bluuebunny/crossref_metadata_2025_split huggingface dataset:
SP7.2 Student reported outcomes of a novel virtual medical work experience: results from an international cohort
Authors: Shakir Taner , Matwala Kabir , Lovett Bryony 
Published: November 2022

Abstract

Introduction
The COVID-19 pandemic had a deleterious effect not only upon medical and surgical training, but also upon inspiring the medics and surgeons of the future. Prior to applying for a career in medicine, students often take part in work experience. This observership provides in insight into what a medical career entails. Nationwide lockdowns and hospital visiting restrictions rendered it impossible to gain this understanding. We designed a novel virtual work experience (VWE) aimed at mitigating this loss.

Methods
A timetable was created to simulate a chronological progression throughout a medical career. A range of speciality talks were given by junior and senior doctors. Students were invited to sign up after contacting local schools, dissemination on social media and word of mouth. The one day event was free and hosted using online video conferencing software. Pre and post course questionnaires assessed confidence with regards to a career in medicine.

Results
There were 434 student registrations which spanned internationally to 9 countries. 140 post course responses were obtained. 131 students (94%) responded that the event was a good alternative to face to face (F2F) experience. Confidence levels of above 3 (on a 5 point Likert scale) improved from 54% to 99% regarding medical school applications and the interview process. 96% of students were interested in pursuing a career in medicine after the event.

Conclusions
This VWE event aimed to combat the loss of F2F experience. Student reported outcomes were extremely favourable. This may form the foundation of a hybrid work experience in the future.
SP11.2 Tackling the post pandemic NHS waiting lists- Mission impossible?
Authors: Bodapati Shruti , Singh Gambhir Raghvinder Pal , Kimura Shiori 
Published: November 2022

Abstract

Aim
The office of national statistics (ONS) has estimated that around 5.8 million people are currently, waiting for treatment and the government has allocated £ 1.5 billion to tackle the backlog. The study aimed to analyze the likely effectiveness of these measures.

Methods
We looked at various government and NHS resources pertaining to the recovery plan.

Results
The actual numbers currently waiting to be treated is predicted to be closer to 13 million. Working within the current timeframes it will take up to 12 years to clear this backlog. Among the surgical specialities the numbers waiting are Orthopaedics- 700,547, Ophthalmology - 595,824, ENT - 459,087, Gynaecology - 438,703, General Surgery - 409,823. The £1.5 billion for elective recovery, includes £500 million capital funding (£250 million for increasing operating theatre capacity and hospital productivity and £250 million for an elective recovery technology fund).
The private setup has been utilized in fits and starts to ensure there is no undue delay for cancer surgeries. Pop up centers and surgical hubs are to speed up the diagnosis and treatments for things like day case cataract surgeries.

Conclusion
Without disruptive thinking, clearing the backlog is mission impossible. The existing capacity has to be utilized beyond the conventional working hours and Hospital at weekend has to designated for pandemic backlog. This will give 104 additional full time days in each of the NHS Hospitals and paying the staff a “new pandemic bank rate” may help get the job done in 4–5 years.

References
1. https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2021-22/; 2. https://www.ons.gov.uk/search?q=nhs+waiting+lists; 3. https://committees.parliament.uk/publications/8352/documents/85020/default/; 4. https://nhswaitlist.lcp.uk.com/; 5. https://ifs.org.uk/publications/15557
WE6.1 A Sustainable Appendicectomy
Authors: Boag Katie , Ho Timothy , Quyn Aaron , Peckham-Cooper Adam 
Published: November 2022

Abstract

Background and Aim
Equipment consumption is the third largest contributor to the carbon footprint of surgery. Laparoscopic surgery is particularly resource intensive. The aim of this quality improvement project is to reduce the carbon footprint of laparoscopic appendicectomies performed at this high volume trust.

Methods
The laparoscopic appendicectomy was process-mapped and carbon footprint calculations performed. Three areas of change were identified: elimination of single use gowns and drapes, elimination of peri-operative catheterisation, and rationalisation of the equipment tray from 119 to 49 items. A staff survey was used to identify practices and gain feedback on the proposed changes. Changes were implemented from January 2022. Surgeons are able to ask for a ‘sustainable appendicectomy pathway’ at team brief. Procedures were monitored for one week.

Results
Survey feedback indicated 100% (n=19) supported the proposed changes. The interventions save an estimated 7.48kgCO2e and £25.1 per procedure. No extra equipment was required during the procedures monitored.

Conclusions
The interventions are predicted to save annually 3.9TCO2e and £13,081 in the approximately 500 appendicectomies performed in this trust, and can be extrapolated to many types of procedures. Support from all members of the operating department is vital to sustaining the momentum of interventions. Following initial positive results, changes were extended to only use reusable gowns in one of the CEPOD theatres which perform around 2400 procedures/year. This will lead to a saving of at least 6386 disposable gowns/year (1.43T of waste). Further plans within this trust are to make the ‘sustainable appendicectomy pathway’ an opt-out decision.
WE6.5 Back to the future: Does increasing the proportion of local anaesthetic inguinal hernia repairs help achieve a #NetZeroNHS?
Authors: Robb Henry , Gan Jonathan , Winter-Beatty Jasmine , Dryden Simon , Ortega Patricia , Purkayastha Sanjay 
Published: November 2022

Abstract

Aim
To investigate whether increasing the proportion of local anaesthetic (LA) inguinal hernia repairs (IHR) provides benefit across the sustainability ‘triple bottom line’ of environmental, financial, and social improvement.

Methods
After establishing suitability criteria for LA IHR, the IHR waiting list was screened and 20 patients were deemed suitable for LA repair. Data was collated on clinical outcomes, surgical timings, medical equipment usage and patient satisfaction. Trust data on our pre-pandemic (2019) practises was analysed to provide environmental and financial estimates.
Extensive carbon footprinting was performed of the resources used in LA and general anaesthetic (GA) cases.

Results
Of the 20 cases identified, 10 IHRs were performed under LA and 10 under GA. LA IHR had a 53.2% shorter length of stay (LOS) and a 40% reduced complication rate. Analysis of our 2019 data mirrored this with the LA IHR patients having a 4.75-hour shorter LOS. In 2019, only 27.7% of cases were performed under LA, far below that in published literature (Sanjay 2007) of 64%.
LA IHR saved 10.2kgCO2e/case. If we increased our annual LA rate to 64%, we would save 2005.12kg/CO2e/year. Financially, our trust would save £15, 984.54/year. Our patient surveys did not identify a difference in quality-of-life outcomes, however our improved clinical outcomes support the superiority of LA IHR for patients.

Conclusion
Increasing the number of LA IHRs would provide significant benefits across the triple bottom line. Our carbon emission savings alone is equivalent to driving from London to Edinburgh 12.5 times.
TH4.1 Systematic review of preoperative magnetic resonance angiography, computed tomography angiography and duplex ultrasonography for diagnosis and planning of surgical, endovascular or hybrid procedures for lower limb revascularisation
Authors: Edgerley Daisy , Rahi Asad 
Published: November 2022

Abstract

Aims
This systematic review assessed literature concerning preoperative magnetic resonance angiography (MRA), computed tomography angiography (CTA), and duplex ultrasonography to determine the sensitivity and specificity at detecting lower limb arterial stenosis and/or occlusion, with digital subtraction angiography (DSA) as the reference standard. The aim was to see if any, or a combination of, methods could replace DSA in peripheral arterial disease diagnosis and treatment planning.

Methods
10 databases were searched on Ovid for studies involving MRA, CTA and/or duplex ultrasonography of the lower limb arteries. The period of interest was 1995-April 2021. The papers were assessed for their relevance to the review against the exclusion criteria.

Results
41 studies were included. For detecting ≥50% stenosis or occlusion, multi-detector CTA had the highest median sensitivity of 93.9% and specificity of 93.4%. Contrast-enhanced MRA and duplex ultrasonography reported median sensitivities and specificities of 91.1% and 91.9%, and 82.7% and 90.6%, respectively. For detecting occlusions, duplex ultrasonography had the best median sensitivity of 92.3% and specificity of 99.5%. Contrast-enhanced MRA and multi-detector CTA had median sensitivities and specificities 92.0% and 96.5%, and 88.6% and 98.3%, respectively.

Conclusion
Contrast-enhanced MRA had the best overall diagnostic accuracy. Multi-detector CTA detected ≥50% stenosis or occlusion well, but the sensitivity for occlusions was lower than MRA and duplex ultrasonography. Though duplex ultrasonography detected occlusions better than MRA and CTA, it was less sensitive and specific at detecting ≥50% stenosis or occlusion. Consequently, contrast-enhanced MRA could be used as an alternative to DSA.
698 Frequency of Short vs Long-Term Reporting of Bariatric Surgery Outcomes
Authors: Oochit K , Shahwan S , Kourounis G 
Published: November 2022

Abstract
Bariatric surgery is an effective treatment for obesity. Though both short- and long-term outcomes have been reported, most of the published literature to date has focused on short-term outcomes. Identification of post-operative weight regain, and re-emergence of comorbidities require long-term follow-up. We aimed to identify the distribution and changes in follow-up times within the bariatric surgery literature.
We screened through 1807 articles from 9 bariatric surgery journals from January to June of 2015 and 2021 via PubMed and identified articles reporting weight loss as a main outcome. Follow-up intervals were divided into short- (&lt;3 years), medium- (3–5 years), and long-term (≥5 years) as per the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines.
53 and 63 articles were identified in 2015 and 2021 respectively. Reported follow-up lengths in 2015 were 32 (60%) short-term, 14 (26%) medium-term, and 7 (14%) long-term; while in 2021 there were 41 (65%) short-term, 6 (10%) medium-term and 16 (25%) long-term articles in 2021. Of the articles reporting long-term outcomes in 2015 and 2021, only 48% and 70% of the included patients respectively had &gt;5 years follow up data available.
Though reporting of long-term outcomes increased (14% to 25%), the majority of published outcomes remains short-term. Bariatric surgery registries such as the United Kingdom National Bariatric Surgery Registry (NBSR) are helping to mitigate this, but an increased focus on investigating and reporting long-term outcomes would be beneficial to clinicians and patients making decisions regarding surgery.
663 Potential for Prophylactic Antibiotics in Renal Transplantation: A Retrospective Study of Kidney Perfusion Fluid Cultures and Kidney Cold Ischaemic Time
Authors: Haq I , Berjaoui N , Hunter J , Roy D , Imray C , O'Callaghan J 
Published: November 2022

Abstract

Aim
Infection is a significant cause of morbidity in kidney transplantation, and it is believed that an increased cold ischemic time is an independent risk factor. Identification of common pathogens in perfusion fluids, as well as the safe limit of cold ischaemic time can be used to reduce the risk of postoperative complications. There are currently no guidelines for prophylactic antibiotics.

Method
This is a retrospective review of the microbiological analysis of kidney perfusion fluids samples for a recipient transplant between 2017–2020. 100 patients were identified in this time period and this data was compared against the cold ischaemic time of the donor kidney.

Results
23% (22/96) samples were positive for bacteria with the majority being gram positive cocci. The most common bacteria grown was Coagulase Negative Staphylococcus (44% - 11/25). However, a broad spectrum of bacteria was grown including Hafnia, Pseudomonas, Klebsiella, Kocuria and E-coli. 3% (3/96) of samples grew two different species of bacteria.
The mean cold ischemic time for all transplants was 799 minutes with a range of 281–1618 minutes. The mean for infected samples was 935 mins with a range of 645–1410. Samples that grew 2 bacteria had a range of 913–941 mins.

Conclusions
There is potential to reduce the risk of infection with the use of broad-spectrum induction antibiotics and it is important that potential bacterial species and common resistance profiles are covered. There is a possible correlation between increased cold ischaemic time and bacterial growth in perfusion fluid however further research is warranted.
Canyons Community Schools: Universities and Colleges as Key Partners
Authors: Anderson-Butcher Dawn , Bates Samantha , Sterling Karen , Voegler Michelle , Dau Wendy , Amorose Anthony 
Published: November 2022

Abstract
Community schools respond to a variety of risk factors that impede student learning and development. School and community leaders in Canyons School District (CSD) have created community schools across one highly impacted feeder pattern to strengthen academic learning efforts, school climate and youth development opportunities, parent and family engagement efforts, health and social services, and community partnerships. Over the past decade, school improvement processes and practices have been supported through key partnerships with colleges and universities. This article describes how universities and colleges assisted five community schools in CSD and illustrates outcomes associated with ongoing evaluation and continuous improvement efforts. The myriad of ways higher education institutions can assist community schools in highly impacted school communities are described, highlighting the various ways schools can leverage university expertise, time, personnel, and capital to help implement expanded models of schooling.
Acute effects of electronic cigarettes on vascular endothelial function: a systematic review and meta-analysis of randomized controlled trials
Authors: Meng Xing-chen , Guo Xin-xin , Peng Zhen-yan , Wang Chun , Liu Ran 
Published: November 2022

AbstractAimThe effects of e-cigarettes on endothelial function remained controversial. The study aimed to investigate the effects of e-cigarettes on vascular endothelial function.Methods and resultsPubMed, Web of Science, Embase, and Cochrane Library were searched up to December 2021. We only included the studies in which the control group included vaping without nicotine and tobacco. Pairwise and network meta-analyses were conducted for flow-mediated dilation (FMD), pulse wave velocity (PWV), and heart rate corrected augmentation index (AIx75). Eight studies involving 372 participants were eligible for this review. Compared with vaping without nicotine, e-cigarettes significantly increase in PWV (mean difference = 3.09; 95% confidential interval: 1.51–4.68, P &lt; 0.001) and AIx75 (mean difference = 2.11; 95% confidential interval: 1.02–3.21, P &lt; 0.001) indicators, but not affect FMD (mean difference = 0.78; 95% confidential interval: −0.08 to 1.64, P = 0.075). But compared with traditional tobacco, e-cigarettes did not affect FMD (mean difference = 0.28, 95% confidential interval: −0.45 to 0.59, P = 0.084). According to surface under the cumulative ranking curve (SUCRA), the e-cigarette ranked first for FMD (SUCRA = 97%), tobacco ranked first for PWV (SUCRA = 75%), and AIx75 (SUCRA = 99%).ConclusionIn summary, evidence from our pooled analyses indicated that acute inhalation of e-cigarettes leads to negative changes in vascular endothelial function. E-cigarettes cannot be used as an alternative to public health strategies for tobacco control and should not be considered cardiovascular safety products. More future research should be conducted to verify our findings.
Diagnostic group differences in return to work and subsequent detachment from employment following cardiovascular disease: a nationwide cohort study
Authors: Bernt Jørgensen Sidsel Marie , Gerds Thomas Alexander , Johnsen Nina Føns , Gislason Gunnar , El-Chouli Mohamad , Brøndum Stig , Maribo Thomas , Kristiansen Maria 
Published: November 2022

Abstract

Aims
Return to work and employment maintenance following cardiovascular disease (CVD) are important rehabilitation goals for people of working age. To identify people in particular need of vocational rehabilitation, we examined differences in return to work and subsequent detachment from employment among people with atrial fibrillation (AF), heart failure (HF), heart valve disease, and ischaemic heart disease.

Methods and results
We conducted a nationwide cohort study and included all individuals of working age (35–65 years) who were employed when diagnosed with incident CVD in 2018. We estimated sex- and age-standardized probabilities of remaining employed at 3, 6, and 12 months after diagnosis, and of detachment from employment within 6 months after having returned to work. Of 46 912 individuals diagnosed in 2018, 8187 were of working age and employed at diagnosis. The mean age was 54.7 years (SD = 6.7), and 74.0% were men. Within 1 year, 89.8% had returned to work, but within the subsequent 6 months, 23.5% of these experienced detachment from employment. At 3, 6, and 12 months after diagnosis the highest standardized probability of being employed was found among people with AF, whereas the lowest probability was found among people with HF {78.9% [95% confidence interval (CI): 77.3–80.4] vs. 62.2% [95% CI: 59.0–65.4] at 12 months}. Similarly, the highest probability of detachment was found for people with HF [30.3% (95% CI: 26.9–33.7)].

Conclusion
People with HF present the highest probability of not returning to work. There is a need for developing and documenting effects of vocational rehabilitation strategies within comprehensive cardiac rehabilitation programmes.
Association between NMR metabolomic signatures of healthy lifestyle and incident coronary artery disease
Authors: Fu Zuqiang , Liu Qian , Liang Jingjia , Weng Zhenkun , Li Wenxiang , Xu Jin , Zhang Xin , Xu Cheng , Gu Aihua 
Published: November 2022

Abstract

Aims
To identify metabolites associated with a healthy lifestyle and explore the possible mechanisms of lifestyle in coronary artery disease (CAD).

Methods and results
The nuclear magnetic resonance metabolomics platform was applied to perform metabolomic profiling of baseline plasma samples from a randomly selected subset of 121 733 UK Biobank participants. Cox proportional hazards models with covariate adjustments were used to investigate the associations between validated lifestyle-associated metabolites and incident CAD and to estimate the accuracy of the inclusion of metabolites to predict CAD compared with traditional prediction models. The discriminatory ability of each model was evaluated using Harrell’s C statistic, integrated discrimination improvement (IDI), and continuous net reclassification improvement (NRI) indexes. During a median of 8.6 years of follow-up, 5513 incident CAD cases were documented. Among the 111 lifestyle-associated metabolites, 65 were significantly associated with incident CAD after multivariate adjustment (Bonferroni P &lt; 3.11 × 10−04). The addition of these metabolites to classic risk prediction models [Framingham Risk Score (FRS) using lipids; FRS using body mass index] improved CAD prediction accuracy as assessed by the C statistic (increasing to 0.739 [95% CI, 0.731–0.747] and 0.752 [95% CI, 0.746–0.758]), respectively; continuous NRI (0.274 [0.227–0.325] and 0.266 [0.223–0.317]) and IDI (0.003 [0.002–0.004] and 0.003 [0.002–0.004]).

Conclusion
Healthy lifestyle-associated metabolites are associated with the incidence of CAD and may help improve the prediction of CAD risk. The use of metabolite information combined with the FRS model warrants further investigation before clinical implementation.
Slowing Heart Rate Protects Against Pathological Cardiac Hypertrophy
Authors: Sebastian Sonia , Weinstein Lee S , Ludwig Andreas , Munroe Patricia , Tinker Andrew 
Published: November 2022

Abstract
We aimed to determine the pathophysiological impact of heart rate (HR) slowing on cardiac function. We have recently developed a murine model in which it is possible to conditionally delete the stimulatory heterotrimeric G-protein (Gαs) in the sinoatrial (SA) node after the addition of tamoxifen using cre-loxP technology. The addition of tamoxifen leads to bradycardia. We used this approach to examine the physiological and pathophysiological effects of HR slowing. We first looked at the impact on exercise performance by running the mice on a treadmill. After the addition of tamoxifen, mice with conditional deletion of Gαs in the SA node ran a shorter distance at a slower speed. Littermate controls preserved their exercise capacity after tamoxifen. Results consistent with impaired cardiac capacity in the mutants were also obtained with a dobutamine echocardiographic stress test. We then examined if HR reduction influenced pathological cardiac hypertrophy using two models: ligation of the left anterior descending coronary artery for myocardial infarction and abdominal aortic banding for hypertensive heart disease. In littermate controls, both procedures resulted in cardiac hypertrophy. However, induction of HR reduction prior to surgical intervention significantly ameliorated the hypertrophy. In order to assess potential protein kinase pathways that may be activated in the left ventricle by relative bradycardia, we used a phospho-antibody array and this revealed selective activation of phosphoinositide-3 kinase. In conclusion, HR reduction protects against pathological cardiac hypertrophy but limits physiological exercise capacity.
Chromosome-level Assembly, Dosage Compensation and Sex-biased Gene Expression in the Small Brown Planthopper,Laodelphax striatellus
Authors: Hu Qing-Ling , Ye Yu-Xuan , Zhuo Ji-Chong , Huang Hai-Jian , Li Jun-Min , Zhang Chuan-Xi 
Published: November 2022

AbstractIn insects, sex chromosome differentiation often results in unequal gene dosages between sexes. Dosage compensation mechanisms evolve to balance gene expression, but the degree and mechanism of regulation often vary by insect species. In hemipteran species, the small brown planthopper (SBPH), Laodelphax striatellus, is an injurious crop pest, with a sex chromosome type XX in females and XO in males. This species offers the opportunity to study dosage compensation and sex-biased gene expression. In this study, we generated a chromosome-level genome of SBPH using Oxford Nanopore Technologies and high-throughput chromatin conformation capture (Hi-C) technology. We also sequenced RNA-seq data from 16 tissue samples to annotate the genome and analyze gene dosage compensation. We finally obtained a 510.2 megabases (Mb) genome with 99.12% of the scaffolds anchored on 15 chromosomes (14 autosomes and 1 X chromosome) and annotated 16,160 protein-coding genes based on full-length cDNA sequencing data. Furthermore, we found complete dosage compensation in all L. striatellus somatic tissues, but lack of dosage compensation in gonad tissue testis. We also found that female-biased genes were significantly enriched on the X chromosome in all tissues, whereas male-biased genes in gonad tissues were enriched on autosomes. This study not only provides a high-quality genome assembly but also lays a foundation for a better understanding of the sexual regulatory network in hemipteran insects.