bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence, knowledge and perception of self-medication practice among undergraduate healthcare students
Authors: Akande-Sholabi Wuraola , Ajamu Amen. T. , Adisa Rasaq
Published: June 2021

Background

Globally, self-medication is a common practice, and an increasingly perceived necessity to relieve burdens on health services. However, inappropriate self-medication may result to reduced health outcomes, increased antimicrobial resistance and economic waste. Healthcare students are the future health professionals who will be consistently responsible for educating the public on rational use of medication. This study therefore aimed to assess the prevalence, knowledge and perception of self-medication practices among healthcare students.

Methods

A cross-sectional study was carried out among 866 healthcare students in a Nigerian University, comprising medical, nursing and pharmacy students. Information was garnered from respondents using a self-administered questionnaire. Data were summarized with descriptive statistics, while Chi-square and logistic regression tests were used for categorical variables at p < 0.05.

Results

Mean age was 21 ± 2.8 years, and female respondents were 447 (51.6%). Prevalence of self-medication among respondents was 473 (54.6%). A total of 288 (55.3%) demonstrated good knowledge of self-medication practices, comprising 250 (52.2%) among those who have previously self-medicated and 229 (47.8%) among those who had not. Reasons for engaging in self-medication practices were mentioned to include treatment of minor ailments (357; 32.4%), while 248 (22.5%) believed they had the medical knowledge of what to use. Analgesic (353; 30.1%), antimalarial (352; 30.0%), and antibiotics (182; 15.5%) were the commonest classes of medication used for self-medication. Headache (363; 18.4%), malaria (334; 16.9%), and cough (184; 9.3%) were the most frequently treated conditions. More than half (281; 59.4%) of the respondents’ purchased their self-medicated drugs from the community pharmacy. Gender and respondents’ disciplines were found to be the independent predictors for good knowledge of self-medication practice.

Conclusion

Prevalence of self-medication among the studied healthcare students is moderately high, while approximately half demonstrates good knowledge and perception of self-medication practices. Stimulation for self-medication practice largely arise from the perception of treating minor ailments. This underscores a need for advocacy on responsible self-medication practice during the formal training of these future health professionals, in order to avert its imminent/widespread negative consequences.
Spatial changes in inclusion band spacing as an indicator of temporal changes in slow slip and tremor recurrence intervals
Authors: Nishiyama Naoki , Ujiie Kohtaro , Kano Masayuki
Published: June 2021

Slow slip and tremor (SST) downdip of the seismogenic zones may trigger megathrust earthquakes by frequently transferring stress to seismogenic zones. Geodetic observations have suggested that the recurrence intervals of slow slip decrease toward the next megathrust earthquake. However, temporal variations in the recurrence intervals of SST during megathrust earthquake cycles remain poorly understood because of the limited duration of geodetic and seismological monitoring of slow earthquakes. The quartz-filled, crack-seal shear veins in the subduction mélange deformed near the downdip limit of the seismogenic zone in warm-slab environments record cyclic changes in the inclusion band spacing in the range from 4 ± 1 to 65 ± 18 μm. The two-phase primary fluid inclusions in quartz between inclusion bands exhibit varying vapor/liquid ratios regardless of inclusion band spacing, suggesting a common occurrence of fast quartz sealing due to a rapid decrease in quartz solubility associated with a large fluid pressure reduction. A kinetic model of quartz precipitation, considering a large fluid pressure change and inclusion band spacing, indicates that the sealing time during a single crack-seal event cyclically decreased and increased in the range from 0.16 ± 0.04 to 2.7 ± 0.8 years, with one cycle lasting at least 27 ± 2 to 93 ± 5 years. The ranges of sealing time and duration of a cycle may be comparable to the recurrence intervals of SST and megathrust earthquakes, respectively. We suggest that the spatial change in inclusion band spacing is a potential geological indicator of temporal changes in SST recurrence intervals, particularly when large fluid pressure reduction occurs by brittle fracturing.
Endothelial cell regulation of systemic haemodynamics and metabolism acts through the HIF transcription factors
Authors: Lambden Simon , Cowburn Andrew S. , Macias David , Garrud Tessa A. C. , Krause Bernardo J. , Giussani Dino A. , Summers Charlotte , Johnson Randall S.
Published: June 2021

Background

The vascular endothelium has important endocrine and paracrine roles, particularly in the regulation of vascular tone and immune function, and it has been implicated in the pathophysiology of a range of cardiovascular and inflammatory conditions. This study uses a series of transgenic murine models to explore for the first time the role of the hypoxia-inducible factors, HIF-1α and HIF-2α in the pulmonary and systemic circulations as potential regulators of systemic vascular function in normoxic or hypoxic conditions and in response to inflammatory stress. We developed a series of transgenic mouse models, the HIF-1α Tie2Cre, deficient in HIF1-α in the systemic and pulmonary vascular endothelium and the L1Cre, a pulmonary endothelium specific knockout of HIF-1α or HIF-2α. In vivo, arterial blood pressure and metabolic activity were monitored continuously in normal atmospheric conditions and following an acute stimulus with hypoxia (10%) or lipopolysaccharide (LPS). Ex vivo, femoral artery reactivity was assessed using wire myography.

Results

Under normoxia, the HIF-1α Tie2Cre mouse had increased systolic and diastolic arterial pressure compared to litter mate controls over the day–night cycle under normal environmental conditions. VO2 and VCO2 were also increased. Femoral arteries displayed impaired endothelial relaxation in response to acetylcholine mediated by a reduction in the nitric oxide dependent portion of the response. HIF-1α L1Cre mice displayed a similar pattern of increased systemic blood pressure, metabolic rate and impaired vascular relaxation without features of pulmonary hypertension, polycythaemia or renal dysfunction under normal conditions. In response to acute hypoxia, deficiency of HIF-1α was associated with faster resolution of hypoxia-induced haemodynamic and metabolic compromise. In addition, systemic haemodynamics were less compromised by LPS treatment.

Conclusions

These data show that deficiency of HIF-1α in the systemic or pulmonary endothelium is associated with increased systemic blood pressure and metabolic rate, a pattern that persists in both normoxic conditions and in response to acute stress with potential implications for our understanding of the pathophysiology of vascular dysfunction in acute and chronic disease.
Rapid and simple detection of Phytophthora cactorum in strawberry using a coupled recombinase polymerase amplification–lateral flow strip assay
Authors: Lu Xinyu , Xu Heng , Song Wen , Yang Zitong , Yu Jia , Tian Yuee , Jiang Min , Shen Danyu , Dou Daolong
Published: June 2021

Phytophthora cactorum is a devastating pathogen that infects a wide range of plants and causes Phytophthora rot disease, which has resulted in great economic losses in crop production. Therefore, the rapid and practicable detection of P. cactorum is important for disease monitoring and forecasting. In this study, we developed a lateral flow recombinase polymerase amplification (LF-RPA) assay for the sensitive visual detection of P. cactorum. Specific primers for P. cactorum were designed based on the ras-related protein gene Ypt1; all 10 P. cactorum isolates yielded positive detection results, whereas no cross-reaction occurred in related oomycete or fungal species. The detection limit for the LF-RPA assay was 100 fg of genomic DNA under optimized conditions. Combined with a simplified alkaline lysis method for plant DNA extraction, the LF-RPA assay successfully detected P. cactorum in naturally diseased strawberry samples without specialized equipment within 40 min. Thus, the LF-RPA assay developed in this study is a rapid, simple, and accurate method for the detection of P. cactorum, with the potential for further application in resource-limited laboratories.
Clozapine-induced myocarditis: electronic health register analysis of incidence, timing, clinical markers and diagnostic accuracy
Authors: Segev Aviv , Iqbal Ehtesham , McDonagh Theresa A. , Casetta Cecilia , Oloyede Ebenezer , Piper Susan , Plymen Carla M. , MacCabe James H.
Published: June 2021

Background

Clozapine is associated with increased risk of myocarditis. However, many common side-effects of clozapine overlap with the clinical manifestations of myocarditis. As a result, there is uncertainty about which signs, symptoms and investigations are important in distinguishing myocarditis from benign adverse effects of clozapine. Clarity on this issue is important, since missing a diagnosis of myocarditis or discontinuing clozapine unnecessarily may both have devastating consequences.

Aims

To examine the clinical characteristics of clozapine-induced myocarditis and to identify which signs and symptoms distinguish true myocarditis from other clozapine adverse effects.

Method

A retrospective analysis of the record database for 247 621 patients was performed. A natural language processing algorithm identified the instances of patients in which myocarditis was suspected. The anonymised case notes for the patients of each suspected instance were then manually examined, and those whose instances were ambiguous were referred for an independent assessment by up to three cardiologists. Patients with suspected instances were classified as having confirmed myocarditis, myocarditis ruled out or undetermined.

Results

Of 254 instances in 228 patients with suspected myocarditis, 11.4% (n = 29 instances) were confirmed as probable myocarditis. Troponin and C-reactive protein (CRP) had excellent diagnostic value (area under the curve 0.975 and 0.896, respectively), whereas tachycardia was of little diagnostic value. All confirmed instances occurred within 42 days of clozapine initiation.

Conclusions

Suspicion of myocarditis can lead to unnecessary discontinuation of clozapine. The ‘critical period’ for myocarditis emergence is the first 6 weeks, and clinical signs including tachycardia are of low specificity. Elevated CRP and troponin are the best markers for the need for further evaluation.
Implementing recovery in mental health services
Authors: Boardman Jed , Shepherd Geoff
Published: June 2021

The ideas of ‘recovery’ arise from the experiences of people with mental health problems. The recovery approach emerged in the North American civil rights and consumer and survivor movements from the 1970s onwards. It is concerned with social justice, individual rights, citizenship, equality, freedom from prejudice and discrimination. In this paper we discuss a project in England that has examined how mental health services may be transformed to be more supportive of recovery and the implications that this has for professional practice.
Mental health in Bhutan
Authors: Naveed Ayesha , Kumar Nirola Damber
Published: June 2021

The Kingdom of Bhutan lies in the folds of the eastern Himalayas, sandwiched between India to the south and China to the north. It has a total area of 38394 km2, which is roughly the size of Switzerland, and a population of a little over 70 0000 (Royal Government of Bhutan, 2002). It is a mountainous country, except for a small flat strip in the southern foothills. The official language is Dzongha, but English is widely spoken. English is the medium of instruction from pre-primary level onwards. In 1999 Bhutan allowed viewing of television and use of the internet, as a step towards modernisation. In the early 20th century, Bhutan came into contact with the British Empire; Bhutan maintains strong bilateral relations with India. Business Week magazine in 2006 rated Bhutan the happiest country in Asia and the eighth happiest in the world, based on a global survey. Bhutan is in fact the only country where happiness is measured in the form of an index, ‘Gross National Happiness’. The main religion practised in the country is Buddhism, with Hinduism as the second most prevalent. The capital and largest city is Thimphu. In 2007, Bhutan made the transition from absolute monarchy to constitutional monarchy, and held its first general election in 2008. Bhutan is a member of the United Nations and of the South Asian Association for Regional Cooperation (SAARC); it hosted the 16th SAARC summit in April 2010.
Retention factors affecting migrant psychiatrists from low- and middle-income countries
Authors: Padmanathan Prianka , Newell James N.
Published: June 2021

A major barrier to the large treatment gap in mental healthcare in low- and middle-income countries is the shortage of psychiatrists, partly caused by a brain drain. This qualitative study aimed to gain an in-depth understanding of the motivations and experiences of migrant psychiatrists in order to address retention factors. We interviewed a convenience sample of 11 psychiatrists from Afghanistan, Iraq, South Asia and Africa. Interviews were semi-structured and based on questions about the participants' reasons for emigrating, their expectations and experiences of the move, their views of psychiatry as a profession in their country of origin and whether any incentives would persuade them to return. Prevention of emigration appears to be far more effective than encouraging expatriates to return; an improvement in training and job opportunities could have a drastic impact on retention. Almost all the psychiatrists interviewed intended to contribute to training and raising the profile of psychiatry in their country of origin, and therefore their emigration may have long-term benefits. It could potentially break the cycle between lack of understanding, lack of demand for mental health services and lack of training. It should therefore be an ethical obligation of UK employers to offer migrant psychiatrists time and support to facilitate these contributions.
Psychological support and recovery in the aftermath of natural disaster
Authors: Forbes David , Creamer Mark , Wade Darryl
Published: June 2021

Natural disasters can result in a range of mental health outcomes among the affected population. Appropriate mental health interventions are required to promote recovery. In the aftermath of the 2009 bushfires in Victoria, Australia, a collaboration of trauma experts, the Australian and Victorian state governments and health professional associations developed an evidence-informed three-level framework outlining recommended levels of care. The framework was underpinned by an education and training agenda for mental health professionals. This framework has been successfully applied after further natural disasters in Australia. This paper outlines the steps included in each of the levels.
Evaluation of a mental health training project in the Republic of the Sudan using the Mental Health Gap Action Programme curriculum
Authors: Ali Sherese , Saeed Khalid , Hughes Peter
Published: June 2021

This paper reports on the training of primary care physicians in the family medicine programme at the University of Gezira, Sudan, using the World Health Organization's Mental Health Gap Action Programme Intervention Guide (mhGAP-IG). The training had a positive impact on their knowledge of and attitudes to mental disorder. More field tests of the mhGAP-IG would be useful to make further recommendations on its cultural relevance and its adaptation for use in low- and middle-income countries. Distance supervision of training of primary care physicians by internal facilitators is seen as critical for the sustainability of the intervention.
Six decades of community psychiatry in India
Authors: Chadda R. K.
Published: June 2021

The community psychiatry movement started in India in the early 1950s. It has gone through different phases of development, beginning with family care of people who are mentally ill in the campus of the mental hospitals, followed by satellite clinics and a national mental health programme. Other initiatives have included the camp approach, initiatives by non-government organisations and the media, and mental health services for disaster-affected populations. The paper traces the development of community psychiatry in India over the past six decades.
Cancer Diagnoses Following Abnormal Noninvasive Prenatal Testing: A Case Series, Literature Review, and Proposed Management Model
Authors: Dow Eryn , Freimund Alison , Smith Kortnye , Hicks Rodney J. , Jurcevic Peter , Shackleton Mark , James Paul A. , Fellowes Andrew , Delatycki Martin B. , Fawcett Susan , Flowers Nicola , Pertile Mark D. , McGillivray George , Mileshkin Linda
Published: June 2021

Noninvasive prenatal testing (NIPT) is a screening test for fetal chromosomal aneuploidy using cell-free DNA derived from maternal blood. It has been rapidly accepted into obstetric practice because of its application from 10-weeks' gestation, and its high sensitivity and specificity. NIPT results can be influenced by several factors including placental or maternal mosaicism and co-twin demise; cell-free DNA from a maternal origin can also complicate interpretation, with evidence that NIPT can detect previously unsuspected malignancies. This study aimed to develop management guidelines for women with NIPT results suspicious of maternal malignancy. The Peter MacCallum Cancer Center's experience of seven cases where abnormal NIPT results led to investigation for maternal malignancy between 2016 and 2019 were reviewed, along with the published literature. Six of the seven women (86%) referred for investigation were diagnosed with advanced malignancies, including colorectal cancer, breast cancer, melanoma, and Hodgkin lymphoma. Based on our single-center experience, as well as the available literature, guidelines for the investigation of women with NIPT results suspicious of malignancy are proposed, including utilization of fluorodeoxyglucose positron emission tomography-computed tomography, which had a high concordance with other investigations and diagnoses. These guidelines include maternal and fetal investigations, as well as consideration of the complex medical, psychologic, social, and ethical needs of these patients and their families.
Concomitant Peripheral Neuropathy and Type 2 Diabetes Impairs Postexercise Cutaneous Perfusion and Flowmotion
Authors: Reynès Cécile , Beaume Jean-Baptiste , Latil-Plat Françoise , Ennaifer Houda , Rocher Laure , Antoine-Jonville Sophie , Benamo Eric , Knapp Yannick , Vinet Agnès
Published: June 2021

Context

Type 2 diabetes and peripheral neuropathy exhibit microvascular dysfunction at rest. However, data regarding their microvascular perfusion during exercise remain scarce.

Objective

This study investigated changes in microvascular perfusion during postexercise recovery in those with type 2 diabetes, with or without peripheral neuropathy, as well as in healthy controls and those with obesity.

Methods

Skin blood perfusion was assessed in each group using laser Doppler flowmetry (LDF) and laser speckle contrast imaging before and immediately after a 6-minute walking test. LDF recordings underwent wavelet transformation to allow specific control mechanisms of blood perfusion to be studied (eg, endothelial nitric oxide–independent and –dependent, neurogenic, myogenic, respiratory, and cardiac mechanisms).

Results

Skin blood perfusion increased after exercise in all groups (22.3 ± 28.1% with laser speckle contrast imaging and 22.1 ± 52.5% with LDF). Throughout postexercise recovery, the decrease was blunted in those with subclinical peripheral neuropathy and confirmed peripheral neuropathy when compared to the other 3 groups. After exercise, total spectral power increased in all groups. The relative contributions of each endothelial band was lower in those with confirmed peripheral neuropathy than in the healthy controls and those with obesity (nitric oxide–dependent function: 23.6 ± 8.9% vs 35.5 ± 5.8% and 29.3 ± 8.8%, respectively; nitric oxide–independent function: 49.1 ± 23.7% vs 53.3 ± 10.4% and 64.6 ± 11.4%, respectively). The neurogenic contribution decreased less in those with confirmed peripheral neuropathy and in those with type 2 diabetes alone, compared to those with subclinical peripheral neuropathy and those with obesity (–14.5 ± 9.9% and –12.2 ± 6.1% vs –26.5 ± 4.7% and –21.7 ± 9.4%, respectively).

Conclusion

Peripheral neuropathy, whatever the stage, altered the microvascular response to exercise via impaired endothelial and neurogenic mechanisms.
Relationship Between Insulin Sensitivity and Menstrual Cycle Is Modified by BMI, Fitness, and Physical Activity in NHANES
Authors: MacGregor Kirstin A , Gallagher Iain J , Moran Colin N
Published: June 2021

Context

There is evidence demonstrating variation in insulin sensitivity across the menstrual cycle. However, to date, research has yielded inconsistent results.

Objective

This study investigated variation in insulin sensitivity across the menstrual cycle and associations with body mass index (BMI), physical activity, and cardiorespiratory fitness (CRF).

Methods

Data from 1906 premenopausal women in NHANES cycles 1999 to 2006 were analyzed. Menstrual cycle day was assessed using questionnaire responses recording days since last period. Rhythmic variation of plasma glucose, triglycerides, and insulin, homeostatic model of insulin resistance (HOMA-IR), and adipose tissue insulin resistance index (ADIPO-IR) across the menstrual cycle were analyzed using cosinor rhythmometry. Participants were assigned low or high categories of BMI, physical activity, and CRF, and category membership included in cosinor models as covariates.

Results

Rhythmicity was demonstrated by a significant cosine fit for glucose (P = .014) but not triglycerides (P = .369), insulin (P = .470), HOMA-IR (P = .461), and ADIPO-IR (P = .335). When covariates were included, rhythmicity was observed when adjusting for: 1) BMI: glucose (P < .001), triglycerides (P < .001), insulin (P < .001), HOMA-IR (P < .001), and ADIPO-IR (P < .001); 2) physical activity: glucose (P < .001), triglycerides (P = .006), and ADIPO-IR (P = .038); and 3) CRF: triglycerides (P = .041), insulin (P = .002), HOMA-IR (P = .004), and ADIPO-IR (P = .004). Triglyceride amplitude, but not acrophase, was greater in the high physical activity category compared to low (P = .018).

Conclusion

Rhythmicity in insulin sensitivity and associated metabolites across the menstrual cycle are modified by BMI, physical activity, and CRF.
Enhancing Gonadotrope Gene Expression Through Regulatory lncRNAs
Authors: Refael Tal , Melamed Philippa
Published: June 2021

The world of long non-coding RNAs (lncRNAs) has opened up massive new prospects in understanding the regulation of gene expression. Not only are there seemingly almost infinite numbers of lncRNAs in the mammalian cell, but they have highly diverse mechanisms of action. In the nucleus, some are chromatin-associated, transcribed from transcriptional enhancers (eRNAs) and/or direct changes in the epigenetic landscape with profound effects on gene expression. The pituitary gonadotrope is responsible for activation of reproduction through production and secretion of appropriate levels of the gonadotropic hormones. As such, it exemplifies a cell whose function is defined through changes in developmental and temporal patterns of gene expression, including those that are hormonally induced. Roles for diverse distal regulatory elements and eRNAs in gonadotrope biology have only just begun to emerge. Here, we will present an overview of the different kinds of lncRNAs that alter gene expression, and what is known about their roles in regulating some of the key gonadotrope genes. We will also review various screens that have detected differentially expressed pituitary lncRNAs associated with changes in reproductive state and those whose expression is found to play a role in gonadotrope-derived nonfunctioning pituitary adenomas. We hope to shed light on this exciting new field, emphasize the open questions, and encourage research to illuminate the roles of lncRNAs in various endocrine systems.
Prevention of Perioperative Abdominal Migraine in a Patient Undergoing Spinal Fusion: A Case Report
Authors: Monteferrante Nikolas R. , Ho Jacquelyn L. , Wilhelmi Brian G. , Uribe Juan S.
Published: June 2021

Abdominal migraine is a variant of migraine headaches characterized by episodic attacks of severe abdominal pain with migrainous features, including anorexia, nausea, vomiting, and pallor. It is more commonly diagnosed in children rather than adults. We describe a 74-year-old patient with progressively worsening back pain, severe neurogenic claudication, and a history of opioid-triggered abdominal migraine. As a precautionary measure, a perioperative opioid-sparing treatment plan was devised to prevent abdominal migraine while the patient underwent elective lumbar fusion surgery. Opioid-sparing treatment plans may enable similar patients to undergo surgery without experiencing perioperative abdominal migraines.
Exorbitant Dust
Authors: León Christina A.
Published: June 2021

This article traces the figure of polvo (dust) across the writing career of Puerto Rican and New York writer Manuel Ramos Otero. Polvo heralds the macabre sensuality of his early short stories, long before his diagnosis with HIV, and persists and morphs through his later essays and poetry up until his eventual death in 1990 from AIDS complications. Writing defiantly as a queer, a feminist, a Puerto Rican, and a sidoso, he produced work that invites death and desire to commingle through a figuration of dust, as a scattered substance that covers skin, coats translation, and dirties conventional genres. Polvo illuminates the dimensions and risks of relation as a particulate matter that exposes our porosity—clinging and hovering in the space between bodies, between the past and the future, between life and death. As the dust settles in the wake of Hurricane María, so too can polvo be read as prescient for how coloniality lingers as enduring conditions of debility and precarity. Ramos Otero's affinity for finitude, figured through polvo, counterintuitively conjures a relational desire that privileges the porous, the marginal, and the always precarious possibility of survival. Polvo moves across the different genres and phases of Ramos Otero's work as a matter that refuses to disentangle the material realities of queerness and coloniality.
Juvenile hormone affects age polyethism, ovarian status and cuticular hydrocarbon profile in workers of the waspPolybia occidentalis
Authors: Prato Amanda , da Silva Rafael C. , Assis Diego S. , Mateus Sidnei , Hartfelder Klaus , do Nascimento Fabio S.
Published: June 2021

Division of labor is one of the most striking features in the evolution of eusociality. Juvenile hormone (JH) mediates reproductive status and aggression among nestmates in primitively eusocial Hymenoptera (species without morphologically distinct castes). In highly social species it has apparently lost its gonadotropic role and primarily regulates the division of labor in the worker caste. Polybia occidentalis, a Neotropical swarm-founding wasp, is an ideal model to understand how JH levels mirror social context and reproductive opportunities because of the absence of a clear morphological caste dimorphism. In this study, we tested the hypothesis that JH influences division of labor, ovary activation and cuticular hydrocarbon profiles of workers. Our observations confirmed that a JH analog (methoprene) and an inhibitor of JH biosynthesis (precocene) affected the cuticular chemical profile associated with age polyethism. Also, methoprene and precocene-I treatment of females influenced ovarian activation differently (individuals treated with methoprene expressed more activated ovaries while precocene treatment did not have significant effect). These results suggest that different hormonal levels induce a differential expression of cuticular chemicals associated with workers’ age polyethism, which may be essential for keeping the social cohesion among workers throughout their lives in the colony. Furthermore, JH is likely to play a gonadotropic role in P. occidentalis. JH has apparently undergone certain modifications in social Hymenoptera, presenting multifaceted functions in different species.
CT findings of acute radiation-induced pneumonitis in breast cancer
Authors: Jung Wonguen , Shim Sung Shine , Kim Kyubo
Published: June 2021

Objectives:

To evaluate the CT findings of acute radiation pneumonitis (RP) in breast cancer patients undergoing post-operative radiotherapy, and to analyze clinicodosimetric factors associated with acute RP.

Methods:

Between 2015 and 2017, 61 patients with breast cancer who underwent follow-up chest CT at 3 months after radiotherapy were analyzed. The degree of acute RP on CT was evaluated by the change of extent and scoring system (grade 0, no RP; Grade 1, ground-glass opacities (GGOs); Grade 2, GGOs and/or consolidations; Grade 3, clear focal consolidation; Grade 4, dense consolidation). The dosimetric parameters were calculated from the dose–volume histogram of RT.

Results:

The acute RP on CT was scored as follows: Grade 0, in 37.7%, Grade 1 in 13.1%, Grade 2 in 44.3%, and Grade 3 in 4.9%. The median extent of RP in patients with Grades 1 to 3 was 6.2 ml (range, 0.2–95.9). There were no clinicodosimetric factors significantly associated with the presence of RP or its severity. One patient developed symptomatic RP.

Conclusion:

This study showed no correlation between acute RP and clinicodosimetric factors, and acute RP based on CT findings were much more common than symptomatic RP.

Advances in knowledge:

CT findings of acute RP or extent of RP were not significantly related to clinicodosimetric factors in breast cancer patients.
Accessory articulation of the cervical vertebrae transverse processes simulating a fracture: Incidental findings of an uncommon anatomical variant
Authors: Naidoo Natasha , Khan Nausheen
Published: June 2021

Accessory articulation of the transverse processes of the cervical vertebrae is an extremely rare congenital anomaly. We present two cases of accessory articulation of the transverse processes of the left C5/C6 and C6/C7 cervical vertebrae. The articulation at C5/C6 was found in a 34-year-old male following a mob assault, the C6/C7 accessory articulation occurred in a 28-year-old female involved in a high velocity motor-vehicle accident. Cervical spine fractures were suspected in both cases. Recognition of this variant anatomy and differentiation from a fracture is important especially in an acute trauma setting to prevent unnecessary immobilization and inappropriate specialist referral of these patients. Our search revealed only five previously reported cases in the literature mostly occurring at the C5/C6 level. This is only the second case ever described at the C6/C7 level.
In vitro assessment of periapical lesions created in sheep mandibles by using high resolution ultrasonography and cone beam computed tomography
Authors: Kamburoğlu Kıvanç , Çakmak Esra Ece , Eratam Nejlan , Sönmez Gül , Karahan Sevilay
Published: June 2021

Objectives:

Providing ultrasound images of periapical lesions may be problematic depending on the thickness of the overlying cortical bone. Clinically, it is crucial to determine the cut-off value of overlaying bone thickness in terms of interference with ultrasound imaging in conjunction with assessment of changes in periapical jaw bone lesions. Our aim was to determine the minimum amount of overlaying buccal bone thickness of artificial periapical lesions in order to be visible by ultrasound imaging and to compare width, height, depth, surface area and volume measurements of detectable periapical lesions obtained from ultrasound and CBCT images.

Methods:

Periapical lesions were created in 16 molar teeth of sheep mandibles. Cavities were enlarged until the borders of lesions were visible on 14 MHz hockey probe ultrasound imaging. CBCT and ultrasound images were obtained simultaneously after drilling and enlarging each size of the cavities and replacing the teeth in their sockets. two observers separately assessed images twice within 2 weeks of interval. By using CBCT and ultrasound images, buccal bone thickness, maximum width, height, depth, surface area and volume of periapical lesions were measured. Intraclass correlation coefficient (ICC) was utilized and significance level was set at p < 0.05.

Results:

The mean buccal bone thickness ranged between 1.21 mm and 1.31 mm for both imaging techniques. For the measurement of buccal bone thickness, periapical lesion width, height, depth, surface area, and volume excellent ICC values were found in terms of intrarater (ranging between 0.907 and 1) and inter-rater (ranging between 0.864 and 1) reliability for both observers and their readings. There were no statistically significant differences for both observers and for their two readings between ultrasound and CBCT measurements of buccal bone thickness, and periapical lesion width and height (p > 0.05).

Conclusions:

We suggested that a buccal thickness of approximately 1.28 mm might be accepted as a cut-off value for the detection of periapical lesions with 14 MHz hockey probe ultrasound. High resolution ultrasound provided accurate information for the measurement of buccal bone thickness and lesion width and height.
A new analysis approach for single nephron GFR in intravital microscopy of mice
Authors: Kessel Friederike , Kröger Hannah , Gerlach Michael , Sradnick Jan , Gembardt Florian , Todorov Vladimir , Hugo Christian
Published: June 2021

Background: Intravital microscopy is an emerging technique in life science with applications in kidney research. Longitudinal observation of (patho-)physiological processes in living mice is possible in the smallest functional unit of the kidney, a single nephron (sn). In particular, effects on glomerular filtration rate (GFR) - a key parameter of renal function - can be assessed.

Methods: After intravenous injection of a freely filtered, non-resorbable, fluorescent dye in C57BL/6 mice, a time series was captured by multiphoton microsopy. Filtration was observed from the glomerular capillaries to the proximal tubule (PT) and the tubular signal intensity shift was analyzed to calculate the snGFR.

Results: Previously described methods for snGFR analysis relied on two manually defined measurement points in the PT and the tubular volume was merely estimated in 2D images. We present an extended image processing workflow by adding continuous measurement of intensity along the PT in every frame of the time series using ImageJ. Automatic modelling of actual PT volume in a 3D dataset replaced 2D volume estimation. Subsequent data analysis in R, with a calculation of intensity shifts in every frame and normalization against tubular volume, allowed exact assessment of snGFR by linear regression. Repeated analysis of image data obtained in healthy mice showed a striking increase of reproducibility by reduction of user interaction.

Conclusions: These improvements in image processing and data analysis maximize the reliability of a sophisticated intravital microscopy technique for the precise assessment of snGFR, a highly relevant predictor of kidney function.
Effects of Remote Ischemic Conditioning on Hand Engagement in individuals with Spinal cord Injury (RICHES): protocol for a pilot crossover study
Authors: Wu Yu-Kuang , Harel Noam Y. , Wecht Jill M. , Bloom Ona E.
Published: June 2021

​​​​​​Background: Most spinal cord injuries (SCI) are not full transections, indicating that residual nerve circuits are retained. Rehabilitation interventions have been shown to beneficially reorganize motor pathways in the brain, corticospinal tract, and at the spinal level. However, rehabilitation training require a large number of repetitions, and intervention effects may be absent or show transient retention. Therefore, the need remains for an effective approach to synergistically improve the amount and duration of neuroplasticity in combination with other interventions. Remote ischemic conditioning (RIC) demonstrates several potential advantages as a candidate for such an approach. Therefore, we propose a protocol to investigate RIC coupled with physical training to promote neuroplasticity in hand muscles.

Methods: This will be a prospective randomized-order crossover trial to be performed in eight able-bodied participants and eight participants with chronic cervical SCI. Patients will participate in two experimental sessions consisting of either active or sham RIC preceding a bout of pinch movement exercise. Serial evaluations will be conducted at baseline, after RIC, immediately after pinch exercise, and follow up 15-minutes later. The primary outcome is the change in corticospinal excitability (primarily measured by the motor evoked potential of abductor pollicis brevis muscle). Secondary outcomes will include maximal volitional pinch force, and inflammatory biomarkers. To ensure safety, we will monitor tolerability and hemodynamic responses during RIC.

Discussion: This protocol will be the first to test RIC in people with cervical SCI and to investigate whether RIC alters corticospinal excitability. By sharing the details of our protocol, we hope other interested researchers will seek to investigate similar approaches – depending on overlap with the current study and mutual sharing of participant-level data, this could increase the sample size, power, and generalizability of the analysis and results.

Trial registration: ClinicalTrial.gov, ID: NCT03851302; Date of registration: February 22, 2019
The role of single-use ECG leads in reducing healthcare-associated infections
Authors: Bloe Charlie
Published: June 2021

An electrocardiogram (ECG), the recording of the electrical activity in the heart, is the most commonly performed cardiac test. It is carried out in a variety of clinical settings in hospitals and primary care, and its use is standard practice among high-risk, critically ill patients, and those who have undergone cardiac surgery. ECG recording is classified into two main categories: monitoring and diagnostic. 12-lead ECGs, which require electrodes to be placed on the chest and each limb, are used for diagnostic purposes, whereas 3- or 5-lead ECGs are used for rhythm monitoring. Cross-infection can arise from reusing ECG cables, even if they have been cleaned. Surgical site infection is a particular risk in patients who have undergone coronary artery bypass grafting, because ECG wires are placed on the chest close to the incision site. Single-use ECG leads, such as the Kendall DL™ ECG cable and lead wire system, reduce the risk of cross-contamination between patients and free nursing time for patient care because they are discarded after use and do not have to be cleaned and disinfected for use with another patient.
Service evaluation of the bereavement care delivered in a UK intensive care unit
Authors: Harris Daniel , Polgarova Petra , Enoch Lisa
Published: June 2021

Background:

Losing a loved one in the intensive care unit (ICU) can be a traumatic experience. The literature highlights that relatives of those who have died in ICU can experience symptoms of stress, anxiety, depression, post-traumatic stress disorder (PTSD) and prolonged grief.

Aim:

To evaluate the service delivery of the bereavement care that is provided on a 20-bed general ICU.

Methods and analysis:

A literature review informing and supporting the service evaluation and development of the questionnaire. Thematic analysis was undertaken using the six-phase framework.

Findings:

Five main themes were found: timing; care, dignity and respect; support; information; and memory making. Bereavement care is described as after-death care. However, the participants stipulated that bereavement care should be discussed prior to the death. Participants described using a range of interventions, such as memorial services, condolence letters, follow-up meetings and diaries.

Conclusion:

Bereavement care was regarded as an important aspect of the care delivered in ICU. It was evident that participants strived to deliver an holistic approach, yet some found this difficult to achieve.
Placement of finger oximeter on the ear: comparison with oxygen saturation values taken from the finger
Authors: Shakespeare Joanna , Parkes Edward , Gilsenan Catherine , Ali Asad
Published: June 2021

Pulse oximetry is widely used to assess oxygen saturation (SpO2) in order to guide patient care and monitor the response to treatment. However, inappropriate oximeter probe placement has been shown to affect the measured oximetry values in healthy and normoxic outpatients. This study evaluated how treatment decisions might be impacted by SpO2 values obtained using a finger probe placed on the pinna of the ear in a cohort of 46 patients receiving non-invasive ventilation compared with values obtained from a probe on the finger and the results of arterial blood gas (ABG) (SaO2) analysis. Bland-Altman analysis was performed to evaluate agreement between the methods. Finger probe saturation was not statistically different from SaO2, with a mean difference of -0.66% (P>0.05). Saturation from the ear was significantly different (-4.29%; P<0.001). Subgroup analysis in hypoxic patients (SaO2<90%) showed a significant difference between ABG SaO2, and finger and ear SpO2. The study provides evidence that placement of a finger probe on the ear is unsafe clinical practice, potentially leading to patient mismanagement.
A Critical Examination of the Impacts and Lessons Learned from a Professional Development Program for Out-of-Field Mathematics Teachers
Authors: Paolucci Catherine , Ríordáin Máire Ní , O’Dwyer Laura
Published: June 2021

As international concerns about the prevalence of out-of-field teaching have grown, so have discussions about how to support out-of-field teachers. In Ireland, the Professional Diploma in Mathematics for Teaching, a two-year professional development program, was created for out-of-field mathematics teachers. A pre-test, post-test, and final survey examined the program’s impact on participating teachers’ mathematical knowledge, confidence in teaching curricular content, and classroom practice. Findings offer evidence of development in participating teachers’ mathematical knowledge and self-efficacy after completing the program. They also raise important concerns about persistent weaknesses in participating teachers’ mathematical knowledge, particularly related to key areas of the curriculum.
Latent fingerprint residue detection method using Sagnac Fourier transform imaging spectroscopy
Authors: Bai Xueqiong , Yang Wenming , Song Weitao , Liao Ningfang
Published: June 2021

We propose a new method to detect latent fingerprints and their residues based on Sagnac ultraviolet Fourier transform imaging spectroscopy. The three-dimensional data cube including two-dimensional images and spectrum dimensions can be obtained by the new hyperspectral imaging technique. The method to inhibit the redundancy from the spectra-image data is also presented, which includes the self-adaptive differential filtering, the apodization algorithm, and a fast Fourier transform method. The whole process is also discussed in detail. Not only the latent fingerprint but also its residues’ distribution are provided in experimental results, and the proposed method is demonstrated.
Physical meaning of the deviation scale under arbitrary turbulence strengths of optical orbital angular momentum
Authors: Tao Zhiwei , Ren Yichong , Abdukirim Azezigul , Liu Shiwei , Rao Ruizhong
Published: June 2021

The recently so-called deviation scale [Phys. Rev. A 99, 013828 (2019)PLRAAN1050-294710.1103/PhysRevA.99.013828] bridges the connection between the result of the infinitesimal propagation equation (IPE) prediction and that of the single phase screen (SPS) approximation. Thanks to the multiple phase screen (MPS) approach, in this paper we elaborate the physical meaning of the deviation scale: the spatial accumulation of slight intensity modulation of incident orbital angular momentum (OAM)-carrying beam splits the original vortex into multiple individual vortices with a topological charge (TC) of

+

1

and regenerates the vortex-antivortex pairs with a TC of

+

1

and with a TC of

−

1

, leading to a significant deviation between these two different results only when the disruption of this compound effect on the phase distribution of the incident OAM-carrying beam becomes more significant. Other than that, we also show that the appearance of the deviation scale cannot be predicted only by the Rytov variance, which can be predicted through the vortex-splitting ratio of the received optical field alone or with the help of the normalized propagation distance.
Experimental observation of the orbital Hall effect of light through pure orbit–orbit interaction for randomly and radially polarized vortex beams
Authors: B S Athira , Mukherjee Sounak , Laha Anuraj , Bar Koushik , Nandy Dibyendu , Ghosh Nirmalya
Published: June 2021

The orbit–orbit interaction of light leads to fundamentally rich optical phenomena whose experimental exploration and theoretical understanding remain challenging. Here, we investigate polarization-independent vortex-induced beam shifts for light beams possessing random polarization and radial polarization. The experiments reveal an intriguing manifestation of the orbital Hall effect of light as a consequence of orbit–orbit interactions and resulting conservation of total angular momentum. An interferometric scheme is experimentally implemented to quantify the change in the phase structure of the orbital angular momentum carrying beam as signatures of the orbital Hall effect of light arising due to partial reflection at a dielectric interface. We also demonstrate, and thus corroborate, the conservation of total angular momentum for such vortex-induced beam shifts.
Optical switching performance of thermally oxidized vanadium dioxide with an integrated thin film heater
Authors: Sarangan Andrew , Ariyawansa Gamini , Vitebskiy Ilya , Anisimov Igor
Published: June 2021

Optical switching performance of vanadium dioxide produced by thermal oxidation of vanadium is presented in this paper. A 100nm thick vanadium was oxidized under controlled conditions in a quartz tube furnace to produce approximately 200nm thick VO2. The substrate was appropriately coated on the front and back side to reduce reflection in the cold state, and an integrated thin film heater was fabricated to allow in-situ thermal cycling. Electrical measurements show a greater than three orders of magnitude change in resistivity during the phase transition. Optical measurements exhibit 70% transparency at 1500nm and about 15dB extinction across a wide spectral band between 1000nm and 3000nm. These results are used to show a huge optical bistability effect in VO2-based devices.