A validation study of data in the National Tonsil Surgery Register in Sweden: high agreement with medical records ensures that data can be used to monitor clinical practices and outcomes

Background The ambition of the National Tonsil Surgery Register in Sweden (NTSRS) is to improve otorhinolaryngological care by monitoring trends in the clinical practices, complications, and outcomes of tonsil surgery. The NTSRS collects data from both surgeons and patients and provides the participating clinics with daily updated data on a publicly available website. On the website, national and local results can be compared and monitored. The use of NTSRS data necessitates that the data is valid, but the NTSRS has not yet been validated. With approximately half of the registered patients responding to the postoperative questionnaires, an analysis of responders and non-responders is also necessary. The aim of this study was to assess the criterion validity of NTSRS data. Another aim was to compare the characteristics and rates of complications between postoperative questionnaire responders and non-responders. Methods Data in the NTSRS were compared with data in electronic medical records. The 200 most recent surgeries, up to 31 Dec 2019, in each of 11 surgical units were included. Criterion validity was analysed in terms of observed agreement, Cohens kappa, Gwet’s AC1, and positive and negative agreement. The sign test was used to analyse systematic differences between the NTSRS and the medical records. Comparisons of rates between groups were made with Fisher’s exact test, the chi-square test, and Fisher’s non-parametric permutation test. Results A total of 1991 registrations were included in the study. All variables showed very high observed agreement ranging from 0.91 to 1.00, and all variables had AC1 values corresponding to almost perfect agreement. The analysis of questionnaire responders and non-responders showed no statistically significant differences regarding age, indication, or type of surgery. The proportion of women was higher in the responder group. The rate of reoperation due to bleeding was higher in the responder group, but there were no differences regarding other complications. Conclusions The results of this study show that data in the NTSRS have criterion validity. The NTSRS is thus well suited for monitoring the clinical practices and outcomes of tonsil surgery. The quality of the data also implies that the registry can be used in both clinical improvement projects and research.

Skill Mismatch yang Dirasakan oleh Alumni Program Studi Diploma IV Akuntansi Politeknik Negeri Padang

Many previous studies found that there was dissatisfaction with graduate users with the competencies possessed by Accounting graduates. Importantly, Accounting graduates must prepare themselves for various competencies needed in the world of work. This purpose of this study is to examine whether there is a competency gap faced by the graduates of Accounting Department of the Padang State Polytechnic while performing their first job. This study uses a quantitative method. Sample selected purposively on the alumni of D-IV 4 Accounting at the Padang State Polytechnic with 54 respondents that had worked after graduation. The data analysis technique in this study used the sign test and the Mann-Whitney U test. The results show that there is a competency gap faced by alumni in the attributes of technical and IT skills except in presenting financial reports, planning and conducting audits, implementing internal controls, measuring company performance, using Office, accounting software and social media. There is also no difference found in competency level between graduates of 2019 and 2020.

Pergeseran Pola Konsumsi Buah Nasional di Awal Masa Pandemi Covid-19 (The Shifting of National Fruit Consumption Pattern at the Beginning of the Covid-19 Pandemic Period)

<p>Studi pola konsumsi buah nasional sebelum dan di awal masa pandemi Covid-19 perlu dilakukan sebagai langkah awal inventarisasi ada atau tidaknya pergeseran, agar strategi dan antisipasi pembenahan dapat dirancang sejalan dengan upaya mewujudkan ketahanan dan keberlanjutan pangan. Empat ratus enam puluh enam responden terlibat dalam studi ini, melalui survei yang dilaksanakan secara daring. Metode analisis deskriptif, uji tanda, dan Fishers exact test digunakan. Hasil studi mengindikasikan adanya pergeseran pola konsumsi sebelum dan pada awal masa pandemi covid-19 untuk lima atribut, yaitu (1) dana alokasi pengeluaran buah per bulan, (2) frekuensi pembelian, (3) tempat, (4) kesulitan dalam perolehan, dan (5) jenis buah nasional yang dikonsumsi. Pergeseran ini menjadi isyarat perlunya upaya peningkatan kesadaran konsumsi buah nasional untuk menjaga imunitas dan krusialnya sinergi antara produsen dan distributor akan rantai pasok yang efisien dan efektif, serta penggunaan platform digital. Pembenahan diharapkan membuat konsumen dapat menikmati buah nasional berkualitas dari rumah dengan harga yang terjangkau. Segmentasi demografis berdasarkan kelompok umur dapat menjadi pertimbangan penyedia, karena memiliki hubungan yang signifikan dengan atribut pola konsumsi kedua sampai kelima. Studi lebih lanjut diperlukan untuk memotret dampak pergeseran terhadap supply dan value chain.</p><p><strong>Keywords</strong></p><p>Daring; Imunitas; Preferensi konsumen; Rantai pasok; Sinergi</p><p><strong>Abstract</strong></p><p>Studies of national fruit consumption patterns before and at the beginning of the Covid-19 pandemic period need to be carried out as an initial step for improvement to achieve food sustainability. A total of 466 respondents were involved in the survey which was conducted online. Descriptive analysis, sign test, and Fishers exact test were used. The results indicated there was a shift in consumption patterns before and at the beginning of the Covid-19 pandemic period, in terms of (1) expenditure allocation for fruit per month, (2) frequency, (3) place of purchase, (4) difficulties in procurement, and (5) types of national fruit consumed. The shift is a sign of the need for efforts to increase awareness of national fruit consumption. The synergy between producers and distributors to form an efficient and effective supply chain, and the use of digital platforms, is crucial, so that consumers can enjoy high quality national fruit from home at affordable prices. Demografic segmentation based on age group can be considered by providers, because it has a significant relationship with the second to fifth consumption pattern attributes. Further studies are needed to capture the shift impact on the supply and value chain.</p>

A Comparative Study of Fluoride Containing Chlorhexidine and Non Chlorhexidine Mouthrinses in a Teenage Group

Background: Mouthwashes are important means used in chemical control of dental plaque. There is strong evidence suggestive of better effectiveness, when fluoride is added to chlorhexidine mouthwash. Objectives: The study was planned to assess the effect of a mouthrinse containing Chlorhexidine (CHX) and amine/stannous fluoride (AmF) on plaque accumulation, gingivitis and salivary fluoride levels in comparison with two mouthrinses containing either essential oils (EO) or cetylpyridinium chloride (CPC) with sodium fluoride (NaF) in a teenage group. Methodology: For this study 90 healthy teenage between 12 and 20 years were recruited for participation. The experimental gingivitis model consisted of a 2-weeks recruitment phase, followed by a 6-day rinsing period with one of the 4 mouthrinse formulations was used for the study. At the end of the pre-phase period and the rinsing period (Day-0/Day-6), gingival index (GI), plaque index (PI) and salivary fluoride levels were recorded. The statistical analyses were performed using Wilcoxon sign test and the dependent t test. Results: A reduction in plaque re-growth was seen for the CHX+AmF formulation rinse, although there were no significant differences among all groups (p>0,001). During the experimental periods, the gingivitis indices increased significantly for all formulations (p<0,001), except for the CHX+AmF formulation. The CHX+AmF formulation scored higher levels of salivary fluoride at the end of the rinsing period (p>0,001). Conclusion: We would like to conclude that the adjunctive use of AmF containing CHX mouthrinses to mechanical oral hygiene should be recommended for teenage at risk groups. Keywords: CT KUB, Radiation safety, Minimise radiation

Studying the Accuracy and Function of Different Thermometry Techniques for Measuring Body Temperature

The purpose of this study was to determine which thermometry technique is the most accurate for regular measurement of body temperature. We compared seven different commercially available thermometers with a gold standard medical-grade thermometer (Welch-Allyn): four digital infrared thermometers (Wellworks, Braun, Withings, MOBI), one digital sublingual thermometer (Braun), one zero heat flux thermometer (3M), and one infrared thermal imaging camera (FLIR One). Thirty young healthy adults participated in an experiment that altered core body temperature. After baseline measurements, participants placed their feet in a cold-water bath while consuming cold water for 30 min. Subsequently, feet were removed and covered with a blanket for 30 min. Throughout the session, temperature was recorded every 10 min with all devices. The Braun tympanic thermometer (left ear) had the best agreement with the gold standard (mean error: 0.044 °C). The FLIR One thermal imaging camera was the least accurate device (mean error: −0.522 °C). A sign test demonstrated that all thermometry devices were significantly different than the gold standard except for the Braun tympanic thermometer (left ear). Our study showed that not all temperature monitoring techniques are equal, and suggested that tympanic thermometers are the most accurate commercially available system for the regular measurement of body temperature.

Changes of plasma nitric oxide, endothelin-1, and blood coagulation following intravitreal conbercept

Intravitreal anti-VEGF (anti-vascular endothelial growth factor) biologics have revolutionized the pharmacological management of chorioretinal diseases. However, the systemic adverse events such as stroke or bleeding are the concerns for many patients and physicians. The mechanism to develop these side effects are poorly understood. Consecutive 95 patients with retinal diseases were studied for their blood activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), and concentration of fibrinogen before and after intravitreal conbercept. Additionally, plasma nitric oxide (NO) and endothelin-1 (ET-1) were investigated on 38 of the 95 patients. Compared with the pre-injection, 4-week post-injection values of APTT and PT were increased by 0.582 s (p = 0.038, paired t test) and by 0.086 s (p = 0.080, paired t test; p = 0.0475, Sign test), respectively. At the same time, fibrinogen decreased by 0.048 g/L. Plasma levels of NO or ET-1 or VEGF did not significantly change from pre-injection levels. Our findings advanced the understanding of mechanism for systemic side effects associated with intravitreal anti-VEGF and emphasized paying more attention to higher risk of possible bleedings for patients following intravitreal conbercept.

P-OGC34 Pandemic paradigms: Early outcomes of radical chemoradiotherapy for patients with operable oesophageal and oesophago-gastric junctional adenocarcinoma

Background The peak waves of the COVID pandemic necessitated a paradigm shift in surgical management of patients with oesophageal adenocarcinoma due to both pressure on services and high mortality rates for those with COVID undergoing surgery. The Association of Upper GI Surgeons (AUGIS) guidance on treating Upper gastrointestinal cancers in the COVID era made suggestions to treat operable adenocarcinomas using definitive/consolidation chemoradiation (DCRT) over standard neo-adjuvant chemotherapy (NAC) and our unit altered practice accordingly for a cohort of patients. For affected patients we monitored and audited clinical outcomes and the initial results from this are presented here. Methods Patients with oesophageal or oesophago-gastric junctional (O/OGJ) adenocarcinoma with potentially curative disease where initial management was altered from a treatment path which would have included surgery (with or without neoadjuvant therapy) to DCRT discussed at our regional multidisciplinary team (MDT) meeting between 1st February-1st June 2020 were included. Patient demographics, investigations, treatment given and clinical outcomes were prospectively recorded. Results 31 Patients with operable adenocarcinoma of O/OGJ had treatment altered to DCRT (mean age 65.4, [range 43 – 79]), 28 (90%) Male. 1 patient deteriorated prior to starting, leaving 30 who completed DCRT. Of these 4 patients had already had NAC prior to DCRT. Follow up was for a median of 8 (range 4-8) months following start of treatment. Post- vs pre-treatment FDG-PET imaging demonstrated a significant reduction in the mean maximum standardized uptake value (SUVmax) (p = 0.003, Sign test), in all but 3 patients. 11 patients had DCRT alone, (all alive at the time of data collection), of whom 3 patients had no sign of tumour. 19 (56%) patients proceeded to salvage oesophagectomy at a median of 15(range 10-25) weeks after completion of DCRT. 42% of these patients had a complete pathological response to treatment. There was a 5% perioperative mortality rate for this group and 1 patient was found to be unresectable on the day of surgery. At the time the data was reviewed overall survival of the entire cohort was 91%, 56% of whom had no sign of residual or recurrent disease. Conclusions A disease free survival of 56% compares poorly with the literature at the 3-month interval. The long-term follow-up of these patients will only be apparent in the coming months and years. This data does not support the use of this modality in the future and alternate treatment plans should be devised for future pandemics.

Vet To Vet Maine: COVID 19 Effect on a Veteran Companion Pilot Study in Reducing Social Isolation and Loneliness

Background Maine veterans represent 11.8% of Maine population, twice that of the United States. Veterans are at risk for social isolation, loneliness and suicide. The mission of Vet To Vet (V2V) Maine, a non-profit organization, connects trained veteran volunteers with fellow veterans (veteran friends) for companionship, assistance with benefits, and support independent living. This study: (1) assessed if V2V program fulfilled its mission; and (2) determined any care partner effects from the program. Methods Mixed methods research spanned 6-months, 2019-2020. Twenty-four participants; trained Veteran Volunteers (VV) were paired with Veteran Friends. Four Care Partners (CP) of Veteran Friends participated. Assessments included pre/post Veteran Rand Health Survey (VR-12), Patient Health Questionnaire (PHQ-9), and Late Onset Stress Symptomatology (LOSS) Short Form. CPs completed pre/post Zarit Burden Interview (ZBI-22) assessments. Qualitative interviews focused on visits/activities, relationship building, and program feedback. Data analyses included Wilcoxon Sign Test and NVivo 12+ Qualitative Data Analysis Software. Results Pre/post data failed to show significance (P=.05), however trends supported an improvement in mental and physical health scores. COVID-19 was a confounding variable as state stay-at-home orders occurred at the companion program study mid-point. Three key themes included; (1) Veteran Companionship; (2) Effects of COVID; and (3) Care Partners. The V2V Companion program was determined effective and reported highly successful relationship matches. CPs confirmed the importance and benefits of V2V. Conclusion The V2V Maine companion program pilot research supported success in connecting Veterans Volunteer and Veteran Friends; fostering companionship, friendships, mentoring, assisting with benefits, and supporting independent living.

DNA barcoding ferns in an unexplored tropical montane cloud forest area of southeast Oaxaca, Mexico

DNA barcoding can be useful for species identification and phylogenetic analysis, but its effectivity has not been verified in most neotropical cloud forest plants. We tested three plastid barcodes, rbcLa, matK, and trnH-psbA, in selected pteridophytes, a well-represented group in these forests, from a little-explored area in Oaxaca, Mexico, applying the CBOL criteria for barcoding. We used BLASTn, genetic distance, and monophyly tree-based analyses employing neighbor-joining (NJ), maximum likelihood (ML), and Bayesian inference methods. Universal primers for rbcLa and trnH-psbA were successfully amplified and bi-directionally sequenced, but matK could not be amplified for most species. rbcLa showed the highest species discrimination in BLASTn (66.67%). trnH-psbA exhibited higher significant interspecific divergence values than rbcL and rbcLa + trnH-psbA (two-sample sign test, P value < 2.2e−16). Using NJ and ML phylogenetic trees, monophyletic species were successfully resolved (100%), differing only in support values and displaying full agreement with the most recent fern classification. ML trees showed the highest mean support value (80.95%). trnH-psbA was the only barcode that could detect the Elaphoglossoideae subfamily. Species discrimination did not increase using rbcLa + trnH-psbA. rbcLa is useful for fern barcoding, trnH-psbA is most helpful for phylogenetic analyses, and matK may not work as a universal barcoding marker.

Abstract 12971: Positive Psychological Growth Post Cardiac Arrest Survivorship: A Pilot Study

Background: Cardiac arrest (CA) has an annual US incidence of >500,000 with survival rates ~10%. Although most studies focus on survival and neurological outcomes, understanding long-term psychological consequences is of equal importance. Some have reported negative psychological outcomes such as anxiety, depression, and PTSD; however, since survivors of other adverse life-threatening disorders, including cancer, report positive psychological growth, we sought to test the hypothesis that CA survival may also be associated with growth of positive psychological traits. Method: Invitations were sent to CA survivors through their local hospitals or national registries to participate in an online pilot cross sectional study. Overall, 47 agreed and were given a series of standardized questionnaires to assess the following positive personality traits: empathy, compassion, forgiveness, altruism, optimism, gratitude, positivity, spirituality, consideration for others’ needs, and happiness. Using a 5-point Likert scale, they then estimated the relative change in these traits since their CA event, where 1=significant decrease, 2=moderate decrease, 3=no change, 4 =moderate increase, and 5=significant increase. Results: Overall 42 of 47 (89%) reported a return to their daily functional activities. Personality trait ratings were analyzed using a sign test relative to a population median score of 3 (i.e. no change) for statistical analysis. Participants showed statistically significant differences in all the assessed personality traits: gratitude (median=4, p<0.0001), compassion (median=4, p= p<0.0001), altruism (median=4, p<0.0001), empathy (median=4, p<0.0001), spirituality(median=4, p<0.0001), consideration for others’ needs (median=4, p<0.0001), forgiveness(median=4, p<0.0005), optimism (median=4, p<0.001), positivity (median=4, p<0.005), and happiness(median=4, p<0.05). Conclusions: Long-term psychological sequelae of CA survivorship remains ill understood. However, some CA survivors may develop greater positive psychological traits following CA. Further studies are required to assess the relationship between CA and long-term positive changes and quality of life, as well as possible therapeutic interventions.