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1.
Journal of Heart and Lung Transplantation ; 41(4):S245, 2022.
Article in English | EMBASE | ID: covidwho-1796797

ABSTRACT

Purpose: The purpose of this study was to compare our institutional experience using durable left ventricular assist devices (dLVADs) as a bridge to transplant before and after the 2018 heart allocation policy change. Methods: Since the allocation change, 29 patients have been bridged to heart transplantation with an isolated dLVAD at our institution. We matched these patients with the most recent 29 consecutive patients bridged to heart transplantation with isolated dLVAD. Baseline pretransplant characteristics and comorbidities were compared between cohorts. Incidence of posttransplant complications, intensive care unit and hospital lengths of stay were compared, as well as 90-day mortality. Results: Annual number of recipients bridged to transplant using a dLVAD declined after the first year following the allocation policy change (Figure A). Median age, body mass index, and distributions of primary heart failure etiology and dLVAD usage were similar between cohorts. The new policy cohort had a higher incidence of female recipients (21% vs 3%;P=0.044), but a lower incidence of patients maintained on intravenous inotropic therapy at time of transplant (3% vs 21%;P=0.044). Rates of prolonged mechanical ventilation, re-intubation, stroke and renal failure were comparable between cohorts. Intensive care unit length of stay and hospital length of stay were also similar. At 90 days, the new policy cohort experienced higher mortality (21% vs 3%;P=0.044) (Figure B). Conclusion: From our institutional experience, there appears to be continual decline in patients bridged with dLVAD following the allocation policy change. While rates of many postoperative complications appear comparable to the prior era, short-term mortality appears to be higher. Changes in the heart transplant allocation system have resulted in changes in donor availability and selection for recipients with durable LVADs. These changes, along with the impact of the COVID-19 pandemic, may be responsible for these observations.

2.
Non-conventional in English | MEDLINE, Grey literature | ID: grc-750357
3.
Lancet Gastroenterology & Hepatology ; 6(6):426-426, 2021.
Article in English | Web of Science | ID: covidwho-1498820
4.
United European Gastroenterology Journal ; 9(SUPPL 8):317-318, 2021.
Article in English | EMBASE | ID: covidwho-1490991

ABSTRACT

Introduction: UBT is the most accurate non-invasive test for H.pylori infection. The orally given urea, labelled with C13, is hydrolysed by the enzyme urease of H.pylori and C13O2 is measured expired in breath. UBT was our gold standard diagnostic test for H.pylori. This practice changed abruptly in March 2020, when our first wave of coronavirus -2 (SARS-CoV-2) started. UBT carries the risk of contamination by SARS-CoV-2 in the aerosol droplets generated by exhaled air. The British Society of Gastroenterology guideline at that time graded UBT as Aerosol Generating Procedure and therefore at high risk for transmission. Only emergency gastroenterology high risk procedures were recommended during restrictions which effectively terminated our standard UBT service. To maintain a non-invasive diagnostic option we developed a novel virtual test. C13 UBT At Home, is performed by patients at home with step by step instructions involving live video conference interaction between the patients and technicians. Aims & Methods: To determine the acceptability and the accuracy of the novel C13 UBT At Home service. Patients on a UBT waiting list were contacted and invited to undergo the alternative virtual breath test. Willing participants were pre assessed over phone to explain the process. Technical aspects (internet, smart phone or laptop requirements), navigation through the video call system attendanywhere and routine clinical parameters including PPI and antibiotic use were discussed. Suitable patients collected a Home UBT kit (Patient information sheet, test documentation, pre and post collection tubes, collection straw, urea tablet and feedback questionnaire) from a drop off point up to a week prior to their scheduled appointment. The test was performed as standard by the patient at home with live interaction for all active steps. The 20 minute rest between samples 1 and 2 collection was offline which allowed technicians to do concurrent cases. Patients were requested to fill in a feedback questionnaire after the test and to return it with the samples to the drop off point within 48 hours for analysis. The questionnaire included 6 questions covering pre procedure, procedure and post procedure domains. In addition to patient satisfaction, positivity rate, sample error rate and activity numbers were compared between UBT at home and a standard UBT cohort which was reinstated in 2021. Results: 300 patients were enrolled, mean age 41 years (range 7-85), 177 female (59%). Overall response rate was 96% (288), 96% (285) rated the entire UBT at home process as either excellent or good. All other parameters except connection to the hospital video call system, which was subject to external factors were also rated excellent/good by >90%. Accuracy between UBT tests was similar: positivity rate 23% (69/299) versus 22% (74/326), sample error rate 0.33% (1/300) versus 0.6% (2/326) for the UBT at home and standard tests respectively. Currently 3 of every 4 UBT's is now virtual despite reduced restrictions. Conclusion: UBT at home is possible and acceptable to patients with equivalent accuracy to standard UBT and should be continued to improve patient choice and satisfaction.

5.
6th International Conference on Smart Learning Ecosystems and Regional Development, SLERD 2021 ; 249:67-78, 2022.
Article in English | Scopus | ID: covidwho-1437234

ABSTRACT

The use of technology as a facilitator in learning environments has become increasingly prevalent with the global pandemic caused by COVID-19. As such, computer-supported collaborative learning (CSCL) gains a wider adoption in contrast to traditional learning methods. At the same time, the need for automated tools capable of assessing and stimulating collaboration between participants has become more stringent, as human monitoring of the increasing volume of conversations becomes overwhelming. This paper introduces a method grounded in dialogism for evaluating students’ involvement in chat conversations based on semantic chains computed using language models. These semantic chains reflect emergent voices from dialogism that span and interact throughout the conversation. Our integrated method uses contextual information captured by BERT transformer models to identify links in a chain that connects semantically related concepts from a voice uttered by one or more participants. Two types of visualizations were generated to depict the longitudinal propagation and the transversal inter-animation of voices within the conversation. In addition, a list of handcrafted features derived from the constructed chains and computed for each participant is introduced. Several machine learning algorithms were tested using these features to evaluate the extent to which semantic chains are predictive of student involvement in chat conversations. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

6.
Endoscopy ; 53(SUPPL 1):S133-S134, 2021.
Article in English | EMBASE | ID: covidwho-1254051

ABSTRACT

Aims The UK JAG on GI Endoscopy's minimum standard for polyp detection rates (PDR) in colonoscopy is 15 %. TheCOVID-19 pandemic precipitated the use of restrictive personal protective equipment (PPE) which might reduce dexterityand decrease PDRs. We audited our polyp excision rates both prior to and post the COVID-19 pandemic in order to assesswhether restrictive PPE led to a diminution therein. Methods Our endoscopy database was queried for all colonoscopies performed between 01/01/2014 and 29/02/2020 (Pre-COVID-19, n = 18,231) and between 01/03/2020 and 02/09/2020 (Post-COVID-19, n = 825) and subsequently irrevocablyanonymised. A polyp excision rate (PER) was calculated for each period as a proxy for PDR. A comparative odds ratio was calculated. An ordinary least squares (OLS) regression, using number of polyps excised as the dependent variable and procedure in thepost-COVID-19 period as a primary explanatory variable, was performed. The regression was controlled for age, malegender and procedure coded as therapeutic (as opposed to diagnostic). Results 4,346 and 209 patients had at least one polyp excised in the pre-COVID-19 (PER 23.8 %) and post-COVID-19 (PER25.3 %) periods respectively. Odds ratio 1.08 (95 %CIs: 0.92, 1.27). OLS regression established positive relationships between number of polyps excised and age (0.004, 95 %CIs: 0.003,0.005), male gender (0.10, 95 %CIs: 0.07, 0.13) and procedure coded as therapeutic (1.75, 95 %CIs: 1.71, 1.78). Itdemonstrated no significant relationship between procedure in the post-COVID-19 period (-0.003, 95 %CIs:-0.07, 0.07)and number of polyps excised. Conclusions Odds ratios comparing PERs and an OLS regression analysing number of polyps excised failed to demonstrateany significant difference between the pre-COVID-19 and post-COVID-19 eras.

7.
Irish Journal of Medical Science ; 189(SUPPL 5):S136-S136, 2020.
Article in English | Web of Science | ID: covidwho-896560
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