bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of Victorian COVID‐19 lockdowns on the presentation and management of acute appendicitis
Authors: Rajagopalan Ashray , Roschach Blake , Grant Katherine , Singh Jasprit , Bak Marek , Burgess Marjorie , Liu Kerry , Chen Nevin , Menzie Jack , Chew Sarah , Gupta Namankit , Frederick Naomi , Hegarty Lachlan , Chan Carina , Penfold Samuel , Walia Anysha , Croagh Daniel 
Published: April 2022

AbstractBackgroundsThe COVID‐19 pandemic presents ongoing challenges for healthcare. Stay at Home orders (‘lockdowns’) and community fears have been suggested to create reluctance to seek healthcare. We aimed to determine whether the rates of perforated appendicitis and negative appendicectomy have been affected by the pandemic, and to analyse the effect of lockdowns on the management of acute appendicitis in Victoria.MethodsWe conducted a retrospective audit of emergency appendicectomies performed under adult General Surgery units at Monash Health in Victoria from January 2019 to September 2021, including 242 days of lockdown.Results2459 patients were included. Fewer patients had perforated appendicitis during the second lockdown (6.3% versus 10.7% baseline; p = 0.027). The rate of negative appendicectomy was reduced during the first lockdown (4.1% versus 14.9% baseline; p = 0.002) and during intervals between lockdown in 2021 (9.8%; p = 0.010). There was no difference in the rate of perforated appendicitis or negative appendicectomy at other times. Time to surgery and number of appendicectomies performed were also not significantly different. Fewer appendicectomies were performed after hours during lockdowns and in 2021 more generally compared to baseline (p < 0.05).ConclusionThe lower negative appendicectomy rate during the first lockdown may reflect increased pre‐operative imaging or clinical observation for undifferentiated presentations. There was a reduction in perforated appendicitis during the second lockdown, and no significant difference at other times. Contrary to other studies, lockdowns associated with the COVID‐19 pandemic may not create a reluctance to seek healthcare in all regions.
Access to essential surgical care in district hospitals of Sarawak Malaysia: outcomes of an audit and the need for urgent attention
Authors: Siow Sze Li , Wahab Mohamed Yusof Abdul , Chuah Jun Sen , Mahendran Hans Alexander 
Published: April 2022

AbstractBackgroundSince access to essential surgical care (ESC) in rural Sarawak, Malaysia, remains subpar, this study aimed to identify pitfalls in its ESC delivery and possible solutions to improve it.MethodsThis cross‐sectional study was undertaken in the Sarawak General Hospital between January 2019 and December 2019. It assessed the caseload of five essential surgical procedures referred from nearby district hospitals. It analysed the number of patients stranded in the accident and emergency department, their waiting time for ward transfer and the duration between admission day and timing of surgery for patients with appendicitis.ResultsThere were 259 referrals for one of the five essential surgical procedures. The baseline characteristics between the referred and the local cohorts of patients for the designated procedures were comparable in terms of gender (P = 0.486), body mass index (P = 0.598) and ASA score (P = 0.284), with the exceptions being that the referred cohorts were older (43.2 vs. 39.7, P = 0.008) and with different racial composition (p < 0.001). The mean number of patients stranded in emergency department was 34.2 ± 4.9 per day and the mean bed waiting time was 21.4 ± 6.3 h. For patients who required appendicectomy, 70.8% of patients had surgery performed within 24 h of admission.ConclusionThe delivery of ESC in Sarawak's district hospitals demands urgent attention for improvement. The action framework proposed outlined six priorities: infrastructure development, service delivery, surgical training, finance, information management and governance.
Mesh fixation techniques in Lichtenstein tension‐free repair: a network meta‐analysis
Authors: Jiang Wei‐Rong , Zhang Xiao‐Bei , Wang Rui , Cao Dong , Yu Yong‐Jiang 
Published: April 2022

AbstractBackgroundsTo compare the clinical effectiveness of different mesh fixation techniques in Lichtenstein tension‐free repair using network meta‐analysis.MethodsCochrane Library, Medline, EMBASE, and Web of Science databases were searched until 1 December 2020, and randomized controlled trials (RCTs) comparing outcomes between different mesh fixation techniques were included. The primary endpoints were chronic postoperative inguinal pain (CPIP) and hernia recurrence. The second endpoint was seroma and infection. Data were processed using Stata MP16.0, and R x64 3.6.1.ResultsThe results demonstrated that 32 RCTs (n = 6362) were eligible for pooling. Six types of mesh fixation techniques were used: non‐absorbable suture, absorbable suture, chemical glue, fibrin glue, self‐gripping mesh, and staple fixation. Network meta‐analysis indicated that the incidence of CPIP with fibrin glue was lower than that with non‐absorbable sutures (relative risk [RR] = 0.23, 95% credibility interval [95%CrI] [0.09, 0.50]), absorbable sutures (RR = 0.24, 95%CrI [0.08, 0.60]), chemical glue (RR = 0.36, 95%CrI [0.13, 0.87]), and self‐gripping mesh (RR = 0.27 95%CrI [0.09, 0.62]). Self‐gripping mesh was superior to non‐absorbable sutures (RR = 0.44, 95%CrI [0.23, 0.74]) in reducing postoperative infection.ConclusionThis network meta‐analysis suggests that fibrin glue might be best for reducing CPIP and recurrence. However, a large‐scale RCT is warranted to confirm the results.
Letter: de novo infection in hepatic encephalopathy—the culprit or the victim?
Authors: Ye Qiaoxia , Yan Yanyan , Li Liguan 
Published: April 2022

LINKED CONTENTThis article is linked to Alabsawy et al papers. To view these articles, visit https://doi.org/10.1111/apt.16790 and https://doi.org/10.1111/apt.16906
Letter: the clinical course of Crohn's disease—the Sicilian experience
Authors: Demarzo Maria Giulia , Viola Anna , Picci Alessandro , Fries Walter 
Published: April 2022

LINKED CONTENTThis article is linked to Burish et al papers. To view these articles, visit https://doi.org/10.1111/apt.16615 and https://doi.org/10.1111/apt.16898
Letter: COVID‐19 outcomes and anti‐TNF treatments—comprehensive evidence matters. Authors' reply
Authors: Kokkotis Georgios , Kitsou Konstantina , Bamias Giorgos 
Published: April 2022

LINKED CONTENTThis article is linked to Kokkotis et al papers. To view these articles, visit https://doi.org/10.1111/apt.16717 and https://doi.org/10.1111/apt.16872
Letter: de novo infection in hepatic encephalopathy—The culprit or the victim? Authors' reply
Authors: Alabsawy Eman , Shalimar  , Jalan Rajiv 
Published: April 2022

LINKED CONTENTThis article is linked to Alabsawy et al papers. To view these articles, visit https://doi.org/10.1111/apt.16790 and https://doi.org/10.1111/apt.16855
A comparison of postoperative pain between transumbilical and suprapubic incision in laparoscopic liver resection
Authors: Soyama Akihiko , Murakami Shunsuke , Natsuda Koji , Hara Takanobu , Matsuguma Kunihito , Matsushima Hajime , Imamura Hajime , Tanaka Takayuki , Adachi Tomohiko , Hidaka Masakaki , Eguchi Susumu 
Published: April 2022

AbstractBackgroundIn laparoscopic liver resection, few reports have investigated the influence of type of incision on postoperative pain in laparoscopic liver resection. We therefore conducted the present study to clarify the difference in postoperative pain between two types of incision.MethodsNineteen patients who underwent laparoscopic lateral sectionectomy were enrolled. In 11 patients with a transumbilical incision and eight with a suprapubic incision, the operation duration, blood loss, length of incision, duration of intravenous fentanyl infusion immediately after surgery and rescue dosage, and period of regular oral nonsteroidal anti‐inflammatory drugs were evaluated.ResultsThere was no significant difference between the two groups in patients' background characteristics, operation time, or amount of blood loss. The length of suprapubic incision was significantly longer than the umbilical incision. Concerning the postoperative pain management, the duration of intravenous fentanyl administration was 1 day (1–2 days) for umbilical incisions and 1.5 days (1–2 days) for suprapubic incisions, showing no significant difference. Regarding the rescue dosage of fentanyl, the results were comparable between the groups. Regarding the postoperative duration of regular nonsteroidal anti‐inflammatory drug administration, there was also no significant difference between the groups (transumbilical: 14 [5–35] days vs suprapubic: 8 [7–32]).ConclusionsPostoperative pain is comparable between umbilical and suprapubic incision in patients who underwent laparoscopic left lateral segmentectomy. In terms of postoperative pain, either a transumbilical incision or a suprapubic incision can be selected for specimen extraction.
Expanding certified professional midwife services during the COVID‐19 pandemic
Authors: Applebaum Jeremy 
Published: April 2022

AbstractGiven concerns of coronavirus disease 2019 (COVID‐19) acquisition in health care settings and hospital policies reducing visitors for laboring patients, many pregnant women are increasingly considering planned home births. Several state legislatures are considering increasing access to home births by granting licensure and Medicaid coverage of certified professional midwife (CPM) services. In this commentary, issues surrounding the expansion of CPM services including safety, standardization of care, patient satisfaction, racial and income equity, and an overburdened health care system are discussed. Lawmakers must account for these factors when considering proposals to expand CPM practice and payment during a pandemic.
Obesity increases the risk for upper extremity deep vein thrombosis and pulmonary embolism in patients with upper extremity central venous catheters
Authors: Druar Nicholas M. , Vosburg Ralph Wesley , Cahan Mitchell 
Published: April 2022

SummaryThe morbidity and mortality of deep vein thrombosis (DVT) remain a significant burden for the healthcare system. The aim of this analysis was to examine the association of upper extremity central venous catheter (UECVC) and venous thromboembolism (UEVTE) with increasing body mass index (BMI) in a large database study and to further examine disposition. Inpatient data from the National Inpatient Sample from 2017 to 2019 were used to investigate the effect of obesity on patients diagnosed with DVT of the upper extremity or pulmonary embolism (PE) who had upper extremity venous central line placement. There was a total of 1690 cases of UEVTE and 3202 cases of PE within the sample. There was an increasing odds of UEVTE in the patients with UECVCs with increasing BMI. Patients with a BMI of 30–39, 40–49 and > 50 kg/m2 were significantly different than those with BMI of <19 and 20–29 kg/m2 in the UECVC group for UEVTE. This study demonstrated increased odds of UEVTE for patients with increased BMI. Practitioners should assume a greater risk for UEVTE and PE in patients with increased BMI when considering CVCs.
Validation of the psychometric properties of a “Modified Version of the Hornheider Screening Instrument” (HSI‐MV) using a sample of outpatient and inpatient skin tumor patients
Authors: Buchhold Britta , Lutze Stine , Freyer‐Adam Jennis , Jünger Michael , Ramp Marleen , Konschake Wolfgang , Jülich Andreas , Nordt Claudia , Peters Sebastian , Arnold Andreas , Hannich Hans‐Joachim 
Published: April 2022

SummaryBackgroundThe basis for adequate psycho‐oncological care is the identification of patients with psychosocial support needs. The German Working Group for Psychooncology also recommends the Hornheider Screening Instrument (HSI) for this purpose. The question, “Is anyone in your family particularly burdened by the hospital stay?” is intended to capture disease‐related family stress. But is this item equally suitable for outpatients and inpatients? The study objective was to examine how replacing the original item affects the test performance of this modified version of the HSI and the frequency of psychosocial stress.Patients and Methods92 outpatients and 98 inpatients with skin tumors assessed their psychosocial situation using different questionnaires.ResultsCompared to inpatients, less than half as many outpatients answered the item in the affirmative. If the question was replaced by: “Is someone in your family particularly burdened by your disease or the course of the disease?” this setting‐related difference did not arise. The “Alternative item” and the “Modified version of the HIS” (HSI‐MV) proved to be superior to the original item and the original HSI with regard to all examined criteria.ConclusionsThe HSI‐MV can be used as a reliable and valid instrument for the systematic assessment of psychosocial care needs in outpatient and inpatient settings. Depending on care capacity, a threshold of ≥ 5 or ≥ 4 is appropriate. In addition to screening, the desire for support should be enquired.
Endoscopic ultrasound‐guided drainage using lumen‐apposing metal stent of malignant afferent limb syndrome in patients with previous Whipple surgery: Multicenter study (with video)
Authors: Pérez‐Cuadrado‐Robles Enrique , Bronswijk Michiel , Prat Fréderic , Barthet Marc , Palazzo Maxime , Arcidiacono Paolo , Schaefer Marion , Devière Jacques , van Wanrooij Roy L. J. , Tarantino Ilaria , Donatelli Gianfranco , Camus Marine , Sanchez‐Yague Andres , Pham Khanh Do‐Cong , Gonzalez Jean‐Michel , Anderloni Andrea , Vila Juan J. , Jezequel Julien , Larghi Alberto , Jaïs Bénédicte , Vazquez‐Sequeiros Enrique , Deprez Pierre H. , Van der Merwe Schalk , Cellier Christophe , Rahmi Gabriel 
Published: April 2022

ObjectivesEndoscopic ultrasound‐guided digestive anastomosis (EUS‐A) is a new alternative under evaluation in patients presenting with afferent limb syndrome (ALS) after Whipple surgery. The aim of the present study is to analyze the safety and effectiveness of EUS‐A in ALS.MethodsThis is an observational multicenter study. All patients ≥18 years old with previous Whipple surgery presenting with ALS who underwent an EUS‐A using a lumen‐apposing metal stent (LAMS) between 2015 and 2021 were included. The primary outcome was clinical success, defined as resolution of the ALS or ALS‐related cholangitis. Furthermore, technical success, adverse event rate, and mortality were evaluated.ResultsForty‐five patients (mean age: 65.5 ± 10.2 years; 44.4% male) were included. The most common underlying disease was pancreatic cancer (68.9%). EUS‐A was performed at a median of 6 weeks after local tumor recurrence. The most common approach used was the direct/freehand technique (66.7%). Technical success was achieved in 95.6%, with no differences between large (≥15 mm) and small LAMS (97.4% vs. 100%, P = 0.664). Clinical success was retained in 91.1% of patients. A complementary treatment by dilation of the stent followed by endoscopic retrograde cholangiopancreatography through the LAMS was performed in three cases (6.7%). There were six recurrent episodes of cholangitis (14.6%) and two procedure‐related adverse events (4.4%) after a median follow‐up of 4 months. Twenty‐six patients (57.8%) died during the follow‐up due to disease progression.ConclusionEUS‐A is a safe and effective technique in the treatment of malignant ALS, achieving high clinical success with an acceptable recurrence rate.
Public support for economic transition
Authors: Coufalová Lucie , Kolajtová Lenka , Žídek Libor 
Published: April 2022

AbstractThis paper focuses on the Czech economic transition and aims to identify the determinants of unusually high and long‐lasting public support for market reforms. The study is based on a unique combination of statistical analysis of survey data and oral history (interviews with reformers, managers etc.), which has enabled us to depict the views of the general public as well as of many people involved in decision‐making processes on both macro and micro levels. These findings allow us to propose recommendations on how to gain and maintain public support for economic reforms. Above all, reformers must utilize the period of euphoria and communicate the individual steps of reform with the public.
Computer vision and deep learning for fish classification in underwater habitats: A survey
Authors: Saleh Alzayat , Sheaves Marcus , Rahimi Azghadi Mostafa 
Published: April 2022

AbstractMarine scientists use remote underwater image and video recording to survey fish species in their natural habitats. This helps them get a step closer towards understanding and predicting how fish respond to climate change, habitat degradation and fishing pressure. This information is essential for developing sustainable fisheries for human consumption, and for preserving the environment. However, the enormous volume of collected videos makes extracting useful information a daunting and time‐consuming task for a human being. A promising method to address this problem is the cutting‐edge deep learning (DL) technology. DL can help marine scientists parse large volumes of video promptly and efficiently, unlocking niche information that cannot be obtained using conventional manual monitoring methods. In this paper, we first provide a survey of computer visions (CVs) and DL studies conducted between 2003 and 2021 on fish classification in underwater habitats. We then give an overview of the key concepts of DL, while analysing and synthesizing DL studies. We also discuss the main challenges faced when developing DL for underwater image processing and propose approaches to address them. Finally, we provide insights into the marine habitat monitoring research domain and shed light on what the future of DL for underwater image processing may hold. This paper aims to inform marine scientists who would like to gain a high‐level understanding of essential DL concepts and survey state‐of‐the‐art DL‐based fish classification in their underwater habitat.
Corrosion fatigue of Ti‐6Al‐4V coupons manufactured by directed energy deposition
Authors: Hattingh Danie G. , Botha Sheldyn , Bernard Dreyer , James M. Neil , du Plessis Anton 
Published: April 2022

AbstractTitanium is a versatile biocompatible metal that is desirable in additively manufactured medical implant devices. However, additively manufactured parts have particular microstructures, porosity, residual stress, and surface conditions which can have a strong impact on fatigue performance. Implants have an added complexity from the saline operating environment and the associated impact on the safe design life. Equally, direct energy deposition induces a complex thermal history which, if not carefully controlled, can significantly alter the mechanical/material properties of the component. This study investigates the decrease in fatigue life, in an in vitro body fluid simulation using Ringer's solution, observed in Ti‐6Al‐4V specimens extracted from coupons manufactured by directed energy deposition. An interrupted deposition strategy was employed to control build regularity, which appeared to influence certain mechanical properties, including corrosion fatigue life. An ≈50% decrease in fatigue life was observed in Ringer's solution at 6 Hz loading frequency, clearly important in designing implants.
Phylogenetic relatedness of food plants reveals highest insect herbivore specialization at intermediate temperatures along a broad climatic gradient
Authors: König Sebastian , Krauss Jochen , Keller Alexander , Bofinger Lukas , Steffan‐Dewenter Ingolf 
Published: April 2022

AbstractThe composition and richness of herbivore and plant assemblages change along climatic gradients, but knowledge about associated shifts in specialization is scarce and lacks controlling for the abundance and phylogeny of interaction partners. Thus, we aimed to test whether the specialization of phytophagous insects in insect‐plant interaction networks decreases toward cold habitats as predicted by the ‘altitude niche‐breadth hypothesis’ to forecast possible consequences of interaction rewiring under climate change. We used a non‐invasive, standardized metabarcoding approach to reconstruct dietary relationships of Orthoptera species as a major insect herbivore taxon along a broad temperature gradient (~12°C) in Southern Germany. Based on Orthoptera surveys, feeding observations, collection of fecal pellets from >3,000 individuals of 54 species, and parallel vegetation surveys on 41 grassland sites, we quantified plant resource availability and its use by herbivores. Herbivore assemblages were richer in species and individuals at sites with high summer temperatures, while plant richness peaked at intermediate temperatures. Corresponding interaction networks were most specialized in warm habitats. Considering phylogenetic relationships of plant resources, however, the specialization pattern was not linear but peaked at intermediate temperatures, mediated by herbivores feeding on a narrow range of phylogenetically related resources. Our study provides empirical evidence of resource specialization of insect herbivores along a climatic gradient, demonstrating that resource phylogeny, availability, and temperature interactively shape the specialization of herbivore assemblages. Instead of low specialization levels only in cold, harsh habitats, our results suggest increased generalist feeding due to intraspecific changes and compositional differences at both ends of the microclimatic gradient. We conclude that this nonlinear change of phylogeny‐based resource specialization questions predictions derived from the ‘altitude‐niche breadth hypothesis’ and highlights the currently limited understanding of how plant‐herbivore interactions will change under future climatic conditions.
Exploring complex water stress–gross primary production relationships: Impact of climatic drivers, main effects, and interactive effects
Authors: Wang Huan , Yan Shijie , Ciais Philippe , Wigneron Jean‐Pierre , Liu Laibao , Li Yan , Fu Zheng , Ma Hongliang , Liang Ze , Wei Feili , Wang Yueyao , Li Shuangcheng 
Published: April 2022

AbstractThe dominance of vapor pressure deficit (VPD) and soil water content (SWC) for plant water stress is still under debate. These two variables are strongly coupled and influenced by climatic drivers. The impacts of climatic drivers on the relationships between gross primary production (GPP) and water stress from VPD/SWC and the interaction between VPD and SWC are not fully understood. Here, applying statistical methods and extreme gradient boosting models—Shapley additive explanations framework to eddy‐covariance observations from the global FLUXNET2015 data set, we found that the VPD‐GPP relationship was strongly influenced by climatic interactions and that VPD was more important for plant water stress than SWC across most plant functional types when we removed the effect of main climatic drivers, e.g. air temperature, incoming shortwave radiation and wind speed. However, we found no evidence for a significant influence of elevated CO2 on stress alleviation, possibly because of the short duration of the records (approximately one decade). Additionally, the interactive effect between VPD and SWC differed from their individual effect. When SWC was high, the SHAP interaction value of SWC and VPD on GPP was decreased with increasing VPD, but when SWC was low, the trend was the opposite. Additionally, we revealed a threshold effect for VPD stress on GPP loss; above the threshold value, the stress on GPP was flattened off. Our results have important implications for independently identifying VPD and SWC limitations on plant productivity, which is meaningful for capturing the magnitude of ecosystem responses to water stress in dynamic global vegetation models.