bluuebunny/crossref_metadata_2025_split huggingface dataset:
P50 Exploring the Merits and Availability of Smartphone Applications Related to Melanoma
Authors: Kabbani Jade , Kabbani Jamil 
Published: April 2021

Abstract

Background
The increased use of smartphone applications across healthcare specialties has been particularly relevant in dermatology, with dermatology related applications widely available on mainstream application stores. We reviewed published literature regarding melanoma-related applications, and the number and types of such applications available for download.

Methods
A literature search of “dermatology”, “smartphone” and “melanoma” was conducted to identify publications assessing applications of interest. “Melanoma” was searched in Apple’s (iOS) “App Store” and Google’s “Google Play”, and application purposes and ratings were analysed.

Results
54 of the 63 literature search results explored smartphone use in relation to melanoma, describing benefits including quicker patient access to care, reduced referrals and hence unnecessary consultations, and improved accessibility to information. However, concerns include insufficient image quality, privacy issues related to encryption, and diagnostic inaccuracy. Searches on the Google Play and iOS stores identified 249 and 51 apps respectively. 25% of Google Play results were categorised as clinical tools, 17% as educational, and 58% as recreational. The corresponding results for the App store were 92%, 6% and 2%. 81% of the educational apps and 92% of the clinical management apps related to dermatology and melanoma on Google Play, whereas all of the clinical management apps and 67% of the education apps on the App store were of relevance.

Conclusion
The results illustrate the widespread availability of applications related to melanoma, particularly for educational and clinical purposes. Standardising photographing techniques, improving diagnostic accuracy, and privacy issues are important aspects to consider and warrant further investigation.
P52 Feasibility of “The Defect Study”: Neonatal diaphragmatic defect measurement and repair techniques in Congenital Diaphragmatic Hernia
Authors:   Paediatric Surgery Trainee Research Network, Eastwood M P , Bethell G , Rooney A , Arthur F , Harwood R 
Published: April 2021

Abstract

Introduction
Defect size and closure technique in neonates with congenital diaphragmatic hernia (CDH) has long term consequences for morbidity in survivors. Although subjective operative reporting of defect size has been standardised, objective evaluation is lacking. There is no reported optimum closure technique related to size and position of diaphragmatic defect. We aimed to objectively describe diaphragmatic defects and repair methods at the time of neonatal CDH repair.

Methods
A national, three centre cohort feasibility study was undertaken over a 4-month period. Data collection was registered as service evaluation at participating centres. All surviving neonates with CDH undergoing defect closure were eligible. Anonymised data were collected using a RedCAP database. Data collection variables (n = 47) included both antenatal and postnatal measures. Data were checked for normality and reported as mean±SD or median (IQR).

Results
12 neonates were eligible for inclusion, 10 (83%) were included. Observed/Expected Lung Head Ratio (%) was reported in 5 cases (45±8), neonates were term, male (60%), birth weight (3.3±0.5kg). 80% of patients had a laparotomy, 80% had a left-sided defect, 60% a patch repair with PTFE and 60% graded defect size C. Poorly reported variables included pre-operative oxygenation and defect size was measured in 30%.

Discussion
Data collection through RedCAP was feasible and most variables were documented. Simplifying the intraoperative data collection form and providing clear instructions for taking measurements may improve reporting. A further pilot study with these modifications and improving engagement through advertisement, emails and online presence is intended to optimize the study before roll-out.
P57 Global recruitment for the RESECT study (transurethral REsection and Single-instillation intravesical chemotherapy Evaluation in bladder Cancer Treatment) - an international observational cohort study aiming to improve the quality of surgery for non-muscle invasive bladder cancer
Authors: Lam C M , Gallagher K , Bhatt N , Clement K , Zimmermann E , Shah T , Khadhouri S , Kulkarni M , Gao C , Light A , Jayaraajan K , Asif A , Anbarasan T , Chan V , Kasivisvanathan V 
Published: April 2021

Abstract

Introduction
Non-muscle invasive bladder cancer (NMIBC) is one of the most expensive cancers to treat, driven by high recurrence rates and disease progression. Mortality rates in the UK for all bladder cancers have remained relatively stable over the past decade. NMIBC can be curatively treated with transurethral resection of the bladder tumour (TURBT). Despite international evidence-based guidelines on the TURBT procedure and postoperative single instillation of mitomycin-C, TURBT quality continues to vary widely. RESECT will be the first ever international study of TURBT surgery evaluating the achievement of TURBT quality indicators globally and assessing if audit and performance feedback can improve surgical outcomes.

Methods
RESECT is a prospective, multicentre international observational cohort study. Collaborators at each site will collect data using REDCap about local TURBT practice, early recurrence rates and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators. Advertisement for the study launched in 2020.

Results
As of October 1st, 2020, 524 collaborators have registered to participate. Collaborators represent 334 centres from 54 countries, with the highest number of centres from the United Kingdom (133), Spain (17), and India (16). 50.8% are trainees, 30.3% consultants, and 17.2% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power.

Conclusion
RESECT has attracted many collaborators internationally from consultants and trainees at all stages. RESECT has significant potential to positively impact TURBT practice, health economics and ultimately improve outcomes for patients with NMIBC globally.
P58 Head Injury CT scan: measuring up to NICE guidelines
Authors: Ghalab Ahmed , Tariq Munim , Akram Rahim , Ikwuagwu Allen 
Published: April 2021

Abstract

Introduction
Head injury is the most common cause of death and disability in individuals between 1-40 years in the UK, with roughly 200,000 annual admissions. The aim is to evaluate how effectively CT scans following a head injury are being performed with reference to NICE guidelines 1-hour criteria1 as patient’s prognosis could potentially be improved with early detection.

Standards

Methods

Results First cycle

Second cycle

Conclusion
About only half of the patients presenting with the risk factors got their scan done in line with NICE guidelines. Following change of ICE to include criteria patients were better categorized, eliminating any unnecessary scans, reducing waiting times and cost, improving patient flow in ED and all scans are now justifiable according to criteria.

References
1-National Institute for Health and Clinical Excellence. CG176. Head Injury: assessment and early management. London. January 2014. https://www.nice.org.uk/guidance/cg176: 2-irefer. The Royal College of Radiologists. Making the best use of clinical radiology services 8th edition. 2017 https://www.rcr.ac.uk/sso/irefer/v8: 3-https://www.rcr.ac.uk/audit/compliance-nice-guidelines-2014-traumatic-head-injury-regard-ct
P59 How COVID-19 influenced UK Burns Services: a national multicentred audit
Authors: Yoshimura Ryo , Phillips Georgina , Wormald Justin , Collins Declan 
Published: April 2021

Abstract

Introduction
COVID-19 has affected national guidelines and availability of resources, resulting in different approaches to treating burns. This project aimed to identify changes to burns management in the UK during the “first wave” of COVID-19, and how the lessons learned can be applied to the current “second wave”.

Methods
Between 11th July-15th September, 18 burns services across the UK completed a MDT survey and contributed data on service evaluation. The MDT survey captured perspectives of multiple stakeholders and included changes to burns services, disruptions to supply chain, and service improvements resulting from COVID-19. Service evaluation data was collected retrospectively and prospectively on patients who received inpatient/outpatient treatment during COVID-19. Patients in the retrospective cohort were first seen by burns services between 6th-30th April (coinciding with the UK’s COVID-19 peak), and the prospective cohort were first seen between 30th April-15th September. Each cohort consisted of 10-20 patients per burns service. Service evaluation covered key areas of burns aetiology, referral pathway changes, patient presentation delays to tertiary services, patient management decisions, and outpatient dressing clinic management. Data from the MDT survey and the service evaluation were analysed by descriptive statistics and thematic analysis.

Results
The changes to burns services include delays in burn referrals, increase in conservative management, and increased use of telemedicine.

Conclusion
Across the UK, safe and effective burns care continued to be delivered despite difficulties from the pandemic. We hope the learning points identified in this study will be of use during the “second wave” of the pandemic.
P63 Improving cervical smear uptake through an Automated Voice Messages Reminder
Authors: Bladt Francesca , Wong Felyx 
Published: April 2021

Abstract
National cervical screening programs have played a pivotal role in the prevention of cervical cancer. However, practices across the UK have reached an all-time low in cervical screening uptake. This study aimed to assess the efficacy of implementing an automated voice message reminder within the local general practice (GP) telephone triage system and explore the reasons which deter eligible patients away from cervical screening.
A 20-second voice-message reminder in the telephone queue was played, addressing key risk factors along with a message from a child who lost his mother to cervical cancer. From the anonymised GP database, weekly new smear test bookings were monitored from 4 weeks prior until 2 weeks after the intervention was implemented. To qualitatively assess factors which deter patients away from screening, female patients were randomly sampled to fill in an anonymous questionnaire.
The use of a low-cost 20 second voice message in the telephone queue across UK GP practices could be an effective method to increase cervical smear test coverage towards the national target of 80%.
35 questionnaire responses were received, main themes reported for not attending screening include embarrassment(37%), busy schedule(32%) and cultural differences(24%). In the week following the intervention, cervical smear tests increased more than 2-fold, from an average of 12 to 26 smears per week. This could be partly due to the convenient timing of voice recording, reminding them to book both appointments simultaneously and the child’s emotive message.
P70 Investigating the current state of practice for reporting on surgeon's learning and the learning curve in IDEAL studies of surgical innovation: A systematic review
Authors: Shah Max , Alford Natasha , Mutanga Ian , Hudson Elizabeth 
Published: April 2021

Abstract

Introduction
Community learning is a key component for the progression of surgical innovation, which is itself crucial to advancing surgical practice. Assessment of learning curve’s (LCs) allow rigorous evaluation of new surgical procedures/devices and their introduction into clinical practice. The Idea–Development–Exploration–Assessment–Long-term (IDEAL) framework provides recommendations for the evaluation of new surgical procedures and devices throughout the stages of innovation. This study aimed to identify the current reporting practice of LCs in IDEAL studies.

Methods
A systematic review was conducted to identify author-reported IDEAL/IDEAL-D studies of any IDEAL stage and surgical specialty. Included were primary studies citing any of 10 key IDEAL papers. Data were extracted including information relating to surgeons’ experience and training, support and performance monitoring, and methods for measuring and assessing the LC.

Results
Searches yielded 1411 publications, of which 59 studies met the eligibility criteria. Some 31/59 (53%) studies reported information on the LC, however, only 3 (5%) studies measured or reported on LC in detail. These 3 papers included statistical methods (cumulative sum control charts, Shewhart control charts and multivariate analysis). Some 21/59 (36%) studies reported training for surgeons and 16 (27%) reported support or performance monitoring.

Conclusion
Reporting of the LC or factors influencing LC such as training, was found to be poor in the included studies. Development of more detailed guidance for measuring and reporting the LC in future studies is recommended to facilitate robust evaluation of new surgical procedures and devices.
P75 Long-Term Survival After Minimally Invasive Resection versus Open Resection for Hepatocellular Carcinoma: A Systematic Review, Meta-Analysis and Meta-Regression
Authors: Gujjuri Rohan R , Kamarajah Sivesh K , Hilal Moh’d Abu , Manas Derek M , White Steven A 
Published: April 2021

Abstract

Introduction
Minimally invasive liver surgery (MILS) for hepatocellular carcinoma (HCC) has gained widespread interest as an alternative to conventional open liver surgery (OLS). However, long-term survival benefits of this approach seem unclear. This meta- analysis was conducted to investigate long-term survival following MILS.

Methods
A systematic review was performed to identify studies comparing long-term survival after MILS and OLS until January 2020. The I2 test was used to test for statistical heterogeneity and publication bias was assessed using Egger test. Random-effects meta-analysis was performed for all-cause 5-year (main outcome) and 3-year mortality, and disease-specific 5-year and 3-year mortality. Meta-regression was performed for the 5-year and 3-year survival outcomes with adjustment for study factors (region, design), annual center volume, patient factors (ASA grade, gender, age, BMI, cirrhosis, tumor size and number), and resection extent. Sensitivity analyses were performed on studies by study year, region, annual centre volume, resection type.

Results
The review identified 50 relevant studies including 13,731 patients undergoing liver resection for HCC of which 4,071 (25.8%) underwent MILS. Pooled analysis revealed similar all-cause (OR: 0.83, 95% CI: 0.70 - 1.11, p = 0.3) and disease-specific (OR: 0.93, 95% CI: 0.80 - 1.09, p = 0.4) 5-year mortality after MILS compared with OLS. Sensitivity analysis of published studies from 2010 to 2019 demonstrated a significantly lower disease-specific 3-year mortality (OR 0.75, 95% CI: 0.59 - 0.96, p = 0.022) and all cause 5-year mortality (OR 0.63, 95% CI: 0.50 - 0.81, p = 0.002). Meta- regression identified no confounding factors in all analyses.

Conclusions
Improvement in MILS techniques over the past decade appears to demonstrate superior disease-specific mortality with MILS compared to OLS. Therefore, MILS can be recommended as a standard surgical approach for HCC.
P87 Paradigms about the COVID-19 pandemic: knowledge, attitudes and practices from medical students
Authors: Lincango-Naranjo Eddy , Solis-Pazmino Paola 
Published: April 2021

Abstract

Introduction
As new coronavirus has spread globally, economic instability in healthcare systems has been significant. This reality is especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors have led it to face the most aggressive outbreak in Latin America. In this context, the participation of medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent need that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes and practices in Ecuadorian final year medical students in order to identify the knowledge gaps, perceptions and behavior patterns which could guide the desig3n of better medical education curricula regarding COVID-19.

Methods
This descriptive 33-item online survey conducted between April 6 to April 20 sent by email and by Facebook and WhatsApp.

Results
309 students responded to the survey. 88% scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID19 in Ecuador and volunteering during the outbreak (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment or training in their health facilities.

Conclusions
Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Creating a national curriculum may be one of the most effective ways for all students to be trained, while simultaneously focusing on the students’ most pressing concerns.
P91 Phyllodes Tumours: Looking for Predictive Features from Multidisciplinary Assessments
Authors: Kandiyil Aneeshya , Guan Yue 
Published: April 2021

Abstract

Introduction
The breast triple assessment enables rapid evaluation of breast abnormalities. Lesions are assessed via the assessments based on clinical examination, imaging and histological sampling. Fibroepithelial lesions (FELs) are amongst the most common breast lesions of uncertain malignant potential. They encompass a spectrum of entities ranging from benign fibroadenomas (FA) to malignant phyllodes tumours (PT), with contrasting clinical management approaches. Unfortunately, the distinction between various FELs is often difficult, despite recent diagnostic advances. This is especially so between FAs and PTs. Nevertheless, understanding how to prioritise key characteristics of PTs, both radiologically and histologically may ease this challenge. In our opinion, a multidisciplinary approach including radiological input is probably the most helpful in reaching an accurate diagnosis.

Methods
We, retrospectively studied data from breast lesions which were initially diagnosed pre-operatively as R3/B3 FELs, and those with a final diagnosis of PT on excision. 71 suitable cases were identified from 2009 to 2019. Information was extracted from reports made by specialists at the pre-operative and post-excision stages. Statistical analysis will be applied to quantify the significance of features evaluated.

Results
Preliminary results suggest diagnoses made by pathologists on pre-operative samples correlated well with the eventual final diagnosis made on post-operative specimens. Adequate sampling appears to be a significant factor in influencing the pre-operative core biopsy diagnosis.

Conclusion
We anticipate to acquire a comprehensive knowledge of various predictive features of PTs, and the correlation between the key radiological features, thereby allowing accurate pre-operative diagnosis of these interesting and challenging lesions.
P98 Quality Improvement Project: Improving documentation and junior doctor confidence on COVID-19 ward rounds using a ward round pro forma
Authors: Brown Niall , Horne Joseph , Low Andrew 
Published: April 2021

Abstract

Introduction.
Templates and checklists have improved patient outcomes in multiple settings.1,2 There are barriers in junior doctors scribing complete entries using blank sheets; patient care might suffer due to incomplete records. This project implemented a ward round pro-forma across three wards of a tertiary hospital containing high risk COVID-19 patients, aiming to improve both documentation rates and subsequent ease in finding pertinent information.

Methods.
Respiratory consultants determined 11 key parameters that should be documented daily for COVID-19 patients.
Baseline objective data collection analysed all high-care ward round entries (n = 15), recording parameters as present or absent. Multidisciplinary team (MDT) opinions were collected via questionnaire. The pro-forma was trialled for two-weeks; repeated subjective and objective analysis was performed. All (n = 12) inpatient notes on the COVID-19 high-care ward were analysed.

Results/Discussion.
Pro-forma compliance was 100%. The mean number of key parameters documented per ward round entry increased by 80%, from 5 to 9. Eleven (100%) of the key parameters showed increased completion rates (fig.1). Junior doctor confidence increased 1-Likert point: ‘average’ to ‘confident’ (fig.2). 97% of respondents (n = 31) reported the pro forma saved time. Information finding and swab tracking both increased by 1-Likert point: ‘average’ to ‘easy’ (fig.2). From a medico-legal perspective, documentation of basic information (date, time) improved by 13%. This project shows not only a 60% increase in ceiling of care documentation, but also improved ease in accessing such information.

Conclusion.
This pro-forma is a simple and acceptable intervention to improve documentation rates and information accessibility, giving junior doctors more confidence.
P101 Remote risk stratification of dyspnoea in acute respiratory disorders and applications for COVID-19 and future pandemics: a systematic review of the literature
Authors: Dominic Catherine , Khare Yuti , Ponnapalli Anuradha , Ganesh Shivani , Bhalla Gaurav , Gokani Shyam 
Published: April 2021

Abstract

Background
Due to the highly infectious nature of the disease, a large amount of community-based triage of COVID-19 is performed by video/telephone consultation, especially in primary care. This presented clinicians with a new challenge in risk stratification of patients with dyspnoea due to suspected COVID19.
This review searched existing literature to identify existing modalities to remotely assess patients with acute respiratory distress, which can be adapted for the COVID-19 pandemic and in future similar situations.

Methods
We conducted a systematic search of Medline, Embase and Medrxiv for studies of the remote assessment of dyspnoea in acute respiratory disorders in adults/children. The study was registered on PROSPERO (ID: CRD42020202292): 3014 abstracts were screened independently by two reviewers and 32 studies were progressed to full text screening.

Results
Five studies were selected for review, including 1317 patients. Two studies assessed video consultation, two assessed telephone related triage tools, and one study assessed an online triage tool for dyspnoea. In one study, video consultation was found to have 83% sensitivity for diagnosing ‘severe’ respiratory distress in comparison to face-to-face assessment. The online triage tool was found to have 87.5% sensitivity for detecting dyspnoea requiring emergency level care.

Conclusion
A range of successful remote risk stratification tools and clinical features were identified for assessing dyspnoea severity which can be adapted to COVID-19 and future pandemics to assess respiratory distress via telemedicine. These findings will influence development of comprehensive evidence-based tools to assess dyspnoea which will reduce resource strain during current/future pandemics.

References
Loinaz C, Marcacuzco A, Fernández-Ruiz M, Caso O, Cambra F, San Juan R, et al. Varied clinical presentation and outcome of SARS-CoV-2 infection in liver transplant recipients: Initial experience at a single center in Madrid, Spain. Transpl Infect Dis Off J Transplant Soc. 2020 Jun 20;e13372.