bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ghosts of the Gulag: Negotiating Spectres of the Penal Past in Northern Russia
Authors: Slade Gavin , Piacentini Laura , Kravtsova Alena 
Published: May 2023

AbstractThe paper develops the concept of penal spectrality—a sense of the presence of those who endured past penal suffering within environments and among objects related to the practice of punishment. The residents of Ukhta, a Gulag town in Northern Russia, engage uncomfortably with penal spectrality and employ two forms of distancing—pragmatic and cultural—to deal with its melancholic affects. Pragmatically, residents repurpose and reincorporate the things of the penal past into the social order, finding a use-value in them for the present day. Culturally, residents engage in the museumification and commodification of Gulag things. The paper advances two directions for research in ghost criminology. First, we show how uneasy spectral feelings are not passively observed but actively negotiated. Second, in this interaction, we show the immediacy of engaged practical interaction with material objects that points to modes of encountering and misrecognizing penal suffering beyond cultural commodification and penal spectatorship.
O002 Expression of MLN64 (lymph node metastasis 64) gene transcript in clinical gastric cancer and relationship with the ERBB4
Authors: Li A , Ji E , Martin T , Jia S , Ji J , Jiang W 
Published: May 2023

Abstract

Introduction
MLN64 (Lymph Node Metastasis 64, or STARD3 (StAR Related Lipid Transfer Domain Containing 3)) has a role in the progression of certain cancers including breast and prostate cancers and connected to the pattern of ERBB2 (Her2). The present study explored the expression of MLN64 in clinical gastric cancer in connection with the ERBB family.

Methods
A gastric cancer cohort (n=322) was tested for the expression profile of MLN64 along with the ERBB family members. Comparisons were made between clinical, pathological subgroups and the clinical outcome together with ERBB expression status.

Results
Gastric tumours expressed significantly raised levels of MLN64 than normal tissues (p=0.0012) and showed a stepwise increase with increased tumour grade and TNM staging. However, there was no significant difference between node negative and node positive tumours. MLN64 alone had a weak value in evaluating the overall (OS) and disease free (DFS) survival. Amongst the four ERBB family members, MLN64 had a significant correlation with ERBB4 (Her4) (p=0.004). Stratification of patients by ERBB4 expression status indicates that in patients with low ERBB4 tumours, MLN64 presents a significant factor in assessing both disease free (DFS) p=0.027) and overall survival (OS) (p=0.048). Similarly, MLN64 expression identified a subpopulation of node positive patients with a most adverse clinical outcome (p=0.009 for DFS and p=0.048 for OS).

Conclusion
MLN64 expression is an indicator for the disease progression and clinical outcome in gastric cancer. Together with the expression pattern of ERBB4, it makes a prognostic factor for the patients.
O023 Effectiveness of augmented reality for surgical training of medical students: a systematic review and meta-analysis
Authors: Shah A , Kaka A , Kumar N S , Patel A , Yunus A , Patel A 
Published: May 2023

Abstract

Introduction
Interest in augmented reality (AR) technologies within an educational setting have surged in recent years. However, few studies evaluate the use of AR in a primarily medical student population. This systematic review with meta-analysis intended to evaluate the existing literature on this topic.

Methods
This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using relevant synonyms for the terms augmented reality, surgery and medical students, the databases Medline, Embase, and Scopus were searched. Data was extracted for outcome measures such as time for task completion, errors/fails, attempts/retries, motion sickness/nausea and focus shifts.

Results
Some 826 records were initially retrieved; 19 studies were included in our review, with a total of 485 participants. The AR group performed better than the comparator group in 84% of the statistically significant main outcomes. The AR groups were less likely to fail assessment, with a pooled odds ratio of 1.76 (95% CI:0.06-51.71, p=0.74, I2=81%). One study reported 57% fewer critical errors than the comparator group. Only two studies reported nausea/motion sickness as an outcome (12% (n=3) and mean Likert-scale score of 3 (of 10) in the AR groups).

Conclusion
AR can be an effective surgical teaching and training tool for medical students. However, the limitations of AR, including visually-induced motion sickness, have not yet been explored extensively by primary studies with a medical student population. Therefore, gradual integration of AR is proposed until further studies elucidating benefits and risks can be undertaken.
O038 Positive impact of an ERAS programme on living and deceased donor renal transplant recipients’ recovery during COVID pandemic
Authors: Simpson-Dent E , Webb M , Meredith H , Winn L , Pestrin O , Balfour A , Sutherland A , Usher H , Wakelin S , Oniscu G C , Thomas R 
Published: May 2023

Abstract

Introduction
An ERAS (Enhanced Recovery After Surgery) programme was created to reduce length of stay (LoS) and improve outcomes following renal transplant surgery. This aimed to reduce post-operative hospital-acquired infection, especially COVID-19.

Methods
The ERAS protocol was finalised following a literature review and MDT discussion. ERAS information, with post-operative exercise advice, was distributed to patients on the renal transplant waitlist. LOS was evaluated, comparing ERAS with pre-ERAS recipients and, to remove pandemic bias, pre-pandemic (December 2019) recipients. Secondary outcomes were opiate use, mobilisation, bowel function and patient-reported outcomes. ERAS protocol compliance was monitored. Data analysis was with student t-test and Chi-2 test in GraphPad Prism.

Results
Some 35 consecutive recipients completed ERAS protocol (March 2021). Baseline characteristics were comparable between live-donor recipients 9/35 vs 13/35 pre-ERAS and 12/35 pre-COVID. BMI&gt;30 was higher in ERAS group (19vs. 11vs. 8). Median LoS was significantly reduced: ERAS - 5 days, pre-ERAS - 7 days, pre-COVID - 8 days (p=0.01). 51% of ERAS discharges were within 5 days vs. 17% pre-ERAS vs. none pre-COVID (X2 12.59, p&lt;0.001). For overstayers (&gt;5 days), potential preventable reasons were identified. 79.2% of ERAS recipients mobilised on day 1 post-op. ERAS indicated no significant reduced opiate use. Two ERAS recipients were readmitted within 30 days (vs.9/70 pre-ERAS) and one returned to theatre (vs.5/70 pre-ERAS).

Conclusion
This ERAS programme successfully reduced the LoS by 2 days in comparative population with minimal adverse events. Patient and staff feedback was positive. It's hypothesised that assigning a specialist ERAS nurse will improve compliance.
O041 Recipient outcomes after simultaneous pancreas and kidney transplant delineated by donor EGFR
Authors: Owen R , Fitzpatrick N , Counter C , Malik A , Mahendran B , Tingle S , Wilson C , Manas D , Sheerin N , White S 
Published: May 2023

Abstract

Introduction
This study aimed to assess if the use of kidneys from donors with a decreased eGFR had an adverse effect on patient and graft survival.

Methods
Data on all UK SPKT's from 2001-2021 were obtained from the NHSBT UK Transplant Registry (n=2,631). Cases with missing information were removed, leaving a final cohort of 1,819 (69.1%). eGFR was calculated using the CKD-EPI equation. Pancreas Graft (PGS), Kidney Graft (KGS) and patient survival analyses were conducted using Kaplan-Meier plots and Cox-regression models.

Results
71% (n=1,292) of grafts were from donors with an eGFR&gt;90 and 29%(n=530) were from donors with an eGFR&lt;90. Donors with an eGFR&lt;90 were statistically significantly more likely to be older (p&lt;0.0001), a DBD donor (p=0.0086**) and have a higher BMI(p&lt;0.0001). Recipients who received a graft from a donor with an eGFR&lt;90 were well matched with those who received a graft from a donor with an eGFR&gt;90. Univariate analysis showed a statistically significant decreased KGS(p=0.007**) when the donor had an eGFR&lt;90. This trend was not seen when comparing patient or pancreas survival.

Conclusion
We accept a lower GFR could be indicative of either an AKI or a sign of early chronic kidney disease. In this current data analysis, we have been unable to successfully distinguish between the two however we have shown poorer KGS in those with a lower eGFR (&lt;90). This had no impact on pancreas or patient survival. Further analysis is needed to explain the precise reasons for the lower eGFRs at the time of organ donation.
O046 Reduction of surgical complications via 3D printed/virtual models available during (robotic-assisted) radical prostatectomy
Authors: Sarhan K , MacAskil F , Raison N , Byrne N , Heath M , Antonelli M , Prezzi D , Hyde E , Ourselin S , Dasgupta P , Granados A 
Published: May 2023

Abstract

Introduction
Prostate cancer is the leading cancer in males in the UK and mostly treated via robotic-assisted radical prostatectomy (RARP). The prognosis of prostate cancer is promising especially if detected early. Studies have shown that the use of 3D patient-specific models has positive effects on surgical outcomes in other fields. This systematic review aims to assess whether 3D printed and virtual models reduce surgical complications for patients undergoing RARP.

Methods
This study was a systematic review conducted using PRISMA guidelines from comprehensive databases - PubMed and Medline. These were then screened using an inclusion and exclusion criteria, to remove papers that were not relevant to the research question. Last, each abstract was screened for relevancy and duplicates were removed.

Results
A total of 201 patients had the use of 3D patient-specific modelling of the prostate to aid in surgery. Across all studies, a decrease in positive surgical margin rates was reported, indicating better outcomes for patients. However, no statistically significant difference was found between intervention and control groups, in nerve sparing, bladder neck sparing and postoperative SHIM score. A decrease in detectable PSA was found in intervention groups. Furthermore, the use of 3D models did lead to more surgeons changing the pre-operative plan, suggesting that 3D modelling enhances surgical planning – leading to potentially improved outcomes.

Conclusion
The use of 3D modelling has positive outcomes for patients undergoing RARP, however, the extent is still unclear as research in this area remains limited.
O053 Are rectus sheath catheters being placed accurately into optimum position during NELA laparotomies?
Authors: Waddell K , Nevins E , McCallum I 
Published: May 2023

Abstract

Introduction
Rectus sheath catheters (RSC) are a method of delivering local anaesthetic to post-operative laparotomy wounds. Ideal standard positioning for RSC's is in the retro-rectus space. They aim to reduce post-operative pain, and show less side effects than epidural analgesia. This audit reviews positioning of RSC in post-operative laparotomy patients at a centre in North East England.

Methods
All NELA (National Emergency Laparotomy Audit) patients who had open laparotomy or laparoscopic converted to open procedures between 1st December 2021 to September 2022 were identified and included. Patients who had both RSC inserted and had a CT scan within the first 3 post-operative days were identified.

Results
105 patients (68%) had RSC inserted. 11 (10.5%) patients with RSC placed had post-operative imaging within 3 days. CT images were reviewed assessing the position of RSC's. One patient had bilateral RSC correctly placed. Of the total individual RSC's (22) on imaging, 9 were correctly positioned, 9 incorrectly positioned, and 4 not identified when reviewing CT images. All of those incorrectly positioned were identified in the subcutaneous fat.

Conclusion
At this hospital in North East England, surgeons insert RSC and do not use ultrasound guidance. This audit highlighted that they are mostly placed in the incorrect position. Ultrasound guided insertion could be considered as a method of inserting RSC more accurately. Further research is needed to assess if correctly placed RSC
O058 Association and one-year trends of frailty, cognition, disability, and quality of life in individuals with chronic limb-threatening ischaemia
Authors: Houghton J , Essop-Adam A , Nduwayo S , Nickinson A , Black I , Bryant N , Meffen A , Gray L , Conroy S , Payne T , Rayt H , Sayers R , Haunton V 
Published: May 2023

Abstract

Introduction
This study aimed to describe the associations of frailty with cognition, disability, and quality of life (QoL) among individuals with chronic limb-threatening ischaemia (CLTI) over one-year following intervention.

Methods
Single-centre prospective cohort study. Patients aged ≥65 with CLTI and a planned intervention between May 2019 and May 2021 were eligible for inclusion. Patients underwent frailty, cognitive function, disability and QoL assessments before their procedure. Delirium screening was performed at 24- and 72-hours post-operatively. Frailty, disability and QoL assessments were repeated at three- and 12-months.

Results
Ninety-nine patients completed baseline assessments, of whom 45 (45%) were classified as frail by the Edmonton frail scale. Frailty was strongly associated with higher prevalence of cognitive impairment (52% vs 17%; p&lt;.001).
Eighty-seven patients underwent a procedure. Ten (11%) developed POD, of whom 8 had frailty (p=.003). Cognitive impairment (OR 8.52; 95%CI 1.12, 64.67; p=.038) was independently associated with POD. Frailty was associated with worse vascular quality of life questionnaire (VascuQoL) (p=.001) and EQ-5D-5L scores (p&lt;.001) at all timepoints, however both those with and without frailty had modest improvement in VascuQoL and EQ-5D-5L scores at 12-months (p=.001). Barthel index (disability) scores were lower for those with frailty (p&lt;.001) and decreased slightly over 12-months for both groups (p=.007). Five patients (12%) transitioned from frailty to non-frailty at 12-months (clinical frailty scale), however 10 patients (23%) transitioned from non-frailty to frailty.

Conclusion
CLTI patients with frailty have worse cognition, QoL and disability. Overall, individuals with CLTI demonstrate progression in frailty and disability at one-year post-intervention.
O066 Outcomes following fenestrated and branched endovascular repair (F/BEVAR) of complex aneurysms in octogenarians: a time to event meta-analysis
Authors: Hanna L , Lam K , Jha R , Abdullah A , Sounderajah V , Antoniou G , Gibbs R 
Published: May 2023

Abstract

Introduction
Objective: To evaluate the clinical outcomes of F/BEVAR among octogenarians.

Methods
Databases were systematically searched for studies that compared outcomes following F/BEVAR between octogenarians and non-octogenarians. The primary outcome measures were peri-operative mortality, survival, re-intervention, aortic rupture, and aneurysm-related deaths. Secondary outcomes were peri-operative outcomes.

Results
Seven studies published between 2017 and 2022 were included reporting on a total of 7,552 patients (&gt;80yrs, 1536; &lt;80yrs, 6016). More males (OR [95% CI] 0.83 [0.73-0.94], p.003), smokers (OR 0.50 [0.43-0.58], p&lt;.001) patients with ASA &gt;3 (OR 0.72 [0.52-0.98], p=.04), hypercholesterolaemia (OR 0.56, [0.42-0.73], p&lt;.001), and pulmonary disease (OR 0.75, [0.66-0.86], p&lt;.001) were observed in non-octogenarians. There was no significant difference in the peri-operative mortality between the two groups, but the hazard of overall mortality during follow-up was significantly higher in the octogenarian group (HR 1.67 [1.27–2.20], p&lt;.001). There was no statistically significant difference in re-intervention (HR 0.96, [0.85-1.09], p=.057) or aneurysm-related deaths (OR 0.02, [-0.02-0.07], p=.31) between the two groups, but older patients were at greater risk of aortic rupture during follow-up (OR 4.71, [1.73–12.85], p=.002). Octogenarians were at a greater risk of intra-operative blood loss (WMD 54.73 [17.89-91.58], p=.004), endoleaks on completion angiogram (ORs 1.42, [1.20-1.67], p&lt;.001), cardiac events (1.34 [1.12-1.62], p=.002) and endoleaks during follow-up (OR 1.40[1.03-1.91], p=.03). The body of evidence for most primary outcomes was judged to be low.

Conclusion
Survival is lower in octogenarians but there was no significant difference in aneurysm-related deaths or re-interventions, despite the increased incidence of aortic rupture and endoleaks during follow-up.
O073 Patient-reported outcome measures (PROMS) used to assess quality of life (QOL) in aortic dissection: a systematic scoping review using COSMIN methodology
Authors: Jha R , Hanna L , Sounderajah V , Makar S , Gibbs R 
Published: May 2023

Abstract

Introduction
Objective: to identify and evaluate all patient reported outcome measures (PROMS) using the established Consensus-based Standard for the selection of health Measurement Instruments (COSMIN) guidelines.

Methods
A scoping systematic review was conducted for studies that used a PROM in aortic dissection (AD) patients according to PRISMA-Scr, using electronic databases and grey literature.

Results
45 studies were found, encompassing 38 PROMs. The most common PROM utilised was the 36-Item Short-Form Survey (SF-36), used in 23 studies. The majority of the remainder PROMs however (30/38) were only utilised once in their respective studies, with no disease-specific tool identified. 6 studies further evaluated a psychometric property of 4 PROMs (PROMIS-29, SF-36, SWL and SWED-QUAL). Only 1 of these studies was a PROM validation study, with the remaining 5 only reporting on internal consistency. None of the studies assessed content validity. The methodological quality for all 6 papers was judged to be adequate or very good, however, the quality of evidence was judged to be low, with none of the PROMs having undergone a rigorous psychometric evaluation within the AD population.

Conclusion
This review identified severe heterogeneity in the PROMs used to assess the QOL of AD patients. These instruments are generic and lack any formal content validity evaluation. A validated dissection-specific tool for use in clinical practice is therefore required to better understand and improve QOL in this patient cohort.
PROMIS-29 – Patient Reported Outcome Measure Information System
SWL – Satisfaction With Life scale
SWED-QUAL – Swedish Health-Related Quality of Life Scale
O075 Pausing NHSBSP during COVID-19 did not increase advanced cancers and may have avoided overdiagnosis
Authors: Aquilina R , Vaidya J , Varghese J 
Published: May 2023

Abstract

Introduction
We ascertained the impact of the paused NHS breast cancer screening programme (NHSBSP) during COVID-19 on number and presentation of breast cancer patients.

Methods
We analysed, breast cancer patients diagnosed across 2 large London NHS trust hospitals in sets: the referral source and numbers in all patients from 2019 to 2021 (n=3,353), and patient/tumour characteristics and treatments received during 6 selected months in 2019 and 2020 (n=318). We analysed proportions using chi-square test.

Results
Overall, there were 31% fewer patients in 2020 compared with 2019 (1281 vs 886, p=0.002). However, there was no corresponding increase in the number of patients during 2021 (n=1186). The reduction was mainly due to fewer referrals from NHSBSP rather than from GPs (53% reduction vs 13%, p&lt;0.00001). In 2020 vs 2019, there were fewer grade 1 (35 vs 9) and node negative tumours (143 vs 72), without a corresponding increase in grade 2 or 3 (159 vs 104), or node positive cases (54 vs 49); also fewer T1 cases (84 to 37) without a corresponding increase in &gt;T1 cases (113 vs 84); reduced breast conservations (111 vs 71) and negative sentinel nodes (114 vs 69), without increase in mastectomies (35 vs 25) or axillary clearances (32 vs 27). There were no receptor status changes.

Conclusion
The COVID-19 pause in NHSBSP avoided diagnosis of good prognosis cancers without rapid increase in worse prognosis cancers or more extensive surgery, suggesting that it may have simply avoided overdiagnosis.
O084 A preoperative breath test to predict post-oesophagectomy pulmonary infection
Authors: Mitra A , Das B , Tarazi M , Lafaurie G , Arya P , Leung K , Converso V , Parker A , Hanna G 
Published: May 2023

Abstract

Introduction
Pulmonary infection (PI) is the most common complication post-oesophagectomy. Identifying patients at risk of PI could facilitate pre-emptive preventative measures. Analysis of exhaled volatile organic compounds (VOCs) is a novel method of diagnosing disease non-invasively. Given the integral contribution of the oro-respiratory system in generating breath VOCs, this study applied breathomics to develop a novel predictive model for PI prior to oesophagectomy.

Methods
Breath samples were collected from patients with oesophageal adenocarcinoma on the morning of their surgery using a quality-controlled methodologically optimised workflow. Breath was analysed using two gold standard analytical platforms: one (GC-MS) and two-dimensional (GCxGC-MS) thermal-desorption gas-chromatography time-of-flight mass-spectrometry, the latter being unrivalled in its chromatographic resolution. Raw spectral data was pre-processed and analysed using a tile-based Fisher ratio method to generate predictive models. Ethical approval REC: 17/WA/0161.

Results
Breath samples were analysed from 23 patients undergoing oesophagectomy and 12 (52%) developed PI. Principal component analysis revealed significantly distinct volatolomes discriminating PI risk status (R2Xcum 0.908, Q2cum 0.806, CV ANOVA p&lt;0.001). A 5 VOC model had an area under the curve of 0.806 (95%CI 0.647-0.947) and 0.859 (95%CI 0.601-1) for predicting PI using GC-MS and GCxGC-MS respectively. Predictive VOCs were tentatively identified to be branched chain in structure suggesting a likely microbial origin.

Conclusion
This is the first predictive PI model using state-of-the-art breathomics. Identification of branched chain VOCs offers unprecedented insights into the disease biology of post-oesophagectomy PI and highlights an important role of the preoperative oro-respiratory microbiome as a risk factor for PI.