bluuebunny/crossref_metadata_2025_split huggingface dataset:
1144 ‘Lite’ Delisting – Enabling Kidney Transplant for Highly Sensitised Patients in the Deceased Donor Waiting Pool
Authors: Ashton G , Kessaris N , Game D , Dorling A , Barnett N , Shaw O 
Published: August 2024

Abstract
Very highly sensitised patients without living donors are unlikely to receive a transplant due to lack of compatible donors. Lite delisting involves removing certain unacceptable antigens from patients’ profiles registered with NHSBT; to achieve a crossmatch negative, antibody positive offer. This project reviews the delisting programme in our centre.
The lite delisting programme was initiated in 2018. Patients included in this report were those currently active in the delisted programme and those transplanted since the initiation of the programme. Electronic patient records were reviewed to identify the number of organ offers received. For transplanted patients, clinical outcomes were retrieved.
37 patients received a total of 79 deceased donor offers over the time-period. 19 transplants were completed, 18 in the context of delisting (Alemtuzumab induction). 60 offers were declined (19 because of positive crossmatch results). Of the 19 (10 Female, 9 Male; average 44 years) patients transplanted, 18 had reached a 3-month time point post-transplant. Death censored allograft survival at 3 months was 15 (83%); 1 patient died following a period of primary non-function, two were alive with failed allografts (1 explanted for ischaemia and 1 primary non-function). 1/18 (6.7%) was diagnosed with acute antibody-mediated rejection (graft survived); there were no recorded episodes of T-cell mediated rejection. Mean creatinine of functioning grafts at 3 months post-transplant was 165µmol/L (n=15).
Lite delisting is an effective method to allow highly sensitised patients to receive transplants, avoiding the long-term risks of dialysis; although, there are associated risks of transplantation. This methodology could be considered in further Transplant Units.
314 Communication With Parents and Post-Operative Clinical Review by Operating Team in Paediatric Trauma
Authors: Nelson A , Suibhne P M , Madhu R , Kadambande S 
Published: August 2024

Abstract

Aim
Communication is one of the key GMC principles and is particularly important when discussing perioperative plans in paediatric trauma. Parents often have consented to multiple procedures for their child, and it is imperative they are informed post operatively on the procedure performed in theatre. The aim is to identify our compliance with parental post operative communication and clinical review of paediatric trauma patients, and the documentation of this.

Method
Retrospective analysis of all patients ≤18 years old operated in trauma theatres at the Grange University Hospital between August-September and October- November 2023. Data was obtained from online operations systems ORMIS, clinical workstation and telephone calls to parents. Interventions were implemented at local audit meetings to encourage changes in clinical practice.

Results
Post operative clinical reviews and communication with parents improved from 34% in Cycle 1 to 66% in Cycle 2. Excluding patients who were not contactable, 77% of patients were reviewed post operatively during Cycle 2. Despite this improvement, there was overall poor documentation of clinical reviews and parental updates. In Cycle 1, 30% of reviews were documented followed by 57% documented in Cycle 2.

Conclusions
Clinical review of children post operatively is essential, providing an opportunity to explain intraoperative findings, procedure performed and confirm follow up to parents. There is room for improvement in our post operative clinical reviews, and the respective documentation of this. We will aim for 100% compliance of post operative reviews, providing an opportunity to answer questions and reduce parental anxieties, therefore optimising patient care.
629 Demographic and Epidemiological Analysis of Pelvic Wing and Acetabular Fractures
Authors: Zhang J , Bradshaw F , Zhu J , Krkovic M 
Published: August 2024

Abstract

Aim
Pelvic and Acetabular fractures (PAFs) are a significant concern, particularly in older individuals with osteoporosis. This study presents a 6-year retrospective review conducted at a tertiary trauma centre in the UK to analyse the incidence, demographics, and associated factors of PAFs.

Method
Data encompassed pelvic ring and acetabular fractures from January 2017 to January 2023, categorized by Young and Burgess or Letournel classifications. Parameters included age at injury, gender, BMI at presentation, injury mechanisms, and related orthopaedic and non-orthopaedic injuries.

Results
The study assessed 2,128 pelvic fractures, comprising 1,093 pelvic ring fractures and 1,035 acetabular fractures. Acetabular fracture patients were older (average 61.5 vs. 56.4 years) and more frequently male (67% vs. 46%) than pelvic ring fracture patients. Both groups displayed similar average BMI and surgical management rates (49.8%).
Among pelvic ring fractures, Lateral compression type-I fractures predominated at 53.7%, while anterior column and posterior hemitransverse fractures were most common in acetabular fractures (23.6%).
High and low-impact falls were the primary causes for pelvic ring (24.0%) and acetabular fractures (30.8%). Interestingly, almost two-thirds of pelvic fractures occurred in isolation without additional orthopaedic polytrauma. Organ lacerations/contusions were the predominant associated non-orthopaedic injuries, followed by pneumothorax and brain injuries, with fewer other injuries.

Conclusions
This study offers insight into PAFs at a UK trauma centre, particularly in sub-classifying pelvic fractures based on the Young-Burgess and Letournel classifications, a rarity in existing literature. These findings contribute to international comparisons and inform evidence-based policies for healthcare resource planning and postoperative care.
819 Assessing Regional Variation in VTE Prophylaxis Prescribing Practice Following Major Lower Limb Arthroplasty
Authors:   Oswestry Stoke Collaborative for Audit and Research (OSCAR) Group
Published: August 2024

Abstract

Aim
There is uncertainty regarding optimal post-operative pharmacological VTE prophylaxis regime following total hip and knee arthroplasty (THA/TKA). 2023 International Consensus Meeting on Venous Thromboembolism (ICM-VTE) guidelines recommend low-dose aspirin for 14 to 35 days in TKA and THA patients. Variation in practice may increase prescribing errors and healthcare-associated costs.

Method
This study defines current VTE prophylaxis regimes following primary THA and TKA in a UK-based region. A cross-sectional survey was performed. Training registrars affiliated with the OSCAR collaborative group documented the standard pharmacological VTE prophylaxis regime of named consultant arthroplasty surgeons in four units within the Oswestry-Stoke rotation.

Results
The practice of 29 consultants performing primary THA were documented. 10 different regimes were noted considering agent type and duration. 8 (27.6%) preferred low-molecular-weight heparin (LMWH), 1 (3.4%) aspirin and 4 (13.8%) direct oral anticoagulant (DOAC) alone. 10 (34.5%) used LMWH followed by aspirin or DOAC. 6 (20.7%) used LMWH alone or LMWH followed by aspirin depending on thrombotic risk. 9 different regimes for 30 consultants performing primary TKA were identified. LMWH, aspirin and DOAC alone were preferred by 10 (33.3%), 1 (3.3%) and 4 (13.3%) consultants respectively. 8 (26.7%) used LMWH as in inpatient followed aspirin or DOAC on discharge. 6 (20.0%) used either LMWH or aspirin alone depending on high- or low-thrombotic risk respectively.

Conclusions
Even within a limited geographical region significant variation in pharmacological VTE prophylaxis prescribing exists. A randomised-controlled trial to compare efficacy of agents is required, though challenging due to the numbers required to adequately power this study.
374 Quality of Life Outcomes for Penile Prosthesis Insertion Post-Priapism – Satisfaction Guaranteed?
Authors: Dighero I , Looney A , Naylor K , Mount C , Holden F , Johnson M , Ralph D , Sangster P 
Published: August 2024

Abstract

Aim
Penile prosthesis (PP) insertion is recommended for patients experiencing long-duration ischaemic priapism to restore erectile function. In this setting, decision making is time critical, and clinicians must counsel appropriately. However, there is a paucity of published data on quality of life (QOL) outcomes. Aiming to equip clinicians to counsel in the acute setting, our objective was to conduct the largest study to date assessing QOL outcomes in post-priapism PP patients.

Method
We contacted patients who received post-priapism PP in our department via telephone and completed the previously validated Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire. Causes of dissatisfaction were collected anecdotally.

Results
167 patients had PPs inserted post-priapism between 2002-2022. Of these, 39 (23%; implants between 2007-2021) completed our questionnaire. The median age of respondents was 55.7 years with a median time post-priapism event to study date of 9.1 years. At time of contact, 95% (37) of respondents were actively using their device. 82% (32) felt their PP had met their expectations, 74% (29) were satisfied with their sexual experience and the same number reported partner satisfaction. Causes of dissatisfaction related to changes in penis size as well as device choice.

Conclusions
PP insertion is a suitable surgical technique to maintain sexual function in patients’ post-priapism, for whom it can have a positive impact on sexual experience for both patient, and their partner. We noted dissatisfaction related to device choice and priapism complication symptoms. This emphasises the importance of managing patient expectation in regard to pathology and device options.
704 Robotic Partial Nephrectomy Results in Reduced Pain Score and Length of Stay Compared with Open Partial Nephrectomy
Authors: Arbide D , Anbarasan T , Laird A 
Published: August 2024

Abstract

Aim
To assess the use of Robotic-Assisted Partial Nephrectomies (RAPN) in reducing patient-reported pain scores and use of opioid analgesia compared with Open Partial Nephrectomy (OPN).

Method
Data was collected from consecutive patients undergoing OPN between Feb 2019 and Nov 2020 and RAPN between Sep 2022 and Aug 2023. Data included demographics, high dependence and hospital stay, patient reported pain scores and opiate use during in-patient stay. Pain scores were recorded in a Likert scale from 0-10. We standardised opiate use across patients as oral morphine dose per day, then calculated maximum and median daily pain scores and median daily analgesia dose used for the first 2 days post-operation.

Results
OPN and RAPN were performed in 17 and 35 patients respectively. No patients undergoing RAPN required HDU admission while all patients undergoing OPN were admitted to HDU post-operatively for a median 2 days (1-6 days). The median length of stay was shorter for RAPN compared with OPN (2 days and 4 days respectively). The pain scores for all patients were highest on post-operative day 1. The median pain score was 3 and 1 respectively for OPN and RAPN on day one. Most OPN patients had an epidural for the first 48 hours (10 [58.8%]) while RAPNs were managed with oral analgesia. The median opiate use was 24mg on day 1 post RAPN.

Conclusions
Patients undergoing RAPN have less pain than OPN with resultant need for less HDU stay and reduced length of stay overall.
892 Prostate Specific Antigen Density (PSAD) in predicting prostate cancer: A District General Hospital Analysis
Authors: Balasubaramaniam V , Kailasa A , Donev K 
Published: August 2024

Abstract

Aim
PSAD is a marker to predict prostate cancer with levels &gt;0.15 ng/ml2 increasing the chances of prostate cancer. This study aims to investigate the use of PSAD in predicting patients with prostate cancer.

Method
A retrospective audit of patients who underwent LATP under one urologist over a 10-month period (11/2/2022-27/11/2022) were included in the study. Data of PSA levels, LATP histology findings, MP-MRI results and cancer MDT notes were found from the online record system and recorded.

Results
A total of 53 male patients underwent LATP over the 10-month period. The mean age of patients was 71.6 years old. 77.4% (41) patients were diagnosed with prostate adenocarcinoma, 18.9% (10) had benign histology, and 2 patients showed high-grade prostate intraepithelial neoplasia (PIN). The median PSA value for patients with adenocarcinoma is 9.3ng/ml (4.8-300.9). For patients with a PSAD of &gt;0.15 ng/ml2, 78% (32) of patients had adenocarcinoma, 20% (2/10) patients had benign histology, and 50% (1/2) patients had high-grade PIN. With a PSAD &gt;0.10 ng/ml2, there was a 92.7% sensitivity and 33.3% specificity in detecting prostate cancer.

Conclusion
PSAD &gt;0.15ng/ml2 is a good marker in predicting prostate cancer, however, other investigations such as MP-MRI and prostate biopsy should be used to facilitate the diagnosis. A lower PSAD value will increase the sensitivity but reduce the specificity, leading to unnecessary prostate biopsies. Further studies with larger sample size and that compares various PSAD cut-off with prostate cancer should be conducted.
293 Evaluation of Imaging Strategies for Carotid Stenosis in Carotid Endarterectomy Patients
Authors: Musa A M , Gaba K , Nash T , Patterson B , Pemberton M 
Published: August 2024

Abstract

Background
The European Society for Vascular Surgery (ESVS) carotid guidelines recommend the use of duplex ultrasound (DUS), computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in assessing carotid stenosis. ESVS recommends corroborating DUS estimates with a CTA, MRA or a repeat DUS with ideally a second operator.

Method
In this retrospective cohort study of 73 consecutive carotid endarterectomy patients (between June 2022 and June 2023), data were collected from the Picture Archiving Communications System which included the date of each investigation and quantification of the degree of carotid stenosis based on the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method. Spearman’s rank correlation coefficient was used to evaluate the correlation between DUS and CTA estimates of carotid stenosis.

Results
71 symptomatic and 2 asymptomatic CEAs were conducted. Among these, 69.9% (n=51) underwent DUS followed by a CTA, 8.2% (n=6) had a CTA preceding DUS, 1.4% (n=1) underwent sequential DUS, CTA and MRA, 8.2% (n=6) received two DUS scans, with 5 conducted by a different operator and 12.3% (n=9) had only a single DUS. For the 57 patients with both DUS and CTA, in any order, a statistically significant, positive correlation was observed (r= 0.514, 95% CI 0.3075 – 0.7135, p&lt;0.0001).

Conclusions
The imaging strategies recommended by the ESVS are being undertaken in the majority of patients. Only 12.3% of patients did not have a corroborating scan undertaken. Despite the acknowledged operator dependence of DUS, this study found a strong positive correlation with CTA estimates of carotid stenosis.
1135 Atraumatic Profonda Brachii Arterial Pseudoaneurysm
Authors: Nawaz S M A , Harkin S , Hassard R , Lambon R , Sharif A 
Published: August 2024

Abstract

Introduction
Peripheral Artery pseudoaneurysm such as brachial artery pseudoaneurysm are very rare and typically happen after trauma or infections. We present a case of a 70-year-old man who presented with a large atraumatic non pulsatile soft tissue mass like swelling.

Case Presentation
A 70 year old gentleman was referred by GP due to atraumatic swelling in right upper arm which was noticed 2 weeks pre-referral.
Patient was unsure about duration of the noticed swelling, which was mobile, tender and was about tennis-ball size. Neurovascular status of arm was intact with no erythema or skin changes. Initially it was treated as infected pseudo-cyst with oral anti-biotics for 5 days. CT-angiogram demonstrated large well-circumscribed mass lesion mid right upper-arm medial to biceps. On ultrasound this appeared to be associated with a branch of the brachial artery as opposed to the brachial trunk proper, with active bleeding within the haematoma. After MDT discussion, patient underwent surgical repair and intra-operative finding showed brachial profunda artery aneurysm. Median nerve and ulnar nerve were preserved along with brachial artery which was separate from the mass. Histopathology report confirmed the presence of pseudoaneurysm with underdetermined aetiology.

Discussion
Although upper extremity peripheral arterial pseudoaneurysm is rare, they can happen iatrogenically post-trauma. Our case was different than usual as being without any previous trauma and therefore, misdiagnosis is not uncommon.

Conclusions
Presence of pulsation is not always mandatory in painless swellings and a high index of suspicion is obligatory for the early diagnosis of pseudoaneurysm where diagnostic delay could lead to detrimental complications.
1264 Applications of Artificial Intelligence and Machine Learning in Endovascular Neurosurgery: A Literature Review
Authors: Al Hussaini N 
Published: August 2024

Abstract

Aim
The integration of artificial intelligence and in healthcare settings is increasingly growing, although its use is limited in clinical practice. This meta-analysis reviews the current implications of artificial intelligence in endovascular surgery, including preoperative risk-stratification, surgical preparation, and follow-up.

Method
This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Through a comprehensive search of PubMed and Scopus from 2017 until 2023. Around 300 articles were gathered and 23 eligible studies on neuroendovascular techniques were chosen to review.

Results
In a comprehensive review of 23 articles on AI applications in endovascular neurosurgery. One study focused on time-effective detection of ischaemic stroke through Viz large vessel occlusion deep learning neural network DLNN. Nine studies reported intracranial aneurysms surveillance implementing ML model by assessing age, hypertension, aneurysm size and previous history. Additionally, three studies utilised DLNN to evaluate the functioning AV fistula maturation with 80% accuracy. Few studies assessed DL algorithm by T2-weighted image analysis to distinguish Moyamoya disease from atherosclerosis.
The da Vinci robotic system has demonstrated a value in improving surgical precision, especially prostatectomies and abdominal surgeries. Although robotic neurovascular intervention is in the early phase, substantial progress has been made, with systems including Magellan and CorPath GRX exhibiting procedures like stroke thrombectomy and endovascular coiling.

Conclusions
The emphasis of artificial intelligence and robotics in endovascular neurosurgery carries transformative power, encouraging growth in surgical performance. AI, specifically deep learning schemes, has shown remarkable efficacy.
Toward accelerated discovery of solid catalysts using extrapolative machine learning approach
Authors: Toyao Takashi 
Published: August 2024

Abstract
Designing novel catalysts is pivotal for overcoming numerous energy and environmental challenges. Although data science approaches, particularly machine learning (ML) approaches, hold promise for accelerating catalyst development, discovering truly novel catalysts through ML remains rare. This is largely due to the perceived inability of the ML models to extrapolate and identify exceptional materials. In this Review, I present our approach taken to tackle this limitation. Specifically, we employed an advanced ML methodology that could make extrapolative predictions. This approach led to the discovery of multielemental solid catalysts for CO2 hydrogenation to CO. The results not only demonstrate the immense potential of ML in catalysis research but also set a new standard for the rapid development of high-performance catalysts.
Methylation-Associated Nucleosomal Patterns of Cell-Free DNA in Cancer Patients and Pregnant Women
Authors: Zhu Guanhua , Jiang Peiyong , Li Xingqian , Peng Wenlei , Choy L Y Lois , Yu Stephanie C Y , Zhou Qing , Ma Mary-Jane L , Kang Guannan , Bai Jinyue , Qiao Rong , Deng Chian Xi Shirley , Ding Spencer C , Lam Wai Kei Jacky , Chan Stephen L , Lau So Ling , Leung Tak Y , Wong John , Chan K C Allen , Lo Y M Dennis 
Published: August 2024

Abstract

Background
Cell-free DNA (cfDNA) analysis offers an attractive noninvasive means of detecting and monitoring diseases. cfDNA cleavage patterns within a short range (e.g., 11 nucleotides) have been reported to correlate with cytosine-phosphate-guanine (CpG) methylation, allowing fragmentomics-based methylation analysis (FRAGMA). Here, we adopted FRAGMA to the extended region harboring multiple nucleosomes, termed FRAGMAXR.

Methods
We profiled cfDNA nucleosomal patterns over the genomic regions from −800 to 800 bp surrounding differentially methylated CpG sites, harboring approximately 8 nucleosomes, referred to as CpG-associated cfDNA nucleosomal patterns. Such nucleosomal patterns were analyzed by FRAGMAXR in cancer patients and pregnant women.

Results
We identified distinct cfDNA nucleosomal patterns around differentially methylated CpG sites. Compared with subjects without cancer, patients with hepatocellular carcinoma (HCC) showed reduced amplitude of nucleosomal patterns, with a gradual decrease over tumor stages. Nucleosomal patterns associated with differentially methylated CpG sites could be used to train a machine learning model, resulting in the detection of HCC patients with an area under the receiver operating characteristic curve of 0.93. We further demonstrated the feasibility of multicancer detection using a dataset comprising lung, breast, and ovarian cancers. The tissue-of-origin analysis of plasma cfDNA from pregnant women and cancer patients revealed that the placental DNA and tumoral DNA contributions deduced by FRAGMAXR correlated well with values measured using genetic variants (Pearson r: 0.85 and 0.94, respectively).

Conclusions
CpG-associated cfDNA nucleosomal patterns of cfDNA molecules are influenced by DNA methylation and might be useful for biomarker developments for cancer liquid biopsy and noninvasive prenatal testing.