bluuebunny/crossref_metadata_2025_split huggingface dataset:
O067 Vessel prep trials – real life or alternative reality?
Authors: Sherazi A , Owen R , Fitzpatrick N , Katsogridakis E 
Published: May 2023

Abstract

Introduction
During the last ten years there have been two notable studies within vessel preparation for peripheral vascular disease; the DEFINITIVE AR prospective multi-centre randomised study (evaluating the use of atherectomy prior to drug-eluting balloon catheters (DCB)) and the DISRUPT PAD III randomized control trial (evaluating the use of intravascular lithotripsy (IVL)). This study aimed to analyse a true cohort of vascular patients who underwent vessel prep and whether this reflects those included in the studies.

Methods
Data were collected on patients with SFA disease in 14 countries across 17 centres. We applied the inclusion criteria for the DEFINITIVE AR and DISRUPT PAD III studies to our cohort.

Results
Data were collected on n=974 patients who received at least one form of vessel prep. Of these patients, 202 (20.7%) underwent atherectomy and 22 (2.26%) underwent lithotripsy. 50.1% (n=103) of those who underwent atherectomy would have been eligible to participate in the DEFINITVE AR study. 18% (n=4) of patients who underwent lithotripsy would have been eligible to participate in the DISRUPT PAD III trial.

Conclusion
Both the DEFINITIVE AR and DISRUPT PAD III trials have shown promising results however in this large multicentre study we have shown that the study participants reflect only a small percentage of the patients seen within a real vascular ward. We would advise caution when interpreting the results from these studies considering the disparity we have shown between the study cohorts and the real life vascular population.
O070 An assessment of information available online for the public regarding aortic dissection
Authors: Guang Y , Lim J , Hanna L , Gibbs R 
Published: May 2023

Abstract

Introduction
Objective To assess the quality of information provided by open access websites regarding aortic dissections on the World Wide Web.

Methods
The first 50 results from Yahoo, Bing and Google were collected using the search term ‘aortic dissection’ and duplicates removed. Website quality was scored using the University of Michigan Consumer Health Website tool (maximum score 80). Website readability was assessed using the Flesch Reading Ease score (maximum score 100) and Simple Measure of Gobbledygook (SMOG) score (years of education needed). Subjective assessment was undertaken to assess the quality of website content.

Results
39 of 75 websites were included for analysis after applying the exclusion criteria. 94.9% of websites did not specify the type of aortic dissection discussed. Most websites were weak, with an average Michigan score of 48.89 (SD ±8.09). Sources published by non-profit organizations were of the lowest quality (mean score = 44.69 SD ± 5.85). Most websites were rated as ‘fairly difficult’ to read, with an overall mean FRE score of 58.92 (SD ± 28.03). Websites aimed at medical trainees had lowest readability (mean = 38.87, SD ±15.36). Websites published by non-profit organisations required the least years of education to read, with mean SMOG score of 10.93 (SD ±3.12).

Conclusion
Current online websites providing education to the public and professionals regarding aortic dissections are difficult to read, with a poor consistency and reliability between publishing organizations. Efforts must be made to produce high-quality, standardised information, to facilitate patient awareness and decision-making autonomy.
O071 An assessment of information available online for the public regarding aortic aneurysms
Authors: Lim J , Guang Y , Hanna L , Gibbs R 
Published: May 2023

Abstract

Introduction
Objective - To assess the quality of information provided by open access websites regarding aortic aneurysms (AA) on the World Wide Web.

Methods
The first 50 results from Yahoo, Bing and Google were collected using the search term ‘aortic aneurysm’ and duplicates removed. Website quality was scored using the University of Michigan Consumer Health Website tool (maximum score 80). Website readability was assessed using the Flesch Reading Ease (FRE)score (maximum score 100) and Simple Measure of Gobbledygook (SMOG) score (years of education needed). Subjective assessment was undertaken to assess the quality of website content.

Results
59 of 81 websites were included for analysis after applying the exclusion criteria. 59.3% of websites were targeted at abdominal aortic aneurysms, and only 3.4% specific to thoracic aneurysms. The mean Michigan score for all sources was 48.6 (SD ±5.8), indicating sources were weak globally irrespective of publisher (public, private, independent or non-profit organization). Most sources were rated as requiring standard reading level, with a global average FRE of 62.72 (SD ±10.8). Mean SMOG scores showed that websites published by private organisations required the least educational level to read (mean = 10.5, SD ± 0.1).

Conclusion
Current online websites providing education to the public and professionals regarding aortic aneuryms are consistently low quality and lack comprehensiveness, with a paucity of information available for thoracic aortic aneurysms specifically. Efforts must be made to improve the quality of sources as well as expanding the scope of content to facilitate patient awareness and decision-making autonomy.
O074 Localisation using multiple magnetic seeds in unilateral breast surgery: a report of clinical and radiological outcomes in a tertiary breast cancer centre
Authors: Al Azzawi M , Kelly O , Welaratne I , Sartini Bhrearhnach A , McGuire A , Stanley E , Kell M , Stokes M , Barry M , Walsh S , Heeney A 
Published: May 2023

Abstract

Introduction
Magnetic seeds (Magseeds) are becoming increasingly used as a method of localising non-palpable breast lesions. The cost effectiveness and reduced scheduling conflicts in comparison with wire localization has led to increased popularity in recent years. There's a paucity of data on outcomes when using multiple magseeds in one breast. In this study, we assess the radiological, operative and pathological outcomes of inserting multiple magseeds in the same breast.

Methods
A retrospective analysis of all magseed guided excisions preformed at the MMUH breast surgery department between January 2020 and December 2022. 40 patients with more than one magseed inserted unilaterally were included. Primary outcome measures were successful excision of lesion(s) and magseed retrieval. Secondary outcomes included re-excision rate and perioperative complications.

Results
The mean distance between magseeds was 48.3 and 42.5 mm on ML and CC views respectively. 9/40 used magseeds for bracketing while the rest used for excision of discrete lesions. Mean operative time was 56.65 minutes and 55% of the procedures were wide local excisions. There was no reported difficulties identifying magseeds intra-operatively or in the specimen mammogram. The mean specimen size is 33.42 mm while the mean size of the final lesion is 15.49 mm. Invasive ductal carcinoma was the commonest pathological outcome. The rate of positive margins was 20% and re-excision was 15%. One patient proceeded to completion mastectomy.

Conclusion
Multiple magseed localisation is a feasible, safe and effective method when utilized in bracketing a unifocal lesion or separate lesion excisions in unilateral breast surgery.
O079 Randomised controlled trial of LigaSure use versus monopolar diathermy in mastectomy
Authors: Keelan S , Dowling G , Boland M , Dhannoon A , Roche T , O'Grady S , Hegarty A , Downey E , Bolger J , Chwanrow B , Sorenson J , Power C , Butt A , Allen M , Hill A 
Published: May 2023

Abstract

Introduction
LigaSure is an electrothermal bipolar vessel-sealing system shown to decrease blood loss and drainage volume compared to electrocautery in axillary node dissection. This prospective randomised controlled trial aimed to assess whether using LigaSure improved perioperative outcomes when compared with monopolar diathermy alone in performing mastectomy without axillary dissection.

Methods
Mastectomy was performed with the LigaSure device and compared with mastectomy using conventional monopolar diathermy in a prospective randomised trial. Patients were recruited over 39 months and were aged from 33 to 86 years of age. Block randomisation (44 in the Ligasure group and 42 in the diathermy group) was performed. The primary outcome measures include total volume in drain output (ml), time to drain volume less than 30mls in 24 hours and operating time.

Results
Drain output volume was measured to the day the drain yielded less than 30mls in a 24 hour period in both groups (484 mls in the monopolar group v 494 mls in Ligasure group). This time point was also used to calculate time to drain removal in both groups (Monopolar 7.2 days and Ligasure 7.3 days). Drain output volume and number or days to drain removal did not show any significant difference in both groups (p=0.05). The operative time in both groups was similar (106mins in monopolar group and 112.5 mins in LigaSure group).

Conclusion
Use of the LigaSure device is feasible in performing mastectomy. It is not associated with reduced drain volume or shorter operative time compared with monopolar diathermy.
O082 A pilot study on prehabilitation for patients undergoing surgery for cancer
Authors: Martin J , Truslove E , Beed M , Lobo D N , Haywood A , Burrows A , Morgan B , Wilson V , Evans D 
Published: May 2023

Abstract

Introduction
In 2022 Nottingham University Hospital NHS Trust (NUH) began offering structured prehabilitation sessions for patients diagnosed with cancer, to help them better prepare for surgical treatment. We have undertaken an audit of patients enrolled onto the programme and examined key outcomes.

Methods
Patients requiring surgery for cancer were initially assessed (April – Oct 2022) and offered 2-3 prehabilitation sessions per week. During initial and final Prehabilitation assessments, patients completed a sit-stand test, shuttle walk test and Patient Reported Outcome Measures for anxiety (GAD-7) and depression (PHQ-9).

Results
Two hundred and twelve patients were enrolled onto the prehabilitation programme and 87 (41%) completed the pre- and post-assessment after 3-6 weeks. Colorectal (47, 54%) and gynaecological (17, 22%) surgery represented the two major procedures for those completing the programme. Mean (±sem) physical activity score (140.1±19.4, n=78) was significantly increased (p&lt;0.001) at the end of the programme (315.3±23.8). Mean shuttle walk test score (340.2±28.7, n=54) increased by approximately 15% (p&lt;0.001) at the end of the programme (394±32.8), while the sit-stand test (24.9±1.3, n=64) also improved significantly (30.9±1.5; p&lt;0.001). The mean (±sem) anxiety GAD-7 score (6.06±0.64 n=85) and depression PHQ-9 score (5.38±0.69, n=85) were significantly reduced (p&lt;0.001) by the programme (3.29±0.46 and 2.76±0.45, respectively).

Conclusion
Initial results from the NUH prehabilitation programme provide evidence for a significant increase in physical activity prior to surgery, accompanied by a general improvement in the mental well-being of the patients.
O097 A drug screen to identify novel radiosensitisers in colorectal cancer cells
Authors: Kler A , Fok M , Grundy G , Parsons J , Vimalachandran D 
Published: May 2023

Abstract

Introduction
Locally advanced rectal cancer is typically treated with neoadjuvant chemoradiotherapy, where chemotherapy acts synergistically to radiosensitise cancer cells. Response to chemoradiotherapy is variable, with 8-20% of cases having a complete pathological response, but 20-30% demonstrate no response or progression. Novel radiosensitisers can potentially improve response, tolerability of radiotherapy and de-escalate treatments, including the need for major surgery. This study aims to perform a screen of available FDA-approved drugs to identify novel radiosensitisers in rectal cancer.

Methods
A drug screen of forty FDA-approved drugs was performed. HCT-116 cells were cultured and treated as a monolayer with 0.3 μM and 1.0 μM of a specific drug for 16 hours. Clonogenic assays were performed in 24 well plates after photon irradiation at 0 and 1 Gy. Relative colony formation (survival fraction) was employed to measure drug efficacy and radiosensitisation. Following the screen, two drugs were selected for dose optimisation and further mechanistic evaluation with DNA repair kinetics and DNA damage using immunofluorescence of γH2Ax foci.

Results
Abexinostat and fomepizole were selected from the screen for dose optimisation based on their radiosensitising capabilities. Dose optimisations determined that both drugs had an optimal concentration of 1.0 μM and required an optimum of 6 hours of treatment and showed significant radiosensitisation. There were significantly more γH2Ax foci after 24 hours in cells treated with Abexinostat than control, demonstrating persistent DNA damage.

Conclusion
Abexinostat and fomepizole show promise as radiosensitizers. Further experimentation is ongoing to determine the mechanisms for these drugs and translational benefit.
O099 A relevant metabolic model for monitoring human metabolism in vivo using dynamic nuclear polarization with 13C magnetic resonance spectroscopy
Authors: Torchi J , Mallinson A , Cooper D , Auer P , Morris P , Lobo D N , Greenhaff P L , Serres S 
Published: May 2023

Abstract

Introduction
DNP increases the signal of carbon-13 molecules on MR scans (&gt;10,000-fold), enabling real-time, dynamic quantitation of tissue metabolism in vivo with significant clinical potential. 13C quantification of metabolism is affected by confounding factors (T1 signal decay, flip angle, and metabolite escape), which necessitates metabolic modelling. Here, we have assessed a mathematical model that requires minimal information on confounding factors to measure metabolic rates with reliability.

Methods
Four healthy male volunteers (age; 24 ± 1.4 years; BMI; 23 ± 0.4 kg/m2) were recruited. Sterile hyperpolarized 13C pyruvate was safely produced using a clinical DNP polariser (SPINlab GE-Healthcare) and administered intravenously to volunteers performing in-bore plantar-flexion exercise to increase muscle pyruvate flux. 13C MR scans of the calf muscle were collected during exercise and used to test our model against 5000 computer simulations using randomised kinetic constants and confounding factors.

Results
The signal of metabolites was used to extract the kinetic constants of hyperpolarised-13C pyruvate conversion to lactate (KpL), alanine (KpA), and bicarbonate (KpB) with reproducibility and satisfactory signal-to-noise ratio (8.2 ± 1.8×102 s−1, 2.3 ± 2.1×102 s−1 to 2.1 ± 1.3 x103 s−1, respectively; mean ± SD). Model predictions were in statistical agreement with the kinetic constants used in the simulations.

Conclusion
Our metabolic model could be used to measure metabolic conversion of hyperpolarised-13C metabolites in the context of surgery, where postoperative insulin resistance is well-known to be linked to stress-induced upregulation of pyruvate dehydrogenase inhibitor.
O100 The effect of acidosis on contractility induced in porcine splanchnic arteries by clonidine or noradrenaline
Authors: Skorepa P , Lobo D N , Wilson V 
Published: May 2023

Abstract

Introduction
Clonidine, through its agonist action on central α2-adrenoceptors, is increasingly being used to induce sedation in critically ill patients with persistent acidosis and impaired renal function. Since it is also known to exert cardiovascular effects via peripheral α2-adrenoceptors, we compared its vasoconstrictor activity in porcine isolated arteries at different pH, to that produced by noradrenaline.

Methods
Isometric tension recordings of porcine isolated mesenteric, splenic and renal arteries (2mm internal diameter) were conducted in modified Krebs-Henseleit solution containing 105mM chloride ions maintained at pH 7.2 and 7.4 (modification of bicarbonate and chloride ions with gluconate ions). The potency of clonidine and noradrenaline was assessed by the pD2 (logarithm of concentration causing 50% of maximum response).

Results
Clonidine elicited concentration-dependent contractions in the renal artery (pD2 - 7.25±0.09 and 7.10±0.10, n=9) and splenic artery (pD2 - 6.81±0.09 and 7.02±0.06, n=8) that were not altered by a reduction in pH from 7.4 to 7.2 (p &gt;0.05 paired Student's t-test). Clonidine failed to elicit consistent responses in the mesenteric artery (&lt; 10% 60mM KCl). In contrast, the maximum response and potency to noradrenaline in the mesenteric artery (226.6±24.6% and pD2 5.43±0.11, n=6) was significantly reduced (p &lt;0.05) by pH 7.2 (174.4±13.3% and pD2 5.13±0.11, n=6). Responses to noradrenaline in the renal and splenic artery were not affected by changes in pH.

Conclusion
Acidosis impairs the peripheral vascular actions of the non-selective α-adrenoceptor agonist noradrenaline more than those elicited by the selective α2-adrenoceptor agonist clonidine.
O101 Mitochondrial P53 inhibition ameliorates acute pancreatitis through reduction of mitochondrial injury and cell necrosis
Authors: Awais M , Cai W , Latawiec D , Mukherjee R , Chvanov M , Tepikin A , Criddle D , Sutton R 
Published: May 2023

Abstract

Introduction
Persistent opening of the mitochondrial permeability transition pore (MPTP) is central to acute pancreatitis (AP). Mitochondrial translocation of P53 promotes MPTP opening, which induces necrotic cell death. We sought to determine whether and how mitochondrial P53 inhibition is protective in experimental AP.

Methods
Mitochondrial translocation of P53 was inhibited by pifithrin-mu (PFT-µ, mitochondrial specific P53 inhibitor) or by Trp53 KO. Mitochondrial membrane potential (ΔΨm) and necrosis of murine pancreatic acinar cells (PACs) were evaluated by confocal microscopy with TMRM and propidium iodide, respectively, in the presence of TLCS. Fluo4 was used for calcium imaging. Caerulein AP (Cer-AP) was induced in male (WT, P53−/+, P53−/−; 10-12 week old) mice by 7 hourly i.p. injections of 50 μg/kg caerulein. PFT-µ (5 mg/kg) was injected after the third injection of caerulein; sacrifice was made 12h after the first injection of caerulein. AP was assessed by standard biomarkers and blinded histopathology.

Results
TLCS-induced collapse of ΔΨm and cell necrosis of wild type PACs were significantly reduced in the presence of PFTµ or in PACs isolated from Trp53 KO mice; calcium overload was also reduced, indicative of improved calcium clearance, and ATP was maintained. Pharmacological or genetic P53 inhibition resulted in significant reductions of biochemical, immunological, and histopathological indices of severity in the Cer-AP model.

Conclusion
Inhibition of P53 maintained mitochondrial integrity, reduced PACs necrosis, and ameliorated the severity of Cer-AP. These data suggest that inhibition of mitochondrial translocation of P53 could be an effective strategy for the treatment of AP.
O117 Burosumab in the management of X-linked hypophosphataemia: a retrospective cohort study reviewing anthropometric and biochemical markers
Authors: Walker E , Lindsay T , Allgrove J , Marlais M , Bockenhauer D , Hayes W 
Published: May 2023

Abstract

Introduction
Rickets is a bone disease caused by a defect in mineralization. When left untreated, it has lifelong Orthopaedic sequelae. Burosumab, an anti-fibroblast growth factor 23 monoclonal antibody, improves rickets severity, symptoms, and growth in children with X-linked hypophosphataemia (XLH) followed to 64 weeks in clinical trials. International dosing guidance recommends targeting normal serum phosphate concentration. However, some children may not achieve this despite maximal dosing. This study compares clinical outcomes in children with XLH on long-term burosumab treatment who achieved normal phosphate, vs those who did not.

Methods
Single-centre retrospective review of a large paediatric cohort with XLH treated with burosumab. We evaluated growth and biochemical markers of bone health in those who did compared to those who did not achieve normal plasma phosphate concentration.

Results
Fifty-five children with XLH with median age 11.7 [6.8–15.5] years were included. 27 (49%) had low plasma phosphate concentration, and 27 (49%) normal phosphate after a median burosumab treatment duration of 3.3 [IQR 2.6–3.7] years. 1 (2%) did not have a recent phosphate level recorded. No difference in growth was found between normal and abnormal phosphate groups (p = 0.9). A trend of superior growth in those with normal compared with abnormal alkaline phosphatase level was observed.

Conclusion
Young children with XLH experience sustained growth on long-term burosumab treatment, albeit without normal plasma phosphate concentration in many. Consideration should be made to changing burosumab dosing recommendations to target the normalisation of alkaline phosphatase instead of plasma phosphate concentration.
O123 Significance of hepatitis A virus cellular receptor-1 (HAVCR1) and its association with tumour immune microenvironment in breast cancer
Authors: Cao X S , Cong B B , Jiang W G , Martin T A 
Published: May 2023

Abstract

Introduction
Immunotherapy has an important role in the intervention of breast cancer, but single-agent efficacy of immunotherapy is poor, owing in part to influence of the surrounding tumour microenvironment. Hepatitis A virus cellular receptor-1 (HAVCR1), plays vital roles in immune microenvironment in pancreatic adenocarcinoma, but not clear in breast cancer. The present study aimed to characterize the role of HAVCR1 in immune microenvironment of breast cancer.

Methods
The Cancer Genome Atlas was used to evaluate functional role of HAVCR1. Kaplan-Meier plotter and Tumor Immune Estimation Resource were applied to illustrate correlation of HAVCR1 with the prognosis and immune infiltration of breast cancer.

Results
In Pietenpol subtype, high HAVCR1 levels indicated a favourable overall survival (OS) (HR=0.08, 95%CI:0.01-0.61, P=0.0024) in mesenchymal stem–like breast cancer. However, it was connected to worse OS (HR=2.29, 95%CI:1.04-5.04, P=0.035) in immunomodulatory subtype. Significant correlation was found between HAVCR1 expression level and immune infiltration in breast cancer, especially with B cells, CD8+ T cells, CD4+ T cells, macrophages, neutrophils and Dendritic cell (P&lt;0.05), and other immune markers, such as PDCD1 and CTLA4 (P&lt;0.05). Decreased of HAVCR1 in Mesenchymal stem cells, Natural killer T-cells and enriched of B cell, CD4+ memory T-cells, CD8+ T-cells, Type 1 T-helper cells, Type 2 T-helper cells significantly improved the prediction of OS (P&lt;0.05). Decreased impression of HAVCR1 in B cells and CD8+ T-cells were correlated with worse OS (P&lt;0.05).

Conclusion
HAVCR1 is closely correlated with immune microenvironment and may serve as a potential tumour immunotherapy target for breast cancer.