13 research outputs found
A scoping review of the research supporting coaching practice in women's football: as the game grows the research strives to keep up
No full textThe aim of this study was to scope the available peer-reviewed literature on competitive women’s football, identifying and mapping the current research on supporting coaching practice in women’s football. The study reviewed all women’s football related studies scoped by Okholm Kryger et al. (2021) for their relevance to coaching in women’s football. Additionally, an updated search was performed from PubMed (1966–2023), PsycINFO (1967– 2023), Web of Science (1900–2023), Scopus (1788–2023), SPORTDiscus (1892–2023) on 7th December 2023. The author, journal, title, and abstract of all included studies were scoped. Information extracted during the scoping process included: the population, playing level, age group, environment, study type and geographical location of the research. A total of 373 articles were scoped. The publication topic most frequently researched was Performance Analysis – Physical (20%), followed by Performance Analysis - Technical/Tactical (18%) and Maturation/Talent Identification (13%). Most studies were focused on coaching senior players (n=207, 55%) and elite football (n=189, 51%). Despite the volume of research growing each year, it is noticeable there are gaps in the research. Five topics only had a single figure number of articles (Teaching and Learning Strategies, Coach Education/Development, Socio-Cultural Experience’s of Coaching, Coaching Philosophy and Responsibilities/Role in Football). At present given there is a particular emphasis on certain playing levels, playing populations and research topics, there is a dearth of information in certain areas. As such, researchers should work to ensure there is greater thematic depth as well as an increased volume of research in women's football
Stratified medicine for mental disorders
No full textThere is recognition that biomedical research into the causes of mental disorders and their treatment needs to adopt new approaches to research. Novel biomedical techniques have advanced our understanding of how the brain develops and is shaped by behaviour and environment. This has led to the advent of stratified medicine, which translates advances in basic research by targeting aetiological mechanisms underlying mental disorder. The resulting increase in diagnostic precision and targeted treatments may provide a window of opportunity to address the large public health burden, and individual suffering associated with mental disorders. While mental health and mental disorders have significant representation in the "health, demographic change and wellbeing" challenge identified in Horizon 2020, the framework programme for research and innovation of the European Commission (2014-2020), and in national funding agencies, clear advice on a potential strategy for mental health research investment is needed. The development of such a strategy is supported by the EC-funded "Roadmap for Mental Health Research" (ROAMER) which will provide recommendations for a European mental health research strategy integrating the areas of biomedicine, psychology, public health well being, research integration and structuring, and stakeholder participation. Leading experts on biomedical research on mental disorders have provided an assessment of the state of the art in core psychopathological domains, including arousal and stress regulation, affect, cognition social processes, comorbidity and pharmacotherapy. They have identified major advances and promising methods and pointed out gaps to be addressed in order to achieve the promise of a stratified medicine for mental disorders
Relationships between psychosocial stress, cortisol, apolipoprotein є4, beta-amyloid, hippocampal volumes and Alzheimer's disease in a sample of South African older adults
No full textIncludes bibliographical references.Many factors contribute to age-related changes in cognitive functioning. There is no single defined profile of factors that is clearly associated with the presence, or rate of progression, of cognitive changes in older adults. Stress, both psychosocial and physiological, may play a role. Aims: The general aim of this study was to explore the relationships between cognitive functioning and cognitive decline, on the one hand, and psychosocial and physiological stress, as well as a range of sociodemographic, psychosocial and physiological factors, on the other, in older adults with a range of cognitive function including healthy and impaired. Methods: Both cross-sectional (Study 1) and longitudinal (Study 2) designs addressed these aims. Study 1 examined the contribution of stress and sociodemographic, psychosocial, and physiological factors to cognition. Participants were 69 cognitively healthy older adults and 65 possible or probable Alzheimer’s disease (AD) patients. They were all over the age of 60 and resided in the greater Cape Town metropolitan region of South Africa. Cognitive functioning was assessed using a battery of neuropsychological tests. Salivary cortisol levels, apolipoprotein E (APOE) genotype, and plasma beta-amyloid levels were determined at baseline
Lynceus magdaleanae TIMMS, 2013, sp. nov.
No full textL. magdaleanae sp. nov. (Figs. 3E, 4E, 12) Etymology. This species is named for Magdaleana Davis (nee Zofkova) to honour molecular her work in identifying the presence of at least three species of Lynceus in Western Australia. Type locality. Australia, Western Australia, 18 km NE of Goomalling, East Oak Park pit gnamma, 31 o 08’ 20”S, 116 o 52’ 49”E, 19 October 2011, collector BVT. Holotype. Male deposited in the Western Australian Museum (Perth). Length 5.5 mm. Registration number WAM 51624. Allotype. Female deposited in the Western Australian Museum (Perth). Length 5.0 mm. Registration number, WAM 51625. Paratypes. 8 altogether; 2 males and 2 females deposited in Australian Museum (Sydney) Registration number, AM P89077, and 2 males and two females deposited in Western Australian Museum (Perth), WAM 51626. Other Material. Northern Territory: Papunya, 4 km E, gnamma on Warumpi Hill, 23 o 15’S, 131 o 54’E), 14 May 1998, IAEB, AM P90069; Macdonnell Ranges, Palm Creek in PalmValley, 24 o 03’ 25”S, 132 o 44’ 47”E, 13 September 1958, D.F. McMichael, AM P55727 & P88376; Kata Tjuta (= Mt. Olga), 25 o 17’ 22”E, 130 o 44’ 18”E, 11 August 1966, A Frecker & P. Keane, AM P55684 & P88157. Queensland: 105 km N of Hughenden, L. Louisa, 19 o 53’ 36”S, 144 o 15’10”E, 7 April 2009, BVT & MS, AM P89078; 7 km E of Boulia, burrow pit, 22 o 54’ 44”S, 139 o 58’24”E, 4 March 2011; BVT & MS, AM P89079; 2 km E of Boulia, swamp, 22 o 54’ 41”S, 139 o 55’ 30”E, 4 March 2011, BVT & MS, AM P90067; 76 km NE of Aramac, L Galilee Hazelmere Inlet, 22 o 26’ 00”S, 145 o 42’30”E, 15 February, 2010, BVT & MS, AM P90068. South Australia: Musgrave Ranges, Erliwunyawunya Rockhole, 29 May 1961, H.G. Cogger, AM P15286, P55685, P88143, P88380; Musgrave Ranges, 7 km S of Mt. Woodroffe, waterhole in Currie Creek tributary, 9 May 1983, 26 o 19.134’E. 131 o 44.715’E, W. Zeidler, SAM C7631; Everard Ranges, Carmeena Rockhole, 27 o 06.51’S, 132 o 33.011’E, 14 August 1914, Capt S. A. White, SAM C7632; Everard Homestead, Victoria Springs, 27 o 0.368’S, 132 o 42.565’E, 31 October 1970, E Matthews SAM C7646; Gawler Ranges, pool near Hiltaba Homestead, 32 o 09.422’S, 135 o 04.084’E, P. Aerfeldt & P. Cokerham, 14 October 1984, SAM 7633; Gawler Ranges, pool near Yarna Homestead, 32 o 03.213’S, 135 o 07.751’E, P. Aerfeldt & P. Cokerham, 15 October 1984, SAM C7634; Gawler Ranges, pool near Paney Homestead, 32 o 35.240’S, 135 o 25.803’E, P. Aerfeldt & P. Cokerham, 16 October 1984, SAM C7635; Gawler Ranges National Park, 40 km NE of Wudinna, Policemans Point, 32 o 35’ 17”S, 135 o 26’ 30”E, 5 October 2009, BVT, SAM C7636; 13.5 km NE of Minnipa, Pildappa Rock, western pit gnamma, 32 o 45’ 05”S, 135 o 13’ 48”E, 23 November 2003, BVT, SAM P7637; 25 km ENE of Wudinna, Peela Rock, northernmost pit gnamma, 33 o 00’ 09”S, 135 o 43’ 28”E, 26 October 2011, BVT, SAM C7638; Frances, Lake Cadnite, 36deg 42.685’S, 140deg 56.559’E, 6 May 1979, W. Zeidler, SAM C7639. Western Australia: Little Sandy Desert, Hutton Range, 16 km N, ca 24 o 46’S, 123 o 48’E, 4 September 1971,no collector recorded, WAM 51322; 83 km N of Northhampton, Euardy Station, roadside ditch, 27 o 36’ 31”S, 114 o 41’ 43”E, 5 July 2011, Koen Martens, WAM 51591; 50 km NW of Cue, pit gnamma on Walloo Hill, 27 o 14’ 47”S, 117 o 25’ 44”E, 23 August 2009, BVT, WAM 51592; Gibson Desert, Gunbarrel Highway, Mt Samuel, pool (probably one of the Mangi gnammas) 1.6 km WSW, 1 June 1966, 25 o 45’ 50”S, 125 o 55’ 50”E (for Mt Samuel), K. Davey. AM P55668, P88159; Great Victoria Desert, Knight Gnamma Holes, 28 o 12.795’S, 124 o 39.993’S, 25 August 2010, IAEB, WAM 51593; Great Victoria Desert, Sunday Surprise Rocks, 27 o 57.379’S, 125 o 00.350’E, 27 August 2009, IAEB, WAM 51594; 60 road km SE of Giles, Kutjurritari Gnammas, ca 25 o 17’S, 127 o 49’E, 23 September 2009, BVT, WAM 51595; Great Victoria Desert, Connie Sue Highway, gnammas 10 km W of Lake Serpentine, 26 August 1980, J.A. Forrest, WAM 51596; Warburton, Windaroo Rockhole, 21 June 1979, J. Blyth, WAM 51597; 71 km WSW of Menzies, pit gnamma on Scorpion Rocks, 29 o 51’ 10”S, 120 o 19’ 36”E, 10 October 2011, Bindy Datson, WAM 51598; Paynes Find area, 2 September 1991, no date or collector recorded, WAM 51317; 11 km NNW of Paynes Find, south pit gnamma on Bullamanya Rocks, 29 o 09’ 53”S, 117 o 39’ 36”E, 5 October 2010, BVT, WAM 51599; 15 km SW of Wubin, pit gnamma on Miamoon Rocks, 30 o 09’ 07”S, 116 o 20’ 45”E, 14 September 2003, BVT, WAM 51600; 25 km E of Wongan Hills, Dingo Rock, 30 o 50’ 41”S, 116 o 58’ 30”E, 27 September 2012, BVT, WAM 51601; 43 km NNW of Hyden, rock pool at base of Mt Walker; 32 o 04’ 11”S, 118 o 45’ 21”E, 31 August 2009, BVT, WAM 51602; 17 km NE of Hyden, northern pit gnamma at The Humps, 32 o 18’ 41”S, 118 o 57’ 37”E, 4 August 2005, BVT, WAM 51603; near Buncubbin, Dajoing, soak at Yalburnunging Rock, no date, E. Simpson, WAM 51318; 40 km NE of Mukinbudin, pit gnamma on Yanneymooning Rock, 30 o 43’ 04”S, 118 o 33’ 24”E, 24 October 2010, BVT, WAM 51604; 44 km S of Coolgardie, pit gnamma on Victoria Rock, 31 o 17’ 37”S, 120 o 55’ 32”E, 14 September 2002, IAEB & BVT, WAM 51605; 40 km E of Lake King Township, pit gnamma on Lilian Stokes Rock, 33 o 04’ 06”S, 120 o 05’ 49”E, 1 September 2009, BVT, WAM 51606; 95 km SW of Norseman, near Metcalf Lake, creek crossing, permanent water under rock tunnel, 32 o 28’ 30”S, 120 o 49’E, no date or collector recorded; WAM 51323; Dundas, rockhole, ca 32 o 27’S, 121 o 46’E, no date or collector, WAM 6735; 27.5 km NE of Norseman, Buldania Rocks, western pit gnamma, 4 December 1959, D.H. Edwards, AM P55661 & P88381; 89.6 road kms E of Norseman off Eyre Highway, Smithania Rock, June 1964, Lee, AM P55656 & P88153; 196 km E of Norseman, a pit gnamma on Balladonia Rock, 32 o 27’ 41”S, 123 o 51’ 48”E, 18 March 2007, BVT, WAM 51607. Diagnosis. Thoracopod I of male with endite VI with a broad almost rectangular base because of a distinct angular hump of about 110–120 o on the distal surface, and a short somewhat triangular process medially, much shorter than the base and reaching only about a third of the medial length of endite III, and not covering all the teeth on the distomedial surface of endite III. Description of male. Head (Fig 12B,C) subequal to body size, finely punctuate. Fornices broad, angulated and arcuate over second antennal base. Small mound centroposteriorly the site of the dorsal organ. Compound eyes close together about midway along central ridge and just posterior to the frontal pore and two small lateral setal fields. Ocellus deeply embedded beneath the setal fields. Rostral dorsal surface lower than surface posterior to compound eye, the junction marked by the lateral suture from the eye to the nearby fornix. Rostrum about as long as wide with upper surface significantly expanded terminally (by about 30% each side). Central carina bold and bifurcated distally associated with terminal truncation to form a broadly based triangular terminal facet. This facet ciliated on the ventral edge and almost at right angles to head alignment and with anterior margin of base straight. First antenna (Fig 12D) small, a little shorter than rostrum, and with two antennomeres. Proximal antennomere cylindrical with concave face terminally and supporting second antennomere. This antennomere subequal in length to the first, clavate and with a few short setae terminally and on dorsal distal surface. Second antenna (Fig 12E) biramous, well developed, twice as long as rostrum. Peduncle of three segments, proximal segment with 3–4 plumose setae, middle segment with 1–2 spines and the distal peduncular segment with about 8 short spines mainly at the base of the anterior ramus. Anterior ramus with about 25 antennomeres and ventral ramus with a few more antennomeres. Both rami with long plumose ventral setae, one per antennomere, while anterior ramus with short dorsal setae also. Labrum large, well developed, clothed in small setae. Mandible broadly spatulate. First maxilla typical for genus and second maxilla absent. Carapace (Fig 12A) with hinge line slightly arcuate, umbo lacking and no growth lines. Anterior margin broadly arcuate, curving evenly to ventral margin and back to the posterior, though posterior is slightly narrower so that deepest part of carapace a little before midway along its length. Dorsally carapace slightly arcuate, thus hiding the hinge line. Valves roundly inflated laterally. Carapace surface finely punctate. Abductor muscle scar in an anteriolateral position about twice its diameter from the margin and associated with oval imprint of maxillary glands lying at about 40 o to the hinge line. Thorax. Ten thoracic segments, each with paired thoracopods. Anal plate partly divided centroposteriorly, each half bearing a long seta. Somite below enlarged, even more divided centroposteriorly and each half bearing a small denticle apically. Thoracopod I (Fig 3E, 12F) modified as a clasping appendage, the right and left claspers equal in shape and size. Endite VI with a broad almost rectangular base because of a distinct angular hump of about 110–120 o on the distal surface, and a short somewhat triangular medial process, much shorter than the base and reaching only about a third of the medial length of endite III and not covering all the spines row on the distiomedial surface of endite III. Endite V cylindrical and straight, and about two and a half times longer than broad and four to five times larger than endite IV. Endite V with a vertical row of about 13 larger stout setae from about one third of the endite’s length to its apex and also with an oval field of numerous lithe setae centred about 90 o around the palp but spreading close to the distinct setal row and covering the distal two-thirds of the palp. Endite IV oval in profile and margined with numerous setae mainly on the side distal to Endite V. Endite III rectangular but distinctly narrowing distally and with major axis at right angles to thoracopod axis. A row of about nine triangular spines distiomedially and a large field of stout setae mediolaterally clumped distally. Thoracopod II of general form for Lynceus (Martin & Belk, 1988) and depicted for L. baylyi (Fig.11) with two significant differences: 1) it lacks serrated anterior setae, all anterior setae being naked and 2) the distal lobe of the exopod narrows evenly along its length instead of having a distinctly wider area near its base. Thoracopods III to XI similar to thoracopod II, though the last three much reduced in size and lacking epipodites and proximal lobe of the exopodites. Description of female: Head (Fig. 12G,H): general structure similar to male. Compound eyes, ocellus, frontal pore and setal fields as in male. However anterior dorsal carina not bifurcated and rostrum not truncated, so that rostrum a little longer than wide. Rostrum increases in width anteriorly by about 30% on each side. Central carinae bold and lateral suture marking boundary between higher posterior surface and lower rostral dorsal surface as in male. Anterior margin of rostrum arcuate, but with a small notch at each anteriolateral corner. Carapace as in male, umbo lacking, no growth lines, same size and shape. Egg mass, if present, visible through the carapace. Thorax. Twelve thoracic segments, the last three with a lamina abdominalis laterally (Fig 12J). This lamina with an obtuse process anteriorly, two subequal triangular lateral lobes and a larger triangular lateral lobe posteriorly. A thin digital process arising dorsolaterally from a broad swollen base between the clavate process and the first triangular lobe. Anal plate as in the male, but last somite more rounded than in male. Thoracopods. 12 pairs of thoracopods, diminishing in size posteriorly, and thoracopods IX and X with exopod dorsal lobes cylindrical and extending dorsally beyond thoracic dorsum. These, plus the lamina abdominalis, help to anchor the egg mass. Resting egg. (Fig 4E) Round, irregular low wide ridges enclosing enlongated irregular depressions. Size 111.5 ± 4.6 ųm (n = 5). Size. Length holotype 5.5 mm, paratypes (n=4) 5.2 – 5.8 (x = 5.5 ± 0.35 mm); height holotype 5.0 mm, paratypes 4.2 – 5.1 (x = 4.75 ± 0.36 mm), width holotype 4.4 mm. Length allotype 5.0 mm, paratypes 4.9 – 5.4 (x = 5.15 ± 0.21 mm), height allotype 4.7 mm, paratypes 4.2 – 5.2 (x = 4.6 ± 0.42 mm), width allotype 3.9 mm. Variability. In males the truncated terminal facet of the rostrum is not always at 90 o to the rostral axis, but may be as low as 75 o. The rostrum may be expanded terminally by about 20–25%, rather than 30%, and the dorsal carina is not always bold, hardly standing expressed beyond the rostral dorsal surface. On the clasper, the hump on the basal part of endite VI is not always so distinct as in the type, the endites V and IV are variable in shape and setation, and the spines on the distomedial corner of endite III vary from six to nine. Interestingly the sites in the distributional outlier of north Queensland, mostly have 22–26 large setae in the setal row on endite V and only five to seven teeth on the distomedial corner of endite III, whereas the average is about 15 setae and seven to nine teeth over most of the range in WA and SA. In females, the rostrum may not be as wide terminally as in the type and on the posteriolateral plate the size and shape of the lateral lobes are variable, but there is always only one dorsal digitiform process anteriorly. Distribution. L. magdaleanae sp. nov. occurs ubiquitously in deeper gnammas throughout the Wheatbelt (e.g. Fig. 9C) and adjacent Goldfields of Western Australia (except the strip from Beacon to Trayning occupied by L. baylyi sp.nov. ― see above). It also occurs in pit gnammas throughout the northern Eyre Peninsula, Gawler Ranges and northwestern half of South Australia and the southwestern Northern Terrritory, and sporadically in gnammas in the central deserts of Western Australia. L. magdaleanae sp. nov. is also established in northern Queensland but not in gnammas; these occurrences and habitat choice seem incongruous considering its widespread occurrence in gnammas in WA and western SA. Perhaps these northern Queensland records are of a separate species, but so far they are only distinguishable by a slightly different count of setae of endite V and of spines on the distomedial corner of endite III. Specimens from the Wheatbelt and Goldfields of Western Australia were previously misidentified by MZ and the author as L. macleayanus (see Bayly et al 2012; Passaq et al. 2011; Timms 2006, 2012; Zofkova 2007).Published as part of TIMMS, BRIAN V, 2013, A Revision of the Australian species of Lynceus Müller, 1776 (Crustacea: Branchiopoda: Laevicaudata, Lynceidae), pp. 501-533 in Zootaxa 3702 (6) on pages 521-524, DOI: 10.11646/zootaxa.3702.6.
Associations of intraoperative end–tidal CO2 levels with postoperative outcome–secondary analysis of a worldwide observational study
No full textBackground: Patients receiving intraoperative ventilation during general anesthesia often have low end–tidal CO2 (etCO2). We examined the association of intraoperative etCO2 levels with the occurrence of postoperative pulmonary complications (PPCs) in a conveniently–sized international, prospective study named ‘Local ASsessment of Ventilatory management during General Anesthesia for Surgery’ (LAS VEGAS). Methods: Patients at high risk of PPCs were categorized as ‘low etCO2’ or ‘normal to high etCO2’ patients, using a cut–off of 35 mmHg. The primary endpoint was a composite of previously defined PPCs; the individual PPCs served as secondary endpoints. The need for unplanned oxygen was defined as mild PPCs and severe PPCs included pneumonia, respiratory failure, acute respiratory distress syndrome, barotrauma, and new invasive ventilation. We performed propensity score matching and LOESS regression to evaluate the relationship between the lowest etCO2 and PPCs. Results: The analysis included 1843 (74 %) ‘low etCO2’ patients and 648 (26 %) ‘normal to high etCO2’ patients. There was no difference in the occurrence of PPCs between ‘low etCO2’ and ‘normal to high etCO2’ patients (20 % vs. 19 %; RR 1.00 [95 %–confidence interval 0.94 to 1.06]; P = 0.84). The proportion of severe PPCs among total occurring PPCs, were higher in ‘low etCO2’ patients compared to ‘normal to high etCO2’ patients (35 % vs. 18 %; RR 1.16 [1.08 to 1.25]; P < 0.001). Propensity score matching did not change these findings. LOESS plot showed an inverse relationship of intraoperative etCO2 levels with the occurrence of PPCs. Conclusions: In this cohort of patients at high risk of PPCs, the overall occurrence of PPCs was not different between ‘low etCO2’ patients and ‘normal to high etCO2’ patients, but severe PPCs occurred more often in ‘low etCO2’, with an inverse dose–dependent relationship between intraoperative etCO2 levels and PPCs. Funding: This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anesthesiology and Intensive Care (ESAIC) and the Amsterdam University Medical Centers, location ‘AMC’. Registration: LAS VEGAS was registered at Clinicaltrials.gov (NCT01601223), first posted on May 17, 2012
Association of preoperative smoking with the occurrence of postoperative pulmonary complications: A post hoc analysis of an observational study in 29 countries
No full textIntroduction: While smoking has been consistently identified as a significant contributor to postoperative complications, the existing literature on its association with postoperative pulmonary complications remains conflicting. Aim: We examined the association of preoperative smoking with the occurrence of postoperative pulmonary complications (PPCs). Methods: Post hoc analysis of an observational study in 146 hospitals across 29 countries. We included patients at increased risk of PPCs, according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (≥ 26 points). The primary endpoint was the occurrence of one or more predefined PPCs in the first five postoperative days, including unplanned postoperative need for supplementary oxygen, respiratory failure, unplanned need for invasive ventilation, ARDS, pneumonia and pneumothorax. Secondary endpoints included length of hospital stay and in–hospital mortality. We performed propensity score matching to correct for factors with a known association with postoperative outcomes. Results: Out of 2632 patients, 531 (20.2 %) patients were smokers and 2102 (79.8 %) non-smokers. At five days after surgery, 101 (19.0 %) smokers versus 404 (19.2) non–smokers had developed one or more PPCs (P = 0.95). Respiratory failure was more common in smokers (5.1 %) than non–smokers (3.0 %) (P = 0.02), while rates of other PPCs like need for supplementary oxygen, invasive ventilation, ARDS, pneumonia, or pneumothorax did not differ between the groups. Length of hospital stay and mortality was not different between groups. Propensity score matching did not change the findings. Conclusion: The occurrence of PPCs in smokers is not different from non–smokers. Funding: This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anaesthesiology through their Clinical Trial Network and the Amsterdam University Medical Centers, Amsterdam, The Netherlands. Registration: LAS VEGAS was registered at Clinicaltrials.gov (NCT01601223). Prior presentation: Preliminary study results have been presented at the Euroanaesthesia 2024 International Congress, in Munich, Germany
Association of preoperative smoking with the occurrence of postoperative pulmonary complications: A post hoc analysis of an observational study in 29 countries
No full textIntroduction: While smoking has been consistently identified as a significant contributor to postoperative complications, the existing literature on its association with postoperative pulmonary complications remains conflicting. Aim: We examined the association of preoperative smoking with the occurrence of postoperative pulmonary complications (PPCs). Methods: Post hoc analysis of an observational study in 146 hospitals across 29 countries. We included patients at increased risk of PPCs, according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (≥ 26 points). The primary endpoint was the occurrence of one or more predefined PPCs in the first five postoperative days, including unplanned postoperative need for supplementary oxygen, respiratory failure, unplanned need for invasive ventilation, ARDS, pneumonia and pneumothorax. Secondary endpoints included length of hospital stay and in–hospital mortality. We performed propensity score matching to correct for factors with a known association with postoperative outcomes. Results: Out of 2632 patients, 531 (20.2 %) patients were smokers and 2102 (79.8 %) non-smokers. At five days after surgery, 101 (19.0 %) smokers versus 404 (19.2) non–smokers had developed one or more PPCs (P = 0.95). Respiratory failure was more common in smokers (5.1 %) than non–smokers (3.0 %) (P = 0.02), while rates of other PPCs like need for supplementary oxygen, invasive ventilation, ARDS, pneumonia, or pneumothorax did not differ between the groups. Length of hospital stay and mortality was not different between groups. Propensity score matching did not change the findings. Conclusion: The occurrence of PPCs in smokers is not different from non–smokers. Funding: This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anaesthesiology through their Clinical Trial Network and the Amsterdam University Medical Centers, Amsterdam, The Netherlands. Registration: LAS VEGAS was registered at Clinicaltrials.gov (NCT01601223). Prior presentation: Preliminary study results have been presented at the Euroanaesthesia 2024 International Congress, in Munich, Germany
Sex dependence of postoperative pulmonary complications – A post hoc unmatched and matched analysis of LAS VEGAS
No full textStudy objective: Male sex has inconsistently been associated with the development of postoperative pulmonary complications (PPCs). These studies were different in size, design, population and preoperative risk. We reanalysed the database of 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery study' (LAS VEGAS) to evaluate differences between females and males with respect to PPCs. Design, setting and patients: Post hoc unmatched and matched analysis of LAS VEGAS, an international observational study in patients undergoing intraoperative ventilation under general anaesthesia for surgery in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs in the first 5 postoperative days. Individual PPCs, hospital length of stay and mortality were secondary endpoints. Propensity score matching was used to create a similar cohort regarding type of surgery and epidemiological factors with a known association with development of PPCs. Main results: The unmatched cohort consisted of 9697 patients; 5342 (55.1%) females and 4355 (44.9%) males. The matched cohort consisted of 6154 patients; 3077 (50.0%) females and 3077 (50.0%) males. The incidence in PPCs was neither significant between females and males in the unmatched cohort (10.0 vs 10.7%; odds ratio (OR) 0.93 [0.81-1.06]; P = 0.255), nor in the matched cohort (10.5 vs 10.0%; OR 1.05 [0.89-1.25]; P = 0.556). New invasive ventilation occurred less often in females in the unmatched cohort. Hospital length of stay and mortality were similar between females and males in both cohorts. Conclusions: In this conveniently-sized worldwide cohort of patients receiving intraoperative ventilation under general anaesthesia for surgery, the PPC incidence was not significantly different between sexes. Registration: LAS VEGAS was registered at clinicaltrial.gov (study identifier NCT01601223)
Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: Post-hoc analysis of LAS VEGAS study
No full textBackground: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs
Postoperative Pulmonary Complications in Conventional Laparoscopic vs Robot-Assisted Abdominal Surgery
No full textImportance: Robot-assisted surgery (RAS) is increasingly used for abdominal procedures; however, postoperative pulmonary complications (PPCs) are more frequent in patients undergoing RAS compared with patients undergoing conventional laparoscopic surgery (CLS). Objective: To compare the incidence of PPCs after CLS and RAS and to determine which patient-, surgery-, and anesthesia-related factors are associated with PPCs. Design, Setting, and Participants: This cohort study used the Laparoscopic and Robot-Assisted Surgery (LapRAS) database, a pooled dataset containing individual patient data of 2 worldwide prospective cohort studies: the Local Assessment of Ventilatory Management During General Anaesthesia for Surgery (LAS VEGAS) study and the Assessment of Ventilatory Management During General Anesthesia for Robotic Surgery and Its Effects on Postoperative Pulmonary Complications (AVATaR) study. Data were collected from adult patients requiring intraoperative ventilation during general anesthesia for CLS or RAS surgical procedures from 163 centers and 31 countries in the Americas, Europe, the Middle East, and North Africa from January 2013 to March 2019. Data were analyzed from December 2023 to October 2024. Exposures: Type of surgical approach (CLS vs RAS), duration of intraoperative ventilation, and intensity of mechanical ventilation, assessed using the 4 times the driving pressure (DP) plus respiratory rate (RR) estimator (4DP + RR). Main Outcome and Measures: The primary outcome was occurrence of 1 or more PPCs in the first 5 postoperative days. Mixed-effects logistic regression assessed associations with PPCs; mediation and matched cohort analyses served as sensitivity analyses. Results: A total of 2738 patients (median [IQR] age, 56 [41-66] years; 1456 female [53.1%]) were included. PPCs occurred in 172 of 903 patients (19.0%) in the RAS group and 174 of 1835 patients (9.5%) in the CLS group (P <.001). Duration of intraoperative ventilation was longer in RAS compared with CLS (median [IQR] duration, 219 [180-270] vs 95 [68-145] minutes; P <.001) and the intensity of mechanical ventilation was higher (median [IQR] intensity, 84 [69-100] vs 72 [60-87] 4DP + RR; P <.001). PPCs were independently associated only with duration of ventilation (adjusted odds ratio [aOR], 1.49; 95% CI, 1.33-1.66; P <.001), not with the surgical approach (ie, RAS vs CLS; aOR, 1.35; 95% CI, 0.72-2.54; P =.35) nor the intensity of ventilation as measured by 4DP + RR (aOR, 1.01; 95% CI, 1.01-1.01; P =.21). A post hoc analysis showed a more pronounced association of intensity of ventilation in surgical procedures of shorter duration. Conclusions and Relevance: In this cohort study, patients who received RAS vs CLS had a higher incidence of PPCs and received longer and more intense mechanical ventilation; however, only the duration of ventilation rather than intensity of ventilation or type of surgical approach (ie, RAS vs CLS) was independently associated with the occurrence of PPCs, indicating that the longer duration of ventilation in RAS underlies the higher incidence of PPCs observed in those who undergo this type of surgery
