bluuebunny/crossref_metadata_2025_split huggingface dataset:
P17: IMPROVING PLASTIC SURGERY OPERATION NOTE ACCESSABILITY AT A MAJOR TRAUMA CENTRE: A PROSPECTIVE COMPLETED AUDIT CYCLE
Authors: Geoghegan L , Reissis D 
Published: April 2021

Abstract

Introduction
Quality operation note documentation is essential for ensuring continuity of care amongst the multi-disciplinary team. The Royal College of Surgeons has published clear and succinct guidelines which outline the necessity for timely, accurate and accessible operation note documentation. Our department uses a bespoke electronic operation note template which is stored within a departmental database. The aim of this study was to evaluate the effect of online operation note guidance on the accessibility of operative documentation.

Method
A prospective audit of operation note documentation was conducted during two one-month periods in May and November 2018. All reconstructive surgical procedures, both trauma and elective, were included. A bespoke online reminder system was introduced to our electronic platform to encourage operation note upload onto electronic medical records.

Result
224 cases (127 elective, 98 consultant-led) were included in the initial audit and 239 cases (173 elective, 131 consultant-led) in the post-intervention audit. 56% of operation notes were accessible to nursing staff pre-intervention. Post-intervention 83% of operation notes were accessible to nursing staff (p&lt; 0.05). No significant correlation was found between operation note accessibility and the type of case (elective vs emergency, r= -0.179), grade of operating surgeon (consultant vs registrar, r=0.259) and the number of operating surgeons (r=0.208).

Conclusion
This study highlights the importance of operation note accessibility to every member of the multidisciplinary team. A pop-up based intervention significantly improved accessibility of operation notes within electronic medical records although performance remains significantly below the expected standard.

Take-home message
The use of bespoke, online platforms may limit access to operation notes. A simple, pop-up based intervention significantly improves upload rate to electronic medical records however accessibility remains significantly below the expected standard.
P18: CONVENTIONAL DUPUYTREN'S DIATHESIS FACTORS ARE NOT ASSOCIATED WITH POOR OUTCOME FOLLOWING SURGERY: A SYSTEMATIC REVIEW
Authors: Geoghegan L , Man J , Jain A , Rodrigues JN 
Published: April 2021

Abstract

Introduction
Dupuytren's diathesis describes an aggressive disease course with tendency for recurrence or extension following intervention. Conventional factors associated with Dupuytren's diathesis are ethnicity, family history, bilateral and ectopic disease. Disease recurrence is not the only cause of poor outcome following intervention. This systematic review aimed to identify all factors that have been investigated for a potential association with the development, progression, recurrence and outcome of treatment in Dupuytren's diathesis.

Method
A systematic review of MEDLINE, EMBASE and CINAHL using a PRISMA-compliant methodology up to February 2019 was conducted. Abstract screening and data extraction were performed in duplicate. Included prognostic cohort studies were quality assessed using the Quality in Prognosis Study tool.

Result
The search revealed 2,661 records from which 11 full text articles reported both conventional diathesis factors and outcomes (in addition to recurrence) following intervention for Dupuytren's in 938 patients. Collectively 67% underwent fasciectomy and seven outcomes were reported: three patient reported outcome measures (DASH, quick-DASH and EQ-5D), three functional measures (grip strength, joint angle correction and range of motion) and treatment complications. Two studies used multiple univariate statistical techniques and found no significant association between diathesis factors and disease outcome.

Conclusion
This systematic review challenges conventional notions of Diathesis factors and provides a comprehensive appraisal of factors associated with poor outcome following intervention for Dupuytren's disease.

Take-home message
Conventional factors associated with recurrence in Dupuytren's disease are not associated with poor outcome following intervention.
P19: THE RELIABILITY OF VENOUS THROMBOEMBOLISM RISK ASSESSMENT TOOLS FOLLOWING FREE FLAP RECONSTRUCTION OF THE LOWER EXTREMITIES
Authors: Geoghegan L , Super J , Onida S , Hettiaratchy S , Davies A 
Published: April 2021

Abstract

Introduction
The incidence of flap failure in lower extremity reconstruction is significantly higher in the lower extremity compared head, neck and breast reconstruction. The commonest cause of flap failure is venous thrombosis. The aim of this study was to assess the reliability of VTE risk assessment tools in patients with open lower extremity fractures and to assess the ability of such tools to identify patients at risk of developing microvascular venous thrombosis following lower extremity free flap reconstruction.

Method
A single centre retrospective cohort study was conducted between August 2012-August 2019. All patients were risk assessed using the Department of Health (DoH), Modified Caprini and Padua VTE risk assessment tools.

Result
58 patients were included, all were at high risk of DVT according to the DoH (mean score± SD, 3.7±0.93), Caprini (10.2±1.64) and Padua (5.4±0.86) risk assessment tools. All patients received thromboprophylaxis, the incidence of clinical deep venous thrombosis was 0%. Intraclass correlation coefficient demonstrated moderate agreement between the Caprini and DoH (0.73, 95% CI 0.54-0.84, p&lt;0.001), the Caprini and Padua (0.52, 95% CI 0.19-0.72, p&lt;0.001) and the DoH and Padua (0.74, 95% CI 0.57-0.85, p&lt;0.001). Microvascular venous thrombosis occurred in 6 patients, resulting in 2 amputations. There were no significant differences in scores between those with and without venous complications.

Conclusion
Current VTE risk assessment tools do not identify patients at risk of developing venous complications following lower extremity reconstruction. Further prospective studies are required to optimise risk prediction models and thromboprophylaxis use in this cohort.

Take-home message
Current VTE risk assessment tools do not identify patients at risk of developing microvascular venous thrombosis following lower limb reconstruction.
P24: MANAGEMENT OF RHEUMATIC VALVE DISEASE OF THE AORTIC VALVE USING THE OZAKI PROCEDURE WITH AUTOLOGOUS PERICARDIUM
Authors: Asif A , Caputo M 
Published: April 2021

Abstract

Case-Study
A 15-year-old boy was referred to our tertiary centre from his local paediatric services with a background of rheumatic fever, severe aortic regurgitation (AR) and mild to moderate mitral regurgitation. He had a history of angina and dyspnoea on exertion, a 2/6 ejection systolic murmur and 2/4 end diastolic murmur. Transthoracic echocardiography showed severe aortic valve insufficiency (with flow reversal seen in the descending aorta and an LV end diastolic volume of 173 ml/m2) and trivial pulmonary valve regurgitation. Autograft failure following the favoured Ross procedure deemed the patient as a candidate for an Ozaki procedure. Autologous pericardium was used to replace the diseased aortic valve. Intraoperative transoesophageal echocardiography showed a deficient left coronary cusp leaflet and a retracted right coronary cusp leaflet. The patient was under cardiopulmonary bypass for 124 minutes and on cross-clamping for 99 minutes with no intraoperative complications. Histological examination of the aortic valve leaflets showed neovascularisation, myxoid changes and disarray of the fibrous stroma. Postoperative recovery was uneventful. The postoperative echocardiogram showed trivial AR, end diastolic volume 217ml, end systolic volume 12 ml and 40% ejection fraction. There was full resolution of the dyspnoea, angina and diastolic murmur on follow-up 4-months postoperatively as supported by healthy valve function on echocardiography. This case highlights that in those of risk of multiple valve pathology, such as in rheumatic valve disease, an Ozaki procedure using autologous pericardium is a viable surgical option for paediatric aortic valve repair with good outcomes.

Take-home message
In cases of systemic conditions affecting the heart valves where there is multiple valve pathology and risk of autograft failure, such as rheumatic valve disease, the use of autologous pericardium to replace these valves has shown to be a viable option in this paediatric case.
P25: EVALUATING THE JOINT EFFECT OF BODY MASS INDEX AND DIABETES WITH LATE-MORTALITY AFTER CORONARY ARTERY BYPASS GRAFTING
Authors: Asif A , Rayner T , Bruno VD , Benedetto U 
Published: April 2021

Abstract

Introduction
Survival analyses following coronary artery bypass grafting (CABG) evaluate the independent effects of body mass index (BMI) and diabetes. However, BMI and diabetes are correlated and their combined effects should be considered, thus we examined the joint association on long-term survival after CABG.

Method
A total of 15129 patients undergoing isolated CABG between 1997 and 2017 were analysed. The BMI categories were defined as Normal-Weight (≥18-&lt;25 kg/m2;n=3783), Overweight (≥25-&lt;30 kg/m2;n=7103), Class-I-Obese (≥30-&lt;35kg/m2;n=3247), and Class-II-Obese (≥35 kg/m2;n=996). Diabetes was defined as ever having a diagnosis of diabetes (n=3203). The association was assessed using Cox-proportional hazards regression models.

Result
During follow-up, 3140 deaths occurred. Compared to Normal-Weight individuals, the multivariable-adjusted hazard ratios (HR) were 0.89 [95%CI: 0.82-0.96], 0.95 [95%CI: 0.86-1.10], and 1.30 [95%CI: 1.07-1.47] for Overweight, Class-I-Obese, and Class-II-Obese patients, respectively. Compared to non-diabetic patients, the multivariable-adjusted HR for diabetic patients was 1.55 [95%CI: 1.43-1.68]. In the joint analysis, compared to Normal-Weight non-diabetic individuals, the multivariable-adjusted HRs were: Normal-Weight diabetic 1.30 [95%CI: 1.10-1.53], Overweight non-diabetic 0.86 [95%CI: 0.78-0.94], Overweight diabetic 1.32 [95%CI: 1.16-1.50], Class-I-Obese non-diabetic 0.87 [95%CI: 0.77-0.99], Class-I-Obese diabetic 1.58 [95%CI: 1.53-1.85], Class-II-Obese non-diabetic 1.11 [95%CI: 0.90-1.38], and Class-II-Obese diabetic 2.06 [95%CI: 1.65-2.56]. The reduction in multivariable-adjusted 10-year survival rates for diabetics versus non-diabetics was 4%, 6%, 9%, and 14% for Normal-Weight, Overweight, Class-I-Obese, and Class-II-Obese, respectively.

Conclusion
A considerable difference in survival after CABG is seen in the joint analysis of diabetes and BMI and should therefore be considered in future studies.

Take-home message
Diabetes and body mass index (BMI) are both correlated with the incidence of coronary artery disease and the need for coronary artery bypass grafting (CABG) and are often statistically analysed as separate entities. We show that the joint affect of diabetes and BMI has a significantly higher risk of late-mortality following CABG, therefore such analyses should be considered in future studies.
P26: EVALUATING AND DEVELOPING A TEACHING TOOL ON FAECAL INCONTINENCE IN THE UNDERGRADUATE MEDICAL CURRICULUM
Authors: Li CH , Parker J , Reeve N , Cornish J 
Published: April 2021

Abstract

Introduction
To evaluate the medical school undergraduate curriculum on faecal incontinence (FI) and develop an educational tool to improve the teaching on the subject.

Method
Qualitative analysis of literature research and data collected from medical students via emails, questionnaires and focused group discussions.

Result
FI has not been implanted into the undergraduate curriculum 12,13 and there are variations in teaching on the topic in different medical schools. n= 111 medical students at Cardiff University responded to the survey. FI was reported to be overlooked compared to other types of bowel dysfunction. 38 students reported to have teaching on bowel incontinence, whereas 64 and 74 students had teaching on diarrhoea and constipation respectively. 77% of medical students would like more teaching on bowel incontinence. 9 students participated in a focused group discussion. An interactive e-learning module from Xerte was created based on the students' suggestions and were trialed by a separate cohort of students (n=20). All 20 students showed significant improvement of students' confidence in faecal incontinence (p &lt;= 2.132e∧-6) after completing the e-learning module.

Conclusion
We recommend introducing the educational resource into the undergraduate curriculum of Cardiff University medical school, especially targeting the clinical year, a clear guidance for FI should be published by the relevant postgraduate healthcare faculties and consider assessing at which stage of the postgraduate training should FI be taught.

Take-home message
Baseline knowledge of FI is poor. Lack of content in medical school curriculum and E learning modules potentially useful adjuncts.
Premarket Development Times for Innovative Vaccines––To What Extent Are the Coronavirus Disease 2019 (COVID-19) Vaccines Outliers?
Authors: Beall Reed F , Kesselheim Aaron S , Hollis Aidan 
Published: April 2021

Abstract
One reason expressed in surveys of people reporting coronavirus disease 2019 (COVID-19) vaccine hesitancy is how rapidly these vaccines have reached the market. To estimate the length of time the COVID-19 vaccine spent in research and development as compared to other novel vaccines, we apply previously established methods for estimating medical product development times, using the key associated patent filings cited by the manufacturer as the marker of when commercial development activity began. Applying these methods to a cohort of recently approved innovative vaccines and comparing them to the first-approved COVID-19 vaccine (BioNTech/Pfizer), we found key patent filings for the technology in this COVID-19 vaccine occurred 10.0 years prior to regulatory authorization. By this metric, the development timelines for innovative vaccines have been shortening since the 1980s, and the COVID-19 vaccine comfortably fits within this pattern. Vaccine development timelines have now even drawn to parity with many of the most commonly used drugs.
Air Pollution and Manufacturing Firm Productivity: Nationwide Estimates for China
Authors: Fu Shihe , Viard V Brian , Zhang Peng 
Published: April 2021

Abstract
We provide nationwide causal estimates of air pollution's effect on short-run productivity for China's manufacturing sector from 1998 to 2007. Using thermal inversions as an instrument, a 1 µg/m3 decrease in PM2.5 increases productivity by 0.82% (elasticity of −0.44). Increased hiring attenuates the elasticity to −0.17. Differential effects of a trade shock on coastal versus inner regions imply a pollution elasticity of output of 1.43. Simulating a dynamic general-equilibrium model yields an output elasticity of −0.28 with respect to PM2.5. An exogenous 1% decrease in PM2.5 nationwide increases gross domestic product by 0.039%.
A New Statistic for Detecting Genetic Differentiation
Authors: Hudson Richard R 
Published: April 2021

Abstract
A new statistic for detecting genetic differentiation of subpopulations is described. The statistic can be calculated when genetic data are collected on individuals sampled from two or more localities. It is assumed that haplotypic data are obtained, either in the form of DNA sequences or data on many tightly linked markers. Using a symmetric island model, and assuming an infinite-sites model of mutation, it is found that the new statistic is as powerful or more powerful than previously proposed statistics for a wide range of parameter values.
Continuous Exchange of Sequence Information Between Dispersed Tc1 Transposons in the Caenorhabditis elegans Genome
Authors: Fischer Sylvia E J , Wienholds Erno , Plasterk Ronald H A 
Published: April 2021

Abstract
In a genome-wide analysis of the active transposons in Caenorhabditis elegans we determined the localization and sequence of all copies of each of the six active transposon families. Most copies of the most active transposons, Tc1 and Tc3, are intact but individually have a unique sequence, because of unique patterns of single-nucleotide polymorphisms. The sequence of each of the 32 Tc1 elements is invariant in the C. elegans strain N2, which has no germline transposition. However, at the same 32 Tc1 loci in strains with germline transposition, Tc1 elements can acquire the sequence of Tc1 elements elsewhere in the N2 genome or a chimeric sequence derived from two dispersed Tc1 elements. We hypothesize that during double-strand-break repair after Tc1 excision, the template for repair can switch from the Tc1 element on the sister chromatid or homologous chromosome to a Tc1 copy elsewhere in the genome. Thus, the population of active transposable elements in C. elegans is highly dynamic because of a continuous exchange of sequence information between individual copies, potentially allowing a higher evolution rate than that found in endogenous genes.
Mitochondrial Genotype Affects Fitness inDrosophila simulans
Authors: James Avis C , Ballard J William O 
Published: April 2021

AbstractDrosophila simulans is known to harbor three distinct mitochondrial DNA (mtDNA) haplotype groups (siI, -II, and -III) with nearly 3.0% interhaplotypic divergence but &lt;0.06% intrahaplotypic diversity. With the large amount of genetic variation in this system, the potential power to detect intraspecific fitness differences in fly lines that carry distinct haplotypes is great. We test three life-history traits on fly lines with known sequence differences in the mtDNA genome after controlling the nuclear genome by backcrossing. We find that flies with the siI haplotype are fastest developing and have the lowest probability of surviving to three experimental periods (2–6, 12–17, and 34–39 days of age). Wild-type males with siIII mtDNA were more active while disruption of specific coadapted nucleo-mitochondrial complexes caused a significant decrease in activity. These results are discussed in the context of the geographic distribution of each haplotype.
Genetic Diversity and Population History of Golden Monkeys (Rhinopithecus roxellana)
Authors: Li Haipeng , Meng Shi-Jie , Men Zheng-Ming , Fu Yun-Xin , Zhang Ya-Ping 
Published: April 2021

AbstractGolden monkey (Rhinopithecus roxellana), namely the snub-nosed monkey, is a well-known endangered primate, which distributes only in the central part of mainland China. As an effort to understand the current genetic status as well as population history of this species, we collected a sample of 32 individuals from four different regions, which cover the major habitat of this species. Forty-four allozyme loci were surveyed in our study by allozyme electrophoresis, none of which was found to be polymorphic. The void of polymorphism compared with that of other nonhuman primates is surprising particularly considering that the current population size is many times larger than that of some other endangered species. Since many independent loci are surveyed in this study, the most plausible explanation for our observation is that the population has experienced a recent bottleneck. We used a coalescent approach to explore various scenarios of population bottleneck and concluded that the most recent bottleneck could have happened within the last 15,000 years. Moreover, the proposed simulation approach could be useful to researchers who need to analyze the non- or low-polymorphism data.
Cloning and Characterization of Maize B Chromosome Sequences Derived From Microdissection
Authors: Cheng Ya-Ming , Lin Bor-Yaw 
Published: April 2021

Abstract
Isolation of sequences from the maize B chromosome is always hampered by its high homology with the normal complements. In this study, this handicap was overcome by cloning the sequences from the pachytene B chromosomes dissected out of a slide by a micromanipulator followed by degenerate oligonucleotide-primed PCR. The isolated sequences were found to hybridize with genomic DNA in a B-dosage-dependent manner and with the pachytene B chromosome by fluorescence in situ hybridization (FISH), corroborating their B origin. A total of 19 B sequences were isolated, all of which are repetitive and, with one exception, are homologous to the A chromosome(s). Three sequences have strong homology to maize sequences that include two knob repeats and one zein gene (noncoding region), and 10 others are homologous to the noncoding region of Adh1, Bz1, Gag, Zein, and B centromere to a lesser degree. Six sequences have no homology to any gene. In addition to FISH, the B-specific sequence and a partially B-specific one were also mapped, by seven newly characterized TB-10L translocations, to a similar location on the central portion of the distal heterochromatic region, spreading over a region of about one-third of the B chromosome.
Positive and Negative Roles of Homologous Recombination in the Maintenance of Genome Stability in Saccharomyces cerevisiae
Authors: Yoshida Jumpei , Umezu Keiko , Maki Hisaji 
Published: April 2021

Abstract
In previous studies of the loss of heterozygosity (LOH), we analyzed a hemizygous URA3 marker on chromosome III in S. cerevisiae and showed that homologous recombination is involved in processes that lead to LOH in multiple ways, including allelic recombination, chromosome size alterations, and chromosome loss. To investigate the role of homologous recombination more precisely, we examined LOH events in rad50Δ, rad51Δ, rad52Δ, rad50Δ rad52Δ, and rad51Δ rad52Δ mutants. As compared to Rad+ cells, the frequency of LOH was significantly increased in all mutants, and most events were chromosome loss. Other LOH events were differentially affected in each mutant: the frequencies of all types of recombination were decreased in rad52 mutants and enhanced in rad50 mutants. The rad51 mutation increased the frequency of ectopic but not allelic recombination. Both the rad52 and rad51 mutations increased the frequency of intragenic point mutations ∼25-fold, suggesting that alternative mutagenic pathways partially substitute for homologous recombination. Overall, these results indicate that all of the genes are required for chromosome maintenance and that they most likely function in homologous recombination between sister chromatids. In contrast, other recombination pathways can occur at a substantial level even in the absence of one of the genes and contribute to generating various chromosome rearrangements.
Molecular Characterization and Analysis of the acrB Gene of Aspergillus nidulans: A Gene Identified by Genetic Interaction As a Component of the Regulatory Network That Includes the CreB Deubiquitination Enzyme
Authors: Boase Natasha A , Lockington Robin A , Adams Julian R J , Rodbourn Louise , Kelly Joan M 
Published: April 2021

Abstract
Mutations in the acrB gene, which were originally selected through their resistance to acriflavine, also result in reduced growth on a range of sole carbon sources, including fructose, cellobiose, raffinose, and starch, and reduced utilization of ω-amino acids, including GABA and β-alanine, as sole carbon and nitrogen sources. The acrB2 mutation suppresses the phenotypic effects of mutations in the creB gene that encodes a regulatory deubiquitinating enzyme, and in the creC gene that encodes a WD40-repeat-containing protein. Thus AcrB interacts with a regulatory network controlling carbon source utilization that involves ubiquitination and deubiquitination. The acrB gene was cloned and physically analyzed, and it encodes a novel protein that contains three putative transmembrane domains and a coiled-coil region. AcrB may play a role in the ubiquitination aspect of this regulatory network.