bluuebunny/crossref_metadata_2025 huggingface dataset:
Overview of The Status of Rock-wallabies in South Australia.
Authors: Copley P.B. , Alexander P.J.
Published: September 2021

The status of Yellow-footed Rock-wallabies (Petrogale xanthopus) and Black-footed Rock-wallabies (P. lateralis) in South Australia was assessed by comparing recent survey and census data with previously collated information about the distribution and relative abundance of each taxon. Petrogale xanthopus has maintained most of its known geographic range within the state; however, its relative abundance has declined significantly and 35 (or 15%) of a total of 229 recorded colonies have become extinct since European settlement. Eight of these colony extinctions have occurred over the past 25 years; three of them since 1981. As this species is continuing to decline it should be regarded as threatened within the state. Petrogale lateralis has at least two sub-species which occur in South Australia. Petrogale lateralis pearsoni is endemic to the state and occurs on offshore islands. Since 1960 its natural occurrence of about 3-500 individuals on North Pearson Island has been expanded to four other islands through translocations and the total population is now about 700-1100 animals. This subspecies, while not occurring in large numbers, is nonetheless relatively secure due to the additional populations established and the fact that these are on islands isolated from most mainland threats. The mainland subspecies, Petrogale lateralis MacDonnell Ranges race, by comparison has suffered a drastic reduction in both geographic range and abundance to the point where it is South Australia’s most critically endangered vertebrate taxon. It has declined from being a very common species in the state’s far north- west to only two known, widely separated, colonies which total less than 100 animals between them. Management and research recommendations are provided.
An Overview of The Status and Management of Rock-wallabies (Petrogale) In New South Wales.
Authors: Dovey L. , Wong V. , Bayne P.
Published: September 2021

Two species of rock-wallabies occur in New South Wales; the Yellow-footed Rock-wallaby Petrogale xanthopus in the far west and the Brush-tailed Rock-wallaby Petrogale penicillata in the east. Both species have contracted in distribution and abundance across their former range and are threatened in NSW. The P. xanthopus population in NSW now comprises only two sub-populations. Removal of large numbers of goats, thought to be the primary threat, has not halted the wallaby's decline. Fox and cat predation is now considered the major threat. Fox control is currently being conducted. P. penicillata has undergone a dramatic and continuing decline from being common throughout south-eastern Australia to currently being extremely rare in the southern and western parts of its range and found only in isolated colonies throughout the north of its range. Predation (particularly fox, but including dog and cat), once again, is considered the major threat. A recovery program has been commenced involving the media and wider community in locating extant colonies, as well as developing and implementing Population Management Plans. This program has documented further local extinctions and extremely low numbers of individuals in colonies in the southern and western parts of the range. While no surviving colonies are known between the Shoalhaven area and the Victorian border, there remain more and larger colonies in the north of the state.
Population Dynamics of The Allied Rock-wallaby Petrogale assimilis: Implications for Conservation.
Authors: Delaney R.
Published: September 2021

Most species of Petrogale live in the arid inland or in the wet-dry tropics of northern Australia. These environments are characterised by the unpredictability of their rainfall, and the reproductive strategies of the animals reflect this. I studied one population of Petrogale assimilis during a period of extended drought. During this time mortality of young (ca. 88%) and adults (≥ 25%) was very high and recruitment into the adult population was negligible. The age structure of the population was skewed towards very old animals and pouch young. Evidence from this and other populations suggests that recruitment into the breeding population is spasmodic, reflecting the irregular pattern of good seasons. Recruitment events may occur asynchronously in neighbouring populations depending on the spatial and temporal variability of the rain. If true, rock-wallaby populations irregularly pass through periods of low numbers and demographic instability. Careful monitoring and management decisions are therefore important. At low points in this climatic cycle additional factors (e.g., predators) could have a devastating impact. We need to protect a relatively large area of habitat to compensate for the asynchronous pulsing of populations and to allow populations to recover. Survey design must also allow for this demographic instability.
Reproductive Ecology of The Allied Rock-wallaby, Petrogale assimilis.
Authors: Delaney R.
Published: September 2021

Petrogale assimilis has a typical life history and reproductive ecology for a macropodid of its size. Both sexes are capable of reproducing continuously; gestation is about the same length as the oestrous cycle (approximately one month); a single young is born and, a post-partum oestrus and embryonic diapause probably occurs. The sex ratio of young is unbiased. Pouch young remain permanently attached to the teat until 110 - 143 days (n=11). Permanent exit from the pouch occurs at 180 - 231 days (mean=201 days, n=25), and weaning occurs between 267 - 387 days (n=5). Sexual maturity occurs at a minimum age of 17.5 months in females and 23 months in males.
Behavioural Ecology of Petrogale penicillata In Relation to Conservation.
Authors: Jarman P.J. , Bayne P.
Published: September 2021

Brush-tailed Rock-wallabies Petrogale penicillata are still widely distributed in the gorges on the east of the New England Tablelands of northern NSW, in small (mean <6 adults) colonies, separated by an appreciable distance (median separation 308 m) from neighbouring colonies. Within colonies, established adults occupy a refuge or set of refuges by day, moving away from the colony to forage mainly at night. A set of 1-3 adult females shares a small number of refuges, with one adult male defending access to them and their refuges. A colony contains one or several such sets. Established females occupy refuges persistently, up to at least 4 years and perhaps until death; males also defend their diurnal ranges persistently, but male ranges do change owner through intrusion or supplanting, as well as when the incumbent dies. Sub-adults of both sexes seem to be the dispersing classes, although a daughter may remain, mature and breed in her mother’s range. Only adults established in refuges appear to breed. The most dominant among the females sharing a set of refuges tends to produce more young than do subordinates. The combination of small and separated colonies, dispersal only by naive sub-adults, a strong restriction of mating opportunities within breeding groups, and unequal contribution to breeding even by females, could make P. penicillata prone to predation by agile predators that can learn the locations of their persistently used sites, and to problems of conserving population numbers and allelic diversity. These latter conservation problems can be simply addressed by artificial dispersal (translocation) of appropriate animals.
The Use of Shelter Sites by Yellow-Footed Rock-wallabies, Petrogale xanthopus, In Central-Western Queensland.
Authors: Sharp A.
Published: September 2021

Across its range, the suitability of colony sites for Petrogale xanthopus has been linked to topographic complexity which has been postulated to provide refuges from temperature extremes and/or predators. This study examined the use of shelter sites by a colony of P. xanthopus in central-western Queensland. Log-linear analysis of seasonal observational data suggests that adult P. xanthopus do not make extensive use of higher quality shade sites (e.g., caves and crevasses). P. xanthopus were found to utilise tree shade to a greater extent than any other shade category in all seasons, though adult females were found to utilise higher quality shade sites more than males. Analysis of P. xanthopus faecal pellet sizes reveals that pellets found within caves was significantly smaller (P<0.05) than those found in rockpiles and adjacent and exposed areas. This re-iterates the avoidance of caves by adult P. xanthopus. In Queensland, adult P. xanthopus may not make extensive use of caves and crevasses as shelter sites because of lower thermo-regulatory demands and/or due to increased threat of predation if cornered within a cave. The correlation between P. xanthopus and topographic complexity may be linked to the need for “nursery sites” for juvenile wallabies.
Aboriginal Involvement in The Survey and Management of Rock-wallabies.
Authors: Pearson D. , The Ngaanyatjarra Council
Published: September 2021

Rock-wallaby populations in central desert regions are insidiously disappearing through a continuing process of local extinctions. Their survival will depend on collaboration between Aboriginal Councils and communities, and conservation agencies. While collaborative survey work to locate rock-wallaby populations has been successful, the next step of managing remnant populations will be more challenging. Differences in concepts of extinction and the preservation of bio-diversity, funding constraints and the cultural appropriateness of management programs are important factors which need to be addressed. These issues are examined with examples of recent initiatives in Western Australia.
An Update of The Proserpine Rock-wallaby Petrogale persephone Recovery Plan.
Authors: Nolan B.
Published: September 2021

The Proserpine Rock-wallaby (Petrogale persephone) was not discovered until 1976, with scientific description occurring in 1982 by G.M. Maynes. Petrogale persephone occurs only within the Whitsunday Shire and on Gloucester Island, North Queensland and lives amongst rocky outcrops in elevated pockets of semi-deciduous vine forests. Food is found within the forest and in adjoining woodlands. Changes in land use and habitat fragmentation, through clearing, has isolated many colonies. Habitat loss remains as the single biggest threat to this species followed by road kills in specific areas. Other threats include predation, harassment and transfer of disease from feral and domestic animals. A Recovery Plan has been prepared which identifies priorities for research and management. These priorities include distribution surveys and mapping of habitat, habitat utilisation by P. persephone, captive colony establishment to study reproduction and age estimation and identifying the significance of road kills and predation on the population dynamics of this rock-wallaby. A public education and awareness program has also been developed for implementation.
Improving Conservation Outcomes: The Partnership Between Research and Management.
Authors: Johnson K.A.
Published: September 2021

Research, management and funding priorities for the conservation of rock-wallabies (Petrogale) has been widely considered at Federal, State and Territory levels in recent years. In general these reviews have been undertaken as part of broader examinations of conservation requirements for other mammal species and of other vertebrate classes. Accounts of the 15 recognised Petrogale species by various authors in Strahan (1995) shows the majority of species to be relatively common with two regarded as vulnerable and a further two regarded as rare. The overarching theme of the species accounts is nonetheless one of restricted distribution and diminishing numbers. The Marsupial and Monotreme Action Plan (Kennedy 1992) indicates a more serious situation with 6 species listed in endangered to potentially endangered categories. In preparing this paper on the priorities for rock- wallabies conservation there seemed to be no need for further review at a species level given the detail to be found in the above publications. Such evaluations are also the role of expert teams of national composition rather than a single individual having inevitable regional perspectives. What did seem important was to examine how we are faring in marshalling our resources to achieve tangible conservation outcomes from the efforts now being applied by the various Federal, State and Territory institutions involved in research and management. This paper attempts to place a quantitative measure of where research effort is being applied and how the involved agencies are combining to further the conservation of rock-wallabies.
Rock-wallaby Bibliography.
Authors: Close R.L. , Eldridge M.D.B.
Published: September 2021

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Review of options for creating and maintaining oxygen refuges for fish during destratification-driven hypoxia in rivers
Authors: Boys Craig A. , Baldwin Darren S. , Ellis Iain , Pera Joe , Cheshire Katherine
Published: September 2021

Climate change, river regulation and water extraction create the conditions where destratification-driven hypoxia will become more common in rivers. Preventing this and the fish deaths that can result requires options that prevent stratification and create oxygen refuges for fish. Here we discuss aeration and mixing approaches that may help prevent fish deaths when flow-related measures are not available. The options were evaluated based on efficacy, environmental risk and readiness to be deployed cost-effectively. The options either promote mixing, aeration or both. Bubble diffusers and paddle wheels used commonly in aquaculture are unlikely to aerate already hypoxic pools. However, if deployed before stratification occurs, they may promote mixing and maintain aeration. In comparison, pumps with Venturi tubes or ultrafine oxygen bubble condensers both mix and aerate, making them suitable for use once hypoxic events are underway. Water jets are low cost and could be deployed quickly. Dosing reaches with calcium peroxide may be useful for emergency aeration, but requires further safety and efficacy testing. Flow management that maintains fish refuges and storage reserves during drought is the best way to guard against fish deaths, but if storage releases are not available, there are options for creating and maintaining oxygen refuges to minimise ecosystem damage.
How fish kills affected traditional (Baakandji) and non-traditional communities on the Lower Darling–
Authors: Ellis Iain , Bates William (Badger) , Martin Sarah , McCrabb Graeme , Koehn John , Heath Peter , Hardman Derek
Published: September 2021

In the summer of 2018–19 mass fish kills occurred in the Lower Darling (Baaka) River in south-eastern Australia. The fish kills received national and international attention and have been the focus of numerous government agency and independent assessments. Although fish kills have previously been recorded in the Lower Darling region, the size and rapid succession of the 2018–19 ‘Menindee’ fish kills made them unprecedented in the Murray–Darling Basin, placing significant pressure on the native fish community. Although the deaths of millions of fish were documented, the significant negative effect that the fish kills had on local communities, particularly the traditional Baakandji people, was largely ignored. The social and cultural aspects of such events can have major non-economic effects on local communities. In this paper we document heart-felt feelings conveyed by local community members. Their sense of loss, despair and helplessness is compounded by frustration regarding water management and policy decision making in the Murray–Darling Basin. However, these tragic events have increased understanding of traditional Baakandji connection to the river and its fish and, together with local recovery efforts, now provide prospects for enhanced community and agency cooperation to improve the health of the lower Darling Baaka River and restore its native fish populations.
Assessment of the causes and solutions to the significant 2018–19 fish deaths in the Lower Darling River, New South Wales, Australia
Authors: Sheldon F. , Barma D. , Baumgartner L. J. , Bond N. , Mitrovic S. M. , Vertessy R.
Published: September 2021

In late 2018 to early 2019, three significant fish death events occurred in the Lower Darling River, Australia, with mortality estimates of millions of fish. We examined the proximate and ultimate causes of these events. We determined that not only were the conditions existing at the time a significant contributing factor, but that antecedent conditions, particularly during the period 2010–17, also contributed. The extreme hot and dry climate during 2018, extending into 2019, shaped the conditions that saw a large fish biomass, which had flourished in the Darling River and Menindee Lakes since favourable spawning conditions in 2016, isolated in weir pools, with no means of escaping upstream or downstream. Strong and persistent weir pool stratification created hypoxic conditions in the hypolimnion. A series of sudden cool changes subsequently initiated rapid and sudden mixing of the stratified waters, causing depletion of oxygen throughout the water column and resulting in the fish deaths. The events were also shaped by broader climatic, hydrological and basin management contexts that placed the Lower Darling River at risk of such fish deaths. Our observations have implications for future river management, and we make several suggestions how policy makers and river operators can minimise fish death risks into the future.
How Selection Over Time Contributes to the Inconsistency of the Association Between Sex/Gender and Cognitive Decline Across Cognitive Aging Cohorts
Authors: Rouanet Anaïs , Avila-Rieger Justina , Dugravot Aline , Lespinasse Jérémie , Stuckwisch Rachel , Merrick Richard , Anderson Emma , Long Leann , Helmer Catherine , Jacqmin-Gadda Hélène , Dufouil Carole , Judd Suzanne , Manly Jennifer , Sabia Séverine , Gross Alden , Proust-Lima Cécile
Published: September 2021

The association between sex/gender and aging-related cognitive decline remains poorly understood because of inconsistencies in findings. Such heterogeneity could be attributable to the cognitive functions studied and study population characteristics, but also to differential selection by dropout and death between men and women. We aimed to evaluate the impact of selection by dropout and death on the association between sex/gender and cognitive decline. We first compared the statistical methods most frequently used for longitudinal data, targeting either population estimands (marginal models fitted by generalized estimating equations) or subject-specific estimands (mixed/joint models fitted by likelihood maximization) in 8 studies of aging: 6 population-based studies (the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study (1996–2009), Personnes Âgées QUID (PAQUID; 1988–2014), the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study (2003–2016), the Three-City Study (Bordeaux only; 1999–2016), the Washington Heights-Inwood Community Aging Project (WHICAP; 1992–2017), and the Whitehall II Study (2007–2016)) and 2 clinic-based studies (the Alzheimer’s Disease Neuroimaging Initiative (ADNI; 2004–2017) and a nationwide French cohort study, MEMENTO (2011–2016)). We illustrate differences in the estimands of the association between sex/gender and cognitive decline in selected examples and highlight the critical role of differential selection by dropout and death. Using the same estimand, we then contrast the sex/gender–cognitive decline associations across cohorts and cognitive measures suggesting a residual differential sex/gender association depending on the targeted cognitive measure (memory or animal fluency) and the initial cohort selection. We recommend focusing on subject-specific estimands in the living population for assessing sex/gender differences while handling differential selection over time.
Adapting Decision Rules to Estimate Occupational Metalworking Fluid Exposure in a Case–Control Study of Bladder Cancer in Spain
Authors: Josse Pabitra R , Koutros Stella , Tardon Adonina , Rothman Nathaniel , Silverman Debra T , Friesen Melissa C
Published: September 2021

Objectives

We adapted previously developed decision rules from the New England Bladder Cancer Study (NEBCS) to assign occupational exposure to straight, soluble, and synthetic metalworking fluids (MWFs) to participants of the Spanish Bladder Cancer Study (SBCS).

Methods

The SBCS and NEBCS are case–control studies that used the same lifetime occupational history and job module questionnaires. We adapted published decision rules from the NEBCS that linked questionnaire responses to estimates of the probability (<5, ≥5 to <50, ≥50 to <100, and 100%), frequency (in h week−1), and intensity (in mg m−3) of exposure to each of the three broad classes of MWFs to assign exposure to 10 182 reported jobs in the SBCS. The decision rules used the participant’s module responses to MWF questions wherever possible. We then used these SBCS module responses to calculate job-, industry-, and time-specific patterns in the prevalence and frequency of MWF exposure. These estimates replaced the NEBCS-specific estimates in decision rules applied to jobs without MWF module responses. Intensity estimates were predicted using a previously developed statistical model that used the decade, industry (three categories), operation (grinding versus machining), and MWF type extracted from the SBCS questionnaire responses. We also developed new decision rules to assess mineral oil exposure from non-machining sources (possibly exposed versus not exposed). The decision rules for MWF and mineral oil identified questionnaire response patterns that required job-by-job expert review.

Results

To assign MWF exposure, we applied decision rules that incorporated participant’s responses and job group patterns for 99% of the jobs and conducted expert review of the remaining 1% (145) jobs. Overall, 14% of the jobs were assessed as having ≥5% probability of exposure to at least one of the three MWFs. Probability of exposure of ≥50% to soluble, straight, and synthetic MWFs was identified in 2.5, 1.7, and 0.5% of the jobs, respectively. To assign mineral oil from non-machining sources, we used module responses for 49% of jobs, a job-exposure matrix for 41% of jobs, and expert review for the remaining 10%. We identified 24% of jobs as possibly exposed to mineral oil from non-machining sources.

Conclusions

We demonstrated that we could adapt existing decision rules to assess exposure in a new population by deriving population-specific job group patterns.
Classifying domain-specific text documents containing ambiguous keywords
Authors: Karimi Kamran , Agalakov Sergei , Telmer Cheryl A , Beatman Thomas R , Pells Troy J , Arshinoff Bradley Im , Ku Carolyn J , Foley Saoirse , Hinman Veronica F , Ettensohn Charles A , Vize Peter D
Published: September 2021

A keyword-based search of comprehensive databases such as PubMed may return irrelevant papers, especially if the keywords are used in multiple fields of study. In such cases, domain experts (curators) need to verify the results and remove the irrelevant articles. Automating this filtering process will save time, but it has to be done well enough to ensure few relevant papers are rejected and few irrelevant papers are accepted. A good solution would be fast, work with the limited amount of data freely available (full paper body may be missing), handle ambiguous keywords and be as domain-neutral as possible. In this paper, we evaluate a number of classification algorithms for identifying a domain-specific set of papers about echinoderm species and show that the resulting tool satisfies most of the abovementioned requirements. Echinoderms consist of a number of very different organisms, including brittle stars, sea stars (starfish), sea urchins and sea cucumbers. While their taxonomic identifiers are specific, the common names are used in many other contexts, creating ambiguity and making a keyword search prone to error. We try classifiers using Linear, Naïve Bayes, Nearest Neighbor, Tree, SVM, Bagging, AdaBoost and Neural Network learning models and compare their performance. We show how effective the resulting classifiers are in filtering irrelevant articles returned from PubMed. The methodology used is more dependent on the good selection of training data and is a practical solution that can be applied to other fields of study facing similar challenges.

Database URL: The code and date reported in this paper are freely available at http://xenbaseturbofrog.org/pub/Text-Topic-Classifier/
322 THORACOSCOPIC RETROSTERNAL GASTRIC CONDUIT RESECTION IN THE SUPINE POSITION FOR GASTRIC TUBE CANCER
Authors: Horie Kazumasa , Oshikiri Taro , Horikawa Manabu , Kitamura Yu , Takiguchi Gosuke , Urakawa Naoki , Hasegawa Hiroshi , Yamamoto Masashi , Kanaji Shingo , Matsuda Yoshiko , Yamashita Kimihiro , Matsuda Takeru , Nakamura Tetsu , Suzuki Satoshi , Kakeji Yoshihiro
Published: September 2021

Recent advances in treatment for esophageal cancer have improved prognosis after esophagectomy, but they have led to an increased incidence of gastric conduit cancer. In most gastric conduit cancer patients who underwent retrosternal reconstruction, median sternotomy is performed, which is associated with a risk of postoperative bleeding and osteomyelitis; pain often negatively affects respiration. To avoid these problems, we developed thoracoscopic retrosternal gastric conduit resection in the supine position (TRGR-S) as new procedure.

Methods

We performed the first case of TRGR-S for a 75-year-old male with retrosternal gastric conduit cancer. He was placed in the supine position. Four ports were placed in the left chest wall. The gastric conduit was separated from the epicardium, sternum, and left brachiocephalic vein. Due to adhesions between the gastric tube and the right pleura, combined resection of the right pleura was performed. Next, pediculated jejunal reconstruction via the presternal route was performed.

Results

Because there were few adhesions in the left thoracic cavity, this approach provided safety and a good surgical view, and it was easy to recognize the landmark including epicardium, sternum, and left brachiocephalic vein leading to appropriate resection of the tissue. Furthermore, there were few restrictions on the operative angle for the forceps and operability was quite ergonomic. Moreover, the lungs can be noninvasively contracted via an artificial pneumothorax. The pathological diagnosis was signet ring cell carcinoma (pT1b, pN0, M0, pStage I), indicating R0 resection. There were no post-operative complications.

Conclusion

This approach does not require sternotomy, so it has less risk of postoperative bleeding and osteomyelitis. Due to fewer adhesions, this approach is safe and provides a good surgical view. TRGR-S is a safe, ergonomic, and reliable procedure for resection of retrosternal gastric conduit cancer.

Video

This is the video of the operation ‘TRGR-S’, which is the new procedure for the gastric conduit cancer. https://www.dropbox.com/s/2whnekgp73hw1lz/video%20for%20ISDE2020.mov?dl=0.
645 THE OUTCOMES OF PALLIATIVE SELF-EXPANDING METALLIC SEM) STENTS IN THE MANAGEMENT OF INOPERABLE ESOPHAGEAL CARCINOMA.
Authors: Lim Kheng Tian
Published: September 2021

The incidence of esophageal carcinoma (EC) in Singapore is declining since 1970s. However, the age-incidence curve in 2010s shows a steep rise after age 40-50s. The majority of EC patients presented late with locally advanced or metastatic disease. The outcomes of inoperable esophageal carcinoma treated with palliative self-expanding metallic (SEM) stents were reviewed.

Methods

Consecutive cases of EC including Siewert Type I adenocarcinoma of esophago-gastric junction (AEG) were identified from electronic medical records from August 2015 to February 2021. There were 78 cases of EC and of which 14 were stented. The outcomes of inoperable or metastatic EC cases treated with palliative SEM stents were analyzed. Other palliative treatment included best supportive care and palliative chemotherapy with or without radiotherapy.

Results

The demographics showed the mean age of 73 ± 11 years with ECOG score 0-1 in 86% and mean BMI 19.1 ± 3.8. All were males with the risks from smoking in 85% and alcohol in 50%. The mean length of EC was 6.2 ± 2.6 cm. There were 10 Wallflex and 4 Ultraflex partially covered stents deployed successfully. The pre-stent dysphagia score was 3 in 72% and 4 in 29% whilst all had post-stent score of 1. The mean duration of survival was 4.4 ± 4.1 months. Post-stent complications included stent migration without obstruction and food bolus obstruction.

Conclusion

About 18% of patients diagnosed with advanced symptomatic EC were treated with palliative SEM stent insertion in a safe and effective manner. Those at risk were elderly males with smoking history. All stented cases had immediate improvement of dysphagia score and were able to tolerate soft diet. The overall duration of survival was variable up to 1 year likely due to different tumour biology and concurrent palliative systemic therapy.
648 APPLICATION OF THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION (GLIM) CRITERIA IN PERIOPERATIVE MANAGEMENT OF ESOPHAGEAL CANCER PATIENTS
Authors: Wang Peiyu , Li Yin , Liu Xianben
Published: September 2021

In 2019, the Global Leadership Initiative on Malnutrition (GLIM) established global malnutrition diagnostic criteria and classification methods. This study aimed to investigate the application of GLIM criteria in nutrition assessment and perioperative management in esophageal cancer patients undergoing esophagectomy.

Methods

A prospective institutional database of 212 esophageal cancer patients was reviewed. The property of the GLIM criteria in diagnosing malnutrition and predicting adverse therapeutic outcomes were evaluated. The two-step approach of initially screening malnutrition risk with conventional tools and then establishing diagnosis and classification with the GLIM criteria was investigated. The candidate malnutrition screening tools include the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening 2002, the Short-Form of Mini Nutritional Assessment, and the Geriatric Nutritional Risk Index.

Results

Among the included 192 patients, the proportions of moderate and severe malnutrition diagnosed by the GLIM criteria were 42.7% and 30.2% before surgery. In multivariable analyses, severe malnutrition was predictive of perioperative overall complications and major complications (both P < 0.001). Among the four candidates, malnutrition screened by the MUST showed highest sensitivity (90.7%), specificity (92.3%) and diagnosis consistency with the GLIM criteria. The two-step approach of MUST-GLIM showed comparable performance with pure GLIM criteria in predicting perioperative morbidities and survival outcomes, better than the conjunction of other three malnutrition screening tools with the GLIM criteria.

Conclusion

The GLIM criteria should be highlighted in perioperative management of esophageal cancer patients. The MUST is the recommended initial malnutrition screening tool in implementing the GLIM criteria.
681 PATTERN OF RECURRENCE IN PATIENTS WITH A PATHOLOGICALLY COMPLETE RESPONSE AFTER NEOADJUVANT CHEMORADIOTHERAPY AND SURGERY FOR OESOPHAGEAL CANCER
Authors: Jongh Marloes , Eyck Ben M , Werf Leonie R , Toxopeus Eelke L A , Lanschot J Jan B , Lagarde Sjoerd M , Gaast Ate , Nuyttens Joost , Wijnhoven Bas P L
Published: September 2021

Neoadjuvant chemoradiotherapy (nCRT) and surgery is a widely used treatment for locally advanced resectable oesophageal cancer, with 20 and 50% of patients having a pathological complete response (pCR). Disease, however, still recurs in 20–30% of these patients. The aim of this study was to assess the pattern of recurrence in patients with pCR after nCRT and surgery.

Methods

All patients with pCR after neoadjuvant chemoradiotherapy and surgery included in the phase II and III ChemoRadiotherapy for Oesophageal followed by Surgery Study (CROSS) trials (April 2001—March 2009) and after the CROSS trials (September 2009—October 2017) were identified. The site of recurrence was compared to the applied radiation and surgical fields. Outcomes were median time to recurrence, overall and progression-free survivals.

Results

A total of 141 patients with a median follow-up of 100 (interquartile range [IQR] 64–134) months were included. Some 29 of 141 patients (21%) developed recurrence. Of these, four (14%) had isolated locoregional recurrence, 15 (52%) distant recurrence only and ten (34%) had both locoregional and distant recurrence. Among the 14 patients with locoregional recurrences, five were within the radiation field, seven outside the radiation field and two at the border. Median (IQR) time to recurrence was 24 (10–62) months. The 5-year overall survival was 74% and recurrence-free survival 70%.

Conclusion

Despite good overall survival, recurrence still occurred in 21% of patients. Most recurrences were distant, outside the radiation and surgical fields.
731 RISK OF ESOPHAGEAL AND GASTRIC ADENOCARCINOMA IN MEN RECEIVING ANDROGEN DEPRIVATION THERAPY FOR PROSTATE CANCER
Authors: Shore Richard , Yu Jingru , Ye Weimin , Lagergren Jesper , Rutegård Martin , Akre Olof , Stattin Pär , Lindblad Mats
Published: September 2021

There is an unexplained male predominance in the incidence of esophageal (EAC) and non-cardia gastric adenocarcinoma (GAC) which cannot be explained by known risk factors. Differences in the exposures to sex hormones may play a part in the observed sex difference. This study aimed to test the hypothesis that androgens increase the risk of EAC, cardia GAC, and non-cardia GAC. We analysed a matched cohort based on a national Swedish database of prostate cancer patients.

Methods

Prostate cancer patients receiving androgen deprivation therapy (ADT) were the exposed group. Prostate cancer-free men from the general population were randomly selected and matched to the index case by birth year and county of residence, forming the unexposed control group. The participants were followed until a diagnosis of esophageal or gastric cancer, death, emigration, or end of the study period. The risk of esophageal adenocarcinoma, cardia gastric adenocarcinoma, non-cardia gastric adenocarcinoma, and esophageal squamous-cell carcinoma among ADT-exposed compared to unexposed was calculated by multivariable Cox proportional hazard regression. The hazard ratios and 95% confidence intervals were adjusted for confounders.

Results

There was a risk reduction of non-cardia gastric adenocarcinoma among ADT-users compared to non-users (HR 0.49 [95% CI 0.24–0.98]). No such decreased risk was found for esophageal adenocarcinoma (HR 1.17 [95% CI 0.60–2.32]), cardia gastric adenocarcinoma (HR 0.99 [95% CI 0.40–2.46]), or esophageal squamous cell carcinoma (HR 0.99 [95% CI 0.31–3.13]).

Conclusion

This study indicates that androgen deprivation therapy decreases the risk of non-cardia gastric adenocarcinoma, while no decreased risk was found for esophageal adenocarcinoma, cardia gastric adenocarcinoma, or esophageal squamous-cell carcinoma.
Trends and predictors of 30-day readmissions in subjects with eosinophilic esophagitis: results from a national cohort
Authors: Srinivasan Sachin , Sundaram Suneha , Kennedy Kevin F , Kohli Divyanshoo R , Emura Fabian , Sharma Prateek , Desai Madhav
Published: September 2021

Background

Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory condition causing recurrent dysphagia and may predispose patients to repeated hospitalizations. We assessed temporal trends and factors affecting readmissions in patients with EoE.

Methods

Patients with primary diagnosis of EoE and/or a complication (dysphagia, weight loss, and esophageal perforation) from EoE between 2010 and 2017 were identified from the National Readmissions Database using the International Classification of Diseases codes. The primary outcome was incidence of EoE related 30-day readmission. Independent risk factors for readmissions were evaluated using multivariable logistic regression analysis. Secondary outcomes were temporal trends of readmissions and healthcare costs.

Results

Of the 2,676 (mean age 45 ± 17.8 years, 1,667 males) index adult admissions, 2,103 (79%) patients underwent an upper endoscopy during the admission. The mean length of stay (LOS) was 3 ± 3.7 days. The 30-day readmission rate was steady at 6.8% from 2010 to 2017 and majority of the readmissions occurred by day 10 of index discharge. Age > 70 years was associated with a higher trend in 30-day readmission (P < 0.001). Longer LOS, history of smoking and the presence of eosinophilic gastroenteritis predicted readmission. Conversely, a history of foreign body impaction and upper endoscopy (including esophageal dilation) at index admission were negatively associated with readmission. Mean hospital charges significantly increased from $24,783 in 2010 to $40,922 in 2017.

Conclusion

Readmissions due to EoE are more likely to occur in the first 10 days of discharge and at a lesser rate when upper endoscopies are performed at the index admission.
Use of Faecal Transplantation with a Novel Diet for Mild to Moderate Active Ulcerative Colitis: The CRAFT UC Randomised Controlled Trial
Authors: Sarbagili Shabat Chen , Scaldaferri Franco , Zittan Eran , Hirsch Ayal , Mentella Maria Chiara , Musca Tania , Cohen Nathaniel Aviv , Ron Yulia , Fliss Isakov Naomi , Pfeffer Jorge , Yaakov Michal , Fanali Caterina , Turchini Laura , Masucci Luca , Quaranta Gianluca , Kolonimos Nitzan , Godneva Anastasia , Weinberger Adina , Kopylov Uri , Levine Arie , Maharshak Nitsan
Published: September 2021

Background

We evaluated whether integration of novel diets for donors and patients, in addition to faecal transplantation [FT], could increase FT remission rate in refractory ulcerative colitis [UC].

Methods

This was a blinded, randomised, controlled trial in adults with active UC, defined by a simple clinical colitis activity index [SCCAI] of ≥5 and ≤11 and endoscopic Mayo score 2–3, refractory to medication. Group 1 received free diet and single donor standard FT by colonoscopy on Day 1and rectal enemas on Days 2 and 14 without dietary conditioning of the donor. Group 2 received FT as above but with dietary pre-conditioning of the donor for 14 days and a UC Exclusion Diet [UCED] for the patients. Group 3 received the UCED alone. The primary endpoint was Week 8 clinical steroid-free remission, defined as SCCAI <3.

Results

Of 96 planned patients, 62 were enrolled. Remission Week 8 Group 1 was 2/17 [11.8%], Group 2 was 4/19 [21.1%], Group 3 was 6/15 [40%] [non-significant]. Endoscopic remission Group 1 was 2/17 [12%], Group 2 was 3/19 [16%], Group 3 was 4/15 [27%] [Group 1 vs 3 p = 0.38]. Mucosal healing [Mayo 0] was achieved only in Group 3 [3/15, 20%] vs 0/36 FT patients [p = 0.022]. Exacerbation of disease occurred in 3/17 [17.6%] of Group 1, 4/19 [21.1%] of Group 2, and 1/15 [6.7%] of Group 3 [Group 2 vs 3, p = 0.35].

Conclusions

UCED alone appeared to achieve higher clinical remission and mucosal healing than single donor FT with or without diet. The study was stopped for futility by a safety monitoring board.
Maternal Stress and Pregnancy Outcomes Evidence from a Natural Experiment: The 2004 Madrid Train Bombings
Authors: Cozzani Marco , Triventi Moris , Bernardi Fabrizio
Published: September 2021

Previous studies have shown that the reproduction of social background inequality starts at birth and even in the womb. We advance the understanding of the inequality in early life outcomes by analysing whether prenatal stress affects prematurity and low birth weight and how this effect varies by parental socio-economic status (SES). To address the endogeneity of prenatal maternal stress and pregnancy outcomes, we use a natural experiment and consider the 2004 Madrid train bombings as an exogenous source of stress. We analyse administrative data referring to the whole population of newborns in Spain between 2000 and 2005 and use a difference-in-differences design with a synthetic control approach. We find that children exposed to the Madrid bombing had a higher risk of prematurity and low birth weight, and that this detrimental effect is consistently concentrated among low-SES offspring. We discuss four possible mechanisms to explain this heterogeneity and rely on findings of previous research and on information from additional data to test their plausibility. In the conclusions, we highlight the broader implications of our findings for the reproduction of social inequalities across generations
Are patient-reported outcomes at discharge associated with employment status after cardiac hospitalization? Results from the national DenHeart study
Authors: Thorup Charlotte Brun , Berg Selina Kikkenborg , Mols Rikke Elmose , Fonager Kirsten , Ekholm Ola , Thrysoee Lars , Rasmussen Trine Bernholdt , Christensen Anne Vinggaard , Borregaard Britt
Published: September 2021

Introduction 

In patients hospitalized for cardiac disease, a more comprehensive understanding of the potential predictors of returning to the workforce or detachment from employment is lacking.

Aim 

The aims were (i) to explore the patterns of employment status within 1 year following hospital discharge and (ii) to investigate the association between self-reported physical health, mental health, and symptom burden at discharge and employment status at 13, 26, and 52 weeks, respectively, following discharge.

Methods and results 

Patients discharged from Danish heart centres from April 2013 to April 2014 who were a part of the workforce prior to hospitalization and aged 18–63 were included. Questionnaires were used to measure physical and mental health and symptom burden. Information on comorbidity and return to the workforce was obtained from registers. Multiple logistic regression models were used to estimate the associations between self-reported health status and returning to the workforce. Of the 5365 patients, 14.1% had not returned to the workforce 52 weeks after discharge. Patients admitted due to ‘observation for a cardiac disease’ had the highest proportion (89.4%) and patients with heart failure had the lowest proportion (72.6%) of returning to the workforce. Poor self-reported physical and mental health and high symptom burden were associated with detachment from the workforce.

Conclusion 

Self-reported health status measured at discharge may be beneficial for identifying patients at increased risk of detachment from the workforce. Occupational initiatives may be implemented in the initial period after discharge, remembering that not all patients will benefit from returning to the workforce.
Accuracy of electroanatomical mapping-guided cardiac radiotherapy for ventricular tachycardia: pitfalls and solutions
Authors: Abdel-Kafi Saif , Sramko Marek , Omara Sharif , de Riva Marta , Cvek Jakub , Peichl Petr , Kautzner Josef , Zeppenfeld Katja
Published: September 2021

Aims

To analyse and optimize the interobserver agreement for gross target volume (GTV) delineation on cardiac computed tomography (CCT) based on electroanatomical mapping (EAM) data acquired to guide radiotherapy for ventricular tachycardia (VT).

Methods and results

Electroanatomical mapping data were exported and merged with the segmented CCT using manual registration by two observers. A GTV was created by both observers for predefined left ventricular (LV) areas based on preselected endocardial EAM points indicating a two-dimensional (2D) surface area of interest. The influence of (interobserver) registration accuracy and availability of EAM data on the final GTV and 2D surface location within each LV area was evaluated. The median distance between the CCT and EAM after registration was 2.7 mm, 95th percentile 6.2 mm for observer #1 and 3.0 mm, 95th percentile 7.6 mm for observer #2 (P = 0.9). Created GTVs were significantly different (8 vs. 19 mL) with lowest GTV overlap (35%) for lateral wall target areas. Similarly, the highest shift between 2D surfaces was observed for the septal LV (6.4 mm). The optimal surface registration accuracy (2.6 mm) and interobserver agreement (Δ interobserver EAM surface registration 1.3 mm) was achieved if at least three cardiac chambers were mapped, including high-quality endocardial LV EAM.

Conclusion

Detailed EAM of at least three chambers allows for accurate co-registration of EAM data with CCT and high interobserver agreement to guide radiotherapy of VT. However, the substrate location should be taken in consideration when creating a treatment volume margin.
Mitochondrial enzyme GPT2 regulates metabolic mechanisms required for neuron growth and motor functionin vivo
Authors: Baytas Ozan , Davidson Shawn M , DeBerardinis Ralph J , Morrow Eric M
Published: September 2021

The metabolic needs for postnatal growth of the human nervous system are vast. Recessive loss-of-function mutations in the mitochondrial enzyme glutamate pyruvate transaminase 2 (GPT2) in humans cause postnatal undergrowth of brain, and cognitive and motor disability. We demonstrate that GPT2 governs critical metabolic mechanisms in neurons required for neuronal growth and survival. These metabolic processes include neuronal alanine synthesis and anaplerosis, the replenishment of tricarboxylic acid (TCA) cycle intermediates. We performed metabolomics across postnatal development in Gpt2-null mouse brain to identify the trajectory of dysregulated metabolic pathways: alterations in alanine occur earliest; followed by reduced TCA cycle intermediates and reduced pyruvate; followed by elevations in glycolytic intermediates and amino acids. Neuron-specific deletion of GPT2 in mice is sufficient to cause motor abnormalities and death pre-weaning, a phenotype identical to the germline Gpt2-null mouse. Alanine biosynthesis is profoundly impeded in Gpt2-null neurons. Exogenous alanine is necessary for Gpt2-null neuronal survival in vitro but is not needed for Gpt2-null astrocytes. Dietary alanine supplementation in Gpt2-null mice enhances animal survival and improves the metabolic profile of Gpt2-null brain but does not alone appear to correct motor function. In surviving Gpt2-null animals, we observe smaller upper and lower motor neurons in vivo. We also observe selective death of lower motor neurons in vivo with worsening motor behavior with age. In conclusion, these studies of the pathophysiology of GPT2 Deficiency have identified metabolic mechanisms that are required for neuronal growth and that potentially underlie selective neuronal vulnerabilities in motor neurons.
Energy analysis of vacuum tube collector system to supply the required heat gas pressure reduction station
Authors: Alayi Reza , Jahangiri Mehdi , Najafi Atabak
Published: September 2021

In city gas pressure reducing stations, in order not to hydrate natural gas after a sudden drop in pressure, the gas temperature is raised by a heater. The increase in temperature is such that after the pressure drop, the gas inside the pipes does not freeze. These heaters are gas burning and very high consumption, and because they use fossil fuels, produce environmental pollution. Accordingly, in this research, solar energy will be used to preheat the gas, which will be used for the most accurate analysis of TRNSYS software. In this regard, the amount of utilization of the sun and the amount of energy required for preheating will be obtained. After the implementation of the TRNSYS program, the highest amount of energy supply by the sun is related to spring, which on this day provides 55% of the thermal energy required by the load by solar energy.