bluuebunny/crossref_metadata_2025_split huggingface dataset:
O47 Safe delivery of surgical tracheostomies in COVID-19 patients during the pandemic
Authors: Angamuthu N , Baker D , Tsui J , Gagasa E , D'Souza R E 
Published: July 2021

Abstract

Introduction
During the corona virus disease (COVID-19) pandemic, frontline units worldwide faced the challenging task of providing high-risk services (like surgical tracheostomy) while safe-guarding the very people performing the high risk procedures. The aim of our study was to assess the incidence of COVID-19 infection among staff involved in surgical tracheostomy on COVID-19 patients

Method
A surgical tracheostomy protocol and operation theatre modifications were put in place at our centre, dictated by local resources, staff availability and previous tracheostomy experience. Between 26/03/2020 and 27/05/2020, staff participating in 71 tracheostomy procedures were sent a questionnaire. The presence of COVID-19 symptoms (new onset continuous cough, fever, loss of taste and/or loss of smell) in tracheostomy staff and patient related data were analysed.

Result
Among the responders (72/122), compliance with personal prophylaxis equipment use was 100%. Eleven (15%,11/72) reported key COVID-19 symptoms and self-isolated. 10 had a COVID-19 swab test and three tested positive. One staff attended (1/72) hospital for symptomatic treatment, none required hospitalisation. 43/72 staff (60%) underwent a COVID-19 antibody test, 18.6% (8/43) were positive. Among the tracheostomised patients, the mean age was 58 years(29–78) and 65.5% were males. The median time from intubation to ST was 15 days (range 5–33, IQR = 9). There were no tracheostomy related deaths and overall mortality was 11%(6/55).

Conclusion
Safe delivery of tracheostomy during a pandemic like COVID-19 is possible with strict adherence to personnel protective equipment, surgical protocols and regulation of traffic flow in theatres to mitigate the potential transmission of COVID-19 among surgical staff.

Take-home Message
Compliance with PPE, adherence to tracheostomy protocol and local modifications can mitigate potential COVID-19 transmission among health care personnel.
O48 Incongruous trends in peripheral arterial disease and amputation in Australia
Authors: Goodall R J , Hughes W R M , Salciccioli J D , Marshall D , Shalhoub J 
Published: July 2021

Abstract

Introduction
We aimed to compare the incidence trends for peripheral arterial disease (PAD) and lower extremity amputation (LEA) in Australia with European Union (EU) 15+ countries.

Method
For the years 1990–2017, we extracted PAOD and LEA incidence data from the Global Burden of Disease (GBD) Study and compared trends across EU15+ countries (19 countries with similar health expenditure—including Australia, the US and the UK).

Result
In 2017, the age-standardised incidence rate (ASIR) for PAOD was lower in Australia than any other EU15+ country for males (90.0/100,000) and third lowest in females (99.9/100,000) (only females in Norway and Spain had lower 2017 ASIRs for PAD). However for LEA, the 2017 ASIRs were higher in Australia for both sexes than in any other EU15+ country (male 119.8/100,000, female 78.0/100,000).
Furthermore, contrasting and anomalous time trends in the incidence of PAOD and LEA were observed in Australia between 1990–2017. The PAOD ASIR decreased over the 28-year period for both males (-16.5%) and females (-17.4%), whereas the LEA ASIR increased over the same time period for both sexes (males +12.5%, females +10.3%). Given the frequency with which LEAs are precipitated by PAOD, these divergent trends were unexpected, especially within a developed country such as Australia.

Conclusion
Our data raises the concern that the true incidence of PAOD in Australia is under-diagnosed, with at-risk patients potentially being recognised late in the disease-process, manifesting as high amputation rates relative to countries with similar health expenditure.

Take-home Message
Australia has anomalous trends in amputation and peripheral arterial disease when compared with other countries with similar health expenditure. Our data raises the concern that the true incidence of PAOD in Australia is under-diagnosed, with at-risk patients potentially being recognised late in the disease-process, manifesting as high amputation rates relative to countries with similar health expenditure.
O49 The use of augmented reality for surgical guidance: an assessment of the human error
Authors: Sharma P R , Brech H , Pérez-Pachón L , Gregory J , Lowe T , Poyade M , Gröning F 
Published: July 2021

Abstract

Introduction
Microsoft HoloLens® is an augmented-reality headset which is increasingly used for surgical guidance. This headset allows the overlay of patient-specific virtual models obtained from medical images onto the patient’s body surface using automatic marker-based alignment. This can guide surgeons during certain surgical tasks, e.g. determining biopsy needle entry points. This study aims to measure the human error in the localisation of virtual models with the headset and discuss its surgical implications.

Method
59 adults were recruited between the ages of 20–59 years. A 12 cm2 digital marker was displayed on a monitor in 9 different positions, one at a time. This was repeated 3 times, resulting in 27 markers shown to each participant. Once a marker was detected by the headset’s camera, a virtual hexagon was rendered on the headset’s transparent lenses. Participants were tasked to click on the hexagon’s vertices using a mouse. The clicks’ coordinates were recorded by the system and compared to the predicted coordinates. This allowed for the calculation of the vertex localisation error.

Result
The mean vertex localisation error was found to be 5.19 mm (±3.56) with a range from 0.08 to 29.77 mm. There was a significant difference between marker positions as determined by a one-way ANOVA (P &lt; 0.001).

Conclusion
This study suggests that the error in the localisation of virtual models depends on the position of the markers relative to the user wearing the headset. Further research is required to explore whether training can reduce the human error with this headset.

Take-home Message
The range of the human error in localising virtual models via the Microsoft HoloLens® headset is large and may be dependent on the position of the marker relative to the user of the headset. Further research is needed to investigate whether training with the headset can improve human performance.
O50 New guidelines to reduce unnecessary blood tests, delayed discharge and costs following robot assisted radical prostatectomy
Authors: Fricker M , Nathan A , Hannah N , Rashid A , Patel S , Phuah Y , Flora K , Cleaveland P , Kasivisvanathan V , Williams N , Miah S , Shah N , Hines J , Collins J , Sridhar A , Kelkar A , Briggs T , Kelly J , Shaw G , Sooriakumaran P , Rajan P , Lamb B , Nathan S 
Published: July 2021

Abstract

Introduction
Routine postoperative blood tests (POBT) are used to evaluate the impact of surgery on pre-existing co-morbidities and to detect early complications. This practice dates back to an era of open surgery, when blood loss and complication rates were higher. We propose new guidelines to improve the specificity of POBT.

Method
The cases of 1040 consecutive patients who underwent a primary or salvage RARP at two large tertiary urology centres in the United Kingdom were retrospectively reviewed, and new guidelines were designed. The guidelines were prospectively validated in a cohort of 300 patients.

Result
Derivation Dataset 3% and 5% had intra- and post-operative Clavien-Dindo complications, respectively. 15% had clinical concerns postoperatively. 0.9% required perioperative transfusion. 78% had routine blood tests without clinical concerns, none of whom developed a complication. 98% of complications were suspected by clinical judgement. 6% of patients had a discharge delay of ≥ 1 days due to delayed or incomplete blood tests.
Validation Dataset No significant difference existed in complication, clinical concern or transfusion rates between the derivation and validation datasets. New guidelines improved sensitivity for complications from 98% to 100% and specificity from 0% to 74%. The number of blood tests requested reduced by 73% (P &lt; 0.001). Discharge delays reduced from 6% to 0% (P = 0.008). Cost savings were £178 per patient.

Conclusion
Postoperative complications and transfusion following RARP are rare. Routine POBT without clinical indication are unnecessary and inefficient. A guideline-based approach to POBT can reduce costs and optimise discharge without compromising patient safety or care.

Take-home Message
Routine postoperative blood tests following robot assisted radical prostatectomy are often unnecessary. A guideline-based approach can reduce costs and optimise patient care.
O51 The utility of plasma circulating cell-free messenger RNA as a biomarker of glioma: a pilot study
Authors: Ita M I , Wang J H , Toulouse A , Lim C H , Fanning N , O’Sullivan M G J , Nolan Y , Kaar G F , Redmond H P 
Published: July 2021

Abstract

Introduction
Research into the potential utility of plasma-derived circulating cell-free nucleic acids as non-invasive adjuncts to radiological imaging has been occasioned by the invasive nature of brain tumour biopsy. Circulating-cell-free messenger RNAs are short fragments of RNA present in blood. The objective of this study was to determine whether significant differences exist in the plasma transcriptomic profile of glioma patients relative to differences in their tumour characteristics, and also whether any observed differences were representative of synchronously obtained glioma samples and TCGA glioma derived RNA.

Method
Blood samples were collected from twenty-nine patients prior to tumour resection. Plasma ccfmRNA and glioma derived RNA were extracted and profiled.

Result
BCL2L1, CXCL5, GZMB, HLA-A, HLA-C, IRF1, MYD88, TGFB1, TLR2, and TP53 genes were significantly over-expressed in glioma (high-grade-glioma-HGG and low-grade-glioma-LGG) patients (P &lt; 0.05, versus control). BCL2L1, GZMB and HLA-A genes were significantly over-expressed in HGG patients (P &lt; 0.05, versus LGG patients). There was positive correlation between the magnitude of fold change of differentially expressed genes in plasma and glioma derived RNA (Spearman r = 0.6344, n = 14, P = 0.017), and with the mean FPKM of TCGA glioma derived RNA samples (Spearman r = 0.4614, n = 19, P = 0.047). There was positive correlation between glioma radiographic tumour burden and the magnitude of fold change of CSF3 gene (r = 0.9813, n = 20, P &lt; 0.001).

Conclusion
We identified significant differential expression of genes involved in cancer inflammation and immunity among patients with different glioma grades, and we identified positive correlation between the plasma transcriptomic profile and tumour samples, and with TCGA glioma derived RNA.

Take-home Message
The plasma transcriptomic profile of glioma patients appears to be representative of synchronously obtained glioma samples.
O52 Plasma circulating cell-free messenger RNA as a potential biomarker of melanoma
Authors: Ita M. I , Wang J H , Fanning N , Kaar G F , Lim C H , Redmond H P 
Published: July 2021

Abstract

Introduction
Blood-borne cell-free nucleic acids are increasingly emerging as significant non-invasive adjuncts to current methods of disease status evaluation in cancer patients. In this study, we sought to examine whether significant differences exist in the plasma transcriptomic profile of advanced melanoma patients with a high disease burden compared to patients with therapeutic response.

Method
Plasma circulating cell-free messenger ribonucleic acid (ccfmRNA) was extracted from twenty patients with stage IV melanoma receiving immunotherapy. Pathway focused gene expression analysis was performed. Patients were assessed with paired blood sample collection and CT scan assessments at baseline and at 3 months follow up. Response Evaluation Criteria in Solid Tumours (RECIST 1.1) was used for tumour burden estimation.

Result
In stage IV melanoma patients, CCL5, GZMB and MYD88 genes were significantly over-expressed (P &lt; 0.05 versus healthy controls). In patients with high disease burden or progressive disease, CCL18, CCR1, CCR4, CD274, CSF2, and GBP1 genes were significantly over-expressed (P &lt; 0.05 versus patients with therapeutic response). Finally, in stage IV melanoma patients with brain metastases, CCL18, CCR1, CCR4, CD274, CSF2, EGF, GBP1, and PTGS2 genes were significantly over-expressed (P &lt; 0.05, versus patients without brain metastasis).

Conclusion
Significant differences were observed in the plasma transcriptomic profile between the various melanoma patient groups, and we postulate that these differences may be exploited to identify novel therapeutic targets or biomarkers relevant to melanoma. CCL4 and CCL5 are prognostic in melanoma, both genes had significantly higher expressions in low disease burden patients compared to patients with a high disease burden.

Take-home Message
CCL4 and CCL5 ccfmRNA transcripts are prognostic in melanoma. High expression of both genes is favourable in melanoma patients.
Reproductive Dormancy in Overwintering AdultEucryptorrhynchus brandti(Coleoptera: Curculionidae)
Authors: Guo Wen-juan , Qin Yan-ni , Wen Jun-bao 
Published: July 2021

AbstractDormancy is important for overwintering insects to resist and adapt to adverse conditions. Dormancy generally contains quiescence and diapause. Eucryptorrhynchus brandti Harold (Coleoptera: Curculionidae), tree-of-heaven trunk weevil (TTW), is a destructive pest and highly host-specific to Ailanthus altissima in China. TTW has one generation per year and overwinters as both larvae and adults. In this study, to examined dormancy type of adults and find a method to store overwintering adults, we collected adults from 20 October 2018 to 13 March 2019. We studied the behavior and reproductive development of adults under field cold conditions for 0 and 10 d and laboratory warm conditions for 5 and 10 d. We recorded developing eggs in females, and the clarity of the testis edge, the yellow point in the testis lobe, the ratio of the inner content in the accessory gland, and the accessory gland color in males. Adults transferred from the field to the laboratory had resumed reproductive development directly. Results indicated that the dormancy type of TTW adults was quiescence. Adults stored in the field were still in a dormant state and the field-storage method was effective. Current study provided basic data for controlling overwintering TTW adults and solve the storage of insect sources during the winter.
Predicting future left anterior descending artery events from non-culprit lesions: insights from the Lipid-Rich Plaque study
Authors: Kuku Kayode O , Garcia-Garcia Hector M , Doros Gheorghe , Mintz Gary S , Ali Ziad A , Skinner William H , Artis Andre K , ten Cate Tim , Powers Eric , Wong Shing Chiu , Wykrzykowska Joanna , Dube Sandeep , Kazziha Samer , van der Ent Martin , Shah Priti , Sum Stephen , Torguson Rebecca , Di Mario Carlo , Waksman Ron 
Published: July 2021

Abstract

Aims
The left anterior descending (LAD) artery is the most frequently affected site by coronary artery disease. The prospective Lipid Rich Plaque (LRP) study, which enrolled patients undergoing imaging of non-culprits followed over 2 years, reported the successful identification of coronary segments at risk of future events based on near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) lipid signals. We aimed to characterize the plaque events involving the LAD vs. non-LAD segments.

Methods and results
LRP enrolled 1563 patients from 2014 to 2016. All adjudicated plaque events defined by the composite of cardiac death, cardiac arrest, non-fatal myocardial infarction, acute coronary syndrome, revascularization by coronary bypass or percutaneous coronary intervention, and rehospitalization for angina with &gt;20% stenosis progression and reported as non-culprit lesion-related major adverse cardiac events (NC-MACE) were classified by NIRS-IVUS maxLCBI4 mm (maximum 4-mm Lipid Core Burden Index) ≤400 or &gt;400 and association with high-risk-plaque characteristics, plaque burden ≥70%, and minimum lumen area (MLA) ≤4 mm2. Fifty-seven events were recorded with more lipid-rich plaques in the LAD vs. left circumflex and right coronary artery; 12.5% vs. 10.4% vs. 11.3%, P = 0.097. Unequivocally, a maxLCBI4 mm &gt;400 in the LAD was more predictive of NC-MACE [hazard ratio (HR) 4.32, 95% confidence interval (CI) (1.93–9.69); P = 0.0004] vs. [HR 2.56, 95% CI (1.06–6.17); P = 0.0354] in non-LAD segments. MLA ≤4 mm2 within the maxLCBI4 mm was significantly higher in the LAD (34.1% vs. 25.9% vs. 13.7%, P &lt; 0.001).

Conclusion
Non-culprit lipid-rich segments in the LAD were more frequently associated with plaque-level events. LAD NIRS-IVUS screening may help identify patients requiring intensive surveillance and medical treatment.
Time trends in ischaemic heart disease incidence and mortality over three decades (1990–2019) in 20 Western European countries: systematic analysis of the Global Burden of Disease Study 2019
Authors: Vancheri Federico , Tate Anne Rosemary , Henein Michael , Backlund Lars , Donfrancesco Chiara , Palmieri Luigi , Strender Lars-Erik 
Published: July 2021

AbstractAimsTo investigate and compare changes in the rates of ischaemic heart disease (IHD) incidence and mortality between 1990 and 2019 in 20 high-income Western European countries with similar public health systems and low cardiovascular risk.Methods and resultsThe 2020 updated version of the Global Burden of Disease database was searched. Variability and differences in IHD incidence and mortality rates (per 100 000) between countries over time, were calculated. A piecewise linear (join point) regression model was used to identify the slopes of these trends and the points in time at which significant changes in the trends occur. Ischaemic heart disease incidence and mortality rates varied widely between countries but decreased for all between 1990 and 2019. The relative change was greater for mortality than for incidence. Ischaemic heart disease incidence rates declined by approximately 36% between 1990 and 2019, while mortality declined by approximately 60%. Breakpoint analysis showed that the largest decreases in incidence and mortality occurred between 1990 and 2009 (−32%, −52%, respectively), with a much slower decrease after that (−5.9%, −17.6%, respectively), and even a slight increase for some countries in recent years. The decline in both incidence and mortality was lower in the Mediterranean European countries compared to the Nordic and Central European regions.ConclusionsIn the Western European countries studied, the decline in age-standardized IHD incidence over three decades was slower than the decline in age-standardized IHD mortality. Decreasing trends of both IHD incidence and mortality has substantially slowed, and for some countries flattened, in more recent years.
Online health information-seeking behaviour of patients attending a primary care clinic in Malaysia: a cross-sectional study
Authors: Lim Hooi Min , Wong Swee Shiuan , Yip Kah Chun , Chang Felicia Wen Si , Chin Adrian Jian Zhi , Teo Chin Hai , Abdullah Adina , Ng Chirk Jenn 
Published: July 2021

Abstract

Background
The internet has become a common source of health information; however, little is known about online health information-seeking behaviour (HISB) among patients in low- and middle-income countries (LMICs).

Objectives
This study aimed to determine the prevalence of online health information-seeking and its associated factors among patients in primary care in Malaysia. We also examined the reasons for, and the sources of, online health information-seeking, patients’ level of trust in the information found and what the information was used for.

Methods
A cross-sectional study using a self-administered questionnaire was conducted on patients who attended a primary care clinic. The questionnaire included the use of the internet to seek health information, sources and types of health information, eHealth literacy, patients’ trust in online information, and how patients appraise and use online health information.

Results
Out of 381 patients in this study, 54.7% (n = 208) used the internet to search for health information. Patients mainly sought information via Google (96.2%) and the most common websites that they visited were Wikipedia (45.2%) and MyHEALTH (37.5%). Higher levels of education, longer duration of internet use, and higher eHealth literacy were significantly associated with online HISB. Patients’ trust in websites (45.6%) and social media (20.7%) was low when compared to trust in healthcare professionals (87.9%). Only 12.9% (n = 22) of patients had discussed online health information with their doctors.

Conclusion
Online HISB was common among primary care patients; however, their eHealth literacy was low, with suboptimal appraisal skills to evaluate the accuracy of online health information.
Influence of Diabetes Duration and Glycemic Control on Dementia: A Cohort Study
Authors: Li Fu-Rong , Yang Hai-Lian , Zhou Rui , Zheng Jia-Zhen , Chen Guo-Chong , Wu Xiao-Xiang , Zou Meng-Chen , Wang Jing-Ya , Fu Qiang , Wu Xian-Bo 
Published: July 2021

Abstract

Background
To investigate the influence of diabetes duration and glycemic control, assessed by glycated hemoglobin (HbA1c) levels, on risk of incident dementia.

Methods
The present study is a prospective study of 461 563 participants from the UK Biobank. The age at diabetes diagnosis was determined by self-report. Diabetes duration was calculated as baseline age minus age at diagnosis. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidential intervals (CIs).

Results
During a median follow-up of 8.1 years, 2 233 dementia cases were recorded. As compared with normoglycemic individuals, individuals with diabetes had higher risk of all-cause dementia, and the risk increased with increasing duration of diabetes; compared with participants with diabetes duration of &lt;5 years, the multivariable-adjusted HRs (95% CIs) were 1.49 (1.12–1.97), 1.71 (1.21–2.41), and 2.15 (1.60–2.90) for those with diabetes durations ≥5 to &lt; 10, ≥10 to &lt;15, and ≥ 15 years, respectively (p for trend &lt; .001). Among participants with diabetes, those with both longer diabetes duration (diabetes duration ≥ 10 years) and poor glycemic control (HbA1c ≥ 8%) had the highest risk of all-cause dementia (multivariable-adjusted HR = 2.07, 95% CI 1.45, 2.94), compared with patients with shorter duration of diabetes and better glycemic control (diabetes duration &lt; 10 years and HbA1c &lt; 8%).

Conclusions
Diabetes duration appeared to be associated with the risk of incident dementia due to factors beyond glycemic control. Clinicians should consider not only glycemic control but also diabetes duration in dementia risk assessments for patients with diabetes.