Misregulation of DNA damage repair pathways in HPV-positive head and neck squamous cell carcinoma contributes to cellular radiosensitivity

This article was migrated. The article was marked as recommended. Phenomenon: Attendance at UK medical school teaching sessions is on the decline. This research aimed to explore the reasons for this reduction. Approach: Attendance was assessed, by way of head counts, at 3rd year students' lectures, tutorials and problem based learning (PBL) sessions at the University of Liverpool. Reasons for absence were explored using a questionnaire sent via email to the year group. Findings: Compulsory lectures attained greater attendance than non-compulsory lectures. Access to PowerPoint presentations prior to lectures correlated with a decline in attendance as did long timetable gaps. Lectures held on-campus were poorly attended compared to those held at hospital sites where students undertook clinical placements. Unsupervised PBL sessions, with sign in sheets, achieved excellent attendance however, turnout was poor when monitoring wasn't present. Similar trends were observed for lecture attendance, indicating that students may be motivated to attend by fear of reprimand. 75 students responded to an online questionnaire exploring reasons for attendance and their responses largely agreed with our findings, however one discrepancy was highlighted. Students reported that access to lecture slides before teaching sessions would not affect attendance, although our evidence showed that when slides were available attendance declined. Insights: Attendance could be improved if teaching coincided with hospital placements. Sign-in sheets, fewer gaps between sessions and multiple lectures on one day would see a marked increase in attendees. In future, medical schools should consider these factors to enhance student motivation to attend teaching sessions.

Atraumatic splenic rupture is a rare complication of a pancreatic pseudocyst (PP), described in the setting of chronic pancreatitis. There is common understanding, within the literature, that an inflammatory process at the tail of the pancreas may disrupt the spleen and result in such splenic complications. The authors present a case report of a 29-year-old male with a PP, associated with chronic pancreatitis. The patient had a history of excessive alcohol intake and presented to the emergency department with a short history of abdominal pain and vomiting. He denied any significant history of trauma and serum amylase levels were normal. An admission computed tomography (CT) scan of the abdomen confirmed the presence of a PP in direct contact with the spleen. The CT also demonstrated a heterogenous hypodense area of the splenic hilum, along with perisplenic fluid. The patient was admitted for observation. His abdominal pain progressed, and he became haemodynamically unstable. An emergency ultrasound scan (USS) at this time revealed intra-abdominal haemorrhage. A subsequent CT confirmed splenic rupture, which was managed surgically with a full recovery. Few such cases are documented within the literature and more understanding of preempting such events is needed.

A preoperative requirement is the correct and clear marking of a specific surgical site. We aimed to compare the ability of marker pens to withstand surgical preparation. Five volunteers with different Fitzpatrick skin types were marked with ten pens. Marked skin sites were prepared with chlorhexidine followed by chlorhexidine, betadine followed by chlorhexidine, and betadine followed by betadine. Each site was photographed in theatre. Two volunteers ranked the top three most visible marker pens from each photograph. The results showed that Sharpie® W10 black, Dual Tip (Purple Surgical), and Easimark modern regular tip (Leonhard Lang) were the best performers across all skin types. Red pen should be avoided with betadine skin preparation. The study concludes that the above named three markers are the best at withstanding surgical skin preparation. Different skin types require different colour ink for maximal clarity in marking. Biro and drywipe markers should never be used for surgical marking.