bluuebunny/crossref_metadata_2025_split huggingface dataset:
O105: Evaluating Surgical Approaches in Non-Small Cell Lung Cancer: Lobectomy vs Sublobar Resection
Authors: Faruqi Duaa , Faruqi Azn , Omran Kareem , Salmasi Yousuf , Asadi Nizar 
Published: March 2024

Abstract

Background
Lung Cancer remains the leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for 85% of cases. Lobectomy has long been regarded as the gold-standard treatment for early-stage NSCLC. A shifting paradigm towards lung-sparing procedures such as sublobar resection, may benefit patients with limited respiratory reserve or high comorbidity index. This study aims to compare survival outcomes between patients undergoing lobectomy and sublobar resection.

Methods
This was a tertiary retrospective cohort study comparing disease-free survival (DFS), overall survival (OS) and postoperative outcomes in lobectomy and sublobar patients between 2013 and 2023 (n=3983). Propensity matched analysis was employed to adjust for treatment selection bias, calculated using a logistic regression model and incorporated eight covariates (n=528). Baseline, post-operative, and survival data were extracted from the hospital database. Comparison of baseline and post-operative characteristics involved Wilcoxon rank sum test, Fisher’s exact test and Pearson’s Chi-squared test. Kaplan Meier estimates and Multivariate Cox Regression were used to evaluate survival. p&lt;0.05 was considered significant.

Results
No significant inter-cohort differences were observed in either DFS (log-rank p=0.32), OS (log-rank p=0.47), or 90-day mortality (log-rank p=0.78). Sublobar resection exhibited shorter post-operative length of stay (p&lt;0.05). Conversely, both approaches demonstrated comparable resection margins and complication rates. Significant predictors of survival were age, gender and low Eastern Cooperative Oncology Group (ECOG) performance status (p&lt;0.05).

Conclusion
These findings further support the non-inferiority of sublobar resection to lobectomy for stage 1 lung cancer. Additionally, improved perioperative outcomes may make sublobar resection more desirable for higher risk patients.
O113: Predictors of textbook outcome following oesophagogastric cancer surgery
Authors: Velayudham Ganesh , Dermanis Alexander , Kamarajah Sivesh , Griffiths Ewen 
Published: March 2024

Abstract
Textbook outcome (TO) is a multidimensional composite measure representing an ideal perioperative course, which has been utilised to assess the quality of care in oesophagogastric cancer surgery. We aim to determine TO rates among oesophagogastric cancer patients in a UK tertiary centre, investigate predictors of TO attainment, and evaluate the relationship between TO and survival. A retrospective analysis of a prospectively collected departmental database between 2006-2021 was conducted. Patients that underwent radical oesophagogastric cancer surgery with curative intent were included. TO attainment required margin-negative resection, adequate lymphadenectomy, uncomplicated postoperative course, and no hospital readmission. Predictors of TO were investigated using multivariable logistic regression. The association between TO and survival was evaluated using Kaplan-Meier analysis and Cox regression modelling. 667 oesophageal cancer and 312 gastric cancer patients were included. TO was achieved in 35.1% of oesophagectomy patients and 51.3% of gastrectomy patients. Several factors were independently associated with a low likelihood of TO attainment: T3 stage (OR:0.41, 95% CI [0.22-0.79], p=0.008) and T4 stage (OR:0.26, 95% CI [0.08-0.72], p=0.013) in the oesophagectomy cohort and high BMI (OR:0.93, 95% CI [0.88-0.98], p=0.011) in the gastrectomy cohort. TO attainment was associated with greater overall survival in oesophagectomy and gastrectomy cohorts, however, it was not associated with recurrence-free survival in the gastrectomy cohort. TO is a useful multidimensional quality improvement metric that can be utilised to compare surgical quality between centres and investigate patients at risk of TO failure. Implementation of preoperative care measures can improve rates of TO and long-term survival.
P34: The prognostic value of pre-treatment sarcopenia in overall survival in head and neck cancer patients: A systematic review
Authors: Syziu Anxhela , Schache Andrew 
Published: March 2024

Abstract

Background
This study aims to determine the prognostic value of pre-treatment sarcopenia, defined radiologically at the cervical (C3) or lumbar (L3) region, in head and neck (HNC) adult patient population undergoing treatment with curative intention.

Methods
A systematic search in the PubMed and Scopus databases was performed before February 2022. The inclusion criteria applied were adult patients with locally advanced HNC, sarcopenia defined radiologically at the C3 and/or L3 level, and patients receiving primary treatment with curative intent. The certainty of study evidence was assessed using the ROBINS-I scale, the Cochrane method for assessing bias in non-randomised trials.

Results
Twenty-six studies were included in this review, totalling 6395 adult patients with HNC. It was evident that pre-treatment sarcopenia was associated with worse overall survival outcomes in 22 out of 26 (85%) studies across all the treatment modalities with curative intent. In addition, the gender-specific skeletal muscle index (SMI) sarcopenic cut-off value of &lt;52.4 cm2/m2 for men and &lt;38.5 cm2/m2 for women, was significantly associated with worse OS compared to other cut-off values seen in a minority of studies.

Conclusions
Despite the retrospective design of the studies and inconsistency in SMI cut-off values, these findings suggest that sarcopenia is a strong prognostic factor of overall survival in HNC patients undergoing primary curative treatment. The clinical implications of these findings suggest that sarcopenia evaluation is a good prognostic marker in the HNC population. Future nutritional interventional studies might focus on reversing the muscle loss and improving the overall outcomes in identified sarcopenic individuals.
P240: Sarcopenia of the lower limb on Magnetic Resonance Imaging in patients with Diabetes Mellitus – a systematic review
Authors: Ahmad Manal , Mohamed Abdulla , Amiras Dimitri , Davies Alun , Shalhoub Joseph 
Published: March 2024

Abstract

Introduction
Sarcopenia is defined by low measures of muscle quantity and quality and physical performance. Accelerated sarcopenic changes in diabetic patients leads to biomechanical changes in the foot and limb loss.

Aim
To systematically review the literature on Magnetic Resonance Imaging (MRI) and sarcopenia in the lower limb in patients with diabetes.

Methods
A literature review was conducted in accordance with PRISMA guidelines. Embase and Medline databases were searched with Ovid interface, as well as Pubmed and Cochrane. The grey literature was also reviewed on ClinicalTrials.gov, WHO international clinical trials registry platform, Cochrane library and the NIHR journals library and ProQuest. The MeSH terms “sarcopenia” AND “diabetes mellitus” AND “magnetic resonance imaging” were employed in the primary search string. The articles were reviewed by two independent reviewers.

Results
874 studies were screened. 20 articles were included in the final review. Methods of measurement included cross sectional area measurements, stereological muscle measurements, muscle volume estimation, adipose infiltration, signal intensity cut-off, Goutallier grading, semiquantitative 5-point scale. Reduction in cross-sectional area and volumes and greater intramuscular fat infiltration was noted in patients with diabetes Sarcopenia ++ in Diabetic polyneuropathy (DPN) compared to non-diabetic and diabetic but non-DPN counterparts. MRI findings correlate with neuropathy disability scores and physical tests. Single study using a semi-automated process to measure sarcopenia.

Conclusion
MRI has its merit in providing accurate and detailed information on skeletal muscle volume and assessment of fat infiltration in muscle. This is relevant to reducing complications associated with changes in the biomechanics of the foot.
Multipattern graph convolutional network-based autism spectrum disorder identification
Authors: Zhou Wenhao , Sun Mingxiang , Xu Xiaowen , Ruan Yudi , Sun Chenhao , Li Weikai , Gao Xin 
Published: March 2024

Abstract
The early diagnosis of autism spectrum disorder (ASD) has been extensively facilitated through the utilization of resting-state fMRI (rs-fMRI). With rs-fMRI, the functional brain network (FBN) has gained much attention in diagnosing ASD. As a promising strategy, graph convolutional networks (GCN) provide an attractive approach to simultaneously extract FBN features and facilitate ASD identification, thus replacing the manual feature extraction from FBN. Previous GCN studies primarily emphasized the exploration of topological simultaneously connection weights of the estimated FBNs while only focusing on the single connection pattern. However, this approach fails to exploit the potential complementary information offered by different connection patterns of FBNs, thereby inherently limiting the performance. To enhance the diagnostic performance, we propose a multipattern graph convolution network (MPGCN) that integrates multiple connection patterns to improve the accuracy of ASD diagnosis. As an initial endeavor, we endeavored to integrate information from multiple connection patterns by incorporating multiple graph convolution modules. The effectiveness of the MPGCN approach is evaluated by analyzing rs-fMRI scans from a cohort of 92 subjects sourced from the publicly accessible Autism Brain Imaging Data Exchange database. Notably, the experiment demonstrates that our model achieves an accuracy of 91.1% and an area under ROC curve score of 0.9742. The implementation codes are available at https://github.com/immutableJackz/MPGCN.
“Walking selectivity” in the occipital place area in 8-year-olds, not 5-year-olds
Authors: Jung Yaelan , Hsu Debbie , Dilks Daniel D 
Published: March 2024

Abstract
A recent neuroimaging study in adults found that the occipital place area (OPA)—a cortical region involved in “visually guided navigation” (i.e. moving about the immediately visible environment, avoiding boundaries, and obstacles)—represents visual information about walking, not crawling, suggesting that OPA is late developing, emerging only when children are walking, not beforehand. But when precisely does this “walking selectivity” in OPA emerge—when children first begin to walk in early childhood, or perhaps counterintuitively, much later in childhood, around 8 years of age, when children are adult-like walking? To directly test these two hypotheses, using functional magnetic resonance imaging (fMRI) in two groups of children, 5- and 8-year-olds, we measured the responses in OPA to first-person perspective videos through scenes from a “walking” perspective, as well as three control perspectives (“crawling,” “flying,” and “scrambled”). We found that the OPA in 8-year-olds—like adults—exhibited walking selectivity (i.e. responding significantly more to the walking videos than to any of the others, and no significant differences across the crawling, flying, and scrambled videos), while the OPA in 5-year-olds exhibited no walking selectively. These findings reveal that OPA undergoes protracted development, with walking selectivity only emerging around 8 years of age.
Public–Private engagement and health systems resilience in times of health worker strikes: a Ghanaian case study
Authors: Buabeng-Baidoo Bettina , Olivier Jill 
Published: March 2024

Abstract
In low and middle-income countries like Ghana, private providers, particularly the grouping of faith-based non-profit health providers networked by the Christian Health Association of Ghana (CHAG), play a crucial role in maintaining service continuity during health worker strikes. Poor engagement with the private sector during such strikes could compromise care quality and impose financial hardships on populations, especially the impoverished. This study delves into the engagement between CHAG and the Government of Ghana (GoG) during health worker strikes from 2010 to 2016, employing a qualitative descriptive and exploratory case study approach. By analysing evidence from peer-reviewed literature, media archives, grey literature and interview transcripts from a related study using a qualitative thematic analysis approach, this study identifies health worker strikes as a persistent chronic stressor in Ghana. Findings highlight some system-level interactions between CHAG and GoG, fostering adaptive and absorptive resilience strategies, influenced by CHAG’s non-striking ethos, unique secondment policy between the two actors and the presence of a National Health Insurance System. However, limited support from the government to CHAG member facilities during strikes and systemic challenges with the National Health Insurance System pose threats to CHAG’s ability to provide quality, affordable care. This study underscores private providers’ pivotal role in enhancing health system resilience during strikes in Ghana, advocating for proactive governmental partnerships with private providers and joint efforts to address human-resource-related challenges ahead of strikes. It also recommends further research to devise and evaluate effective strategies for nations to respond to strikes, ensuring preparedness and sustained quality healthcare delivery during such crises.
The Rumble of a Locomotive, Traumatizing Screams, and Mortal Dance: Firsthand Poetic Testimonies Haunted by the Sounds of the Holocaust
Authors: Lisak-Gębala Dobrawa 
Published: March 2024

Abstract
This article analyzes the relationship between Holocaust trauma and firsthand poetic testimonies through the lens of literary acoustics. Specifically, it explores the work of three Jewish poets, Stanisław Wygodzki, Ilona Karmel, and Stanisław Jerzy Lec, who wrote in Polish of their tragic experiences in the Nazi camps. The article compares these poetical works to involuntary flashbacks composed of haunting sounds that recall trauma and violence and applies the concept of thantosonics to these auditory memories. In particular, the author notes the importance of trains as not only an auditory motif, but also as the metrical underpinning of the verses, and as a point of juxtaposition against sounds of innocence in the Holocaust soundscape. Furthermore, the article also explores the imagery of folk dance as a kind of danse macabre, as well as instances of involuntary sonic identification with the perpetrators.
Genome-wide variants and optimal allelic combinations for citric acid in tomato
Authors: Gai Wenxian , Yuan Liangdan , Yang Fan , Ahiakpa John Kojo , Li Fangman , Ge Pingfei , Zhang Xingyu , Tao Jinbao , Wang Fei , Yang Yang , Zhang Yuyang 
Published: March 2024

Abstract
Citric acid (CA) plays a crucial role as a fruit flavor enhancer and serves as a mediator in multiple metabolic pathways in tomato fruit development. Understanding factors influencing CA metabolism is essential for enhancing fruit flavor and CA-mediated biological processes. The accumulation of CA, however, is influenced by a complex interplay of genetic and environmental factors, leading to challenges in accurately predicting and regulating its levels. In this study, we conducted a genome-wide association study (GWAS) on CA, employing six landmark models based on genome-wide variations including structural variants, insertions and deletions, and single nucleotide polymorphisms. The identification of 11 high-confidence candidate genes was further facilitated by leveraging linkage disequilibrium and causal variants associated with CA. The transcriptome data from candidate genes were examined, revealing higher correlations between the expression of certain candidate genes and changes in CA metabolism. Three CA-associated genes exerted a positive regulatory effect on CA accumulation, while the remaining genes exhibited negative impacts based on gene cluster and correlation analyses. The CA content of tomatoes is primarily influenced by improvement sweeps with minimal influence from domestication sweeps in the long-term breeding history, as evidenced by population differentiation and variants distribution. The presence of various causal variants within candidate genes is implicated in the heterogeneity of CA content observed among the tomato accessions. This observation suggests a potential correlation between the number of alternative alleles and CA content. This study offers significant function-based markers that can be utilized in marker-assisted breeding, thereby enhancing their value and applicability.
Acute type A aortic dissection features and outcomes in octogenarians: a propensity score analysis
Authors: Park You Kyeong , Lee Jae Hang , Kim Kang Min , Jung Joon Chul , Chang Hyoung Woo , Kim Dong Jung , Kim Jun Sung , Lim Cheong , Park Kay-Hyun 
Published: March 2024

Abstract

OBJECTIVES
The clinical characteristics and early outcomes of surgical repair in octogenarians with acute type A aortic dissection were compared with those in nonoctogenarians.

METHODS
All patients who underwent emergency surgical repair for acute type A aortic dissection in our institution between 2003 and 2022 were included in this study. The patients were divided into an octogenarian group and a nonoctogenarian group. The patients in the 2 groups were propensity score matched at a ratio of 1:1. Before matching, the baseline characteristics were compared between 2 groups. The major complication and 30-day mortality rates were compared in the matched population.

RESULTS
A total of 495 patients were screened, and 471 were included in the analysis, with 48 in the octogenarian group and 423 in the nonoctogenarian group. Before matching, DeBakey type II dissection was significantly more prevalent in the octogenarians (42% vs 14% in the octogenarians and nonoctogenarians, respectively, P &lt; 0.001). Additionally, intramural haematomas (39.6% vs 14.4%, P &lt; 0.001) were more prevalent in the octogenarians. However, severe aortic regurgitation (4.2% vs 15.4%, P = 0.046) and root enlargement (0% vs 13.7%, P = 0.009) were less prevalent in the octogenarians. After matching (36 pairs), the incidence of postoperative delirium was higher in the octogenarians (56% vs 25%, P = 0.027). However, there were no significant differences in 30-day and in-hospital mortality rates, intensive care unit stay or major complications, including stroke, paraplegia, respiratory complications, mediastinitis and haemodialysis.

CONCLUSIONS
The octogenarians with acute type A aortic dissection had higher incidences of DeBakey type II dissection and intramural haematomas and lower incidences of severe aortic regurgitation and aortic root enlargement than the nonoctogenarians. Being an octogenarian was not associated with an increased risk of early major complications or mortality after surgery for acute type A aortic dissection.
Early and long-term outcomes following redo mitral valve surgery in patients with prior minimally invasive mitral valve surgery
Authors: Schumacher Katja , Marin Cuartas Mateo , de la Cuesta Manuela , Noack Thilo , Kiefer Philipp , Leontyev Sergey , Borger Michael A , Vollroth Marcel , Misfeld Martin 
Published: March 2024

Abstract

OBJECTIVES
The frequency of minimally invasive mitral valve surgery (MVS) has steadily increased over the last decades and therefore surgeons are now encountering an increasing number of patients requiring mitral valve (MV) reoperations post-minimally invasive MVS. The aim of this study was to analyse the early postoperative outcomes and the long-term survival in patients who undergo reoperative MVS following previous minimally invasive surgery.

METHODS
Patients who underwent redo MVS following prior minimally invasive MVS between January 2002 and December 2021 were included in our analysis. Study data were prospectively collected and retrospectively analysed. The primary outcomes were 30-day mortality and long-term survival.

RESULTS
Among the 187 included patients, 34 (18.2%) underwent repeat MV repair and 153 (81.8%) MV replacement. The median age was 66 years (interquartile range 56–74) and 80 (42.8%) patients were female. Redo MVS was performed through median sternotomy in 169 patients (90.4%). A total of 77 (41.2%) patients had additional concomitant procedures. The median intensive care unit stay was 1 day (1–5). The 30-day mortality was 6.4% (12/187). Estimated survival at 5 and 12 years was 61.8% and 38.3%, respectively. Preoperative stroke (hazard ratio 3.28, 95% confidence interval 1.37–7.85, P = 0.007) as well as infective endocarditis (hazard ratio 1.85; 95% confidence interval 1.09-3.11, P = 0.021) were independent predictors of long-term mortality.

CONCLUSIONS
Redo MVS following prior minimally invasive MVS can be performed safely with low early perioperative mortality and acceptable long-term survival. Preoperative stroke, infective endocarditis and concomitant tricuspid valve surgery are independent predictors of long-term mortality.
Corynebacterium diphtheriae and Corynebacterium ulcerans: development of EUCAST methods and generation of data on which to determine breakpoints
Authors: Berger Anja , Badell Edgar , Åhman Jenny , Matuschek Erika , Zidane Nora , Kahlmeter Gunnar , Sing Andreas , Brisse Sylvain 
Published: March 2024

Abstract

Background
Evidence-based clinical susceptibility breakpoints have been lacking for antimicrobial agents used for diphtheria.

Objectives
We aimed to evaluate broth microdilution and disc diffusion methods and create a dataset of MIC values and inhibition zone diameters (ZDs) from which breakpoints could be determined.

Methods
We included 400 recent clinical isolates equally distributed by species (Corynebacterium diphtheriae and Corynebacterium ulcerans) and by national surveillance programmes (France and Germany). Non-duplicate toxigenic and non-toxigenic isolates were chosen to enable the inclusion of a diversity of susceptibility levels for the 13 agents tested. Broth microdilution and disc diffusion, using EUCAST methodology for fastidious organisms, were used.

Results
The distributions of MIC and ZD values were largely in agreement among methods and countries. Breakpoints to allow categorization of WT isolates as susceptible, i.e. susceptible (S) or susceptible, increased exposure (I) were determined for 12 agents. The data supported a breakpoint for benzylpenicillin and amoxicillin of resistant (R) &gt; 1 mg/L since WT isolates were inhibited by 1 mg/L or less. WT isolates were categorized as I (S ≤ 0.001 mg/L) for benzylpenicillin, emphasizing the need for increased exposure, and S (S ≤ 1 mg/L) for amoxicillin. Erythromycin breakpoints were set at S ≤ 0.06 mg/L and R &gt; 0.06 mg/L. The corresponding ZD breakpoints were determined for all agents except amoxicillin, for which categorization was based on benzylpenicillin results.

Conclusions
This work provided a large set of antimicrobial susceptibility data for C. diphtheriae and C. ulcerans, using a harmonized methodology. The dataset allowed EUCAST and experts in the diphtheria field to develop evidence-based breakpoints in January 2023.