bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teleonomy in living systems: an overview
Authors: Vane-Wright Richard I , Corning Peter A 
Published: June 2023

Abstract
An introduction, overview and discussion are provided for this special issue of the Biological Journal of the Linnean Society, entitled ‘Teleonomy in Living Systems’. The introduction offers a brief account of the origin of Colin Pittendrigh’s notion of teleonomy, in many ways comparable to Dobzhansky’s later proposal of ‘internal teleology’, and a subsequent externalist interpretation of the concept by Ernst Mayr which, unfortunately, has remained influential. As part of the growing movement that places organismic purpose, goal-directedness and agency back at the centre of biology, in June 2021 a 2-day online international meeting was organized by the authors through the Linnean Society of London, under the title Evolution ‘On Purpose’: Teleonomy in Living Systems. Our overview provides a summary, with some commentary, for each of 15 papers presented here. Together with a complementary volume of 18 papers published by MIT Press, they form a selected and extended proceedings. These papers represent scientifically founded views of evolutionary biologists and philosophers of science who seriously question the adequacy of the neo-Darwinian Modern Synthesis to account for the purposive nature of living systems. Like any other phenomena associated with life, purposive and teleonomic behaviours demand evolutionary explanations and context. Without any recourse to supernatural or non-material processes, various approaches to trying to understand how this goal-directed, teleonomic property of life has influenced the course of evolution are explored.
Bite and seek: bite force and exploratory behaviour of the lizard Podarcis siculus across its non-native range in the north-eastern United States
Authors: Patti Thomas , Donihue Colin M , Dressler Caroline , Luo Andy , Kartzinel Tyler R 
Published: June 2023

Abstract
Understanding how animals succeed in novel environments is critical to predicting the outcomes of species introductions under global change. Variation in exploratory behaviour—the willingness to investigate unfamiliar environments—has potential to influence species’ invasion success. The Italian wall lizard, Podarcis siculus, is native to southern Europe and has been introduced across Europe and North America. To compare the exploratory behaviour and bite force of individuals from three non-native populations in the United States, we conducted a laboratory experiment involving wild-caught lizards from New York City, Philadelphia, and Boston. We tested a series of hypotheses concerning the predictions that: (1) exploratory behaviour would be greatest in the most recently established population and (2) bite force—associated with competitive ability—would be greatest in the densest populations. Across populations, exploratory behaviour increased significantly with body size. Contrary to our first prediction, exploratory behaviour was not significantly greater in more recently established populations. Consistent with our second prediction, however, lizards from the low-density Philadelphia population exhibited weaker bites. Results suggest that contemporary behavioural variation reflects differences in local ecological conditions, such as resource abundance, population density, and size structure rather than establishment history. Our findings highlight the need for further research into behavioural and performance drivers of lizard invasion success.
Objective Research Priorities in Pancreatic Surgery – Results of a Worldwide Online Expert Survey
Authors: Holze M , Klotz R , Antony P , Diener M K , Probst P 
Published: June 2023

Abstract

Background
Several evidence gaps still need to be addressed in pancreatic surgery research. In our times of scarcity of resources in finances and time, research activities should be prioritized according to their clinical and political relevance.

Aims
Prioritize research topics in pancreatic surgery based on existing evidence and expert voting.

Methods
A digital survey among national and international pancreatic societies was performed over the course of six months. International experts were asked to rate their “Top 5” research topics requiring an RCT based on the 76 research topics from the Evidence Map of Pancreatic Surgery. Moreover, experts rated the importance of having an RCT for existing evidence gaps i.e. from the eleven research topics currently without an existing RCT.

Results
A total of 149 surgeons from 30 countries contributed to this study. Currently, the most relevant research topic is vascular resection in pancreatic surgery (39 votes). Radical antegrade modular pancreatosplenectomy (RAMPS) versus standard distal pancreatectomy was ranked second (30 votes). Celiac axis resection versus standard resection and spleen management in distal pancreatectomy were ranked third and fourth (both 27 votes). Finally, the time point for surgery for chronic pancreatitis was ranked fifth with 25 votes.
With regard to the eleven evidence gaps, the topic of RAMPS versus standard distal pancreatectomy and total versus partial pancreatectomy were both rated as having “very high priority” to have an RCT.

Conclusions
Research activities should be based on objective prioritization. The current study allows researchers and funding bodies to address the most relevant research questions based on a systematic evidence overview evaluated by pancreatic surgeons worldwide. This will allow for clinically relevant, high-quality evidence while also saving resources.
Impact of Circular Stapled Oesophagogastric Anastomosis Caliber on the Incidence of Postoperative Anastomotic Leakage in Minimally Invasive Ivor Lewis Oesophagectomy
Authors: Kröll D , Matthias B , Fehrenbach U , Raakow J , Pratschke J , Denecke C , Seika P 
Published: June 2023

Abstract

Background
Minimally invasive oesophagectomy (MIE) with intrathoracic anastomosis is increasingly used in treating patients with oesophageal cancer. Anastomotic leakage (AL) remains a critical perioperative complication, despite recent advances in surgical techniques. It remains unclear to what extent the size of the circular stapler (CS), a 25 mm CS or a bigger CS, may affect the incidence of AL.

Aims
This study aimed to evaluate whether the CS size in oesophagogastrostomy affects the postoperative AL rates and related morbidity in MIE.

Methods
We conducted a retrospective review of consecutive patients who had undergone thoracic MIE between August 2014 and July 2019 using a CS oesophagogastric anastomosis at the level of the Vena azygos. The patients were grouped according to CS size (mm): small-sized (SS25) and large-sized (LS29). The patient demographics, data regarding morbidity, and clinical outcomes were compared. The primary outcome measure was the AL rate related to the stapler size.

Results
A total of 119 patients were included (SS25: n = 65; LS29: n = 54). Except for the distribution of squamous cell carcinoma, the demographics were similar in each group. The AL rate was 3.7% in the LS29 group and 18.5% in the SS25 group (p = 0.01). The major morbidity (CD ≥ 3a) was significantly more frequent in the SS25 group compared with the LS29 group (p = 0.02). CS size, pulmonary complications, and cardiovascular disease were independent risk factors for AL in the multivariate analysis.

Conclusions
A 29 mm CS is associated with significantly improved surgical outcomes following standard MIE at the level of the azygos vein and should be conducted whenever technically feasible.
Mechanical Parameters Influencing Recurrence in Ventral Midline Incisional Hernia Open Repair
Authors: Pal N , Mehta A , Hagen M , Dupuis A , Toso C , Douissard J 
Published: June 2023

Abstract

Background
Ventral midline incisional hernia (VMIH) is common and recurrence rates remain of concern after gold-standard open repairs. Personalized optimization and risk stratification are traditionally performed through preoperative considerations regarding patients’ general and medical status and occulting mechanical factors.

Aims
The aim of this retrospective observational cohort study is to identify mechanical parameters potentially influencing VMIH recurrence (VMIHR) after repair.

Methods
Data were derived from an institutional quality database. Patients who underwent VMIH open repair with retromuscular or preperitoneal non-absorbable mesh reinforcement, confirmed by an available preoperative CT scan for biomechanical measurements, between June 2012 – June 2020 in a single centre, were included. Exclusion criteria were non-open repairs, non-midline hernias, absence of preoperative scan, absence of mesh reinforcement, intraperitoneal/bridging mesh positions, biologic/biosynthetic mesh and use of component separation techniques. The main outcome was VMIHR, a symptomatic clinically confirmed recurrence re-operated in the same institution within 36 months maximum following primary open repair. Patients with/without recurrence were compared using standard analytic tools.

Results
Fourty-eight patients met the inclusion criteria of which 11 (23%) developed VMIHR. The following parameters were statistically significantly associated with VMIHR: smaller visceral fat surface (mean of 244.9 cm2 in the recurrence group vs 286.3 cm2 in non-recurrence group, p = 0.0295), smaller mesh length (17.2 cm vs 23 cm, p = 0.001), smaller total mesh surface (315.2 cm2 vs 550.1 cm2, p = 0.0095), coated meshes (p = 0.033), absorbable suture for mesh anchoring (p = 0.043) and a greater largest defect width/mesh width ratio (0.42 vs 0.29, p = 0.0146).

Conclusions
When focusing on mechanical parameters, non-modifiable and patient-related parameters seem to play a limited role. However, using uncoated meshes of larger dimensions (greater than/equal to 3.5x defect size) than suggested previously (defect size + 5cm) resulted in fewer recurrences. This may help to orientate further larger prospective trials.
Implementation of the Dexter Robot System in Daily Practice - First Experiences in Gall Bladder and Hernia Surgery
Authors: Hotz A S , Breitenstein S , Kambakamba P , Grochola L F , Zehnder A , Bächler T , Gantner L , Seeger N , Gelpke H , Adamina M , Grieder F 
Published: June 2023

Abstract

Background
The use of surgical robots is increasing in the field of visceral surgery. Recently, new robotic platforms have entered the market. Dexter Robotic System is a computer-assisted surgical device with two working arms and one camera arm.

Aims
The purpose of this study was to assess the implementation this innovative robotic system in general visceral surgery.

Methods
This prospective study investigated the efficiency in elective cholecystectomy and inguinal hernia surgery of the Dexter robot. The Primary endpoints was safety, defined by device related adverse events. Secondary endpoints were performance of the Robotic System (defined as completion of the robotic procedure), operative parameters and surgeons’ comfort. Patients were consented for participation and the study was approved by the Ethical committee.

Results
The first 25 consecutive Dexter robotic assisted elective procedures (14 hernia, 11 cholecystectomies) were included. No device related adverse events occurred. 24 operations could be completed robotically. One hernia procedure was converted to a laparoscopic operation, due to a software failure of the Dexter-system. The median robot usage time were 55 minutes (IQR 41-5-79.5) for cholecystectomy and 95 minutes (IQR 90.5-115.25) in hernia, while the operating time amounted 99 minutes (IQR 84-133) in cholecystectomy and 131 minutes (IQR 124.75-153.75) in hernia. The median docking time of the Dexter robot was 7 minutes (IQR 7-10.5). Operators perceived comfort as high, median 4 (IQR 4-10.5, Discomfort Score range 4-16) and subjective stress levels as low, median 25 (IQR 10-35, Mental Effort Questionnaire range 10-60). (This study is ongoing, we expect to include 50 cases until June 2023).

Conclusions
This world's first clinical study of the Dexter Robotic System in general visceral surgery demonstrates a safe and efficient implementation of this innovative robotic system in clinical practice. Further studies will refine the effective applications of the Dexter Robotic System and its advantages over conventional surgical techniques.
Noise in the Operating Room as Indicator for Long and Difficult Surgeries
Authors: Peisl S , Beldi G , Sanchez-Taltavull D , Tschan F , Keller S 
Published: June 2023

Abstract

Background
Noise pollution in the operating room (OR) has been shown to have adverse effects on the surgical team and has been linked to the occurrence of surgical site infections.

Aims
The aim of this study was to evaluate whether intraoperative sound levels were associated with postoperative complications.

Methods
Sound levels were measured during 407 procedures of patients undergoing elective or emergency surgery in four Swiss hospitals. Sound levels were registered every second in decibels dB(A). The percentage of time above 70dBA and the time-averaged sound levels were calculated. A standard questionnaire at the end of the surgery was used to evaluate subjectively perceived difficulty of the surgery and distraction during the procedure by the OR members. The POSSUM classification (“Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity”) was used to assess complexity of each procedure. Noise levels were then related to the occurrence of postoperative complications in multivariate regression models.

Results
Of the 294 patients included, 38% had any kind of postoperative complication. Intraoperative sound levels (percentage of time above &gt;70dB(A) and time-averaged sound levels) were significantly higher for patients who developed a postoperative complication (0.7% versus 0.5%, respectively 60dB(A) versus 58dB(A), p-value &lt; 0.01). Further, higher sound levels were significantly correlated with the duration and complexity of the procedure as well as subjectively perceived difficulty by the members of the surgical team. In a multivariate analysis including procedure- and patient-related factors, only the duration of the surgery was an independent predictor for postoperative complications.

Conclusions
Higher intraoperative sound levels were associated with an increased rate of postoperative complications. Here, we showed that this is likely the result of louder procedures being technically more challenging for the surgical team. Thus, increased sound levels may represent a surrogate marker for long and complex surgical procedures.
MicroRNA Expression Correlates with Clinical Presentation of Chronic Thromboembolic Pulmonary Hypertension
Authors: Martinez Lopez I S , Papasotiropoulos T , Schläpfer F , Ulrich S , Opitz I , Kirschner M B 
Published: June 2023

Abstract

Background
Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a rare, debilitating disease characterized by pathological changes that obstruct both sides of the pulmonary arteries (PA). The underlying pathophysiology is poorly understood.

Aims
Trying to understand the possible contribution of microRNAs to CTEPH pathophysiology, we here analysed the expression of four candidate microRNAs in pulmonary endarterectomy (PEA) specimens.

Methods
MicroRNA specific RT-qPCR for miR-939, miR-942, let-7b and let-7d was done on RNA from PEA specimens of 50 CTEPH patients and from PAs resected from explant lungs of 48 transplant recipients (25 due to COPD, and including 22 with PH). Associations between microRNA expression and clinical presentation (not all factors available for every patient) were assessed by Spearman correlation. MicroRNA expression between CTEPH and reference PAs was compared by Mann Whitney test.

Results
Expression levels in left-side PEA-derived tissues correlated negatively with: CRP for let-7d (n = 49, R = -0.29, p=0.039), oxygen saturation (SpO2) at peak 6-minute walk distance for miR-939 (n = 44, R = -0.39, p=0.007), and Right Jamieson classification for miR-942 (n = 40, R = -0.34, p=0.03). Right-side samples let-7d levels correlated negatively with mPAP (n = 42, R = -0.33, p=0.031). Contrastingly, mean expression levels of miR-942 showed positive correlation with mPAP (n = 49, R = 0.28, p=0.049) and Borg Scale showed a similar tendency with miR-939 (n = 50, R = 0.31, p=0.027). Compared to reference PAs, right-side expression of miR-942 reached significance (n = 47 CTEPH vs n = 46 Reference, p=0.0001).

Conclusions
Correlations with clinical parameters suggest that miRNAs may be associated with clinical presentation of CTEPH. Furthermore, the significant elevation compared to reference PA tissue suggest that microRNA dysregulation might be involved in CTEPH pathophysiological mechanisms, encouraging us to investigate further.
Galectin-9 in synergy with NF-κB inhibition restores immune regulatory capability in dendritic cells of subjects with food allergy
Authors: Li Linjing , Xu Xuejie , Wang Xinxin , Zhang Shuang , Yao Wenkai , Liu Jiangqi , Liu Zhiqiang , Yang Pingchang 
Published: June 2023

Abstract
The pathogenesis of immune tolerance disruption is not fully understood. Galectin-9 (Gal9) has immune regulatory functions. The objective of the present study is to assess the role of Gal9 in maintaining immune tolerance. Blood and intestinal biopsies were taken from patients with food allergy (FA). The status of tolerogenic dendritic cells (tDC) and type 1 regulatory T cells (Tr1 cells) in the samples was evaluated and used as representative parameters of immune tolerance. An FA mouse model was established to assess the role of Gal9 in maintaining immune tolerance. We found that peripheral CD11c+ CD5+ CD1d+ tDC frequency was significantly lower in FA patients as compared to health control (HC) subjects. There was no significant change in CD11c+ DC frequency between the FA group and the HC group. The expression of IL-10 in peripheral tDCs was lower in the FA group than that in the HC group. A positive correlation was detected between the serum levels of IL-10 and Gal9. The expression of Gal9 was observed in intestinal biopsies, which was positively correlated with the serum levels of Gal9 as well as serum IL-10 levels. Peripheral Tr1 cells had lower frequencies in the FA group than in the non-FA (Con) group. tDCs demonstrated the ability to generate Tr1 cells, which was weaker in the FA group as compared with the Con group. Exposure of FA tDCs to Gal9 in culture restored the ability to generate Tr1 cells. In summary, the lower frequency of tDC and Tr1 cell of FA patients was associated with the levels of Gal9. The presence of Gal9 restored the capacity of tDC to generate Tr1 cells.
Pharmacokinetic Data of Dolutegravir in Second-line Treatment of Children With Human Immunodeficiency Virus: Results From the CHAPAS4 Trial
Authors: Bevers Lisanne A H , Waalewijn Hylke , Szubert Alexander J , Chabala Chishala , Bwakura-Dangarembizi Mutsa , Makumbi Shafic , Nangiya Joan , Mumbiro Vivian , Mulenga Veronica , Musiime Victor , Burger David M , Gibb Diana M , Colbers Angela 
Published: June 2023

Abstract

Background
Dolutegravir (DTG), combined with a backbone of 2 nucleoside reverse transcriptase inhibitors, is currently the preferred first-line treatment for human immunodeficiency virus (HIV) in childhood. CHAPAS4 is an ongoing randomized controlled trial investigating second-line treatment options for children with HIV. We did a nested pharmacokinetic (PK) substudy within CHAPAS4 to evaluate the DTG exposure in children with HIV taking DTG with food as part of their second-line treatment.

Methods
Additional consent was required for children on DTG enrolled in the CHAPAS4 trial to participate in this PK substudy. Children weighing 14–19.9 kg took 25 mg DTG as dispersible tablets and children ≥20 kg took 50 mg film-coated tablets. Steady-state 24-hour DTG plasma concentration-time PK profiling was done at t = 0 and 1, 2, 4, 6, 8, 12, and 24 hours after observed DTG intake with food. Reference adult PK data and pediatric data from the ODYSSEY trial were used primarily for comparison. The individual target trough concentration (Ctrough) was defined as 0.32 mg/L.

Results
Thirty-nine children on DTG were included in this PK substudy. The geometric mean (GM) area under the concentration–time curve over the dosing interval (AUC0-24h) was 57.1 hours × mg/L (coefficient of variation [CV%], 38.4%), which was approximately 8% below the average AUC0-24h in children in the ODYSSEY trial with comparable dosages, but above the adult reference. The GM (CV%) Ctrough was 0.82 mg/L (63.8%), which was comparable to ODYSSEY and adult reference values.

Conclusions
This nested PK substudy shows that the exposure of DTG taken with food in children on second-line treatment is comparable with that of children in the ODYSSEY trial and adult references.
Clinical Trials Registration.ISRCTN22964075.
‘Not Time to Make a Change’? Reviewing the Rhetoric of Law Reform
Authors: Lee James 
Published: June 2023

Abstract
How do we talk about changing the law? This article considers the rhetoric of law reform and what it can tell us about the current relationships between key institutions involved in the relevant processes. A key claim is that the rhetoric deployed in formulating proposals can complicate the fate of law reform projects as they develop. Several examples from private and criminal law are used to support the argument, with assessment of the interaction of time and legal development. The language of ‘modernisation’—a noticeable theme in contemporary proposals from the Law Commission of England and Wales—is scrutinised. The Commission’s statutory functions expressly include ‘the repeal of obsolete and unnecessary enactments… and generally the simplification and modernisation of the law’, but what ‘modernisation’ means in this area has, so far, been under-examined. The author then goes on to identify attitudinal and structural tensions in the current relationship between the Law Commission and Government. Constructive suggestions are offered for reforming our law reform practices. The way in which we talk about law reform can be understood as both a cause and symptom of some of the problems in developing the law today.
How can physiology best contribute to wildlife conservation in a warming world?
Authors: Seebacher Frank , Narayan Edward , Rummer Jodie L , Tomlinson Sean , Cooke Steven J 
Published: June 2023

Abstract
Global warming is now predicted to exceed 1.5°C by 2033 and 2°C by the end of the 21st century. This level of warming and the associated environmental variability are already increasing pressure on natural and human systems. Here we emphasize the role of physiology in the light of the latest assessment of climate warming by the Intergovernmental Panel on Climate Change. We describe how physiology can contribute to contemporary conservation programmes. We focus on thermal responses of animals, but we acknowledge that the impacts of climate change are much broader phylogenetically and environmentally. A physiological contribution would encompass environmental monitoring, coupled with measuring individual sensitivities to temperature change and upscaling these to ecosystem level. The latest version of the widely accepted Conservation Standards designed by the Conservation Measures Partnership includes several explicit climate change considerations. We argue that physiology has a unique role to play in addressing these considerations. Moreover, physiology can be incorporated by institutions and organizations that range from international bodies to national governments and to local communities, and in doing so, it brings a mechanistic approach to conservation and the management of biological resources.