bluuebunny/crossref_metadata_2025_split huggingface dataset:
148 Development of a test Method to Determine Inhalation Exposure of Microplastic Particles when Reusable Disposable Masks in Place
Authors: Soo Jhy-Charm , Perez Rocio , Adhikari Atin , Chen Yu-Cheng 
Published: May 2023

Abstract

Situation/broad aims
The SARS-CoV-2 pandemic has swept the globe since late 2019 and has driven explosive growth in the use of masks that has arisen an emerging concern of inhaled microplastic particles (MPs) when reuse disposable masks. In this study, we proposed a new methodology to determine whether the inhaled particles of microplastics emitted from the disposable masks when reusable mask in place as source control.

Methods
All experiments were conducted using a head-form manikin with a constant inspiratory flow at a simulated chamber. One commercially available ASTM Level 1 face (or surgical) mask with three-layer material, namely polypropylene (outer and middle layers), and polyethylene (inner layer) was used as test specimen to characterize the inhalation exposure of MPs. Brand new and reusable masks with and without a hand rubbing were compared. Particle physical characterization and morphology were determined using fluorescent staining with Nile red dye and scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) as well. The multiple-path particle dosimetry model was utilized to calculate the particle deposition in the respiratory tracts of human adults for emitted MPs fallen within the micrometer size range. Outcomes of the work: In this study, we proposed a method that the incorporation of scanning electron microscopy and infrared spectroscopy into the current fluorescent staining method to enhance the detection of MPs for qualitative analysis, may be more predictive of fragment microplastics are sourced from the different layer of disposable mask with a hand rubbing when in use.
O008 The impact of home-based exercise prehabilitation on skeletal muscle mitochondrial function in patients awaiting curative surgery for cancer
Authors: Smart T , Hatt J , Bass J , Lund J , Phillips B 
Published: May 2023

Abstract

Introduction
Cancer cachexia is associated with poor surgical outcomes, including increased length of stay, morbidity and mortality. Cachexia is a complex multi-faceted pathological process consistently associated with energy imbalance via hypermetabolism. Beyond this, pre-clinical animal models suggest mitochondrial dysfunction to be an important component of cachexia, although this is unconfirmed in humans. This study aimed to investigate the mitochondrial function of pre-surgical cancer patients, and the impact of exercise prehabilitation on this.

Methods
This study was approved by an NHS research ethics committee (IRAS: 275264). Male patients awaiting surgery with curative intent for colorectal and prostate cancer were eligible, with healthy volunteers recruited for comparison. Muscle biopsies of vastus lateralis were taken before and after 4-weeks home-based exercise (3x/wk). Mitochondrial oxidative phosphorylation (OXPHOS) was analysed using high-resolution respirometry (Oroboros Instruments).

Results
Eleven cancer patients and 6 healthy volunteers were recruited. Cancer patients had significantly lower maximal coupled (44.49pmol/(s*mg) vs. 74.81pmol/(s*mg), p=0.004) and uncoupled (55.82pmol/(s*mg) vs. 100.00pmol/(s*mg), p&lt;0.001) OXPHOS capacity compared to healthy controls. Exercise training significantly increased maximal coupled (44.10pmol/(s*mg) vs. 54.64pmol/(s*mg), p=0.045) and uncoupled (56.20pmol/(s*mg) vs. 71.96pmol/(s*mg), p=0.001) OXPHOS capacity in this cancer cohort.

Conclusion
Declines in mitochondrial function appear to play a role in cancer cachexia. Short-term exercise training, in keeping with target timeframes for surgery (i.e., &lt;31-days from decision-to-treat), appears to attenuate these declines. Further work is needed to determine if declines in mitochondrial function are causative or reactive, and to identify optimal exercise regimes to mitigate these declines.
O012 Elevated sGP130 characterises dysregulated chronic inflammation in diabetic peripheral vascular disease
Authors: Lui D , Abu-Hanna J , Ponticos M , Xu S , Portou M , Abraham D , Tsui J 
Published: May 2023

Abstract

Introduction
Chronic systemic inflammation is integral to the pathophysiology of cardiovascular disease and diabetes mellitus. Interleukin 6 (IL-6) is a cytokine which may stimulate either pro- or anti-inflammatory activity depending cell population. Classical IL-6 signalling only occurs in cells expressing membrane-bound IL-6 receptor, and results in anti-inflammatory JAK/STAT3 pathway activation. Trans-signalling, by contrast, involves soluble IL-6 receptor α and soluble glycoprotein 130 (sGP130), and therefore may affect any cell regardless of membrane receptor expression. We designed a study to characterise Interleukin-6 (IL-6) trans-signalling in a diabetic cohort receiving treatment for symptomatic peripheral vascular disease and identify whether IL-6 signalling is correlated to outcomes in this patient group.

Methods
A single-centre, prospective cohort study of patients with DM undergoing infra-inguinal revascularization was conducted. Pre-operative serum was obtained from patients, who were then followed and observed for major amputation, death, and need for re-intervention as primary outcomes. Quantitative serum assays for IL-6, sIL-6rα, and sGP130 were performed.

Results
40 patients (20 controls) were included in the study. Diabetic peripheral vascular disease patients had significantly higher serum IL-6 (p=0.0038), as well as higher serum sGP130 (p=0.0119) at baseline. Significant correlation was found between serum IL-6 and C-reactive Protein (p= 0.02), and serum IL-6 and sGP130 (p=0.02) in the disease group, but not in controls. sGP130 was higher in patients who reached primary outcomes (p=0.0196).

Conclusion
Systemic IL-6 trans-signalling is dysregulated in diabetic peripheral vascular disease and may be a future therapeutic target or adjunct to surgical management. Elevated sGP130 may be a prognostically-relevant biomarker in this population.
O016 Leukocyte gene expression profiles in fatty acid ethyl ester-induced acute pancreatitis
Authors: Wu D , Mukherjee R , Armstrong J , Wen L , Sud A , Latawiec D , Cai W , Huang W , Lane B , Criddle D , Evans A , Sutton R 
Published: May 2023

Abstract

Introduction
Gene expression has been poorly studied in acute pancreatitis (AP). We examined leukocyte differential gene expression (DGE) in fatty acid ethyl ester-induced AP (FAEE-AP), which models alcohol-associated AP.

Methods
Wild type C57Bl/7 mice were randomly divided into 5 groups of 6 receiving two hourly intraperitoneal injections of either 150 mg/kg palmitoleic acid (POA) and 1.35 g/kg ethanol (FAEE-AP), or 50 mg/kg POA and 1.35 g/kg ethanol (FAEE-AP), or 1.35 g/kg ethanol alone (contrast), or saline (control), or no injections (control). Mice were humanely killed at 12 hours for AP assessment and Agilent two-colour RNA blood microarray, with Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway analyses (DGE P &lt;0.05, log FC &gt;1).

Results
AP developed in FAEE-AP, more severe with 150 mg/kg POA, but not in either control group, with &lt;10 DGEs between the FAEE-AP groups, and between saline and no injection groups. Comparison between combined FAEE and combined controls identified 1180 upregulated and 355 downregulated mRNAs. GO and KEGG analyses found DGEs strongly enriched in inflammatory response and NOD-like receptor signalling pathways, respectively. Comparison of ethanol alone and controls identified 307 upregulated and 82 downregulated mRNAs, enriched in mononuclear cell differentiation and cytokine-cytokine receptor interaction; 336 of 389 DGEs overlapped with FAEE-AP.

Conclusion
These data suggest appropriateness of either control, with little detectable difference in DGEs between FAEE-AP protocols despite differing AP severity; limited additional data were obtained using an ethanol group. Comparison with other AP models may improve understanding of disease mechanisms.
O028 Training and validity of the Microsoft HoloLens, an augmented reality device, for total knee arthroplasty. a double-blinded randomised controlled trial
Authors: Kaka A , Shah A , Yunus A , Patel A , Patel A 
Published: May 2023

Abstract

Introduction
Challenges in surgical training have led to the exploration of technologies such as augmented reality (AR), which present novel approaches to teaching orthopaedic procedures to medical students. The aim of this double-blinded randomised-controlled trial was to compare the validity and training effect of AR to traditional teaching on medical students understanding of total knee arthroplasty (TKA).

Methods
Twenty medical students from 7 UK universities were randomised equally to either intervention or control groups. The control received a consultant-led teaching session and the intervention received training via Microsoft HoloLens, where surgeons were able to project virtual information over physical objects. Participants completed written knowledge and practical exams which were assessed by 2 orthopaedic consultants. Training superiority was established via 4 quantitative outcome measures: OSATS scores, a checklist of TKA-specific steps, procedural time, and written exam scores. Qualitative feedback was evaluated using a 5-point Likert scale.

Results
AR training was superior in teaching basic technical proficiency and understanding of TKA, with the intervention group significantly outperforming the control group in 3 metrics [OSATS (38.6%, p=0.021), checklist (33%, p=0.011) and written exam (54.5%, p=0.001)]. Procedural time was equivalent between cohorts (p=0.082). AR was rated as significantly more enjoyable (p=0.044), realistic (p=0.003), easy to understand (p=0.040), and proficient in teaching (p=0.02).

Conclusion
In this adequately powered, double-blinded randomised-controlled trial, AR training demonstrated substantially improved translational technical skills and knowledge needed to understand TKA over traditional learning in medical students. Additionally, the results showed face, content, and transfer validity for AR in surgical training.
O035 Incidence, timing and risk factors of postoperative cardiac complications: an international prospective cohort study
Authors:   STARSurg Collaborative
Published: May 2023

Abstract

Introduction
Postoperative cardiac complications (PCC) have been associated with increased risk of death after major surgery, however, PCC remain heterogeneously reported in trials. This international prospective cohort study aimed to define incidence and risk of PCC after major abdominal surgery in Europe, Ireland, and UK.

Methods
A prospective, international cohort study was performed between January 23 and May 1, 2022. Data were collected on consecutive patients undergoing major abdominal surgery in 446 hospitals from 28 countries of Europe. The primary outcome was PCC as defined by Standardised Endpoints and COMs for Perioperative and Anaesthetic Care (StEP-COMPAC) to 30-days after surgery. The secondary outcome was 30-day postoperative mortality. Multilevel logistic regression was used to adjust for risk factors associated with PCC rates.

Results
This study included 24,260 patients, of whom 611 (2.5%) developed PCC and 458 (1.9%) died within 30-days of surgery. Of patients who died, 123 (26.9%) were related to cardiac causes. Mortality rates were higher in patients who developed PCC than those who did not (19.8% vs 1.4%, p&lt;0.001). On adjusted analyses, age &gt;65 years (OR: 2.47, 95% CI: 1.99-3.06), ASA grade III-V (OR: 1.95, 95% CI: 1.58 - 2.40), emergency surgery (OR: 1.62, 95% CI: 1.31 - 2.00), and contaminated/dirty surgery (OR: 1.60, 95% CI: 1.15 - 2.23) were risk factors for PCC.

Conclusion
PCC are infrequent but occur early after major abdominal surgery. Death from cardiac causes were higher than previously reported. Identification of groups at high-risk of PCC and death for risk-reduction strategies is warranted.
O039 Subnormothermic acellular perfusion of human kidneys
Authors: Kaczmarek M , Hosgood S , Walker-Panse L , MacMillian S , Nicholson M L 
Published: May 2023

Abstract

Introduction
The optimum conditions for normothermic machine perfusion (NMP) in kidney transplantation have yet to be determined. Traditionally, kidneys are perfused with a red blood cell (RBC) based solution at 37°C. NMP at a subnormothermic temperature without RBCs could reduce the harmful effects of haemolysis but still preserve kidney function. This study examines the effect of subnormothermic acellular machine perfusion (SNAP) in human kidneys.

Methods
Five pairs of human kidneys offered for research were included in the study. One of each pair was perfused with an oxygenated albumin-based solution with red cells (RBC) and the other without red blood cells (SNAP) at 32°C for 6h. After perfusion, kidneys were reperfused for 4h with a red cell-based solution at 37°C for assessment. Perfusion parameters and renal function were compared between groups.

Results
The mean age of the donors was 66±12y. The mean renal blood flow (RBF) was numerically higher in the SNAP group (156.5±57.1 vs 115.3±41.21ml/min/100g; P=0.063). RBC kidneys produced more urine but this did not reach statistical significance (154±159 vs 64±73ml; P=0.217). During reperfusion levels of RBF, urine output and percentage creatinine fall were similar between the groups (Creatinine fall; SNAP 66±18 vs RBC 74±16%; P=0.382).

Conclusion
This study suggests that SNAP is equivalent to perfusion with RBCs with no adverse effects on perfusion parameters. The removal of RBCs negates any detrimental effects of haemolysis and provides a simpler method of kidney perfusion.
O040 Do donor liver blood tests predict liver transplant outcomes? UK registry cohort study
Authors: Tingle S , Bramley R , Goodfellow M , Thompson E , McPherson S , White S , Wilson C 
Published: May 2023

Abstract

Introduction
Safely increasing organ utilisation is a global priority. Donor serum transaminase levels are often used to decline livers, despite minimal evidence to support such decisions. We aimed to investigate the impact of donor ‘liver blood tests’ on transplant outcome.

Methods
This retrospective cohort study used the NHS registry on adult liver transplantation (2016–2019); adjusted regressions models assessed the effect of donor ‘liver blood tests’ on outcomes.

Results
3299 adult liver transplant recipients were included (2530 following brainstem death, 769 following circulatory death). Peak alanine transaminase (ALT) ranged from 6-5927U/L (median=45). Donor cause of death significantly predicted donor ALT; 4.2-fold increase in peak-ALT with hypoxic brain injury versus intracranial haemorrhage (adjusted P&lt;0.001). On multivariable analysis, adjusting for a wide range of factors, transaminase level (ALT or aspartate aminotransferase) failed to predict graft survival, primary non-function, 90-day graft loss or mortality. This held true in all examined subgroups; steatotic grafts, donation following circulatory death, hypoxic brain injury donors, and donors where ALT was still rising at the time of retrieval. Even grafts from donors with extremely deranged ALT (&gt;1000), display excellent post-transplant outcome. In contrast, donor peak alkaline phosphatase was a significant predictor of graft loss (aHR=1.808, 1.016-3.216, P=0.044).

Conclusion
Donor transaminases do not predict post-transplant outcomes. When other factors are favourable, livers from donors with raised transaminases can be accepted and transplanted with confidence. Such knowledge should improve organ utilisation decision-making and prevent future unnecessary organ discard. This provides a safe, simple and immediate option to expand the donor pool.
O045 Sentiment analysis of radical prostatectomy from social media: investigating patient experience
Authors: Harsh A , Nguyen V , Ourselin S , Dasgupta P , Granados A 
Published: May 2023

Abstract

Introduction
Prostate cancer is the most common cancer amongst men and is treated via radical prostatectomy. Patient sentiment towards radical prostatectomy provides opportunities to highlight areas of improvement based on the patients experience under treatment. Using social media to gauge patient sentiment towards surgery is largely unexplored. To address this deficiency, we investigated sentiment analysis on tweets related to radical prostatectomies derived from Twitter.

Methods
Search terms including Prostate Removed, Prostatectomy, My Prostatectomy and After Prostatectomy were each inputted into a query to derive tweets automatically from Twitter. Using the Natural Language Toolkit, we performed sentiment analysis of tweets for categorisation [positive, negative or neutral] while highlighting the most prevalent words used in each sentiment category.

Results
A total of 13160 tweets were extracted. The largest negative sentiment category (52.7%) was derived using the search term Prostate Removed which generated most patient-specific data, including words used by relatives (dad, husband). However, the resulting tweets did not only originate specifically from patients but also included posts from professionals.

Conclusion
This is the first work investigating patients experiences towards surgery from social media. We highlight the need for better technology to filter data from patients while tweets written by patient relatives should not be disregarded as they too provide insight into patient experience. Understanding patient experiences from data collected from social media may provide insight into improvements of surgery while empowering patients. We envisage future research providing robust technology to understand surgery from patient opinions at local or global scales.
O048 Vote counting and sign testing methodology to assess the effect of tissue typing in liver transplantation
Authors: Lofthouse B , Cambridge W , Marson L , Stutchfield B 
Published: May 2023

Abstract

Introduction
Liver grafts are currently matched by blood group and size. Due to immune privilege of transplanted livers, tissue typing (HLA matching) is not routinely undertaken. Emerging evidence suggests typing may be beneficial for specific patient groups. This systematic review aimed to determine patient and graft outcomes in HLA matched liver transplant patients.

Methods
Criteria included primary articles exploring effects of typing for liver transplantation, identified from PubMed/MEDLINE and Web of Science databases until January 2022, excluding articles published pre-2000. The Newcastle-Ottawa scale assessed risk of bias. Cochrane protocols for synthesis without meta-analysis (vote counting and sign testing) determined proportions of studies favouring typing.

Results
All 28 included articles were cohort studies with low-medium bias risk. Graft survival syntheses favoured typing across all patients in studies of both living (LDLT) and deceased donor liver transplantation (DDLT), where 1 study showed a beneficial effect, and 1 showed no effect. In LDLT-only studies, 2 showed benefit, 4 showed no effect, and 1 showed harm. Additionally, typing was favoured in adult-only DDLT recipients. Rejection syntheses favoured typing across all patients for studies of LDLT, DDLT, and both, and for subgroups including adult-only, paediatric-only, tacrolimus-treated, and negative lymphocyte crossmatch. Patient survival syntheses favoured typing across all patients, and for adult-only, PBC, and hepatitis/viral/cirrhosis diseases subgroups, in DDLT studies. Graft failure syntheses favoured typing across all patients in LDLT-only studies, and both LDLT & DDLT.

Conclusion
Findings evidenced disparate subgroup benefits of typing, and numerous studies reported no effect, or harmful effects.
O050 Utility of ramp test time in patients undergoing assessment for renal transplantation
Authors: Satish P , Smith R , Bedwani N , Frackiewicz E , Jones G , Motallebzadeh R 
Published: May 2023

Abstract

Introduction
Prior to renal transplant listing, cardiovascular screening is performed to stratify the risk of cardiovascular disease (CVD). During pre-assessment in our centre, patients undergo a ramp test (a timed assessment to walk 130m), which is a rapid and non-invasive method of quantifying exercise tolerance. The purpose of this study is to correlate ramp test time (RTT) with transplant waiting list status, cardiac stress testing, and post-transplant CV events and mortality.

Methods
Retrospective analysis of patients that underwent pre-assessment. Data collection included patient demographics, history of CVD and diabetes, RTT, ejection fraction and evidence of myocardial ischaemia, transplant list status, any subsequent CV event, and mortality. Three groups were analysed: (1) patients unable to perform the test; (2) RTT≥2mins; (3) RTT≤1min.

Results
1508 patients were pre-assessed for transplantation between 2014-2022. Mean RTT was 86 seconds (SD±26 seconds). Patients with RTT&lt;1min were younger with less pre-existing CVD, of whom 93% had normal cardiac stress testing. Over half of the patients who either had RTT &gt;2mins or were unable to perform the test had abnormal cardiac function, with a 3-year mortality of about 30%.

Conclusion
RTT can be used to assess cardiovascular suitability for transplantation. Patients unable to perform the test are unlikely to be listed for transplantation, with a quarter suffering a CV event post-assessment. In contrast, patients with RTT≤1min are almost all activated with no subsequent CV events. The low rate of CV events or abnormal stress tests in this group may allow early activation without extensive cardiovascular assessment.
O062 Female gender is associated with increased length of hospital stay following infra-inguinal bypass for peripheral arterial disease (PAD). A retrospective cohort study
Authors: Farndon D J , Bennett P C 
Published: May 2023

Abstract

Introduction
Women have previously been found to have longer post-operative stays following coronary artery bypass. However, impact of gender on length of stay following infra-inguinal bypass (IIB) surgery for PAD is unknown.

Methods
A 3-year single centre retrospective case notes analysis of all people undergoing IIB between 2017-2019. Rutherford stage, graft conduit, urgency of bypass, level of bypass, procedure details, baseline demographics, length of stay (LoS), co-morbidities were collected and univariate associations with LoS were reported. Factors associated with increased LoS on univariate analysis were entered into a multivariate model and reported as hazard ratios (HR).

Results
:193 IIB outcomes on 176 patients were analysed on: mean(±SD) age 68.9(9.2) years; 135(69.9%) male; 88(45.6%) had DM; 87(45.1%) were current smokers and 107(55.4%) underwent emergency procedures. On univariate analysis, LoS for female patients was significantly longer than for male patients (9.5 [6-21] vs. 7[5-15] days, p=0.016). Other factors associated with increased LoS were emergency vs. elective (13[7-22] vs. 5 [4-9] days, p&lt;0.0001, Rutherford stage (p&lt;0.0001), bypass level (p=0.001) and diabetes (9 [5-21] vs. 7[4-15] days, p=0.017) After multivariate adjustment, female gender (RR 1.56 95% CI: 1.12-2.18) was associated with increased LoS. As was elective bypass (RR 0.50 95% CI:0.36-0.71) and lower Rutherford stage (3 vs. 5: RR 0.32 95% CI: 0.2-0.52) (4 vs 5:0.46 95% CI: 0.31-0.68).

Conclusion
We have demonstrated that female gender is independently associated with significantly longer hospital stays. With further investigation into causation, this could potentially inform pre- and post-operative management to reduce risks to women undergoing IIB.