Budget Impact Analysis of Molecular Lymph Node Staging Versus Conventional Histopathology Staging in Colorectal Carcinoma

Background: The presence of lymph node (LN) metastasis is a critical prognostic factor in colorectal cancer (CRC) patients and is also an indicator for adjuvant chemotherapy. The gold standard (GS) technique for LN diagnosis and staging is based on the analysis of haematoxylin and eosin (H&E)-stained slides, but its sensitivity is low. As a result, patients may not be properly diagnosed and some may have local recurrence or distant metastases after curative-intent surgery. Many of these diagnostic and treatment problems could be avoided if the one-step nucleic acid amplification assay (OSNA) was used rather than the GS technique. OSNA is a fast, automated, standardised, highly sensitive, quantitative technique for detecting LN metastases. Objectives: The aim of this study was to assess the budget impact of introducing OSNA LN analysis in early-stage CRC patients in the Spanish National Health System (NHS). Methods: A budget impact analysis comparing two scenarios (GS vs. OSNA) was developed within the Spanish NHS framework over a 3-year time frame (2017-2019). The patient population consisted of newly diagnosed CRC patients undergoing surgical treatment, and the following costs were included: initial surgery, pathological diagnosis, staging, follow-up expenses, systemic treatment and surgery after recurrence. One- and two-way sensitivity analyses were performed. Results: Using OSNA instead of the GS would have saved 1,509,182, 6,854,501 and 10,814,082 during the first, second and third years of the analysis, respectively, because patients incur additional costs in later years, leading to savings of more than 19 million for the NHS over the 3-year time horizon. Conclusions: Introducing OSNA in CRC LN analysis may represent not only an economic benefit for the NHS but also a clinical benefit for CRC patients since a more accurate staging could be performed, thus avoiding unnecessary treatments

Levelling Profiles and a GPS Network to Monitor the Active Folding and Faulting Deformation in the Campo de Dalias (Betic Cordillera, Southeastern Spain)

The Campo de Dalias is an area with relevant seismicity associated to the active tectonic deformations of the southern boundary of the Betic Cordillera. A non-permanent GPS network was installed to monitor, for the first time, the fault- and fold-related activity. In addition, two high precision levelling profiles were measured twice over a one-year period across the Balanegra Fault, one of the most active faults recognized in the area. The absence of significant movement of the main fault surface suggests seismogenic behaviour. The possible recurrence interval may be between 100 and 300 y. The repetitive GPS and high precision levelling monitoring of the fault surface during a long time period may help us to determine future fault behaviour with regard to the existence (or not) of a creep component, the accumulation of elastic deformation before faulting, and implications of the fold-fault relationship

Proposta sobre l’ordenació de la cirurgia bariàtrica en població adulta als hospitals públics de Catalunya

Cirugía bariátrica; Hospitales públicos; AdultosBariatric surgery; Public hospitals; AdultsCirurgia bariàtrica; Hospitals públics; AdultsL'objectiu és definir les indicacions de cirurgia bariàtrica en població adulta i disminuir la variabilitat entre centres hospitalaris; analitzar i definir els diferents nivells quirúrgics segons la complexitat de la cirurgia bariàtrica en població adulta; definir el seguiment a curt/mitjà i llarg termini de la postcirurgia bariàtrica en població adulta i establir els criteris i requeriments mínims dels centres hospitalaris per dur a terme cirurgia bariàtrica en població adulta. L’àmbit d’aplicació del consens és el Sistema sanitari integral d’utilització pública de Catalunya (SISCAT).El objetivo es definir las indicaciones de cirugía bariátrica en población adulta y disminuir la variabilidad entre centros hospitalarios; analizar y definir los diferentes niveles quirúrgicos segundos la complejidad de la cirugía bariátrica en población adulta; definir el seguimiento a corto/medio y largo plazo de la postcirugía bariátrica en población adulta y establecer los criterios y requerimientos mínimos de los centros hospitalarios para llevar a cabo cirugía bariátrica en población adulta. El ámbito de aplicación del consenso es el Sistema sanitario integral de utilización pública de Cataluña (SISCAT).The aim is to define the indications for bariatric surgery in the adult population and to decrease the variability between hospitals; analyze and define the different surgical levels according to the complexity of bariatric surgery in the adult population; define the short / medium and long-term follow-up of bariatric surgery in the adult population and establish the minimum criteria and requirements for hospitals to carry out bariatric surgery in the adult population. The scope of the consensus is the Comprehensive Health System for Public Use in Catalonia (SISCAT)

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

The 42nd Symposium Chromatographic Methods of Investigating Organic Compounds : Book of abstracts

The 42nd Symposium Chromatographic Methods of Investigating Organic Compounds : Book of abstracts. June 4-7, 2019, Szczyrk, Polan

Transanal total mesorectal excision versus anterior total mesorectal excision for rectal cancer: a propensity-score matched, population-based study in Catalonia, Spain

Background: the clinical value of transanal total mesorectal excision is debated. Objective: to compare short- and medium-term effects of transanal versus anterior total mesorectal excision for rectal cancer. Design: this was a multicenter retrospective cohort study. Setting: the study included all Catalonian public hospitals. Patients: all non-metastatic patients receiving transanal or anterior total mesorectal excision (open or laparoscopic) for primary rectal cancer in 2015-16. Main outcome measures: data on vital status were collected to March 2019. Between-group differences were minimized by applying propensity score matching to baseline patient characteristics. Competing risk models were used to assess systemic and local recurrence along with death at two years, and multivariable Cox regression to assess two-year disease-free survival. Results are expressed with their 95% confidence intervals. Results: the final subsample was 537 patients receiving total mesorectal excision (transanal approach: n=145; anterior approach: n=392). Median follow-up was 39.2 months (interquartile range 33.0-45.8). Accounting for death as a competing event, there was no association between transanal total mesorectal excision and local recurrence (matched sub-hazard ratio 1.28, 0.55-2.96). There were no statistical differences in the comparative rate of local recurrence (transanal: 1.77 per 100 person-years, 0.76-3.34; anterior: 1.37 per 100 person-year, 0.8-2.15) or mortality (transanal: 3.98 per 100 person-year, 2.36-6.16; anterior: 2.99 per 100 person-years, 2.1-4.07). Groups presented similar two-year cumulative incidence of local recurrence (4.83% versus 3.57%, respectively) and disease-free survival (hazard ratio 1.33, 0.92-1.92). Limitations: we used data only from the public system, the study is retrospective, and data on individual surgeons are not reported. Conclusion: these population-based results support the use of either the transanal, open, or laparoscopic approach for rectal cancer in Catalonia. See Video Abstract at http://links.lww.com/DCR/B744

Dataset for Active shortening simultaneous to normal faulting based on GNSS, geophysical and geological data: The seismogenic Ventas de Zafarraya Fault (Betic Cordillera). Tectonics

<p>Dataset for "Active shortening simultaneous to normal faulting based on GNSS, geophysical and geological data: The seismogenic Ventas de Zafarraya Fault (Betic Cordillera)" Tectonics<br><br>File "hypoDD_10_300.reloc.txt" compile all the relocated seismicity in the study area.<br>Files "810_.NEU, 811_.NEU, 812_.NEU, 813_.NEU, 814_.NEU, 815_.NEU,  and 816_.NEU" presents the time series data of GNSS sites of the Zafarraya network.</p&gt