Developmentally appropriate transitional care during the Covid-19 pandemic for young people with juvenile-onset rheumatic and musculoskeletal diseases : the rationale for a position statement

Background The importance of developmentally appropriate transitional care in young people with juvenile-onset rheumatic and musculoskeletal disease is well recognised. The Paediatric Rheumatology European Society (PReS) / European League Against Rheumatism (EULAR) Taskforce has developed international recommendations and standards for transitional care and a growing evidence base supports the positive benefits of such care. However, there is also evidence that universal implementation has yet to be realised. In 2020, against this background the COVID-19 pandemic arrived with significant impact on all our lives, young and old, patient, public and professional alike. The unfortunate reality of the pandemic with potential for unfavourable outcomes on healthcare provision during transition was acknowledged by the PReS working groups in a position statement to support healthcare professionals, young people and their caregivers. Aim The aim of this review is to present the literature which provides the rationale for the recommendations in the PReS Position Statement. Summary The following areas are specifically addressed: the prime importance of care coordination; the impact of the pandemic on the various aspects of the transition process; the importance of ensuring continuity of medication supply; the pros and cons of telemedicine with young people; ensuring meaningful involvement of young people in service development and the importance of core adolescent health practices such as routine developmental assessment psychosocial screening and appropriate parental involvement during transitional care

First inverse kinematics measurement of key resonances in the 22Ne(p, γ)23Na reaction at stellar temperatures

In this Letter we report on the first inverse kinematics measurement of key resonances in the ${}^{22}\text{Ne}(p,\gamma)^{23}\text{Na}$ reaction which forms part of the NeNa cycle, and is relevant for ${}^{23}$Na synthesis in asymptotic giant branch (AGB) stars. An anti-correlation in O and Na abundances is seen across all well-studied globular clusters (GC), however, reaction-rate uncertainties limit the precision as to which stellar evolution models can reproduce the observed isotopic abundance patterns. Given the importance of GC observations in testing stellar evolution models and their dependence on NeNa reaction rates, it is critical that the nuclear physics uncertainties on the origin of ${}^{23}$Na be addressed. We present results of direct strengths measurements of four key resonances in ${}^{22}\text{Ne}(p,\gamma)^{23}\text{Na}$ at E$_{{\text c.m.}}$ = 149 keV, 181 keV, 248 keV and 458 keV. The strength of the important E$_{{\text c.m.}}$ = 458 keV reference resonance has been determined independently of other resonance strengths for the first time with an associated strength of $\omega\gamma$ = 0.439(22) eV and with higher precision than previously reported. Our result deviates from the two most recently published results obtained from normal kinematics measurements performed by the LENA and LUNA collaborations but is in agreement with earlier measurements. The impact of our rate on the Na-pocket formation in AGB stars and its relation to the O-Na anti-correlation was assessed via network calculations. Further, the effect on isotopic abundances in CO and ONe novae ejecta with respect to pre-solar grains was investigated

Atrial natriuretic peptide Its measurement in plasma and role in blood volume homeostasis

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN010799 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Protection against nerve agent poisoning by a noncompetitive nicotinic antagonist

The acute toxicity of organophosphorus (OP) nerve agents arises from accumulation of acetylcholine (ACh) and overstimulation of ACh receptors. The mainstay of current pharmacotherapy is the competitive muscarinic antagonist, atropine. Nicotinic antagonists have not been used due to the difficulties of administering a dose of a competitive neuromuscular blocker sufficient to antagonise the effects of excessive ACh, but not so much that it paralyses the muscles. An alternative approach would be to use a noncompetitive antagonist whose effects would not be overcome by increasing ACh concentrations. This study demonstrates that the compound 1,1'-(propane-1,3-diyl)bis(4-tert-butylpyridinium), which blocks open nicotinic ion channels noncompetitively, is able to reverse the neuromuscular paralysis after nerve agent poisoning in vitro and to protect guinea pigs against poisoning by nerve agents when used as part of a therapeutic drug combination including a muscarinic antagonist. In contrast to the oxime HI-6, this compound was equally effective in protecting against poisoning by sarin or tabun. Further studies should identify more effective compounds with this action and optimise doses for protection against nerve agent poisoning in vivo