bluuebunny/crossref_metadata_2025_split huggingface dataset:
1463 One Urology Unit’s Experience With Holmium Laser Enucleation Of The Prostate(Holep)
Authors: James G , Bryant D 
Published: October 2021

Abstract

Introduction
Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure for the management of Benign Prostatic Hyperplasia and Bladder Outlet Obstruction. The European Associations of Urologists (EAU) recommend HoLEP should be offered to patients with prostates measuring &gt;30cc or who are anticoagulated

Aim
To review the outcomes of one-unit HoLEP procedures. Comparing the first third of patients to the final third of patients in a 183-patient cohort.

Method
We collected data retrospectively over 44-month period from 183 patients using electronic patient records. Outcomes measured; length of stay (los), length of time for catheter. Length of time of procedure. comparing the 1st 61 patient with the last 61 patients and reviewed rates of complications from HoLEP using the Clavien-Dindo classification

Results
The mean size of prostate was 83cc. 149 (81%) of patients had a LOS of £ 1 day. The mean length of catheter time 3.44 days. Mean length of operating time – 71 minutes. Length of time for the 1st 61 patients was 70.2 minutes compared with 73.1 minutes for last 61 patients. With regards to complications, 8 patient had Grade 3 however 0 patients had grade 4 or 5.

Conclusions
Patients undergo HoLEP procedure with Prostate size in keeping with EAU. This unit has a short length of stay post-op with low complication rate. HoLEP has a short post op catheter time.
1604 Infection and Morbidity After Local Anaesthetic Intravesical Botox Treatment Without Prophylactic Antibiotics
Authors: Satherley H , Parkinson R 
Published: October 2021

Abstract

Aim
Intravesical Botulinum Toxin Type A (BoNT-A) is a common treatment for overactive bladder symptoms refractory to anticholinergic and beta-3 agonist medications. Urinary tract infection rates of &lt; 10% are commonly reported for flexible cystoscopy. We aimed to establish whether local anaesthetic flexible cystoscopy BoNT-A treatment could be performed with an acceptable rate of infection and morbidity without prophylactic antibiotics.

Method
Prospective audit of patients treated with local anaesthetic intravesical BoNT-A over 8 weeks. A telephone questionnaire was administered at 10 to 17 days post-procedure assessing symptoms, infection and antibiotic use. Electronic records were used to review pre-procedure urine analysis and post-procedure urine culture. Antibiotic use and positive cultures within 10 days were considered significant.

Results
51 (76%) of the 67 patients treated were contacted by telephone. These consisted of 41 female and 10 male patients with mean (range) age of 58 (25 to 86) years. 35 (69%) reported being asymptomatic or having symptoms as expected and 2 (4%) patients reported symptoms worse than expected following the procedure. 14 (27%) reported having a urinary tract infection with 9 (18%) provided with antibiotics. Positive urine cultures were present in 5 (10%) patients. Pre-procedure urine analysis, patient age, history of recurrent infection and catheter use did not predict post-procedure urinary tract infection.

Conclusions
Patients reported higher levels of infection and antibiotic use than expected. Patients should be well counselled about symptoms and complications to minimise antibiotic use. Further work is planned to establish whether prophylactic antibiotics will reduce symptomatic infections, antibiotic use and healthcare interactions post-procedure.
708 A 360 Degree Exploration of Key Factors in Consent in Aortic Aneurysm Repair
Authors: Rolls A , Guni A , Sharp B , Rajgopal A , Normahani P , Jenkins M , Jaffer U 
Published: October 2021

Abstract

Introduction
Shared decision making is the gold standard for treatment decisions. Although there is an evidence base to recommend either open surgical repair or endovascular repair (EVAR) for patients with abdominal aortic aneurysms (AAA) based on individual outcome factors, there is scope for choice depending on subjective factors. This study aims to identify key factors to be addressed in the consent process using a 360-degree exploration.

Method
A literature search conducted on Medline and Embase databases identified 13 key factors, which were formulated into questions with five-point Likert scales. Seven vascular surgeons, two interventional radiologists, two vascular anaesthetists, two intensivists, one vascular physician, and five patients who underwent either open surgical repair or EVAR were interviewed in a semi-structured manner. Descriptive statistical analysis was performed to identify the importance of each factor.

Results
The most important factors for clinicians and patients were “pre-existing medical conditions” and “risk of post-operative complications”. The least important factors were “need for follow-up appointments” and “post-operative pain”. Patients placed the most importance on “type of anaesthetic used”, and relatively less importance on “length of hospital stay” and “probability of admission to ICU”. Analysis of free-flowing answers yielded another 14 factors. Factors were grouped into “surgical focus”, “medical and perioperative focus” and “patients and communication”.

Conclusions
There is heterogeneity in the importance given to factors between clinicians and patients. The factors identified from this 360-degree assessment should be integrated into formal topics of discussion in the consent process to support patients in making informed decisions regarding AAA treatment.
1705 Mortality Following Major Lower Extremity Amputation in People with And Without Diabetes in Scotland 2004-2013
Authors: Murgitroyd E , Yao X , Kerssens J , Walker J , Wild S 
Published: October 2021

Abstract

Aim
To describe short and longer-term mortality following major lower extremity amputation (LEA) by diabetes status over two time periods

Method
A retrospective cohort study of patients who underwent major LEA between 2004 and 2013 was conducted based on linkage of national population-based hospital records and a register of people with diagnosed diabetes. Post-operative mortality was estimated at 30 days, one year and where available, five years. Using logistic regression models, we estimated the odds of death associated with diabetes adjusted for age, sex and socio-economic status within these time points compared to the non-diabetic population stratified by type of diabetes and five-year calendar periods.

Results
There were a total of 5436 people who received an amputation during the study period of whom approximately 40% had diabetes. Overall mortality for the 2004-8 and 2009-13 cohorts respectively was not significantly different at 7.9% and 7.3% at 30 days and 31% and 27% at one year. Almost 64% of the 2004-8 cohort were dead within five years. The only statistically significantly associations between diabetes and mortality were observed within five-year follow-up of the 2004-8 cohort with odds ratios (95% CI) compared to the non-diabetic population of 1.62 (1.17, 2.26) for type 1 diabetes and 1.38 (1.14, 1.66) for type 2 diabetes.

Conclusions
An adverse association between diabetes and mortality after LEA only became apparent in longer term follow-up.
996 Non ST Elevation Myocardial Infarction (NSTEMI) And Complex Coronary Artery Fistula In A Fit 57 Year Old Man And Its Management
Authors: Malik M I K 
Published: October 2021

Abstract
A fit 57-year-old man presented with exertional chest pain to the emergency department and was found to have anterolateral T wave inversion on ECG and blood troponin of 1290. Coronary angiography showed a severe proximal to mid-course lesion in the mid left anterior descending artery (LAD), severe ostial disease in obtuse marginal 1 (OM1) and large a coronary artery fistula (CAF) between the proximal LAD and main pulmonary artery (PA). Subsequent cardiac computer tomography multiple gated acquisition (CT MUGA) scan showed a coronary artery to main PA fistula, fed by small branches of the LAD and right coronary artery (RCA). Cardiac magnetic resonance (CMR) showed preserved left ventricle systolic function, ejection fraction 62%, and small left to right shunt. Following multidisciplinary discussion, the consensus was to offer coronary artery bypass grafting (CABG) and fistula ligation as the first option, but percutaneous intervention (PCI) to the LAD would also be feasible. After lengthy discussions, the patient declined CABG and opted for PCI and stent insertion.
CAF on angiogram is a rare finding, CAF is an abnormal connection between a coronary artery and either a cardiac chamber or a great vessel including the pulmonary artery. This case highlights a rare finding and its subsequent investigative workup and management considerations.
1566 A Rare Case of Aorto-Duodenal Fistula Associated with Bacterial Meningitis
Authors: Allon O , Williams A , Blaszczynski M 
Published: October 2021

Abstract
Aorto-enteric fistula (AEF) is an extremely rare complication of aortic disease with potentially fatal outcome. AEF is defined as a fistulous connection between aorta and bowel and can be classified into primary (involving native aorta) or secondary (occurring after aortic surgery). Primary AEF is by far the less common of the two and may be associated with malignancy, radiotherapy or infection. We present a case of a 75-year-old male presenting with collapse and haemetemesis. CT imaging revealed a fistula between native aorta and duodenum. Emergency surgery was carried out but ultimately the patient did not survive. The underlying cause remains uncertain. Notably, the patient had a recent history of bacterial meningitis 6 months prior to presentation and, despite negative cultures, infection of the aortic wall was strongly suspected.
299 An Unusual Nasal Lump
Authors: Ainine A 
Published: October 2021

Abstract
A 70-year-old man received a few courses of various antibiotics for left dacrocystitis under the care of ophthalmologists. Despite the treatment, the lump was not improving. The patient, in the meantime, presented to his GP with recurrent left-sided epistaxis and it became apparent that he was also experiencing ipsilateral nasal blockage. He reported a 3-year history of left-sided tinnitus but no other red flag symptoms.
He was subsequently referred as 2-Week-Wait to ENT and nasoendoscopy revealed complete blockage of the left nostril with the postnasal space fully obstructed by enlarged mucosal tissue and no palpable lymph nodes. CT showed an aggressive locally invasive sinonasal tumour and a necrotic posterior mediastinal lesion. MRI further defined the extent of invasion and revealed a significant level 2 lymph node. A gastroscopy and EUA nose were arranged to obtain histology to confirm the differential diagnosis of sinonasal SCC.
This case highlights the importance of lateral thinking when presented with a refractory symptom, as a more sinister diagnosis can be detected earlier. It also reinforces the need for examination of surrounding anatomy that may influence the condition.
1560 Unusual Sites of Colorectal Cancer Metastases – A Complete Systematic Review
Authors: Alfred J , Altaf K , Anuar A , Williams R , Titley-Wilson G , Shah M , Ahmed S 
Published: October 2021

Abstract

Background
While colorectal cancer (CRC) usually metastasizes to liver, lungs, and central nervous system, spread to more unusual sites is rarely reported in literature. We aimed to investigate unusual colorectal metastases (UCRM), their clinical course and disease progression.

Method
MEDLINE, EMBASE and Cochrane Library were searched by independent reviewers to identify clinical studies to date that reported UCRM and relevant demographic/clinical data were extracted.

Results
We identified 349 patients, involving 28 sites (bone, musculo-skeletal, skin, brain/spinal cord, head, eye, oral mucosa, thyroid, mediastinum, heart, bronchus, breast, biliary/GI tract, stomach, pancreas, spleen, adrenal, urinary tract, inguinal canal, ovaries, vagina, vulva, testes, spermatic cord, prostate, penis) with male preponderance and median age of 59 years (IQR=54.5-65). These were diagnosed at a median interval of 18 months (IQR=6-36)) after a median follow-up of 12 months (IQR=6-22.5). More were metachronous (n = 210) with recurrence rate of 15.75%. Primary CRC staging revealed T3 in 61% (28%-T4), equal distribution of N0/N1 (38%/37%) and M0 in 85%. 74% of primaries were surgically resected (96%=adenocarcinomas) and 54% underwent adjuvant therapy. UCRM were resected in 45% of cases and showed same histology as primary. 30% had chemotherapy. Only 8% were palliated. Overall morality was 35.24%.

Conclusions
This is the first comprehensive review looking at clinical course and outcomes of patients with UCRM. Most of these developed in patients with primary T3/N0 staging. Outlook of these patients is comparable to those with usual metastatic disease. Judicious and rigorous surveillance is the key to early detection and timely management.
Resting Hypoconnectivity of Theoretically Defined Addiction Networks during Early Abstinence Predicts Subsequent Relapse in Alcohol Use Disorder
Authors: Camchong J , Haynos A F , Hendrickson T , Fiecas M B , Gilmore C S , Mueller B A , Kushner M G , Lim K O 
Published: October 2021

Abstract
Theoretical models of addiction suggest that alterations in addiction domains including incentive salience, negative emotionality, and executive control lead to relapse in alcohol use disorder (AUD). To determine whether the functional organization of neural networks underlying these domains predict subsequent relapse, we generated theoretically defined addiction networks. We collected resting functional magnetic resonance imaging data from 45 individuals with AUD during early abstinence (number of days abstinent M = 25.40, SD = 16.51) and calculated the degree of resting-state functional connectivity (RSFC) within these networks. Regression analyses determined whether the RSFC strength in domain-defined addiction networks measured during early abstinence predicted subsequent relapse (dichotomous or continuous relapse metrics). RSFC within each addiction network measured during early abstinence was significantly lower in those that relapsed (vs. abstained) and predicted subsequent time to relapse. Lower incentive salience RSFC during early abstinence increased the odds of relapsing. Neither RSFC in a control network nor clinical self-report measures predicted relapse. The association between low incentive salience RSFC and faster relapse highlights the need to design timely interventions that enhance RSFC in AUD individuals at risk of relapsing faster.
Detecting Urban Anomalies Using Factor Analysis and One Class Support Vector Machine
Authors: Lu Cong , Huang Jianbin , Huang Longji 
Published: October 2021

AbstractThe detection of anomalies in spatiotemporal traffic data is not only critical for intelligent transportation systems and public safety but also very challenging. Anomalies in traffic data often exhibit complex forms in two aspects, (i) spatiotemporal complexity (i.e. we need to associate individual locations and time intervals formulating a panoramic view of an anomaly) and (ii) multi-source complexity (i.e. we need an algorithm that can model the anomaly degree of the multiple data sources of different densities, distributions and scales). To tackle these challenges, we proposed a three-step method that uses factor analysis to extract features, then uses the goodness-of-fit test to obtain the anomaly score of a single data point and then uses one class support vector machine to synthesize the anomaly score. Finally, we conduct extensive experiments on real-world trip data include taxi and bike data. And these extensive experiments demonstrate the effectiveness of our proposed approach.
Site form classification—a practical tool for guiding site-specific tropical forest landscape restoration and management
Authors: Do Ha T T , Zimmer Heidi C , Vanclay Jerome K , Grant John C , Trinh Bon N , Nguyen Hoang H , Nichols J Doland 
Published: October 2021

AbstractReliable estimates of forest productivity at the site scale can guide site-specific forest management. However, the best methods to evaluate productivity of natural forest sites, and in particular secondary natural forests, remain undefined. In this study we: (1) applied an indirect method for estimation of the potential productivity of a forest site (‘site form’) in Dong Nai Biosphere Reserve. In addition, we: (2a) investigated the influence of a range of environmental conditions on site form, (2b) built models to estimate site form from the corresponding environmental variables and (3) generated site form maps for the region. We found that Michaelis–Menten models provided the most consistent representation of tree height–diameter relationships, with reliable anamorphic curves at both plot-scale (50 m × 20 m) and multiplot-scales. Predicted tree height at 25-cm diameter (H25) was selected as the best indicator for site form as 25 cm was both a tree size, which was common in the forests, and for which height could be accurately predicted. H25 was significantly correlated with site environmental conditions, with the dominant influences being factors related to water availability. We generated site form maps for Dong Nai province based on the relationship between known environmental variables and H25. We conclude that maps such as these could have broad application in guiding tropical forest restoration measures elsewhere, particularly where there is limited knowledge of tree ages and species.
Entropy of Monomial Algebras and Derived Categories
Authors: Lu Li , Piontkovski Dmitri 
Published: October 2021

Abstract
Let $A$ be a finitely presented associative monomial algebra. We study the category $\textsf{qgr}(A)$, which is a quotient of the category of graded finitely presented $A$-modules by the finite-dimensional ones. As this category plays a role of the category of coherent sheaves on the corresponding noncommutative variety, we consider its bounded derived category $\textbf{D}^b(\textsf{qgr}(A))$. We calculate the categorical entropy of the Serre twist functor on $\textbf{D}^b(\textsf{qgr}(A))$ and show that it is equal to the (natural) logarithm of the entropy of the algebra $A$ itself. Moreover, we relate these two kinds of entropy with the topological entropy of the Ufnarovski graph of $A$ and the entropy of the path algebra of the graph. If $A$ is a path algebra of some quiver, the categorical entropy is equal to the logarithm of the spectral radius of the quiver’s adjacency matrix.
Analysis of Severe Acute Respiratory Syndrome 2 Replication in Explant Cultures of the Human Upper Respiratory Tract Reveals Broad Tissue Tropism of Wild-Type and B.1.1.7 Variant Viruses
Authors: Schulze Jessica , Mache Christin , Balázs Anita , Frey Doris , Niemeyer Daniela , Olze Heidi , Dommerich Steffen , Drosten Christian , Hocke Andreas C , Mall Marcus A , Hippenstiel Stefan , Wolff Thorsten 
Published: October 2021

Abstract

Background
The upper respiratory tract (URT) is the primary entry site for severe acute respiratory syndrome 2 (SARS-CoV-2) and other respiratory viruses, but its involvement in viral amplification and pathogenesis remains incompletely understood.

Methods
In this study, we investigated primary nasal epithelial cultures, as well as vital explanted tissues, to scrutinize the tropism of wild-type SARS-CoV-2 and the recently emerged B.1.1.7 variant.

Results
Our analyses revealed a widespread replication competence of SARS-CoV-2 in polarized nasal epithelium as well as in the examined URT and salivary gland tissues, which was also shared by the B.1.1.7 virus.

Conclusions
In our analyses, we highlighted the active role of these anatomic sites in coronavirus disease 2019.
Type I interferon production elicits differential CD4+ T-cell responses in mice infected withPlasmodium bergheiANKA andP. chabaudi
Authors: Ntita Mbaya , Inoue Shin-Ichi , Jian Jiun-Yu , Bayarsaikhan Ganchimeg , Kimura Kazumi , Kimura Daisuke , Miyakoda Mana , Nozaki Eriko , Sakurai Takuya , Fernandez-Ruiz Daniel , Heath William R , Yui Katsuyuki 
Published: October 2021

AbstractAbstractPlasmodium parasites that infect humans are highly polymorphic, and induce various infections ranging from an asymptomatic state to life-threatening diseases. However, how the differences between the parasites affect host immune responses during blood-stage infection remains largely unknown. We investigated the CD4+ T-cell immune responses in mice infected with P. berghei ANKA (PbA) or P. chabaudi chabaudi AS (Pcc) using PbT-II cells, which recognize a common epitope of these parasites. In the acute phase of infection, CD4+ T-cell responses in PbA-infected mice showed a lower involvement of Th1 cells and a lower proportion of Ly6Clo effector CD4+ T cells than those in Pcc-infected mice. Transcriptome analysis of PbT-II cells indicated that type I interferon (IFN)-regulated genes were expressed at higher levels in both Th1- and Tfh-type PbT-II cells from PbA-infected mice than those from Pcc-infected mice. Moreover, IFN-α levels were considerably higher in PbA-infected mice than in Pcc-infected mice. Inhibition of type I IFN signaling increased PbT-II and partially reversed the Th1 over Tfh bias of the PbT-II cells in both PbA- and Pcc-infected mice. In the memory phase, PbT-II cells in PbA-primed mice maintained higher numbers and exhibited a better recall response to the antigen. However, recall responses were not significantly different between the infection groups after re-challenge with PbA, suggesting the effect of the inflammatory environment by the infection. These observations suggest that the differences in Plasmodium-specific CD4+ T-cell responses between PbA- and Pcc-infected mice were associated with the difference in type I IFN production during the early phase of the infection.
CREG1 administration stimulates BAT thermogenesis and improves diet-induced obesity in mice
Authors: Kusudo Tatsuya , Okada Tadashi , Hashimoto Michihiro , Takeuchi Tamaki , Endo Yuki , Niwa Ayumi , Yamashita Hitoshi 
Published: October 2021

Abstract
Brown and beige adipocytes, which express thermogenic uncoupling protein-1 (UCP1), stimulate glucose and lipid metabolism, improving obesity and metabolic diseases such as type 2 diabetes and hyperlipidemia. Overexpression of cellular repressor of E1A-stimulated genes 1 (CREG1) promotes adipose tissue browning and inhibits diet-induced obesity (DIO) in mice. In this study, we investigated the effects of CREG1 administration on DIO inhibition and adipose browning. Subcutaneous administration of recombinant CREG1 protein to C57BL/6 mice stimulated UCP1 expression in interscapular brown adipose tissue (IBAT) and improved DIO, glucose tolerance and fatty liver compared with those in phosphate-buffered saline-treated mice. Injection of Creg1-expressing adenovirus into inguinal white adipose tissue (IWAT) significantly increased browning and mRNA expression of beige adipocyte marker genes compared with that in mice injected with control virus. The effect of Creg1 induction on beige adipocyte differentiation was supported in primary culture using preadipocytes isolated from IWAT of Creg1-transgenic mice compared with that of wild-type mice. Our results indicate a therapeutic effect of CREG1 on obesity and its associated pathology and a potential of CREG1 to stimulate brown/beige adipocyte formation.