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In the pre-vaccine era, surgical patients without evidence of prior infection had similar comorbidity rates to patients pre-pandemic, but patients operated on within 7 weeks of infection had higher comorbidity rates. Surgery soon after COVID-19: transparent big data have value but careful interpretation is still required The study examines morbidity and mortality rates in patients undergoing surgery within 2 weeks, 2-4 weeks, 4-7 weeks or > 7 weeks after their most recent evidence of a SARS-CoV-2 infection compared with patients without evidence of previous infection. Keywords: cancellation; COVID-19; guidelines; surgery EN cancellation COVID-19 guidelines surgery 671 676 6 05/08/23 20230601 NES 230601 Unnecessary delays to surgery should be avoided. [Extracted from the article]

Summary: What is known and objectives: Inadequate management of chronic medication puts patients at risk and causes unnecessary suspension of surgical procedures. The objective of the study was to calculate the rate of cancellation of elective surgical procedures due to inadequate management of chronic medications and to analyse the underlying causes of cancellation. Methods: We designed an analytic, observational, retrospective study of all elective surgical procedures performed from July to October 2017 in a tertiary hospital. The main variable was the percentage of surgeries cancelled owing to inadequate management of chronic medications. Other variables recorded included demographic characteristics, time between the preanaesthesia evaluation and surgery, drug involved, and the reason for incorrect management of the medication. Results: During the study period, 5415 surgical procedures were programmed, and 793 (14.6%) were cancelled. Cancellations due to inadequate patient preparation accounted for 5.3% (42 cases), and 19 were related to incorrect medication management (2.4% of the total number of cancellations). The 19 patients, who were mostly men (73.7%), had a median age of 76 years (IQR 68‐81). The drugs involved were acenocoumarol (6), enoxaparin (4), clopidogrel (4), direct‐acting oral anticoagulants (2), acetylsalicylic acid (1), tocilizumab (1) and leflunomide (1). The reasons for drug mishandling were poor understanding of the anaesthesiology recommendations (15) and lack of a preanaesthesia evaluation (4). What is new and conclusion: Inadequate management of chronic medications (2.4%) is not the most frequent reason for cancellation, although it is one of the easiest to avoid. Based on our results, starting in October 2017, the Pharmacy Department began to offer a pharmaceutical service to patients with doubts about the preoperative management of chronic medications. [ABSTRACT FROM AUTHOR]

Prism adaptation (PA) is a widely used intervention for (visuo‐)spatial neglect. PA‐induced improvements can be assessed by visual search tasks. It remains unclear which outcome measures are the most sensitive for the effects of PA in neglect. In this review, we aimed to evaluate PA effects on visual search measures. A systematic literature search was completed regarding PA intervention studies focusing on patients with neglect using visual search tasks. Information about study content and effectiveness was extracted. Out of 403 identified studies, 30 met the inclusion criteria. The quality of the studies was evaluated: Rankings were moderate‐to‐high for 7, and low for 23 studies. As feature search was only performed by five studies, low‐to‐moderate ranking, we were limited in drawing firm conclusions about the PA effect on feature search. All moderate‐to‐high‐ranking studies investigated cancellation by measuring only omissions or hits. These studies found an overall improvement after PA. Measuring perseverations and total task duration provides more specific information about visual search. The two (low ranking) studies that measured this found an improvement after PA on perseverations and duration (while accuracy improved for one study and remained the same for the other). This review suggests there is an overall effect of PA on visual search, although complex visual search tasks and specific visual search measures are lacking. Suggestions for search measures that give insight in subcomponents of visual search are provided for future studies, such as perseverations, search path intersections, search consistency and using a speed–accuracy trade‐off. [ABSTRACT FROM AUTHOR]

Disorders in spatial exploration can be expressed in a disorganized fashion of target cancellation. There is debate regarding whether disorganized search is related to stroke in general, to right brain damage or to unilateral spatial neglect ( USN) in particular. In this study, 280 stroke patients and 37 healthy control subjects performed a computerized shape cancellation test. We investigated the number of perseverations and several outcome measures regarding disorganized search: Consistency of search direction (best r), distance between consecutive cancelled targets and intersections with paths between previous cancelled targets. We compared performance between patients with left and right brain damage ( L, R) and with and without USN ( USN+, USN−), resulting in four subgroups: LUSN−, RUSN−, LUSN+, and RUSN+. Higher numbers of intersections were found for the left brain- and right brain-damaged patients with USN and for the right brain-damaged patients without USN, compared to healthy control subjects. Furthermore, right brain-damaged patients with USN showed a higher number of intersections compared to right brain-damaged patients without USN and compared to left brain-damaged patients with USN. To conclude, disorganized search was most strongly related to the neglect syndrome, and patients with more severe USN were even more impaired. [ABSTRACT FROM AUTHOR]

Purpose: To investigate potential indicators of in vitro fertilization (IVF) treatment outcome for female infertility patients aged ≥ 40 years based on the clinical course. Methods: We retrospectively examined results of 111 female infertility patients aged ≥ 40 years undergoing IVF treatment. We investigated the relationship between treatment cycle cancellation and the final outcome of IVF treatment in female infertility patients aged ≥ 40 years. Results: A total of 44 pregnancies were achieved. Overall pregnancy rate per initiated treatment cycle was 12.1%, and 24 spontaneous abortions occurred (54.5%). No woman aged ≥ 45 years achieved pregnancy. No patients conceived after 10 treatment cycles while 42 (11.5%) oocyte pick-up cycles and 120 (33.0%) embryo transfer cycles were canceled. Investigation of correlation with treatment cycle cancellation revealed that patients who experienced embryo transfer cancellation had a high spontaneous abortion rate while only a few patients who experienced oocyte pick-up cancellation achieved pregnancy and even fewer achieved a successful outcome. Conclusions: Our study suggests that, in addition to patient age and number of treatment cycles, cancellation of treatment cycle also provides another useful indicator for pregnancy outcome. [ABSTRACT FROM AUTHOR]

Aim: Cancelled operations are a major drain on hospital resources. The maxillofacial department at the Leicester Royal Infirmary (LRI) performs at least 14 elective operating sessions each week. A study reported that our cancellation rate or performance indicator (PI) was 0.3% at LR1. The most common reasons for cancellation of procedures at that time were lack of post-operative beds and insufficient operating time. This study aimed to continue to develop a methodology for looking at this complex issue and to further investigate the reasons for delay to assess whether the system could be managed more efficiently. Material and Methods: In this study, the computerised theatre records system has been utilised to investigate the reasons for theatre delays. A retrospective analysis of data for 1212 patients treated in the 1 year period between December 2006 and December 2007 was performed. Results and Conclusions: Eight hundred and forty-nine patients were treated on a day-surgery basis, of which 710 were dentoalveolar procedures and 139 were other operations. The remaining 363 patients were treated as in-patients of which 97 were oncological patients, 84 orthognathic, 35 salivary gland surgery, 65 traumas, and 82 other operations. Sixty-four (5.28%) of these treatment episodes were logged as delayed. The main reasons for delays were related to the ward (17%) or anaesthetist (22%).The operating time consumed 74% of the overall time in theatre complex. The utilisation of operating time was much better for in-patient operations (81%) than day-surgery procedures (64%). Suggestions have been made to reduce theatre delays. [ABSTRACT FROM AUTHOR]

Time Warp distributed simulations can enter a catastrophic state of cascading rollbacks where out of order (premature) event executions propagate faster than the corrective measures (anti-messages) designed to terminate them. In this paper, a distributed, proactive cancellation mechanism designed to avoid this situation is presented. We also present a version of total clocks called Plausible Total Clocks (PTC). PTC employs a compact time vector of event counter range to address the scalability issues typically suffered by total clock solutions. That is, PTC consists of constant size vectors and are independent of the number of simulation objects in the simulation. The events generated due to an out of order execution are proactively cancelled by determining its causality relation with the already annihilated events. We present a proof of correctness of the distributed cancellation mechanism using PTC and also show that the catastrophic states are avoided with this proactive cancellation mechanism. This cancellation mechanism assumes first-input–first-output communication layer, static inter-connection topology, and logical processes consisting of multiple simulation objects. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A central goal of neuroscience is to understand the cellular mechanisms enabling the cultural transmission of behaviors, such as speech and music. Birdsong is a rare non-human instance of a culturally transmitted vocal behavior. The songbird's brain provides a powerful system in which to study the cellular mechanisms underlying auditory-guided vocal learning. Identifying those mechanisms requires an analysis of synaptic function, because the synapse is the fundamental organizational unit of the neuronal networks that mediate behavior. Intracellular recordings provide a powerful method for simultaneously probing the activities of a single neuron and the synaptic networks in which that cell is embedded. This chapter details initial steps in the in vivo intracellular analysis of the synaptic connectivity of neurons important to singing and song learning. Our analysis is focused upon HVC and involves studies of interneurons as well as projection neurons of the two major output pathways of HVC. We test predictions derived from several models of how such learning may take place, including contributions from "comparator" and "corollary discharge" auditory feedback cancellation mechanisms. Our studies in anesthetized animals and brain slices provide insight into the synaptic properties of HVC that might be well suited for these mechanisms, although extrapolation to synaptic behavior in the awake, singing bird must be made with caution. We suggest that future work must extend the analysis of synaptic properties into the intact brain of the songbird, preferably as the bird learns to sing. [ABSTRACT FROM AUTHOR]

This article presents findings on the restructuring component of the decision process. Two experiments are described employing hypothetical vacation choice dilemmas. The aim was to explore the conditions under which outcomes common to two risky prospects with the same probabilities of occurrence are or are not cancelled and how consequent decisions are influenced. The design of the options presented to participants was based on pilot work to establish appropriate contexts. The key independent variable was the semantic relatedness between outcomes of the same risky prospect. The main finding was that the participants did not cancel the outcome shared by two prospects when it was semantically related to another outcome within the same prospect. In this case, the prospect with greater risk was chosen significantly more frequently in comparison to when the common outcome was unrelated to other outcomes. An interpretation of the findings is presented in terms of contingent editing processes. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]