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.

Evaluating parent and public involvement activities within a paediatric palliative care research centre: Route map to impactful and meaningful engagement.

BACKGROUND: Patient and Public Involvement (PPI) is an important component of healthcare research. Conducting PPI within paediatric palliative care research requires specific ethical and practical considerations. Regular reviews of PPI activity are important. AIM: To evaluate a paediatric palliative care research centre's PPI activity to determine what went well, or less well; and how future activities can be improved. DESIGN: Two stage evaluation: first a review of PPI study logs; second a qualitative exploration using a survey, structured interviews and a focus group. Data were analysed thematically. SETTINGS/PARTICIPANTS: Parents of children with life-limiting conditions, bereaved parents and researchers, all engaged in PPI activity within a paediatric palliative care research centre. FINDINGS: The review of PPI logs for 15 studies highlighted the crucial role of funding in enabling PPI throughout the research. Eight parents completed the survey, 4 parents were interviewed and 12 researchers participated in a focus group. Three themes were developed: Clarity of processes and purpose; balanced relationships created a safe space; and mutual respect and value for PPI. These themes highlight what is working well within the Centre's approach to PPI and the opportunities to improve. CONCLUSIONS: To undertake meaningful PPI in paediatric palliative care research, adequate time and resources are required. Roles, processes and expectations must be explicitly agreed. Establishing relationships ensures trust and enables authenticity and vulnerability. In addition to improving research, PPI has personal benefits for researchers and parents. The evaluation led to the development of a 'route map' for establishing an impactful PPI group for paediatric palliative care research.

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.

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.

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.

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.

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.

Safety and toxicity of combined oclacitinib and carboplatin or doxorubicin in dogs with solid tumors: a pilot study.

BACKGROUND: Oclacitinib is an orally bioavailable Janus Kinase (JAK) inhibitor approved for the treatment of canine atopic dermatitis. Aberrant JAK/ Signal Transducer and Activator of Transcription (STAT) signaling within hematologic and solid tumors has been implicated as a driver of tumor growth through effects on the local microenvironment, enhancing angiogenesis, immune suppression, among others. A combination of JAK/STAT inhibition with cytotoxic chemotherapy may therefore result in synergistic anti-cancer activity, however there is concern for enhanced toxicities. The purpose of this study was to evaluate the safety profile of oclacitinib given in combination with either carboplatin or doxorubicin in tumor-bearing dogs. RESULT: Oclacitinib was administered at the label dose of 0.4-0.6 mg/kg PO q12h in combination with either carboplatin at 250-300 mg/m2 or doxorubicin at 30 mg/m2 IV q21d. Nine dogs were enrolled in this pilot study (n = 4 carboplatin; n = 5 doxorubicin). No unexpected toxicities occurred, and the incidence of adverse events with combination therapy was not increased beyond that expected in dogs treated with single agent chemotherapy. Serious adverse events included one Grade 4 thrombocytopenia and one Grade 4 neutropenia. No objective responses were noted. CONCLUSIONS: Oclacitinib is well tolerated when given in combination with carboplatin or doxorubicin. Future work is needed to explore whether efficacy is enhanced in this setting.

Sex differences in postprandial lipaemia after acute high-intensity interval running in young people.

Acute exercise reduces postprandial triacylglycerol concentrations ([TAG]) in boys and girls; however, it is not known whether between-sex differences exist in response to exercise. Fifteen boys (mean(SD): 11.8(0.4) years) and sixteen girls (12.1(0.7) years) completed two, 2-day conditions. On day 1, participants rested (CON) or completed 10 × 1 min high-intensity interval runs at 100% maximal aerobic speed with 1 min recovery (HIIR). On day 2, participants consumed a standardised breakfast and lunch over a 6.5-h period during which seven capillary blood samples were collected. Based on ratios of the geometric means (95% CI for ratios), fasting [TAG] was 32% lower in boys than girls (-44 to -18%, ES = 1.31, P < 0.001), and 12% lower after HIIR than CON (-18 to -5%, ES = 0.42, P = 0.003); the magnitude of reduction was not significantly different between the sexes (8% (ES = 0.36) vs. 15% (ES = 0.47), respectively; P = 0.29). The total area under the [TAG] versus time curve was 27% lower in boys than girls (-40 to -10%, ES = 1.02, P = 0.005), and 10% lower after HIIR than CON (-16 to -5%, ES = 0.36, P = 0.001); the magnitude of reduction was similar between the sexes (11% (ES = 0.43) vs. 10% (ES = 0.31), respectively; P = 0.87). The small-moderate reduction in postprandial [TAG] after HIIR was similar between the sexes.

Oxygen Saturation Measurements from Green and Orange Illuminations of Multi-Wavelength Optoelectronic Patch Sensors.

Photoplethysmography (PPG) based pulse oximetry devices normally use red and infrared illuminations to obtain oxygen saturation (SpO2) readings. In addition, the presence of motion artefacts severely restricts the utility of pulse oximetry physiological measurements. In the current study, a combination of green and orange illuminations from a multi-wavelength optoelectronic patch sensor (mOEPS) was investigated in order to improve robustness to subjects' movements in the extraction of SpO2 measurement. The experimental protocol with 31 healthy subjects was divided into two sub-protocols, and was designed to determine SpO2 measurement. The datasets for the first sub-protocol were collected from 15 subjects at rest, with the subjects free to move their hands. The datasets for the second sub-protocol with 16 subjects were collected during cycling and walking exercises. The results showed good agreement with SpO2 measurements (r = 0.98) in both sub-protocols. The outcomes promise a robust and cost-effective approach of physiological monitoring with the prospect of providing health monitoring that does not restrict user physical movements.

MicroRNA profiling of dogs with transitional cell carcinoma of the bladder using blood and urine samples.

BACKGROUND: Early signs of canine transitional cell carcinoma (TCC) are frequently assumed to be caused by other lower urinary tract diseases (LUTD) such as urinary tract infections, resulting in late diagnosis of TCC which could be fatal. The development of a non-invasive clinical test for TCC could dramatically reduce mortality. To determine whether microRNAs (miRNAs) can be used as non-invasive diagnostic biomarkers, we assessed miRNA expression in blood and/or urine from dogs with clinically normal bladders (n = 28), LUTD (n = 25), and TCC (n = 17). Expression levels of 5 miRNA associated with TCC pathophysiology (miR-34a, let-7c, miR-16, miR-103b, and miR-106b) were assessed by quantitative real-time PCR. RESULTS: Statistical analyses using ranked ANOVA identified significant differences in miR-103b and miR-16 levels between urine samples from LUTD and TCC patients (miR-103b, p = 0.002; and miR-16, p = 0.016). No statistically significant differences in miRNA levels were observed between blood samples from LUTD versus TCC patients. Expression levels of miR-34a trended with miR-16, let-7c, and miR-103b levels in individual normal urine samples, however, this coordination was completely lost in TCC urine samples. In contrast, co-ordination of miR-34a, miR-16, let-7c, and miR-103b expression levels was maintained in blood samples from TCC patients. CONCLUSIONS: Our combined data indicate a potential role for miR-103b and miR-16 as diagnostic urine biomarkers for TCC, and that further investigation of miR-103b and miR-16 in the dysregulation of coordinated miRNA expression in bladder carcinogenesis is warranted.

Your teaching strategy matters: how engagement impacts application in health information literacy instruction.

OBJECTIVE: The purpose of this study was to compare two pedagogical methods, active learning and passive instruction, to determine which is more useful in helping students to achieve the learning outcomes in a one-hour research skills instructional session. METHODS: Two groups of high school students attended an instructional session to learn about consumer health resources and strategies to enhance their searching skills. The first group received passive instruction, and the second engaged in active learning. We assessed both groups' learning using 2 methods with differing complexity. A total of 59 students attended the instructional sessions (passive instruction, n=28; active learning, n=31). RESULTS: We found that the active learning group scored more favorably in four assessment categories. CONCLUSIONS: Active learning may help students engage with and develop a meaningful understanding of several resources in a single session. Moreover, when using a complex teaching strategy, librarians should be mindful to gauge learning using an equally complex assessment method.

Acute high-intensity interval rowing increases thrombin generation in healthy men.

PURPOSE: High-intensity exercise induces several health benefits, but may acutely and transiently increase the risk of cardiovascular events due to thrombotic changes promoting blood coagulation and thrombin formation. This study examined the effects of high-intensity exercise on plasma thrombin generation and triacylglycerol concentrations. METHODS: Sixteen healthy men completed two, 2-day conditions separated by 1 week. On day 1, participants rested (control) or completed four, 3-min high-intensity rowing intervals at an average rating of perceived exertion of 17 (exercise). Venous blood samples were collected pre- and post-intervention to determine plasma thrombin generation. On day 2, participants rested and consumed a glucose load (0 h) and high-fat meal (2 h). Fifteen venous blood samples were collected between 0 and 8 h to measure plasma thrombin generation and triacylglycerol concentrations. RESULTS: On day 1, lag time was shorter and peak thrombin and endogenous thrombin potential were greater in the exercise than control condition (ES ≥ 0.37, main effect condition P ≤ 0.03), and post-intervention compared with pre-intervention (ES ≥ 0.49, main effect time P ≤ 0.003). The magnitude of the post-intervention change was greater in the exercise than control condition for all thrombin generation parameters (condition by time interaction P ≤ 0.05). On day 2, no differences in postprandial thrombin generation parameters were seen between conditions (P ≥ 0.21). The total area under the curve for triacylglycerol was lower in the exercise than control condition (ES = 0.34, P = 0.02). CONCLUSION: An acute bout of high-intensity interval rowing increased plasma thrombin generation immediately after exercise, but these differences were eliminated 16-24 h after exercise.

Exercise intensity and postprandial health outcomes in adolescents.

PURPOSE: The effect of exercise intensity and sex on postprandial risk factors for cardiovascular disease in adolescents is unknown. We examined the effect of a single bout of work-matched high-intensity interval exercise (HIIE) and moderate-intensity exercise (MIE) on postprandial triacylglycerol (TAG) and systolic blood pressure (SBP) in adolescents. METHOD: Twenty adolescents (10 male, 14.3 ± 0.3 years) completed three 1-day trials: (1) rest (CON); (2) 8 × 1 min cycling at 90 % peak power with 75 s recovery (HIIE); (3) cycling at 90 % of the gas exchange threshold (MIE), 1 h before consuming a high-fat milkshake (1.50 g fat and 80 kJ kg(-1)). Postprandial TAG, SBP and fat oxidation were assessed over 4 h RESULTS: Compared to CON, the incremental area under the curve for TAG (IAUC-TAG) was not significantly lowered in HIIE [P = 0.22, effect size (ES) = 0.24] or MIE (P = 0.65, ES = 0.04) for boys. For girls, HIIE and MIE lowered IAUC-TAG by 34 % (P = 0.02, ES = 0.58) and 38 % (P = 0.09, ES = 0.73), respectively, with no difference between HIIE and MIE (P = 0.74, ES = 0.14). Changes in TAG were not related to energy expenditure during exercise or postprandial fat oxidation. Postprandial SBP (total-AUC pooled for both sexes) was lower in HIIE compared to CON (P = 0.01, ES = 0.68) and MIE (P = 0.02, ES = 0.60), with no difference between MIE and CON (P = 0.45, ES = 0.14). CONCLUSION: A single bout of HIIE and MIE, performed 1 h before an HFM, can meaningfully attenuate IAUC-TAG in girls but not boys. Additionally, HIIE, but not MIE, may lower postprandial SBP in normotensive adolescents.

Acute Effects of Energy Deficit Induced by Moderate-Intensity Exercise or Energy-Intake Restriction on Postprandial Lipemia in Healthy Girls.

Eleven healthy girls (mean ± SD: age 12.1 ± 0.6 years) completed three 2-day conditions in a counterbalanced, crossover design. On day 1, participants either walked at 60 (2)% peak oxygen uptake (energy deficit 1.55[0.20] MJ), restricted food energy intake (energy deficit 1.51[0.25] MJ) or rested. On day 2, capillary blood samples were taken at predetermined intervals throughout the 6.5 hr postprandial period before, and following, the ingestion of standardized breakfast and lunch meals. Fasting plasma triacylglycerol concentrations (TAG) was 29% and 13% lower than rest control in moderate-intensity exercise (effect size [ES] = 1.39, p = .01) and energy-intake restriction (ES = 0.57, p = .02) respectively; moderate-intensity exercise was 19% lower than energy-intake restriction (ES = 0.82, p = .06). The moderate-intensity exercise total area under the TAG versus time curve was 21% and 13% lower than rest control (ES = 0.71, p = .004) and energy-intake restriction (ES = 0.39, p = .06) respectively; energy-intake restriction was marginally lower than rest control (-10%; ES = 0.32, p = .12). An exercise-induced energy deficit elicited a greater reduction in fasting plasma TAG with a trend for a larger attenuation in postprandial plasma TAG than an isoenergetic diet-induced energy deficit in healthy girls.

Effect of repeated sprints on postprandial endothelial function and triacylglycerol concentrations in adolescent boys.

This study investigated whether repeated, very short duration sprints influenced endothelial function (indicated by flow-mediated dilation) and triacylglycerol concentrations following the ingestion of high-fat meals in adolescent boys. Nine adolescent boys completed two, 2-day main trials (control and exercise), in a counter-balanced, cross-over design. Participants were inactive on day 1 of the control trial but completed 40 × 6 s maximal cycle sprints on day 1 of the exercise trial. On day 2, capillary blood samples were collected and flow-mediated dilation measured prior to, and following, ingestion of a high-fat breakfast and lunch. Fasting flow-mediated dilation and plasma triacylglycerol concentration were similar in the control and exercise trial (P > 0.05). In the control trial, flow-mediated dilation was reduced by 20% and 27% following the high-fat breakfast and lunch; following exercise these reductions were negated (main effect trial, P < 0.05; interaction effect trial × time, P < 0.05). The total area under the plasma triacylglycerol concentration versus time curve was 13% lower on day 2 in the exercise trial compared to the control trial (8.65 (0.97) vs. 9.92 (1.16) mmol · l(-1) · 6.5 h, P < 0.05). These results demonstrate that repeated 6 s maximal cycle sprints can have beneficial effects on postprandial endothelial function and triacylglycerol concentrations in adolescent boys.

A multi-channel opto-electronic sensor to accurately monitor heart rate against motion artefact during exercise.

This study presents the use of a multi-channel opto-electronic sensor (OEPS) to effectively monitor critical physiological parameters whilst preventing motion artefact as increasingly demanded by personal healthcare. The aim of this work was to study how to capture the heart rate (HR) efficiently through a well-constructed OEPS and a 3-axis accelerometer with wireless communication. A protocol was designed to incorporate sitting, standing, walking, running and cycling. The datasets collected from these activities were processed to elaborate sport physiological effects. t-test, Bland-Altman Agreement (BAA), and correlation to evaluate the performance of the OEPS were used against Polar and Mio-Alpha HR monitors. No differences in the HR were found between OEPS, and either Polar or Mio-Alpha (both p > 0.05); a strong correlation was found between Polar and OEPS (r: 0.96, p < 0.001); the bias of BAA 0.85 bpm, the standard deviation (SD) 9.20 bpm, and the limits of agreement (LOA) from -17.18 bpm to +18.88 bpm. For the Mio-Alpha and OEPS, a strong correlation was found (r: 0.96, p < 0.001); the bias of BAA 1.63 bpm, SD 8.62 bpm, LOA from -15.27 bpm to +18.58 bpm. These results demonstrate the OEPS to be capable of carrying out real time and remote monitoring of heart rate.

Acute exercise and postprandial lipemia in young people.

Exaggerated postprandial triacylglycerol concentrations (TAG) independently predict future cardiovascular events. Acute exercise and diet interventions attenuate postprandial TAG in adults. This paper aims to examine the exercise postprandial lipemia studies published to date in young people. Nine studies satisfied the inclusion criteria adopted for this summary. The majority of studies are in boys (22% girls) and have shown a single ~60-min session of moderate-intensity exercise, performed 12-18 hours before a standardized meal, reduces postprandial TAG. Manipulations of exercise duration and intensity suggest an exercise energy expenditure dose-dependent response is not supported directly in healthy young people. Studies investigating alternative exercise bouts have reported lower postprandial TAG after simulated intermittent games activity, high-intensity interval running and cumulative 10-min blocks over several hours, which may appeal to the spontaneous physical activity habits of young people. Although extension of these initial findings is warranted, exercise may be an effective strategy to promote regular benefits in TAG metabolism in children and adolescents; this may contribute to an improved cardiovascular disease risk profile early in life.