bluuebunny/crossref_metadata_2025_split huggingface dataset:
Semipinacol rearrangement of a bicyclo[7.2.0]undecane framework into a bicyclo[6.3.0]undecane skeleton: a model study on the biosynthesis of seiridiasteriscane A
Authors: Ishibashi Osamu , Nishiyama Mami , Kwon Eunsang , Hashimoto Masaru , Kuwahara Shigefumi , Enomoto Masaru 
Published: May 2021

ABSTRACT
Seiridiasteriscane A is an asteriscane-type sesquiterpenoid bearing a trans-fused bicyclo[6.3.0]undecane skeleton. Although its biosynthesis has been proposed to involve a semipinacol rearrangement of a putative intermediary acetate bearing a bicyclo[7.2.0]undecane ring system (presumably derived from coisolated pestalotiopsin M) followed by epimerization of the resulting cis-fused seiridiasteriscane B, such a type of semipinacol rearrangement has never been reported so far. Our model study revealed that a 1-hydroxybicyclo[7.2.0]undecan-2-yl acetate underwent a smooth and stereospecific semipinacol rearrangement with the assistance of Et2AlCl to give the corresponding bicyclo[6.3.0]undecane-9-one. In addition, the resulting cis-fused 5,8-bicyclic ketone was partially epimerized to the corresponding trans-fused ketone by prolonged adsorption onto a silica gel plate. These results may support a recently proposed biosynthetic pathway of seiridiasteriscane A.
Discovery-defense strategy as a mechanism of social foraging of ants in tropical rainforest canopies
Authors: Antoniazzi Reuber , Camarota Flávio , Leponce Maurice , Dáttilo Wesley 
Published: May 2021

AbstractMany hypotheses have been proposed to explain the coexistence of ants sharing similar food resources, including ecological trade-offs, however, these hypotheses have mostly been tested in ground-dwelling ant communities. For instance, the discovery-dominance trade-off hypothesis states that species with overlapping food resources differ in their ability to find and dominate resources. However, ant species may use different strategies to share food resources, including discovery-defense, in which the first species to arrive at a food resource maintains control of it. Here, we evaluated whether the discovery-dominance trade-off hypothesis, or the discovery-defense strategy could be a mechanism that promotes coexistence of ant species in the canopy of highly diverse tropical forest canopies. We evaluated the succession of ant species on 72 baits exposed on 24 trees during 13 observation periods (15–195 min) in the canopy of a tropical rain forest in Mexico. In general, we observed little variation in ant species composition (i.e., low β-diversity values) during the 195 min of bait exposure. Moreover, we found that ant species with the greatest ability to discover new food resources were those that dominated them. These findings empirically show that the discovery-defense strategy can be a social foraging strategy in rain forest canopy ants and reject the discovery-dominance trade-off. In short, our results highlight the importance of the discovery of a food resource in the canopy of a tropical rain forest, allowing it to be dominated.
Full-length de novo protein structure determination from cryo-EM maps using deep learning
Authors: He Jiahua , Huang Sheng-You 
Published: May 2021

Abstract

Motivation
Advances in microscopy instruments and image processing algorithms have led to an increasing number of Cryo-electron microscopy (cryo-EM) maps. However, building accurate models for the EM maps at 3–5 Å resolution remains a challenging and time-consuming process. With the rapid growth of deposited EM maps, there is an increasing gap between the maps and reconstructed/modeled three-dimensional (3D) structures. Therefore, automatic reconstruction of atomic-accuracy full-atom structures from EM maps is pressingly needed.

Results
We present a semi-automatic de novo structure determination method using a deep learning-based framework, named as DeepMM, which builds atomic-accuracy all-atom models from cryo-EM maps at near-atomic resolution. In our method, the main-chain and Cα positions as well as their amino acid and secondary structure types are predicted in the EM map using Densely Connected Convolutional Networks. DeepMM was extensively validated on 40 simulated maps at 5 Å resolution and 30 experimental maps at 2.6–4.8 Å resolution as well as an Electron Microscopy Data Bank-wide dataset of 2931 experimental maps at 2.6–4.9 Å resolution, and compared with state-of-the-art algorithms including RosettaES, MAINMAST and Phenix. Overall, our DeepMM algorithm obtained a significant improvement over existing methods in terms of both accuracy and coverage in building full-length protein structures on all test sets, demonstrating the efficacy and general applicability of DeepMM.

Availability and implementation
http://huanglab.phys.hust.edu.cn/DeepMM.

Supplementary information
Supplementary data are available at Bioinformatics online.
662 Tool-tissue Forces in Surgery: A Systematic Review
Authors: Khan D Z , Kafai Golahmadi A , Mylonas G , Marcus H 
Published: May 2021

Abstract

Introduction
Excessive tool-tissue interaction forces in surgery may result in tissue damage and intraoperative complications, while insufficient forces prevent the completion of the task.

Method
A systematic review of studies exploring tool-tissue forces applied during surgery was performed in accordance with PRISMA guidelines.

Results
45 studies discussing tool-tissue forces during surgical procedures or tasks were included. Mean forces per speciality were as follows: ophthalmology (0.04N), vascular (0.7N), neurosurgery (0.68N), cardiothoracic surgery (1.5N), general surgery (4.7N), otorhinolaryngology (8.5N), obstetrics & gynaecology (mean 8.7N), urology (9.8N) and orthopaedic surgery (210N). Senior surgeons applied 25% less force than novice surgeons, and feedback (haptic, visual or audio) reduced force application by 40% - across specialities and tasks. Nervous tissue required the least amount of force to manipulate (0.4N, n = 17), followed by epithelial (3.8N, n = 18), muscle (4.1N, n = 4) and connective tissue (45.8, n = 10). For manoeuvres, retraction-with-grasping recorded the highest forces (3.65N, n = 13), whilst vessel clamping recorded the lowest (0.5N, n = 2).

Conclusions
The measurement of tool-tissue forces is a novel but rapidly expanding field. Knowledge of the safe range of surgical forces will improve surgical safety whilst maintaining effectiveness. Measuring surgical forces may provide an objective metric for training and assessment. Development of smart instruments, robotics and integrated feedback systems will facilitate this.
677 Incidental Diagnosis of Metastatic Prostate Cancer by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) In the Absence of Pelvic Lymphadenopathy
Authors: Rahman S , Islam R , Hammadeh M , Reekhaye A 
Published: May 2021

Abstract
Metastasis pattern of prostate cancer varies widely; however, predominant affinity is towards regional lymph nodes. Mediastinal lymphadenopathy as the initial presentation, in absence of any pelvic lymph node involvement, remains extremely rare. Most patients are incidentally diagnosed and often have widespread metastatic disease on confirmation of diagnosis. A high index of clinical suspicion is necessary and routine clinical examination such as a digital rectal examination (DRE) can aid in earlier diagnosis and prompt clinical intervention can improve disease outcome. We present this case study of a 53-year-old patient who was incidentally diagnosed with metastatic adenocarcinoma of prostatic origin by TBUS-EBNA of hilar lymph nodes in the absence of pelvic lymphadenopathy.
78 A Lockdown Dilemma; Ingestion of Magnetic Beads Presenting as Right Iliac Fossa Pain and Sub-Acute Small Bowel Obstruction
Authors: Oyewole B , Sandhya A , Maheswaran I , Campbell-Smith T 
Published: May 2021

Abstract
A 13-year-old girl presented with a three-day history of migratory right iliac fossa pain. Observations and inflammatory markers were normal, and an ultrasound scan was inconclusive. A provisional diagnosis of non-specific abdominal pain or early appendicitis was made, and she was discharged with safety netting advice.
She represented six days later with ongoing abdominal pain now associated with multiple episodes of vomiting; hence, the decision was made to proceed to diagnostic laparoscopy rather than a magnetic resonance scan for further assessment as recommended by the radiology department.
Intra-operative findings revealed 200mls of serous fluid in the pelvis, normal-looking appendix, dilated stomach, and a tangle of small bowel loops. Blunt and careful dissection revealed fistulous tracts that magnetized the laparoscopic instruments.
A mini-laparotomy was performed with the extraction of fourteen magnetic beads and the repair of nine enterotomies.
Foreign body ingestion is a known cause of abdominal pain, which in some cases might mimic or even be the cause of acute appendicitis.
This case highlights the importance of careful history taking in children presenting with acute abdominal pain of doubtful aetiology.
91 An audit of COVID-19 Awareness and Public Health Message Effectiveness in the Hospital Setting Over the Course of the Pandemic
Authors: Render L , Truss A , Waddington H , John S , Henderson C , Aldaraggi A , Page O 
Published: May 2021

Abstract

Introduction
An audit of healthcare workers investigated the effectiveness of Public Health England’s (PHE) information campaign across COVID’s timeline and assess knowledge between job roles.

Method
Data was collected across 3 cycles in 3 hospitals. A questionnaire assessed four domains: symptoms; spread; risk factors and the means to reduce transmission. PHE materials were shown before cycle 2 and respondents then subjected to the general campaign.

Results
253 responses were collected. Symptom recognition was 84%, increasing to 88% post-intervention, longer-term recognition remained high at 81% - including the new symptom of anosmia.
Identification of COVID’s means of transmission increased from 76% to 95% post intervention, risk factor recognition increased from 85% to 93% post-intervention. This fell to 74% later in the pandemic when recognised risk factors increased. Recognition of the new risk factors BAME status and BMI was 73% and 79% respectively in the final cycle.
Doctors had the highest number of pre-intervention correct answers for 3 domains and nurses gave the most incorrect answers for 3 domains pre-intervention.

Conclusions
We have shown the PHE message is being transmitted effectively. We have also shown an increase in hospital workers recognition of aspects of COVIDs characteristics that have since been verified in the literature.
190 Determinants of Psychological Well-Being in Healthcare Workers During the Covid-19 Pandemic: A Multinational Cross-Sectional Study
Authors: Goh E T , Denning M , Purkayastha S , Kinross J 
Published: May 2021

Abstract

Introduction
The Covid-19 pandemic has placed unprecedented pressures on healthcare systems globally, impacting working conditions, safety attitudes and the psychological well-being of healthcare workers. This cross-sectional study explores the prevalence and predictors of anxiety/depression amongst healthcare workers in the UK, Singapore, and Poland.

Method
From 22 March to 18 June 2020, healthcare workers from the UK, Singapore and Poland were invited to complete a self-administered questionnaire on psychological well-being. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Other components of the questionnaire include demographic information, Safety Attitudes Questionnaire (SAQ) measuring safety culture and the Oldenburg Burnout Inventory (OLBI) to measure burnout. Multivariate logistic regression was used to determine predictors of anxiety and depression.

Results
Of 3537 healthcare workers who participated in the study, 701 (20%) screened positive for anxiety and 389 (11%) for depression. Significant predictors of depression and anxiety include low SAQ score, nursing role, redeployment, burnout, and depression. There was significant overlap between anxiety and depression. The doctor role was protective.

Conclusions
Our findings demonstrate a significant burden of anxiety and depression amongst healthcare workers during Covid-19. These findings highlight the impact of Covid-19 on psychological well-being and suggests which groups would benefit from targeted support.
208 Assessment of The Impact Of COVID-19 On the Management of Patients with Neck of Femur Fractures in A Major Trauma Center In Wales
Authors: Solari F , Ansar Z 
Published: May 2021

Abstract

Introduction
Neck of femur (NOF) fractures form a significant proportion of trauma. Especially since they do not benefit from COVID-19 social isolation policies. Surgery and hospital admissions present risks to patients during the COVID-19 pandemic.

Method
Retrospective analysis of all NOF fractures from 24/3/20 to 26/6/20 in Morriston Hospital. Directly compared with 2019, allowing assessment of COVID-19’s impact.

Results
179 NOF fractures were admitted, 158 had an operation. Increased from 127 patients in 2019. Average time to surgery increased from 39 to 67 hours. There were operation delays for 98 patients, and non-operative treatment increased from 2 to 21 patients. Prompt orthogeriatric reviews completed in 80.4% patients in 2020, up from 72.5%. Prompt physiotherapy review increased from 66.9% to 74.6%. Mortality remained similar at 8.6% (2019) and 8.5% (2020). Average length of stay reduced; 17.4 to 11 days in 2020.

Conclusions
2020 saw increased waits for operations. There was reduction in length of stay and improved promptness of orthogeriatric and physiotherapy reviews. Increased non-operative treatment in 2020, reflecting decisions about risks and benefits of surgery in the pandemic. Mortality remained stable. This department improved some aspects of care, potentially due to pressures of COVID-19 heightening awareness of patient's needs.
228 Resilience, Mindset and Burnout of Healthcare Workers During the COVID-19 Pandemic
Authors: Lupi M , Maweni R , Foley R , Shirazi S , Machando D , Woods S , Vig S 
Published: May 2021

Abstract

Introduction
We investigated the impact of the Biopsychosocial challenges associated with the COVID-19 Pandemic on the Healthcare Workforce, exploring the impact on and relationship between Healthcare Workers’ Mindset, Resilience and Burnout.

Method
An electronic survey was distributed to Healthcare Workers through Professional Associations' websites and social media. The survey contained demographic questions, a Burnout Inventory, a General Resilience scale, a scale to assess for Resilience during the Pandemic, as well as an Adapted Dweck Mindset instrument to measure Mindset as related to Workplace Environment and Resilience. Univariate and multivariate analysis was undertaken to examine the relationship between these factors.

Results
1,370 healthcare workers completed the questionnaire. 58.5%, 25.4%, 28.5% reported having Burnout, Low General Resilience and Low COVID Resilience, respectively. Burnout was significantly associated with Fixed Mindset, Low General Resilience and Low COVID Resilience. Resilience Training was found to be protective for Burnout.

Conclusions
The COVID-19 Pandemic has led to a higher proportion of HCWs experiencing Burnout than previously reported. Our findings demonstrate that HCWs with Low Resilience and Fixed Mindsets are more likely to experience Burnout, suggesting that, in combination with improved institutional support, there is a role for personalised Resilience and Mindset Training, in helping reduce the proportion of HCW Burnout.
335 Planned Surgery in the COVID-19 Pandemic: A Prospective Cohort Study from Nottingham
Authors: Catton J , Banerjea A , Gregory S , Hall C , Crooks C , Lewis-Lloyd C , Marshall A , Humes D 
Published: May 2021

Abstract

Introduction
Globally planned surgical procedures were deferred during the current COVID-19 pandemic. We aim to report planned urgent and cancer case outcomes during the pandemic using a multi-disciplinary prioritisation group.

Method
Prospective cohort of patients prioritised by a multi-disciplinary COVID Surgery group undergoing urgent or cancer surgery at a NHS Trust from 1st March-30th April 2020. 30-day post-operative rates of PCR positive and suspected COVID-19 infections, 30-day mortality and COVID-19 related deaths are reported.

Results
During the period, 597 patients underwent surgery, median age 65-years (interquartile range 54-74) of which 86% (514/597) had a cancer diagnosis. 61% (362/597) had surgery at the NHS Trust whilst 39% (234/597) had surgery at Independent Sector hospitals. The COVID-19 incidence in the East Midlands was 193.7 per 100,000 population. 30-days following surgery, 1.3% (8/597) tested COVID-19 positive with all cases at the NHS site. 30-day mortality was 0.7% (4/597). Mortality following PCR positive COVID-19 diagnosis was 25% (2/8). Including PCR positive and suspected cases 3.0% (18/597) developed COVID-19 infection, 1.3% at the independent site compared to 4.1% at the NHS Trust (p = 0.047).

Conclusions
Rates of COIVD-19 infection in the post-operative period were low especially in the Independent Sector site. Mortality following a post-operative diagnosis of COVID-19 was high.
516 Patient Opinion on The Disruption Caused to Daily Life by Attending A Virtual Clinic Over A Face-to-Face Clinic Appointment in General Surgery During The COVID-19 Pandemic. A Retrospective Patient Feedback Study
Authors: Fanning S , Sturrock B , Palmer H , Hussain A , Carney C , Jaunoo S 
Published: May 2021

Abstract

Introduction
During the COVID-19 pandemic many hospitals adopted the use of virtual clinics to reduce in-person contact. We identified the need to assess patient’s opinion of the disruption caused to their lives by attending a virtual clinic appointment compared to a face-to-face appointment at a General Surgery department of a UK hospital.

Method
627 patients attended a virtual clinic in General Surgery between 25th March 2020 and 30th April 2020. Patients were selected using a random number generator; they were called and asked to complete a google survey which was sent via email. A shorter survey was also conducted over the phone for patients who did not have an email address.

Results
73 patients completed the online or telephone survey. 77.8% (n = 42) reported that they had no problems accessing the virtual clinic. 74.1% of patients (n = 40) agreed that virtual clinics caused less disruption to their daily life. 87.7% (n = 64) saved time by attending the virtual clinic. 67.1% (n = 49) saved two or more hours. 65.8% made a financial saving.

Conclusions
Patients found the clinic easy to access. Overall, the virtual clinics cause less disruption to patients’ lives than a face-to-face clinic appointment with notifiable savings in both time and money.
535 Private Trauma Lists: A Pragmatic Panacea During This Pandemic
Authors: Biggs A , Moore E , Zbaeda M , Shah K , Keightley A 
Published: May 2021

Abstract

Introduction
COVID-19 has disrupted the efficiency of hospitals nationwide. Ambulant trauma surgery was minimised to reduce risk of contracting COVID-19. Operating capacity significantly reduced and surgical training dramatically curtailed. Locally, a private hospital has been utilised as a green site with consultant-lead trauma lists. Our aim is to review the safety and efficiency of this service.

Method
Patients underwent pre-assessment, COVID-19 swabs and 7 days isolation pre and post-op. Staff also underwent swabbing. Prospectively data was gathered for all patients operated on at this site from 12/05/2020 to 20/08/2020. Records reviewed for readmission, complications and COVID status. A satisfaction questionnaire was sent to trainees who operated at this site.

Results
79 operations were completed during this period. 50 male and 29 female, average age 49, average ASA 2. No complications or COVID-19 infections were recorded. Mean time to theatre was 18 days. Delays to theatre led to 2 complications. 87% of trainees felt training was maintained.

Conclusions
Establishing a green site enabled efficient and safe management whilst still facilitating surgical training. This requires clear guidelines for staff and patients. We believe this model can help trauma service provision as the pandemic evolves.
598 Patients’ Knowledge and Compliance with Government Guidelines for COVID 19
Authors: Eskander J , Khallaf A , Zaki S , Elkawafi M , Makar R 
Published: May 2021

Abstract

Background
Since the outbreak of COVID-19; social distancing and recognized effective precautions were recommended by various governments to fight the viral spread.
Our aim was to assess the inpatient knowledge and compliance with the government guidelines during their hospital stay and at their discharge in two different NHS hospitals.

Method
The study took place in two hospitals: Berrywood hospital, UK and Countess of Chester hospital, UK. We invited inpatients to answer an anonymized questionnaire which was designed to include the contemporary government guidelines. We excluded patients with cognitive impairment and those who were not expected to be discharged within days.

Results
Out of 209 patients, 50% were male. Patients showed good awareness of the main symptoms of the virus (90%). However, A significant number of patients were not fully aware of the recommended precautions to minimize viral spread (28%) and the method of spread (43%). About 41% did not know the recommended safe distance.

Conclusions
Despite being aware of the main symptoms of COVID-19, a significant number of patients lack essential information needed to minimize the spread of the virus in the society and hospital. We recommend providing patients with information leaflets and direct advice on admission and discharge.
668 The Consequences to Emergency Surgery During COVID19 Pandemic in a UK District General Hospital in The North East of England
Authors: Evans R , Ng C 
Published: May 2021

Abstract

Aim
COVID19 pandemic has significantly affected surgical services. We aim to review its effects on our theatre output and risk of encountering COVID 19 cases.

Method
Serial record of operations performed locally were reviewed from start of UK COVID19 pandemic lockdown on 23rd March 2020 to 13th July 2020 after it was lifted. A weekly average by month of operations and the percentage of COVID19 cases diagnosed within 30 days of the procedure were noted.

Results
733 operations performed through this period. In March, 33 operations/week performed, 88.4% emergency and 7% diagnosed with COVID19. April, 31 operations /week performed, 95.9% emergency and 10.6% diagnosed with COVID19. May 46 operations /week performed, 94.5% emergency and 3.3% diagnosed with COVID19. June 56 operations /week, 80.9% emergency and less than 0.01% diagnosed with COVID19. By July 80 operations/week, 59.4% emergency and none diagnosed with COVID 19. Since testing capacity increased, only 6 of the 27 operated were diagnosed with COVID19.

Conclusions
There was initial reduction to non-emergency workload. However, this has gradually shifted as protocols are in place improve public confidence to return for surgical treatment. Mandatory admission testing allows early identification and remains essential for planning of services and protecting the workforce.