bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detuning regulation of temporal solitons in a CaF2 microcavity
Authors: Xu Xin , Jin Xueying , Gao Haoran , Ye Huichun , Chen Dong , Lu Yang , Yu Liandong 
Published: October 2021

Abstract
Detuning regulation based on the scanning pump wavelength plays an important role in the generation of temporal solitons in an optical microcavity. Field evolution inside a CaF2 microcavity during the detuning regulation process is demonstrated. It is found that a stable single soliton can be excited when modulation instability dominates in the microcavity during frequency tuning with an appropriate scanning speed and operational parameters. However, due to the excessive loss caused by tuning, the soliton eventually evolves into a DC distribution. The influence of different parameters on the light field after formation of the soliton is also studied. Other different parameters lead to different distributional forms of soliton evolution. For maintenance of the single soliton, the appropriate detuning parameter and pump power are changed suddenly after the soliton is generated, causing the soliton to remain stable. Moreover, in the single soliton region, a path within the parameter space of detuning and pump power is planned in order to compress the pulse width of the soliton, and the comb spectrum is broadened. The results of theoretical analysis are important for studying field and spectral characteristics during frequency detuning and for maintaining the temporal soliton in the microcavity.
The role of NaSICON surface chemistry in stabilizing fast-charging Na metal solid-state batteries
Authors: Quérel Edouard , Seymour Ieuan D , Cavallaro Andrea , Ma Qianli , Tietz Frank , Aguadero Ainara 
Published: October 2021

Abstract
Solid-state batteries (SSBs) with alkali metal anodes hold great promise as energetically dense and safe alternatives to conventional Li-ion cells. Whilst, in principle, SSBs have the additional advantage of offering virtually unlimited plating current densities, fast charges have so far only been achieved through sophisticated interface engineering strategies. With a combination of surface sensitive analysis, we reveal that such sophisticated engineering is not necessary in NaSICON solid electrolytes (Na3.4Zr2Si2.4P0.6O12) since optimised performances can be achieved by simple thermal treatments that allow the thermodynamic stabilization of a nanometric Na3PO4 protective surface layer. The optimized surface chemistry leads to stabilized Na|NZSP interfaces with exceptionally low interface resistances (down to 0.1 Ω cm2 at room temperature) and high tolerance to large plating current densities (up to 10 mA cm−2) even for extended cycling periods of 30 min (corresponding to an areal capacity 5 mAh cm−2). The created Na|NZSP interfaces show great stability with increment of only up to 5 Ω cm2 after four months of cell assembly.
mySmartCheck, a Digital Intervention to Promote Skin Self-examination Among Individuals Diagnosed With or at Risk for Melanoma: A Randomized Clinical Trial
Authors: Manne Sharon L , Marchetti Michael A , Kashy Deborah A , Heckman Carolyn J , Ritterband Lee M , Thorndike Frances P , Viola Adrienne , Lozada Carolina , Coups Elliot J 
Published: October 2021

Abstract

Background
Regular skin self-examination (SSE) reduces melanoma mortality but is not often conducted.

Purpose
To promote SSE performance in individuals at increased risk for melanoma.

Methods
One hundred sixteen individuals at heightened risk for development of melanoma (i.e., personal/family history of melanoma, high-risk mole phenotype) who did not conduct a thorough SSE during in the prior 3 months were randomly assigned to receive either an automated internet-based intervention (mySmartCheck) or usual care (UC). One hundred sixteen participants completed surveys before random assignment and 99 completed the follow-up survey 13-weeks afterward. The primary outcome was participant self-reported examination (SSE) of all 15 parts of the body in the last 3 months. Secondary outcomes were SSE of any part of the body in the last 3 months and number of body parts examined during the last SSE.

Results
More mySmartCheck participants examined all 15 body parts (32.6% vs. 7.1%, p = .001). More individuals in mySmartCheck reported conducting SSE on any body part than those in UC (81.4% vs. 62.5%, p = .04). Effect sizes were large (d = 1.19 all 15 body parts) to moderate (d = 0.55 for any body part). mySmartCheck participants examined more body areas than UC participants (12.7 vs. 10.3, p = 0.003) during the last SSE. Participants in mySmartCheck reported higher levels of knowledge of suspicious lesions, SSE benefits, SSE self-efficacy, and planning for SSE, and lower SSE barriers, than those assigned to UC.

Conclusions
mySmartCheck had a significant positive impact on SSE performance and behaviors. Additional research with a larger sample size, a longer follow-up, and more varied clinical settings is needed.

Trial Registration
ClinicalTrials.gov registration # NCT03725449 (https://clinicaltrials.gov/ct2/show/NCT03725449).
An electronic tool for health systems to assess and communicate discharge medication access
Authors: Griebe Kristin M , Hencken Laura N , Efta Jessica , Patel Nisha , Stine John J , Bott Brandon , El-Khoury Caren , MacDonald Nancy C 
Published: October 2021

Abstract

Purpose
The purpose of this study was to describe how the discharge medication cost inquiry (DMCI) consult order and workflow were created and used to communicate transition of care needs and medication access barriers before discharge.

Summary
Health-system pharmacists collaborated with the information technology department to develop the DMCI consult order and workflow. This institutional review board–approved retrospective case study evaluated use of the DMCI consult order throughout the health system. Outcomes that could not be retrieved electronically were collected for every third patient encounter using manual chart review. The DMCI consult order was used at each hospital in the health system. Physicians placed the most DMCI consult orders; however, pharmacists at the large academic tertiary hospital utilized the DMCI consult order the most. The DMCI consult order was sent most frequently for anticoagulants. Although most medications were covered by insurance, the tool and workflow identified barriers to medication access. Almost 90% of the patients with a DMCI consult order had at least one prescription generated on discharge.

Conclusion
The DMCI consult order is a novel electronic tool to aid in communicating discharge medication needs. When incorporated into care transition planning, the DMCI consult order and workflow provide a model to ensure patients have access to medications. It can also be used to document and evaluate the role of pharmacy in transitions of care in the health system.
1160 LEARN (Urological Teaching in British Medical Schools Nationally): A Multicentre Cross-Sectional Study
Authors: Ng A , Chan V W S , Asif A , Lam C M , Light A , Jayaraajan K , Cambridge W A , Matthew M G , Clement K D , Kulkarni M , Bhatt N R , Khadhouri S , Kasivisvanathan V 
Published: October 2021

Abstract

Introduction
Urology is a common rotation for UK Foundation Year (FY) doctors, and accounts for &gt;25% of acute surgical referrals. In 2012, the British Association of Urological Surgeons (BAUS) produced ‘An Undergraduate Syllabus for Urology’, advising on common clinical areas of urology to be covered during medical school. However, its national uptake remains unknown. LEARN aims to assess undergraduate urology teaching across UK medical schools.

Method
LEARN is the largest ever multicentre cross-sectional study of undergraduate urology teaching. Year 2-5 medical students and FY1 doctors were invited to complete a survey between 3rd October-20th December 2020. The primary objective is to compare current undergraduate urology teaching against the BAUS syllabus. Secondary objectives investigate the type and quantity of teaching provided, the reported performance rate of GMC mandated urological procedures, and the proportion of those considering urology as a career.

Results
A total of 7,611/8,346 (91.2%) responses from 39 medical schools that met the inclusion criteria were analysed. 16.5% of responses were newly appointed FY1 doctors. In their undergraduate training, the most commonly taught topics were urinary tract infection, acute kidney injury and haematuria; the least taught topics were male urinary incontinence, male infertility and erectile dysfunction. 90.6% and 86.3% had reported performing catheterisation as undergraduates on male and female patients respectively, and 16.9% had considered a career in urology.

Conclusion
LEARN provides the largest evaluation of any undergraduate specialty teaching. It has identified areas to improve teaching, to equip the future workforce with the competencies to manage urological pathology, irrespective of future career choice.
1565 In Covid-19 Pandemic, Following the Updated Royal College of Surgeons of England Guidelines in Management of Acute Appendicitis; A General District Hospital Audit
Authors: Dorra A , Abdellatif M , Fahmy W , Salama Y 
Published: October 2021

Abstract

Aim
The Aim of the study is assessment of the compliance with the updated Royal College of Surgeons of England (RCS) guidelines in management of acute appendicitis in a general district hospital during COVID-19 pandemic. Conservative treatment of acute appendicitis is encouraged unless unresponsiveness to treatment or complications ensues.

Method
Collection of retrospective data using hospital coding system was done from 63 patients medical records who were diagnosed with acute appendicitis from April 2020 to June 2020.

Results
The collected data analysis showed adherence to conservative treatment in 16 out of 63 (16/63) patients (25.4%). It succeeded in 10/16 patients (63 %). 6/16 patients were switched to operative intervention (37 %). There were no complications in patients who needed operative intervention after failure of conservative management. Operative management was primarily chosen in 47/63 patients (74.6 %). Re-admissions were 3/16 patients (18.75 %) in conservative group in comparison to 1/47 patient (2.12 %) in primarily operative group.

Conclusions
The work showed a promising rate of success of conservative treatment. However, there is a low level of compliance with RCS guidelines in management of acute appendicitis during COVID-19 pandemic. The study showed increased re-admission rate for conservative management versus primarily operative management pathways. No complications were detected in cases who needed operative intervention after failure of conservative management. Re-auditing is to follow. The study recommends national comparison of data as it might be worthwhile considering primary management of acute appendicitis.
1643 Quality Assessment of Intra-Oral Radiography Within Two Hospitals in South Wales, UK: A Two-Cycle Audit and Introduction to The Updated 2020 Public Health England Quality Grading System
Authors: Aruede G , Jenkins S 
Published: October 2021

Abstract

Aim
To evaluate the quality of intra-oral radiographs taken within two hospitals in South Wales, United Kingdom, and assess the impact of radiographer training, with the aim of reducing the percentage of undiagnostic radiographs to 10% or less in accordance with national performance targets.

Method
Details of intra-oral periapical and occlusal radiographs taken in the two hospitals between the 1st July 2015 and the 30th June 2016 were retrieved. 100 radiographs were randomly selected and assessed. Change was then implemented in the delivery of radiographer training workshops, which involved two hours of both didactic teaching and hands-on skills training. There were 10 workshops and 52 attendees. A second audit cycle was completed, with a further 100 radiographs randomly selected from the 1st December 2018 and 30th April 2019.

Results
There was a 33.2% reduction of undiagnostic radiographs, bringing the total down to 6.3%, meeting the standards of the audit. Feedback from the workshops were also extremely positive; 50% of radiographers grading the quality of the workshops at 10/10.

Conclusions
The workshops were successful in improving the quality of intra-oral radiographs, therefore improving the quality of this service. This blueprint can be shared amongst other hospitals, to sustainably improve the overall quality of dental radiography in the hospital setting. Recent updated guidance in 2020 introduced a new two-point scale radiograph grading system: ‘Acceptable’ and, ‘not acceptable’. Radiographs graded as, ‘not acceptable’, should account for no more than 5% of radiographs. Future audit cycles will follow this new grading system and standard.
1674 Training Opportunities and Safe Staffing Levels – Loop Closure Audit
Authors: Teklay S , Dhillon D , Aslam-Pervez N 
Published: October 2021

Abstract

Aim
It is not uncommon to find rota gaps at junior doctors’ level across many NHS Trusts within United Kingdom – especially in district general hospitals. In the trauma and orthopaedic department at Huddersfield Royal Infirmary, there were significant rota gaps that frequently relied on locum doctors to provide adequate service coverage. The aim of the audit was to determine whether rota gaps had any impact on safe staffing levels, training of core surgical trainees (CSTs) and costs to the department.

Method
Retrospective audit - assess daily staffing levels as per rota for three weeks before and after implementation of recommended better utilisation of the department’s Advanced Clinical Practitioners (ACPs) to cover trauma wards. The audit took place over October 2018 – December 2018.

Results
There were safe staffing levels daily in both audits. Audit 1 demonstrated locum doctors were required to cover 36.6% of ward duties and 42.9% of oncall shifts – costing the department £25, 190. Following implementation of recommendation, where ACPs were rostered to cover trauma, audit 2 reduced the requirements of locum doctors for coverage of ward duties and oncalls to 23.7% and 33.3%, respectively. Protected theatre allocation of CSTs remained less than 1 day/week. The cost of locum doctors in audit 2 was reduced to £17, 050.

Conclusions
Through better utilisation of the department’s ACPs to cover trauma wards, we managed to significantly reduce cost of locum doctors by £8, 140 over a three-week period. We believe CST theatre allocation will also improve from this intervention.
614 Elective Bariatric and Metabolic Surgery in United Kingdom During the Coronavirus Pandemic
Authors: Mamidanna R , Askari A , Patel K , Adil M T , Jain V , Jambulingam P , Whitelaw D , Rashid F , Munasinghe A , Al-Taan O 
Published: October 2021

Abstract

Aim
Elective Bariatric and Metabolic Surgery (BMS) was halted in the UK during the first wave of the Coronavirus (COVID-19) pandemic. Obesity is a predictor of poor outcome in those infected with this virus. This study reports our experience resuming elective weight loss surgery safely amidst the pandemic.

Method
Guidance from national bodies (BOMSS/NICE) were reviewed and a Standard Operating Procedure (SOP) was drafted to accommodate local considerations. Data were prospectively collected on patients undergoing BMS following commencement of elective surgery after the first national lockdown.

Results
A total of 50 patients underwent BMS at our institution within six weeks of resuming the services. The median age was 41 years old and BMI was 43.8(IQR 40.0-48.8 kg/m2). Equal number of patients underwent laparoscopic Sleeve Gastrectomy (SG) and Roux en-Y Gastric Bypass (RYGB). Of these, 9 patients (18%) had revisional surgery and 48 patients (96%) were discharged within 24 hours of their surgery. The rate of readmission within thirty days of surgery was 6% (n = 3) and 1 patient returned to theatre with an obstruction proximal to the jejuno-jenunal anastomosis. None of the patients exhibited symptoms or tested positive for the COVID-19 virus.

Conclusions
With appropriate precautions and protocols, it is feasible and safe to resume BMS, with no increased risk to bariatric patients during the COVID-19 pandemic. This is particularly encouraging for other units in UK to offer BMS after the current lockdown.
736 Current Management Strategies, Perceptions, and Attitudes of the Paediatricians on Childhood Obesity: An Experience from the Middle East
Authors: Al-Saadi H , Kamzari A. Al , Malallah H , AlSheala N , Al-Saadi J , Al-Saadi T 
Published: October 2021

Abstract

Background
Childhood obesity is a public health concern that in expanding globally. Of those aged between 5-19 years in Oman, 32% were found to be overweight in 2016.

Method
An electronic survey was distributed to in-training and post residency paediatricians in Oman.

Results
A total of 69 responses met the inclusion criteria and were analysed. 50% of participants were less than 30 years-old (53.6% female). 70% were in training residency (R1, R2 24.6%, R3, R4 36.2%,) and 30% were post residency. 72% had their training in Oman. About half of participants measure child’s weight and Height, however, only 24.4% document BMI and compare with previous records. 75% regularly obtain family history of obesity and related conditions along with dietary intake. More than half of participants were not confident on discussing weight and related complication with the child, but 62.3 % were confident in discussing it with the parents. 50% were confident in initiating treatment for childhood obesity and providing dietary advice. Attitudes towards exposure to childhood obesity and management varied and overall excellent exposure accounted for less than one third of responses (Medical school 21.7%, Residency 26.1%, 27.5%). In general, only 20.6% believe they are confident in managing childhood obesity and only 29% attended seminar or training on childhood obesity. 93% believe there is a need for a more focused training on childhood obesity prevention and management.

Conclusions
Great efforts need to be targeted towards strengthening Paediatricians’ confidence in childhood obesity prevention and management via in residency-training and continuous professional development.
1139 Effectiveness of One-Anastomosis Gastric Bypass Vs Sleeve Gastrectomy in Short- And Long-Term Weight Loss – A Review
Authors: Jothi A A 
Published: October 2021

Abstract

Aim
Bariatric surgery has been the most efficient treatment option for moderate to severe obesity. Recently, the sleeve gastrectomy (SG) has become the most widely performed bariatric surgery. However, the one-anastomosis gastric bypass (OAGB) has exponentially increased recently and is associated with excellent short- and long-term weight loss benefits. Hence, the aim of this review is to compare the effectiveness of OAGB vs SG in short- (≤ 1 year) and long-term (&gt; 1 year) weight loss.

Method
A comprehensive literature search of PubMed, Scopus and Google Scholar databases were conducted. Search criteria included keywords such as one-anastomosis gastric bypass, mini-gastric bypass, omega-loop gastric bypass, sleeve gastrectomy, short-term weight loss and long-term weight loss. Selection criteria included any randomised controlled trials (RCTs) and cohort studies comparing the effects of OAGB vs SG in weight loss, published from the years 2010 onwards. Only full text studies and papers published in English language were chosen.

Results
nine studies were selected to be reviewed in this study. 62.5% of studies which had reports for short-term weight loss showed that OAGB was able to achieve a significantly greater % excess weight loss (%EWL) or % excess BMI loss (%EBMIL) (P &lt; 0.05). Whereas 80% of studies which had reports for long-term weight loss showed that OAGB achieved a significantly greater %EWL or %EBMIL, up to five years.

Conclusions
This review suggests that OAGB is associated with significantly greater short-and long-term weight loss than SG. However, due to the small number of RCTs on OAGB vs SG, more long-term RCTs should be conducted for greater evaluation.
46 Primary Care Practitioners Have A High Level of Satisfaction with The Current Breast Referral Pathway but The Majority Would Support A Change to Patient Self-Referral
Authors: Russell T , Cooper J , McIntyre M , Ramzi S 
Published: October 2021

Abstract

Aim
Currently, patients must consult with a primary care practitioner (PCP) prior to being referred to secondary care breast services. A change to patient self-referral would arguably reduce primary care workload, improve access for patients, and allow breast units to allocate resources more appropriately; no data currently supports this. This study aims to explore PCP's views on breast referral, evaluate the community breast workload, and to investigate the impact of COVID-19 on referral rates.

Method
An electronic survey was designed on SurveyMonkey.com which aimed to collect both quantitative and qualitative data. The weblink to the survey was sent out via two electronic newsletters. Participants were asked: their role and gender, their level of confidence surrounding breast care, details surrounding their breast workload, how they felt COVID-19 had affected their referral rates, their level of satisfaction with the current pathway, and their opinions on a potential change to patient self-referral.

Results
79 responses were received. PCPs estimated that 7.0% (median) of their total consultations were regarding a breast-related issue and that COVID-19 had not had a significant impact on the rate of referral to breast units (P = 0.75). 84.8% of PCPs were satisfied with the current referral pathway. Whilst 74.5% felt a change to patient self-referral would benefit patients and primary care services, their free text comments highlighted some of their reservations.

Conclusions
PCPs have a high level of satisfaction with the current breast referral pathway, but the majority would be open to a change to patient self-referral to specialist breast units.
86 Adequate Assessment Can Affect the Management of Breast Cancer in The Geriatric Population
Authors: Monib S , Elkorety M , Habashy H 
Published: October 2021

Abstract

Background
Breast cancer (BC) risk increases with age; about a third of patients are diagnosed in age older than 70. Treatment of this age group remains a thorny issue leading to inferior outcome with lower survival rate compared to younger patients.

Aim
We aimed to evaluate performance status tools as well as the outcome of management of breast cancer in the geriatric population.

Method
We have conducted a retrospective database analysis looking into the management of breast cancer patients older than 65 years old presenting to our unit during the period between June 2015 to June 2019. All patients had triple assessment as well as multimodality performance status assessment with their treatment modalities and outcomes recorded and assessed.

Results
We have included 578 patients, 0.8% male and 99.2 % female, and our patients mean age was 71 years. Most of our patients scored one or two on the WHO/ ECOG performance status score, Clinical Frailty Score, as well as ASA-PS score. 3.2% had no treatment, 4.3% had endocrine therapy only, 0.5% had primary endocrine therapy followed by surgery, 92.3 % underwent surgery with 4.1% complication rate. Patients who underwent breast-conserving surgery had adjuvant breast radiotherapy, and 23.7% had adjuvant chest wall radiotherapy, 78.8% had adjuvant endocrine treatment and 4.8% had adjuvant chemotherapy out of which 30.7% had adjuvant chemotherapy and Herceptin.

Conclusions
Patients’ age should trigger the use of objective assessment tools while assessing elderly patients with a new breast cancer diagnosis, and treatment modalities offered should be individualised to reach the optimum outcome.