bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normative Reference Values for Crystallized–Fluid Discrepancy Scores for the NIH Toolbox Cognition Battery
Authors: Iverson Grant L , Gaudet Charles E , Kissinger-Knox Alicia , Karr Justin E 
Published: October 2022

Abstract

Introduction
The purpose of this study was to translate NIH Toolbox Cognition Battery (NIHTB-CB) Crystallized–Fluid discrepancy scores into research and clinical practice with adults by providing normative data for discrepancy scores for both age-adjusted standard scores (SSs) and demographically adjusted T-scores.

Method
We included adult participants from the NIHTB-CB standardization sample who denied having neurodevelopmental, medical, psychiatric, or neurological conditions (n = 730; M = 47.4 years old, SD = 17.6, range: 18–85; 64.4% women; 63.1% White). Descriptive statistics were calculated for the Fluid and Crystallized composite scores and Crystallized–Fluid discrepancy score, along with correlations between the composite scores and reliability estimates of the discrepancy score. Percentiles were calculated for the discrepancy score, with stratifications by the gender, education, and Crystallized composite for the age-adjusted SSs and demographically adjusted T-scores (T).

Results
Crystallized–Fluid discrepancy scores ranged from −40 to 44 (M = −0.63, SD = 14.89, Mdn = −1, interquartile range [IQR]: −11 to 10) for age-adjusted SSs and from −29 to 27 (M = −0.39, SD = 10.49, Mdn = −1, IQR = −8 to 7) for demographically adjusted T-scores. Crystallized–Fluid discrepancy scores of SS = 15 and T = 11 were at the 16th percentile (1 SD below the mean) and discrepancy scores of SS = 21 and T = 15 were at the 7th percentile (1.5 SD below the mean).

Conclusions
Crystallized–Fluid discrepancy scores may be, with future research, a useful within-person interpretive approach for detecting a decline from pre-injury or pre-disease levels of cognitive functioning. These normative reference values assist clinicians and researchers in determining the frequency at which given Crystallized–Fluid discrepancy scores occurred among healthy adults in the normative sample.
Changes in Glucose Control and Lipid Levels Following Trunk-Based Body Contouring Surgery in Postbariatric and Nonbariatric Patients
Authors: Henderson Joshua T , Koenig Zachary A , Woodberry Kerri M 
Published: October 2022

Abstract

Background
Despite consistent interest over the past 2 decades regarding the metabolic effects of body contouring (BC), previous studies are limited by short follow-up periods, small sample sizes, gender-specific cohorts, and assessment of all anatomic regions together.

Objectives
This study evaluates the changes in glucose and lipid levels over long-term follow up after trunk-based BC and compares postbariatric with nonbariatric patients.

Methods
The retrospective cohort study included patients who underwent trunk-based BC from January 1, 2009 through July 31, 2020 at West Virginia University. A minimum 12-month follow up was required for inclusion. With BC surgery as the reference point, patients' glucose, hemoglobin A1c, and lipid levels were assessed prior to surgery and at long-term follow up. Change over time was compared between postbariatric and nonbariatric cohorts. Multivariable linear regression models were performed to assess the effect of potential confounding variables on the difference between cohorts.

Results
Seventy-seven BC patients had glucose levels evaluated during the study period, and 36 had lipid profiles obtained. Average follow up from date of BC was 41.2 months for the patients with glucose follow up and 40.9 months for those with lipid levels. From pre-BC to endpoint follow up, glucose levels mildly increased in all patients. Multivariable linear regression models accounting for age showed nonbariatric patients experience significantly improved total cholesterol levels compared to postbariatric patients (P = 0.0320). Weight loss maintained following BC was not associated with significant differences between cohorts.

Conclusions
Fasting glucose levels marginally increase in most BC patients through follow up. Nonbariatric patients generally experience more favorable changes in lipid profile following trunk-based BC than do postbariatric patients.

Level of Evidence: 3
BJS-01 SARCOPENIA AND VISCERAL FAT IN PATIENTS WITH INCISIONAL HERNIA AFTER URGENT LAPAROTOMY
Authors: Romano L , Fiasca F , Mattei A , Tersigni L , Gianneramo C , Schietroma M , Carlei F , Giuliani A 
Published: October 2022

Abstract

Aim
Various risk factors have been associated with the development of incisional hernia (IH). Some recent papers underlined that visceral fat could be a reliable indicator. Another risk factor which is of increasing clinical interest is sarcopenia. Recent studies have identified it as an independent predictor of poor postoperative outcomes following abdominal surgery. We aimed to investigate the role of visceral fat and skeletal muscle as emerging risk factors for IH after urgent laparotomy.

Material & methods
Patients aged 18 years or older who underwent urgent median laparotomy and with continuous direct suturing of the laparotomy were included. They were categorized into two groups: those with a median IH and those without IH at 12-months follow-up. Demographic data were prospectively collected while CT scans were retrospectively reviewed. The data were compared among two groups.

Results
From January 2018 to May 2021, 364 patients underwent urgent surgery in our Department, of whom 222 were aged &gt;18 years-old and underwent median laparotomy. Forty-four patients had diagnosis of median IH, while 41 patients without IH were identified as the control group. Statistically significant differences emerged for BMI and for the area of visceral fat. The association with the presence/absence of sarcopenia was not significant.

Conclusions
When surgery is performed in urgent settings it could be important to identify patients at risk, especially as CT scans are generally available for all patients with urgent abdominal disease. In these patients a prophylactic mesh placement could be evaluated.
OC-009 SYNGENEIC VERSUS ALLOGENEIC NON-VASCULARIZED RECTUS FASCIA TRANSPLANTATION IN A RABBIT MODEL WITHOUT IMMUNOSUPPRESSION: SHORT TERM OUTCOME
Authors: Van De Winkel N , Mori Da Cunha M , Pirenne J , De Hertogh G , Fehervary H , Miserez M , Terrie L , Muylle E , D'hoore A , Ceulemans L 
Published: October 2022

Abstract

Background and aim
Transplantation (Tx) of non-vascularized rectus fascia (NVRF) is a valid option in solid organ transplant recipients to avoid open abdomen after Tx. To extrapolate this technique for non-Tx patients, we investigated in a preclinical rabbit model the feasibility of transplanting NVRF in a syngeneic (Syn) versus allogeneic (Allo) strain without using immunosuppression (IS). Short-term outcome was evaluated after 4 weeks.

Material and methods
A validated rabbit model of NVRF Tx was used comparing 6 Syn New Zealand White (NZW) rabbits versus 6 Allo Mixed breed to NZW Tx without IS. Animals were macroscopically analyzed at harvesting after 4 weeks for graft integration, herniation, adhesions, seroma, hematoma, and surgical site infections. Histological and immunohistochemical analysis was performed to assess inflammatory cell reaction and neovascularization. Mechanical testing was performed to assess the thickness, stiffness and strength.

Results
Results showed similar sufficient macroscopic ingrowth of the NVRF in both groups. At the histological level, cell infiltration suggested a clearing reaction more than a rejection-based inflammation, which was more pronounced in the Allo group. No significant differences were seen concerning mechanical properties.

Conclusions
In a validated rabbit model of NVRF Tx, we showed that Tx was possible in an Allo strain without the need for IS, resulting in satisfying short term inflammatory and mechanical outcomes. Longer-term experiments are needed to evaluate the effect of graft integration and possible hernia development.
OC-014 FAVOURABLE OUTCOMES AFTER RETRO-RECTUS (RIVES-STOPPA) MESH REPAIR AS TREATMENT FOR NON-COMPLEX VENTRAL ABDOMINAL WALL HERNIA, A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Den Hartog F , Sneiders D , Darwish E , Yurtkap Y , Menon A , Muysoms F , Kleinrensink G J , Bouvy N , Jeekel J , Lange J 
Published: October 2022

Abstract

Aim
Ventral abdominal wall hernia is a common problem, tied to increasing frailty and obesity of patients undergoing surgery. For noncomplex ventral hernia, retro-rectus (Rives-Stoppa) repair is considered the gold standard. Level-1 evidence confirming this presumed superiority is lacking. The aim of this study was to assess prevalence of hernia recurrence, surgical site infection (SSI), seroma, serious complications, and mortality.

Material & Methods
Five databases were searched for studies reporting retro-rectus repair. Randomized and non-randomized studies were included. Outcomes were pooled with random-effects models.

Results
Ninety-three studies representing 12,440 patients undergoing retro-rectus repair were included. Pooled hernia recurrence was estimated at 3.2% [95% confidence interval (CI): 2.2%–4.2%, n = 11,049] after minimally 12 months and 4.1%, (95%CI: 2.9%–5.5%, n = 3830) after minimally 24 months. Incidences of SSI and seroma were estimated at respectively 5.2% (95%CI: 4.2%–6.4%, n = 4891) and 5.5% (95%CI: 4.4%–6.8%, n = 3650). Retro-rectus repair was associated with lower recurrence rates compared to onlay repair (odds ratios (OR): 0.27, 95%CI: 0.15–0.51, P &lt; 0.001) and equal recurrence rates compared to intraperitoneal onlay mesh (IPOM) repair (OR: 0.92, 95%CI: 0.75–1.12, p = 0.400). Retro-rectus repair was associated with more SSI than IPOM repair (OR: 1.8, 95%CI: 1.03–3.14, p = 0.038). Minimally invasive retro-rectus repair displayed low rates of recurrence (1.3%) and SSI (1.5%), albeit based on non-randomized studies.

Conclusions
Retro-rectus repair results in excellent outcomes, superior or similar to other techniques for all outcomes except SSI. The latter occurred less after IPOM repair, which is usually laparoscopic.
OC-016 PROSPECTIVE DATA ANALYSIS OF 1307 VENTRAL HERNIA PATIENTS: EMERGENCY HERNIA REPAIR AND SMOKING PREDICT RECURRENCE
Authors: Soppe S F , Wirsching A , Slieker J , Keerl A , Muller M K , Nocito A 
Published: October 2022

Abstract

Aim
Ventral hernias are frequent and hernia repair is regularly performed by general surgeons. Emergency repair is less frequent and can be challenging. Long term data comparing outcomes of emergency- vs. elective ventral hernia repair are scarce.

Material & Methods
Consecutive patients undergoing emergency and elective ventral hernia repair at our institution were prospectively entered in our HerniaMed database between August 2013 and February 2020. Patients were contacted after one-, five- and ten years to assess long-term complications. Risk factors for emergency repair and hernia recurrence were assessed by univariate and multivariate analysis.

Results
We included 1307 patients. Emergency and elective hernia repair were performed in 11% and 89% of patients with one-year follow-op rates of 94% and 92%. Female gender, BMI &gt;40 kg/m2, ASA class 3 and 4, large size umbilical herniation (&gt;4cm) and epigastric herniation were more frequent in emergency hernia repair. Binary logistic regression analysis identified emergency repair and smoking as predictors of recurrence (Odds ratio: 4.04 and 95% confidence interval: 1.67–14.21, p=0.004; Odds ratio: 2.94 and 95% confidence interval: 1.33–9.15, p=0.011). Furthermore, female gender and significant comorbidity (ASA class 3 and 4) were risk factors for emergency repair (Odds ratio: 1.98 and 95% confidence interval: 01.05–3.74, p=0.034; Odds ratio: 3.54 and 95% confidence interval: 1.79–6.98, p&lt;0.001).

Conclusion
Emergency repair and smoking predicted hernia recurrence. Females and highly comorbid patients are at increased risk for emergency repair and should be prioritized for early elective hernia repair.
OC-023 USING FIBROBLAST MEDIATED MATRIX CONTRACTION TO TEST MESH SHRINKAGE - A PROTOTYPE FOR IN VITRO MESH TESTING
Authors: Whitehead-Clarke T , Khader R , Kureshi A , Mudera V 
Published: October 2022

Abstract

Background/Aim
Measuring how hernia meshes shrink after implantation is a commonly used parameter in in vivo mesh testing. We aim to use fibroblast populated collagen matrices (FPCMs) and their contraction to assess how different meshes shrink.

Methods/Materials
1 millilitre circular FPCMs were formed in 24 well plates. Different hernia meshes were placed halfway through the FPCMs so that they were embedded. Matrices were seeded with immortalised human fibroblasts, allowed to set and then separated form the well plate using a sterile needle. Gels were cultured in fibroblast media at 37 degrees 5% CO2 for seven days and were allowed to contract naturally. Each day, photographs were taken and the area of the collagen and the mesh were calculated.

Results
When comparing collagen contraction with/without hernia mesh, It was noted that significantly greater contraction was observed without mesh - which hampered collagen contraction. When comparing meshes, It was noted that a lightweight mesh with larger pores lead to greater collagen contraction (54% Vs 45%) and greater mesh shrinkage (55% Vs 20%) compared to heavyweight mesh with smaller pores.

Conclusion
We present a cheap, standardised and unique technique for measuring mesh contraction in vitro.
OC-024 MINIMALLY INVASIVE TREATMENT OF COMPLEX INCISIONAL/VENTRAL HERNIAS USING BOTULINUM TOXIN COMBINED WITH ROBOTIC SURGERY: ROBOTOX PROTOCOL
Authors: Villalobos R , Maestre Y , González Barranquero A , Olsina J 
Published: October 2022

Abstract

Introduction
Incisional/ventral hernia repair has changed in the last 20 years. Posterior component separation like TAR (transversus abdominis muscle release) has increased as a revolutionary technique. On the other hand, the use of botulinum toxin (BT) has allowed better closure defect with no tension. We present a preliminary original protocol named ROBOTOX for complex incisional /ventral hernia repair that combined BT and robotic surgery to minimize the TAR procedure.

Material and methods
BT (Dysport®) was administered in patients with a complex incisional hernia repair and a transverse defect ≧8cm one month before robotic surgery. Demographic variables (age, sex, BMI), EHS classification, need of TAR, size transverse defect, postoperative complications and recurrence were studied. All patients had a previous CT scan.

Results
Five patients were included in ROBOTOX protocol, 3 men and 2 women with a median age of 63±8, median BMI of 32±3. Four patients had a M3W3 and one a L3 W2 hernia. Median size defect of 11,2±2. Three of them only needed Rives technique, one a unilateral TAR and one a 5 cm dissection of bilateral TAR. At the moment, with a FU of 6±2 months, no recurrences have been reported.

Conclusions
Robotic surgery combined with BT would allow a downstaging treatment in patients with complex incisional/ventral hernias. A major cases and long term follow up is needed to better conclusions.
OC-027 IS THERE A CORRELATION BETWEEN TYPE OF PROSTHESIS FIXATION IN T.A.P.P. AND AFTER SURGERY RECOVERY? OUR CENTER EXPERIENCE
Authors: Gianazza S , Guzzetti L , Grappolini N , Odeh M , Scorza A , Palillo A , Gerosa S , Morabito M , Inversini D , Ietto G , Carcano G 
Published: October 2022

Abstract

Aim
A retrospective study was carried out on patients treated for bilateral inguinal hernia with TAPP technique by the department of Urgency Surgery and Transplantation of Varese's hospital in order to investigate the VAS one month after surgery and functional recovery in two groups of patients.

Material and Methods
38 patients treated in the last year were enrolled, dividing them in two groups: those who received a single fixing material (reabsorbable clips) and those with a double fixing material (reabsorbable clips and glue). Primary end point was the post-operative pain using the VAS scale at one month. Secondary end-point was the return to daily activities and work in days. The Mann-Whitney test with p-value set&lt; 0.05 was used.

Results
The single fixing material group shown a 1-month VAS of 0.57 ±1, versus 1.43±4 of the second group (p-value&lt;0.05); with a return of daily activities in 4.92± 8 days, versus 8.06 ± 11 days (p-value&lt;0.05). In addition, analyzing the subpopulation of still active workers (28 of the 38 patient), it was assessed the working back timing. The positioning of only reabsorbable clips, compared with a double fixing material, ensured a faster return to work in 8.2 ±10 days versus 20 ± 30 days (p-value&lt;0.05).

Conclusions
Fixing the prosthetic mesh with resorbable clips alone, could lead to a more rapid resumption of daily and work activities, with less pain one month after surgery.
OC-030 EARLY OUTCOMES OF ROBOTIC TAPP HERNIA REPAIR FOR INGUINAL HERNIA: A SINGLE SURGEON'S EXPERIENCE
Authors: Chaudhary R , Venkata Sairam M 
Published: October 2022

Abstract

Aim
The aim of this study was to evaluate the early outcomes of robotic TAPP (trans abdominal pre-peritoneal) inguinal hernia repair in a tertiary hospital.

Material & methods
This is a retrospective analysis of patients who underwent robotic TAPP by a single surgeon from November 2019 to May 2022. Three-arm, 4-port technique of robotic TAPP was performed. The patient cart was advanced depending upon laterality of the hernia. Three ports were placed in a linear fashion at the level of umbilicus, and the fourth port or assistant port was taken on the side opposite to the cart, triangulated from the umbilical and lateral ports.

Results
37 male patients were included, of which, 16 had unilateral hernias and 11 had bilateral hernias. Mean age was 46.2 (SD 16.5) years. One patient had a recurrent groin hernia after open repair. Mean operating time was 137.6 (SD 33.2) minutes. Operating time for the first ten cases was 158.2 (SD 25.1) min, and that of the last ten cases was 127 (SD 42.2) minutes, showing a steady decrease over time. One patient had intraoperative injury of the vas deferens, which was repaired. Mean hospital stay was 1.4 (SD 0.8) days. One patient had seroma. None of the patients had recurrence or mesh infection.

Conclusions
Robotic TAPP is a safe and effective procedure for the repair of inguinal hernias. Placing of assistant port near the umbilicus offers ergonomic advantage over linear port placement.
OC-034 EVIDENCE-BASED CHANGES IN PERI-OPERATIVE PATIENT CARE IN A TERTIARY HERNIA CENTER(THC): PROSPECTIVE STUDY OF OUTCOMES OVER 18 YEARS AND 1842 OPEN PREPERITONEAL VENTRAL HERNIA REPAIRS(OPPVHR)
Authors: Katzen M , Kercher K , Sacco J , Ayuso S , Ku D , Scarola G , Colavita P , Augenstein V , Heniford B T 
Published: October 2022

Abstract

Background
Over 18 years, a THC frequently changed patient-care protocols according to repeated reviews of our prospectively collected data outcomes, which have been published in peer-reviewed journals. This study aimed to describe these progressive, evidence-based changes and the subsequent results in PP-VHR.

Methods
Prospective, tertiary hernia center data(2004–2021) was examined for patients undergoing midline open PP-VHR with mesh. “Early”(2004–2012) and “Recent”(2013–2021) groups were based on surgery date.

Results
Comparison of Early(n=675) versus Recent(n=1,167) groups showed that Recent patients were older (56.9±12.6vs58.7±12.1 years;p&lt;0.001), more comorbid(3.6±2.2vs5.2±2.6 diagnoses;p&lt;0.001), lower BMI(33.5±8.3 vs 32.0±6.8 kg/m2; p=0.003), more prior failed VHR(46.5% vs 60.8%; p&lt;0.001), larger hernia defects(199.7±232.8vs214.4±170.5 cm2;p&lt;0.001), more CDC-class 3/4 wounds(11.3%vs18.6%;p&lt;0.001), more biologic mesh(10.5% vs 25.4%;p&lt;0.001), component separations(CST; 22.5%vs45.7%;p&lt;0.001), and more pre-op Botox(0%vs12.3%;p&lt;0.01). Wound complication(26.7%vs13.2%;p&lt;0.001), mesh infection(3.1%vs0.9%;p&lt;0.01), and hernia recurrence rates decreased over time(7.1%vs2.4%;p&lt;0.001) with long-term follow-up(4.2±4.1vs2.2±1.8years;p&lt;0.001).
Comparing respective multivariable analyses (Early vs Recent), wound complications were associated with panniculectomy(OR[95%CI]:2.9[1.9–4.5],p&lt;0.001 vs 2.1[1.4–3.3],p&lt;0.01), contaminated wounds(2.1[1.1–3.7],p=0.02 vs 1.8[1.1–3.1],p=0.02), anterior CST(1.8[1.1–2.9], p=0.02 vs 3.2[1.9–5.3],p&lt;0.01), and operative time(per minute:1.01[1.008–1.015], p&lt;0.01 vs 1.004[1.001–1.007], p&lt;0.01) in both time periods. Diabetes(2.6[1.7–4.0],p&lt;0.01) and tobacco(1.8[1.1–2.9], p=0.02) were only significant in the Early group with the Recent group requirements for preop smoking cessation and a HgbA1C of &lt;7.2. In both groups, recurrence was associated with wound complication(8.9[4.1–20.1],p&lt;0.01 vs 3.4[1.3–8.2].p&lt;0.01) and prior failed VHR hernias(4.9[2.3–11.5],p&lt;0.01 vs 2.1[1.1–4.2],p=0.036).

Conclusion
Despite increased patient and hernia complexity over time, detecting and implementing best practices, as determined by repeated self-analysis of a THC's data, significantly improved patient outcomes, including wound and mesh complications and recurrence.
OC-041 SHEEN PAAJANEN GROIN RECOMMENDED TREATMENT ‘SPORT’ SCORE FOR GROIN PAIN
Authors: Sheen A J , Biswas S , Stathakis P , Jamdar S , Harwood R , Paajanen H 
Published: October 2022

Abstract

Introduction
Evaluating groin pain still evades many clinicians with at times difficulty in determining the cause of pain when no true hernia exists. This study's aim was to evaluate a simple and novel reproducible scoring system, to help determine whether conservative measures or surgery should be recommended for the management of groin pain attributable to inguinal disruption.

Methods
Patients that underwent surgery or conservative management for inguinal disruption from 2018 to 2020, with at least one year follow-up, were evaluated with the proposed scoring system. The scoring system is based on MRI and ultrasound imaging as well as clinical findings, with scores given from -2 to +2 based upon the defined findings listed. The sensitivity (ability of SPoRT score to correctly identify physiotherapy required) and specificity (ability of SPORT score to correctly identify surgery required) were calculated for each potential cut off point. The Youden Index was used to find the cut off which optimises specificity and sensitivity.

Results
A total of 172 patients were evaluated over a two-year period, n=33 (19%) underwent conservative measures with physiotherapy and rehabilitation the mainstay of treatment, whilst n=139 (81%) underwent surgery to repair diagnosed inguinal disruption. All the patients were males. The table below summarises the mean scores.
A ROC curve was used to determine the optimal cut off for the SPORT score to correctly identify people who can have physiotherapy. The ROC curve has an area under the curve (AUC) of 0.936 (95% confidence interval: 0.874, 0.997) suggesting that the SPoRT scoring system is very good at distinguishing between cases requiring surgery and cases where physiotherapy can be used in this data set.
Sensitivity and specificity were weighted equally to determine the optimal cut off. SPoRT scores of 0 and lower indicate physiotherapy should be used, whilst 1 and higher indicate surgery. The sensitivity at this cut off is 0.909 (95% confidence interval 0.757, 0.981); the specificity is 0.892 (95% confidence interval 0.828, 0.938).
This means the cut off can correctly determine if someone needs physio 90.9% (95% CI: 75.7%, 98.1%) of the time and can correctly determine if someone needs surgery 89.2% (95% CI: 82.8, 93.8%) of the time.

Conclusion
In this dataset, SPoRT score of 0 or less can recommend a patient should undergo conservative measures or physiotherapy as a mainstay of treatment, a score of 1 or greater can recommend surgery. Further validation of the scoring system is required.