYSIS OF RESULTS AFTER 7 YEARS SINCE ITS PROTOCOLIZATION IN A THIRD-LEVEL HOSPITAL
Authors: García Alonso L , Rodicio Miravalles J L , López-Negrete Cueto E , Íbero Casadiego P , Del Val Ruiz P , Amoza Pais S , Moreno Gijón M , Sanz Álvarez L 
Published: February 2024

Abstract

Introduction
The open abdomen (OA) procedure is a useful resource in critical situations. Its use has increased significantly since the development of negative pressure therapy (NPT) and the implementation of specific protocols.

Methods
Retrospective descriptive study in a third level hospital between January 2015 and December 2022. All patients who required OA were included.

Results
92 patients (68 men, 24 women) underwent surgery, with a mean age of 65 years, 65.3% were ASA 3-4. Although there were multiple indications for open abdomen, more than 50% were due to intestinal ischemia or damage control surgery.
45 patients were closed without need of replacement, while in the remaining cases, the first replacement was conducted within 48-72 hours, requiring a mean of 3.5 changes. 14 patients died before the definitive closure.
Of the 78 patients who were closed, 24 patients died before discharge, there were 54 survivors.
The median follow-up time was 22 months. Among the 30 patients with primary fascial closure, 5 developed incisional hernias. In contrast, among the 43 patients treated with prophylactic mesh, there were no instances of eventrations, although one case of chronic rejection and one of enterocutaneous fistula were reported. 9 patients died during follow-up.

Conclusion
Although OA is a useful resource, it must not be forgotten that it is used in complex patients with high morbidity and mortality in the short and long term. These patients have multiple risk factors for the development of incisional hernias, justifying the use of prophylactic mesh.
18. RISK FACTORS FOR EVISCERATION IN PATIENTS UNDERGOING MIDLINE LAPAROTOMY AT A TERTIARY HOSPITAL
Authors: Nieto Martos M R , Bajawi Carretero M , Andrade Yagual A A , Oto González D , Fernández Cebrián J M 
Published: February 2024

Abstract

Introduction
Evisceration is a frequent complication in patients undergoing median laparotomy that results in a significant increase in morbidity and mortality, hospital stay and healthcare expenditure. Numerous risk factors associated with the appearance of this complication have been described without being able to determine the individual influence of each one of them. Our aim is to describe the most frequent risk factors in our sample.

Methods
We retrospectively collected all eviscerations registered in our center between January 1, 2010 and December 31, 2020 in patients undergoing median laparotomy. Seventy-five cases were recruited. Seventy-five controls undergoing median laparotomy in the same time period were collected and associated risk factors were analyzed.

Results
The risk factors that were statistically significant were male sex (protective factor with OR 6.4 CI95% 3.4-7.6), COPD (OR 5.6 CI95% 1.69-19.9), surgical wound infection (OR 3.49 CI95% 1.86-14.1), ileus (OR 14.7 CI95% 1.66-131.40) and anastomotic dehiscence (OR 7.58 CI95% 1.76-32.50). No statistically significant differences were found between the different types of sutures used for abdominal wall closure. 92% of the cases underwent surgical repair, 8% were managed conservatively. Postoperative mortality was 16%.

Conclusion
The occurrence of evisceration appears to be related to risk factors associated with the patients' pre-existing comorbidities and postoperative complications.
27. OBJECTIVE ANALYSIS OF ERGONOMICS IN ROBOTIC MICROSURGERY
Authors: Kappel M , Sánchez Margallo J A , Pérez Salazar M J , González Nuño F M , Pires Louça L C , Sánchez Margallo F M 
Published: February 2024

Abstract

Introduction
This study compares the surgeon's ergonomics during the performance of microsurgical procedures using a robotic platform and conventional techniques. The study evaluates the differences in the surgeons' muscle activity.

Methods
Four surgeons with expertise in microsurgery participated in this study. They performed various microsurgical and supermicrosurgical procedures, including vascular and lymphatic-venous anastomoses. The procedures were performed by both robotic and conventional techniques. Muscle activity of five muscle groups was recorded bilaterally using a wireless electromyography system. For analysis, derivation of the evolution of mean frequencies and amplitudes was calculated to quantify muscle fatigue.

Results
Less muscle activity was observed with the use of the robot for the upper trapezius. In contrast, the brachioradialis shows higher muscle activity in robotic surgery. The erector spinae, medial trapezius and abductor did not show significant differences in terms of median but in terms of distribution. As for muscle fatigue, it is less dispersed among subjects in robotic surgery and tends to be less accentuated than with the conventional surgical technique.

Conclusion
According to muscle activity indicators, ergonomics differs in conventional and robotic surgery depending on the muscle group. However, preliminary results show less muscle fatigue in robotic surgery.
Incident Proteinuria by HIV Serostatus Among Men With Pre­–Diabetes Mellitus: The Multicenter AIDS Cohort Study
Authors: Slama Laurence , Barrett Benjamin W , Abraham Alison G , Palella Frank J , Magnani Jared W , Viard Jean Paul , Lake Jordan E , Brown Todd T 
Published: February 2024

Abstract

Background
Pre–diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons.

Methods
The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100–125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%–6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) &gt;200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria.

Results
Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3–4.8 times) greater than in PWOH (P &lt; .01). Among PWH, current CD4 cell count &lt;50/µL (P &lt; .01) and current use of protease inhibitors (P = .03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk.

Conclusions
Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.
Exposure to air pollution is associated with DNA methylation changes in sperm
Authors: Schrott Rose , Feinberg Jason I , Newschaffer Craig J , Hertz-Picciotto Irva , Croen Lisa A , Fallin M Daniele , Volk Heather E , Ladd-Acosta Christine , Feinberg Andrew P 
Published: February 2024

Abstract
Exposure to air pollutants has been associated with adverse health outcomes in adults and children who were prenatally exposed. In addition to reducing exposure to air pollutants, it is important to identify their biologic targets in order to mitigate the health consequences of exposure. One molecular change associated with prenatal exposure to air pollutants is DNA methylation (DNAm), which has been associated with changes in placenta and cord blood tissues at birth. However, little is known about how air pollution exposure impacts the sperm epigenome, which could provide important insights into the mechanism of transmission to offspring. In the present study, we explored whether exposure to particulate matter less than 2.5 microns in diameter, particulate matter less than 10 microns in diameter, nitrogen dioxide (NO2), or ozone (O3) was associated with DNAm in sperm contributed by participants in the Early Autism Risk Longitudinal Investigation prospective pregnancy cohort. Air pollution exposure measurements were calculated as the average exposure for each pollutant measured within 4 weeks prior to the date of sample collection. Using array-based genome-scale methylation analyses, we identified 80, 96, 35, and 67 differentially methylated regions (DMRs) significantly associated with particulate matter less than 2.5 microns in diameter, particulate matter less than 10 microns in diameter, NO2, and O3, respectively. While no DMRs were associated with exposure to all four pollutants, we found that genes overlapping exposure-related DMRs had a shared enrichment for gene ontology biological processes related to neurodevelopment. Together, these data provide compelling support for the hypothesis that paternal exposure to air pollution impacts DNAm in sperm, particularly in regions implicated in neurodevelopment.
Successful ablation of Purkinje ectopy–triggered ventricular fibrillation storm in a patient with orthotopic heart transplantation and severe SARS-CoV-2 pneumonia: a case report
Authors: Khalaph Moneeb , Costard-Jäckle Angelika , Braun Martin , El Hamriti Mustapha 
Published: February 2024

Abstract

Background
Catheter ablation is one of the most effective treatment options for patients with drug-refractory, scar-related monomorphic ventricular tachycardia (VT). In selected cases, catheter ablation also plays an important role in treatment of polymorphic VT (PMVT) and/or ventricular fibrillation (VF). Rarely, premature ventricular contractions (PVCs) originating from the Purkinje network can induce PMVT/VF. Ablation and elimination of these PVCs can prevent VF recurrences.

Case summary
A 41-year-old patient with a history of orthotopic heart transplantation (HTX) 8 years before admission and newly diagnosed SARS-CoV-2 pneumonia was referred to our centre after experiencing several episodes of drug-refractory VF. An electrophysiological study showed ectopy-triggered VF originating from the anterior and posterior fascicles of the left bundle branch (LBB). Ablation of these PVCs from the LBB led to complete elimination of VF. A subcutaneous implantable cardioverter defibrillator was implanted as secondary prophylaxis. During the observation period of 6 months, no VF recurrence was observed.

Conclusion
Identifying and eliminating the trigger (PVCs) can be life-saving and prevent VF in the specific cohort of HTX patients. High-density mapping using multipolar catheters with microelectrodes contributes significantly to our understanding of tachycardia mechanisms.
Tricuspid valve agenesis: a case report of a rare cause of tricuspid regurgitation in an adult
Authors: Raicea Victor C , Mirea Oana , Berceanu Mihaela C , Raicea Andrei D 
Published: February 2024

Abstract

Background
Tricuspid valve agenesis is an exceptionally rare congenital cardiac disease characterized by the incomplete formation or complete absence of one or more tricuspid leaflets. It is commonly diagnosed during childhood due to the development of heart failure symptoms.

Case summary
We report the case of a 62-year-old woman admitted for a worsening of heart failure symptoms (New York Heart Association functional Class IV at admission). A standard transthoracic echocardiogram was performed, which showed severe right heart dilatation and severe tricuspid regurgitation. A three-dimensional echocardiogram revealed the absence of the posterior tricuspid leaflet. The patient underwent an uncomplicated surgical bioprosthetic valve replacement with a favourable outcome and partial recovery of right ventricular function. In our patient, valve repair was not favoured due to the additional mild hypoplasia of the anterior leaflet. The 3-month post-operative evolution of the patient was favourable, with significant symptom relief.

Discussion
The diagnosis of tricuspid agenesis during adulthood is uniquely uncommon. A three-dimensional echocardiography can provide accurate pre-procedural insight into the valve anatomy, allowing surgeons to plan for either valve repair when the anatomy is suitable or valve replacement.
Cardiovascular magnetic resonance imaging-derived intraventricular pressure gradients in ST-segment elevation myocardial infarction: a long-term follow-up study
Authors: Konijnenberg Lara S F , Beijnink Casper W H , van Lieshout Maarten , Vos Jacqueline L , Rodwell Laura , Bodi Vicente , Ortiz-Pérez José T , van Royen Niels , Rodriguez Palomares José , Nijveldt Robin 
Published: February 2024

Abstract

Aims
Recently, novel post-processing tools have become available that measure intraventricular pressure gradients (IVPGs) on routinely obtained long-axis cine cardiac magnetic resonance (CMR) images. IVPGs provide a comprehensive overview of both systolic and diastolic left ventricular (LV) functions. Whether IVPGs are associated with clinical outcome after ST-elevation myocardial infarction (STEMI) is currently unknown. Here, we investigated the association between CMR-derived LV-IVPGs and major adverse cardiovascular events (MACE) in a large reperfused STEMI cohort with long-term outcome.

Methods and results
In this prospectively enrolled multi-centre cohort study, 307 patients underwent CMR within 14 days after the first STEMI. LV-IVPGs (from apex-to-base) were estimated on the long-axis cine images. During a median follow-up of 9.7 (5.9–12.5) years, MACE (i.e. composite of cardiovascular death and de novo heart failure hospitalisation) occurred in 49 patients (16.0%). These patients had larger infarcts, more often microvascular injury, and impaired LV-IVPGs. In univariable Cox regression, overall LV-IVPG was significantly associated with MACE and remained significantly associated after adjustment for common clinical risk factors (hazard ratio (HR) 0.873, 95% confidence interval (CI) 0.794–0.961, P = 0.005) and myocardial injury parameters (HR 0.906, 95% CI 0.825–0.995, P = 0.038). However, adjusted for LV ejection fraction and LV global longitudinal strain (GLS), overall LV-IVPG does not provide additional prognostic information (HR 0.959, 95% CI 0.866–1.063, P = 0.426).

Conclusion
Early after STEMI, CMR-derived LV-IVPGs are univariably associated with MACE and this association remains significant after adjustment for common clinical risk factors and measures of infarct severity. However, LV-IVPGs do not add prognostic value to LV ejection fraction and LV GLS.
Training simulator efficacy in developing thoracic and general surgical skills in a residency programme: a pilot study
Authors: Grossi Sarah , Cattoni Maria , Filipponi Luca , Marzorati Alessandro , Rotolo Nicola , Carcano Giulio , Imperatori Andrea 
Published: February 2024

Abstract

OBJECTIVES
Virtual training simulators have been introduced in several surgical disciplines to improve residents’ abilities. Through the use of the LapSim® virtual training simulator (Surgical Science, Göteborg, Sweden), this study aims to plan an effective learning path in minimally invasive thoracic and general surgery.

METHODS
All thoracic and general surgery trainees in their 1st and 2nd year of residency at the University of Insubria were enrolled and randomized into 2 groups: residents undergoing an intensive twice-a-week virtual training programme (group A: n = 8) and those undergoing a once-weekly non-intensive virtual training programme (group B: n = 9). The virtual training programme was divided into 4 modules, each of 12 weeks. In the 1st module, trainees repeated grasping, cutting, clip application, lifting and grasping, and fine dissection exercises during each training session. Seal-and-cut exercise was performed as the initial and final test. Data on surgical manoeuvres (time and on mistakes) were collected; intra- and inter-group comparisons were planned.

RESULTS
No significant differences were observed between groups A and B at the 1st session, confirming that the 2 groups had similar skills at the beginning. After 12 weeks, both groups showed improvements, but comparing data between initial and final test, only Group A registered a significant reduction in total time (P-value = 0.0015), left (P-value = 0.0017) and right (P-value = 0.0186) instrument path lengths, and in left (P-value = 0.0010) and right (P-value = 0.0073) instrument angular path lengths, demonstrating that group A acquired greater precision in surgical manoeuvres.

CONCLUSIONS
Virtual simulator training programme performed at least twice a week was effective for implementing basic surgical skills required for the trainee’s professional growth. Additional virtual training modules focused on more complex exercises are planned to confirm these preliminary results.
Impact of bacterial and fungal inoculants on the resident rhizosphere microbiome and the volatilome of tomato plants under leaf herbivory stress
Authors: Lee Díaz Ana Shein , Minchev Zhivko , Raaijmakers Jos M , Pozo María José , Garbeva Paolina 
Published: February 2024

Abstract
Various studies have addressed the impact of microbial inoculants on the composition of the resident microbiome. How microbial inoculants impact plant metabolism and interact with the resident rhizobiota under herbivory stress remains elusive. Here, we investigated the impact of two bacterial and two fungal inoculants, inoculated as single species and as a synthetic community, on the rhizosphere microbiome and volatilome of tomato plants (Solanum lycopersicum) comparing nonstress conditions to exposed to leaf herbivory by Spodoptera exigua. Based on amplicon sequencing analysis, rhizobacterial community composition was significantly affected by all four inoculants and the magnitude of this effect was dependent on herbivory stress. Fungal community composition was altered by the microbial inoculants but independent of herbivory stress. The rhizosphere volatilome was impacted by the microbial inoculation and differences between treatments were evened under herbivory stress. Each microbial inoculant caused unique changes in the volatilome of stressed plants but also shared similar responses, in particular the enhanced production of dimethyl disulfide and benzothiazole. In conclusion, the introduction of microbial inoculants in the tomato rhizosphere caused unique as well as common changes in the rhizosphere microbiome and volatilome, but these changes were minor compared to the microbiome changes induced by herbivory stress.
Novel techniques for in situ estimation of shear-wave velocity and damping ratio through MASW testing part II: a Monte Carlo algorithm for the joint inversion of phase velocity and phase attenuation
Authors: Aimar Mauro , Foti Sebastiano , Cox Brady R 
Published: February 2024

SUMMARY
This paper deals with in situ characterization of the small-strain shear-wave velocity VS and damping ratio DS from an advanced interpretation of Multi-channel Analysis of Surface Waves (MASW) surveys. A new approach based on extracting Rayleigh wave data using the CFDBFa method has been discussed in the companion paper. This paper focuses on mapping the experimental Rayleigh wave phase velocity and attenuation into profiles of VS and DS versus depth, which is achieved through a joint inversion procedure. The joint inversion of phase velocity and attenuation data utilizes a newly developed Monte Carlo global search algorithm, which implements a smart sampling procedure. This scheme exploits the scaling properties of the solution of the Rayleigh eigenvalue problem to modify the trial earth models and improve the matching with the experimental data. Thus, a reliable result can be achieved with a limited number of trial ground models. The proposed algorithm is applied to the inversion of synthetic data and of experimental data collected at the Garner Valley Downhole Array site, as described in the companion paper. In general, inverted soil models exhibit well-defined VS profiles, whereas DS profiles are affected by larger uncertainties. Greater uncertainty in the inverted DS profiles is a direct result of higher variability in the experimental attenuation data, the limited wavelength range at which reliable values of attenuation parameters can be retrieved, and the sensitivity of attenuation data to both DS and VS. Nonetheless, the resulting inverted earth models agree well with alternative in situ estimates and geological data. The results stress the feasibility of retrieving both stiffness and attenuation parameters from active-source MASW testing and the effectiveness of extracting in situ damping ratio estimates from surface wave data.