Hospital trainees' worries, perceived sufficiency of information and reported psychological health during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has been unsurpassed in clinical severity or infectivity since the 1918 Spanish influenza pandemic and continues to impact the world. During the A/H1N1 pandemic, healthcare workers presented concerns regarding their own and their families' health, as well as high levels of psychological distress. We aim to assess hospital trainees' concerns, perceived sufficiency of information, behaviour and reported psychological health during the COVID-19 pandemic. DESIGN: Single 39-point questionnaire. SETTING: A large NHS foundation trust in London. PARTICIPANTS: 204 hospital trainee doctors. RESULTS: 204 trainees participated, of whom 91.7% (n=187) looked after COVID-19 patients. 91.6% (n=164) were worried about COVID-19; the most frequent concern was that of family and friends dying from COVID-19 (74.6%, n=126). 22.2% (n=36) reported being infected with COVID-19. 6.8% (n=11) of trainees considered avoiding going to work. Perceived sufficiency of information about COVID-19 was moderately high. 25.9% (n=42) reported social distancing at work compared with 94.4% (n=152) outside work. 98.2% (n=159) reported using PPE and 24.7% (n=40) were confident the provided PPE protected them. 41.9% (n=67) reported their psychological health had been adversely affected. 95.6% (n=153) supported provision of psychological support services and 62.5% (n=100) stated they would consider using them. CONCLUSIONS: A significant proportion of hospital trainees expressed worries about COVID-19, above all with regards to the wellbeing of their loved ones over their own. Confidence in sufficiency of provided information was high and in utilised infection control measures low. A larger proportion of trainees reported psychological as compared with physical health concerns, with a smaller proportion confirming having been infected with COVID-19 although most perceived their risk of infection as high. Seeking solutions to support hospital trainees in their duties and their wellbeing with their input would help to empower them and improve their health and morale while working during pandemics.

Impact of plant growth promoting rhizobacteria on different forms of soil potassium under wheat cultivation.

This study aimed to investigate the effect of some plant growth promoting rhizobacteria with potassium dissolution ability on different forms of potassium in soil under the cultivation of wheat. The factorial experiment was conducted as a randomized complete design with three replications in greenhouse conditions. The treatments consisted of bacterium inoculation (without inoculation, Enterobacter cloacae Rhizo_33, Pseudomonas sp. Rhizo_9, consortium of Enterobacter cloacae Rhizo_33 and Pseudomonas sp. Rhizo_9), potassium application (2·87 mg K kg-1 of soil and without potassium application).The results indicated that soils treated with Enterobacter cloacae Rhizo_33, either receiving potassium or not, maintain a higher amount of exchangeable K (337 mg kg-1 ) and water-soluble K (1·25 and 1·31 meq L-1 with and without K application respectively). The nonexchangeable K and nitric acid-extractable K values were decreased by inoculating bacterial strains. The grain yield was significantly enhanced by the inoculation of bacterial strains irrespective of rates of potassium application. About 19·16% increase of grain yield was recorded by inoculation of Enterobacter cloacae Rhizo_33 and without potassium application. A significantly greater amount of K uptake in grain was obtained in soils treated with Enterobacter cloacae Rhizo_33, with and without the application of potassium (28·7 and 30·7 mg per pot respectively). There was a significant (P < 0·01) and positive correlation between grain yield and grain, shoot and root K uptake. Potassium uptake had a positive significant correlation with water-soluble K and exchangeable K; it was negatively correlated with K (HNO3 ). The data suggested that inoculation of soil with mentioned bacteria can improve plant growth and potassium uptake. SIGNIFICANCE AND IMPACT OF THE STUDY: As one of the macronutrients, Potassium is the most abundant absorbed cation in most plants and exists in soil in different forms. Soluble and exchangeable forms of potassium (K) are important with regard to plant uptake. K-solubilizing bacteria can convert insoluble potassium to soluble forms; therefore using K-solubilizing bacteria as biofertilizers is a sustainable solution for the improvement of plant growth, nutrition, root growth, plant competitiveness and reducing the use of potassium chemical fertilizer.

Reliability and Validity Testing of the Persian Version of the Derriford Appearance Scale 24 in a Sample of Individuals with Craniofacial Irregularity and Amputation.

BACKGROUND: Despite the recent advancements in the design and manufacture of prostheses for individuals with craniofacial irregularity and amputation, these individuals tend to become self-conscious about their appearance. The aim of this study was to investigate the reliability and validity of Persian version of the Derriford Appearance Scale24 (P-DAS24) for a sample of individuals with craniofacial irregularity and limb loss. METHODOLOGY: Reliability of the P-DAS24 was determined by computing internal consistency and test-retest reliability utilizing Cronbach's alpha coefficient and Pearson's correlation coefficient. Discriminant validity was investigated with comparing the total score of the P-DAS24 between disfigured participants and those with no appearance problem. Known-groups validity was evaluated regarding the participants' gender and their level of involvement. FINDINGS: The sample size comprised of 251 individuals with disfigurement and 101 without disfigurement who were deemed normal in appearance. The P-DAS24 showed satisfactory internal consistency (Cronbach's alpha = 0.89) and excellent test-retest reliability (r = 0.96). The total score of the P-DAS24 showed a statistically significant difference between individuals deemed disfigured or normal (P=0.01). The total scores P-DAS24 in individuals with different levels of involvement were significantly different (P<0.001). The scores of the DAS2, DAS18, DAS21, and DAS24 were significantly different between men and women (P<0.01, <0.01, 0.03, and 0.01, respectively). CONCLUSION: The P-DAS24 is a valid and reliable tool that may be utilized in clinical practice and researches to assess the outcomes of prosthetic reconstructions in individuals with disfigurement.

Effects of flushing and hormonal treatment on reproductive performance of Iranian Markhoz goats.

Forty-eight Iranian Markhoz goats were allocated to six groups (n = 8) to study the effect of flushing and hormonal treatments on reproductive performance. Treatments were divided into two categories including, hormonal treatments and flushing. The goats in each group were fed the same basal ration and received one of the following treatments: Groups A and B--injection of GnRH and equine chorionic gonadotropin (eCG) respectively; Groups C, D and E--a supplement of barley grain, soybean oil and sunflower oil in flushing diets, respectively, were offered and Group F--control (only received basal diet). In the flushing treatments, only the source of energy was different between rations. Both hormonal treatments and flushing treatments improved fertility and kidding rates. Treatment B with 16 and control with seven kids represented the highest and the lowest number of progeny respectively. Among flushing treatments, group C resulted in the highest number of kids being 15. Oestrogen levels in follicular phase increased with the injection of eCG and consumption of barley grain. GnRH injection and consumption of oil sources in the diet increased blood progesterone levels during ovulation and post-ovulation periods. Under current market conditions, using hormone or flushing can be profitable for Markhoz goats farmers.

Identifying priority core habitats and corridors for effective conservation of brown bears in Iran.

Iran lies at the southernmost range limit of brown bears globally. Therefore, understanding the habitat associations and patterns of population connectivity for brown bears in Iran is relevant for the species' conservation. We applied species distribution modeling to predict habitat suitability and connectivity modeling to identify population core areas and corridors. Our results showed that forest density, topographical roughness, NDVI and human footprint were the most influential variables in predicting brown bear distribution. The most crucial core areas and corridor networks for brown bear are concentrated in the Alborz and Zagros Mountains. These two core areas were predicted to be fragmented into a total of fifteen isolated patches if dispersal of brown bear across the landscape is limited to 50,000 cost units, and aggregates into two isolated habitat patches if the species is capable of dispersing 400,000 cost units. We found low overlap between corridors, and core habitats with protected areas, suggesting that the existing protected area network may not be adequate for the conservation of brown bear in Iran. Our results suggest that effective conservation of brown bears in Iran requires protection of both core habitats and the corridors between them, especially outside Iran's network of protected areas.

Study of imidaclopride removal from aqueous solution by adsorption onto granular activated carbon using an on-line spectrophotometric analysis system.

The removal of imidaclopride as a pesticide by granular activated carbon (GAC) and its adsorption kinetics were studied at different pH values and temperatures. In all experiments, the amount of GAC and initial concentration of imidaclopride were 2g and 25 ppm, respectively. The adsorption process was followed by an on-line spectrophotometric analysis system, which consisted of UV-spectrophotometer, a designed absorption cell, peristaltic pump and special glassy reactor. The effect of pH and temperature on adsorption was studied over 90 min adsorption periods. The obtained data were treated according to various kinetic models. The results showed that second order model was the most suitable one on the overall. The our results also showed that the adsorption rate constants for first order, second order and intraparticle diffusion models followed decreasing order: pH=7>4>10>1, T=25>35>45>55 degrees C.

Daily bread: a novel vehicle for dissemination and evaluation of psychological first aid for families exposed to armed conflict in Syria.

BACKGROUND: Risks to the mental health of children and families exposed to conflict in Syria are of such magnitude that research identifying how best to deliver psychological first aid is urgently required. This study tested the feasibility of a novel approach to large-scale distribution of information and data collection. METHODS: Routine humanitarian deliveries of bread by a bakery run by a non-governmental organisation (NGO) were used to distribute parenting information leaflets and questionnaires to adults looking after children in conflict zones inside Syria. Study materials were emailed to a project worker in Turkey. Leaflets and questionnaires requesting feedback were transported alongside supplies to a bakery in Syria, and then packed with flatbreads. Three thousand bread-packs were distributed, from three distribution points to which questionnaires were returned, and then taken to Turkey and dispatched to the UK. FINDINGS: Notwithstanding delays, 3000 leaflets and questionnaires were successfully distributed over 2 days. Questionnaire return yielded 1783 responses, a 59.5% return rate. Overall ratings of the usefulness of the leaflet were 1060 (59.5%) 'quite a lot' and 339 (19.0%) 'a great deal'. Content analysis was used to code 400 respondent comments. Four themes emerged; positive comments about the leaflet, suggestions for modifications, descriptions of children's needs and the value respondents placed on faith. INTERPRETATION: Findings indicate the willingness of NGO staff and volunteers to assist in research, the remarkable willingness of caregivers to respond and the value of brief advice. It demonstrates the scope for using existing humanitarian routes to distribute information and receive feedback even in high-risk settings.

Intracerebral rhabdoid and papillary meningioma with leptomeningeal spread and rapid clinical progression.

OBJECTIVE AND IMPORTANCE: Rhabdoid meningioma (RM) is a relatively new, Grade III tumor entity according to the latest WHO classification. We report rhabdoid and partly papillary, highly anaplastic, intracerebral meningioma with diffuse leptomeningeal spread and distant SCF metastasis to the cervical cord. CLINICAL PRESENTATION: This 27-year-old female was admitted to the hospital with radiological findings suggestive of a primary brain tumor or a metastasis. After subtotal resection and during radiotherapy, follow-up MRI revealed recurrence, metastasis to meninges at the high cervical level, and diffuse basal leptomeningeal enhancement indicating infiltrating tumor. She died approximately 3 months after onset of symptoms. RESULTS: Histological examination revealed rhabdoid and papillary meningioma with high proliferation rate (80% of MIB1-positive cells), necrosis and extensive brain invasion. It was positive for vimentin and S-100 protein, showed focal epithelial membrane antigen expression and accumulation of intermediate filaments on ultrastructural examination. The recurrent tumor diffusely infiltrated leptomeninges and subarachnoid space. CONCLUSION: This is a rare example of mixed, rhabdoid and papillary variant of meningioma, located entirely within the brain parenchyma and accompanied by a fulminant clinical course. The combination of the histological anaplasia with the highest reported proliferation rate, and loss of the cohesion of neoplastic cells led to diffused infiltration of the leptomeninges and metastasis to the spinal cord.

Establishing the feasibility of assessing the mental health of children displaced by the Syrian conflict.

BACKGROUND: In the humanitarian crisis context of conflict zones, collecting data is essential for identifying and addressing the mental health needs of refugee children to avoid mass suffering. This study tested the feasibility of recruiting refugees caring for children and using established and brief parent-report questionnaires in a challenging context to collect mental health data on refugee children displaced by Syria's conflict. METHODS: Caregivers of 4-10-year olds attending primary schools run by non-governmental organisation (NGO) Generation Freedom in and near refugee camps on the Syrian-Turkish border were invited to complete the Pediatric Emotional Distress Scale (PEDS) and Strengths and Difficulties Questionnaire (SDQ). RESULTS: It was possible to reach 144 adult refugees caring for children with research participation information and use informed consent procedures. A total of 106 caregivers completed the questionnaires yielding a good return rate (74%). Eighty-two (77.4%) caregivers had complete data on the PEDS and 61 (57.5%) on the SDQ. Almost half (49%) of the children met the clinical cut-off for being anxious/withdrawn and 62% for being fearful rated using the PEDS and 45% for SDQ rated emotional symptoms. More than a third had clinical levels of behavioural problems on both scales. CONCLUSIONS: It proved feasible to collect child mental health data in challenging conditions in the context of the Syrian crisis with support from a local NGO providing humanitarian assistance. The PEDS performed better than the SDQ in this context. High levels of emotional distress and behavioural problems in children reiterate the urgent need for evidence-based psychosocial support.

Intrasilicone oil injection of bevacizumab at the end of retinal reattachment surgery for severe proliferative vitreoretinopathy.

PURPOSE: To evaluate the role of bevacizumab injected into the silicone oil at the end of retinal reattachment surgery for rhegmatogenous retinal detachment (RRD) associated with severe proliferative vitreoretinopathy (PVR) for prevention of postoperative PVR and compare the results with those without intrasilicone injection. METHODS: In this prospective comparative interventional study, eyes with RRD with grade C PVR were included. Standard 20 gauge pars plana vitrectomy, and retinal reattachment was performed. In case group, 1.25 mg bevacizumab was injected into the silicone oil at the end of surgery. The rate of retinal redetachment associated with PVR was assessed. RESULTS: In all 38 eyes of 38 patients (19 cases and 19 controls) with a mean age of 46.6 ± 18.3 years were studied. The two groups were matched for age, sex, preoperative visual acuity, presence of anterior and posterior PVR, extent of PVR, and history of previous retinal detachment surgery. Retinal redetachment with PVR occurred in nine (47.3%) and seven (36.8%) eyes in case and control groups, respectively (P=0.5). Extensive subretinal fibrous proliferations in addition to preretinal membranes occurred more in the case group (55.5 vs 14.3%). At final visit, visual acuity was similar between the two groups (1.6 ± 0.8 and 1.6 ± 0.6, respectively, P=0.9). CONCLUSION: Intrasilicone injection of bevacizumab at the end of vitrectomy for RRD with severe PVR does not eliminate the risk of postoperative PVR.

Photodynamic inactivation of drug-resistant bacteria isolated from diabetic foot ulcers.

BACKGROUND AND OBJECTIVES: Due to the extensive use of antibiotics, the spread of drug-resistant bacteria is one of the most worrisome threats to public health. One strategy that can be used to overcome potential shortcomings might be the inactivation of these organisms by photodynamic therapy. In this study, we have investigated whether drug-resistant wound-associated organisms (Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli) are sensitive to lethal photosensitization using the dye methylene blue coupled with laser light of 660 nm. MATERIALS AND METHODS: Effect of photosensitizer concentration (25, 50, 100 µg/ml) and laser light dose (27.3, 54.6 and 109.2 J/cm(2)) on lethal photosensitization was investigated. RESULTS: All species were susceptible to killing by photodynamic inactivation. The bactericidal effect was not dependent on the concentration of methylene blue but it was dependent on the light dose. Methylene blue photosensitization using red laser light (109.2 J/cm(2)) was able to achieve reductions of 99.03% and 98.95% in the viable counts of S. aureus and S. epidermidis (using starting concentrations of 10(4)-10(5) CFU/ml). Eradication of 92.23% were obtained for E. coli (initial concentration 10(4)-10(5) CFU/ml) photosensitized by the red light (109.2 J/cm(2)). CONCLUSION: These findings imply that MB in combination with red light may be an effective means of eradicating drug- resistant bacteria from wounds.