Wall Volley Test Performance as a Function of Grip and Wrist Strength

This study tested the hypothesis that grip and wrist strength affect performance on wall volley tests that were designed to test ability in tennis, badminton, and volleyball

What are the barriers to primary prevention of type 2 diabetes in black and minority ethnic groups in the UK? A qualitative evidence synthesis.

Background: This review aimed to synthesise available qualitative evidence on barriers and facilitators to the implementation of community based lifestyle behaviour interventions to reduce the risk of diabetes in black and minority ethnic (BME) groups in the UK. Methods: A search of medical and social science databases was carried out and augmented by hand-searching of reference lists and contents of key journals. Qualitative evidence was synthesised thematically. Results: A total of 13 papers varying in design and of mainly good quality were included in the review. A limited number of intervention evaluations highlighted a lack of resources and communication between sites. A lack of understanding by providers of cultural and religious requirements, and issues relating to access to interventions for users was reported. Behaviour change was impeded by cultural and social norms, and resistance to change. There were variations in the way dietary change and physical activity was approached by different groups and contrasting practices between generations. Conclusions: Qualitative data provided insight into the ways that providers might improve or better design future interventions. Acknowledgement of the way that different groups approach lifestyle behaviours may assist acceptability of interventions

Pseudo-Chilblains in Adult Patients with Confirmed COVID-19: A Systematic Review

Background: Pseudo-chilblains have been associated with COVID-19. Many reports, however, lack confirmation of COVID-19 infection. While likely associated, all chilblains/chilblain-like lesions during this time should not be assumed to be COVID-19 related. This study examines the characteristics of adults with pseudo-chilblains and confirmed COVID-19. Methods: A systematic review of PubMed/MEDLINE database was performed using the PRISMA guidelines. Adults (>18 years) with confirmed COVID-19 were included. De-identified registries were excluded to avoid duplication. We extracted study design, age, sex, race, geographic location, relationship of COVID-19 diagnosis to chilblains onset, confirmatory testing, hospitalization status, anatomical location, cold/damp exposure, presence/absence/description of pseudo-chilblains symptoms, presence/absence of biopsies/histopathologic findings, tissue IHC/PCR, presence/absence/details of extracutaneous COVID-19 disease, pre-existing chilblains, treatment and resolution timeline. The search was completed in July 2022. Results: We identified 13 studies (29 patients). In COVID-19-infected adults, pseudo-chilblains were reported primarily from North America and Europe, occurring in both sexes over a wide age-range, affected well and ill patients, favored the hands and feet and could be symptomatic or asymptomatic. Most patients had extracutaneous symptoms. Resolution time ranged from 50 days. There was marked variation in treatment strategies and appearance of pseudo-chilblains relative to entire disease course. Biopsies were infrequently performed but findings similar to classical chilblains were described. Conclusions: Many patients reported as pseudo-chilblains of COVID-19 lack confirmed infection. Infection confirmation, photographic documentation and histopathology are critical to establish homogeneity in reported pseudo-chilblains during this global pandemic. Further work clarifying the relationship of acral eruptions and COVID-19 is necessary

Developing Mn-doped lead sulfide quantum dots for MRI labels

Magnetic interactions of Mn2+ions in lead sulfide (PbS) nanocrystals with protons in water are probed by NMR and MRI. A thin layer of capping molecules enables free solvent diffusion to the nanocrystal surface resulting in a decrease of proton relaxation times. Magnetic resonance imaging of neuronal cell pellets exposed to (PbMn)S at non-toxic concentrations demonstrates their prospects as MRI-labels

Risperidone Provides Better Improvement of Sleep Disturbances Than Haloperidol Therapy in Schizophrenia Patients With Cannabis-Positive Urinalysis

A high percentage of persons with Schizophrenia also uses Cannabis and this may potentially alter the therapeutic benefits of the antipsychotic medications prescribed. The aim of this study was to assess the impact of Cannabis usage on antipsychotic therapy of sleep disturbances in schizophrenia subjects. Male subjects, ≥18 years, admitted to the University Hospital of the West Indies psychiatric ward between October 2015 and October 2016, and diagnosed with schizophrenia were recruited for the study. Following written informed consent to the study, subjects were prescribed either risperidone monotherapy or haloperidol monotherapy orally for 14 days and classified as Cannabis users (CU) or non-users (non-CU), with presence/absence of Cannabis metabolite in urine samples. After 1 week of admission, subjects wore the Actiwatch-2 device, to record sleep data for 7 consecutive nights. Inferential statistical analysis involved non-parametric tests, expressed as median and inter-quartile ranges (IQR), with p<0.05 considered statistically significant. Fifty subjects were assessed, with a median (IQR) age of 28 (14) years. Majority (30; 60%) were CU, displaying longer sleep latency (SL) than non-CU when receiving haloperidol; but equivalent SL when receiving risperidone. In comparison to non-CU, the CU also displayed longer time in bed, but shorter durations asleep, awoke more frequently during the nights and for longer durations, whether receiving haloperidol or risperidone. This resulted in lower sleep efficiency for the CU (<85%) compared to the non-CU (≥85%). Over the study period, sleep efficiency was significantly improved for non-CU receiving either risperidone (p = 0.032) or haloperidol (p = 0.010); but was only significantly improved with risperidone for the CU (p = 0.045). It is apparent that the presence of Cannabis may be impacting the therapeutic benefits of antipsychotic drugs on sleep. In schizophrenia subjects with concomitant Cannabis use, risperidone is more beneficial than haloperidol in improving sleep efficiency

Unexpected depletion in plasma choline and phosphatidylcholine concentrations in a pregnant woman with bipolar affective disorder being treated with lithuim, haloperidol and benztropine: a case report

<p>Abstract</p> <p>Introduction</p> <p>Patients with bipolar affective disorder can be effectively managed with pharmacological intervention. This case report describes a pregnant woman with a ten-year history of bipolar affective disorder that was being treated with lithium, haloperidol and benztropine.</p> <p>Case presentation</p> <p>The patient had a normal pregnancy, but developed an elevated blood pressure and started to lose weight at 36 weeks of gestation. During pregnancy, plasma concentrations of choline and phosphatidylcholine are increased to meet the demands of the foetus. However, our findings in this case included depletion of plasma choline and phosphatidylcholine concentrations. Other unusual outcomes included low placental weight and low infant birth weight.</p> <p>Conclusion</p> <p>This report suggests that the pharmacological management of this patient could possibly account for the findings.</p

Screening the Geomechanical Stability (Thermal &amp; Mechanical) of Shared Multi-user CO2 Storage Assets, a Simple Effective Tool Applied to the Captain Sandstone Aquifer

Multi-user storage systems are anticipated in the near future to permanently store CO2 captured at industrial sources to meet emissions reductions targets. Multiple storage permit applications will be required to exploit the immense potential capacity within extensive CO2 storage assets. To retain 99% of the injected CO2 for 1000 years the geomechanical stability of the sealing strata above the pressurised storage reservoir is a key factor which needs to be included in the geo-engineering design of shared storage assets. The potential for interaction of increased pressure at multiple injection sites needs to be predicted and assessed at a regional scale to assure the integrity at all existing sites before a storage permit is granted. Geomechanical models coupled with the expected fluid pressure response predict the stability of the storage asset during and after injection of CO2 at multiple injection sites, and can be used as a tool to ensure efficient utilisation of the storage capacity. The geomechanical analysis of the thermal stress as well as local and regional fluid pressure changes requires a detailed numerical evaluation, often at a resolution significantly higher than the data available. Coupling of regional-scale static geological models, dynamic multi-phase flow models and detailed geomechanical models requires extensive computational resources. Such models often produce seemingly detailed results, but are usually only one or two realisations of a system populated by a statistically generated parameter set. Limits on time and computational resources prevent more simulations within fixed time and financial budgets. To enable a more time and cost efficient methodology of assessing the geomechanical stability of potential storage sites we present a four-tier modelling approach with increasing complexity that allows an in-depth evaluation of the geomechanical stability at a regional scale of a multi-user storage asset taking into account the fluid pressure increase and the thermal stress impact on the stability of the strata sealing the CO2 store. The tiers include: (1) development of a geo-mechanical facies model of the storage system,(2) development of an analytical geomechanical model for the storage site static stress conditions, (3)fitting an empirical multivariable polynomial function to the analytical modal, and (4) conditioning the empirical function using coupled numerical THM modelling for dynamic stress conditions. The result is look up function which gives the maximum possible fluid pressure as a function of location. This approach significantly simplifies the computational requirements and time for the prediction of geomechanical behaviour. In addition to presenting this methodology, using the Captain Sandstone of the North Sea as an example, three key findings are further examined. Firstly, detailed analysis of the stress changes as a result of cold fluid injection suggests that the redistribution of thermal stress can, in some cases, be beneficial to the storage system depending on the stress bridging which occurs. Secondly, pressure plume migration over time in dipping strata, from deeper injection sites to shallower sites, needs to be taken into account. Thirdly, the nature of the strata underlying the storage formation is critical to the pressure increase in response to the fluid injection. The methodology developed in this paper enables a rapid and efficient screening of the dynamic geomechanical stability and facilitates an efficient coupling to diverse discrete multiphase fluid flow models using commonly available computational resources

Nephron Sparing Treatment (NEST) for Small Renal Masses: A Feasibility Cohort-embedded Randomised Controlled Trial Comparing Percutaneous Cryoablation and Robot-assisted Partial Nephrectomy

There is a paucity of high-level evidence on small renal mass (SRM) management, as previous classical randomised controlled trials (RCTs) failed to meet accrual targets. Our objective was to assess the feasibility of recruitment to a cohort-embedded RCT comparing cryoablation (CRA) to robotic partial nephrectomy (RPN). A total of 200 participants were recruited to the cohort, of whom 50 were enrolled in the RCT. In the RCA intervention arm, 84% consented (95% confidence interval [CI] 64-95%) and 76% (95% CI 55-91%) received CRA; 100% (95% CI 86-100%) of the control arm underwent RPN. The retention rate was 90% (95% CI 79-96%) at 6 mo. In the RPN group 2/25 (8%) were converted intra-operative to radical nephrectomy. Postoperative complications (Clavien-Dindo grade 1-2) occurred in 12% of the CRA group and 29% of the RPN group. The median length of hospital stay was shorter for CRA (1 vs 2 d; p = 0.019). At 6 mo, the mean change in renal function was -5.0 ml/min/1.73 m2 after CRA and -5.8 ml/min/1.73 m2 after RPN. This study demonstrates the feasibility of a cohort-embedded RCT comparing CRA and RPN. These data can be used to inform multicentre trials on SRM management. PATIENT SUMMARY: We assessed whether patients with a small kidney tumour would consent to a trial comparing two different treatments: cryoablation (passing small needles through the skin to freeze the kidney tumour) and surgery to remove part of the kidney. We found that most patients agreed and a full trial would therefore be feasible