bluuebunny/crossref_metadata_2025_split huggingface dataset:
77 The Development of Core Outcome Sets and Common Data Elements in Clinical Neurosciences: A Scoping Review
Authors: Horsfall H L , Bandyopadhyay S , Chari A , Kolias A 
Published: May 2021

Abstract

Introduction
The use of core outcome sets (COS) and common data elements (CDEs) minimises research wastage by increasing the cross-comparison and meta-analysis of study findings. Our study sought to identify the clinical neuroscience subspecialties that have developed COS and CDEs, the countries of origin of authors, and the process through which COS and CDEs were developed.

Method
A search between 2000-2020 of the top 40 Impact Factor neurosurgical and neurological journals was conducted. A scoping review was performed in accordance with the PRISMA-ScR Checklist.

Results
Our search returned 169 papers, of which 35 were eligible for inclusion. The USA published the majority of papers (20/35). The papers mostly related to neurosurgery (30/35), with the most common neurosurgical sub-specialty being traumatic brain injury (14/35). There is an increasing publication trend over time, with 12 papers published in 2019. Five papers were systematic reviews conducting with the intention of COS/CDE development. 27 papers reported CDE development and 2 papers reported COS development. The COS development papers utilised international consensus meetings and adhered to international development statements.

Conclusions
COS and CDEs are increasingly being developed within clinical neurosciences. There is a need for greater international collaboration with regards to COS and CDEs development.
245 Multidisciplinary Learning in the Elective Orthopaedic Setting: Can Junior Doctors and Nursing Staff Learn Together?
Authors: Gnap R , Carew E , Wijeratna M 
Published: May 2021

Abstract

Introduction
Feedback from junior doctors highlighted dissatisfaction with the educational value of their orthopaedic job. Surveys showed that none had had a formal departmental induction, only 33% felt their confidence had improved during the placement and only 50% reported having adequate opportunities to complete workplace-based assessments. Nurses, overall, were dissatisfied with the relationship with ward-based doctors.

Method
We developed an educational programme for doctors and nurses which sought to cover induction to the specialty and common orthopaedic and allied specialty topics. The biweekly teaching programme utilised a variety of teaching methods including group learning, simulation, and seminars to facilitate interdisciplinary learning and team bonding with the emphasis on mirroring the way care is delivered. Doctors and nurses were re-surveyed at the end of the placement.

Results
75% of doctors had now received an induction and confidence in managing orthopaedic conditions improved from 33% to 75%. Adequate opportunities to complete assessments improved from 50% to 75%. 100% of nurses agreed that multidisciplinary learning was both possible and beneficial compared to only 54% beforehand.

Conclusions
Multidisciplinary education can improve confidence and teamwork among doctors and nursing staff. A service that boasts a robust teaching programme makes orthopaedics a more attractive speciality for nurses and doctors alike.
385 Intra-Operative Use of Biological Products – A Study Investigating the Awareness Amongst Surgeons in The UK
Authors: Bhamra N , Jolly K , Darr A , Bowyer D , Ahmed S 
Published: May 2021

Abstract
Global medical advances within healthcare have subsequently led to the widespread introduction of biological products such as grafts, haemostats, and sealants. Although these products have been used for many decades, this subject is frequently not discussed during the consent process and remains an area of contention.
A nationwide confidential online survey was distributed to UK-based junior registrars (ST3-5), senior registrars (ST6-8), post-CCT fellows, specialist associates/staff grade doctors and consultants working in general/vascular surgery, neurosurgery, otolaryngology, oral & maxillofacial surgery and plastic surgery.
Data was collected from a total of 308 survey respondents. Biological derivatives were correctly identified in surgical products by only 25% of survey respondents, only 19% stated that they regularly consent for use of these products. An overwhelming 74% of participants agreed that further education on the intra-operative use of biological materials would be valuable.
This study highlights deficiencies in knowledge that results in potential compromise of the consenting process for surgical procedures. A solution to this would be for clinicians to increase their awareness via educational platforms and to incorporate an additional statement on the consent form which addresses the potential intra-operative use of biological products and what their derivatives may be.
429 National Evaluation of Confidence and Preparedness for Surgical Rotations in Medical Students and Foundation Year Doctors
Authors: Tan L , Mullins W , Gargan A , Townsend J , Gargan K , Brice J , Shea J , Jang C , Shukla S , Asif A , Fricker M , Mohan M , Nathan A 
Published: May 2021

Abstract

Introduction
Limited published and anecdotal evidence suggests foundation year (FY) doctors start their surgical rotations with lower confidence than medical rotations. This may be due to insufficient undergraduate practical teaching related to common surgical rotations. This study aimed to evaluate the confidence and preparedness for surgical rotations of medical students and FY doctors.

Method
An expert-validated questionnaire was distributed nationally to UK medical students and FY doctors. The primary outcome was confidence in completing common tasks during surgical rotations.

Results
491 participants (84% medical students, 16% FYs) were recruited from 36 UK medical schools. 80% were likely to pursue a career in surgery however only 7% felt confident about starting a surgical FY job. 66% felt neutral or unsatisfied about the quality of medical school surgical teaching, and 80% indicated that placements did not prepare them well to manage common FY surgical tasks. The internal reliability of the questionnaire was high (=0.939).

Conclusions
Medical students and FY doctors lack confidence and preparation for surgical jobs. High-quality, practically grounded educational courses such as the National Surgical Teaching Society (NSTS) webinar curriculum could improve confidence and preparedness for surgical rotations. Further research evaluating the benefits of such courses is warranted.
520 Training in Electrocautery, Too Hot to Handle?
Authors: Waterman J , Osinkolu I , Abdeldayem M , Haray P 
Published: May 2021

Abstract

Introduction
The use of electrical energy has become common practice in surgery. Although electrocautery is deemed safe, arguably its safety is dependent on the level of knowledge among its users. The primary aim of this study is to assess what level of knowledge surgeons in Wales, UK have on the safe use of electrocautery.

Method
A survey was carried out involving 61 surgical doctors across 6 different health boards in Wales. The survey was implemented using an anonymous questionnaire distributed via online and by hard copy.

Results
Of the 61 doctors surveyed, 9.8% had not received any form of training on electrocautery. 54.5% of those who had training, had this through supervision or teaching in operating rooms during live operating. 37% of participants did not know the difference between bipolar and monopolar electrocautery. 77% of the participants expressed an interest in specific training to help increase the level of education and the safe use of electrocautery.

Discussion
This study shows that a gap still exists in the training and education of surgeons on the use of electrocautery. Electrocautery has the potential to cause harm and more needs to be done to improve education around this topic to ensure patient and user safety.
533 The Use of Virtual Reality Simulation to Facilitate Surgical Ward-Based Learning in Medical Students During the Covid-19 Pandemic
Authors: Carty I , Shah R 
Published: May 2021

Abstract

Introduction
The Covid-19 pandemic quickly resulted in the removal of all non-essential personnel from surgical wards. It also resulted in suspending medical student placements which are heavily relied upon to provide the students with necessary “hands-on” experience. Virtual Reality (VR) simulation was employed in order to ensure that the students had a comparable experience.

Method
VR simulations were used to simulate the ward environments and the students were able to gain valuable experience with common scenarios encountered on surgical wards. Each student was allocated a 1-hour time slot per session with a debriefing session after each. The digital immersive environment allowed students to build upon their didactic preparation and previously acquired knowledge base.

Results
Feedback was given at the end of each simulation by the simulation facilitator. Using the technical proficiency that they had acquired in the first scenario; the students went on to employ these skills directly in their next scenarios thereby capitalising on the repetition of core skills to maximize their learning.

Conclusions
In this instance, VR was successfully used to enhance both knowledge acquisition and experience. Feedback from the participating students was overwhelmingly positive with many suggesting that they were more comfortable learning in a simulated environment.
747 YouTube And Neurosurgery: Better Content, More Views
Authors: Mayo I , Manivannan S , Bisson J , Leach P , Zaben M 
Published: May 2021

Abstract

Introduction
YouTube is the world’s largest open-access media sharing platform and contains much content on Neurosurgery. Inserting an External Ventricular Drain is a common procedure, often performed by neurosurgical trainees to treat emergency hydrocephalus. We set out to evaluate the content on EVD insertion posted on YouTube and its usefulness for trainees in learning the procedure

Method
A YouTube keyword search was conducted to identify videos on EVD insertion. Inclusion criteria was used to find videos specifically aimed to EVD insertion. We devised a scoring sheet to give each video an educational score (0-20), which two independent reviewers used to analyse the included videos.

Results
A total of 12/556 videos met the inclusion criteria. Dates posted ranged from 01/07/2012 to 24/04/2019, with views ranging from 359 – 166,388 (mean 30531, SD 49, 570). The mean educational score was 6.91 (SD 3.86), with only four videos scoring 10 or greater. There was a strong correlation between viewership and educational score (R .085 p &lt;.001).

Conclusions
The majority of YouTube content relating to EVD insertion is not useful to trainees, but useful content can attract a greater viewership. There is an opportunity for Neurosurgeons and Institutions to gain exposure on YouTube with high-quality open-access educational content.
843 Improving Practical Skills Training with In-Situ Trauma Simulation
Authors: Fisher R , Nambiar A , Subramanian R 
Published: May 2021

Abstract

Introduction
Safe and effective management of trauma patients requires numerous practical skills. Our in-situ trauma simulation identified key areas requiring increased training and exposure. This enabled improvement to education, patient safety and efficiency when managing these emergencies.

Method
We carried out a simulated trauma call according to ATLS principles, recording the time and person completing each task. Key areas for improvement were identified; most notably the application of Femoral Traction Splints (FTS). 0/7 doctors present were not able to do this. Subsequently, a formal training day was delivered, with 38 attendees across specialties, assessing confidence before and after the session.

Results
Prior to the training session, 52.6% of attendees did not have formal teaching using FTS and 65.8% had never used one. Confidence with FTS application was measured on a scale of 1 (not confident) to 5 (very confident), with an average score of 2.6/5.
After training, the average confidence score was 4.7/5 (p &lt; 0.01). 100% of participants found the session very useful.

Conclusions
In-situ simulation allows identification of key areas for improvement in training of practical skills. Essential tailored teaching can then be delivered to increase exposure and confidence for these necessary practical skills.
879 Establishing the First Eoe Deanery-Wide Trainee Led Virtual Journal Club: Keeping Up Morale by Encouraging Trainee Interaction and Continuous Professional Development During the Hiatus to Teaching Activities Enforced by Coronavirus
Authors: Adegbola S , Rabie M , Currow C , Aly M , Patel K , Aker M , Patel K , Askari A 
Published: May 2021

Abstract

Introduction
Over the initial COVID months and with the cancellation of several teaching programs / courses/ conferences; we identified a NEED for trainee interaction and continuous professional development, despite staff redeployments. We since established a deanery-wide trainee led VIRTUAL journal club, run by the Surgical Trainees of East of England Research collaborative (STEER) group.

Method
Following decision in May2020, the STEER group collated curriculum topics and related landmark papers, drafting a programmed-schedule for sessions (45mins – 1hour). CPD accreditation was sought and received from RCSEd prior to some sessions. Sessions were delivered using the Microsoft Teams app (via desktop/tablet/phone). Targeted audience included FYs, CTs, STs, JCFs, SCFs (candidates preparing for MRCS/FRCS or interested in academia). Live polling / feedback forms and attendance certificates were distributed.

Results
Six journal club sessions have been run to-date. A minimum of 15-20 participants attended each session with spread of junior/senior trainees. Sessions were video recorded for repeat playback for those unable to attend. Feedback was overwhelmingly positive, with good engagement from participants.

Conclusions
A deanery wide virtual journal club was positively received by trainees and benefits included: critique and dissemination of evidence (especially recently with COVID-related literature), trainee interaction and keeping up-to-date and understanding and analysing information.
908 Personal Protective Equipment (PPE) Guidance During A Global Pandemic: A Statistical Analysis of National Perceived Confidence, Knowledge, And Educational Deficits Amongst U.K. Based Doctors
Authors: Al-Hity S , Bhamra N , Kumar R , Gupta K , Howard J , Jolly K , Darr A 
Published: May 2021

Abstract

Introduction
March 11th, 2020 saw the World Health Organisation declare a global pandemic following the eruption of the novel coronavirus disease 2019. Unprecedented global demand for personal protective equipment (PPE) was complicated by limited availability and conflicting guidance from healthcare bodies. This study aimed to assess perceived confidence and knowledge of Public Health England’s PPE guidance amongst doctors of varying specialties and grades.

Method
A nationwide 11-point survey comprising of multiple-choice questions (MCQs) and a Likert scale assessing perceived confidence (1=not confident, 5=very confident) was disseminated to U.K. based doctors using multiple platforms.

Results
Data collated from 697 respondents revealed average perceived confidence was low. Notably, 59% felt they had received insufficient education regarding up-to-date guidance, with 81% advocating further training. Anaesthetics and ophthalmology were the highest and lowest scoring specialties in knowledge based MCQs, achieving 59% and 31% respectively. Subsequent statistical analysis revealed significant differences between specialties."

Conclusions
Ensuring consistency in published PPE guidance and education can develop doctor’s confidence and knowledge of appropriate PPE use. The absence of a unified consensus and global education regarding the use of PPE poses significant ramifications for patient and healthcare professional (HCP) safety whilst risking further depletion of already sparse resources.
986 A Systematic Review of Medical Student Willingness to Volunteer and Preparedness for Pandemics and Disasters
Authors: Byrne M , Ashcroft J , Alexander L , Wan J , Harvey A 
Published: May 2021

Abstract

Introduction
We aimed to identify motivators and barriers to volunteering during a disaster and knowledge and medical school curriculum of disaster and pandemic medicine.

Method
We systematically searched the literature on 28/6/2020, following PRISMA guidelines.

Results
A total of 37 studies met inclusion criteria including 11,168 medical students and 91 medical schools. 24 studies evaluated knowledge (64.9%), 16 evaluated volunteering (43.2%), and five evaluated medical school curricula (13.5%). Weighted mean willingness to volunteer during a disaster was 68.4% (SD = 21.7%, n = 2911), and there was a significant difference between those planning to volunteer and those who actually volunteered (P&lt;.001). We identified a number of modifiable barriers which may contribute to this difference. Overall, knowledge of disasters was poor with a weighted mean of 48.9% (SD = 15.1%, n = 2985).

Conclusions
There is a large number of students who are willing to volunteer during pandemics. However, they are likely to be under-prepared for these roles due to poor overall knowledge and limited teaching. During the current COVID-19 pandemic and in future disasters, medical students may be required to volunteer as auxiliary staff. Medical schools need to develop infrastructure to facilitate this process as well as providing education and training to ensure students are adequately prepared for these roles.
19 Colectomy Rate for Moderate to Severe Ulcerative Colitis with Biologics
Authors: Koh J W H , Ng C H , Lee M H , Chin Y H , Ong Z H , Tham H Y , Chong C S , Shim H H , Fo F J 
Published: May 2021

Abstract

Introduction
Biologics are recommended by both the ACG and ECCO community for the treatment of ulcerative colitis. Yet, current literature has yet to estimate the rate of colectomies after biologic therapy, and thus a pooled meta-analysis was conducted the rate of colectomies in 1month, 6 months, 1 year, 2years and five years after biologics.

Method
Medline and Embase were searched for articles examining biologics use in moderate to severe UC or acute severe UC (ASUC) from inception to 21st May 2020. Analysis of proportions were undertaken after a freeman-tukey double arcsine transformation.

Results
The pooled overall colectomy rates of ASUC and moderate to severe UC were 9% (CI: 4% - 14%) at one month, 18% (CI: 13% - 25%) at six months, 21% (CI:16% - 27%) at one year, 29% (CI:24% - 34%) at two years and 38% (CI:30% - 45%) at five years. Additionally, colectomy rates were consistently lower comparing between articles before and after 2010. At one-year, overall colectomy rate following infliximab use was at 25%, golimumab at 15%, vedolizumab at 14%, and adalimumab at 3%.

Conclusions
Colectomy rates in the era of biologics ranged from 8% to 38% and lower post-2010 showing significant improvement in management and supporting the utility of biologics in Ulcerative colitis management.
20 Post-Operative Biologics and the Rate of Recurrence in Crohn’s Disease
Authors: Ng C H , Jain S R , Ow Z G W , Lim W H , Tham H Y , Wong N W , Chong C S , Foo F J 
Published: May 2021

Abstract

Introduction
Post-operative recurrence after Crohn’s surgery poses a significant challenge to clinicians with an estimated of 70-90% recurrence rate. However, with the advent of biologics, reduction of recurrence after surgery has been observed in various landmark trials. Hence, we aim to quantify the rate of recurrence with post-operative biologics.

Method
Searches were done on Embase and Medline database for articles using biologics for post-operative management. A single arm meta-analysis with generalized linear mixed model and Clopper-Pearson method confidence interval was applied in the synthesis of the data on six months, one year, two year and five year.

Results
A total of 1,864 abstracts were identified, with a final total of 24 articles and 1042 patients were included in the meta-analysis. The one-year rate of recurrence for surgical, endoscopic and clinical was 3.08% (CI: 0.74% - 11.95%), 19.93% (15.81% - 24.81%) and 13.06% (CI: 8.18% - 18.92%) respectively. Correspondingly, the five-year recurrence 16.90% (CI: 9.57% - 28.11%), 84.21% (CI: 72.35% - 91.57%), 5.60% (CI: 9.92% -23.66%) respectively.

Conclusions
An observed reduction in surgical rates was reduced at five years with post-operative Crohn’s disease with biologics. Biologics therapy thus can be considered as a suitable alternative for reducing post-operative recurrence in individuals with higher risk.
373 A Review of Microsatellite Instability (MSI) Testing: Real World Clinical Data
Authors: Harris C , McCallum I , Mills S 
Published: May 2021

Abstract

Introduction
Colorectal cancers (CRC) are the second most common cause of death by cancer, in the UK. Microsatellite instability (MSI) analysis is novel yet important part of managing CRC and used as a tool for predicting prognosis, treatment and identifying lynch syndrome. Where lynch syndrome is identified, preventative screening can be utilised. Previous studies only focused tumour testing on high-risk cases.

Method
A retrospective study at Northumbria Health Care NHS Trust was performed on all new CRC patients between 2017-2020.

Results
A total of 965 patients with CRC were identified. After exclusion criteria was applied to the cohort, a total of 483 patients were identified as having undergone MSI analysis. The mean age was 73.5 years old, with the female to male ratio being 1:1.4. Patients were further grouped into MSI stable, low, and high. MSI High patients accounted for 10% of patients analysed. Further genetic testing was performed on these patients which highlighted 28 patients with BRAF positive genes who went on to screening for Lynch syndrome associated cancers.

Conclusions
MSI testing provides essential diagnostic, prognostic information and also guides treatment options. 2.9% of patients identified as high risk for familial cancers and went on to have genetic screening and surveillance.
428 Hepatic Epithelioid Hemangioendothelioma: A Rare Vascular Malignancy Mimicking as Intrahepatic Cholangiocarcinoma
Authors: Kawka M , Mak S , Qiu S , Gall T M H , Jiao L R 
Published: May 2021

Abstract
Hepatic epithelioid hemangio-endothelioma (EHE) is a rare, often misdiagnosed malignancy of vascular origin. We describe a case of a 36-year-old, who presented with a burning sensation in his chest on exercise and was believed to have bilobar intrahepatic cholangiocarcinoma. After receiving chemotherapy with partial response, the patient underwent staged resection modified ALPPS (associating liver partition with portal vein ligation for staged hepatectomy) procedure – laparoscopic radiofrequency assisted ALPPS (RALPPS). Histological examination of the stage 1 specimen revealed EHE deposits in the left lobe of the liver. The patient proceeded to have stage 2 open right hepatectomy with concurring histology. 90-days follow-up CT scan showed almost complete resolution of EHE lesions.
Low incidence, non-specific clinical and radiological characteristics all contribute to high EHE misdiagnosis rate. Histological analysis can be used for confirmation of the diagnosis; however, specialist staining is required, which is not routinely performed. Multiple treatments are available against EHE, but only liver resection and liver transplantation are potentially curative. ALPPS and its modifications (such as RALPPS) offer an alternative for conventional two-stage hepatectomy for patients with extensive bilobar EHE, who are at risk of developing post-hepatectomy liver failure or patients with anomalous hepatic vasculature anatomy, which makes PVE challenging.