bluuebunny/crossref_metadata_2025_split huggingface dataset:
391 An Audit of Nurse-Led Follow-Up of Patients with Colorectal Cancer in a District General Hospital
Authors: Boodhoo V. , Payne A. 
Published: February 2022

Abstract

Introduction
Rates of recurrence of colorectal cancer after potentially curative surgery vary between 30–65%. Regular post-operative surveillance of these patients is essential in detecting recurrence and improves overall survival. NICE guidelines recommend follow-up with measurement of serum carcinoembryogenic antigen (CEA) and with CT scans of the chest abdomen and pelvis. In our unit, patients have been followed up by Cancer Nurse Specialists (CSNs) since 2016. The aim of this audit is to determine the compliance with surveillance guidelines in our nurse-led follow-up programme.

Method
This is a retrospective audit of randomly selected post-operative patients with colorectal cancer who were followed up by CSNs. All patients with appointments with CSNs in 2 randomly selected months (1st January- 28th February 2020) were included. Data was collected using electronic patient records.

Results
54 patients were identified. For low-risk patients, 100% (34/34) had their CT surveillance at 1 year, and, for those 30 months post- surgery, 100% (30/30) had their 30 months CT scan. 94% (32/34) had recommended CEA measurements.
In high-risk patients, 85% (17/20) had their 1-year CT scan, 100% of eligible patients (19/19) had their 2-year CT, or a plan in place for one. Of patients eligible for a 3-year CT scan, 46% (6/13) had one. 95% (19/20) had recommended CEA measurements.

Conclusions
Nurse-led follow-up overall leads to adequate follow-up, better compliance with guidelines and improved continuity of care.
393 Cholecystostomy Drains Patients Selections, Management and Outcomes
Authors: Mohamed B. , Nurmeen Nahaboo Solim Z. , Canelo R. 
Published: February 2022

Abstract

Background
Laparoscopic cholecystectomy (LC) is the gold standard treatment for acute cholecystitis (AC). Percutaneous cholecystostomy (PC) has been developed to reduce the morbidity and mortality associated with high-risk patients. PC offers advantages such as general anaesthesia is not required, can be performed at the bedside, success rate is above 95%, low complication rate and can be used as bridging therapy before elective surgery.

Aim
To investigate the demographics, clinical factors, and the outcomes of cholecystostomy in management of cholecystitis.

Method
The sample includes 24 inpatients at North Cumbria trust who had cholecystostomy drain insertion in 2019 and 2020 (retrospective audit)

Results
One patient was less than 40 years old. 6 were between 40 and 60 years old while 17 were above 60 years old. 21 patients had 1 drain, 2 patients had 2 drains and 1 patient had 3 drains in total. Duration of the drain insertion 0–7 days 5 patients, 8–21 days 7 patients, more than 3 weeks 12 patients. Numbers of patients attended SDEC 1 times 4 patients 2–5 times 15 patients more than 5 times 5 patients. 5 patients had no investigations, while12 (50%) patients had more than one investigation post procedure.

Complications

Conclusions
17 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations During the First 9 Months
Authors: Khaleeq T. , Lancaster P. , Fakoya K. , Ferreira P. , Ahmed U. 
Published: February 2022

Abstract

Introduction
Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety.

Method
A protocol was developed by the clinical team on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes.

Results
In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately.

Conclusions
BOA guidelines state all patients must be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient and make the most of the resources available.
120 Artificial Intelligence (AI) Risk-Based Stratification for Surgical Waiting List Prioritisation: A Pilot Study Addressing the NHS Growing Waiting Times
Authors: Jegatheeswaran L. , Tolley N. 
Published: February 2022

Abstract

Aim
336,733 patients in England awaited NHS hospital treatment in May 2021. The Royal College of Surgeons of England’s New Deal for Surgery report encouraged utilising new technology in healthcare to address this.
During the pandemic’s second wave, this pilot study investigated utilising COMPASS Surgical List Triage (COMPASS SLT), an artificial intelligence-based system, in assisting surgical decision-making on patient prioritisation. Data generated from COMPASS SLT was compared to data from the British Association of Endocrine and Thyroid Surgeons’ prioritisation guidance.

Method
A cohort of Thyroidectomy and Parathyroidectomy patients on the surgical waiting list at Imperial College Healthcare NHS Trust was used. COMPASS SLT calculated individuals’ mortality and significant morbidity risk (risk &gt;2.5%). Additional increase in mortality and morbidity due to treatment delay were calculated. Actual treatment time was aligned to the treatment delay (in weeks) experienced by each patient.

Results
29 patients, with a median age and waiting time at the onset of the second wave of 43 years and 18 weeks respectively, were enrolled. Non-statistically significant differences (p=0.937) between the FSSA and BAETS classification existed. However, cohort size could promote a type II error. There was an increase in mean mortality and morbidity risk (p&lt;0.001) arising from treatment delay, and decisions based on the FSSA and BAETS classifications.

Conclusions
COMPASS SLT can supplement clinical decision making. The FSSA and BAETS guidance lacks precision and responsiveness to solely inform patient prioritisation. An AI tool provides clinicians objectivity and flexibility in prioritising patients, with information on individual morbidity, mortality, and treatment delay costs.
Increased acrolein–DNA adducts in buccal brushings of e-cigarette users
Authors: Cheng Guang , Guo Jiehong , Carmella Steven G , Lindgren Bruce , Ikuemonisan Joshua , Niesen Brittany , Jensen Joni , Hatsukami Dorothy K , Balbo Silvia , Hecht Stephen S 
Published: February 2022

Abstract
DNA adducts are central in the mechanism of carcinogenesis by genotoxic agents. We compared levels of a DNA adduct of acrolein, a genotoxic carcinogen found in e-cigarette vapor, in oral cell DNA of e-cigarette users and non-users of any tobacco or nicotine product. e-Cigarette users and non-users visited our clinic once monthly for 6 months, and oral brushings and urine samples were collected. For this study, we analyzed oral cell DNA adducts from three monthly visits in e-cigarette users and non-users as confirmed by urinary cyanoethyl mercapturic acid and total nicotine equivalents. DNA was isolated from the oral brushings and analyzed by a validated liquid chromatography-nanoelectrospray ionization-high resolution tandem mass spectrometry method for the acrolein DNA adduct 8R/S-3-(2’-deoxyribos-1’-yl)-5,6,7,8-tetrahydro-8-hydroxypyrimido[1,2-a]purine-10-(3H)-one (γ-OH-Acr-dGuo). The median value of this DNA adduct in the e-cigarette users was 179 fmol/µmol dGuo (range 5.0 - 793 fmol/µmol dGuo) while that for non-users was 21.0 fmol/µmol dGuo (range 5.0 - 539 fmol/µmol dGuo), P = 0.001. These results demonstrate for the first time that e-cigarette users have elevated levels of a carcinogen–DNA adduct in their oral cells.
Effect of various ratios of poly(3-hexylthiophene) with polyvinyl alcohol gel-polymer electrolytes in flexible sodium-ion batteries using Samanea saman tree-leaf-derived carbon quantum dots decorated with SnO2 and NaVO3
Authors: Thangaraj Baskar , Wongyao Nutthapon , Solomon Pravin Raj , Chaiworn Wachira , Chuangchote Surawut , Surareungchai Werasak 
Published: February 2022

Abstract
Gel-polymer electrolytes with high thermal stability and mechanical properties were considered suitable in rechargeable batteries so as to overcome the problems encountered in liquid electrolytes. In a previous study, flexible sodium-ion batteries (FSIBs) were fabricated using electrodes made of carbon quantum dots (CQDs) decorated with SnO2 and NaVO3 utilizing a polyvinyl alcohol (PVA)/P3HT gel-polymer electrolyte at a ratio of 1:0.05. In addition, various separators such as indium-doped tin oxide/polyoxyethylene tridecyl ether (ITO/PTE), rice paper (RP), silicone with three big holes (SIL BH), silicone with many small holes (SIL SH) and cellulose paper (CP) were tested in flexible Na-ion batteries. The SIL SH delivered a high specific discharge capacity of 4246 mAh g–1 in the initial cycle at 2 V and maintained a value of 71 mAh g–1 in the 50th cycle. With the aim of improving the cyclic ability of FSIBs, different weight ratios of PVA/P3HT (1:0.025, 1:0.05, 1:0.1, 1:0.15, 1:0.2) were tried in this work using the electrodes CQDs@SnO2 and CQDs@NaVO3. The above ratios were referred to as B25, B50, B100, B150 and B200, respectively. SIL SH was used as a separator. Cyclic voltammetry studies indicated that B150 had a high specific capacitance of 13 062 F g–1. B25 and B100 exhibited high discharge capacities (171 mAh g–1) and (151 mAh g–1) compared to that of other ratios B50 (75 mAh g–1), B150 (88 mAh g–1) and B200 (54 mAh g–1) in the 50th cycle at 2.0 V. This study reveals the scope of developing FSIBs of high capacity and cyclability at different voltages using carbonaceous electrodes and gel-polymer electrolytes with different ratios of PVA/P3HT. The focus of the present study is to bring out the optimum ratio of PVA/P3HT for maximizing the cyclic ability of FSIBs.
Dynamics of cortical and corticomuscular connectivity during planning and execution of visually guided steps in humans
Authors: Spedden Meaghan E , Beck Mikkel M , West Timothy O , Farmer Simon F , Nielsen Jens B , Lundbye-Jensen Jesper 
Published: February 2022

AbstractThe cortical mechanisms underlying the act of taking a step—including planning, execution, and modification—are not well understood. We hypothesized that oscillatory communication in a parieto-frontal and corticomuscular network is involved in the neural control of visually guided steps. We addressed this hypothesis using source reconstruction and lagged coherence analysis of electroencephalographic and electromyographic recordings during visually guided stepping and 2 control tasks that aimed to investigate processes involved in (i) preparing and taking a step and (ii) adjusting a step based on visual information. Steps were divided into planning, initiation, and execution phases. Taking a step was characterized by an upregulation of beta/gamma coherence within the parieto-frontal network during planning followed by a downregulation of alpha and beta/gamma coherence during initiation and execution. Step modification was characterized by bidirectional modulations of alpha and beta/gamma coherence in the parieto-frontal network during the phases leading up to step execution. Corticomuscular coherence did not exhibit task-related effects. We suggest that these task-related modulations indicate that the brain makes use of communication through coherence in the context of large-scale, whole-body movements, reflecting a process of flexibly fine-tuning inter-regional communication to achieve precision control during human stepping.
Cyto/myeloarchitecture of cortical gray matter and superficial white matter in early neurodevelopment: multimodal MRI study in preterm neonates
Authors: Yuan Shiyu , Liu Mengting , Kim Sharon , Yang Jingda , Barkovich Anthony James , Xu Duan , Kim Hosung 
Published: February 2022

Abstract
The cerebral cortex undergoes rapid microstructural changes throughout the third trimester. Recently, there has been growing interest on imaging features that represent cyto/myeloarchitecture underlying intracortical myelination, cortical gray matter (GM), and its adjacent superficial whitematter (sWM). Using 92 magnetic resonance imaging scans from 78 preterm neonates, the current study used combined T1-weighted/T2-weighted (T1w/T2w) intensity ratio and diffusion tensor imaging (DTI) measurements, including fractional anisotropy (FA) and mean diffusivity (MD), to characterize the developing cyto/myeloarchitectural architecture. DTI metrics showed a linear trajectory: FA decreased in GM but increased in sWM with time; and MD decreased in both GM and sWM. Conversely, T1w/T2w measurements showed a distinctive parabolic trajectory, revealing additional cyto/myeloarchitectural signature inferred. Furthermore, the spatiotemporal courses were regionally heterogeneous: central, ventral, and temporal regions of GM and sWM exhibited faster T1w/T2w changes; anterior sWM areas exhibited faster FA increases; and central and cingulate areas in GM and sWM exhibited faster MD decreases. These results may explain cyto/myeloarchitectural processes, including dendritic arborization, synaptogenesis, glial proliferation, and radial glial cell organization and apoptosis. Finally, T1w/T2w values were significantly associated with 1-year language and cognitive outcome scores, while MD significantly decreased with intraventricular hemorrhage.
Noise-rearing precludes the behavioral benefits of multisensory integration
Authors: Bean Naomi L , Smyre Scott A , Stein Barry E , Rowland Benjamin A 
Published: February 2022

AbstractConcordant visual–auditory stimuli enhance the responses of individual superior colliculus (SC) neurons. This neuronal capacity for “multisensory integration” is not innate: it is acquired only after substantial cross-modal (e.g. auditory–visual) experience. Masking transient auditory cues by raising animals in omnidirectional sound (“noise-rearing”) precludes their ability to obtain this experience and the ability of the SC to construct a normal multisensory (auditory–visual) transform. SC responses to combinations of concordant visual–auditory stimuli are depressed, rather than enhanced. The present experiments examined the behavioral consequence of this rearing condition in a simple detection/localization task. In the first experiment, the auditory component of the concordant cross-modal pair was novel, and only the visual stimulus was a target. In the second experiment, both component stimuli were targets. Noise-reared animals failed to show multisensory performance benefits in either experiment. These results reveal a close parallel between behavior and single neuron physiology in the multisensory deficits that are induced when noise disrupts early visual–auditory experience.
Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Hospitals: Effects of Aerosol-Generating Procedures, HEPA-Filtration Units, Patient Viral Load, and Physical Distance
Authors: Thuresson Sara , Fraenkel Carl Johan , Sasinovich Sviataslau , Soldemyr Jonathan , Widell Anders , Medstrand Patrik , Alsved Malin , Löndahl Jakob 
Published: February 2022

Abstract

Background
Transmission of coronavirus disease 2019 (COVID-19) can occur through inhalation of fine droplets or aerosols containing infectious virus. The objective of this study was to identify situations, patient characteristics, environmental parameters, and aerosol-generating procedures (AGPs) associated with airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus.

Methods
Air samples were collected near hospitalized COVID-19 patients and analyzed by RT-qPCR. Results were related to distance to the patient, most recent patient diagnostic PCR cycle threshold (Ct) value, room ventilation, and ongoing potential AGPs.

Results
In total, 310 air samples were collected; of these, 26 (8%) were positive for SARS-CoV-2. Of the 231 samples from patient rooms, 22 (10%) were positive for SARS-CoV-2. Positive air samples were associated with a low patient Ct value (OR, 5.0 for Ct &lt;25 vs &gt;25; P = .01; 95% CI: 1.18–29.5) and a shorter physical distance to the patient (OR, 2.0 for every meter closer to the patient; P = .05; 95% CI: 1.0–3.8). A mobile HEPA-filtration unit in the room decreased the proportion of positive samples (OR, .3; P = .02; 95% CI: .12–.98). No association was observed between SARS-CoV-2–positive air samples and mechanical ventilation, high-flow nasal cannula, nebulizer treatment, or noninvasive ventilation. An association was found with positive expiratory pressure training (P &lt; .01) and a trend towards an association for airway manipulation, including bronchoscopies and in- and extubations.

Conclusions
Our results show that major risk factors for airborne SARS-CoV-2 include short physical distance, high patient viral load, and poor room ventilation. AGPs, as traditionally defined, seem to be of secondary importance.
Mechanically Ventilated Patients Shed High-Titer Live Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) for Extended Periods From Both the Upper and Lower Respiratory Tract
Authors: Saud Zack , Ponsford Mark , Bentley Kirsten , Cole Jade M , Pandey Manish , Jolles Stephen , Fegan Chris , Humphreys Ian , Wise Matt P , Stanton Richard 
Published: February 2022

Abstract

Background
SARS-CoV-2 infection can lead to severe acute respiratory distress syndrome needing intensive care admission and may lead to death. As a virus that transmits by respiratory droplets and aerosols, determining the duration of viable virus shedding from the respiratory tract is critical for patient prognosis, and informs infection-control measures both within healthcare settings and the public domain.

Methods
We prospectively examined upper and lower airway respiratory secretions for both viral RNA and infectious virions in mechanically ventilated patients admitted to the intensive care unit (ICU) of the University Hospital of Wales. Samples were taken from the oral cavity (saliva), oropharynx (subglottic aspirate), or lower respiratory tract (nondirected bronchoalveolar lavage [NBAL] or bronchoalveolar lavage [BAL]) and analyzed by both quantitative PCR (qPCR) and plaque assay.

Results
117 samples were obtained from 25 patients. qPCR showed extremely high rates of positivity across all sample types; however, live virus was far more common in saliva (68%) than in BAL/NBAL (32%). Average titers of live virus were higher in subglottic aspirates (4.5 × 107) than in saliva (2.2 × 106) or BAL/NBAL (8.5 × 106) and reached &gt;108 PFU/mL in some samples. The longest duration of shedding was 98 days, while most patients (14/25) shed live virus for ≥20 days.

Conclusions
ICU patients infected with SARS-CoV-2 can shed high titers of virus both in the upper and lower respiratory tract and tend to be prolonged shedders. This information is important for decision making around cohorting patients, de-escalation of personal protective equipment, and undertaking potential aerosol-generating procedures.
Revisiting “Leadership” in Global Climate Governance: China’s Normative Engagement with the CBDRs Principle
Authors: Jiang Chaoyi 
Published: February 2022

Abstract
This paper studies how China has established and exercised leadership by creating and operationalising the principle of “common but differentiated responsibilities” (CBDRs) in United Nations climate negotiations—from the embryo of this principle in the Stockholm Declaration to its operationalisation in the Paris Agreement. Building on the updated scholarship on climate leadership, this paper proposes a four criteria test to ascertain the existence of a leadership relationship. It comprises (1) a wilful leader; (2) consensual followers; (3) a commonly shared goal shaped mainly by the leader and accepted by the followers; and (4) a process of leadership-building triggered through use of any one of the following four modes of leadership: ideational, directional, instrumental, or structural. In light of the leadership criteria, this paper focuses on how China has operationalised these various leadership modes towards realising the evolving collective goals of its developing followers. In doing so, the paper provides empirical evidence of the significance of each of the four leadership modes in underpinning China’s leadership in the climate regime. This paper finds that while ideational leadership was prominent in creating the CBDRs principle, instrumental leadership, with the support of occasional usages of directional and structural leadership, has also been vital to China in tackling the internal divisions of developing countries and in overcoming the limitations of such countries’ normative power in the post-Kyoto era.
On the inversion and admissibility for a class of Volterra integro-differential problems
Authors: Tismane M , Bounit H , Fadili A 
Published: February 2022

Abstract
We study the Volterra integro-differential problems of convolution kernel type from two perspectives: complex inversion formula and the admissibility in the Salamon–Weiss sense (which leads us to consider unbounded control operators). Due to the hybrid Cauchy–Volterra context of these problems, the control operators need to have the admissibility property. First, we show the validity of the inverse formula of the Laplace transform for the resolvent operators associated with some class of Volterra integro-differential problems of convolution type in Banach spaces with the leading operator generating a $C_{0}$-semigroup. This extends and improves the results in Hille & Phillips (1957, 347–348, Theorem 11.6.1), Driouich & El-Mennaoui (1999, 72, Theorem 1), Cioranescu & Lizama (2003, 188–189, Proposition 2), Haase (2008, 84, 81–82, Theorems 4.2 and 4.1) and Fadili & Bounit (2014, 7–8, Proposition 8), including the strong version for this class on UMD spaces. Second, the sufficient or/and necessary conditions for $L^{p}$-admissibility with $p\in (1,+\infty )$ of the control operators are given in terms of the UMD geometric property of its underlying control spaces for a wide class of Volterra integro-differential problems, which provides a generalization of a result known to hold for the standard Cauchy problems shown in Bounit et al. (2010, Proposition 3.2) and the standard Volterra integro-differential problems shown in Fadili & Bounit (2014, 9–10, Theorem 12).