16 research outputs found
Validation of ultrasonic harmonic scalpel for real-time tissue identification using rapid evaporative ionization mass spectrometry
No full textIn this study, we integrate rapid evaporative ionization mass spectrometry (REIMS) with the Harmonic scalpel, an advanced laparoscopic surgical instrument that utilizes ultrasound energy to dissect and coagulate tissues. It provides unparalleled manipulation capability to surgeons and has superseded traditional electrosurgical tools particularly in abdominal surgery, but is yet to be validated with REIMS. The REIMS platform coupled with the Harmonic device was shown to produce tissue-specific lipid profiles through the analysis of porcine tissues in both negative and positive ionization modes. Comparison with other methods of electrosurgical dissection, such as monopolar electrosurgery and CO2 laser, showed spectral differences in the profile dependent on the energy device used. The Harmonic device demonstrated major spectral differences in the phospholipid region of m/z 600–1000 compared with the monopolar electrosurgical and CO2 laser-generated spectra. Within the Harmonic REIMS spectra, high intensities of diglycerides and triglycerides were observed. In contrast, monopolar electrosurgical and laser spectra demonstrated high abundances of glycerophospholipids. The Harmonic scalpel was able to differentiate between the liver, muscle, colon, and small intestine, demonstrating 100% diagnostic accuracy. The validation of the Harmonic device–mass spectrometry combination will allow the platform to be used safely and robustly for real-time in vivo surgical tissue identification in a variety of clinical applications
Mass spectrometry transanal minimally invasive surgery (MS-TAMIS) to promote organ preservation in rectal cancer
No full textBACKGROUND: Transanal minimally invasive surgery (TAMIS) is deployed for organ preservation in early rectal cancer and significant rectal polyps. Rapid evaporative ionisation mass spectrometry (REIMS) provides biochemical tissue analysis, which could be applied intraoperatively to give real-time tissue feedback to the surgeon and decrease the risk of an involved margin. However, the accuracy and feasibility of this approach have not been established. METHODS: In this prospective observational study, patients undergoing resection of rectal adenomas or carcinomas were recruited. An electrosurgical handpiece analysed tissues ex vivo using diathermy, with the aerosol aspirated into a Xevo G2-S ToF mass spectrometer. The relative abundance of lipids underwent predictive statistical modelling and leave-one-patient-out cross-validation. The outcomes of interest were the ability of REIMS to differentiate normal, adenomatous and cancerous tissue, or any disease subtype from normal. REIMS was coupled with TAMIS for in vivo sampling, assessing the accuracy of tissue recognition and distinguishing bowel wall layers. RESULTS: Forty-seven patients were included, yielding 266 spectra (121 normal, 109 tumour and 36 adenoma). REIMS differentiates normal, adenomatous and cancerous rectal tissues with 86.8% accuracy, and normal and adenomatous tissue with 92.4% accuracy and 91.4% accuracy when differentiating disease from normal. We have performed the first five in-man mass spectrometry augmented TAMIS (MS-TAMIS). In real time, MS-TAMIS can differentiate rectal mucosa and submucosa based on their relative abundance of triglycerides and glycerophospholipids. The ex vivo accuracy distinguishing diseased and normal tissues is maintained in vivo at 90%, with negative predictive value of 95%. The system identified a deep and lateral involved tumour margin during TAMIS. CONCLUSIONS: REIMS distinguishes rectal tissue types based on underlying lipid biology, and this can be translated in vivo by coupling it to TAMIS. There is a role for this technology in improving the efficacy of resection of early rectal cancers
Abstract 4536: Rapid evaporative ionization mass spectrometry (REIMS) analysis of the mucosal lipidome has a high diagnostic accuracy for adenomas and early colorectal cancer
No full textEstimation of sex from metatarsals using discriminant function and logistic regression analyses
No full text© 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. South Africa has one of the highest crime rates in the world and the discovery of dismembered bodies for human identification process poses a greater challenge. The South African Africans (also known as South African blacks) population group is often the victims of crimes as they are the largest group. While measurements of several bones of the human skeleton have been used for sex estimation, the potential of metatarsals have not been explored in this population group. Metatarsal bones are usually well-preserved since they are recovered in shoes protected from scavengers and they are able to withstand environmental degradation and taphonomy. This study investigated the potential of measurements of metatarsals in sex estimate amongst South African Africans using logistic and discriminant function analysis. Six measurements of metatarsals from 100 individuals of known sex and population affinity from the Raymond Dart Collection of Human skeletons were analysed. Various combinations of measurements of metatarsal bones yielded suitably high average accuracies (79% to 84%) for sex estimation and are comparable to functions derived from other skeletal elements of South African Africans. Metatarsals of South African Africans are therefore useful as alternatives to highly sexual dimorphic bones in the forensic estimation of sex
Sa1207 - Prospective Observational Cohort Study of Rapid Ionization Mass Spectrometry (Reims) for Near-Real Time Diagnosis and Stratification of Colorectal Cancer
No full textThe role of social media in health misinformation and disinformation during the COVID-19 pandemic : bibliometric analysis
No full textBACKGROUND: The use of social media platforms to seek information continues to increase. Social media platforms can be used
to disseminate important information to people worldwide instantaneously. However, their viral nature also makes it easy to share
misinformation, disinformation, unverified information, and fake news. The unprecedented reliance on social media platforms
to seek information during the COVID-19 pandemic was accompanied by increased incidents of misinformation and disinformation.
Consequently, there was an increase in the number of scientific publications related to the role of social media in disseminating
health misinformation and disinformation at the height of the COVID-19 pandemic. Health misinformation and disinformation,
especially in periods of global public health disasters, can lead to the erosion of trust in policy makers at best and fatal consequences
at worst.
OBJECTIVE: This paper reports a bibliometric analysis aimed at investigating the evolution of research publications related to
the role of social media as a driver of health misinformation and disinformation since the start of the COVID-19 pandemic.
Additionally, this study aimed to identify the top trending keywords, niche topics, authors, and publishers for publishing papers
related to the current research, as well as the global collaboration between authors on topics related to the role of social media in
health misinformation and disinformation since the start of the COVID-19 pandemic.
METHODS: The Scopus database was accessed on June 8, 2023, using a combination of Medical Subject Heading and author-defined
terms to create the following search phrases that targeted the title, abstract, and keyword fields: (“Health*” OR “Medical”) AND
(“Misinformation” OR “Disinformation” OR “Fake News”) AND (“Social media” OR “Twitter” OR “Facebook” OR “YouTube”
OR “WhatsApp” OR “Instagram” OR “TikTok”) AND (“Pandemic*” OR “Corona*” OR “Covid*”). A total of 943 research
papers published between 2020 and June 2023 were analyzed using Microsoft Excel (Microsoft Corporation), VOSviewer (Centre
for Science and Technology Studies, Leiden University), and the Biblioshiny package in Bibliometrix (K-Synth Srl) for RStudio
(Posit, PBC).
RESULTS: The highest number of publications was from 2022 (387/943, 41%). Most publications (725/943, 76.9%) were articles.
JMIR published the most research papers (54/943, 5.7%). Authors from the United States collaborated the most, with 311
coauthored research papers. The keywords “Covid-19,” “social media,” and “misinformation” were the top 3 trending keywords,
whereas “learning systems,” “learning models,” and “learning algorithms” were revealed as the niche topics on the role of social
media in health misinformation and disinformation during the COVID-19 outbreak.
CONCLUSIONS: Collaborations between authors can increase their productivity and citation counts. Niche topics such as “learning
systems,” “learning models,” and “learning algorithms” could be exploited by researchers in future studies to analyze the influence
of social media on health misinformation and disinformation during periods of global public health emergencies.The South African Department of Science and Innovation and the South African Medical Research Council under the Brazil, Russia, India, China, and South Africa Joint Application Form 2020/33.https://infodemiology.jmir.org/InformaticsSDG-03:Good heatlh and well-beingSDG-16:Peace,justice and strong institution
Lipidomic profiling of colorectal lesions for real-time tissue recognition and risk-stratification using rapid evaporative ionisation mass spectrometry.
No full textOBJECTIVE: Rapid Evaporative Ionisation Mass Spectrometry (REIMS) is a metabolomic technique analysing tissue metabolites, which can be applied intra-operatively in real-time. The objective of this study was to profile the lipid composition of colorectal tissues using REIMS, assessing its accuracy for real-time tissue recognition and risk-stratification. SUMMARY BACKGROUND DATA: Metabolic dysregulation is a hallmark feature of carcinogenesis, however it remains unknown if this can be leveraged for real-time clinical applications in colorectal disease. METHODS: Patients undergoing colorectal resection were included, with carcinoma, adenoma and paired-normal mucosa sampled. Ex vivo analysis with REIMS was conducted using monopolar diathermy, with the aerosol aspirated into a Xevo G2S QToF mass spectrometer. Negatively charged ions over 600-1000m/z were used for univariate and multivariate functions including linear discriminant analysis. RESULTS: 161 patients were included, generating 1013 spectra. Unique lipidomic profiles exist for each tissue type, with REIMS differentiating samples of carcinoma, adenoma and normal mucosa with 93 1% accuracy and 96 1% negative predictive value for carcinoma. Neoplasia (carcinoma or adenoma) could be predicted with 96 0% accuracy and 91 8% negative predictive value. Adenomas can be risk-stratified by grade of dysplasia with 93 5% accuracy, but not histological subtype. The structure of 61 lipid metabolites was identified, revealing that during colorectal carcinogenesis there is progressive increase in relative abundance of phosphatidylglycerols, sphingomyelins and mono-unsaturated fatty acid containing phospholipids. CONCLUSIONS: The colorectal lipidome can be sampled by REIMS and leveraged for accurate real-time tissue recognition, in addition to risk-stratification of colorectal adenomas. Unique lipidomic features associated with carcinogenesis are described
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Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial
No full textBackground: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH2O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH2O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. Trial registration ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1929-0) contains supplementary material, which is available to authorized users.Version of Recor
Association of intraoperative end-tidal CO2 levels with postoperative outcomes: a patient-level analysis of two randomised clinical trials
No full textBackground: The relationship between intraoperative end-tidal CO2 (etCO2) levels and postoperative outcomes remains unclear. We conducted a post hoc analysis of two randomised trials in adults undergoing major surgery under general anaesthesia. Methods: We re-analysed individual participant data comparing high or low positive end-expiratory pressure with low tidal volume intraoperative ventilation using a merged database derived from two randomised trials in non-obese (PROVHILO: ISRCTN70332574) and obese (PROBESE: NCT02148692) patients. The exposure of interest was low etCO2 (<4.7 kPa) vs normal-high etCO2 (≥4.7 kPa). The primary outcome was postoperative pulmonary complications within 5 days. A time-weighted etCO2 analysis and propensity score matching were also performed to adjust for confounding. Results: Of 2793 participants, 891 (29.4%; 52% female) had low etCO2, compared with 1972/2793 (70.6%; 65% female) participants with normal-high etCO2. Compared with participants with normal-high etCO2, higher minute volumes (normalised to body weight) were delivered in participants with low etCO2. Postoperative pulmonary complications developed in 278/821 (34%) participants with low etCO2, compared with 462/1972 (23%) participants who had normal-high etCO2 (adjusted hazard ratio, 1.3; 95% confidence interval, 1.1–1.6; P<0.001). The time-weighted analysis showed an inverse linear relationship between the mean etCO2 and postoperative pulmonary complications, which was also confirmed by propensity matching. Conclusions: Low etCO2 occurs often during intraoperative ventilation and is associated with a higher rate of PPCs. The etCO2 level has an inverse dose-dependent relationship with postoperative pulmonary complications. Clinical trial registration: NCT05550181
Erratum to Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial
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