bluuebunny/crossref_metadata_2025_split huggingface dataset:
O196: Gallbladder Necrosis: Predictive Factors in Patients Undergoing Emergent Cholecystectomy
Authors: Maharajh Sandeep , Brown Joshua , Chmelo Jakub , Phillips Alexander 
Published: March 2024

Abstract

Introduction
Gallstones are present in up to 25% of the general population and approximately 2% of these become symptomatic. Gallbladder necrosis is a complication of gallstones associated with higher risks of morbidity and mortality. Identification of risk factors which portend to gallbladder necrosis is key in prioritising investigation and treatment for higher risk patients.

Method
A retrospective review of all patients undergoing emergency cholecystectomy in a tertiary hospital over a 2-year period was performed. Gallbladder necrosis was diagnosed on histopathological examination of operative specimens. Multivariable logistic regression was performed to determine risk factors for gallbladder necrosis.

Results
152 patients underwent acute cholecystectomy and 44 (29%) had proven gallbladder necrosis. Multivariable model demonstrated that white cell count (WCC) (OR 1.122, 95% CI 1.031-1.221, p=0.007), C-reactive protein (CRP) (OR 1.004, 95% CI 1.001-1.008, p=0.022) and smoking status (OR 5.724, 95% CI 1.323-24.754, p=0.020) were independently predictive of gallbladder necrosis. Notably, advancing age, elevated BMI, diabetes mellitus or ASA grade were not found to be associated with developing necrosis.

Conclusion
Patients at risk of gallbladder necrosis include those with higher WCC, CRP and active smokers. Given the increased potential complications, these risk factors should be identified early in the management of those admitted with gallstone disease to ensure such patients receive aggressive medical therapy alongside timely and guided surgical intervention.
O93: Calcium channel blockers are associated with improved survival in pancreatic cancer patients undergoing neoadjuvant chemotherapy and resection
Authors: Fong Zhi , Severs George , Moir John , White Steve , Qadan Motaz , Tingle Samuel 
Published: March 2024

Abstract

Background
Repurposing existing drugs for use in oncology is more safe, efficient and cost-effective than novel drug discovery. Calcium signalling is increasingly recognised to have a key role in chemoresistance and many of the hallmarks of cancer. This study aims to assess the impact of calcium channel blockers (CCB) in pancreatic cancer.

Methods
Retrospective population study including patients in the SEER-Medicare linked database who underwent resection with curative intent of pancreatic ductal adenocarcinoma diagnosed between 2007 and 2017. Adjusted cox regression models were built to assess the impact on overall survival. As laboratory studies suggest a chemosensitising effect, we assessed the impact of CCB separately in patients receiving chemotherapy.

Results
6,223 patients were included, of whom 660 were prescribed CCB. 591 patients received neoadjuvant chemotherapy prior to resection; in this cohort CCB prescription was associated with a significant improvement in overall survival when adjusting for multiple prognostic factors (aHR=0.715, 0.514-0.996, P=0.047). This effect was not observed in patients who did not receive neoadjuvant chemotherapy (aHR=1.082, 0.982-1.191, P=0.112), or in the overall cohort (aHR=1.056, 0.963-1.158, P=0.248), suggesting a chemosensitising effect.

Discussion
CCB prescription was associated with improved overall survival in patients receiving neoadjuvant chemotherapy prior to pancreatic cancer resection. The association was specific to the group of patients receiving neoadjuvant chemotherapy. This indicates a chemosensitising effect of CCB, which mirrors previous laboratory studies. This study defines those receiving neoadjuvant chemotherapy as a target population for prospective clinical trials of CCB in pancreatic cancer.
P35: A Systematic review on the outcomes of the reverse shoulder arthroplasty versus hemiarthroplasty for the 3- and 4- part proximal humeral fractures in the elderly population
Authors: Syziu Anxhela , Brooks-Fazakerley Steven 
Published: March 2024

Abstract

Background
The hemiarthroplasty (HA) and reverse total shoulder arthroplasty (RTSA) are common surgical methods in of the proximal humerus management, where the surgical fixation is not feasible. Our aim is to analyse the most recent data to inform choices on best management for managing 3- and 4 -part fracture dislocations of the proximal humeral fractures in the elderly population.

Methods
The Medline, PubMed and Scopus databases were searched in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify the relevant literature to include for analysis. The inclusion criteria involved English language, functional outcomes, revision rates, hemiarthroplasty, and reverse total shoulder arthroplasty. The exclusion criteria were publications before 2018, systematic reviews and meta-analysis, other management options such as conservative management, surgical fixation, and total anatomical shoulder replacement.

Results
The data collected included study design and level of evidence, number of patients and patients’ characteristics, follow-up time post-surgery, functional outcomes, range of movement, Constant score, subjective scores including Disability of Arm and Shoulder (QuickDASH) and American Shoulder and Elbow Score (ASES), and revision rates.

Conclusions
The evidence suggests that RTSA is the new gold standard management for 3- and 4-part fracture dislocations of the proximal humerus in a selected group of patients over 65 years old with irreparable rotator cuff. The available literature is medium quality, requiring more robust evidence including prospective large cohort studies utilising unified objective and subjective functional outcome scores.
P230: The challenges of implementing early surgery for terminal ileal Crohn’s disease – a qualitative study of the clinician perspective
Authors: Husnoo Nilofer , Morgan Jenna L , Wyld Lynda , Brown Steven R 
Published: March 2024

Abstract

Background
Recent evidence suggests that “early” bowel resection may offer more stable remission in terminal ileal (TI) Crohn’s disease compared to medical therapy. Surgery is still often considered late in the treatment pathway. The aims of this study were to understand how clinicians make decisions about treatment for TI Crohn's and to explore their views on the role of surgery.

Methods
Semi-structured interviews with clinicians across the UK, with an interest in inflammatory bowel disease (IBD), were undertaken using videoconferencing (February to November 2022). Inductive thematic analysis was performed and 10% of the data were double-coded. Data saturation was confirmed before stopping recruitment.

Results
Participants included 9 consultant surgeons, 7 consultant gastroenterologists and 7 specialist nurses (n=23) from secondary care and tertiary referral centres. Five key themes were identified: approach to management and decision-making, opinions on medical therapy, opinions on surgery, approach to information-giving, and patients’ preferences from a clinician perspective. Symptoms, disease phenotype, patient choice and the influence of the IBD multidisciplinary team were frequently discussed factors that guide management. Trial of multiple drugs before offering surgery was commonly described. A lack of IBD surgeons and long waiting lists for surgical clinics and theatre were cited as barriers to timely surgery. Patients' fear of surgery was thought to be driven by the risk of a stoma.

Conclusion
This study highlights key barriers to early surgery for TI disease. Early discussion of surgery may allow patients to make an informed choice. Organisational barriers should be considered when designing local services.
P261: Metaverse gamified aesthetic education – a think-aloud usability pilot study
Authors: Zargaran Alexander , Zargaran David , Sousi Sara , Mosahebi Afshin 
Published: March 2024

Abstract

Introduction
Ten years on from the Keogh Review of cosmetic surgery in the UK, improvements in training and education are yet to be achieved. Gamified learning and metaverse technology have been posited as transformational media for learning. This study evaluates the usability of a metaverse gamified platform for aesthetic education.

Methods
An aesthetic education platform for administration of Botulinum Toxin was developed in Unity Game Engine. Qualitative semi-structured interviews were conducted using Nielsen’s (1994) usability testing of end-users, combining task-based assessment with free exploration of the platform. Articulated thoughts were transcribed, whilst the platform was screen recorded. Verbal and observational data were thematically analysed and coded, whilst barriers and facilitators were rated on a modified Likert scale.

Results
A total of eight medical students and junior doctors were included in the study. Six higher themes were developed including aesthetic interface, familiarity, coherence, interactivity, ease of use and utility. Coherence and interactivity were identified as the most potent drivers of learning, whilst familiarity and aesthetic interface were the biggest potential barriers.

Conclusion
A metaverse gamified educational platform in aesthetic plastic surgery is potentially usable and useful for doctors and medical students as a learning tool. Important facilitators include focus on in-game coherence and interactivity. Further work is needed to develop educational experiences further within metaverse settings in aesthetic plastic surgery to enhance education and promote patient safety.
Black ceiling tiles reduce occupational ultraviolet light exposure from phototherapy cabinets
Authors: Bajek David , Sharpe Katherine , Eadie Ewan 
Published: March 2024

Abstract
Phototherapy clinics administer ultraviolet (UV) light to patients using phototherapy cabinets. The UV radiation from these cabinets is reflected on the white ceiling tiles of the clinic and is then redirected toward both staff and patients in the area. This is particularly problematic for clinical technologists who must undertake dosimetry in these areas and have a specific time (often as low as 30 min) before they reach their maximum exposure limit. By replacing white tiles with black ones, which absorb any stray radiation, we were able to reduce stray reflection by almost 90%, prolonging the time to maximum exposure by nearly 10 times. We present these findings to encourage other similar clinics to undertake the simple protocols outlined in this article, which will significantly improve staff and patient safety.
High-level language brain regions process sublexical regularities
Authors: Regev Tamar I , Kim Hee So , Chen Xuanyi , Affourtit Josef , Schipper Abigail E , Bergen Leon , Mahowald Kyle , Fedorenko Evelina 
Published: March 2024

Abstract
A network of left frontal and temporal brain regions supports language processing. This “core” language network stores our knowledge of words and constructions as well as constraints on how those combine to form sentences. However, our linguistic knowledge additionally includes information about phonemes and how they combine to form phonemic clusters, syllables, and words. Are phoneme combinatorics also represented in these language regions? Across five functional magnetic resonance imaging experiments, we investigated the sensitivity of high-level language processing brain regions to sublexical linguistic regularities by examining responses to diverse nonwords—sequences of phonemes that do not constitute real words (e.g. punes, silory, flope). We establish robust responses in the language network to visually (experiment 1a, n = 605) and auditorily (experiments 1b, n = 12, and 1c, n = 13) presented nonwords. In experiment 2 (n = 16), we find stronger responses to nonwords that are more well-formed, i.e. obey the phoneme-combinatorial constraints of English. Finally, in experiment 3 (n = 14), we provide suggestive evidence that the responses in experiments 1 and 2 are not due to the activation of real words that share some phonology with the nonwords. The results suggest that sublexical regularities are stored and processed within the same fronto-temporal network that supports lexical and syntactic processes.
Perceiving and misperceiving speech: lexical and sublexical processing in the superior temporal lobes
Authors: Tolkacheva Valeriya , Brownsett Sonia L E , McMahon Katie L , de Zubicaray Greig I 
Published: March 2024

AbstractListeners can use prior knowledge to predict the content of noisy speech signals, enhancing perception. However, this process can also elicit misperceptions. For the first time, we employed a prime–probe paradigm and transcranial magnetic stimulation to investigate causal roles for the left and right posterior superior temporal gyri (pSTG) in the perception and misperception of degraded speech. Listeners were presented with spectrotemporally degraded probe sentences preceded by a clear prime. To produce misperceptions, we created partially mismatched pseudo-sentence probes via homophonic nonword transformations (e.g. The little girl was excited to lose her first tooth—Tha fittle girmn wam expited du roos har derst cooth). Compared to a control site (vertex), inhibitory stimulation of the left pSTG selectively disrupted priming of real but not pseudo-sentences. Conversely, inhibitory stimulation of the right pSTG enhanced priming of misperceptions with pseudo-sentences, but did not influence perception of real sentences. These results indicate qualitatively different causal roles for the left and right pSTG in perceiving degraded speech, supporting bilateral models that propose engagement of the right pSTG in sublexical processing.
Impact of sex and reproductive status on the default mode network in early midlife: implications for aging of memory circuitry and function
Authors: Spets Dylan S , Cohen Justine E , Konishi Kyoko , Aroner Sarah , Misra Madhusmita , Lee Hang , Goldstein Jill M 
Published: March 2024

Abstract
Alterations to the resting-state default mode network (rsDMN) are early indicators of memory decline and Alzheimer’s disease (AD). Brain regions shared by the rsDMN and memory circuitry are highly sexually dimorphic. However, data are limited regarding the impact of sex and reproductive status on rsDMN connectivity and memory circuitry and function. In the current investigation, rsDMN connectivity was assessed in 180 early midlife adults aged 45 to 55 by sex and reproductive status (87 women; 93 men). Associations between left and right hippocampal connectivity of rsDMN and verbal memory encoding circuitry were examined using linear mixed models, controlled for age and parental socioeconomic status, testing interactions by sex and reproductive status. Relative to men, women exhibited greater rsDMN connectivity between the left and right hippocampus. In relation to rsDMN-memory encoding connectivity, sex differences were revealed across the menopausal transition, such that only postmenopausal women exhibited loss of the ability to decrease rsDMN left–right hippocampal connectivity during memory encoding associated with poorer memory performance. Results demonstrate that sex and reproductive status play an important role in aging of the rsDMN and interactions with memory circuitry/function. This suggests the critical importance of sex and reproductive status when studying early midlife indicators of memory decline and AD risk.
Genome assembly of Genji firefly (Nipponoluciola cruciata) reveals novel luciferase-like luminescent proteins without peroxisome targeting signal
Authors: Fukuta Kentaro , Kato Dai-ichiro , Maeda Juri , Tsuruta Atsuhiro , Suzuki Hirobumi , Nagano Yukio , Tsukamoto Hisao , Niwa Kazuki , Terauchi Makoto , Toyoda Atsushi , Fujiyama Asao , Noguchi Hideki 
Published: March 2024

Abstract
The Genji firefly, Nipponoluciola cruciata, is an aquatic firefly endemic to Japan, inhabiting a wide area of the Japanese archipelago. The luminescence of fireflies is a scientifically interesting phenomenon, and many studies have evaluated this species in Japan. In this study, we sequenced the whole genome of male N. cruciata and constructed a high-quality genome assembly of 662 Mb with a BUSCO completeness of 99.1% in the genome mode. Using the detected set of 15,169 protein-coding genes, the genomic structures and genetic background of luminescence-related genes were also investigated. We found four new firefly luciferase-like genes in the genome. The highest bioluminescent activity was observed for LLa2, which originated from ancestral PDGY, a mitochondrial acyl-CoA synthetase. A thioesterase candidate, NcruACOT1, which is involved in d-luciferin biosynthesis, was expressed in the lantern. Two opsins were also detected and the absorption wavelength of the UV-type opsin candidate shifted from UV to blue. These findings provide an important resource for unravelling the adaptive evolution of fireflies in terms of luminescence and vision.
The process of ratifying the treaty to establish the African Medicines Agency: perspectives of national regulatory agencies
Authors: Ncube Bakani Mark , Dube Admire , Ward Kim 
Published: March 2024

Abstract
The vision of the African Medicines Agency (AMA) is to ensure that all Africans have access to affordable medical products that meet internationally recognized standards of quality, safety and efficacy for priority diseases/conditions. The AMA is being established by a treaty which had to be ratified by a minimum of 15 African countries. Although there was no deadline, the ratification process has been slower than expected. This study therefore analysed the rationale, perceived benefits, enabling factors and challenges of the AMA’s establishment. This study was a qualitative, cross-sectional, census survey of the national medicines regulatory authorities (NRAs) of 45 African countries. The Heads of NRAs and a senior NRA staff member were contacted to complete self-administered questionnaires. The existence of mature NRAs, the desire to have harmonized regulatory systems, the presence of strong political will and appropriate advocacy to expedite treaty signing are all enabling factors for AMA treaty signing. The challenges reported include the fact that the process is slow and there is limited understanding of the process. Competing national priorities, changes in office bearers in the public system and stagnation of the process at the ministerial level were also challenges reported. This study has improved the understanding of the treaty signing and ratification process and the perceived benefits and enabling factors of signing and ratification from African NRAs’ perspective. NRAs also highlighted challenges encountered in the process. Addressing these challenges will result in effective medicines regulation by galvanizing technical support, regulatory expertise and resources at a continental level.
Novel tetracycline resistance gene tet(65) located on a multi-resistance Corynebacterium plasmid
Authors: Kittl Sonja , Brodard Isabelle , Tresch Milena , Perreten Vincent 
Published: March 2024

Abstract

Background
Corynebacterium (C.) sp. 22KM0430 related to C. oculi and isolated from a dog exhibited resistance to tetracycline, and its WGS analysis revealed a putative resistance gene on a 35 562-bp plasmid also harbouring the MLSB resistance gene erm(X).

Objectives
To characterize the novel tetracycline resistance gene tet(65) and demonstrate its functionality by expression in C. glutamicum and Escherichia coli and plasmid curing of the host strain.

Methods
tet(65) was cloned with and without its repressor tetR(65) and expressed in C. glutamicum DSM20300 and E. coli DH5α. Plasmid was cured by non-selective passages. Minimal inhibitory concentrations (MICs) of tetracyclines were determined according to CLSI guidelines. Association of tet(65) with efflux was shown by the addition of reserpine to MIC assays. Phylogenetic position and transmembrane structure of Tet(65) were analysed using MEGA11 and DeepTMHMM.

Results
Tet(65) shows 73% amino acid identity with the closest related Tet(Z), contains 12 transmembrane domains and is structurally related to the Major Facilitator Superfamily. The tetracycline MICs decreased in the plasmid-cured strain and increased when tet(65) was expressed in C. glutamicum and in E. coli. The MICs of tetracycline decreased in the presence of reserpine indicating that tet(65) functions as an efflux pump. A GenBank search also identified tet(65) in C. diphtheriae and Brevibacterium (B.) casei and B. luteolum.

Conclusions
A novel tetracycline efflux gene tet(65) was identified in a C. oculi related species and was also present in the human pathogen C. diphtheriae and in Brevibacterium species indicating broader potential for dissemination.
Small area estimation of labour force indicators under unit-level multinomial mixed models
Authors: Bugallo María , Esteban María Dolores , Hobza Tomáš , Morales Domingo , Pérez Agustín 
Published: March 2024

Abstract
This paper presents a new statistical methodology for the small area estimation of the proportion of employed, unemployed and inactive people, and of unemployment rates. The novel empirical best and plug-in predictors are based on a multinomial mixed model that is fitted to unit-level data. Model parameters are estimated by maximum-likelihood and mean-squared errors by parametric bootstrap. Several simulation experiments are carried out to empirically investigate the properties of these estimators and predictors. Finally, a detailed application to real data from the first Spanish Labour Force Survey of 2021 is included, where the target is to map labour force indicators by province, sex, and age group.
Effect of textile colour on vector mosquito host selection: a simulated field study in Mali, West Africa
Authors: Benz Ursula , Traore Mohamad M , Revay Edita E , Traore Amadou S , Prozorov Alexey M , Traoré Issa , Junnila Amy , Cui Liwang , Saldaitis Aidas , Kone Aboubakr S , Yakovlev Roman V , Ziguime Younoussa , Gergely Petrányi , Samake Siriman , Keita Alou , Müller Günter C , Weitzel Thomas , Rothe Camilla 
Published: March 2024

Abstract

Background
The effect of clothing colour on the biting rates of different vector mosquito species is not well understood. Studies under tropical field conditions are lacking. This study aimed to determine the influence of clothing colours on mosquito biting rates in rural and suburban settings in West Africa.

Methods
We performed a simulated field study in a suburban and a rural site in Mali using Mosquito-Magnet traps utilizing CO2 and other attractants, which were covered with black, white, and black/white striped textile sheets covers. These targets operated continuously for 10 consecutive days with bright nights (around full moon) and 10 consecutive days with dark nights (around new moon). Trapped mosquitoes were collected and catch rates counted hourly. Mosquitoes were morphologically identified to the species complex level (Anopheles gambiae s.l. and Culex pipiens s.l.) or species level (Aedes aegypti). A subset of Anopheles specimens were further identified by molecular methods.

Results
Under bright-night conditions, An. gambiae s.l. was significantly more attracted to black targets than to white and striped targets; during dark nights, no target preference was noted. During bright nights, Cx. pipiens s.l. was significantly more attracted to black and striped targets than to white targets; a similar trend was noted during dark nights (not significant). For day-active Ae. aegypti, striped targets were more attractive than the other targets and black were more attractive than white targets.

Conclusions
The study firstly demonstrated that under field conditions in Mali, West Africa, mosquito catch rates were influenced by different clothing colours, depending on mosquito species and light conditions. Overall, light colours were least attractive to host-seeking mosquitoes. Using white or other light-coloured clothing can potentially reduce bite exposure and risk of disease transmission in endemic tropical regions.