bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbial-mediated Pesticide Bioremediation: An Approach Through the OMIC Technologies
Authors: Rodríguez A. , Castrejón-Godínez M. L. , Mussali-Galante P. , Tovar-Sánchez E. , Díaz-Soto J. A.
Published: August 2024

The worldwide use of pesticides has great benefits for agriculture. Pesticides offer crop protection from pests, enhance crop yields, and preserve the quality of agricultural products during storage, transport, and commercialization, generating great economic benefits for farmers. However, the extensive use of pesticides in agricultural activities is related to severe environmental pollution, mainly in soil and water bodies, constituting a menace to biodiversity, soil fertility, food supply, and human health. The use of biological systems such as microorganisms has been proposed as an effective approach to mitigate pesticide-related environmental pollution. Establishing effective pesticide bioremediation strategies requires considering important aspects of microbial physiology as well as deep knowledge of the cellular processes, enzymes, and metabolic pathways that drive the pesticide degradation process in microorganisms. Modern research technologies, like genomics, transcriptomics, proteomics, and metabolomics, have been applied to studying microorganisms involved in pesticide bioremediation. The present chapter describes relevant research on the use of OMIC approaches during pesticide microbial degradation. The analysis of this information gives us an overview of the pesticide biodegradation mechanisms, such as the cellular strategies employed by microorganisms to counteract the stress and cellular damage caused by pesticide exposure and the molecular mechanisms (genes, enzymes, metabolites) involved in pesticide degradation. The information generated from multi-omics approaches is very useful for establishing more effective pesticide bioremediation strategies.
Microbial Assisted Phytoremediation of Contaminated Soils: An Effective Way to Enhance Bioremediation of Contaminated Areas
Authors: Castrejón-Godínez M. L. , Rodríguez-Solís A. J. , Mussali-Galante P. , Tovar-Sánchez E.
Published: August 2024

Soil is a non-renewable resource with an essential role for life because it provides a habitat for most species and ecosystem services such as provisioning, culture, maintenance, and regulation. However, anthropogenic activities, mainly agriculture and mining, are sources of contamination that have caused the release of pollutants that can accumulate in the soil and enter food chains, affecting the environment and human health. Hence, remediation strategies are sought for sites contaminated with pesticides and heavy metals; one of these strategies consists in biological treatments, which present advantages over physicochemical remediation treatments. In these treatments, microorganisms, such as bacteria and fungi, plants, or their enzymes are used to remove pollutants from the soil. In particular, assisted phytoremediation combines the potential of different microorganisms and plants to remove contaminants, such as pesticides and heavy metals, from the soil. This chapter analyzes the effects of contaminants in the soil, mainly heavy metals and pesticides, and the underlying mechanisms that microorganisms and plants use to tolerate, eliminate, or degrade these contaminants from soils.
Fluorescence-based pH-shift assay with wide application scope for high-throughput determination of enzymatic activity in enzyme mining and engineering
Authors: Sunder Avinash Vellore , Reif Marie-Luise , Fessner Wolf-Dieter
Published: August 2024

A fluorescence-based pH-shift assay allows determination of the activity of a wide range of enzymes, demonstrated by the high-throughput screening of directed evolution libraries of transketolase on 3-hydroxyaldehydes.
Fouling control of different pretreatments on ceramic fouling ultrafiltration: a review
Authors: Qiao Yimu , Han Xue , Chen Feiyong , Sun Cuizhen , Xu Linxu , Yao Jiaxin , Wu Yaqi , Qi Zhen , Liu Rupeng , Shen Xue
Published: August 2024

Several pretreatment technologies for reducing ceramic ultrafiltration membrane fouling were reviewed, their advantages and disadvantages were analyzed, and the future development direction of the technology was discussed.
Trace Sn modified Zn catalysts for efficient CO2 electroreduction to HCOOH
Authors: Yang Rui , Fu Hao , Han Zimin , Feng Guoqing , Liu Huaizhi , Hu Yangguang , Huang Yiyin
Published: August 2024

Trace Sn effectively modifies the chemical environment and electronic structure of Zn based electrocatalysts, enhancing the O-bonding mode of CO2 adsorption and strengthening the adsorption of an *OOCH intermediate.
Remarkable enhancement of Ca2+ affinity using a redox-switchable coordinating group
Authors: Merino Juan Pedro , Abelairas Adrián M. , Hernández-Ferrer Javier , Benito Ana M. , Maser Wolfgang K. , Vilas-Vilela José L. , Esteban-Gómez David , Criado Alejandro , Mosquera Jesús , Platas-Iglesias Carlos
Published: August 2024

A simple organic motif, 2-nitropyridine, is applied as a redox-switchable coordinating group for Ca2+. Upon reduction, a remarkable 1011-fold increase in affinity is observed, representing the highest reported affinity for this cation to date.
Electrochemical and DFT insights into 2-amino-4-(4-hydroxy-3-methoxyphenyl)-7-methyl-4H-chromene-3-carbonitrile: an innovative strategy for antibacterial activity and corrosion protection of carbon steel
Authors: Al Jahdaly Badreah A.
Published: August 2024

This study evaluated AHMCC as a broad-spectrum antibacterial agent and corrosion inhibitor for carbon steel in 0.5 M HCl.
A well-designed P2-Na0.67Mn0.85Al0.05Zn0.1O2 cathode for superior sodium-ion batteries
Authors: Ding Xiang , Hu Cuixian , Fan Yong , Lin Yue , Liu Jinyang , Yang Yibing , Liu Liangwei , Ma Haibao , Xiao Yi , Han Lili
Published: August 2024

Due to the synergistic doping of Al3+/Zn2+, the superior P2-Na0.67Mn0.85Zn0.05Al0.1O2 cathode enhances the stability of the material throughout charging and discharging, optimizes structural reversibility, and inhibits phase transitions.
Core–shell magnetic mesoporous 3-aminophenol–formaldehyde resin microspheres with rich functional groups via interface co-assembly and polymerization
Authors: Li Jiarong , Liu Shude , Xie Yuanzhao , Jiang Fengluan , Huang Xinyu , Xia Jianfeng , Wu Limin , Deng Yonghui
Published: August 2024

Core–shell magnetic mesoporous 3-aminophenol–formaldehyde resin microspheres were designed to immobilize Au nanoparticles for use as magnetically separable heterogeneous catalysts for the efficient hydrogenation of 4-nitrophenol at room temperature.
Combining sandblasting and pink anodisation of Ti implants as a promising method for improving fibroblast adhesion and immune response
Authors: Arias-Mainer Carlos , Romero-Gavilán Francisco , Cerqueira Andreia , Peñarocha-Oltra David , Bernabeu-Mira Juan Carlos , Elortza Félix , Azkargorta Mikel , Gurruchaga Mariló , Goñi Isabel , Suay Julio
Published: August 2024

This study is performed with the aim of enhancing the cell response to titanium surfaces through sandblasting and pink anodizing (MC04 + PA), correlating in vitro findings with protein adsorption patterns.
A systematic review study: Do human resources management practices have an impact on organizational performance?
Authors: Kelgokmen Ilic Derya , Arpinar Tarık , Ada Nesrin
Published: August 2024

One of the 17 goals of sustainable development is decent work and economic growth. In line with this goal, businesses can elevate the welfare of employees and create quality workplaces through evolving and changing human resource practices. The result of these good practices also enhances organizational performance (OP), thereby contributing to economic development. The aim of the study is to put forward the effect of human resources management (HRM) practices on OP and to examine the studies in the literature on this subject by applying a systematic descriptive content analysis called PRISMA (Preffered Reporting Items for Systematic Review and MetaAnalysis). Totally 26 articles addressing the effects of HRM practices on OP were examined in the light of the dimensions determined for the research through simple statistical methods and tables, and holistic conclusions were tried to be drawn from the studies conducted in the field.
Experimental analysis of consumer behaviour and green business adaptation
Authors: Nazarova Karina , Nezhyva Mariia , Hordopolov Volodymyr , Tsimoshynska Oksana , Mysiuk Viktoriia , Nehodenko Viktoriia
Published: August 2024

The impact of climate change is becoming increasingly clear, with consumers moving towards greener lifestyles and expecting companies to make a positive impact through their operations and overall brand image. The purpose of the article is to study the influence of consumer preferences on the sustainable development of society. Each type of consumer has different priorities regarding other sustainability issues. Knowing customers is critical to running a successful business. For baby boomers and Gen Xers, environmental legacy – what kind of planet they will leave to their children and grandchildren – is very important. The desire to be thrifty increases with age. Millennials and Gen Z have been found to make purchasing decisions based on values and personal principles. The impact of climate change is becoming more apparent; consumers are moving towards greener lifestyles and expect companies also to make a positive impact on their operations and overall brand image. Understanding how consumers think and act about sustainability is vital for companies to function effectively. It was found that all consumer types are concerned about climate change. However, each consumer type has different priorities regarding other sustainability issues.
Implementation of open public information on environmental protection
Authors: Pozniakovska Nataliia , Moshynskyi Viktor , Mikluha Olesia , Pyliavets Viktor , Konarivska Oksana , Andryeyeva Natalya
Published: August 2024

The study analyses the state of the open data ecosystem development in the area of environmental safety and protection in Ukraine and worldwide. It provided an essential characterisation of the new category of “open data maturity” and the possibilities and parameters of its assessment. The requirements of Ukrainian and EU legislation for open environmental data are compared. The processes and current challenges affecting the transparency and excellence of environmental datasets are considered. The roles of data managers (governmental institutions) and intermediaries in data disclosure and creation of accessible services that accumulate, reorganise, structure and format these data are systematised. Scenarios for using public open data services in the environmental sphere are identified. The role of open data in exposing corruption and damage to the environment is noted. The problems of limiting free access to various data sets during the war emphasize the need to create, update and maintain public access to open environmental data that is important and socially significant for the public and the expert community. The most critical areas of work to support the maturity of an open data ecosystem in environmental safety and protection are identified and opportunities for using digital tools and technologies to address current problems and challenges.
Assessment of marketing affects on innovation advancement in the transport cluster
Authors: Koval Viktor , Nencheva Iskra , Metil Tetiana , Honcharova Iryna , Valiavska Nataliia
Published: August 2024

Implementation of high-quality innovation is possible using marketing in a specialised cluster. Creating the basis for a fundamental approach to assessing the impact of innovation requires differentiation and ranking of factors influencing the final results of innovation. This study examines the general principles of using differentiation and ranking as tools for analysing the impact of marketing on the success of innovations in the transport cluster and on the final results of logistics companies. When developing a methodology for assessing marketing effectiveness, special attention was paid to the formation of criteria and performance indicators for companies providing transport services when introducing innovations for which there is a need to integrate logistics space. A method for assessing the influence of various factors on financial results for conducting a quantitative analysis is presented. A study was also conducted on the effectiveness of using cluster marketing when introducing innovations in a transnational company and in a company whose activities are limited at the local level. One of the marketing directions was using digital tools for cargo processing in the integrated logistics space, which can increase by 80% the number of goods processed exclusively by digital means for a logistics company.
Gender gap in access to multi-sectoral resources: The example of Kazakhstan
Authors: Kireyeva Anel , Kredina Anna , Oshanova Kuralay , Kenzhegulova Gaukhar
Published: August 2024

In recent decades, sustainable development has become a crucial global agenda. Equal access to resources fosters an economic model aimed at reducing ecological risks and conserving natural resources while supporting economic growth. However, disparities in resource distribution between social groups lead to socio-economic inequalities and conflicts, posing national and economic security threats, particularly affecting women and children. The research methodology includes conducting a literature review and collecting primary data. The literature review addresses gender differences in providing natural, social, economic, and digital resources. A literature review showed that women living in rural areas are at risk for security. The second part of the methodology was a description of the survey of respondents (N=543). The survey included a Likert scale, and the target group was women living in various regions in rural Kazakhstan. The survey revealed that the most significant problems are related to the digital provision of villages. Infrastructure requires financial investments, which will ultimately lead to a reduction in inequality in access to resources and will contribute to the development of the countries of Central Asia.
Assessing the Compatibility of Menatetrenone with Excipients: A
Spectroscopic Approach and Implication in Drug Formulation
Development
Authors: Singh Widhilika , Kushwaha Poonam , Kushwaha Shom Prakash
Published: August 2024

An experiment was conducted to evaluate the compatibility of menatetrenone with
selected pharmaceutical excipients. Fourier Transform Infrared Spectroscopy
(FTIR) was used to assess drug-excipient compatibility. The present research
systematically investigates the FTIR spectrum of each chemical compound
separately and their physical blends, analyzing for possible shifts, alterations
or novel peak that may indicate chemical interactions. This study aims to
utilize spectral data interpretation to detect potential compatibility problems
that may occur while design and production of menatetrenone containing dosage
forms ensuring their increased stability and effectiveness. The FTIR results
demonstrated that all the pharmaceutical excipients were compatible with
menatetrenone. In conclusion, the compatibility of pharmaceutical excipients
with menatetrenone was successfully assessed using FTIR that will aid in future
design of formulations containing menatetrenone as therapeutic moiety.
Amputation Risk in Type II Diabetes Mellitus Patients Treated with
SGLT-2 Inhibitors: A Systematic Literature Review of Randomized Clinical
Trials
Authors: Hoda Farazul , Jamali Mohammad Chand , Arshad Mawrah , Habib Mohammad Anwar , Akhtar Mohd , Najmi Abul Kalam
Published: August 2024

Background SGLT-2 inhibitors, prescribed for type 2 diabetes, have a
heightened risk of amputation. The FDA issued a warning in May 2017, leading to
the inclusion of a cautionary label. Vigilance is essential for patients and
healthcare providers to promptly identify and address potential limb
complications associated with the use of SGLT-2 inhibitors.

Method A comprehensive search of electronic databases was conducted,
covering the period from inception to May 2024. This systematic literature
review adhered to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. The quality of the included studies was
assessed using the Cochrane risk of bias (ROB) tool. Inclusion and exclusion
criteria were predefined, and data extraction was performed to summarize the
findings.

Result A total of 12 randomized control trial (RCT) studies were included
in the present systematic review. 37,657 (54.89%) participants were randomly
assigned to receive the different interventions of SGLT-2 inhibitor, whereas
30,959 (45.11%) received a placebo. Overall, 618 events were reported in the
treatment group, whereas 396 events were reported in the placebo group.

Conclusion In conclusion, patients treated with SGLT-2 inhibitors did not
have any significant difference in amputation occurrences compared to placebo
across various studies. However, canagliflozin usage has led to higher
amputation events in certain trials.
Remote sensing technologies provide glimpse into urban airflow dynamics
Authors: Thompson Avery
Published: August 2024

Lidar and microwave radiometers provide detailed data on the urban atmospheric boundary layer, with implications for urban design.
Restoring wind-induced responses of supertall buildings
Authors: Patrick Chris
Published: August 2024

Machine learning model can reconstruct missing displacement measurements of supertall buildings during typhoons, enabling real-time structural health monitoring.
HeF2 and ArF2 molecules from first-principles study
Authors: Wu R. Q.
Published: August 2024

Electronic and structural properties of noble gas difluorides XF2 (X = He, Ne, Ar, Kr, and Xe) in linear molecular form are systematically calculated by the first-principles method based on density functional theory. Except NeF2, all the proposed molecules have been found to have stable structures, and a mechanism for the formation of chemical bond between noble gases and fluorines is proposed. Electronic formation enthalpies and vibrational frequencies suggest that molecular HeF2 and ArF2 promise to be experimentally synthesized. This study provides preliminary analysis for later experimental works.
Thermal rectification in segmented Frenkel–Kontorova lattices with asymmetric next-nearest-neighbor interactions
Authors: Romero-Bastida M , Varela A Poceros
Published: August 2024

In this work, we conduct an extensive study of the asymmetric heat flow, i.e. thermal rectification, present in the two-segment Frenkel Kontorova model with both nearest-neighbor (NN) and next-nearest-neighbor (NNN) interactions. We have considered systems with both high and low asymmetry and determined that, in the weak-coupling limit, thermal rectification is larger when NNN interactions are relevant. The behavior of the heat fluxes as a function of the coupling strength between the two segments is largely consistent with a well-defined rectification for larger system sizes. The local heat fluxes present a very different behavior for systems with high and low asymmetry. The results of this work may help in the design of molecular bridges, which have recently been shown to be able to function as thermal rectification devices.
CTMRG study of the critical behavior of an interacting-dimer model
Authors: Chatelain C
Published: August 2024

The critical behavior of a dimer model with an interaction favoring parallel dimers in each plaquette of the square lattice is studied numerically using the corner transfer matrix renormalization group algorithm. The critical exponents are known to depend on the chemical potential of vacancies, or monomers. At large average density of the latter, the phase transition becomes the first-order. We compute the scaling dimensions of both the order parameter and temperature in the second-order regime and compare them with the conjecture that the critical behavior is the same as the Ashkin–Teller model on its self-dual critical line.
Risk evaluation and mitigation strategy compliance for pulmonary hypertension medications after policy implementation with computerized provider order entry support
Authors: Liske Joshua , Patel Nisha , Makowski Charles , Awdish Rana , Smith Zachary R
Published: August 2024

Purpose

Treatment for pulmonary hypertension includes medications with risk evaluation and mitigation strategy (REMS) programs. Health-system inpatient pharmacies dispensing these agents must comply with inpatient REMS dispensing criteria. Implementing a health-system policy with computerized provider order entry (CPOE) decision support may improve REMS compliance.

Methods

This was a retrospective, quasi-experimental study comparing REMS compliance before and after development of a policy with CPOE decision support that was implemented in August 2019. Patients 18 years of age or older with a diagnosis of pulmonary hypertension were included if they received at least one dose of an endothelin receptor antagonist or riociguat while hospitalized. Patients were included in the preintervention group if they were hospitalized between August 1, 2017, and August 31, 2019, and in the postintervention group if they were hospitalized between September 1, 2019, and August 31, 2021. The primary outcome was the REMS compliance rate. Secondary endpoints included the time to REMS compliance and independent factors associated with failed or delayed REMS compliance.

Results

A total of 150 patients were included, with 75 patients in both the pre- and postintervention groups. Compliance increased significantly from the preintervention (50%) to postintervention (92%) group (P < 0.001). Time to compliance was also significantly reduced from 770 minutes in the preintervention group to 140 minutes in the postintervention group (P = 0.031). Factors independently associated with REMS compliance were being in the postintervention group (odds ratio, 16.9; 95% confidence interval, 5.8-49.2) and being admitted to a pulmonary hypertension center for comprehensive care. (odds ratio, 7.8; 95% confidence interval, 2.9-21.2).

Conclusion

A health-system policy with CPOE decision support improved both the rate of and time to compliance with inpatient REMS dispensing procedures.
72219 - Endoscopic treatment of epidermoid metaplasia
Authors: Elbe Peter , Omae Masami , Maltzman Henrik , Vujasinovic Miroslav
Published: August 2024

Introduction

Epidermoid metaplasia in the esophagus is an unusual condition that is considered to give an increased risk of squamous cell neoplasia. Endoscopic treatment has therefore been described as a method to prevent cancer. In the case of dysplasia, endoscopic resection is recommended and in case of metaplasia, ablation is recommended.

Method

We reviewed all patients diagnosed with epidermoid metaplasia at Karolinska University Hospital in 2022-2023.

Result

We identified six patients with epidermoid metaplasia. We decided not to treat an 86-year-old man due to age and co-diseases. Five of the patients, two women and three men, received endoscopic treatment. The average age was 69 years. One patient had high-grade squamous dysplasia and underwent endoscopic submucosal dissection (ESD) in a first session and a round of radiofrequency ablation (RFA) in a second session. Four of the patients had epidermoid metaplasia without dysplasia and underwent only RFA. Of these four, three of the patients only needed one round of treatment. The fourth patient required three ablations, but that patient had a concomitant eosinophilic esophagitis with narrow esophagus and only the smallest RFA catheter (Channel catheter) could be used. None of the patients had any complications.

Discussion

Endoscopic treatment is a fast and safe method that should be considered in all patients with epidermoid metaplasia.
71779 - Health-related quality of life by type of breast surgery in women with primary breast cancer: prospective longitudinal cohort study
Authors: Gulis Kim , Ellbrant Julia , Bendahl Pär-Ola , Svensjö Tor , Rydén Lisa
Published: August 2024

Introduction

Health-related quality of life (HRQoL) and patient-related outcome measures for patients with cancer have gained increased interest over the last decade. However, few prospective studies with longitudinal data evaluated HRQoL in patients with breast cancer. This study aimed to investigate how HRQoL changed from the time of diagnosis to 1 year post breast cancer surgery for the main surgical techniques.

Method

This prospective longitudinal single-centre study included 340 patients with primary breast cancer diagnosed in 2019–2020 who underwent surgery. Patients completed a HRQoL questionnaire (Breast-Q) at baseline. One year post surgery, they completed the Breast-Q a second time, the EORTC Quality of life questionnaire (QLQ)-C30 and the QLQ-BR23. Analysis of variance and Kruskal-Wallis tests were used to evaluate the differences in HRQoL between surgical groups. Analysis of covariance with robust standard errors was used to adjust for confounders.

Result

Patients that had partial mastectomy or oncoplastic partial mastectomy were more satisfied with their breasts (P<0.001), had a better body image (P=0.006) and higher sexual functioning scores (P=0.027) than patients who had a mastectomy with/without reconstruction. The oncoplastic and mastectomy with reconstruction groups had more breast symptoms than other groups (p<0.001), and the mastectomy group had the least symptoms from the chest area.

Discussion

Partial mastectomy and oncoplastic partial mastectomy have the best outcomes in terms of breast satisfaction, body image and sexual functioning. This highlights the importance of preserving the breast when feasible and underscores that breast reconstruction is not equal to breast conservation.
72235 - Pattern of regional recurrences in patients with trunk melanoma and implications for ultrasound follow-up
Authors: Krabbe Ellen , Riaz Nazia , Mattsson Jan , Huibers Anne , Bagge Roger Olofsson
Published: August 2024

Introduction

Optimal follow-up of patients with sentinel lymph node (SLN) positive trunk melanoma is uncertain. Completion lymph node dissection (CLND) is no longer indicated and instead these patients are followed by ultrasound examinations. However, exactly which nodal basins to examine has not been established, should it be focused on the positive sentinel node site or all basins indicated by the lymphoscintigraphy? This study aims to describe the patterns of recurrences in patients with trunk melanoma.

Method

Patients diagnosed with trunk melanoma undergoing wide local excision and SLN biopsy at Sahlgrenska University Hospital, Sweden, between 2017-2021 were retrospectively evaluated in a prospectively held registry. Patients with a positive SLN biopsy did not undergo CLND, instead they were followed with ultrasound every six months for 3 years.

Result

A total of 261 patients were identified and 39 patients (15%) had a recurrence. Twenty-one (54%) presented with distant recurrences, 12 (31%) with regional nodal recurrences and six (15%) with in-transit metastasis as the first site of recurrence. Of the 261 patients, 55 (21%) had a positive SLN biopsy, and six (11%) of these had a regional nodal recurrence where one recurrence (2%) was outside of the positive SLN basin.

Discussion

For patients with a positive SLN, the risk of having a first recurrence in a regional nodal basin is 11%. Of these recurrences 83% were in the positive sentinel node basin, making it reasonable to focus the ultrasound examinations on the basin where the positive SLN was identified.
72236 - Tumor Localization within the breast is an Independent Factor for Sentinel Lymph Node Positivity in Breast Cancer
Authors: Oddos Nizar Abu , Riaz Nazia , Wärnberg Fredrik , Bagge Roger Olofsson
Published: August 2024

Introduction

Sentinel lymph node (SLN) biopsy is the current standard for prognostication and guiding therapeutics in early breast cancer. Recent level I evidence suggests that omitting up-front axillary surgery in select low-risk patients is oncologically safe. The relevance of identifying clinicopathological factors in guiding the selection of patients at low risk for SLN metastasis cannot be understated. Limited evidence exists regarding the capacity of tumor localization within the breast as a risk factor for SLN metastasis. This study aims to evaluate whether the localization of the primary breast cancer predicts SLN status.

Method

We conducted a retrospective study of consecutive patients with stage I-III primary breast cancer undergoing up-front breast surgery and SLN biopsy between 2003 and 2008 at Sahlgrenska University Hospital, Sweden. Multivariable logistic regression analysis was used to identify independent predictive factors for sentinel node positivity.

Result

A total of 1231 clinically node-negative patients were identified with a mean age of 60 years. The majority of tumors measured ≤5 cm (n=1159, 94%) and exhibited estrogen receptor positivity (n=1079, 88%). Unifocal cancers, lower grade, T1-2 size and localization within the breast showed a significant correlation with SLN negative status (p<0.05). Multivariable logistic regression identified increasing age and tumour size, tumor localization in the lower outer and upper inner quadrants as independent factors for SLN metastasis (p<0.05) (Table 1).

Discussion

Tumor localization within the breast is an independent risk factor for SLN metastasis. The location of breast cancer is a clinical parameter worthy of consideration for selecting patients for axillary surgery de-escalation.
72287 - MRI protocol for rapid identification of sentinel lymph nodes using iron nanoparticles - Fast Acquisition Sentinel lymph node Tracking MRI (FAST-MRI)
Authors: Zaar Pontus , Mirzaei Nushin , Jalnefjord Oscar , de Coursey Erica , Wärnberg Fredrik , Leonhardt Henrik , Bagge Roger Olofsson
Published: August 2024

Introduction

Determining sentinel lymph node (SLN) status is crucial for treatment decisions in patients with melanoma. Superparamagnetic iron oxide nanoparticles (SPIO) combined with MRI have emerged as an alternative to technetium and lymphoscintigraphy for preoperative mapping of SLN. The MRI protocols so far are extensive with long in-camera time. This study aimed to evaluate an optimized MRI protocol for rapid identification of SLNs using SPIO as a tracer without compromising diagnostic quality, the Fast Acquisition Sentinel lymph node Tracking MRI (FAST-MRI).

Method

Patients with confirmed melanoma on the trunk or limbs, without clinically suspected lymph node metastasis, were eligible. All patients received an injection of 0.1 mL SPIO divided into four quadrants around the scar. The 5-minute FAST-MRI protocol, using only T1-sequences over the axillary and/or inguinal basins, was conducted no earlier than 30 minutes post-injection. Technetium and lymphoscintigraphy were used according to routine. SLN-biopsy was performed using a magnetometer and gamma probe for SLN-detection.

Result

Twenty patients were enrolled, and SLNs were successfully identified in all with both methods. The FAST-MRI protocol detected more SLNs than lymphoscintigraphy (50 vs 39 SLNs), but the number of SLNs identified during surgery was similar (46 vs 44) (Table 1). Out of 53 SLNs removed, four had metastases, all identified by both methods.

Discussion

The novel FAST-MRI protocol, with a 5-minute scan time, was feasible in detecting SLNs without compromising diagnostic quality. Both the preoperative SLN-mapping and intraoperative SLN-detection using the magnetic technique proved comparable to the radioactive technique.
71262 - Surgical outcomes after TNT in rectal cancer with short-course radiotherapy using protons or photons: Early results from the randomised PRORECT trial
Authors: Nilsson Per J , Marsk Richard , Karimi Masoud , Asklid Daniel , Brattström Daniel , Östling-Palme Joanna , Martling Anna , Valdman Alexander
Published: August 2024

Introduction

The ongoing PRORECT trial (NCT04525989) randomises between short-course radiotherapy (SCRT) using proton beam (PBT) or photon radiotherapy in total neoadjuvant therapy (TNT). Primary endpoint is preoperative toxicity. This report compares short-term surgical outcomes between the two arms.

Method

Patients with locally advanced rectal cancer with at least one risk criteria (cT4, cN2, EMVI+, MRF+ and/or lateral lymph nodes) on MRI were included. All patients received TNT (SCRT + 4 CAPOX). Post-operative complications were according to Clavien-Dindo, anastomotic leaks according to Rahbari and specimen quality according to Quirke.

Result

The first 10 consecutively operated patients in each arm were analysed. There was no 30-day postoperative mortality. Distribution of sex, age, and tumour stage and height was similar between groups. Median time from radiotherapy to surgery was 129 days in PBT and 142 days in photon treated. Seventeen operations were robot-assisted and 5 patients in each group had anterior resection and abdominoperineal excision (APE). Extended surgery was performed in 4 patients (PBT=3). Major complications (> CD3b) occurred in 3 patients (PBT=2), anastomotic leak in 3 (PBT=1) and perineal complications after APE in 3 (PBT=1). R0 resection was achieved in 18 patients, 9 in each group. Pathological complete response was detected in 3 patients (PBT=2) and ypT0 in 4 (PBT=3) (thus, 1 ypT0N1). Specimen quality was judged as the correct mesorectal plane in 17 (PBT=9).

Discussion

These preliminary results of the first 20 patients having undergone TNT and surgery in the PRORECT trial indicate that PBT has no negative impact on early surgical outcomes.
71948 - Anastomotic leak and recurrence-free survival in relation to postoperative CRP
Authors: Gerdin Anders , Park Jennifer , Häggström Jenny , Segelman Josefin , Matthiessen Peter , Lydrup Marie-Louise , Rutegård Martin
Published: August 2024

Introduction

Anastomotic leakage following resection surgery for rectal cancer is often linked with reduced overall survival and higher rates of recurrence. Some data suggest that an aggravated inflammatory response as well might lead to worse oncological outcomes, but few attempts have been made to investigate leakage and inflammation in conjunction.

Method

This is a retrospective multicentre cohort study including patients operated with anterior resection for rectal cancer in Sweden during 2014–2018. Anastomotic leakage within 12 months was exposure and primary outcome was recurrence-free survival. Mediation analysis was performed to evaluate the potential effect of systemic inflammatory response, as measured by the highest postoperative C-reactive protein (CRP) level within 14 days of surgery. Confounders were chosen using a causal diagram, while multiple imputation was used to handle missing data.

Result

Some 1036 patients were eligible for analysis, of which 218 (21%) experienced an anastomotic leakage. At the end of follow-up at a median of 1865 days after surgery, recurrence-free survival amounted to 82.6% and 77.8% in the group with and without leakage, respectively. The median maximum postoperative CRP value after surgery was higher in the leakage group (218.5 mg/l), compared with the group without leakage (108 mg/l). Leakage did not confer worse recurrence-free survival (HR 0.66; 95% CI: 0.43–0.94), and there was no apparent effect through postoperative highest CRP (HR 1.12; 95% CI: 0.93–1.29).

Discussion

In conclusion, anastomotic leakage, with its accompanying CRP increase, was not found to be associated with recurrence and long-term death after anterior resection for rectal cancer in this patient cohort.
72204 - Can preoperative information affect postoperative outcomes among patients with colorectal cancer who are cared for with an ERAS protocol
Authors: Arvidsson Klara , Nylander Anna-Carin
Published: August 2024

Introduction

Preoperative information is a requirement for healthcare and a prerequisite for the patient's participation. Patients have reported to feel more secure and confident when given adequate preoperative information. The evidence-based consensus protocol Enhanced Recovery After Surgery (ERAS) is included in the national care program for colorectal surgery in Sweden. The protocol recommends standardized preoperative information by a registered nurse about a week prior surgery.

Method

The purpose of this study is to examine if preoperative information given by a registered nurse at a pre-admission clinic can affect postoperative outcomes among patients with colorectal cancer who are cared for with an ERAS protocol. The method were a retrospective, descriptive and comparative study with quantitative approach.

Result

Patients who had participated in the pre-admission clinic had higher compliance to ERAS (p<0,001) and lower risk of suffering from infectious complications within 30 days (p<0,005). Patients who had underwent laparoscopic or robotic assisted surgery and patients who were converted to open surgery were more compliant to the ERAS protocol (p<0,001).

Discussion

Preoperative information given by a registered nurse at a pre-admission clinic can affect postoperative outcomes among patients with colorectal cancer. Preoperative information has also in qualitative studies enabled to make patients feel safer prior surgery. Although, a greater sample in this study is required because the results are not in line with previous studies regarding that compliance to the ERAS protocol can reduce length of stay and decrease various complications.
71308 - Assessing Efficacy and Survival of the Neo-Aortoiliac System Bypass (NAIS) Technique at Sahlgrenska University Hospital
Authors: Langenskiöld Marcus , Ihari Mahia Aivaz , Millinger Johan , Nordanstig Joakim
Published: August 2024

Introduction

In-situ reconstruction with the neo-aortoiliac system bypass (NAIS) technique is one option to manage both primary mycotic aneurysms and secondary aortic graft and endograft infections in the abdominal aorta. The aim of this study was to evaluate NAIS procedural outcomes at the Sahlgrenska University Hospital.

Method

The National Quality Registry for Vascular Surgery and local registries were used to identify all patients undergoing NAIS between 2010-2023.

Result

Thirty-two patients (25 males, 17 previous open repairs, 8 previous EVAR and 1 previous FEVAR; 14 presenting with aorto-enteric fistula) operated with NAIS based on autologous veins (n=26) or bovine pericardial grafts (n=6) were reviewed. The median time from the primary aortic intervention to NAIS was 65 months (range 1-217 months). Twenty-nine (94%) had a positive microbial culture. Twenty (63%) patients required suprarenal clamping, and the renal vein was divided in 16 (50%) patients. Periprocedural temporary renal or mesenteric artery endoshunting was performed in 11 patients, and prosthetic material was explanted under supravisceral aortic balloon occlusion in 12 patients.

All but three patients survived 30 days (91%) whereas 26/32 (82%) patients survived until 90 days. Freedom from antimicrobial treatment at 90 days, 6 months and one year were 11/26 (42%), 20/25 (80%) and 21/23 (91%, three patients not yet reaching 1 year follow-up). After a mean follow-up time of 59 (±SD 52.1) months, 22 out of 32 (69%) patients remained alive.

Discussion

The NAIS procedure yielded favorable overall survival outcomes and exhibited a high curative frequency marked by cessation of antimicrobial therapy.
72107 - The use of INVOS as a prognostic tool for peripheral artery disease
Authors: Petri Marcelo , McGreevy David , Hörer Tal
Published: August 2024

Introduction

Chronic peripheral arterial disease (PAD), intermittent claudication (IC) or critical limb ischemia (CLI), carries a high-risk of amputation if untreated. Endovascular angioplasty, can treat PAD. However, there is no reliable tool to predict the outcome of treatment beyond clinical evaluation.

INVOS measures tissue oxygen saturation. It is frequently used in other vascular procedures but never used in PAD.

The aim is to investigate the use of INVOS during endovascular surgery for PAD and shows if INVOS can predict the surgical outcome and guide treatment decisions.

Method

The pilot study included 15-IC and 15-CLI that underwent endovascular surgery. Before the surgery, INVOS patches were placed on the treated foot. INVOS and systolic blood pressure (SBP) were recorded pre-procedure, and then at 1, 2, and 3-hours post-procedure.

At the 30-day follow-up, the ankle brachial index was measured and both the patients and physicians assessed the outcome of the surgery as "good," "bad," or "unchanged."

The data was analyzed in raw values, including INVOS and SBP and ratio INVOS/SBP was calculated and then divided by the pre-operative value to observe the fold change post-procedure.

Result

No changes were observed in raw values of INVOS, SBP, sex and the affected side between IC and CLI.

The INVOS/SBP ratio demonstrated significantly higher levels for CI compared to CLI post-opeative. At 30 day follow-up, patient and physician assessment demonstrated lower ratio levels for those assessed as bad/unchanged.

Discussion

This pilot study demonstrates that the INVOS/SBP ratio could show an ineffective procedure. Bigger study is important to confirm these results.
71267 - Emergency Laparotomy and No-lap (EL-Nolap) for the old and frail, a 5-year report from an improvement project at Capio S:t Görans Hospital (CStG)
Authors: Leo Jonas
Published: August 2024

Introduction

Emergency laparotomy patients are often frail and suffer from high postoperative mortality and morbidity rates. In NHS/UK this has been addressed and gradually the National Emergency Laparotomy Audit (NELA) improves quality and safety for this “forgotten group” of patients operated on by the “Cinderella surgeons”. At CStG the EL-pathway has been subject to a continuous cross-functional improvement project since 2018.

Method

A structural pathway lead- and improvement organization was set up with representatives from all involved departments: Emergency, Radiology, Anesthesiology, ASIH and Surgery. Quality-data was analyzed (NELA mirroring), VSM (Value Stream Mapping) was conducted, evidence analyzed and a future EL (and No-lap 2023) perioperative pathway standard was created.

During this period LÖF and the ERAS Society has presented EL guidelines, which was consistent with the new CStG EL-Nolap standard.

The test of the new perioperative standard started 2019 and has been running since and we have created some internal pathway innovations, CHRA and Akut VERAS. Results are followed up automatically in the national SPOR-SWELA database and locally in our Power BI.

Result

2019-2023

Operations n: 959

Mortality(30d) reduction: 75%

Morbidity(Modified CD 3+4) reduction: 50%

No-lap prevalence(2023): 7,5%

Discussion

CStG have shown that you can improve Clinician Reported Outcome Measures (CROM) for EL-Nolap patients with a cross-functional improvement project. Near future demographics will make this kind of organizational learning imperative for the old and frail EL-patients. SKR has set up a NAG (National Working Group), EL-Nolap for the old and frail, with the objective to present Swedish EL-Nolap guidelines spring 2026.
72231 - A Retrospective Review Comparing the Outcome of Robotic Assisted Surgery to Conventional Laparoscopy and Open Treatment for Ventral Incisional Hernia
Authors: Sandblom Vanessa , Rietz Göran , Sandblom Gabriel
Published: August 2024

Introduction

Robotic-assisted ventral hernia repair has some potential advantages as it offers minimally invasive surgery while ensuring visibility and stability for the surgeon. However, there is limited evidence for its clinical superiority. The aim of this study was to compare the risk of hernia recurrence, postoperative complications and length of hospital stay of robotic assisted laparoscopic surgery with those of conventional laparoscopic surgery and open surgery.

Method

A single-center retrospective review was conducted, utilizing data from the Swedish National Ventral Hernia Register paired with patient records. The review targeted patients who underwent surgical repair for ventral, mid-line incisional hernia from the 1st of January 2018 until the 31st of December 2023. The primary outcome was hernia recurrence which was analyzed with regards to gender and age. Secondary outcomes were length of hospital stay and 30-day complications.

Result

124 patients were included for analysis. Of these, 3 (2.4%) developed hernia recurrence within the study period. There were no recurrences in the robotic group. The average length of hospital stay was 1 day (IQR=0) for the robotic-assisted group, which was significantly lower than the open surgery group with a mean of 4 days (IQR=5, p<0.001). The rate of 30-day complications was the lowest (2.7%) for robotic-assisted surgery with no significant difference between the groups.

Discussion

Robotic-assisted surgery was associated with fewer recurrences, shorter hospital stay and lower rates of complications, in comparison to conventionally laparoscopic and open repair. However, further studies with larger samples are necessary to confirm these findings.
72226 - Clinical impact and prognosis of Bone Metastases evident on 68Galium DOTATOC PET/CT in patients with Si-NET - Do they matter?
Authors: Wedin Maria , Wallin Göran , Daskalakis Kosmas , Sundin Anders , Janson Eva Tiensuu
Published: August 2024

Introduction

The prevalence of Bone metastases (BM) in small intestinal neuroendocrine tumours (Si-NET) ranges from 6-23 % and has increased due to new radiology modalities. The aim of our study was to evaluate the overall survival (OS) and the associated symptoms, in particular bone-related pain and fractures in Si-NET patients with BM.

Method

Retrospective cohort study between 2010-2023 including 138 Si-NET patients with BM detected at 68Gallium-DOTATOC-PET/CT, treated and followed at Uppsala University Hospital in Sweden.

Patients were grouped into two groups according to their number of BM; ≤ BM or > 5 BM. We also included 77 sex and age matched control patients with Si-NET and liver metastases, matched to 77 Si-NET patients with BM and liver metastases.

Result

Of 138 patients, 14 % were treated for BM related pain and 4% patients had a fracture related to Si-NET BM. OS of patients with >5 BM was shorter compared to patients with ≤5 BM (5-year OS 21 % vs 58%; p-=0.028). Concurrent carcinoid heart disease was present in 22% of Si-NET patients with BM, more frequently found in those with > 10 BM (40%). In the case-control group, OS was 30 % in the case group with BM compared to the control group 64 % (p-value <0.01).

Discussion

Fractures are rare and bone-related pain treatment is needed in 14 % of patients with BM. Presence of > 5 BM is associated with shorter OS and increased risk of carcinoid heart disease. The presence of BM also impair the prognosis, compared to control patients with comparable abdominal metastastic burden.