Time spent in the radiotherapy department for breast cancer treatment, pre-, mid- and post-COVID-19 pandemic (a 6-year, single-centre service review)

Introduction: Before COVID-19, breast cancer patients in the UK typically received 15 radiotherapy (RT) fractions over three weeks. During the pandemic, adoption of a 5-fraction treatment prescription and more advanced treatment techniques like surface-guided RT, meant a change in the duration and number of hospital visits for patients accessing treatment. This work sought to understand how breast cancer patients’ time in the RT department has changed, between 2018 and 2023. Methods: Appointments for CT simulation, mould room, and RT, from January 2018 to December 2023, were extracted from the Mosaiq® Oncology Management System. Appointments lasting between 5 minutes and 5 hours were analysed. Total visit time was calculated from check-in to completion on the quality checklist. Results: In total, 29,523 attendances were analysed over 6 years. Average time spent in the department decreased during the pandemic but has since increased 12·4% above pre-COVID-19 levels. Early morning and late afternoon appointments resulted in the shortest visits, with early afternoon appointments leading to the longest visits. On average, patients spend the longest in the department on a Monday, and the least amount of time on a Friday. Friday was the least common day to start a 15-fraction treatment, whereas Tuesday and Friday were equally uncommon for the 5-fraction regime. Conclusions: During the COVID-19 pandemic, the number of visits a patient makes for breast cancer RT and related services dropped, and remained lower post-COVID-19, due to fewer treatment fractions being prescribed. Average time spent in the department initially decreased but has since increased beyond pre-COVID-19 levels

‘John Williams: Stoner (1965)’

The chapter offers a critical summary and evaluation of this classic US campus novel

Hydrogen barrier coatings: Application and assessment

Hydrogen embrittlement (HE) threatens the structural integrity of industrial components exposed to hydrogen-rich environments. This review critically explores hydrogen barrier coatings (HBCs), polymeric, metallic, ceramic, and composite, their application and assessment, focusing on measured effectiveness in limiting hydrogen permeation and hydrogen embrittlement. Also, coating application methods and permeation assessment techniques are evaluated. Recent advances in nanostructured and hybrid coatings are emphasized, highlighting the pressing need for durable, scalable, and environmentally sustainable hydrogen barrier coatings to ensure the reliability of emerging hydrogen-based energy solutions. This comprehensive critical review further distinguishes itself by linking coating deposition methods to defect-driven transport behaviour, critically assessing permeation test approaches. It also highlights the emerging role of polymeric and hybrid multilayer coatings with direct implications for advanced and reliable hydrogen production, storage, and transport infrastructure

Smartphone app-delivered Acceptance and Commitment Therapy (ACT) for post-traumatic stress disorder and gambling harm in veterans: A pilot feasibility study

Gambling harm and post-traumatic stress disorder (PTSD) appear to be prevalent among veterans. Globally, help-seeking rates for gambling are low, and veterans may experience obstacles in accessing mental health support due to stigma. Digital health interventions may increase treatment uptake and improve outcomes for veterans. Here, we report findings from a pilot feasibility study of a novel smartphone application-based intervention, “ACT Vet”, based on Acceptance and Commitment Therapy (ACT) for veterans experiencing PTSD symptoms, gambling harm, or both. A 10-week, within-subjects design was employed with 24 veterans (21 men, 2 women, 1 undisclosed; Mage = 45.29 years; SD = 10.70). Outcome measures assessed PTSD symptoms, gambling severity, psychological flexibility, anxiety, alcohol use, suicidality, and loneliness. We also examined participants’ quality of life and app usability and acceptability ratings. Findings demonstrated significant reductions in both PTSD and gambling symptoms across the intervention, with a corresponding increase in psychological flexibility. Alcohol use also decreased post-intervention. High usability scores suggest the app was well-received by participants. Overall, the sustained improvements post-intervention indicates the successful deployment of ACT-based methods in an app format. ACT Vet has potential scalability as a first-line digital intervention for PTSD and/or gambling harm

Nostalgia and the Emotional Turn in Postbellum Plantation Memoirs

This article examines how white southern memoirists of the late nineteenth-century nostalgically constructed the Old South, using plantation life-writing to assert regional identity and historical distinctiveness after emancipation, the Civil War, and Reconstruction. These memoirs depict the antebellum plantation as a harmonious, orderly society characterized by racial stability, rigid class hierarchies, and prescribed gender roles. The article carefully explores how nostalgia shaped these depictions, transporting former enslavers and their families into a romanticized past that glossed over, or elided, the harsh realities of plantation era slavery. Central to these narratives is the image of the ‘faithful slave,’ particularly the Mammy figure, whose depiction reinforced paternalistic myths. Through these rhetorical strategies, plantation memoirists sought to create a vision of race relations rooted in an idealized past, one that could influence future interactions between white and Black southerners to ensure continued white dominance within southern society and culture

Conditions for biofilm formation in Extraintestinal Pathogenic E. coli (ExPEC)

Sepsis is a complex multi-organ state caused by a dysfunctional immune response to infection. Recent estimates suggest an incidence of around 360 cases per 100,000 population per year, resulting in approximately 20% of all mortality rates. Bacteria cause about 70% of sepsis cases, with extrapathogenic Escherichia coli (ExPEC) being a major contributor locally in the Hywel Dda University Health Board (HDUHB). ExPEC utilise various virulence factors (VF) to evade the immune system. Some of these are responsible for producing biofilms, which are aggregates of bacteria, providing protection in diverse environments, but less work has focused on parameters of biofilm formation in ExPEC. This thesis aimed to identify optimal conditions for biofilm formation in ExPEC strains, then use these conditions to implicate phenotypes, genes and visualise structure in the biofilm formation process. Blood culture-positive E. coli isolates from HDUHB were used in growth and biofilm assays. Phenotypic, clinical and sequence metadata was used for isolate comparisons, while imaging experiments were performed using confocal laser scanning microscopy (CLSM). The optimal parameters needed for biofilm formation in ExPEC were Luria Bertani, Tryptic Soy Broth+Glucose or Escherichia Coli broth, 24-hour pre-culture and bile salts. Sequence type 73 (ST73) isolates had significantly higher biofilm levels than ST131 isolates. Subsequently, fimACDFGHI, rcsAB and acrE genes were associated with biofilm formation in ExPEC bacteraemia strains. CLSM confirmed live biofilms with significant biomass and thickness in both biofilm-positive and negative isolates. This work demonstrated the requirement of bile salts for biofilm formation in ExPEC, while iron supplementation had no effect. It also identified potential list of biofilm-promoting genes in ExPEC, requiring functional confirmation in knockout mutants and visualisation in live biofilm structures. In conclusion, this work will enhance the understanding of ExPEC pathogenesis and contribute to biomarker identification to predict severe infections using optimised methods for gene identification