Is it time for integration of surgical skills simulation into the United Kingdom undergraduate medical curriculum? A perspective from King’s College London School of Medicine

PURPOSE: Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King's College London School of Medicine, and the programme was evaluated. METHODS: A programme was designed in-line with the established Royal College of Surgeons course. Undergraduates were taught four key skills over four weeks: knot-tying, basic-suturing, tying-at-depth and chest-drain insertion, using low-fidelity bench-top models. A Likert-style questionnaire was designed to determine educational value and influence on career choice. Qualitative data was collected. RESULTS: Only 29% and 42% of students had undertaken previous practice in knot-tying and basic suturing, respectively. 96% agreed that skills exposure prior to starting surgical rotations was essential and felt a dedicated course would augment undergraduate training. There was a significant increase in confidence in the practice and knowledge of all skills taught (p<0.01), with a greater motivation to be actively involved in the surgical firm and theatres. CONCLUSION: A simple, structured BSS programme can increase the confidence and motivation of students. Early surgical skills targeting is valuable for students entering surgical, related allied, and even traditionally non-surgical specialties such as general practice. Such experience can increase the confidence of future junior doctors and trainees. We advocate the introduction of a BSS programme into United Kingdom undergraduate curricula

Elimination of unoccupied state summations in it ab initio self-energy calculations for large supercells

We present a new method for the computation of self-energy corrections in large supercells. It eliminates the explicit summation over unoccupied states, and uses an iterative scheme based on an expansion of the Green's function around a set of reference energies. This improves the scaling of the computational time from the fourth to the third power of the number of atoms for both the inverse dielectric matrix and the self-energy, yielding improved efficiency for 8 or more silicon atoms per unit cell

Tailoring the magnetic ordering of the Cr4O5/Fe(001) surface via a controlled adsorption of C60&#160;organic molecules

We analyse the spinterface formed by a C60 molecular layer on a Fe(001) surface covered by a two-dimensional Cr4O5 layer. We consider different geometries, by combining the high symmetry adsorption sites of the surface with three possible orientations of the molecules in a fully relaxed Density Functional Theory calculation.We show that the local hybridization between the electronic states of the Cr4O5 layer and those of the organic molecules is able to modify the magnetic coupling of the Cr atoms. Both the intra-layer and the inter-layer magnetic interaction is indeed driven by O atoms of the two-dimensional oxide. We demonstrate that the C60 adsorption on the energetically most stable site turns the ferromagnetic intra-layer coupling into an antiferromagnetic one, and that antiferromagnetic to ferromagnetic switching and spin patterning of the substrate are made possible by adsorption on other sites

A Low Rhodium Content Smart Catalyst for Hydrogenation and Hydroformylation Reactions

Abstract: This paper describes the preparation, broad characterization and study of activity in hydrogenation and hydroformylation reactions of an easily produced 0.18% Rh/Al2O3. Analytical studies on fresh and recycled samples shed light on the smart properties of such catalyst. Results showed high activity as well as fine/excellent chemoselectivity or regioselectivity, characteristics that may suggest a wide range of applicability. Graphic Abstract: The low metal content catalyst 0.18% Rh/Al2O3 was very active in both hydrogenation and hydroformylation reactions so providing intermediates for valuable APIs, as Nabumetone and Eletriptan, and a fragrance with a fresh, green-floral smell, that recalls scent of lily of the valley.[Figure not available: see fulltext.

Excitonic effects in solids described by time-dependent density functional theory

Starting from the many-body Bethe-Salpeter equation we derive an exchange-correlation kernel $f_{xc}$ that reproduces excitonic effects in bulk materials within time-dependent density functional theory. The resulting $f_{xc}$ accounts for both self-energy corrections and the electron-hole interaction. It is {\em static}, {\em non-local} and has a long-range Coulomb tail. Taking the example of bulk silicon, we show that the $- \alpha / q^2$ divergency is crucial and can, in the case of continuum excitons, even be sufficient for reproducing the excitonic effects and yielding excellent agreement between the calculated and the experimental absorption spectrum.Comment: 6 pages, 1 figur

Antibacterial β-Glucan/Zinc Oxide Nanocomposite Films for Wound Healing

Advanced antimicrobial biomaterials for wound healing applications are an active field of research for their potential in addressing severe and infected wounds and overcoming the threat of antimicrobial resistance. Beta-glucans have been used in the preparation of these materials for their bioactive properties, but very little progress has been made so far in producing biomedical devices entirely made of beta-glucans and in their integration with effective antimicrobial agents. In this work, a simple and eco-friendly method is used to produce flexible beta-glucan/nanostructured zinc oxide films, using glucans derived from the yeast Saccharomyces cerevisiae. The properties of the films are characterized through scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, infrared and UV–visible spectroscopy, thermogravimetric analysis, differential scanning calorimetry, and water absorption tests. Finally, the antibacterial properties of the nanostructured zinc oxide and of the composite films are assessed against Staphylococcus epidermidis and Escherichia coli, showing a marked effectiveness against the former. Overall, this study demonstrates how a novel bionanocomposite can be obtained towards the development of advanced wound healing devices

Tranexamic acid-loaded mesoporous silica microspheres as a hemostatic material

Bleeding management is considered essential for saving life both in the military and civilian field. There is still a need to develop topical hemostats that can stop bleeding and be used easily in the trauma sites. The aim of this work is to develop a hemostat based on mesoporous silica particles with large pores for bleeding control. Mesoporous silica microspheres (MSM) with particle size of 1.5 − 5 µm and pores diameter of 25 nm have been successfully synthesized and, for the first time, loaded with tranexamic acid (TXA) with a content of 4.7%w/w. The hemostatic activity of both the pure material and TXA-loaded material (TXA@MSM) was investigated. It was found that the blood clotting time was significantly shortened by both systems with respect to control. A hemolysis assay was performed to evaluate the hemolytic activity of MSM, and the result indicated that the material was blood compatible. A preliminary TXA in vitro release test was performed, showing the complete release of TXA from the carrier within one hour. Considering the above results, TXA@MSM can be considered a promising material for the development of new hemostats

Systematic review of exercise therapy in the management of post-thrombotic syndrome

Objectives Exercise improves haemodynamic parameters in patients with chronic venous disease. There is a paucity of evidence on its effect in post-thrombotic syndrome (PTS). The aim of this systematic review is to assess the impact of exercise in PTS. Methods Adhering to PRISMA guidelines and following PROSPERO registration (CRD42021220924), MEDLINE, Cochrane Library, EMBASE database, and trial registries were searched on 19th May 2022. Results One article met the inclusion criteria and a narrative synthesis was carried out. The included randomised controlled trial reported a between-group mean difference of 4.6 points (p = .027) in the VEINES-QOL score and −2.0 points (p = .14) in the Villalta score, in favour of exercise therapy. The statistical significance threshold was not reached. Conclusion Data on exercise in PTS remains sparse but exercise appears to be a safe intervention. In the context of this literature, a potential future trial and outcome reporting measures are suggested

Supercritical solvent impregnation of different drugs in mesoporous nanostructured zno

Supercritical solvent impregnation (SSI) is a green unconventional technique for preparing amorphous drug formulations. A mesoporous nanostructured ZnO (mesoNsZnO) carrier with 8-nm pores, spherical-nanoparticle morphology, and an SSA of 75 m2/g has been synthesized and, for the first time, subjected to SSI with poorly water-soluble drugs. Ibuprofen (IBU), clotrimazole (CTZ), and hydrocortisone (HC) were selected as highly, moderately, and poorly CO2-soluble drugs. Powder X-ray diffraction, Fourier transform infrared spectroscopy, field emission scanning electron microscopy, nitrogen adsorption analysis, and ethanol extraction coupled with ultraviolet spectroscopy were employed to characterize the samples and quantify drug loading. Successful results were obtained with IBU and CTZ while HC loading was negligible, which could be related to different solubilities in CO2, drug size, and polarity. Successful SSI resulted in amorphous multilayer confinement of the drug. The mesoNsZnO-IBU system showed double drug loading than the mesoNsZnO-CTZ one, with a maximum uptake of 0.24 g/g. Variation of contact time during SSI of the mesoNsZnO-IBU system showed that drug loading triplicated between 3 and 8 h with an additional 30% increment between 8 h and 24 h. SSI did not affect the mesoNsZnO structure, and the presence of the adsorbed drug reduced the chemisorption of CO2 on the carrier surface