Title Participants Abstract "Circadian effect of time of anaesthesia on postoperative outcomes in major elective and urgent intervention: a secondary analysis of the Peri-interventional Outcome Study in the Elderly (POSE)" "Danny Hoogma, Layth Al Tmimi, Steffen Fieuws, Jos Tournoy, Steffen Rex" "BACKGROUND A recent prospective study reported a decreasein postoperative mortality when cardiac surgery was started in the afternoon instead of in the morning. In contrast, several large retrospective analyses have not confirmed this finding. Larger prospective studies are requires to elucidate the effects of circadian rhythm on postoperative outcomes. OBJECTIVE To identify any relation between starting time of anaesthesia/surgery and postoperative outcomes in patients aged 80 years or older to aid in clinical decision making with regard to scheduling surgery. DESIGN A multivariable model with a priori defined confounders was constructed to evaluate the impact of anaesthesia starting time on hospital length of stay and postoperative complications. SETTING A European multicentre, observational study of outcomes after geriatric anaesthesia from October 2017 to December 2018. PATIENTS Patients aged 80 years or older having major elective or urgent intervention with anaesthesia starting time between 7 a.m. and 7 p.m. MAIN OUTCOME MEASURE Primary outcome measure was the difference in hospital length of stay after any major elective or urgent morning or afternoon intervention. RESULTS We included 3551 patients of whom 2592 had an intervention starting in the morning (7 a.m. to 1 p.m.). These patients, compared with those with interventions in the afternoon (1 p.m. to 7 p.m.), were slightly younger, were less frail but had a longer duration of the intervention. Hospital length of stay or postoperative complications were not different between morning or afternoon interventions. Multivariable analysis showed no impact of time of anaesthesia (morning vs. afternoon) on hospital length of stay or postoperative complications, hazard ratio of 1.03 (95% CI 0.94 to 1.12) and odds ratio of 1.13 (95% CI 0.92 to 1.39), respectively. CONCLUSION Our results do not support the hypothesis of circadian effects on postoperative outcomes for elective and urgent major interventions in patients at least 80 years of age. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03152734..." "Impact of early candidemia on the long-term outcome of allogeneic hematopoietic stem cell transplant in non-leukemic patients: an outcome analysis on behalf of IDWP-EBMT" "Johan Maertens" "We assessed the incidence and outcome of early candidemia after hematopoietic stem cell transplant (HSCT). The analysis included all first HSCTs performed from 2000 to 2015 in adult and pediatric patients with a non-leukemic disease and recorded in the EBMT registry. Overall survival (OS), non-relapse mortality (NRM), and relapse mortality (RM) were evaluated. Candidemia was diagnosed in 420 of 49,852 patients at a median time of 17 days post HSCT (range 0-100), the cumulative incidence being 0.85%. In 65.5% of episodes, candidemia occurred by day 30 after HSCT. The mortality rate by day 7 was 6.2%, whereas 100-day NRM was higher (HR 3.47, p " "Technology assessment, outcome analysis research, comparative effectiveness, and evidence-based radiation oncology" "Carlos A Perez, Edward C Halperin, Yolande Lievens" "Analysis of clinical outcome and postoperative organ function effects in a propensity-matched comparison between conventional and minimally invasive mitral valve surgery" "Sophie Missault, Jérôme Van Causenbroeck, Korneel Vandewiele, Jens Czapla, Tine Philipsen, Thierry Bové" "The proliferative phase endometrium in IVF/ICSI: an in-cycle molecular analysis predictive of the outcome following fresh embryo transfer" "Shari Mackens, S. Santos-Ribeiro, Annalisa Racca, Dorien Daneels, Alex Koch, Wafaa Essahib, Willem Verpoest, Claire Bourgain, Ingrid Van Riet, Herman Tournaye, Jan J Brosens, Y. H. Lee, Christophe Blockeel, Hilde Van De Velde" "Study question: Does an early proliferative phase endometrial biopsy harvested during ovarian stimulation harbour information predictive of the outcome following fresh embryo transfer (ET) in that same cycle? Summary answer: Transcriptome analysis of the whole-tissue endometrium did not reveal significant differential gene expression (DGE) in relation to the outcome; however, the secretome profile of isolated, cultured and in vitro decidualized endometrial stromal cells (EnSCs) varied significantly between patients who had a live birth compared to those with an implantation failure following fresh ET in the same cycle as the biopsy. What is known already: In the majority of endometrial receptivity research protocols, biopsies are harvested during the window of implantation (WOI). This, however, precludes ET in that same cycle, which is preferable as the endometrium has been shown to adapt over time. Endometrial biopsies taken during ovarian stimulation have been reported not to harm the chances of implantation, and in such biopsies DGE has been observed between women who achieve pregnancy versus those who do not. The impact of the endometrial proliferative phase on human embryo implantation remains unclear, but deserves further attention, especially since in luteal phase endometrial biopsies, a transcriptional signature predictive for repeated implantation failure has been associated with reduced cell proliferation, possibly indicating proliferative phase involvement. Isolation, culture and in vitro decidualization (IVD) of EnSCs is a frequently applied basic research technique to assess endometrial functioning, and a disordered EnSC secretome has previously been linked with failed implantation. Study design, size, duration: This study was nested in a randomized controlled trial (RCT) investigating the effect of endometrial scratching during the early follicular phase of ovarian stimulation on clinical pregnancy rates after IVF/ICSI. Of the 96 endometrial biopsies available, after eliminating those without fresh ET and after extensive matching in order to minimize the risk of potential confounding, 18 samples were retained to study two clinical groups: Nine biopsies of patients with a live birth versus nine biopsies of patients with an implantation failure, both following fresh ET performed in the same cycle as the biopsy. We studied the proliferative endometrium by analysing its transcriptome and by isolating, culturing and decidualizing EnSCs in vitro. We applied this latter technique for the first time on proliferative endometrial biopsies obtained during ovarian stimulation for in-cycle outcome prediction, in an attempt to overcome inter-cycle variability. Participants/materials, setting, methods: RNA-sequencing was performed for 18 individual whole-tissue endometrial biopsies on an Illumina HiSeq1500 machine. DGE was analysed three times using different approaches (DESeq2, EdgeR and the Wilcoxon rank-sum test, all in R). EnSC isolation and IVD was performed (for 2 and 4 days) for a subset of nine samples, after which media from undifferentiated and decidualized cultures were harvested, stored at-80°C and later assayed for 45 cytokines using a multiplex suspension bead immunoassay. The analysis was performed by partial least squares regression modelling. Main results and the role of chance: After correction for multiple hypothesis testing, DGE analysis revealed no significant differences between endometrial samples from patients who had a live birth and those with an implantation failure following fresh ET. However secretome analysis after EnSC isolation and culture, showed two distinct clusters that clearly corresponded to the two clinical groups. Upon IVD, the secretome profiles shifted from that of undifferentiated cells but the difference between the two clinical groups remained yet were muted, suggesting convergence of cytokine profiles after decidualization. Limitations, reasons for caution: Caution is warranted due to the limited sample size of the study and the in vitro nature of the EnSC experiment. Validation on a larger scale is necessary, however, hard to fulfil given the very limited availability of in-cycle proliferative endometrial biopsies outside a RCT setting. Wider implications of the findings: These data support the hypothesis that the endometrium should be assessed not only during the WOI and that certain endometrial dysfunctionalities can probably be detected early in a cycle by making use of the proliferative phase. This insight opens new horizons for the development of endometrial tests, whether diagnostic or predictive of IVF/ICSI treatment outcome. Study funding/competing interest(s): This study was supported by Fonds Wetenschappelijk Onderzoek (FWO, Flanders, Belgium, 11M9415N, 1 524 417N), Wetenschappelijk Fonds Willy Gepts (WFWG G160, Universitair Ziekenhuis Brussel, Belgium) and the National Medicine Research Council (NMRC/CG/M003/2017, Singapore). There are no conflicts of interests. Trial registration number: NCT02061228." "Obstetric outcome in donor oocyte pregnancies: a matched-pair analysis." "Dominic Stoop, Myriam Baumgarten, P. Haentjens, Nikolaos P. Polyzos, Michel De Vos, Greta Verheyen, Michel Camus, Paul Devroey" "BACKGROUND: To investigate the obstetrical and perinatal impact of oocyte donation, a cohort of women who conceived after OD was compared with a matched control group of women who became pregnant through in vitro fertilisation with autologous oocytes (AO). METHODS: A matched-pair analysis has been performed at the Centre for Reproductive Medicine of the UZ Brussel, Dutch speaking Free University of Brussel. A total of 410 pregnancies resulted in birth beyond 20 weeks of gestation occurring over a period of 10 years, including 205 oocyte donation pregnancies and 205 ICSI pregnancies with autologous oocytes (AO). Patients in the OD group were matched on a one-to-one basis with the AO group in terms of age, ethnicity, parity and plurality. Matched groups were compared using paired t-tests for continuous variables and McNemar test for categorical variables. A conditional logistic regression analyses was performed adjusting for paternal age, age of the oocyte donor, number of embryos transferred, and singleton/twin pregnancy. RESULTS: Oocyte donation was associated with an increased risk of pregnancy induced hypertension (PIH) (matched OR: 1.502 CI: 1.024-2.204), and first trimester bleeding (matched OR: 1.493 CI: 1.036-2.15). No differences were observed between the two matched groups with regard to gestational age, mean birth weight and length, head circumference and Apgar scores. CONCLUSIONS: Oocyte donation is associated with an increased risk for PIH and first trimester bleeding independent of the recipients' age, parity and plurality, and independent of the age of the donor or the partner. However, oocyte donation has no impact on the overall perinatal outcome." "Anaesthetic factors affecting outcome after bariatric surgery, a retrospective levelled regression analysis" "Bruno Dillemans" "Comparison of the CRASH ScoreU+2013predicted and real outcome of traumatic brain injury in a retrospective analysis of 417 patients" "Matthias Dullaert, Joyce Oerlemans, Peter De Paepe, Giorgio Hallaert" "Assessment of the short-term functional outcome after urethroplasty : a prospective analysis" "Nicolaas Lumen, S Spiers, S De Backer, R Pieters, Willem Oosterlinck" "Using an interim analysis based exclusively on an early outcome in a randomized clinical trial with a long-term clinical endpoint" "Leandro Garcia Barrado, Tomasz BURZYKOWSKI, Catherine LEGRAND, Marc BUYSE" "In RCTs with an interest in a long-term efficacy endpoint, the follow-up time necessary to observe the endpoint may be substantial. In order to reduce the expected duration of such trials, early-outcome data may be collected to enrich an interim analysis aimed at stopping the trial early for efficacy. We propose to extend such a design with an additional interim analysis using solely early-outcome data in order to expedite the evaluation of treatment's efficacy. We evaluate the potential gain in operating characteristics (power, expected trial duration, and expected sample size) when introducing such an early interim analysis, in function of the properties of the early outcome as a surrogate for the long-term endpoint. In the context of a longitudinal age-related macular degeneration (ARMD) ophthalmology trial, results show potentially substantial gains in both the expected trial duration and the expected sample size. A prerequisite, though, is that the treatment effect on the early outcome has to be strongly correlated with the treatment effect on the long-term endpoint, that is, that the early outcome is a validated surrogate for the long-term endpoint."