Study of GaN coalescence by dark-field X-ray microscopy at the nanoscale.

This work illustrates the potential of dark-field X-ray microscopy (DFXM), a 3D imaging technique of nanostructures, in characterizing novel epitaxial structures of gallium nitride (GaN) on top of GaN/AlN/Si/SiO2 nano-pillars for optoelectronic applications. The nano-pillars are intended to allow independent GaN nanostructures to coalesce into a highly oriented film due to the SiO2 layer becoming soft at the GaN growth temperature. DFXM is demonstrated on different types of samples at the nanoscale and the results show that extremely well oriented lines of GaN (standard deviation of 0.04°) as well as highly oriented material for zones up to 10 × 10 µm2 in area are achieved with this growth approach. At a macroscale, high-intensity X-ray diffraction is used to show that the coalescence of GaN pyramids causes misorientation of the silicon in the nano-pillars, implying that the growth occurs as intended (i.e. that pillars rotate during coalescence). These two diffraction methods demonstrate the great promise of this growth approach for micro-displays and micro-LEDs, which require small islands of high-quality GaN material, and offer a new way to enrich the fundamental understanding of optoelectronically relevant materials at the highest spatial resolution.

Neurological and Neuropsychological Changes Associated with SARS-CoV-2 Infection: New Observations, New Mechanisms.

SARS-CoV-2 infects cells through angiotensin-converting enzyme 2 (ACE2), a ubiquitous receptor that interacts with the virus' surface S glycoprotein. Recent reports show that the virus affects the central nervous system (CNS) with symptoms and complications that include dizziness, altered consciousness, encephalitis, and even stroke. These can immerge as indirect immune effects due to increased cytokine production or via direct viral entry into brain tissue. The latter is possible through neuronal access via the olfactory bulb, hematogenous access through immune cells or directly across the blood-brain barrier (BBB), and through the brain's circumventricular organs characterized by their extensive and highly permeable capillaries. Last, the COVID-19 pandemic increases stress, depression, and anxiety within infected individuals, those in isolation, and high-risk populations like children, the elderly, and health workers. This review surveys the recent updates of CNS manifestations post SARS-CoV-2 infection along with possible mechanisms that lead to them.

Educational benefits of the online journal club: A systematic review.

INTRODUCTION: Online journal clubs (JCs) have increased during the COVID-19 pandemic with the resulting social distancing and popularity of online platforms. This systematic review aims to explore current evidence of their use/benefits for clinicians and compare their value to face-to-face (F2F) JCs. METHODS: PubMed, Web of Science, and Scopus were searched systematically, adhering to PRISMA guidelines. Articles were included if they involved clinicians in medical/surgical populations, using an online JC assessing utility, experience and educational value. Quality assessment was undertaken using MERSQI. RESULTS: Fifteen studies were included with findings synthesised into five themes: critical appraisal skills, satisfaction/value, accessibility/environment, evidence-based practice, and preference of online JC. Studies revealed high satisfaction and equivocal or increased preference of online JCs compared to F2F due to ease of access, diverse participation, and less time/cost spent travelling. Online JCs were found to be educationally valuable, aiding development of critical appraisal skills, and promoting change in practice. Disadvantages included lack of discussion intensity, technical issues, and limited interaction on some platforms. DISCUSSION: Online JCs are educationally valuable with high satisfaction rates and distinct advantages/disadvantages to F2F JCs. More high-quality studies are required to elucidate the ideal format to further improve their educational value, utility, and adoption.

Repurposing Ivermectin for COVID-19: Molecular Aspects and Therapeutic Possibilities.

As of January 2021, SARS-CoV-2 has killed over 2 million individuals across the world. As such, there is an urgent need for vaccines and therapeutics to reduce the burden of COVID-19. Several vaccines, including mRNA, vector-based vaccines, and inactivated vaccines, have been approved for emergency use in various countries. However, the slow roll-out of vaccines and insufficient global supply remains a challenge to turn the tide of the pandemic. Moreover, vaccines are important tools for preventing the disease but therapeutic tools to treat patients are also needed. As such, since the beginning of the pandemic, repurposed FDA-approved drugs have been sought as potential therapeutic options for COVID-19 due to their known safety profiles and potential anti-viral effects. One of these drugs is ivermectin (IVM), an antiparasitic drug created in the 1970s. IVM later exerted antiviral activity against various viruses including SARS-CoV-2. In this review, we delineate the story of how this antiparasitic drug was eventually identified as a potential treatment option for COVID-19. We review SARS-CoV-2 lifecycle, the role of the nucleocapsid protein, the turning points in past research that provided initial 'hints' for IVM's antiviral activity and its molecular mechanism of action- and finally, we culminate with the current clinical findings.

Improving the use of treatment escalation plans: a quality-improvement study.

OBJECTIVES: Treatment escalation plans (TEPs) are vital in communicating a ceiling of care. However, many patients still deteriorate and die without a pre-established ceiling of care for attending clinicians to rely on. We aimed to increase the proportion of suitable patients that have TEPs in place in a rural district general hospital. METHODS: We undertook three 'Plan-Do-Study-Act' (PDSA) cycles between 1 December 2016 and 9 June 2017. These cycles aimed to assess the problem, implement a solution and monitor its sustainability. We sampled all acute medical admissions at different time points, focusing on the acute medical unit. We identified patients requiring TEP forms using SupportiveandPalliative Care Indicators Tool. Stakeholders were surveyed during the project, and a process communication map was developed to understand the human interfaces that occur when producing a TEP. RESULTS: We sampled a total of 323 patients (PDSA 1, n=128; PDSA 2, n=95; PDSA 3, n=100). Following implementation of a 'talking to your doctor about treatment' leaflet, the proportion of patients who did not have a TEP but required one fell from 43% (n=38, PDSA 1) to 27% (n=20, PDSA 3) then to 23% (n=77, PDSA 3) (CI 0.6631 to 39.917, p=0.028). CONCLUSIONS: This study highlights the challenges of TEP form completion. The impact of our intervention appeared to raise awareness of advanced care planning. The information contained in our leaflet could be distributed in more innovative ways to ensure patients unable to access textual information are able to receive this message.