Basic open surgical training course

INTRODUCTION: Fewer open surgical procedures are performed, and thus a need to learn open surgical techniques outside the operating room has emerged. Simulation training offers the possibility to train in a safe environment before operating on patients. The purpose of this study is to evaluate the effect of a simulation-based course in basic open surgical skills and to describe its pedagogical foundation, content and organisation. METHODS: Surgical trainees at the beginning of their surgical career participated in a basic open surgical skills course and were assessed before the course, after the course and during a one-day course operating on live sedated pigs using the Objective Structures Assessment of Technical Skills (OSATS) instrument. RESULTS: We found that the course participants matched the target group. The participants' OSATS score increased from 12.1 in the pre-test to 19.9 points (p &lt; 0.0001) in the post-test. The completion rate was 99% and the failure rate was 11%. The course met 13 out of 14 requirements for a simulation-based course. CONCLUSIONS: The basic open surgical skills course teaches trainees the basic skills for open surgery including knot tying, suturing, dissection and surgical assistance. The course significantly increases the participants' surgical abilities and meets requirements for a well-structured simulation course. FUNDING: Equipment was provided by Copenhagen Academy for Medical Education and Simulation, Capital Region, Copenhagen, Denmark. The authors have no conflicts of interest or financial ties to disclose. TRIAL REGISTRATION: The study did not require registration as this is a retrospective quality control study using anonymised participant data.</p

Basic open surgical training course

INTRODUCTION: Fewer open surgical procedures are performed, and thus a need to learn open surgical techniques outside the operating room has emerged. Simulation training offers the possibility to train in a safe environment before operating on patients. The purpose of this study is to evaluate the effect of a simulation-based course in basic open surgical skills and to describe its pedagogical foundation, content and organisation. METHODS: Surgical trainees at the beginning of their surgical career participated in a basic open surgical skills course and were assessed before the course, after the course and during a one-day course operating on live sedated pigs using the Objective Structures Assessment of Technical Skills (OSATS) instrument. RESULTS: We found that the course participants matched the target group. The participants' OSATS score increased from 12.1 in the pre-test to 19.9 points (p &lt; 0.0001) in the post-test. The completion rate was 99% and the failure rate was 11%. The course met 13 out of 14 requirements for a simulation-based course. CONCLUSIONS: The basic open surgical skills course teaches trainees the basic skills for open surgery including knot tying, suturing, dissection and surgical assistance. The course significantly increases the participants' surgical abilities and meets requirements for a well-structured simulation course. FUNDING: Equipment was provided by Copenhagen Academy for Medical Education and Simulation, Capital Region, Copenhagen, Denmark. The authors have no conflicts of interest or financial ties to disclose. TRIAL REGISTRATION: The study did not require registration as this is a retrospective quality control study using anonymised participant data.</p

Palaeoproteomics confirm earliest domesticated sheep in southern Africa ca. 2000 BP.

We used palaeoproteomics and peptide mass fingerprinting to obtain secure species identifications of key specimens of early domesticated fauna from South Africa, dating to ca. 2000 BP. It can be difficult to distinguish fragmentary remains of early domesticates (sheep) from similar-sized local wild bovids (grey duiker, grey rhebok, springbok-southern Africa lacks wild sheep) based on morphology alone. Our analysis revealed a Zooarchaeology by Mass Spectrometry (ZooMS) marker (m/z 1532) present in wild bovids and we demonstrate through LC-MS/MS that it is capable of discriminating between wild bovids and caprine domesticates. We confirm that the Spoegrivier specimen dated to 2105 ± 65 BP is indeed a sheep. This is the earliest directly dated evidence of domesticated animals in southern Africa. As well as the traditional method of analysing bone fragments, we show the utility of minimally destructive sampling methods such as PVC eraser and polishing films for successful ZooMS identification. We also show that collagen extracted more than 25 years ago for the purpose of radiocarbon dating can yield successful ZooMS identification. Our study demonstrates the importance of developing appropriate regional frameworks of comparison for future research using ZooMS as a method of biomolecular species identification

Quality-of-life outcomes following topical melatonin application against acute radiation dermatitis in patients with early breast cancer:A double-blind, randomized, placebo-controlled trial

The aim of this double-blind, placebo-controlled, randomized study was to investigate whether topical melatonin administered during radiation therapy could increase the quality of life in patients with primary breast cancer. Patients were followed from the first radiation fraction until 3 weeks after the last. The patients applied 1 g of cream to the irradiated area of the skin twice daily, consisting of either 25 mg/g melatonin and 150 mg/g dimethyl sulfoxide, or a placebo cream. Outcomes were the European Organisation for Research and Treatment of Cancer's quality-of-life questionnaires for breast cancer (QLQ-C30 and QLQ-BR23) on the last day of radiation therapy. As a secondary outcome, we evaluated the breast symptom (BS) scores over the entire duration of the trial in a repeated measures linear model. We included 65 patients and had 17 drop-outs, thus totaling 26 and 22 patients in the melatonin and placebo groups, respectively. BS scores on the last day of radiation did not differ between groups (p =.333). However, the linear model analyzing BS for the entire duration showed that melatonin significantly decreased the symptoms (p =.001). There was no difference in the BS score on the last day of radiation, however, we found that the patients in the melatonin group had significantly lower BS scores over the entire duration of the trial.</p

Effect of melatonin cream on acute radiation dermatitis in patients with primary breast cancer:A double-blind, randomized, placebo-controlled trial

Aim: This was a double-blind, placebo-controlled randomized study investigating whether melatonin can protect against radiation dermatitis in women receiving radiation therapy for primary breast cancer. Methods: Patients were included before radiation therapy and followed once weekly throughout treatment with a 3-week follow-up. Patients applied 1 g of cream to the irradiated skin twice daily, consisting of either 25 mg/g melatonin and 150 mg/g dimethyl sulfoxide, or placebo. Our outcomes were the Radiation Therapy Oncology Group's (RTOG) acute radiation morbidity scoring criteria for skin, a pixel analysis of erythema in clinical photographs, and patients’ use of corticosteroid cream. Outcomes were evaluated once weekly throughout the trial. The primary outcomes were RTOG-score and pixel analysis at 2 weeks follow-up. Secondary outcomes were the use of corticosteroid cream and analyses of RTOG-scores and pixel analyses throughout the trial. Results: Sixty-five patients were included, 17 dropped out, totaling 26 and 22 patients randomized to melatonin and placebo, respectively. RTOG-scores and pixel analyses at 2 weeks follow-up showed no difference p =.441 and p =.890, respectively). There was no difference in the use of corticosteroid cream (p =.055). Using logistic regression, the melatonin group had a higher likelihood of having a low RTOG-score (p =.0016). The logistic regression showed no difference between the groups for the pixel analyses. Conclusion: Our primary outcome showed no difference in RTOG-scores at 2 weeks follow-up, however, the RTOG-score over the entire duration of the study demonstrated a protective effect of melatonin. Further studies are warranted investigating higher doses of melatonin, and whether corticosteroids may influence the effect of melatonin cream against radiation dermatitis.</p

The biomolecular characterization of a finger ring contextually dated to the emergence of the Early Neolithic from Syltholm, Denmark.

We present the analysis of an osseous finger ring from a predominantly early Neolithic context in Denmark. To characterize the artefact and identify the raw material used for its manufacture, we performed micro-computed tomography scanning, zooarchaeology by mass spectrometry (ZooMS) peptide mass fingerprinting, as well as protein sequencing by liquid chromatography tandem mass spectrometry (LC-MS/MS). We conclude that the ring was made from long bone or antler due to the presence of osteons (Haversian canals). Subsequent ZooMS analysis of collagen I and II indicated that it was made from Alces alces or Cervus elaphus material. We then used LC-MS/MS analysis to refine our species identification, confirming that the ring was made from Cervus elaphus, and to examine the rest of the proteome. This study demonstrates the potential of ancient proteomics for species identification of prehistoric artefacts made from osseous material

Public health genomics capacity assessment: readiness for large-scale pathogen genomic surveillance in Canada’s public health laboratories

Abstract Background Along with rapid diagnostic testing, contact tracing, and public health measures, an effective pandemic response incorporates genomics-based surveillance. Large-scale SARS-CoV-2 genome sequencing is a crucial component of the global response to COVID-19. Characterizing the state of genomics readiness among Canada’s public health laboratories was necessary to inform strategic planning and deployment of capacity-building resources in the early stages of the pandemic. Methods We used a qualitative study design and focus group discussions, encompassing both technical and leadership perspectives, to perform an in-depth evaluation of the state of pathogen genomics readiness in Canada. Results We found substantial diversity in the state of readiness for SARS-CoV-2 genomic surveillance across Canada. Despite this variability, we identified common barriers and needs in the areas of specimen access, data flow and sharing, computing infrastructure, and access to highly qualified bioinformatics personnel. Conclusions These findings enable the strategic prioritization and deployment of resources to increase Canada’s ability to perform effective public health genomic surveillance for COVID-19 and prepare for future emerging infectious diseases. They also provide a unique qualitative research model for use in capacity building

Palaeoproteomics confirm earliest domesticated sheep in southern Africa ca. 2000 BP

Abstract: We used palaeoproteomics and peptide mass fingerprinting to obtain secure species identifications of key specimens of early domesticated fauna from South Africa, dating to ca. 2000 BP. It can be difficult to distinguish fragmentary remains of early domesticates (sheep) from similar-sized local wild bovids (grey duiker, grey rhebok, springbok—southern Africa lacks wild sheep) based on morphology alone. Our analysis revealed a Zooarchaeology by Mass Spectrometry (ZooMS) marker (m/z 1532) present in wild bovids and we demonstrate through LC–MS/MS that it is capable of discriminating between wild bovids and caprine domesticates. We confirm that the Spoegrivier specimen dated to 2105 ± 65 BP is indeed a sheep. This is the earliest directly dated evidence of domesticated animals in southern Africa. As well as the traditional method of analysing bone fragments, we show the utility of minimally destructive sampling methods such as PVC eraser and polishing films for successful ZooMS identification. We also show that collagen extracted more than 25 years ago for the purpose of radiocarbon dating can yield successful ZooMS identification. Our study demonstrates the importance of developing appropriate regional frameworks of comparison for future research using ZooMS as a method of biomolecular species identification