Comparison of Three Chemotherapy Protocols With Electrochemotherapy for the Treatment of Feline Cutaneous Squamous Cell Carcinoma.

Electrochemotherapy (ECT) with intravenous (IV) and/or intratumoral (IT) bleomycin has shown considerable efficacy in the treatment of non-resectable feline cutaneous squamous cell carcinoma (cSCC), boasting response rates of up to 95%, but other chemotherapy protocols have not yet been investigated. The objective of this prospective multicentre study was to compare the overall response rate (ORR) and progression-free interval (PFI) between cats with cSCC treated with ECT using IT and IV carboplatin (IV + IT), IV carboplatin (IV) or IV bleomycin (IV). A total of 44 cats with unresectable cSCC across three centres were enrolled and treated with ECT using carboplatin IV + IT (n = 10), carboplatin IV (n = 11) or bleomycin IV (n = 23). Treatment response according to RECIST criteria was recorded at 2 and 4 weeks post-treatment, and patients were followed until disease progression and/or death. All three groups were comparable regarding age, sex, weight, and lesion size. Adverse events were generally mild, localised and similar between groups. ORRs were 90.0% (carboplatin IV + IT), 90.9% (carboplatin IV) and 95.6% (bleomycin IV) and were not significantly different (p = 0.79). Median PFI was not reached for carboplatin IV + IT or carboplatin IV and was 566 days for bleomycin IV, with no significant difference between the three groups (p = 0.81). This study suggests that ECT using IV or IV + IT carboplatin is a reasonable alternative therapeutic option for managing cSCC, and further studies are warranted to compare outcomes between treatment protocols.

High-contrast coercive field engineering for periodic poling of RbKTiOPO4 with Ba2+/K+ ion-exchange.

We investigate a new method of coercive field engineering for periodic poling of RbKTiOPO4 (RKTP). By ion exchanging RKTP in a molten salt containing 7 mol% Ba(NO3)2 and 93 mol% KNO3 we achieve more than an order of magnitude difference in polarization switching time between the exchanged and non-exchanged regions. This method is used to fabricate periodic gratings of 2.92 µm in 1 mm thick bulk RKTP for second harmonic generation at 779 nm with a normalized conversion efficiency of 2%/Wcm. We show that the poled domain structures are stable at 300 °C, and that there is no bulk refractive index modification associated with the periodic ion exchange.

Feline high-grade and large granular lymphocyte alimentary lymphomas treated with COP- or CHOP-based chemotherapy: A multi-centric retrospective study of 57 cases.

Specific data regarding outcome of cats with high-grade and large granular lymphocyte alimentary lymphoma (HGAL and LGL, respectively) treated with multi-agent chemotherapy are scarce. The aims of this multi-centric, retrospective study were to describe the outcome of cats with HGAL and LGL treated with COP- or CHOP-based chemotherapy and to identify potential prognostic factors. Cats with a cytological or histological diagnosis of HGAL or LGL lymphoma treated with COP- or CHOP-based protocol as first-line chemotherapy were included. Data regarding diagnosis, staging, treatment and follow-up were collected. Fifty-seven cats treated with CHOP (n = 37) or COP (n = 20) protocols were included. Complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) were observed in 20%, 22%, 36% and 22% of cats, respectively, for an overall response rate of 42%. Median progression-free interval (PFI) was 148 days and overall median survival time (OST) was 131 days. Cats achieving CR, PR or SD showed significantly longer PFI (p < .01) and OST (p < .015) compared with cats with PD. Other positive prognostic factors in multi-variate analysis were rescue treatment (p < .001) and absence of lymph node involvement (p < .03). Negative prognostic factors were diffuse infiltration of the gastrointestinal tract (p = .035) and infiltration of a non-haematopoietic organ (p < .01).

The Reliability and Validity of a Portable Three-Dimensional Scanning System to Measure Leg Volume.

(1) Background: The study examined the reliability (test-retest, intra- and inter-day) and validity of a portable 3D scanning method when quantifying human leg volume. (2) Methods: Fifteen males volunteered to participate (age, 24.6 ± 2.0 years; stature, 178.9 ± 4.5 cm; body mass, 77.4 ± 6.5 kg; mean ± standard deviation). The volume of the lower and upper legs was examined using a water displacement method (the criterion) and two consecutive 3D scans. Measurements were taken at baseline, 1 h post-baseline (intra-day) and 24 h post-baseline (inter-day). Reliability and validity of the 3D scanning method was assessed using Bland-Altman limits of agreement and Pearson's product moment correlations. (3) Results: With respect to the test-retest reliability, the 3D scanning method had smaller systematic bias and narrower limits of agreement (±1%, and 3-5%, respectively) compared to the water displacement method (1-2% and 4-7%, respectively), when measuring lower and upper leg volume in humans. The correlation coefficients for all reliability comparisons (test-retest, intra-day, inter-day) would all be regarded as 'very strong' (all 0.94 or greater). (4) Conclusions: The study's results suggest that a 3D scanning method is a reliable and valid method to quantify leg volume.

Hashimoto's Encephalopathy with Use of Intravenous Immunoglobulin as First-Line Therapy.

Hashimoto's encephalopathy is an uncommon cause of altered mental status in hospitalized patients and is challenging to diagnose, particularly in the presence of other psychiatric comorbidities. Corticosteroids are the primary treatment. Here, we present a patient with history of post-traumatic stress disorder and prior substance abuse admitted with profound altered mental status and agitation requiring admission to the intensive care unit and mechanical ventilation. He was treated with intravenous immunoglobulin (IVIG) instead of the standard steroid course because of concerns for worsening agitation. The patient had improvement with IVIG infusions, returned to a functional state, and has remained on IVIG therapy monthly since the initial episode without any disease recurrence.

Performance of the FreeStyle Libre Flash Glucose Monitoring System during an Oral Glucose Tolerance Test and Exercise in Healthy Adolescents.

This study's aim was to assess FreeStyle Libre Flash glucose monitoring (FGM) performance during an oral glucose tolerance test (OGTT) and treadmill exercise in healthy adolescents. This should advance the feasibility and utility of user-friendly technologies for metabolic assessments in adolescents. Seventeen healthy adolescents (nine girls aged 12.8 ± 0.9 years) performed an OGTT and submaximal and maximal treadmill exercise tests in a laboratory setting. The scanned interstitial fluid glucose concentration ([ISFG]) obtained by FGM was compared against finger-prick capillary plasma glucose concentration ([CPG]) at 0 (pre-OGTT), -15, -30, -60, -120 min post-OGTT, pre-, mid-, post- submaximal exercise, and pre- and post- maximal exercise. Overall mean absolute relative difference (MARD) was 13.1 ± 8.5%, and 68% (n = 113) of the paired glucose data met the ISO 15197:2013 criteria. For clinical accuracy, 84% and 16% of FGM readings were within zones A and B in the Consensus Error Grid (CEG), respectively, which met the ISO 15197:2013 criteria of having at least 99% of results within these zones. Scanned [ISFG] were statistically lower than [CPG] at 15 (-1.16 mmol∙L-1, p < 0.001) and 30 min (-0.74 mmol∙L-1, p = 0.041) post-OGTT. Yet, post-OGTT glycaemic responses assessed by total and incremental areas under the curve (AUCs) were not significantly different, with trivial to small effect sizes (p ≥ 0.084, d = 0.14-0.45). Further, [ISFGs] were not different from [CPGs] during submaximal and maximal exercise tests (interaction p ≥ 0.614). FGM can be a feasible alternative to reflect postprandial glycaemia (AUCs) in healthy adolescents who may not endure repeated finger pricks.

Rapid Vital Sign Extraction for Real-Time Opto-Physiological Monitoring at Varying Physical Activity Intensity Levels.

Robustness of physiological parameters obtained from photoplethysmographic (PPG) signals is highly dependent on a signal quality that is often affected by the motion artefacts (MAs) generated during physical activity. This study aims to suppress MAs and obtain reliable physiological readings using the part of the pulsatile signal, captured by a multi-wavelength illumination optoelectronic patch sensor (mOEPS), that minimizes the residual between the measured signal and the motion estimates obtained from an accelerometer. The minimum residual (MR) method requires the simultaneous collection of (1) multiple wavelength data from the mOEPS, and (2) motion reference signals from a triaxial accelerometer attached to the mOEPS. The MR method suppresses those frequencies associated with motion in a manner that is easily embedded on a microprocessor. The performance of the method in reducing both in-band and out-of-band frequencies of MAs is evaluated through two protocols with 34 subjects engaged in the study. The MA-suppressed PPG signal, obtained through MR, enables the calculation of the heart rate (HR) with an average absolute error of 1.47 beats/min for the IEEE-SPC datasets, and the calculation of HR and respiration rate (RR) to 1.44 beats/min and 2.85 breaths/min respectively for our in-house datasets. Oxygen saturation (SpO 2) levels calculated from the minimum residual wave forms were consistently [Formula: see text]. The comparison with the reference HR and RR show errors with an absolute accuracy of [Formula: see text] and the Pearson correlation ( R) for HR and RR are 0.9976 and 0.9118, respectively. These outcomes demonstrate that MR is capable of effective suppression of MAs for a range of physical activity intensities and to achieve real-time signal processing for wearable health monitoring.

Understanding parent experiences of end-of-life care for children: A systematic review and qualitative evidence synthesis.

BACKGROUND: An estimated 21 million children worldwide would benefit from palliative care input and over 7 million die each year. For parents of these children this is an intensely emotional and painful time through which they will need support. There is a lack of synthesised research about how parents experience the care delivered to their child at the end of life. AIM: To systematically identify and synthesise qualitative research on parents' experiences of end-of-life care of their child. DESIGN: A qualitative evidence synthesis was conducted. The review protocol was registered in PROSPERO (CRD42021242946). DATA SOURCES: MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science databases were searched for qualitative studies published post-2000 to April 2020. Studies were appraised for methodological quality and data richness. Confidence in findings was assessed by GRADE-CERQual. RESULTS: About 95 studies met the eligibility criteria. A purposive sample of 25 studies was taken, of good-quality papers with rich data describing the experience of over 470 parents. There were two overarching themes: parents of children receiving end-of-life care experienced a profound need to fulfil the parental role; and care of the parent. Subthemes included establishing their role, maintaining identity, ultimate responsibility, reconstructing the parental role, and continuing parenting after death. CONCLUSIONS: Services delivering end-of-life care for children need to recognise the importance for parents of being able to fulfil their parental role and consider how they enable this. What the parental role consists of, and how it's expressed, differs for individuals. Guidance should acknowledge the need to enable parents to parent at their child's end of life.

Assessing the use of prescription drugs and dietary supplements in obese respondents in the National Health and Nutrition Examination Survey.

INTRODUCTION: Obesity is a common disease and a known risk factor for many other conditions such as hypertension, type 2 diabetes, and cancer. Treatment options for obesity include lifestyle changes, pharmacotherapy, and surgical interventions such as bariatric surgery. In this study, we examine the use of prescription drugs and dietary supplements by the individuals with obesity. METHODS: We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data 2003-2018. We used multivariate logistic regression to analyze the correlations of demographics and obesity status with the use of prescription drugs and dietary supplement use. We also built machine learning models to classify prescription drug and dietary supplement use using demographic data and obesity status. RESULTS: Individuals with obesity are more likely to take cardiovascular agents (OR = 2.095, 95% CI 1.989-2.207) and metabolic agents (OR = 1.658, 95% CI 1.573-1.748) than individuals without obesity. Gender, age, race, poverty income ratio, and insurance status are significantly correlated with dietary supplement use. The best performing model for classifying prescription drug use had the accuracy of 74.3% and the AUROC of 0.82. The best performing model for classifying dietary supplement use had the accuracy of 65.3% and the AUROC of 0.71. CONCLUSIONS: This study can inform clinical practice and patient education of the use of prescription drugs and dietary supplements and their correlation with obesity.

Breaking Sitting Time with Physical Activity Increases Energy Expenditure but Does Not Alter Postprandial Metabolism in Girls.

PURPOSE: Young people spend a substantial proportion of their time at school sedentary; therefore, this setting represents an important target for interventions aimed at displacing sedentary time with physical activity. This study aimed to examine the postprandial metabolic effects of breaking sedentary time by accumulating walking and repeated bouts of nonambulatory standing during simulated school days in inactive adolescent girls. METHODS: Seventeen girls (mean ± SD = 12.8 ± 0.4 yr) completed two 3-d experimental conditions. On days 1 and 2 of the standing + walking (STD-WLK) experimental trial, participants interrupted sedentary time by completing 4 × 10 min bouts of self-paced walking and accumulated 18 × 5 min standing bouts during each simulated school day. On day 3 of STD-WLK, participants attended school as normal with no additional physical activity or standing prescribed. On all 3 d of the control condition (CON), participants attended school as normal with no physical activity intervention. On days 2 and 3 of both STD-WLK and CON, a baseline capillary blood sample was provided to determine fasting [TAG] and [glucose]. Participants then consumed a standardized breakfast (0 h) and lunch (4.7 h), and blood samples were provided postprandially at 2.7, 5.3, and 7.3 h for [TAG] and [glucose]. RESULTS: Energy expenditure was 28% (95% confidence interval = 8% to 52%) higher during school hours on day 1 and day 2 during STD-WLK compared with CON (2171 vs 1693 kJ; effect size = 0.89, P = 0.008). However, no reduction of fasting or postprandial [TAG] or [glucose] was observed on day 2 or day 3 ( P ≥ 0.245). CONCLUSIONS: Two consecutive days of breaking prolonged sitting with self-paced walking and intermittent standing had no meaningful effect on postprandial metabolism in adolescent girls.

Intra-cavity dark pulse generation through synchronized sum-frequency mixing.

A Nd:YVO4 laser operating at 1064 nm generating a stable mode-locked train of 10 ps-long dark pulses with a 211 MHz repetition rate is presented. The mode-locking relies on a periodic loss modulation produced by intra-cavity sum-frequency mixing with a synchronous bright-pulse train from a mode-locked femtosecond Yb:KYW laser at 1040 nm. A modulation depth of 90% was achieved for the dark pulses, confirmed by cross-correlation measurements. The ultrafast loss modulation injects power into the Nd:YVO4 laser cavity modes beyond the laser gain bandwidth. At proper laser cavity length, the detuning interaction of these modes with the lasing modes leads to the generation of periodic ultrafast transients at frequencies above 1.5 THz.

Room temperature photon-counting lidar at 3 µm.

A midinfrared single-photon-counting lidar at 3 µm is presented. The 3 µm photons were upconverted to 790 nm in a periodically poled rubidium-doped KTiOPO4 crystal through intracavity mixing inside a 1064 nm Nd:YVO4 laser and detected using a conventional silicon single-photon avalanche detector (SPAD). The lidar system could distinguish 1 mm deep features on a diffusely reflecting target, limited by the SPAD and time-tagging electronics. This technique could easily be extended to longer wavelengths within the transparency of the nonlinear crystal.

Understanding Information Needs and Barriers to Accessing Health Information Across All Stages of Pregnancy: Systematic Review.

BACKGROUND: Understanding consumers' health information needs across all stages of the pregnancy trajectory is crucial to the development of mechanisms that allow them to retrieve high-quality, customized, and layperson-friendly health information. OBJECTIVE: The objective of this study was to identify research gaps in pregnancy-related consumer information needs and available information from different sources. METHODS: We conducted a systematic review of CINAHL, Cochrane, PubMed, and Web of Science for relevant articles that were published from 2009 to 2019. The quality of the included articles was assessed using the Critical Appraisal Skills Program. A descriptive data analysis was performed on these articles. Based on the review result, we developed the Pregnancy Information Needs Ontology (PINO) and made it publicly available in GitHub and BioPortal. RESULTS: A total of 33 articles from 9 countries met the inclusion criteria for this review, of which the majority were published no earlier than 2016. Most studies were either descriptive (9/33, 27%), interviews (7/33, 21%), or surveys/questionnaires (7/33, 21%); 20 articles mentioned consumers' pregnancy-related information needs. Half (9/18, 50%) of the human-subject studies were conducted in the United States. More than a third (13/33, 39%) of all studies focused on during-pregnancy stage; only one study (1/33, 3%) was about all stages of pregnancy. The most frequent consumer information needs were related to labor delivery (9/20, 45%), medication in pregnancy (6/20, 30%), newborn care (5/20, 25%), and lab tests (6/20, 30%). The most frequently available source of information was the internet (15/24, 63%). PINO consists of 267 classes, 555 axioms, and 271 subclass relationships. CONCLUSIONS: Only a few articles assessed the barriers to access to pregnancy-related information and the quality of each source of information; further work is needed. Future work is also needed to address the gaps between the information needed and the information available.

Effect of Changing Match Format from Halves to Quarters on the Performance Characteristics of Male University Field Hockey Players.

The study examined whether the performance characteristics of male university field hockey players differed when the match format was 2 × 35 min halves compared to 2 × 2 × 17.5 min quarters. Thirty-five male university field hockey players (age 21.2 ± 3.0 years, height 1.81 ± 0.07 m, body mass 75.1 ± 8.9 kg), competing at national level in the UK, were monitored over 52 matches played across the 2018-2019 (2 × 35 min halves) and 2019-2020 (2 × 2 × 17.5 min quarters) seasons using 15 Hz Global Positioning System units and heart rate monitors. Total distance, high-speed running distance (≥15.5 km·h-1), accelerations (≥2 m·s-1), decelerations (≤-2 m·s-1), average heart rate and percentage of time spent at >85% of maximum heart rate were recorded during both match formats. Two-level random intercept hierarchal models (Match-level 1, Player-level 2) suggested that the change in format from 2 × 35 min halves (2018-2019 season) to 2 × 2 × 17.5 min quarters (2019-2020 season) resulted in a reduction in total distance and high-speed running distance completed during a match (by 221 m and 120 m, respectively, both p < 0.001). As no significant cross-level interactions were observed (between season and half), the change from 35 min halves to 17.5 min quarters did not attenuate the reduced physical performance evident during the second half of matches (total distance: -235 m less in second half; high-speed running distance: -70 m less in second half; both p < 0.001). Overall, the findings suggest that the change in match format did alter the performance characteristics of male university field hockey players, but the quarter format actually reduced the total distance and high-speed running distance completed during matches, and did not attenuate the reduction in performance seen during the second half of matches.

Assessing the Use and Perception of Dietary Supplements Among Obese Patients with National Health and Nutrition Examination Survey.

Complementary alternative medicine, especially dietary supplements (DS), has gained increasing popularity for weight loss due to its availability without prescription, price, and ease of use. Besides weight loss, there are various perceived, potential benefits linked to DS use. However, health consumers with limited health literacy may not adequately know the benefits and risk of overdose for DS. In this project, we aim to gain a better understanding of the use of DS products among obese people as well as the perceived benefits of these products. We identified obese adults after combining the National Health and Nutrition Examination Survey data collected from 2003 to 2014. We found that there is a knowledge gap between the reported benefits of major DS by obese adults and the existing DS knowledge base and label database. This gap may inform the design of patient education material on DS usage in the future.

Short Sprints Accumulated at School Modulate Postprandial Metabolism in Boys.

INTRODUCTION: This study examined the efficacy of maximal sprint running accumulated during a typical school day to modulate postprandial metabolism in adolescent boys. METHODS: Nineteen adolescent boys completed three 2-d experimental conditions: a standard-practice control (CON), an accumulated in-school sprint running (ACC), and a single block of afterschool sprint running (BLO). On day 1, a fasting capillary blood sample was taken at 0735 h in the school. Three subsequent postprandial blood samples were taken at predetermined times after consumption of standardized breakfast and lunch. During ACC, participants accumulated four sets of 10 × 30-m maximal-intensity sprint runs across natural breaks in lessons. During BLO, participants performed the same number of sprints (40) in a single after-school exercise session. The blood samples from day 1 were replicated on the day after exercise (day 2). RESULTS: On day 1, no significant differences in total area under the plasma triacylglycerol concentration versus time curve (TAUC-TAG) were observed between conditions (P = 0.126). However, TAUC-insulin was lower in ACC compared with BLO (-26%, effect size [ES] = 0.86, P = 0.001) and CON (-22%, ES = 0.72, P = 0.010). On day 2, TAUC-TAG was 12% lower after ACC (ES = 0.49; P = 0.002) and 10% lower after BLO (ES = 0.37; P = 0.019) compared with CON. No significant differences were observed between conditions on day 2 for postprandial insulin or glucose (P ≥ 0.738). CONCLUSION: Four sets of 10 × 30-m sprints, accumulated in four separate bouts (<5 min) during the school day, reduced postprandial triacylglycerol and insulin concentrations in adolescent boys and may represent an effective in-school exercise strategy to promote metabolic health.

Exploring the Discrepancies in Actual and Perceived Benefits of Dietary Supplements Among Obese Patients.

Dietary supplements (DSs) have gained increased popularity for weight loss due to its availability without prescription, relatively low price, and ease of use. Consumers with limited health literacy may not adequately know the benefits and risks associated with DSs. In this project, we found a knowledge gap between reported benefits of major DSs by adults with obesity in the National Health and Nutrition Examination Survey 2003-2014 and those reported in existing DS knowledge databases.