bluuebunny/crossref_metadata_2025_split huggingface dataset:
1197 RandomSTOP Vessel Prep Trials – Real Life or Alternative Reality?
Authors: Owen R , Fitzpatrick N , Sherazi A , Katsogridakis E 
Published: August 2023

Abstract

Aim
During the last ten years there have been two notable studies within vessel preparation for peripheral vascular disease; the DEFINITIVE AR prospective multi-centre randomised study (evaluating the use of atherectomy prior to drug-eluting balloon catheters (DCB)) and the DISRUPT PAD III randomized control trial (evaluating the use of intravascular lithotripsy (IVL)). This study aimed to analyse a true cohort of vascular patients who underwent vessel prep and whether this reflects those included in the studies.

Method
Data was collected on patients with SFA disease in 14 countries across 17 centres. We applied the inclusion criteria for the DEFINITIVE AR and DISRUPT PAD III studies to our cohort.

Results
Data was collected on n = 974 patients who received at least one form of vessel prep. Of these patients, 202 (20.7%) underwent atherectomy and 22 (2.26%) underwent lithotripsy. 50.1% (n = 103) of those who underwent atherectomy would have been eligible to participate in the DEFINITVE AR study. 18% (n = 4) of patients who underwent lithotripsy would have been eligible to participate in the DISRUPT PAD III trial.

Conclusions
Both the DEFINITIVE AR and DISRUPT PAD III trials have shown promising results however in this large multicentre study we have shown that the study participants reflect only a small percentage of the patients seen within a real vascular ward. We would advise caution when interpreting the results from these studies considering the disparity, we have shown between the study cohorts and the real life vascular population.
1201 A Systematic Review and Meta-Analysis of Venous Thromboembolism Risk in Surgical Patients with Recent Air Travel
Authors: Shea J , Ghosh A , Turner B , Onida S , Davies A 
Published: August 2023

Abstract

Aim
Venous thromboembolism (VTE) is associated with recent surgery; additionally, long-haul air-travel increases VTE risk. As surgical tourism increases, more patients are flying long distances seeking surgical intervention. This meta-analysis aimed to estimate post-operative VTE risk in the context of recent air-travel.

Method
Embase, Ovid MEDLINE, Cochrane and Scopus databases were accessed from 1947 to May 2022. Inclusion criteria were any study design with adults undergoing surgical intervention with recent air-travel, reporting VTE incidence. PRISMA guidelines were followed with a registered protocol (PROSPERO:CRD42022323561). Data was extracted independently by two reviewers and pooled using fixed and random effects. Primary outcome was pooled VTE rate; secondary outcomes were pooled rates of deep vein thrombosis (DVT) and pulmonary embolism (PE). ROBINS-I tool was used to assess risk of bias.

Results
Seven retrospective studies were included, totalling 24,975 patients. Overall odds of VTE in the flying plus surgery group was 1.96 (95%CI 0.54-7.08). For surgery with post-operative flight odds ratio (OR) of VTE was 1.31 (95%CI 0.63-2.71), whilst for surgery with pre-operative flight OR was 7.86 (95%CI 0.23–265.26). Three studies reported DVT/PE incidence specifically. DVT: for surgery and air-travel DVT rate was 0.67% (95%CI 0.31%-1.51%) versus 0.45% (95%CI 0.10%-2.00%) in surgery alone. PE: for surgery and air travel, PE rate was 0.41 (95%CI 0.00%-1.29%) versus 0.55% (95%CI 0.31%-0.86%) for surgery alone.

Conclusions
Whilst meta-analysis demonstrates that air-travel confers no additional VTE risk for surgical patients, it does not account for confounding factors. Future research should risk score then propensity match participants to generate higher quality evidence.
1279 Do Carotid Webs Raise the Risk of Ischaemic Stroke? a 12 Year Single Centre Retrospective Study
Authors: Erete L , Islam S , Glasgow S , Baker D 
Published: August 2023

Abstract

Aim
Carotid webs are a rare type of fibromuscular dysplasia (FMD), thought to be a cause of ischaemic stroke. We aimed to review the presentation and outcomes of patients with carotid webs attending our unit over a 12-year period.

Method
The cohort of patients with carotid webs who presented to our unit between 2010 and 2021 were identified by electronically interrelating imaging reports (CT/MR/angiogram) for the phase “carotid web”. Images were re-reviewed to confirm the diagnosis. The electronic records for the cohort were also reviewed.

Results
60 patients with carotid webs were identified, with an age range of 36 to 92 years (mean age 64 years) and a similar sex distribution (31 male, 29 female). 29 carotid webs were left-sided, 22 were right-sided and 9 were bilateral. None had a pre-event diagnosis of FMD. 27 patients had an ischaemic stroke - 18 in the territory relevant to the web location, 9 in other territories. 1 patient was treated with thrombolysis, 1 with thrombectomy and 1 with thrombolysis and thrombectomy. None underwent carotid intervention. Of the 18 patients with a carotid web on the ipsilateral side to their ischaemic event, none had a repeat event recorded.

Conclusions
30% of the cohort had an ischaemic stroke event corresponding to the territory supplied by a carotid artery with a web. Current management of carotid webs leans towards conservative management with antiplatelet therapy. However, these data suggest carotid intervention should be considered in selected cases where stroke symptoms correlate to the laterality of the carotid web.
476 Manels and Gender Representation at Major Urological Surgery Conferences
Authors: Leung H C K , Georgi M , Asif A , Fricker M , Patel S , Raja A K , Gargan A , Gargan K , Lee K , Burton O E , Kamboj R , Thamilmaran A , Abdi Z , Haque S , Tse F , Moore C , Nathan A 
Published: August 2023

Abstract

Aim
Females are disproportionately under-represented in surgery despite the upward trend in women entering the medical profession (Rakestraw et al., 2022). Visibility of female surgeons at academic meetings gives a cross-sectional view of inclusion within the field. We aimed to quantify the proportion of female faculty and prevalence of all-male panels (“manels”) at major international urological surgery meetings.

Method
We retrospectively analysed annual meetings organised by major urological surgery associations or societies between January 2016 and December 2021. Demographic and academic metrics, including H-index, number of publications, and number of citations were collected for each invited lecturer, panellist and chair/moderator.

Results
Twenty-two conferences held by four urological surgery organisations were identified, including 1871 sessions delivered by 5427 speakers. On average across all speakers, 12.0% (n = 643) were female. Of the 838 panel sessions, 584 (69.7%) were manels. Percentage of manels was statistically significant between online and in-person conferences (online 64.6% versus in-person 75.1%; p&lt;0.05). There was a statistically significant difference in the proportion of manels over time (79.4% in 2016 versus 28.8% in 2021; p&lt;0.05). Male invited lecturers had significantly higher H-index than female invited lecturers (male 32 versus female 17; p&lt;0.05).

Conclusions
Despite the encouraging findings that manels are becoming less prevalent in major urological surgery meetings, manels continue to comprise the majority, whilst female speaker representation remains poor. This study hopes to highlight the need for greater gender diversity and female representation in urology.
546 Gender Distribution of Invited Speakers at Major General Surgical Conferences: A Retrospective Cohort Study
Authors: Kamboj R , Georgi M , Asif A , Fricker M , Patel S , Raja A , Gargan A , Gargan K , Lee K , Leung K H C , Burton O , Thamilmaran A , Abdi Z , Haque S , Tse F , Moore C , Nathan A 
Published: August 2023

Abstract

Aim
Disparity within gender distribution in surgery manifests underrepresentation of women at the top of their field. Despite increasing women entering the profession, decreased academic representation of women stresses the importance of closing the gender gap. This study aimed to quantify gender distribution of speakers and prevalence of all-male panels (“manels”) at major general surgical conferences.

Method
Data were collected and analysed retrospectively across four annual general surgical meetings held between 2016 and 2021. Male and female faculty amongst these were academically stratified by mean number of publications, citations and H-index. A ‘MANEL’ was identified as a session with two or more speakers, all identifying as men.

Results
In total, the 14 conferences across 4 annual meetings identified 454 sessions delivered by 2346 speakers. On average, 21.5% (n = 505) of these were identified as female. From 357 panels, 35.3% (n = 126) of these were identified as manels. No statistically significant difference in percentage of manels was observed between online versus in person conferences (online 42.9% (n = 24), in person 35.8% (n = 96); p = 0.321). Male invited lecturers indicated a significantly higher H-index than female invited lecturers (male = 31.5 vs female = 19.4; p&lt;0.05). No statistically significant difference in the percentage of manels was observed over time (28.3% in 2016, 33.3% in 2021; p = 0.448).

Conclusions
This provides an evidence basis supporting the underrepresentation of females within major general surgical meetings is a recurring issue despite improvement. This study aims to explicitly highlight the necessity for greater gender distribution and diversity across the general surgical discipline.
614 “Women in Surgery – Breaking Stereotypes”: Value of Organising WINS Sessions Early in Medical Teaching to Tackle Stereotypes
Authors: Rao E 
Published: August 2023

Abstract

Aim
Despite 59% medical students being female, only 12% consultant surgeons in the UK are female. This study explores the value offered by teaching sessions to promote Women in Surgery (WINS) and help tackle stereotypes amongst medical students.

Method
A virtual session aimed at medical students delivered by a female surgeon who shared her journey of being and becoming a surgeon was offered. A post-session survey collected data from the attendees on their perceptions of the challenges women face in pursuing a career in surgery. Free-text data from the survey were analysed thematically.

Results
Three key themes emerged based on the views attendees shared on the challenges women face in surgery– ‘women cannot make good surgeons’; ‘surgery is harder for females to access’ and ‘women are more family-orientated with less passion for the job’. Following the session, the participants were asked to share their key learning points which they identified as ‘women can make excellent surgeons’; ‘support is available’ and ‘work-life balance is possible’. Overall, all participants stated that the session motivated them in taking up a career in surgery.

Conclusions
Our results indicate that direct early medical student-to-surgeon engagement is significant in addressing misconceptions which might be helpful in dealing with some stereotypes surrounding WINS. Well-informed students are more likely to pursue surgery as a career, addressing current gender disparities. Feedback indicated that attendees valued personal insights and experiences of the invited speaker and this information is of value to inform future interventions which help address issues of representation of females in surgery.
839 A Retrospective, Multi-National, Longitudinal Study for Quantitative Analysis of Gender Distribution of Speakers at Major Neurosurgical Conferences
Authors: Burton O , Georgi M , Asif A , Fricker M , Patel S , Raja A K , Gargan A , Gargan K , Lee K , Kamboj R , Thamilmaran A , Leung K H C , Abdi Z , Haque S , Tse F , Moore C , Nathan A 
Published: August 2023

Abstract

Aim
To explore gender distribution of invited lecturers and panel speakers at major international neurosurgical conferences and investigate this as a potential contributor to lack of female representation in neurosurgery, known as a significant workforce problem, worldwide.

Method
We retrospectively analysed annual meetings organised by 4 major neurosurgical organisations between January 2016 and December 2021. Male and female faculty were academically stratified according to mean publications, citations, and H-index. A manel was defined as a session with 2 or more speakers, all of whom are men. Sex was determined by specific speaker title in conference program, online autobiography, or Gender Balance Assessment Tool (GBAT).

Results
Of the 21 conferences hosted by 4 major international neurosurgical societies/organisations analysed there were 5883 speakers, of which 10.93% (n = 643) were female. Of 885 panel sessions, 534 (60.34%) were manels. There were statistically significant changes between online and in-person conferences (45.45% (n = 60) manels online vs 62.95% (n = 474) manels in-person; p&lt;0.05). Male invited lecturers had significantly higher mean H-index than female invited lecturers (male = 34.88, female = 18.95; p&lt;0.05). There was a significant reduction in the proportion of manels over time (67.35% in 2016 vs 39.83% in 2021; p&lt;0.05).

Conclusions
Despite encouraging findings that manels are becoming less prevalent in major neurosurgical meetings, they continue to comprise the majority, while female representation remains poor. This study hopes to highlight the need for greater gender diversity and female representation in neurosurgery.
875 Women in Surgery: A Qualitative Analysis of Tweets Engaged in the Gender Disparity Discourse
Authors: Lowe C 
Published: August 2023

Abstract

Aim
This study was conducted to identify the main areas of gender bias affecting current female-identifying surgeons through posts shared on a social media platform, Twitter, and to use this analysis, alongside contemporary literature, to suggest how social media can help progress the movement towards gender parity in surgery.

Method
The study analysed five Twitter hashtags used to engage in the gender-bias discourse: #ILookLikeASurgeon, #MedBikini, #WomenInSurgery, #OperateWithRespect, and #HammerItOut. Phase One involved the manual collection and thematic analysis of tweets to identify the main areas of gender bias before relating this to literature. Phase Two used Twitter analysis software, TweetBinder, to create analytical reports to demonstrate the efficacy of Twitter as a data resource.

Results
Three-hundred-and-fifteen tweets were collected, with five main themes of gender-based discrimination identified: sexism, bullying, sexual harassment, patients’ perceptions, and pay and job disparity. Female-identifying junior staff have experienced gender-based microaggressions to deter them from a surgical career. Bullying and incidences of sexual harassment promote the attrition of female-identifying surgeons, resulting in great pay disparity and global under-representation. The Twitter hashtags significantly improved the outreach of the tweets, promoting engagement with new users to the discourse.

Conclusions
The thematic analysis of tweets echoes the findings of contemporary research but personalises the statistics around gender disparity to create a more compelling provocation for attitude change. Twitter can facilitate contemporary engagement in the surgical gender-parity discussion from both familiar and new users. This may influence current surgical trainees and inspire a new generation of diverse and inclusive surgeons.
Tissue and toxin-specific divergent evolution in plant defense
Evolución divergente específica de tejido y toxina en defensa de plantas
Authors: López-Goldar Xosé , Agrawal Anurag A 
Published: August 2023

Abstract
A major predicted constraint on the evolution of anti-herbivore defense in plants is the nonindependent expression of traits mediating resistance. Since herbivore attack can be highly variable across plant tissues, we hypothesized that correlations in toxin expression within and between plant tissues may limit population differentiation and, thus, plant adaptation. Using full-sib families from two nearby (&lt;1 km) common milkweed (Asclepias syriaca) populations, we investigated genetic correlations among 28 distinct cardenolide toxins within and between roots, leaves, and seeds and examined signatures of tissue-specific divergent selection between populations by QST–FST comparisons. The prevalence, direction, and strength of genetic correlations among cardenolides were tissue specific, and concentrations of individual cardenolides were moderately correlated between tissues; nonetheless, the direction and strength of correlations were population specific. Population divergence in the cardenolide chemistry was stronger in roots than in leaves and seeds. Divergent selection on individual cardenolides was tissue and toxin specific, except for a single highly toxic cardenolide (labriformin), that showed divergent selection across all plant tissues. Heterogeneous evolution of cardenolides within and between tissues across populations appears possible due to their highly independent expression. This independence may be common in nature, especially in specialized interactions in which distinct herbivores feed on different plant tissues.
A gap-free reference genome reveals structural variations associated with flowering time in rapeseed (Brassica napus)
Authors: Li Bao , Yang Qian , Yang Lulu , Zhou Xing , Deng Lichao , Qu Liang , Guo Dengli , Hui Rongkui , Guo Yiming , Liu Xinhong , Wang Tonghua , Fan Lianyi , Li Mei , Yan Mingli 
Published: August 2023

Abstract
Allopolyploid oilseed rape (Brassica napus) is an important oil crop and vegetable. However, the latest version of its reference genome, with collapsed duplications, gaps, and other issues, prevents comprehensive genomic analysis. Herein, we report a gap-free assembly of the rapeseed cv. Xiang5A genome using a combination of ONT (Oxford Nanopore Technologies) ultra-long reads, PacBio high-fidelity reads, and Hi-C datasets. It includes gap-free assemblies of all 19 chromosomes and telomere-to-telomere assemblies of eight chromosomes. Compared with previously published genomes of B. napus, our gap-free genome, with a contig N50 length of 50.70 Mb, has complete assemblies of 9 of 19 chromosomes without manual intervention, and greatly improves contiguity and completeness, thereby representing the highest quality genome assembly to date. Our results revealed that B. napus Xiang5A underwent nearly complete triplication and allotetraploidy relative to Arabidopsis thaliana. Using the gap-free assembly, we found that 917 flowering-related genes were affected by structural variation, including BnaA03.VERNALIZATION INSENSITIVE 3 and BnaC04.HIGH EXPRESSION OF OSMOTICALLY RESPONSIVE GENES 1. These genes may play crucial roles in regulating flowering time and facilitating the adaptation of Xiang5A in the Yangtze River Basin of China. This reference genome provides a valuable genetic resource for rapeseed functional genomic studies and breeding.
VvWRKY5 enhances white rot resistance in grape by promoting the jasmonic acid pathway
Authors: Zhang Zhen , Jiang Changyue , Chen Cui , Su Kai , Lin Hong , Zhao Yuhui , Guo Yinshan 
Published: August 2023

Abstract
Grape white rot is a disease caused by Coniella diplodiella (Speg.) Sacc. (Cd) can drastically reduce the production and quality of grape (Vitis vinifera). WRKY transcription factors play a vital role in the regulation of plant resistance to pathogens, but their functions in grape white rot need to be further explored. Here, we found that the expression of the WRKY IIe subfamily member VvWRKY5 was highly induced by Cd infection and jasmonic acid (JA) treatment. Transient injection and stable overexpression (in grape calli and Arabidopsis) demonstrated that VvWRKY5 positively regulated grape resistance to white rot. We also determined that VvWRKY5 regulated the JA response by directly binding to the promoters of VvJAZ2 (a JA signaling suppressor) and VvMYC2 (a JA signaling activator), thereby inhibiting and activating the transcription of VvJAZ2 and VvMYC2, respectively. Furthermore, the interaction between VvJAZ2 and VvWRKY5 enhanced the suppression and promotion of VvJAZ2 and VvMYC2 activities by VvWRKY5, respectively. When VvWRKY5 was overexpressed in grape, JA content was also increased. Overall, our results suggested that VvWRKY5 played a key role in regulating JA biosynthesis and signal transduction as well as enhancing white rot resistance in grape. Our results also provide theoretical guidance for the development of elite grape cultivars with enhanced pathogen resistance.
Outcomes of a Comprehensive Specialist Inflammatory Bowel Disease Nursing Service
Authors: Yu Natalie , Wu Kyle , Samyue Tamie , Fry Stephanie , Stanley Annalise , Ross Alyson , Malcolm Ruth , Connell William , Wright Emily , Ding Nik S , Niewiadomski Ola , Lust Mark , Schulberg Julien , Flanagan Emma , Kamm Michael A , Basnayake Chamara 
Published: August 2023

Abstract

Background
Inflammatory bowel disease (IBD) is best managed by a multidisciplinary team within a dedicated IBD service. IBD nurses play an important role within this team. We aimed to evaluate the contribution of our comprehensive outpatient IBD nursing service on patient outcomes, quality of care, and healthcare costs.

Methods
We performed a retrospective review of all IBD nurse encounters with patients over a 12-month period from October 2020 to September 2021 at a tertiary IBD referral center. Each nurse encounter was classified with respect to its clinical context, activities, and outcomes. Descriptive statistics were used to characterize these encounters and an economic analysis was performed to estimate the cost savings to the hospital.

Results
A total of 2537 nurse encounters occurred with 682 patients; 41% of encounters were nurse-initiated contacts with patients and 34% were patient-initiated contacts with the nurse helpline (26% via email, 8% via telephone). Most encounters involved clinical assessments (66%), providing education, counseling or updates (47%), and reviewing investigation results (38%). A gastroenterologist was consulted for advice in 35% of contacts. An estimated 29 emergency department visits, 1925 outpatient clinic visits, and 137 general practitioner visits were avoided. After deducting costs incurred, a net estimated annual saving of up to AUD $570 838 was achieved. Nurses commonly facilitated faster access to investigations (29%), education provision (28%), delivery of biologic services (25%), and medication changes (19%).

Conclusions
A comprehensive IBD nursing service is associated with improved patient outcomes and quality of care, and reduced healthcare costs. This study supports the expanding role of IBD nurses in a modern multidisciplinary IBD service and the need for greater funding and integration of IBD nurses into IBD services.
The Global Mpox Outbreak and Effective Vaccine Communication
Authors: Sayers David R 
Published: August 2023

ABSTRACT
The effectiveness and durability of vaccination to protect against localized anogenital mpox skin lesions is not well defined. Overestimating vaccine effectiveness against mild infection risks degrading vaccine confidence. Acknowledging and communicating vaccine unknowns and limitations is vital to direct mpox research, maintain vaccine confidence, and optimize uptake.