bluuebunny/crossref_metadata_2025_split huggingface dataset:
Septal myectomy with mitral valve surgery in patients after alcohol septal ablation
Authors: Rudenko Kostiantyn V , Lazoryshynets Vasyl V , Nevmerzhytska Lidiia O , Tregubova Mariia O , Danchenko Polina A 
Published: January 2022

Abstract

OBJECTIVES
We studied 16 patients after failed alcohol septal ablation who underwent extended septal myectomy to analyse the results of surgical correction and identify technical pitfalls the surgeons may be confronted by.

METHODS
Between October 2017 and March 2019, 16 patients underwent surgical extended septal myectomy with accompanying anomalous secondary chordae resection, papillary muscles mobilization [in 9 (56.3%) patients], and anterior mitral leaflet plication after previously failed alcohol septal ablation. Routine preoperative computed tomography or cardiac magnetic resonance planning and intraoperative transoesophageal echocardiography were performed in each of the studied patients. Major technical features were identified and complemented during septal myectomy of the calcified interventricular septum.

RESULTS
The mean age of the studied patients accounted 50.5 ± 14.6, median—54; males—5 (31.3%). Mean cross-clamp time accounted 52 ± 7.2 min. Calcified basal interventricular septum was identified in 2 (12.5%) patients. No iatrogenic ventricular septal defect (0%) was made during surgical correction. Peak systolic pressure gradient decreased from 86 (interquartile range: 75–104.7) to 20 (16–22) mmHg (P&lt; 0.001). No patients with moderate or severe mitral regurgitation were identified, whereas before the procedure, the number of those accounted 13 (81.2%) individuals. In-hospital and overall mortality after septal myectomy accounted 0%.

CONCLUSIONS
Extended septal myectomy in patients who previously underwent alcohol septal ablation is a safe procedure that affects all pathological manifestations of the disease. Routine preoperative computed tomography or cardiac magnetic resonance provides detailed anatomy of the anomalous left ventricle and subvalvular structures and allows to measure the extension of myectomy preventing the occurrence of iatrogenic ventricular septal defect. Septal myectomy of the calcified interventricular septum requires avoidance of ‘one-piece technique’ since fragmental myectomy allows visually control the adequacy of the left ventricle outflow tract release.
Risk factors for stroke after total aortic arch replacement using the frozen elephant trunk technique
Authors: Berger Tim , Kreibich Maximilian , Mueller Felix , Breurer-Kellner Lara , Rylski Bartosz , Kondov Stoyan , Schröfel Holger , Pingpoh Clarence , Beyersdorf Friedhelm , Siepe Matthias , Czerny Martin 
Published: January 2022

Abstract

OBJECTIVES
This study aimed to analyse risk factors for postoperative stroke, evaluate the underlying mechanisms and report on outcomes of patients suffering a postoperative stroke after total aortic arch replacement using the frozen elephant trunk technique.

METHODS
Two-hundred and fifty patients underwent total aortic arch replacement via the frozen elephant trunk technique between March 2013 and November 2020 for acute and chronic aortic pathologies. Postoperative strokes were evaluated interdisciplinarily by a cardiac surgeon, neurologist and radiologist, and subclassified to each’s cerebral territory. We conducted a logistic regression analysis to identify any predictors for postoperative stroke.

RESULTS
Overall in-hospital was mortality 10% (25 patients, 11 with a stroke). A symptomatic postoperative stroke occurred in 42 (16.8%) of our cohort. Eight thereof were non-disabling (3.3%), whereas 34 (13.6%) were disabling strokes. The most frequently affected region was the arteria cerebri media. Embolism was the primary underlying mechanism (n = 31; 73.8%). Mortality in patients with postoperative stroke was 26.2%. Logistic regression analysis revealed age over 75 (odds ratio = 3.25; 95% confidence interval 1.20–8.82; P = 0.021), a bovine arch (odds ratio = 4.96; 95% confidence interval 1.28–19.28; P = 0.021) and an acute preoperative neurological deficit (odds ratio = 19.82; 95% confidence interval 1.09–360.84; P = 0.044) as predictors for postoperative stroke.

CONCLUSIONS
Stroke after total aortic arch replacement using the frozen elephant trunk technique remains problematic, and most lesions are of embolic origin. Refined organ protection strategies, and sophisticated monitoring are mandatory to reduce the incidence of postoperative stroke, particularly in older patients presenting an acute preoperative neurological deficit or bovine arch.
Operative versus non-operative management of rib fractures in flail chest after cardiopulmonary resuscitation manoeuvres
Authors: Dorn Patrick , Pfister Selina , Oberhaensli Simone , Gioutsos Konstantinos , Haenggi Matthias , Kocher Gregor J 
Published: January 2022

Abstract

OBJECTIVES
Blunt chest trauma after mechanical resuscitation manoeuvres appears to have a significant impact on the often complicated course. Due to a lack of data in the literature, the purpose of this study was to investigate the feasibility and immediate outcome of chest wall stabilization for flail chest in this vulnerable patient population.

METHODS
We retrospectively reviewed the medical records of patients after cardiopulmonary resuscitation between January 2014 and December 2018 who were diagnosed with flail chest. We attempted to compare patients after surgery with those after conservative treatment.

RESULTS
Of a total of 56 patients with blunt chest trauma after mechanical resuscitation and after coronary angiography, 25 were diagnosed with flail chest. After the exclusion of 2 patients because of an initial decision to palliate, 13 patients after surgical stabilization could be compared with 10 patients after conservative therapy. Although there was no significant difference in the total duration of ventilatory support, there was a significant advantage when the time after stabilization to extubation was compared with the duration of ventilation in the conservative group. The presence of pulmonary contusion, poor Glasgow Coma Scale score or the development of pneumonia negatively affected the outcome, but additional sternal fracture did not.

CONCLUSIONS
Surgical stabilization for chest wall instability is well tolerated even by this vulnerable patient population. Our results should be used for further randomized controlled approaches. It is necessary to evaluate the situation with all parameters in an interdisciplinary manner and to decide on a possible surgical therapy at an early stage if possible.
Surgical smoke: modern mobile smoke evacuation systems improve occupational safety in the operating theatre
Authors: Gioutsos Konstantinos , Nguyen Thanh-Long , Biber Ulrich , Enderle Markus D , Koss Abigail , Kocher Gregor J 
Published: January 2022

Abstract

OBJECTIVES
Evaluation of smoke capture efficiency of different mobile smoke evacuation devices with respect to volatile organic compounds and their noise emission.

METHODS
Electrosurgical incisions were performed on fresh porcine liver in an operating room with vertical laminar flow. The generated surgical smoke was analysed with proton-transfer-reaction mass spectrometry with and without the use of a mobile smoke evacuation system consisting of a smoke evacuator machine, a suction hose and a handpiece. The inlet of the mass spectrometer was positioned 40 cm above the specimen. Various devices were compared: a hard plastic funnel, a flexible foam funnel, an on-tip integrated aspirator of an electrosurgical knife and a standard secretion suction (Yankauer). Also, sound levels were measured at a distance of 40 cm from the handpieces’ inlet.

RESULTS
The smoke capture efficiency of the secretion suction was only 53%, while foam funnel, plastic funnel and integrated aspirator were all significantly more effective with a clearance of 95%, 91% and 91%, respectively. The mean sound levels were 68 and 59 A-weighted decibels with the plastic and foam funnel, respectively, 66 A-weighted decibels with the integrated aspirator and 63 A-weighted decibels with the secretion suction.

CONCLUSIONS
Carcinogenic, mutagenic and reprotoxic volatile organic compounds in surgical smoke can be efficiently reduced by mobile smoke evacuation system, providing improved protection for medical personnel. Devices specifically designed for smoke evacuation are more efficient than standard suction tools. Noise exposure for the surgeon was lowest with the flexible foam funnel and higher with the other handpieces tested.
Robotic-assisted lobectomy after bilateral lung transplantation
Authors: Romero-Vielva Laura , Ascanio-Gosling Fernando , González-Tallada Anna , Rosado-Rodríguez Joel 
Published: January 2022

Abstract
A 67-year-old woman diagnosed with a lung nodule on the left upper lobe was referred for surgical treatment. She had undergone a bilateral lung transplant in 2014. A robotic-assisted lobectomy with mediastinal lymph node dissection was performed. Final pathology revealed a pT3N0M0 Micropapillary Adenocarcinoma. The patient is alive and disease-free 13 months after the operation. This case report and video illustrate the safety and feasibility of a robotic-assisted lobectomy in a lung transplant recipient.
Neurostructural Differences in Adolescents With Treatment-Resistant Depression and Treatment Effects of Transcranial Magnetic Stimulation
Authors: Seewoo Bhedita J , Rodger Jennifer , Demitrack Mark A , Heart Karen L , Port John D , Strawn Jeffrey R , Croarkin Paul E 
Published: January 2022

Abstract

Background
Despite its morbidity and mortality, the neurobiology of treatment-resistant depression (TRD) in adolescents and the impact of treatment on this neurobiology is poorly understood.

Methods
Using automatic segmentation in FreeSurfer, we examined brain magnetic resonance imaging baseline volumetric differences among healthy adolescents (n = 30), adolescents with major depressive disorder (MDD) (n = 19), and adolescents with TRD (n = 34) based on objective antidepressant treatment rating criteria. A pooled subsample of adolescents with TRD were treated with 6 weeks of active (n = 18) or sham (n = 7) 10-Hz transcranial magnetic stimulation (TMS) applied to the left dorsolateral prefrontal cortex. Ten of the adolescents treated with active TMS were part of an open-label trial. The other adolescents treated with active (n = 8) or sham (n = 7) were participants from a randomized controlled trial.

Results
Adolescents with TRD and adolescents with MDD had decreased total amygdala (TRD and MDD: −5%, P = .032) and caudal anterior cingulate cortex volumes (TRD: −3%, P = .030; MDD: −.03%, P = .041) compared with healthy adolescents. Six weeks of active TMS increased total amygdala volumes (+4%, P &lt; .001) and the volume of the stimulated left dorsolateral prefrontal cortex (+.4%, P = .026) in adolescents with TRD.

Conclusions
Amygdala volumes were reduced in this sample of adolescents with MDD and TRD. TMS may normalize this volumetric finding, raising the possibility that TMS has neurostructural frontolimbic effects in adolescents with TRD. TMS also appears to have positive effects proximal to the site of stimulation.
Pharmacists supporting athletes: a scoping review exploring the knowledge, role and responsibilities of pharmacists in preventing the unintentional use of prohibited substances by athletes
Authors: Greenbaum Deborah H , McLachlan Andrew J , Roubin Rebecca H , Chaar Betty B 
Published: January 2022

Abstract

Background
Following the establishment of the World Anti-Doping Agency in 1999, the International Pharmacy Federation (FIP) published guidelines – The Role of the Pharmacist in the Fight against Doping in Sport (2014) – intended for implementation into national standards of practice, to clarify pharmacists’ roles in supporting athletes. Despite 7 years since the publication of these guidelines, the extent of practice and knowledge regarding sport pharmacy remains unclear.

Objectives
To explore the literature to ascertain knowledge held by pharmacists and pharmacy students regarding anti-doping and to determine current/potential roles and responsibilities for pharmacists in the dissemination of information about, and the reduction in unintentional use of, prohibited substances by athletes.

Method
A literature search of five databases utilising terms such as athlete, performance-enhancing and pharmacist was undertaken. Relevant articles published since 1999 were searched for knowledge, roles and responsibilities of pharmacists.

Key findings
We identified 16 research studies outlining knowledge, as well as roles and responsibilities of pharmacists in assisting athletes. Pharmacists reportedly had limited knowledge of anti-doping organisations and prohibited substances. Roles identified included counselling, education, advice about prohibited substances and dispensing. Responsibilities included medication review and assisting athletes to avoid unintentional ingestion of prohibited substances.

Conclusion
Pharmacists, by training, can play a role in providing accurate medication-related information to athletes to avoid prohibited substances. Key barriers identified were pharmacists’ lack of knowledge and the absence of guidelines articulating specific roles and responsibilities for pharmacists, highlighting the need for educational programmes and inclusion of specific responsibilities in national guidelines.
Emergence of rare carbapenemases (FRI, GES-5, IMI, SFC and SFH-1) in Enterobacterales isolated from surface waters in Japan
Authors: Gomi Ryota , Matsumura Yasufumi , Tanaka Michio , Ihara Masaru , Sugie Yoshinori , Matsuda Tomonari , Yamamoto Masaki 
Published: January 2022

Abstract

Objectives
Carbapenemase-producing Enterobacterales (CPE) pose serious threats to public health. Compared with clinical CPE, the genetic characteristics of environmental CPE are not well understood. This study aimed to characterize the genetic determinants of carbapenem resistance in CPE isolated from environmental waters in Japan.

Methods
Eighty-five water samples were collected from rivers and a lake in Japan. CPE were identified using selective media, and genome sequencing was performed for the obtained isolates (n = 21).

Results
Various rare/novel carbapenemases were identified: GES-5 in Raoultella planticola (n = 1), FRI-8 and FRI-11 in Enterobacter spp. (n = 8), IMI-22 and IMI-23 in Serratia ureilytica (n = 3), and SFC-1, SFC-2 and SFH-1 in Serratia fonticola (n = 9). Genomes of 11 isolates could be closed, allowing the elucidation of the genetic contexts of the carbapenemase genes. The blaGES-5 gene was located within a class 1 integron, In2071 (cassette array, blaGES-5-aacA3-aadA16), on a 33 kb IncP6 plasmid. The blaFRI-8 genes were carried on IncFII(Yp) plasmids ranging in size from 191 kb to 244 kb, and the blaFRI-11 genes were carried on 70 kb and 74 kb IncFII(pECLA)/IncR plasmids. The blaIMI-22 and blaIMI-23 genes were co-located on a 107 kb plasmid. The blaSFC and blaSFH-1 genes were found on putative genomic islands inserted at tRNA-Phe genes in chromosomes.

Conclusions
This study revealed the presence of rare/novel carbapenemases among CPE in aquatic environments, suggesting that the environment may act as a potential reservoir of these minor carbapenemases.
Biology and Management of Small Hive Beetles (Coleoptera: Nitidulidae): A Pest of European Honey Bee (Hymenoptera: Apidae) Colonies
Authors: Roth Morgan A , Wilson James M , Gross Aaron D 
Published: January 2022

AbstractSmall hive beetle (Aethina tumida Murray) control has become an issue of increasing importance for North American apiculturists throughout the past two decades. Aethina tumida was discovered in Florida in 1989, presumably transported from its native habitat of sub-Saharan Africa through the shipment of European honey bee (Apis mellifera L) queens. Estimates of damage from A. tumida were as high as $3 million annually in the United States by the year 2004, and A. tumida was found in nearly every state by 2008. When adult beetles emerge from pupation in soil surrounding the hive, they are attracted to A. mellifera hives through a variety of pheromones and volatile organic compounds from bees and hive products. Aethina tumida larvae and adults consume hive products and bee brood, generating fermenting waste (or slime), which can eventually lead to hive abandonment in cases of severe infestation. Pest management efforts for A. tumida have focused on trapping adults, applying lime, diatomaceous earth, pyrethroid soil drenches, and entomopathogenic nematodes to the soil surrounding A. mellifera hives. Understanding the biology and life history of A. tumida, along with current control methods, can aid apiculturists in making informed integrated pest management decisions. Additionally, understanding critical knowledge gaps in the current research is an important step in identifying promising future management tactics in the ongoing efforts to manage this invasive pest.
FOLFIRINOX as Initial Treatment for Localized Pancreatic Adenocarcinoma: A Retrospective Analysis by the Trans-Atlantic Pancreatic Surgery Consortium
Authors: Janssen Quisette P , van Dam Jacob L , Doppenberg Deesje , Prakash Laura R , van Eijck Casper H J , Jarnagin William R , O’ Reilly Eileen M , Paniccia Alessandro , Besselink Marc G , Katz Matthew H G , Tzeng Ching-Wei D , Wei Alice C , Zureikat Amer H , Groot Koerkamp Bas ,   for the Trans-Atlantic Pancreatic Surgery (TAPS) Consortium
Published: January 2022

Abstract

Background
Large pragmatic studies of patients who received 5-fluorouracil with leucovorin, irinotecan, and oxaliplatin ([m]FOLFIRINOX) as initial treatment for localized pancreatic ductal adenocarcinoma (PDAC) are lacking. This study aimed to provide realistic estimates of oncologic outcomes in these patients.

Methods
This international retrospective cohort study included all consecutive patients presenting with localized PDAC who received at least 1 cycle of (m)FOLFIRINOX as initial treatment in 5 referral centers from the United States and the Netherlands (2012-2019). Primary outcome was median overall survival (OS), calculated from the date of tissue diagnosis, assessed using Kaplan-Meier estimates. Log-rank test was used to compare OS between groups. A Cox proportional hazards regression model was used to assess prognostic baseline factors for OS. All statistical tests were 2-sided.

Results
Overall, 1835 patients were included, of whom 958 (52.2%) had locally advanced (LA), 531 (28.9%) had borderline resectable (BR), and 346 (18.9%) had potentially resectable (PR) PDAC. The median number of (m)FOLFIRINOX cycles was 6 (interquartile range = 4-8). Subsequent treatment included second chemotherapy (12.9%), radiotherapy (49.0%), and resection (37.9%). The resection rate was 17.6% for LA, 53.1% for BR, and 70.5% for PR PDAC (P &lt; .001). The margin-negative resection rate (&gt;1 mm) was 55.2% for LA, 62.6% for BR, and 79.2% for PR PDAC (P &lt; .001). The median OS was 18.7 months (95% confidence interval [CI] = 17.7 to 19.9 months) for LA, 23.2 months (95% CI = 21.0 to 25.7 months) for BR, and 31.2 months (95% CI = 26.2 to 36.6 months) for PR PDAC (P &lt; .001). The median OS for 695 patients who underwent a resection was 38.3 months (95% CI = 36.1 to 42.0 months). Independent prognostic factors at baseline for worse OS were more advanced stage, worse performance status, baseline carbohydrate antigen (CA) 19-9 &gt; 500 U/mL, and body mass index ≤18.5 kg/m2.

Conclusions
This large international cohort study provides realistic estimates of resection rates and survival in patients with LA, BR, and PR PDAC who started (m)FOLFIRINOX treatment in PDAC referral centers.
Structural Effects on Implicature Calculation
Authors: Ander Mendia Jon 
Published: January 2022

Abstract
This paper provides an investigation of Ignorance Inferences by looking at the superlative modifier at least. The formal properties of these inferences are characterized in terms of the epistemic conditions that they impose on the speaker, thereby establishing how much can and must be inferred about what the speaker is ignorant about. The paper makes two main contributions. First, it argues that the form of these inferences depends solely on the structural properties of the expression that at least is modifying, which do not necessarily coincide with semantic entailment. Rather, rank and order seems to matter: with totally ordered associates, at least triggers Ignorance Inferences that may be formally different than those obtained with partially ordered associates (Mendia (2016b)). Second, it builds on neo-Gricean double alternative generation mechanisms (like Schwarz (2016)) arguing that one of them must be provided by focus.
Modified laparoscopic Sugarbaker repair of a recurrent ileostomy prolapse
Authors: Orovec Adele S , Minor Samuel F , Hoogerboord C Marius 
Published: January 2022

Abstract
A 57-year-old male who presented with a recurrent ileostomy prolapse was successfully treated with the modified laparoscopic Sugarbaker procedure. This case demonstrates a novel application of the modified laparoscopic Sugarbaker procedure and provides an alternative option for the surgeon managing this challenging problem of recurrent stomal prolapse.
How Does Back Translation Fare Against Team Translation? An Experimental Case Study in the Language Combination English–German
Authors: Behr Dorothée , Braun Michael 
Published: January 2022

AbstractWhen it comes to quality in questionnaire translation and hence comparability in comparative research, the chosen translation method is crucial for the outcome. Few empirical studies compare different translation methods—a fact which is often deplored in the research community. To fill the gap, in this study, the team translation approach is compared against a simple back-translation approach. The starting point in both cases was the initial English–German translations of ISSP (International Social Survey Program) questions. The final translations from both approaches were assessed, with a focus on how translation issues, such as mistranslations or wording issues identified in the initial translations were addressed. While none of the twenty-nine issues in the initial translation were present in the final team translation version, twenty-two of these issues were still present in the final version after the back-translation approach. For a selected number of items, we also ran a split-ballot experiment in a web survey. Only five out of fifteen items (33 percent) that went into the experiment showed significant differences between the translations, and only one could clearly be attributed to remaining errors in the back-translation version. In sum, the final translation from the team approach clearly outperformed the final translation from the back-translation approach when it comes to text-based criteria (in particular, accuracy and fluency). The quantitative test showed that many translation issues (those remaining in the translation after the back translation step) had no effect on the estimates. Nevertheless, we ask respondents to put effort into survey responding; in the same vein, we as researchers should put effort in the survey experience by providing questions that are clearly worded and free of errors, which puts the team approach ahead of the back-translation approach.