bluuebunny/crossref_metadata_2025_split huggingface dataset:
O62: Five year followup of the abdominal aortic aneurysm Get Fit Trial: a randomised controlled trial of exercise to improve fitness in patients with AAA
Authors: Tay Tricia , Haque Adam 
Published: March 2024

Abstract

Aims
Improved fitness of patients on Abdominal Aortic Aneurysm(AAA) surveillance is predicted to reduce cardiovascular events and improve perioperative morbidity and mortality. The AAA GetFit Trial was a randomised control trial comparing community exercise programme(CEP) with standard care which demonstrated improved CardioPulmonary Exercise Test-related fitness in AAA patients to inform a definitive RCT. This study aims to investigate longer-term five-year clinical outcomes of these individuals.

Methods
The AAA GetFit trial recruited participants from Greater Manchester’s AAA Surveillance programme, and randomly assigned participants to either i)24-week CEP with choice of gym or home exercises, or ii) standard clinical care. We performed a retrospective analysis of clinical outcomes from this trial over five-year follow-up reviewing whether they underwent operative repair, 30-day postoperative morbidity, cardiovascular event, and mortality. We defined 30-day post-operative morbidity using Clavien-Dindo classification≥3.

Results
In total, 56 participants were recruited, 28 were randomised to CEP group, 86% were males. Mean age at time of enrolment was 72.8(SD5.7) years. At five-year follow-up, mortality in control and CEP were 60%(n=6) and 40%(n=4). In each group, 36%(n=20) underwent operative repair. There was no perioperative mortality. One perioperative morbidity occurred in control subject. Cardiovascular events(n=8) occurred in 7% and 21% control and CEP, respectively. Mean diameter of aneurysm increased in both CEPvsControl(0.89vs0.82cm).

Conclusions
The AAA GetFit trial showed significant benefits in cardiovascular fitness through community-based exercise. Clinical outcomes thus far were similar in both groups, there is an indication CEP improves perioperative outcomes.
O25: Accuracy of NELA score in predicting the risk of mortality following emergency laparotomy in patients aged above and below 80: A cohort study
Authors: Linganathan Saranya , Saji Alwin Puthiyakunnel , Hughes Ioan , Mitra Kalyan , Hajibandeh Shahin , Hajibandeh Shahab 
Published: March 2024

Abstract

Objectives
To compare accuracy of National Emergency Laparotomy Audit (NELA) score in predicting the risk of mortality following emergency laparotomy in patients aged above and below 80.

Methods
In compliance with STROCSS statement standards a retrospective cohort study was conducted. The study period was between January 2017 and January 2022. All adult patients with non-traumatic acute abdominal pathology who underwent emergency laparotomy in two centres were included. The Receiver Operating Characteristic (ROC) curve analysis and Hosmer & Lemeshow test were conducted to evaluate the discrimination and calibration of NELA score in predicting the risk of 30-day mortality in patients aged above and below 80 years.

Results
A total of 1458 eligible patients were included; 289 patients were aged above 80 with median age of 84 (IQR 81-87) and 1168 patients were aged below 80 with median age of 60 (IQR 46-71). The risk of 30-day mortality was 13.5 % in the above 80 group and 8% in the below 80 group. ROC curve analysis showed that the AUC of NELA score was 0.78 (95% CI 0.73-0.83) in the above 80 group and 0.89 (95% CI 0.87-0.91) in the below 80 group. The score was not well-calibrated for either groups.

Conclusions
The NELA score is less accurate in predicting the risk of mortality following emergency laparotomy in patients aged above 80 compared to younger patients. This may be explained by the fact that it does not take into account the measures of age-related decline in physical status of the patients.
O160: Novel Monitoring of General Surgeons' Intraoperative Cognitive Load following Surgical Sabermetrics Principles
Authors: Howie Emma , Dias Roger , Wigmore Stephen , Skipworth Richard , Yule Steven 
Published: March 2024

Abstract

Introduction
Surgeons strive to continually enhance performance. Currently, assessment relies on subjective, retrospective methods-hindering real-time improvement and error prevention. Learning from sports, surgeons can utilise surgical sabermetrics for data-driven analysis. Cognitive load(CogL) impacts performance, with overload impairing skills and judgement. Sabermetrics can be leveraged to measure CogL objectively(e.g.Electrodermal activity(EDA)) and subjectively. This study aimed to combine these measures and explore their relationship with surgeon factors and patient outcomes.

Methods
Fourteen surgeons conducting 58 benign surgery cases participated. Surgeons’ intraoperative EDA was captured using a digital sensor. Subjective data collected included (i)Surgery Task-Load-Index(SURG-TLX)), (ii)mood, (iii)sleep-disturbance and (iv)risk-aversion. EDA underwent decomposition into (a)tonic (background autonomic arousal) and (b) phasic(response to events) components. Patient outcomes included (i)30-day morbidity and (ii)case difficulty.

Results
Overall, mean phasic-EDA was 0.038μS and mean tonic-EDA was 0.483μS(ranges 0-1:1 indicating highest CogL). Mean SURG-TLX was 47.128(/120, where 120 is the highest workload). Negative mood related to changes in tonic-EDA(p&lt;0.05,F=11.84). EDA climbed throughout each case (Tonic:p&lt;0.05,F=2.035;Phasic:p&lt;0.05,F=1.626). SURG-TLX were weakly correlated with sleep(p&lt;0.05,ϱ=-0.273) and moderately correlated with case duration(p&lt;0.05, ϱ=0.598), but not EDA(p&gt;0.50).

Discussion
This study is the first in the UK to report combined CogL measures gathered during live surgery. Awareness of factors that affect CogL crucially allows for the management of factors to prevent overload and to inform targeted interventions for performance improvement. Using digital sensors to measure CogL provides opportunity for automated, real-time performance assessment, advanced feedback, and behavioural modifications.
O140: How clinically relevant are prostate cancer cell lines? A comprehensive multiomics analysis.
Authors: Ahmed Zahra , Mosabbir Warda , Tandon Devansh , Pereira Snehal Pinto , Cheema Umber , Loizidou Marilena , Whithington John , Moore Caroline , Heavey Susan 
Published: March 2024

Abstract

Introduction
Cell lines remain a heavily used resource in cancer research despite their questionable clinical relevance, mainly due to their feasibility and affordability. A range of in silico, in vivo and ex vivo approaches are gaining popularity to potentially replace cell lines, however, we cannot ignore the plethora of historical data from cell lines, nor write off their future use. Therefore, we question if and how cell lines hold clinical relevance.

Methods
The clinical characteristics of 45 PCa cell lines were compared against worldwide data and the biological features of seven cell lines were compared to over 10,000 well-characterised cases from 23 studies in eight countries. Clinical comparisons included age, race, Gleason grade, cancer type and multiomics variables included mutations, copy number alterations, structural variants, microsatellite instability, mRNA and protein expression, and tumour mutational burden. Using this, cell-line-like patients were identified and characterised.

Results
The most used cell lines were derived from metastases over 40 years ago and accurately represented very few patients. The most common alterations in clinical datasets were not necessarily altered in cell lines and 24% of key PCa gene alterations were not altered in any cell line. From the seven cell lines analysed, the greatest number of patients were found to be biologically similar to VCaP.

Conclusion
Cell lines are valuable in cancer research, but they must hold biological and clinical relevance. PCa cell lines should either be applicable to typical PCa patients or representative of specific cancer subtypes to increase the relevance of translational research.
O167: 3D-TIPS Printed Nanohybrid Composite Vascular Grafts for Evaluation of Human Umbilical Vein Endothelial Cell Response
Authors: Imran Maryam , Li Johanne , Ibrahim Maryam , Huang Xia , Song Wenhui 
Published: March 2024

Abstract

Introduction
Cardiovascular disease is a global killer. For progressive disease coronary artery bypass grafting is used, which is limited by suboptimal vasculature and patency. Alternatively, tissue engineered scaffolds are cell seeded structures supporting neovascularization. Poly(ethylene-diethylene glycol succinate)urea-urethane-polyhedral oligomeric silsesquioxane [P(EDS)UU-POSS] shows potential for its elastic and degradation properties. In this study, we manufacture a P(EDS)UU-POSS scaffold and assess human umbilical vein endothelial cell (HUVEC) attachment.

Method
3D printed thermally induced phase separated (3DTIPS) scaffolds were manufactured. Mechanical testing was employed to compare scaffold stress-strain curves with those of currently utilised vessels and synthetic grafts. HUVEC were seeded onto scaffolds coated with type I collagen and peptide hydrogel respectively. Surface functionalization in this way, is hypothesised to optimise cell attachment. Assessment of cell viability was with PrestoBlueTM and total DNA assay. Confocal imaging was also performed.

Results
Tensile properties of 3D-TIPS scaffolds match the greater saphenous vein. 3D-TIPS scaffolds exhibit higher elasticity than synthetic PCL grafts, meeting stretch and strength requirements of vessels. Metabolism data shows an initial increase followed by a decrease for both types of coating. This indicates a decrease in overall metabolism but not cell death, attributed to cellular adaptation to the scaffold microenvironment, with collagen coating performing better. Visualisation of type I collagen samples demonstrates increases in cellular attachment.

Conclusions
There is potential for optimised 3DTIPS P(EDS)UU-POSS scaffolds with suitable mechanical properties. Further study of HUVEC and smooth muscle cell co-culture will better mimic in vivo environments, assessing sustained potential as vascular grafts.
O193: Drains versus No Drain in Thyroid Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Authors: Ahmad Mohammad , Sarwar Safdar , Shaikh Shahzeb , Ashrafian Hutan , Siddiqui Muhammed , Khwaja Sadie , Kumar Nirmal 
Published: March 2024

Abstract

Introduction
Thyroid surgery does not come without its risks of complications of post-operative haemorrhage, haematoma and seroma, for which drains may be used. Placement of a drain may prevent these complications, which may be life-threatening due to vascular compromise and airway compression.

Objective
This study aims to evaluate the outcomes and complications in patients undergoing thyroid surgery with a drain and without a drain.

Methods
Systematic review of all studies up to October 2023. These studies were identified from all major databases including MEDLINE, Cochrane (1960–2023), and EMBASE (1991–2023). All studies reporting a comparison between drain and no drain thyroid surgery were searched; all studies were included. Post-operative complications and outcomes were recorded and analysed.

Results
35 studies with 4089 patients contributed to the summative outcome measures. The no drain group showed a statistically significant superiority compared to the drain group when it came to infection rates (p=0.0001), re-operation rates (p=0.05), pain score (p&lt;0.00001) and length of stay (p&lt;0.00001). There was no statistical difference for haematoma (p=0.52), haemorrhage (p=0.39) or seroma rates (p=0.38).

Conclusion
There is a superiority in postoperative outcomes and reduced complications in favour of patients without a drain compared to patients with a drain following thyroid surgery. A large number of studies with a large patient population were included; further studies are required to assess the individual suitable indications for a drain in thyroid surgery.
O79: Adjuvant chemotherapy following surgery for adenocarcinoma arising from intraductal papillary mucinous neoplasia and impact on recurrence and survival: ADENO-IPMN study
Authors: Lucocq James ,   Adeno-IPMN Collaborative, Pandanaboyana Sanjay 
Published: March 2024

Abstract

Background
The clinical impact of giving adjuvant chemotherapy after resection for adenocarcinoma arising from intraductal papillary mucinous neoplasia (IPMN) is unclear. The present study aims to identify factors related to receipt of adjuvant chemotherapy, the type and its impact on recurrence, site specific recurrence and survival in a large international cohort of patients.

Method
Patients undergoing pancreatic resection for adenocarcinoma arising from IPMN between 2010-2020 at 18 pancreatic centres were identified. Propensity score matching (PSM) and survival analyses were performed to identify the impact of adjuvant chemotherapy on recurrence and survival.

Results
A total of 459 patients underwent pancreatic resection and 275 patients (59.9%) received adjuvant chemotherapy (Gemcitabine,51.3%; Gemcitabine-capecitabine,21.8%; Folfirinox,8.0%; and other,18.9%). In multivariate analysis, poor differentiation (30.2%vs.19.0%; p=0.007) was associated with adjuvant chemotherapy use. Adjuvant chemotherapy was not associated with all, locoregional, systemic or site-specific recurrence compared to no adjuvant chemotherapy on Kaplan-Meier analysis (median time to recurrence 26 versus 50 months; p=0.14), multivariate analysis (HR 0.79, p=0.175), and on propensity score matching (HR 0.76, p=0.111). No particular subgroup had lower rates of recurrence with adjuvant chemotherapy. No particular chemotherapy regime resulted in lower recurrence rates or longer survival. The overall or disease-free survival rates were not significantly different in multivariate analysis.

Conclusion
Based on the contemporary data, adjuvant chemotherapy after pancreatic resection for adenocarcinoma arising from IPMN does not appear to impact on recurrence rates, recurrence patterns and long term survival. However, data on the most potent chemotherapy (Folfirinox) is limited and warrants further studies
Prevalence and clinical outcomes of isolated or combined moderate to severe mitral and tricuspid regurgitation in patients with cardiac amyloidosis
Authors: Tomasoni Daniela , Aimo Alberto , Porcari Aldostefano , Bonfioli Giovanni Battista , Castiglione Vincenzo , Saro Riccardo , Di Pasquale Mattia , Franzini Maria , Fabiani Iacopo , Lombardi Carlo Mario , Lupi Laura , Mazzotta Marta , Nardi Matilde , Pagnesi Matteo , Panichella Giorgia , Rossi Maddalena , Vergaro Giuseppe , Merlo Marco , Sinagra Gianfranco , Emdin Michele , Metra Marco , Adamo Marianna 
Published: March 2024

Abstract

Aims
Evidence on the epidemiology and prognostic significance of mitral regurgitation (MR) and tricuspid regurgitation (TR) in patients with cardiac amyloidosis (CA) is scarce.

Methods and results
Overall, 538 patients with either transthyretin (ATTR, n = 359) or immunoglobulin light-chain (AL, n = 179) CA were included at three Italian referral centres. Patients were stratified according to isolated or combined moderate/severe MR and TR. Overall, 240 patients (44.6%) had no significant MR/TR, 112 (20.8%) isolated MR, 66 (12.3%) isolated TR, and 120 (22.3%) combined MR/TR. The most common aetiologies were atrial functional MR, followed by primary infiltrative MR, and secondary TR due to right ventricular (RV) overload followed by atrial functional TR. Patients with isolated or combined MR/TR had a more frequent history of heart failure (HF) hospitalization and atrial fibrillation, worse symptoms, and higher levels of NT-proBNP as compared to those without MR/TR. They also presented more severe atrial enlargement, atrial peak longitudinal strain impairment, left ventricular (LV) and RV systolic dysfunction, and higher pulmonary artery systolic pressures. TR carried the most advanced features. After adjustment for age, sex, CA subtypes, laboratory, and echocardiographic markers of CA severity, isolated TR and combined MR/TR were independently associated with an increased risk of all-cause death or worsening HF events, compared to no significant MR/TR [adjusted HR 2.75 (1.78–4.24) and 2.31 (1.44–3.70), respectively].

Conclusion
In a large cohort of patients with CA, MR, and TR were common. Isolated TR and combined MR/TR were associated with worse prognosis regardless of CA aetiology, LV, and RV function, with TR carrying the highest risk.
Development and validation of a prognostic score integrating remote heart failure symptoms and clinical variables in mortality risk prediction after myocardial infarction: the PragueMi score
Authors: Wohlfahrt Peter , Jenča Dominik , Melenovský Vojtěch , Stehlik Josef , Mrázková Jolana , Šramko Marek , Kotrč Martin , Želízko Michael , Adámková Věra , Piťha Jan , Kautzner Josef 
Published: March 2024

Abstract

Aims
While heart failure (HF) symptoms are associated with adverse prognosis after myocardial infarction (MI), they are not routinely used for patients’ stratification. The primary objective of this study was to develop and validate a score to predict mortality risk after MI, combining remotely recorded HF symptoms and clinical risk factors, and to compare it against the guideline-recommended Global Registry of Acute Coronary Events (GRACE) score.

Methods and results
A cohort study design using prospectively collected data from consecutive patients hospitalized for MI at a large tertiary heart centre between June 2017 and September 2022 was used. Data from 1135 patients (aged 64 ± 12 years, 26.7% women), were split into derivation (70%) and validation cohort (30%). Components of the 23-item Kansas City Cardiomyopathy Questionnaire and clinical variables were used as possible predictors. The best model included the following variables: age, HF history, admission creatinine and heart rate, ejection fraction at hospital discharge, and HF symptoms 1 month after discharge including walking impairment, leg swelling, and change in HF symptoms. Based on these variables, the PragueMi score was developed. In the validation cohort, the PragueMi score showed superior discrimination to the GRACE score for 6 months [the area under the receiver operating curve (AUC) 90.1, 95% confidence interval (CI) 81.8–98.4 vs. 77.4, 95% CI 62.2–92.5, P = 0.04) and 1-year risk prediction (AUC 89.7, 95% CI 83.5–96.0 vs. 76.2, 95% CI 64.7–87.7, P = 0.004).

Conclusion
The PragueMi score combining HF symptoms and clinical variables performs better than the currently recommended GRACE score.
Identification of chemosensory genes in the stingless bee Tetragonisca fiebrigi
Authors: Balbuena María Sol , Latorre-Estivalis Jose M , Farina Walter M 
Published: March 2024

Abstract
Reception of chemical information from the environment is crucial for insects' survival and reproduction. The chemosensory reception mainly occurs by the antennae and mouth parts of the insect, when the stimulus contacts the chemoreceptors located within the sensilla. Chemosensory receptor genes have been well-studied in some social hymenopterans such as ants, honeybees, and wasps. However, although stingless bees are the most representative group of eusocial bees, little is known about their odorant, gustatory, and ionotropic receptor genes. Here, we analyze the transcriptome of the proboscis and antennae of the stingless bee Tetragonisca fiebrigi. We identified and annotated 9 gustatory and 15 ionotropic receptors. Regarding the odorant receptors, we identified 204, and we were able to annotate 161 of them. In addition, we compared the chemosensory receptor genes of T. fiebrigi with those annotated for other species of Hymenoptera. We found that T. fiebrigi showed the largest number of odorant receptors compared with other bees. Genetic expansions were identified in the subfamilies 9-exon, which was also expanded in ants and paper wasps; in G02A, including receptors potentially mediating social behavior; and in GUnC, which has been related to pollen and nectar scent detection. Our study provides the first report of chemosensory receptor genes in T. fiebrigi and represents a resource for future molecular and physiological research in this and other stingless bee species.
Age, Political Participation, and Political Context in Africa
Authors: Dim Eugene Emeka , Schafer Markus H 
Published: March 2024

Abstract

Objectives
Political participation differs across the age range, but little is known about these patterns outside of developed countries. Political context is a particularly important consideration for all political behavior in Africa, where only a few countries are fully democratic. Drawing from political opportunity structures theory, we investigate how political freedom conditions the age-based pattern of electoral and nonelectoral political engagement, as well as protesting.

Methods
This study merges the fifth, sixth, and seventh rounds of the Afrobarometer data sets, spanning 36 African countries, with country-level data on political freedom from Freedom House. Using multilevel regression models, we examine how political freedom shapes the relationship between age and 3 forms of political participation.

Results
Africans aged from 18 to 60 years and living in nonfree countries are most engaged in electoral and nonelectoral political activities, though participation begins to drop markedly past age 60. For protest participation, young Africans living in partially and non-free countries are the most engaged in protests; yet limited political freedom again means a sharp age-based decline.

Discussion
The impact of political context on the age–participation association is nuanced in ways not anticipated by mainstream research on the developed West. Repressive regimes, while spurring engagement at younger ages, appear to disproportionately deter older Africans from political engagement, especially its riskiest forms. We conclude by calling for more country-comparative gerontological research with careful attention to contextual heterogeneity, particularly in the understudied Global South.
Agency is Positionally Distributed: Practice Theory and (Post)Colonial Structures
Authors: Pingeot Lou , Pouliot Vincent 
Published: March 2024

Abstract
Why are some practices available to some actors in world politics, but not to others? In this theory note, we develop a theory of agency as positionally distributed: In global politics, the action potentials of groups and individuals vary depending on their location in the macrostructures inherited from common histories of colonial domination and exploitation. We contribute to the understanding of subordinate agency by exploiting the many synergies between International Practice Theory and Postcolonial Theory. Where the former sometimes struggles to capture deep macrostructures, the latter emphasizes the constitutive effects of coloniality. Conversely, where the postcolonial gaze faces the aporia of giving voice to the subordinate, a practice approach helps make sense of the indexicality of agency, including defiance and subversion. Based on these complementarities, we develop a structural concept according to which agency, including subordinate forms, is a relational effect of an unequal playing field characterized by centuries of (post)colonial dynamics. Overall, the theory note helps explain why the very same practices, such as border crossing, seem to be distributed unequally across groups depending not on their competence but on their position in social and international structures such as the North–South divide or the global color line.