bluuebunny/crossref_metadata_2025_split huggingface dataset:
P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer)
Authors:   Global Children’s NCDs
Published: April 2021

Abstract

Introduction
Childhood cancers are a leading cause of non-communicable disease deaths for paediatric patients around the world. The COVID-19 pandemic may have impacted on global children’s cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children’s Non-Communicable Diseases (Global Children’s NCDs) is currently undertaking the first international study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short to medium term impacts on childhood cancer outcomes.

Methods and analysis
This is a multicentre, international, cohort study that will use routinely collected hospital data in a de-identified and anonymised form. Patients will be recruited consecutively into the study, with a 12 -month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anti-cancer treatment for the following cancers: Acute lymphoblastic leukaemia, Burkitt’s Lymphoma, Hodgkin's lymphoma, Wilms Tumour, Sarcoma, Retinoblastoma, Gliomas, Medulloblastomas and Neuroblastomas. Patients must be newly presented or be undergoing active anti-cancer treatment from the 12th March 2020 to the 12th December 2020. The primary objective of the study is to determine 30- and 90-day all-cause mortality rates. This study will examine the factors that influenced these outcomes. Chi-squared analysis will be used to compare mortality between low and middle-income countries and high-income countries. Multilevel, multivariate logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors.

Ethics and dissemination
At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally, and internationally. The results will be submitted for publication in a peer reviewed journal.
P19 An audit to improve ENT SHO confidence in using Floseal in the management of epistaxis
Authors: Ringrose T , Crossley E 
Published: April 2021

Abstract

Background
Departmental guidelines regarding the management of epistaxis were adapted to deal with the additional challenges presented during the Covid-19 pandemic. One of these adjustments involved the increasing use of haemostatic sealants such as Floseal in the management of epistaxis allowing reduced admission rates and hospital stay lengths for patients therefore reducing their risk of exposure to Covid-19.

Aims
To improve SHO’s confidence in using Floseal in the management of epistaxis.

Methods
A primary online survey was conducted to assess local ENT SHO’s confidence in making up and using haemostatic Floseal in the management of epistaxis. The SHO’s were then given teaching on how to make up Floseal and a poster including pictures was created. A secondary online survey was performed to re-audit the SHO’s confidence following this intervention.

Results
Of the 10 respondents, 3 had previous experience in using Floseal. Pre intervention the average confidence rating on a scale of 1 to 5 (5 – Most confident) in drawing up Floseal was scored at 2. Following teaching and implementation of the new poster the average confidence rating was scored at 4.4 (a 48% increase). From the respondents, 90% expressed that they found the poster useful and that they would also find further teaching on the use of Floseal beneficial in the future.

Conclusion
Teaching and creation of a clear stepwise poster including photographs improved ENT SHO’s confidence in drawing up Floseal. Ongoing education will be given to new juniors to ensure long-standing improvement.
P24 Audit reviewing viability of removing pre-operative Group and Save Tests prior to Transurethral Prostate Surgery during the COVID19 pandemic
Authors: Wong Nicholas 
Published: April 2021

Abstract

Introduction
COVID19 has stressed and stretched healthcare resources to the limit, thus the rational deployment of any resource should be necessary and of patient benefit. This retrospective audit aims to ascertain if a policy of two valid group and save tests prior to transurethral prostate surgery is necessary and if this resource can be redistributed safely during the ongoing pandemic.

Methods
A retrospective review of electronic patient records for patients that underwent transurethral prostate surgery from June 2017 to June 2018. During a single admission for surgery it was identified how many pre-operative group and save tests, and if a post-operative blood transfusion patients underwent.

Results
146 patients underwent transurethral prostate surgery between June 2017 to June 2018.
97 patients had two valid group and save tests prior to surgery. 49 patients did not have 2 valid group and save tests. 21 patients had expired tests, 20 had only one valid sample, and 8 had no group and save test at all.
No patient underwent a blood transfusion during their admission for transurethral prostate surgery.

Conclusion
This single centre study illustrates pre-operative group and save tests before transurethral prostate surgery are unnecessary as no patient required an associated blood transfusion during admission; and can safely be omitted. The clinical time and resource could be redirected elsewhere for greater patient benefit. £2855.00 of efficiency savings could be made foregoing unneeded group and save tests.
A policy omitting pre-operative group and save before transurethral prostate surgery will be implemented under COVID19 pandemic conditions and re-audited in 6 months.
P26 Barriers and Facilitators to Help-Seeking for Common Mental Disorders among University Students: A Systematic Review
Authors: Lui Joyce , Brown June 
Published: April 2021

Abstract

Background
High rates of mental health illness affect university students, most commonly depression and anxiety. Despite this, help-seeking behaviours are extremely low. This is the first systematic review aiming to summarise the barriers and facilitators to help-seeking for depression and/or anxiety among university students.

Methods
Three databases, EMBASE, MEDLINE and PsychINFO were searched for studies reporting barriers and facilitators to help-seeking for university students with depression and/or anxiety. In order to review data from both qualitative and quantitative studies, information on barriers and facilitators were coded into themes.

Results
Ten final papers were included; four qualitative and six quantitative. The most prominent barriers were self-reliance, stigma, physical barriers, poor awareness of mental health symptoms, poor knowledge of services and effectiveness, and symptom severity. Although there was significantly less research on facilitators, common facilitator themes were good mental health literacy and encouragement or pressure from others to seek help.

Conclusions
A recommendation from this review is the need to explore self-reliance as a barrier to help-seeking as this was the most commonly barrier, but a little researched area. Another recommendation is that more research is undertaken to investigate the facilitators to help-seeking. Clinical recommendations include using the internet to provide support and information on mental health disorders and services, implementing anti-stigma workshops in universities and integrating family members, partners, and friends into an individual’s mental health care. It is hoped that the findings from this review will be used to improve mental health services to address poor help-seeking behaviours among this student population.
P46 Effect of the COVID-19 pandemic on hip fracture patients in a Teaching London Hospital
Authors: Umarji Shamim , Sturley Rhonda , Tsinaslanidis Prodromos , Hing Caroline B 
Published: April 2021

Abstract

Introduction
Hip fractures are the commonest serious injury in older people, the commonest reason for older people needing surgery and the commonest cause of death following an accident. The NHFD is a national database whereby markers of care are recorded prospectively for patients over 60 years sustaining a hip fracture and requiring inpatient care, with a Best Practice Tariff linked to key performance indicators. The aim of this study was to review how care varied for patients sustaining a hip fracture during the COVID-19 pandemic compared to the equivalent time last year.

Methods
Using the NHFD we compared data from March – May 2019 to the same period in 2020 during the pandemic at St George’s Hospital. The study provides a snapshot of care during the pandemic.

Results
There were more admissions and more discharges during the pandemic. There was an increase in time to theatre and subsequent reduction in BPT. There was also an increase in non- operative treatment for these patients. 6 patients were confirmed COVID-19 positive, one of whom died. There was a reduction in time to ortho-geriatrician review and also a reduction in delirium review post-operatively. Length of stay was also reduced.

Conclusion
The COVID-19 pandemic had an effect on care provided to hip fracture patients. There was an increase in time and a deterioration in orthogeriatric review within 72 hours. The length of stay however improved due to improved focus on pathways and discharge processes. There was also a lower threshold to offer non- operative care wherever possible.
P47 Evaluating the Relationship of Pre-Assessment Host Systemic Inflammatory Response Biomarkers (Neutrophil Lymphocyte Ratio) to Post-Operative Infective Complication Risk in Colorectal Cancer Resection
Authors: Cooper Gordon , Knight Katrina , Bain Pamela , McLellan Morag , Torpiano Giuliana , Stewart Brian 
Published: April 2021

Abstract

Introduction
The host systemic inflammatory response (SIR) is prognostic in a wide variety of solid tumours, with a greater degree of inflammation being associated with a worse clinical outcome. Neutrophil Lymphocyte Ratio (NLR) is an established way to measure SIR in vivo. We aimed to establish whether preoperative NLR correlates with infective complications in patients undergoing colorectal cancer (CRC) resection.

Methods
Data was extracted retrospectively for all CRC resections over a 2 year period (2016-2018) at a single district general hospital. NLR was measured for each patient from bloods at the time of pre-operative assessment. Post-operative complications were recorded using the Clavien-Dindo classification and subsequently classified as infective and non-infective. A Two-tailed Mann-Whitney U test was used to evaluate the data from an online resource.

Results
Of the 131 patients, 49 had complications of which 20 were infective. Of total complications 58% were male and 35% were aged 75 years or older. Current or ex-smokers constituted 43% and 41 of the total patients had a BMI &gt;30 kg/m2. Pre-assessment mean NLR was 2.3 in those without complications and 4.7 in those with any complication. A mean NLR of 5.4 was present in those with infective complications, p-value 0.026.

Conclusion
This study found that a raised NLR was present preoperatively in those who developed infective complications following CRC resection. This is a simple, readily available and cost-effective method of identifying patients at risk of complication. This ultimately may be useful in highlighting patients who would benefit from enhanced pre-operative optimisation. Further research to validate these findings in larger studies would seem warranted.
P49 Exploring medical student confidence in social media health advocacy through the lens of a pandemic
Authors: Veerappan Vigneshwar Raj , Begum Ruksana , Raja Abdullah , Quddus Tanjim , Senan Rahul 
Published: April 2021

Abstract

Introduction
Social media facilitates the rapid spread of information and misinformation to the public. Medical students as healthcare professionals in training have a responsibility to support public health advocacy. As such, it is important to understand whether medical students feel comfortable to use social media as a tool to promote public health. There is little literature evaluating this. The covid-19 pandemic gives us a unique opportunity to characterise this relationship.

Methods
This is a cross sectional survey-based study run by the student surgical society at Hull York Medical School. Data will be collected on confidence of medical students in receiving, appraising and resharing information on social media. The study will first be run as a single centre study. Following data collection and analysis, will be promoted to other student surgical societies across the UK to be run as a collaborative national study.

Results Primary Objective
How confident are medical students in receiving, appraising and resharing information they receive on social media?: Secondary Objective: Is there a relationship between years of training or postgraduate/undergraduate status and confidence in using social media amongst medical students? How often do medical students use social media as their primary source of information? Is there adequate education on how social media can be used to combat misinformation?: Conclusion: The covid-19 pandemic allows a unique opportunity to characterise the relationship between medical students, social media, and health advocacy. Understanding this relationship will help guide medical education to incorporate social media as an effective tool in healthcare.
P51 External Ventricular Drainage Insertion Audit
Authors: Lopuszko Aleksandra , McKenna  , Rosmarin Yordanov 
Published: April 2021

Abstract

Introduction
External Ventricular Drainage (EVD) is a neurosurgical technique used to lower the intercranial pressure while cerebrospinal fluid (CSF) flow is obstructed. The infection rate associated with the EVD insertion in the UK is 9.3%, with ventriculitis being the most common one. The aim of the audit was to compare our outcomes and infection rates and national standards and to implement an EVD Management protocol to improve patient outcome.

Methods
The data was collected from 43 patients, 98% of whom were emergency admitted cases. For all EVD procedures, silver coated catheters were used. The surgical factors such as the surgical team performance and the average operative time (1h 11min) were accounted for in the audit. The most common reason for EVD insertion was subarachnoid haemorrhage. Prophylactic antibiotics were administered in all cases before the surgery. 12% of the EVDs were used for Intercranial Pressure Monitoring.

Results
12% patients’ samples had catheter associated infections. The average EVD insertion period was 18 days. Leaks occurred in 11 cases (26%). 3 of them subsequently developed ventriculitis. White cell count result was over 10,000 cells per mm3 in 40% of patients.

Conclusions
Twice longer sampling time then the national average (8 days) increased the number of ITU transfers. The cause would be the use of out-of-date EVD type. However, the silver impregnated lines versus non-impregnated have a lower cerebrospinal fluid infection rate, the bolt connected EVDs would be more precise and decrease the rate of resuturing and hence decrease a chance of CSF infection.
P53 First Reported Case of Successful Non-Surgical Management for Acute Small Intestinal Obstruction Caused by Enterolith as A Rare Complication of Jejunal Diverticulosis
Authors: Quek Fang Fang , Tanase Andrew 
Published: April 2021

Abstract

Introduction
Enterolith ileus is a rare complication of jejunal diverticulosis, which in itself is a rare entity. Here we report a rare case of enterolith ileus as a complication of jejunal diverticulosis which is successfully managed conservatively.

Case Report
A 75-year-old female presented with a 7- day history of “gripey” abdominal pain with intermittent vomiting. She was able to pass flatus and had open bowel with small amount of loose stool. Patient was previously fit and well with no significant past medical history and had not undergone previous abdominal surgery. On admission, patient was in no acute distress and was afebrile. On examination, she had a very distended tympanic abdomen with left-sided tenderness but no palpable mass. Bowel sounds were present. Laboratory investigations revealed a white cell count of 22.6 x109/L, C-reactive protein of 26 mg/L and haemoglobin of 144 g/L. Abdominal X-rays revealed distended loops of small bowel indicating small bowel obstruction. CT images did not reveal pneumobilia which would be suggestive of gallstone ileus but showed intraluminal small bowel obstruction secondary to an enterolith in the terminal ileum. The scan also showed an inflamed jejunal diverticulum with fat stranding around but no perforation nor abscess was seen. The working diagnosis was acute intestinal obstruction caused by jejunal enterolith expulsed from jejunal diverticulum. Since no perforation nor abscess was noted, this patient was treated conservatively. Patient recovered uneventfully and was discharged with an MRI scheduled in 4-6 weeks for follow-up. The follow-up MRI was completely normal and patient has recovered uneventfully with conservative management.

Discussion
Acute intestinal obstruction caused by jejunal enterolith expulsed from jejunal diverticulum is rare. However, it is important to diagnose jejunoileal diverticulosis timely as they may lead to acute complications which can be life- threatening and may even cause death.

Conclusion
Many cases have reported jejunoileal diverticulosis being overlooked or misdiagnosed for other acute abdominal conditions. It is important to have a clinical awareness of this condition as although rare, it can lead to life-threatening complications.
P86 PANC Study - Pancreatitis: A National Cohort Study
Authors:   PANC Study Group
Published: April 2021

Abstract

Introduction
Pancreatitis is a common, yet complex, surgical presentation with an incidence of approximately 56 cases per 100,000 people per year in the UK. The management of pancreatitis can vary significantly between different regions, hospitals or clinicians despite a number of national and international guidelines. Historic regional studies in the UK have shown management to be suboptimal with regards to time to diagnosis, higher dependency care or dynamic CT for severe cases and time to definitive treatment of gallstones.

Aim
We aim to assess current variation in practice in the management of patients diagnosed with early acute pancreatitis. This will identify areas for future research need, and give the groundwork for a potential future model of ambulatory care in a select subgroup of patients.

Study design
Pancreatitis: A National Cohort Study (PANC Study) is a multicentre, prospective cohort audit which will be conducted through trainee-led research collaboratives in Spring 2021. All patients &gt;18 years, presenting with a diagnosis of acute pancreatitis by modified Atlanta classification, will be included during the 2-month collection period. Data will only be collected for the first 30-days from presentation. The data collected will include patient demographics, admission observations and investigations, aetiology, management and complications and will be anonymised and uploaded onto an online platform for analysis.

Conclusions
Management of pancreatitis has not been previously assessed nationally in the UK. Obtaining data on population characteristics, management choices and patient outcomes will allow for resource planning so that the service provision reflects local and national population needs.
P89 Patient reported comorbidity is not a reliable data source: a systematic review of the literature
Authors: Lin Chung Mun Alice , Ng Nathan , Orman Alexander , Clement Nicholas D , Deehan David J 
Published: April 2021

Abstract

Introduction
There is currently an increased demand for elective orthopaedic surgery. However, due to the ever-growing financial, time and resource limitations, there is a pressing need to identify those who would benefit most from surgery but with the lowest risk of complications. Comorbidities are a fundamental factor in this decision and the traditional way to ascertain this is through medical record data abstraction during pre-operative assessment. However, this can be time consuming and expensive. We therefore set out to establish whether patient reported comorbidities are reliable as a principal source of information.

Method
Searches were performed on PubMed and Medline, and citations independently screened. Included studies were published between 2010 to 2020 assessing the reliability of at least one patient reported comorbidity against their medical record or clinical assessment as gold standard. Cohen’s kappa coefficient values were grouped into systems and a meta-analysis performed comparing the reliability between studies.

Results
Meta-analysis data showed poor-to-moderate reliability for diseases in cardiovascular, musculoskeletal, neurological and respiratory systems as well as for malignancy and depression. Endocrine diseases showed good-to-excellent reliability. Factors found to affect the concordance included sex, age, ethnicity, education, living alone, marital status, number or severity of comorbidities, mental health and disability.

Conclusion
Our study showed poor-to-moderate reliability for all systems except endocrine, consisting of thyroid disease and diabetes mellitus, which demonstrated good-to-excellent reliability. Although patient reported data is useful and can facilitate a complete pre-operative overview of the patient, it is not reliable enough to be used as a standalone measure.