Selection Criteria Research Articles

Effectiveness of Therapeutic Exercise for Children Undergoing Treatment for Cancer: A Systematic Review: Therapeutic Exercise Children Cancer.

To evaluate the effectiveness of therapeutic physical exercise (TPE) interventions on the physical functioning, psychosocial well-being, and quality of life (QoL) of children undergoing treatment for cancer. Systematic review: databases were searched in April 2023. Selection criteria: children (<18years old) undergoing treatment for cancer or a malignant neoplasm, randomized controlled trial design, utilization of TPE, and including physical and psychosocial outcomes. Internal validity was measured with Physiotherapy Evidence Database scale. Seven randomized controlled trials were included. Most studies showed that strength, fatigue, and QoL improved after the intervention. Cardiorespiratory capacity through 6-minute walk test and physical activity levels were better in the experimental groups. No changes were noted in other variables. This review supports the importance of a TPE program during cancer treatment, with the aim of maintaining physical capacities and counteracting physical inactivity.

Comparison of Demographics: National Amyotrophic Lateral Sclerosis Registry and Clinical Trials Data.

To characterize the participant demographics in the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) database compared with the web-portal National Amyotrophic Lateral Sclerosis (ALS) Registry (the Registry). Demographics and ALS symptom information were compared between the self-reported registrant data in the Registry web portal (2010-2021) and the latest available PRO-ACT data (updated August 2022), which is a collection of clinical trials data. Greater percentages of younger (≤ 59years old) but smaller percentages of older (60 + years old) participants were represented in PRO-ACT compared to Registry. Enrollment for minority race groups was greater in the Registry portal data, but race information was largely missing/unknown in PRO-ACT database. Median age at the time of diagnosis and age at the time of symptom onset were significantly higher for Registry enrollees compared to the participants of PRO-ACT. Symptom onset sites were similarly reported, but duration between self-noted symptom onset and diagnosis was slight, but significantly longer for the Registry enrollees (11 vs. 9months). Hispanic were as likely as non-Hispanic to participate in research studies, based on the Registry data. There was a notable difference in the age distribution and minority representation of enrollees between the PRO-ACT and Registry study populations. Age distribution in the PRO-ACT database skewed to a younger and less diverse cohort. Despite the clinical heterogeneity and complex disease mechanism of ALS, identifying the underrepresented demographic niche in the PRO-ACT and Registry study populations can help improve patient participation and criteria for patient selection to enhance generalizability.

Comparison of WAIC and posterior predictive approaches for N-mixture models.

Hierarchical models are common for ecological analysis, but determining appropriate model selection methods remains an ongoing challenge. To confront this challenge, a suitable method is needed to evaluate and compare available candidate models. We compared performance of conditional WAIC, a joint-likelihood approach to WAIC (WAICj), and posterior-predictive loss for selecting between candidate N-mixture models. We tested these model selection criteria on simulated single-season N-mixture models, simulated multi-season N-mixture models with temporal auto-correlation, and three case studies of single-season N-mixture models based on eBird data. WAICj proved more accurate than the standard conditional formulation or posterior-predictive loss, even when models were temporally correlated, suggesting WAICj is a robust alternative to model selection for N-mixture models.

Ventriculo-arterial (VA) coupling and fQRS as new selection criteria for primary prevention ICD placement.

For decades, left ventricular ejection fraction (LVEF < 35%) has been a mainstay for identifying heart failure (HF) patients most likely to benefit from an implantable cardioverter defibrillator (ICD). However, LVEF is a poor predictor of sudden cardiac death (SCD) and ignores 50% of HF patients with mildly reduced and preserved LVEF. The current international guidelines for primary prophylaxis ICD therapy are inadequate. Instead of LVEF, which is not a good measure of LV contractility or hemodynamic characterization, we hypothesize ventriculo-arterial (VA) coupling combined with fragmented QRS (fQRS) will improve risk stratification and patient suitability for an ICD. Quantifying cardiac and aortic mechanics, and predicting active arrhythmogenic substrate, from varying fQRS morphologies, may help to stratify ischemic and non-ischemic patients with different functional capacities and predisposition for lethal arrhythmias. We propose HF patients with alow physiological reserve may not benefit from ICD therapy, whereas those patients with higher reserves and extensive arrhythmogenic substrate may benefit. Our hypothesis combining VA coupling with fQRS changes has the potential to widen HF patient participation (low and high LVEF) and advance personalized medicine for HF patients at high risk of SCD.

Cognitive behavioural therapy and third-wave approaches for anxiety and related disorders in older people.

Cognitive behavioural therapy (CBT) is the most researched psychological therapy for anxiety disorders in adults, and known to be effective in this population. However, it remains unclear whether these results apply to older adults, as most studies include participants between 18 and 55 years of age. This systematic review aims to provide a comprehensive and up-to-date synthesis of the available evidence on CBT and third wave approaches for older adults with anxiety and related disorders. To assess the effects of Cognitive Behavioural Therapy (CT, BT, CBT and third-wave CBT interventions) on severity of anxiety symptoms compared with minimal management (not providing therapy) for anxiety and related disorders in older adults, aged 55 years or over. To assess the effects of CBT and related therapies on severity of anxiety symptoms compared with other psychological therapies for anxiety and related disorders in older adults, aged 55 years or over. We searched the Cochrane Common Mental Disorders Controlled studies Register (CCMDCTR), CENTRAL, Ovid MEDLINE, Ovid Embase and Ovid PsycINFO to 21 July 2022. These searches were updated on 2 February 2024. We also searched the international studies registries, including Clinicalstudies.gov and the WHO International Clinical Trials Registry Platform (ICTRP), to identify additional ongoing and unpublished studies. These sources were manually searched for studies up to 12 February 2024. We included randomised controlled trials (RCTs) in older adults (≥ 55 years) with an anxiety disorder, or a related disorder, including obsessive compulsive disorder (OCD), acute stress disorder and post-traumatic stress disorder (PTSD), that compared CBT to either minimal management or an active (non-CBT) psychological therapy. Eligible studies had to have an anxiety-related outcome. Several authors independently screened all titles identified by the searches. All full texts were screened for eligibility according to our prespecified selection criteria. Data were extracted and the risk of bias was assessed using the Cochrane tool for RCTs. The certainty of evidence was evaluated using GRADE. Meta-analyses were performed for outcomes with quantitative data from more than one study. We included 21 RCTs on 1234 older people allocated to either CBT or control conditions. Ten studies focused on generalised anxiety disorder; others mostly included a mix of clinical diagnoses. Nineteen studies focused on the comparison between CBT and minimal management. Key issues relating to risk of bias were lack of blinding of participants and personnel, and participants dropping out of studies, potentially due to treatment preference and allocation. CBT may result in a small-to-moderate reduction of anxiety post-treatment (SMD -0.51, 95% CI -0.66 to -0.36, low-certainty evidence). However, compared to this benefit with CBT immediately after treatment, at three to six months post-treatment, there was little to no difference between CBT and minimal management (SMD -0.29, 95% CI -0.59 to 0.01, low-certainty evidence). CBT may have little or no effect on clinical recovery/ improvement post-treatment compared to minimal management, but the evidence is very uncertain (RR 1.56, 95% CI 1.20 to 2.03, very low-certainty evidence). Results indicate that five people would need to receive treatment for one additional person to benefit (NNTB = 5). Compared to minimal management, CBT may result in a reduction of comorbid depression symptoms post-treatment (SMD -0.57, 95% CI -0.74 to -0.40, low-certainty evidence). There was no difference in dropout rates post-treatment, although the certainty of the evidence was low (RR 1.19, 95% CI 0.80 to 1.78). Two studies reported adverse events, both of which related to medication in the control groups (very low-certainty evidence, no quantitative estimate). Only two studies compared CBT to other psychological therapies, both of which only included participants with post-traumatic stress disorder. Low-certainty evidence showed no difference in anxiety severity post-treatment and at four to six months post-treatment, symptoms of depression post-treatment, and dropout rates post-treatment. Other outcomes and time points are reported in the results section of the manuscript. CBT may be more effective than minimal management in reducing anxiety and symptoms of worry and depression post-treatment in older adults with anxiety disorders. The evidence is less certain longer-term and for other outcomes including clinical recovery/improvement. There is not enough evidence to determine whether CBT is more effective than alternative psychological therapies for anxiety in older adults.

Understanding goat keepers’ breeding objectives and selection criteria in northwestern Ethiopia: application of participatory own-flock and group-animal ranking experiments

Understanding goat keepers’ breeding objectives and selection criteria in northwestern Ethiopia: application of participatory own-flock and group-animal ranking experiments

Dupilumab for the treatment of alopecia areata in pediatric patients with atopic dermatitis: A scoping review.

Our study aims to synthesize existing evidence of dupilumab for alopecia areata (AA) in pediatric patients with atopic dermatitis (AD). We searched MEDLINE and Embase on March 1, 2024, using keywords related to AD, AA, dupilumab, and pediatric patient populations per PRISMA-ScR guidelines. A mean SALT score reduction of 42.6 following dupilumab treatment (p < .01) over an average of 3.21 months, and a mean reduction of Investigator Global Assessment (IGA) levels of 2.14 units (p < .01) demonstrates the efficacy of dupilumab in pediatric AA when there is concurrent AD. Our findings in combination with dupilumab's favorable safety profile in pediatric AD makes it an appealing option for AA treatment, however, a greater understanding of the underlying mechanisms, optimal pediatric patient selection criteria, long-term efficacy, and safety profile of dupilumab in this context is warranted.

P-537 Linking genetic variation to infertility and embryonic genomic instability. Lessons from a database of whole genomes from targeted populations: challenges, and future directions

Abstract Study question Can novel genomic analysis methods be developed to identify genetic variants that predispose to specific types of infertility and genomic instability in embryos? Summary answer Whole genome analysis and the creation of a genomic variation database of highly targeted populations yielded several genomic links to human infertility and genomic instability. What is known already Infertility is a phenotypic manifestation that originates from highly variable causes, like repeated miscarriage (RM), repeated implantation failure (RIF) or various male and female factors. Specific genetic variations can predispose carriers to distinct types of infertility however quantifiable genetic risks are difficult to be established clinically due to the high amount of variables that exist in any relevant infertility studies. In addition, the combination of the maternal and paternal genetics further complicates the interpretation of genomics results especially when genetic instability in embryos are studied. Several studies have indicated multi[le risk variants however few have managed to establish causal relationships. Study design, size, duration The causes of infertility are extremely variable, which presents a challenge in the design and analysis of genome sequencing studies that involve large populations of participants with similar characteristics. In this study a targeted approach highly selected populations allows more detailed examination of the whole genome of the participants and the different subgroups that exist among them. The participants were recruited using specific selection criteria and samples were collected over a period of 5 years. Participants/materials, setting, methods Couples presenting with infertility and went through preimplantation genetic testing for aneuploidy (PGT- A) were invited to participate. Selection criteria were applied: i) referred for PGT-A after &amp;gt;3 assisted reproduction failed cycles, ii) Normal karyotypes, iii) Female age less than 37, iv) Embryonic instability in their subsequent PGT-A cycles in more than 40% of the produced embryos. After whole genome sequencing (WGS) and variant calling, a bespoke genomic SQL database was constructed for genomic analysis. Main results and the role of chance From 118 individuals that consented to participate 28 individuals with repeated implantation failure (RIF) and 8 individuals RIF/RM passed the selection criteria and their DNA was processed with WGS using a short read platform. In addition, WGS Validation was performed using genomes with known mutations. After the WGS quality control and validation. In total 50 genomes were processed and produced variant results. A novel MySQL database was successfully constructed and validated. Variant z scores were calculated for each participant and the significantly flagged variants were pulled and analysed and comparison with other bespoke and publicly available databases was performed. Ethnicity bias in novel variations detected and corrected. Several smaller cohorts were identified with similar genomic characteristics and accumulation of specific sets of polymorphisms, that were associated with certain types of infertility and preimplantation embryo abnormalities. Of particular interest were variants in synaptonemal complex genes associated with gamete failure, meiotic errors and instability in embryos. Structural variations were significant for male factor infertility. The WGS approach also revealed novel intronic and extragenic variants that would not be usually picked up by other methods like exome sequencing but can play a vital role in gene expression. Limitations, reasons for caution As with all genomic studies relating to infertility, association does not mean causation. Further functional analysis would be required to establish definitive causal pathways based on significant risk variants. In addition, although our study is highly targeted more genomic data can enhance to validation of these results. Wider implications of the findings This highly targeted study using a personalised approach to genome analysis combined with WGS can lead to protocols that determine the cumulative clinical risk for infertility, by revelling the accumulation of specific sets of polymorphisms, intronic and exonic, can be associated with certain types of infertility and preimplantation embryo abnormalities. Trial registration number not applicable

P-338 Redefining elective co-parenting: a systematic assessment of concepts and definitions found in the literature and a recommendation for new terminology

Abstract Study question What concepts and concept definitions (including normative meanings) are found in the literature for forms of ‘elective co-parenting’ and which can be recommended? Summary answer Current terminology lacks comprehensiveness and often contains additional (hidden) meanings, thereby jeopardizing its usability for research on contemporary family formation. We suggest a new nomenclature. What is known already There is an increase in the variation of family forms, types of parenthood roles and methods for family formation. One such way of family building has most recently been referred to as “elective co-parenting”. Not to be confused with parenting after separation, elective co-parenting typically alludes to the intentional undertaking of a shared parental project by persons who are primarily in a reproductive (and not a ‘romantic’) relationship with each other. However, many other terms and somewhat diverging concept definitions have been put forward. It seems that a fundamental conceptual framework has not yet been established. Study design, size, duration We will adhere to a tailored set of guidelines for conceptual engineering organized in five stages: (i) Identify potential attributes by collecting a representative set of definitions, (ii) Organize the potential attributes by theme and identify any necessary &amp; sufficient or shared ones, (iii) Develop a preliminary definition of the concept, (iv) Determine what functions our concepts should serve going forward, (v) Refine the conceptual definition and improve or replace the concept. Participants/materials, setting, methods A scoping review was performed by implementing a wide-ranging search string in ProQuest. We used the following selection criteria: the article is (a) a peer-reviewed journal article, book chapter, conference paper, or report, (b) published in the last ten years, (c) written in English, that (d) proposes an explicit concept definition (also including normative meanings). Papers cited in the retrieved publications were also included if they satisfied (a), (b), (c) and (d). Main results and the role of chance After screening the available literature for academic articles that contained one or several explicit definition(s) of ‘elective co-parenting’, and that met the other selection criteria; (a), (b) and (c), key attributes mentioned in these definitions were organized in themes, i.e. necessary and/or sufficient conditions; e.g. (a) ‘Pre-conception temporality’, (b) ‘Collaborative nature’, etc. Data analysis is currently ongoing. Our aim is to put forward a new and comprehensive concept definition. In this, we will provide more clarity by making explicit all the necessary conditions (and not merely one or two as is the case in many current definitions). Furthermore, prompted by ethical considerations (e.g. ‘elective’ puts notable emphasis on free choice), we will also propose a new term for the concept of ‘elective co-parenting’; one that is more neutral and therefore more appropriate to describe the particular family building practice. The study will be completed in the forthcoming months. Limitations, reasons for caution The main challenge of this study was the construction of a suitable search strategy to find papers on a topic for which a wide range of (often contested) concepts and terminology was used. For this, several, but certainly not all (e.g. empirical research), possible strategies and data sources were explored. Wider implications of the findings This study highlights the importance of establishing clear concepts and concept definitions in the pursuit of high quality research. Providing a more appropriate concept and concept definition for what is now known as “elective co-parenting” renders further inquiry into the topic more intellectually and ethically sound. Trial registration number N/A

450 Outcomes of Groin Hernia Surgery in ELHT: A Comparative Retrospective Study with NICE, BHS, and EHS Statistics

Abstract Aim The aim of this study was to evaluate the results of groin hernia surgery, at East Lancashire Hospitals Trust (ELHT) by comparing the severity of pain and recurrence rates with established standards set by the National Institute for Health and Care Excellence (NICE) British Hernia Society (BHS) and European Hernia Society (EHS). Method This retrospective analysis involved patients who underwent groin hernia repair between 2019 and 2021 at ELHT trust hospitals. The selection criteria were based on guidelines provided by the BHSs Hernia Commission Guide. Data was collected from records during the specified time frame. Results Out of all cases chronic pain occurred in 2.90% which's notably lower compared to the 10 12% range reported by the European Hernia Society. Furthermore, the recurrence rate at ELHT was found to be 2.51% below the rate of 15% mentioned by the European Hernia Society. Conclusions Based on these findings it can be concluded that ELHT has achieved outcomes in groin hernia surgery when compared to benchmarks set by the European Hernia Society. Notably ELHT demonstrated rates of chronic pain and recurrence highlighting successful surgical interventions and providing valuable insights for best practices in hernia surgery. These results have implications for optimizing outcomes. May influence future guidelines and practices, in groin hernia surgery.

P-502 Mosaic embryos result in equivalent live birth rates when compared to euploid embryos following frozen embryo transfer

Abstract Study question Are mosaic embryos associated with a lower live birth rate (LBR) than euploid embryos? Summary answer In this adequately powered study, mosaic embryos had nearly identical LBR and similar miscarriage rates (MR) when compared to euploid embryos. What is known already While prior data has suggested that mosaic embryos result in almost half the LBR and three-fold higher MR than euploid embryos, all prior data supports mosaic embryo transfers as safe with acceptable LBRs. Recent studies have suggested a revised selection criteria choosing either euploid or mosaic embryos for transfer based on embryo grade, day of freeze, low level (LL) versus high level (HL) mosaicism and segmental versus whole chromosome mosaicism. Given the lower LBR reported with mosaics, we initially offered double embryo transfer (DET). We initiated this study to assess our LBR, MR, aneuploidy and DET outcomes with mosaics. Study design, size, duration This was a retrospective case-control cohort study. All mosaic embryos (51) that underwent frozen embryo transfer (FET) between January 2020 and June 2023 were compared to all euploid embryos (706) among all patients with tested embryos that underwent FET in the same time frame. Our Power analysis confirmed that with the 14:1 ratio of 706/51 euploid/mosaic embryos this study is sufficiently powered to exclude a &amp;gt; 20% lower LBR following mosaic transfer. Participants/materials, setting, methods All patients seen at our IVF center undergoing FET of mosaic or euploid embryos tested with next generation sequencing during the study period were included. Primary outcome was LBR. Further comparison included age, MR, twin rate, freeze day and grade. Embryos were further analyzed for HL versus LL mosaicism, segmental or whole chromosomal mosaicism, freeze date and grade. Statistics employed chi-squared for categorical and student t-test for continuous data with significance set at p &amp;lt; 0.01 Main results and the role of chance Mosaic embryos resulted in nearly identical LBR when compared to euploid embryos, 26/51(50.9%) versus 359/706(50.85%). Implantation rate was also equivalent, 29/51(54.6%) and 376/706(53.3%). Both biochemical pregnancy [mosaics, 8/45(17.8%) versus euploid 127/683(18.6)], and MR [mosaics 3/29(10.3%) versus euploids 24/373(6.4%)] were not significantly different. Among mosaic embryos, the LBR in LL versus HL mosaics were 17/28 (60.7%) and 9/23 (39.1%), respectively. LBR following segmental only versus whole chromosomal defects were 14/27(51.9%) and 11/24(45.8%). LBR following Day 5 versus Day 6/7 freeze were 10/22(45.5%) and 16/29(55.2%) and LBR for favorably graded embryos were 19/34(55.9%) versus fair to poor graded 7/17(41.2%). None of these achieved statistical significance. While Mosaic embryos were transferred in significantly older patients (37.6 vs 36.1 p &amp;lt; 0.01), there was no difference in mean age associated with LBR (36.1 vs 36.3 p =.4). Additionally, there was no statistically significant difference in LBR between age groups, &amp;lt;35yo 143/259(55.2%), 35-37yo 96/202(47.5%), 38-40yo 96/207(46.4%) or &amp;gt; 40yo 50/90(55.6%) among tested embryos. DET was performed more often with mosaic 19/45 (42.2%) than euploid embryos 36/683 (5.3%) p &amp;lt; 0.001, resulting in significantly higher twin births/LB 5/22 (23.8%) versus 6/356 (1.7%) p &amp;lt; 0.001. All DET data sets included the 13 DETs where one euploid and one mosaic embryo were transferred. Limitations, reasons for caution Our small mosaic numbers may have kept the higher LBR with LL, segmental and good quality mosaic embryos from achieving statistical significance, and may be too small to confirm a higher MR with mosaics. Prospective trials are needed to confirm which euploid or mosaic embryo should be selected for transfer. Wider implications of the findings Given the equivalent LBR, mosaic embryos should be used for transfer prior to repeating IVF retrieval for euploids. The high rate of twin delivery following mosaic DET suggests only eSET should be utilized with any tested embryos. Larger prospective trials are needed to further refine euploid versus mosaic embryo selection criteria. Trial registration number not applicable

P-553 Embryo collection improves clinical pregnancy outcomes in next-generation sequencing(NGS)-based preimplantation genetic testing for aneuploidy (PGT-A) euploid embryo transfers

Abstract Study question Is there still a significant impact of embryo-related characteristics on pregnancy rates in NGS based PGT-A euploid embryo transfers for advanced-age patients? Summary answer In single frozen euploid embryo transfers, priority of embryo transfer and grade significantly influence clinical pregnancy rates in women over 35 years old with PGT-A. What is known already It is widely recognized that better embryo grades and a shorter duration of blastulation are associated with favorable reproductive outcomes. Recent meta-analyses have affirmed these findings even in the context of transfer with euploid embryos. However, the impact of prioritizing the highest-ranked embryo among multiple vitrified euploid embryos on pregnancy rates remains unclear. The lack of research in this area implies a gap in understanding whether selecting embryos for transfer among multiple viable euploid embryos could enhance reproductive success. Study design, size, duration Throughout the year 2022, a retrospective review was conducted on 428 cycles of single frozen-thawed euploid embryo transfers performed at a single institution, targeting patients aged 35 and older. The study aimed to explore potential differences in clinical pregnancy rates based on embryo grade, embryo freezing date, and embryo selection priority. Participants/materials, setting, methods Women ≥ 35 years old with single frozen euploid blastocyst transfer cycles was categorized into three groups: (a) with one blastocyst (1/1), (b) with ≥ two blastocysts having the top-priority(½ or higher), and (c) lower-priority blastocysts (lower than ½) to examine potential differences in clinical pregnancy rates among groups based on embryo characteristics, including Gardner grading and day of embryo freezing. Results highlight the impact of both selection criteria and freezing conditions on pregnancy outcomes. Main results and the role of chance This study analyzed a total of 428 frozen embryo transfer (FET) cycles. In the context of frozen-thawed single embryo transfer, the clinical pregnancy rate was 52.2% (128/245) when only one euploid embryo was frozen and subsequently thawed for transfer (a). For cases where two or more euploid embryos were frozen, and embryos with a higher priority (½ or higher) were selected for transfer (b), the clinical pregnancy rate significantly increased to 71.3% (62/87). Conversely, when embryos with a lower priority (lower than ½ in order) were chosen for transfer (c), the clinical pregnancy rate was lower at 38.5% (15/38), indicating a statistically significant difference between the groups (p = 0.001). Categorizing embryos based on Gardner grading, “good” embryos (&amp;gt;3BB) demonstrated a clinical pregnancy rate of 66.8% (141/211), while embryos with lower quality (3BB or below) showed a significantly lower clinical pregnancy rate of 40.6% (88/217) (p &amp;lt; 0.001). The analysis of clinical pregnancy rates based on the embryo freezing day revealed significant differences among embryos freezing on 5 days (71.9%, 133/185), 6 days (39.9%, 71/178), 7 days (25%, 2/8), and thawing PGT-A embryos (38.2%, 21/55) (P &amp;lt; 0.001). Limitations, reasons for caution One limitation of this study is its retrospective nature, and the potential confounding effect of the close association between embryo selection and embryo grading. Further analysis will be conducted to confirm correlations and address this potential confounding effect. Wider implications of the findings In single euploid frozen embryo transfers, selecting the highest-quality embryo through careful embryo selection remains relevant. Morphological indicators of embryos significantly impact early pregnancy outcomes, highlighting the continued importance of strategic embryo accumulation for enhanced procedural success. Trial registration number not applicable

MeerKAT observations of starburst galaxies and AGNs within the core of XMMXCS J2215.9 – 1738 at z = 1.46

Abstract We present the first detailed radio study of the galaxy cluster XMMXCS J2215.9-1738 at z = 1.46 using MeerKAT L-band (1.3 GHz) observations. We combine our radio observation with archival optical and infrared data to investigate the star formation and AGN population within R200 (R = 0.8 Mpc) of the cluster centre. Using three selection criteria; the radio luminosity, the far-infrared radio ratio (qIR) and the mid-infrared colour, we distinguish galaxies with radio emission predominantly powered by star formation from that powered by AGNs. We selected 24 cluster members within R200 in the MeerKAT image based on either their photometric or spectroscopic redshift. We classified 12/24 (50 %) as galaxies whose radio emission is dominated by star-formation activity, 6/24 (25 %) as intermediate star-forming galaxies and 6/24 (25 %) as AGN-dominated galaxies. Using the radio continuum luminosities of the star-forming cluster galaxies, we estimated an integrated star formation rate (SFR) value of 1700 ± 330 M⊙yr−1 within R200. We derived a mass-normalized integrated SFR value of (570 ± 110) × 10−14 yr−1. This supports previous observational and theoretical studies that indicated a rapid increase in star formation activity within the core of high-redshift clusters. We also show that the high AGN fraction within the cluster core is consistent with previous cluster observations at z &amp;gt; 1.5.

P-732 Analysis of health and lifestyle behaviour data from 300,065 UK-based women to analyse preconception lifestyle choices in the context of the broader female population

Abstract Study question Do health and lifestyle behaviours from 300,065 UK-based women indicate preconception choices exceeding national recommended limits? Summary answer The majority indulged in lifestyle behaviour(s) that negatively impact fertility despite actively trying to conceive or wanting to start a family in the future. What is known already Existing knowledge underscores the impact of alcohol consumption, drug use, smoking, and vaping on preconception health and fertility. Understanding the associated risks is crucial for optimising reproductive outcomes. Awareness regarding limits of exposure and intake also remains low, hindering informed decision-making. This study, examining data from 300,065 UK-based women, aims to bridge this gap by shedding light on the prevalence of lifestyle choices and their potential implications for fertility. Emphasising the need for heightened awareness, the findings can contribute to informed preconception counselling, promoting healthier lifestyle choices and empowering individuals with the knowledge needed for optimal reproductive well-being. Study design, size, duration A cross-sectional study was conducted on 300,065 women aged 18-58 who used an at-home hormone testing service between September 2020 and January 2024. Users were asked to complete an online health assessment (OHA) assessing demographics, menstrual cycle history, lifestyle and medical history and asked to select one or more categories that best described them - planning for the future (PFF), actively Trying to Conceive (TTC), just curious about their reproductive health, concerned only about symptoms. Participants/materials, setting, methods Among the 300,065 users, 133,682 were PFF, 76,692 were TTC, 81,257 were just curious, and 42,966 were only concerned about symptoms. We analysed the lifestyle habits of users including alcohol consumption, smoking, vaping and recreational drug use. Only users who were PFF, TTC or just curious were included in the analysis. Counts, means and percentages of completed VHAs were calculated using R software. Main results and the role of chance For those TTC, the mean age was 30.7, 39.53% (n = 30,317), consumed 1-14 units of alcohol weekly, 3.95% (n = 3,028) exceeded 14 units, 21.95% (n = 16,834) regularly or occasionally smoked, 22.40% (n = 9,436) regularly or occasionally vaped, and 7.06% (n = 5,415) used recreational drugs regularly or occasionally. Among those PFF, the mean age was 28.3, 57.27% (n = 76,556) consumed 1-14 units of alcohol weekly, 5.31% (n = 7,095) exceeded 14 units, 22.86% (n = 30,566) regularly or occasionally smoked, 27.29% (n = 21,002) regularly or occasionally vaped, and 13.52% (n = 18,071) used recreational drugs regularly or occasionally. For those who were just curious, the mean age was 27.9, 58.10% (n = 30,602) consumed 1-14 units of alcohol weekly, 5.70% (n = 3,010) exceeded 14 units, 21.17% (n = 11,143) regularly or occasionally smoked, 28.53% (n = 15,018) regularly or occasionally vaped, and 14.63% (n = 7,701) used recreational drugs regularly or occasionally. Limitations, reasons for caution As all data was self-reported, there is a risk of recall bias and inaccurate reporting. As the users who completed the OHA were seeking a reproductive healthcare service, there is likely a bias in the selection criteria of study participants. Wider implications of the findings Although those TTC demonstrated fewer adverse lifestyle behaviours our data demonstrates that a significant number were still not following national recommendations. This highlights the need for tailored preconception education to improve fertility awareness and uptake of practices to improve preconception health and pregnancy outcomes. Trial registration number NA

P-250 Only euploidy does not ensure optimal chances for successful live birth through single blastocyst cryotransfer

Abstract Study question What does a euploid blastocyst require to provide the greatest probability of successful birth? Summary answer Morphokinetic and morphological features of the inner cell mass (ICM) and trophectoderm (TE) are crucial for optimizing live birth chances in cryo-transferred euploid blastocysts. What is known already Embryo selection through preimplantation genetic testing for aneuploidy (PGT-A) alongside frozen embryo transfer strategy enhances outcomes of single-embryo transfer cycles. While euploidy is a crucial indicator, investigations on the identification of additional criteria influencing implantation and live birth rates remain imperative. Studies suggest morphokinetic and morphological quality may supplement predictive factors for euploid embryo success, with varying correlations. The impact of factors like age or gamete origin on euploid blastocyst success remains uncertain, differentiating it from clear effects on non-diagnosed embryos. Optimizing selection criteria involves navigating the intricate interplay of these variables. Study design, size, duration This retrospective study analyses the pregnancy rate (PR) in 596 single embryo cryotransfers of full euploid blastocysts (without detected mosaicism) between February 2019 and September 2023. From these, 437 had a known outcome, and the live birth rate (LBR) was calculated. The study explored the potential impact of gamete origin, oocyte provider age, recipient age, morphokinetics, and morphological quality of ICM or TE (Gardner score) on the reproductive success of the transferred embryo. Participants/materials, setting, methods All embryos were biopsied at the blastocyst stage and successively vitrified. High-resolution next-generation sequencing was used for PGT-A. Only deferred transferences of single post-thawing intact embryos were included. Morphokinetic was assessed using the KIDscoreD5 3.1. Quantitative variables (oocyte provider age, recipient age, and morphokinetic score) were compared using the t-student test, while qualitative variables (gamete origin, morphological quality of ICM and TE) were assessed using the chi-square test. Main results and the role of chance Oocytes leading to pregnancies and live births were derived from women with ages comparable to those without success (Pregnancy: 30.0±7.1 vs. 30.8±6.8, p = 0.174; Live Birth: 30.1±7.1 vs. 30.5±6.9, p = 0.499). Similar age was also observed among recipients achieving pregnancy (41.5±5.4) and live births (41.1±5.1) compared to those who did not (Pregnancy: 41.8±5.1, p = 0.506; Live Birth: 41.5±5.3, p = 0.411). The origin of oocytes and semen (own or donor) did not significantly affect PR (Oocytes: 199/273 vs. 217/323, p = 0.130; Semen: 328/473 vs. 88/123, p = 0.224) or LBR (Oocytes: 113/205 vs. 116/232, p = 0.285; Semen: 183/347 vs. 46/90, p = 0.783). Morphokinetics played a crucial role, with euploid embryos resulting in pregnancy (7.5±1.7) and live births (7.6±1.6) exhibiting significantly higher scores than those without success (6.9±1.7; 7.1±1.7; p &amp;lt; 0.05).199 ICM quality did not significantly impact PR (A:211/296, B:190/275, C:15/25; p = 0.469). However, higher miscarriage rates in C-quality ICM blastocysts significantly reduced the LBR (A:116/211, B:107/205, C:6/21; p &amp;lt; 0.05). TE quality exhibited significant differences in PR (A:221/289, B:184/289, C:11/18; p &amp;lt; 0.05). Since the miscarriage rate was similar among groups (p = 0.787), LBR remained higher in A-quality TE blastocysts (A:124/209, B:98/213, C:7/17; p &amp;lt; 0.05). Limitations, reasons for caution As a retrospective analysis, this study is inherently limited. The influence of expansion grade on success rates remains unexplored, given the use of assisted hatching on day 3 of culture. Performing assisted hatching at the time of biopsy could potentially overcome this limitation. Wider implications of the findings The pursuit of a euploid embryo often becomes the priority in IVF laboratories. However, once the milestone is achieved, morphokinetics and embryonic morphological quality must continue to be considered. This study provides valuable insights for conveying a detailed message to patients with euploid embryos about their prospects for homebirth success. Trial registration number not applicable

P-062 The impact of isolated teratozoospermia on cumulative live birth rates in IVF and ICSI treatment: a retrospective analysis of 5254 completed cycles

Abstract Study question To assess fecundity using cumulative live birth rate (CLBR) per egg collection to determine if IVF and ICSI outcomes are significantly influenced by sperm morphology. Summary answer The presence of isolated teratozoospermia does not have a significant impact on the CLBR of IVF treatment. What is known already There is ongoing debate regarding the clinical significance. Some studies indicate a pivotal role of sperm morphology in successful pregnancies, others cast doubt on its reliability as a predictive factor. Despite the application of stringent grading criteria, concerns remain about the subjective nature of assessing sperm morphology. Discrepancies in success rates between normozoospermic and isolated teratozoospermic groups shown by previous research findings underscore the uncertainty surrounding this matter. Inconsistent findings in previous research may be explained by limited sample sizes and a focus on immediate successes, neglecting subsequent frozen cycles. This study seeks to address the overlooked aspects of teratozoospermia. Study design, size, duration A retrospective study was conducted at Waterstone Clinic, involving 5254 IVF/ICSI autologous cycles completed between 2009-2022 cycles (completed meaning all embryos were either transferred or disposed of). Cycles were categorised according to sperm morphology and divided into two groups: the isolated teratospermic (ITS) group (1218 cycles) defined as having less than 4% normal morphologic forms with all other semen parameters being normal, and the normal sperm (NS) group (4036 cycles). Participants/materials, setting, methods The primary outcome measures, included fertilisation rate, number of cryopreserved embryos per egg collection, and CLBR. Employing multivariate statistics, the analysis explored the impact of interferons on CLBR in relation to variables such as sperm morphology, female age, egg number, and aetiology. Main results and the role of chance The female base characteristics were similar between the two groups in terms of age (37.1 vs 37.1 y/o), oocyte number (9.4 vs. 9.7) and FSH level (7.6 vs. 7.6 IU/L). Statistically significant differences were observed in fertilisation rates (61.7% vs. 65.8%, p &amp;lt; 0.001) and fertilisation failure (5.9% vs. 3.3%, p &amp;lt; 0.001) from IVF treatments when comparing the ITS and the NS groups. However, there was not any significant difference in the number of cryopreserved embryos between the two groups. Additionally, the CLBR did not show any significant difference between the two groups for IVF (35.8% vs. 37.8%, p &amp;gt; 0.05) or ICSI treatments (38.1% vs. 33.2%, p &amp;gt; 0.05). ICSI did not confer any benefit in improving the CLBR outcome when compared to conventional IVF, when adjusted for female age, number of oocytes collected, and aetiology. Limitations, reasons for caution While this study is retrospective it encompasses a substantial cohort. A potential for bias due to the selection criteria for IVF and ICSI exists. The intrinsic subjectivity in sperm morphology assessment introduces additional potential bias. Wider implications of the findings Despite the lack of support from CLBR to advocate for choosing ICSI in patients with ITS, this study suggests that couples with ITS experience lower fertilisation and higher fertilisation failure rates with IVF. This observation can serve as a valuable indicator for investigating the occurrence of fertilisation failure. Trial registration number not applicable

P-532 Preimplantation genetic testing versus morphology as selection criteria for single embryo transfer in women aged 35-42: results of a pilot randomized controlled trial

Abstract Study question To assess the feasibility of running a large randomised controlled trial (RCT) evaluating the benefit of preimplantation genetic testing for aneuploidy (PGT-A) for embryo selection. Summary answer Running a PGT-A RCT is feasible. Considerations include participant recruitment, seven-day biopsy-embryologist availability and logistical complexities. What is known already Critics question the effectiveness of PGT-A leading to concerns about false positives and negatives, unnecessary embryo discarding and clinical effectiveness. Past studies have been criticised for only performing biopsy on top quality embryos, their criteria for randomization and the age of the population being assessed. Given these uncertainties there is a need for a rigorous RCT evaluating the role of PGT-A using current methodologies and biopsy techniques in women most affected by aneuploidy. Our pilot study is the first study where all embryos generated will undergo biopsy and ranked in terms in implantation potential prior to transfer. Study design, size, duration In this prospective, concealed allocation two-arm parallel RCT, our goal was to randomise 100 women with ≥3 good quality embryos on day 3 post egg collection into two groups: embryos screened using next-generation sequencing (NGS)-based PGT-A or selection-based on morphology alone. PGT-A patients underwent a trophectoderm biopsy on day 5/6/7 following egg collection. Biopsied embryos were frozen and subsequently transferred. Euploid and embryos described as being low mosaic (&amp;lt;30% abnormal cells) were prioritised for transfer. Participants/materials, setting, methods Women aged between 35–42 years undergoing IVF±ICSI were included, with those undergoing PGT for inherited genetic disorders, gamete donation cycles, untreated hydrosalpinges or untreated uterine abnormalities excluded. Primary objective during the pilot phase was to assess the ability to recruit, randomise, adherence to the study protocol and plan for a full study. Secondary outcomes were clinical pregnancy rate per embryo transferred, clinical pregnancy rate per couple randomised, miscarriage rate and time to pregnancy. Main results and the role of chance Out of 247 eligible women,100 were randomised, and 94 received the assigned treatment. The recruitment rate was 70.18%(173/247, 95%CI 61.65%-78.70%). An average of 6 participants were randomised each month. All randomised participants completed the follow-up. Our main recruitment challenges included 19% of eligible patients choosing to have PGT-A privately and 6% withdrawing their consent choosing to have a fresh transfer. Lack of biopsy-embryologist also meant patients whose potential biopsy would have been on a weekend had to be excluded in the first 4 months of our recruitment process. Baseline characteristics including age, BMI and cause of infertility were comparable in both arms and a total of 56 euploid, 53 aneuploid and 3 low mosaic embryos were identified. There was no statistically difference in CPR (23/50 vs 21/50, RR 1.09 95%CI:0.83-1.15, p-value&amp;gt;0.23) and miscarriage rate (3/50 vs 2/50, RR 1.5 95%CI:0.84-1.75, p-value: 0.15) per single embryo transfer or per woman randomised (23/46 vs 21/48, RR 1.14 95%CI 0.78-1.27, p-value:0.24 and 3/46 vs 2/48, RR 0.72 95%CI 0.58-1.17 p-value: 0.17) in either arm of the study. We cannot yet confirm the clinical benefit of PGT-A owing to the insufficient sample size in this pilot study. No low mosaic embryos were transferred. Limitations, reasons for caution The study was conducted in a single centre. If future definitive trials are conducted in multiple centres, the criteria for recruitment, randomisation, intervention, and follow-up still need to be unified. Many women aged above 40 failed to reach randomization due to challenges in producing three good-quality embryos. Wider implications of the findings The pilot study found that the eligibility rate is adequate however researchers should consider reviewing the conditions for randomisation in main study such as reducing the number of good embryos required to two. In addition, stratified randomization should be used in order to better balance female age within each group. Trial registration number NCT05009745

O-225 A study investigating whether egg share donors treatment outcome impacted on their overall psychological well-being and treatment experience

Abstract Study question Does unsuccessful egg sharing treatment impact on the egg share donor’s psychological well-being or make her regret her decision to participate? Summary answer Egg share (ES) donors whose treatment was unsuccessful did not regret egg sharing, and were unanimously happy for their recipient if her treatment was successful. What is known already ES programmes are a unique form of egg donation for two main reasons. First, both the donor and her anonymously matched recipient are engaged in the simultaneous pursuit of having a baby. Second, egg sharing schemes offer a benefit for the donor other than altruism. However, a major concern is for the psychological well-being of ES donors whose own treatment is not successful. This concern raised was based on opinion, rather than empirical research. It is therefore vital that the psychological well-being of ES donors through egg sharing is better studied. Study design, size, duration Data for this study were gathered using a questionnaire. Selection criteria for the study were those who had participated in egg donation treatment between 2014-2022 at Lister Fertility Clinic (LFC), Chelsea, London. Only patients who had agreed to participate in research during the consenting process of their treatment were sent an email invitation asking them to participate in the study. 394 ES donors were sent an email invite. Participants/materials, setting, methods After receiving the email link, respondents filled out the questionnaire online using the Qualtrics survey tool. The paper copies received were manually inputted by the research team onto Qualtrics. The questionnaire took on average 15-20 minutes for participants to complete. 197 egg share donors were included in analysis Statistical analysis was conducted using the χ², analysis of variance (ANOVA), Mann Whitney U test, and Fisher’s exact test. Main results and the role of chance This is the largest study to investigate the psychological issue surrounding ES donation. Overall, ES donors rated their treatment ‘very positively’ (85.7%). The vast majority of egg sharers (91.8%) were glad they took part in the programme. Significantly, patients were stratified into whether IVF treatment was successful or not, with successful treatment being defined as a resulting live birth. For egg sharers, there was no difference between positive or negative treatment outcome, and their responses to whether they: would participate in egg sharing again in the future; would recommend egg sharing to a friend or family member who needs fertility treatment; felt well informed of egg sharing; and felt they had sufficient support from the fertility clinic during and after treatment. The only answer that was statistically significant based on treatment outcome was when asked if they were ‘glad they took part’, with 99.4% of successful egg sharers answering yes, compared to 72.7% of unsuccessful egg sharers (Fishers exact, p &amp;lt; 0.05). Of the unsuccessful ES donors who found out their recipient’s treatment was successful, 100% reported they were ‘happy for their recipients’, with the vast majority of this category stating they were glad they took part (85.7%). Limitations, reasons for caution As with all questionnaire generated data, there is a potential for sampling bias. Second, this is a single centre study. LFC is one of the largest ES centres in the UK and has success rates above the national average. Therefore, this data may not represent the ES programme nationally. Wider implications of the findings As with all questionnaire generated data, there is a potential for sampling bias. Second, this is a single centre study. LFC is one of the largest ES centres in the UK and has success rates above the national average. Therefore, this data may not represent the ES programme nationally. Trial registration number n/a

Incidence of Recurrence Post Hemi Thyroidectomy in Thyroid Papillary Carcinoma: A Meta-Analysis

Abstract Background Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid carcinoma. It has an excellent prognosis, with a 10-year survival rate of more than 95 per cent, although outcome is poorer for aggressive subtypes. Aim of the Work Our work in this study shows that the incidence of recurrence post hemi thyroidectomy is significantly higher compared to post total thyroidectomy and in case of multifocal and insular carcinoma with hemi thyroidectomy it increases the incidence of recurrence and drastically affecting the 10-year survival rate and the quality of life. Material and Methods We followed the PRISMA statement guideline during this systematic review and meta-analysis preparation and performed all steps according to the Cochrane handbook of systematic reviews of intervention. We searched PubMed, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and Science Direct till November 2021 relevant keywords. We used the following search strategy for searching different databases: (“Papillary Thyroid Cancer” OR “Papillary Thyroid Cancers” OR “Papillary Thyroid Carcinomas” OR “Papillary Carcinoma Of Thyroid” OR “Papillary Thyroid Carcinoma” OR “Familial Non medullary Thyroid Cancer” OR “Non medullary Thyroid Carcinoma” OR “Non medullary Thyroid Carcinomas” OR “Thyroid Carcinoma, Non medullary” OR “Thyroid Carcinomas, Non medullary”) AND (Hemithyroidectomy OR Thyroidectomy OR Thyroidectomies OR thyroid removal). All the references of the included studies were searched for relevant studies. Results Multifocality and insular carcinoma and bilaterality increase the incidence of recurrence drastically so it is recommended for total thyroidectomy. Gender plays a role in the aggressiveness of the tumor but not in the incidence of recurrence as this is determined by the selection criteria of the candidate and the surgical technique. We studied 7 risk factors through this meta-analysis and it is recommended for application of LNR as a post op prognostic tool for recurrence and to apply hemi thyroidectomy for tumor size &amp;lt;2 cm instead of &amp;lt; 4 also meticulous pre-operative workup, accurate risk assessment, stratification and staging this is to customize a road map for every patient through a multi-disciplinary team. Conclusion In this meta-analysis we found that in low grade differentiated papillary thyroid carcinoma the recurrence is higher with hemithyroidectomy than in total thyroidectomy after applying the ATA guidelines for 10 years retrospectively but in case of 10 year survival it showed no significant difference.

MHealth Apps for Dementia, Alzheimer Disease, and Other Neurocognitive Disorders: Systematic Search and Environmental Scan.

Lifestyle behaviors including exercise, sleep, diet, stress, mental stimulation, and social interaction significantly impact the likelihood of developing dementia. Mobile health (mHealth) apps have been valuable tools in addressing these lifestyle behaviors for general health and well-being, and there is growing recognition of their potential use for brain health and dementia prevention. Effective apps must be evidence-based and safeguard user data, addressing gaps in the current state of dementia-related mHealth apps. This study aims to describe the scope of available apps for dementia prevention and risk factors, highlighting gaps and suggesting a path forward for future development. A systematic search of mobile app stores, peer-reviewed literature, dementia and Alzheimer association websites, and browser searches was conducted from October 19, 2022, to November 2, 2022. A total of 1044 mHealth apps were retrieved. After screening, 152 apps met the inclusion criteria and were coded by paired, independent reviewers using an extraction framework. The framework was adapted from the Silberg scale, other scoping reviews of mHealth apps for similar populations, and background research on modifiable dementia risk factors. Coded elements included evidence-based and expert credibility, app features, lifestyle elements of focus, and privacy and security. Of the 152 apps that met the final selection criteria, 88 (57.9%) addressed modifiable lifestyle behaviors associated with reducing dementia risk. However, many of these apps (59/152, 38.8%) only addressed one lifestyle behavior, with mental stimulation being the most frequently addressed. More than half (84/152, 55.2%) scored 2 points out of 9 on the Silberg scale, with a mean score of 2.4 (SD 1.0) points. Most of the 152 apps did not disclose essential information: 120 (78.9%) did not disclose expert consultation, 125 (82.2%) did not disclose evidence-based information, 146 (96.1%) did not disclose author credentials, and 134 (88.2%) did not disclose their information sources. In addition, 105 (69.2%) apps did not disclose adherence to data privacy and security practices. There is an opportunity for mHealth apps to support individuals in engaging in behaviors linked to reducing dementia risk. While there is a market for these products, there is a lack of dementia-related apps focused on multiple lifestyle behaviors. Gaps in the rigor of app development regarding evidence base, credibility, and adherence to data privacy and security standards must be addressed. Following established and validated guidelines will be necessary for dementia-related apps to be effective and advance successfully.