Not all worries were created equal: the case of COVID-19 anxiety.

OBJECTIVES: The objective of this study was to investigate possible differences in COVID-19-related anxiety based on previous theories in social psychology. STUDY DESIGN: Cross-sectional online questionnaire delivered via the crowdworking platform. METHODS: Four-hundred and seven (120 men and 287 women) adults (aged >18 years) from the United Kingdom answered the State-Trait Anxiety Inventory 'in light of the COVID-19 situation', followed by three health and three financial anxiety items. RESULTS: Our findings imply that women are more anxious than men, people are more anxious about others than about themselves, their anxiety about relatives is higher than about strangers, and anxiety about health is higher than about financial issues. CONCLUSIONS: We suggest that these preliminary findings should be further investigated to help policymakers improve both their treatment of pandemic-related anxiety and their messages.

Absolute fluorescence quantum yield determined by photothermal deflection spectroscopy.

We present a spectroscopic method for measuring the fluorescence quantum efficiency [Formula: see text] of fluorophores that does not require calibration standards. Photothermal Deflection Spectroscopy (PDS) is combined with conventional absorbance spectroscopy, and [Formula: see text] is extracted from fits over the spectral range of interest. This technique obviates the need for multiple measurements-either on calibration standards or as a function of concentration-and yields results of [Formula: see text] in a single measurement consistent with previously reported values. Five different organic dyes are tested whose absorbance/fluorescence profiles span the visible spectrum and whose known quantum efficiencies range from 0 to near 1. The accuracy of the results over significant ranges of wavelength and quantum yield demonstrate the robustness and efficacy of this method.

A comparative evaluation of the Adaptive knee and Catech knee joints: a preliminary study.

The Adaptive knee joint is a microprocessor-controlled prosthetic knee that incorporates both pneumatic and hydraulic control in one electronic unit. Pneumatic control is said to provide control during swing phase and the hydraulic control during the stance phase of the gait. This hybrid controller is triggered by a computer contained within the knee that responds to input from force, time and angle sensors. The microprocessor then selects an appropriate speed and stability setting. The Catech knee joint is a conventional hydraulic knee joint. The aim of this study was to compare the Adaptive and Catech knee joints in established trans-femoral amputees. The patients meeting the inclusion criteria were all established trans-femoral amputees using the Catech knee joint. The study was carried out by performing gait analysis, assessing energy requirements using the Physiological Cost Index (PCI) and using questionnaires. There was no significant benefit gained from the use of the Adaptive knee over the Catech knee joint in our small study group.

The effect of the impedance of a thin hydrogel electrode on sensation during functional electrical stimulation.

Surface functional electrical stimulation results in stimulation of cutaneous receptors and discomfort. The degree of non-uniformity of current distribution in the cutaneous layers in the vicinity of the electrode may influence the sensation experienced. This paper describes the effects on sensation of a thin, high impedance electrode designed to reduce the non-uniformity of current distribution. Sensation associated with stimulation via a self-adhesive electrode with much higher impedance than conventional electrodes was compared with a low impedance electrode in a single-blinded, crossover study. The high impedance electrode does not alter either the current at which sensation is first registered. However, at higher currents, the high impedance electrode allows 9% more current to be passed for an equivalent sensation to that experienced with the conventional electrode. A 28% decrease in discomfort with the use of the high impedance electrode was also reported.

AdaptFlow: protocol-based medical treatment using adaptive workflows.

OBJECTIVES: In many medical domains investigator-initiated clinical trials are used to introduce new treatments and hence act as implementations of guideline-based therapies. Trial protocols contain detailed instructions to conduct the therapy and additionally specify reactions to exceptional situations (for instance an infection or a toxicity). To increase quality in health care and raise the number of patients treated according to trial protocols, a consultation system is needed that supports the handling of the complex trial therapy processes efficiently. Our objective was to design and evaluate a consultation system that should 1) observe the status of the therapies currently being applied, 2) offer automatic recognition of exceptional situations and appropriate decision support and 3) provide an automatic adaptation of affected therapy processes to handle exceptional situations. METHODS: We applied a hybrid approach that combines process support for the timely and efficient execution of the therapy processes as offered by workflow management systems with a knowledge and rule base and a mechanism for dynamic workflow adaptation to change running therapy processes if induced by changed patient condition. RESULTS AND CONCLUSIONS: This approach has been implemented in the AdaptFlow prototype. We performed several evaluation studies on the practicability of the approach and the usefulness of the system. These studies show that the AdaptFlow prototype offers adequate support for the execution of real-world investigator-initiated trial protocols and is able to handle a large number of exceptions.

Standardized terminology for clinical trial protocols based on top-level ontological categories.

This paper describes a new method for the ontologically based standardization of concepts with regard to the quality assurance of clinical trial protocols. We developed a data dictionary for medical and trial-specific terms in which concepts and relations are defined context-dependently. The data dictionary is provided to different medical research networks by means of the software tool Onto-Builder via the internet. The data dictionary is based on domain-specific ontologies and the top-level ontology of GOL. The concepts and relations described in the data dictionary are represented in natural language, semi-formally or formally according to their use.

Gait, cost and time implications for changing from PTB to ICEX sockets.

The ICEX system (Ossur, Iceland), allows a socket to be manufactured directly onto the stump and is thought to provide improved comfort due to better pressure distribution whilst being easier to fit and manufacture. The aims of this project were to a) compare gait performance by measuring several gait characteristics, b) compare production and fitting times, c) investigate financial implications and d) attempt to gauge the amputees' subjective opinions of socket comfort. A randomised, controlled trial was conducted on 27 trans-tibial amputees with an existing patellar tendon bearing (PTB) socket on the Endolite system (Chas A. Blatchford, UK). Twenty one (21) subjects completed the study. Of these, 10 in the control group received new PTB sockets while 11 in the experimental group received ICEX. Gait analysis wearing existing sockets was performed and kinetic data obtained from a force plate. This was repeated with the new sockets after a 6 week period of adjustment. Mann-Whitney tests were used in statistical evaluations with a significance level of 5%. Subjects were asked to score their prosthesis for comfort using the Socket Comfort Score (Hanspal et al., 2003) and the frequency of visits for socket adjustments over a three-month period post-delivery of the sockets was recorded. This study demonstrates no significant difference in any of the gait parameters measured. Though the time required to manufacture a PTB prosthesis was found to be considerably longer than the ICEX, the overall cost for producing the ICEX was significantly greater. Subjects showed only minor comfort preference for the ICEX design and there was no significant difference in the mean number of visits for socket adjustments. In view of the considerable additional cost of providing ICEX and the lack of evidence of improvement in any parameter tested, the routine provision of ICEX prostheses to unselected trans-tibial amputees cannot be recommended.

The effects of ACL injury on lower extremity activation during closed kinetic chain exercise.

AIM: Injury to the anterior cruciate ligament (ACL) has been suggested to alter the neuromuscular mechanism in the lower extremity. However, conclusive evidence regarding this occurrence has yet to be established during closed kinetic chain exercise. The purpose of this study was to assess differences in muscle activation during slideboard exercise between non-injured, ACL deficient, and ACL reconstructed individuals. EXPERIMENTAL DESIGN: comparative study. SETTING: research laboratory. PARTICIPANTS: subjects for this study included 10 healthy, non-injured (NI) individuals, 7 uni-lateral ACL deficient (ACLD) individuals, and 6 uni-lateral ACL reconstructed (ACLR) individuals. INTERVENTIONS: EMG activity was measured from the vastus medialis (VM), vastus lateralis (VL), medial hamstring (MH), lateral hamstring (LH), tibialis anterior (TA), and medial gastrocnemius (MG) muscles during slideboard performance. MEASURES: EMG for each muscle during each of 6 phases of 1 average slideboard cycle was expressed as a percentage of EMG during a maximal voluntary contraction. RESULTS: The results demonstrated that during slideboard phase I the VM, VL, and TA muscles generated the greatest amount of activity as compared to the other muscles. Vastus medialis muscle activation was found to be significantly higher than the other muscles in the involved/dominant limb, as compared to the non-involved/non-dominant limb during slideboard phase II. During slideboard phases III-VI, tibialis anterior muscle activation was found to be consistently higher than the other muscles, while hamstring muscle activity was consistently the lowest. CONCLUSION: It is concluded that adaptive changes following ACL injury during a dynamic, closed kinetic chain activity such as the slideboard exercise, may be a restoration of a bi-lateral balance in muscle activation.

A new hybrid spring brake orthosis for controlling hip and knee flexion in the swing phase.

In this study it is proposed that active contraction of muscles might be artificially replaced by a spring brake orthosis (SBO) to provide near-natural knee and hip swing phase trajectories for gait in spinal cord injured subjects. The SBO is a new gait restoration system in which stored spring elastic energy and potential energy of limb segments are utilized to aid gait. It is also shown that hip flexion can be produced without the need for withdrawal reflex, hip flexor stimulus or any mechanical actuator at the hip. A hip flexion angle of 21 degrees was achieved by a nonimpaired subject wearing a prototype orthosis.

Gender-dependent enhanced adult neurotoxic response to methamphetamine following fetal exposure to the drug.

Methamphetamine use by females of child-bearing age has become a major public health concern in terms of the long-term risk to the exposed fetus. We examined the possibility of enhanced adult neurotoxic potential of the drug in offspring that had been exposed to methamphetamine in utero during gestational days 7 to 18. While basal levels of monoamines were not affected by prenatal exposure to methamphetamine, we observed an enhanced neurotoxicity in adult male offspring following drug challenge with effects localized primarily to the dopaminergic nigrostriatal projection. This was evidenced by greater methamphetamine-induced reductions of dopaminergic markers in the striatum [dopamine (DA), dihydroxyphenylacetic acid, homovanillic acid (HVA), and 3-methoxytyramine (3-MT)] and ventral brainstem (DA) of prenatal methamphetamine-treated males compared with saline-treated animals. Some effects of prenatal methamphetamine exposure were observed in female offspring, but these were limited to striatal levels of 3-MT and HVA. Differential gender sensitivity to the neurotoxic effect of methamphetamine was shown to be correlated with hyperthermic response. Hyperthermic effects, however, do not account for the increased susceptibility of prenatal methamphetamine-treated males to drug-induced striatal DA neurotoxicity since methamphetamine challenge did not evoke a significantly greater hyperthermic response in these animals compared with prenatal saline-treated males. The findings raise the concern that male methamphetamine abusers may be at risk for an enhanced neurotoxic risk if they were exposed to the drug in utero.

Computer experiments to determine whether over- or under-counting necessarily affects the determination of difference in cell number between experimental groups.

Computer cell counting experiments were performed in order to examine the consequences of over- or under-counting. The three-dimensional reaggregate culture laboratory environment for cell counting was used as a model for computer simulation. The laboratory environment for aggregate and cell sizes, numbers and spatial placement in gelatin blocks was mimicked in the computer setup. However, in the computer, cell counting was set to be either ideally unbiased, or deliberately biased in regard to over- or under-counting so as to compare eventual results when using the various cell counting methods. It was found that there was no effect of the cell counting methods used in determining whether there was a significant difference in cell number between two experimental groups. In addition, it was found that under the conditions of these simulations, the optical dissector method behaved similarly, on the average, as the ideal method of counting cell centers and in both of those cases, the average ratio between actual cell number in a flask and estimated number was close to 1.00.

Wires should not be used routinely on skin scars for mammograms after breast-conserving surgery.

The accuracy of skin wire markers on surgical incision scars during mammography to locate the primary tumor excision site was prospectively determined for 100 women. The shortest distance between the excision site and skin scar wire on either the craniocaudal or mediolateral oblique projection was 10 mm or greater in 48 per cent of patients and 20 mm or greater in 30 per cent of patients. Wire markers placed on skin incision scars during mammography after breast-conserving surgery are inadequate for the localization of the primary excision site and should not be used routinely.

A pilot study comparing the cognitive demand of walking for transfemoral amputees using the Intelligent Prosthesis with that using conventionally damped knees.

OBJECTIVE: To compare the cognitive demand of walking when using a conventional prosthesis with that using a microprocessor-controlled prosthesis. DESIGN: Ten unilateral transfemoral amputees wearing conventional pneumatic swing phase control (conventional prosthesis) prostheses walked on a treadmill which enforced a pattern of constantly varying speeds. The subjects simultaneously performed a simple or a complex distracting task. Following a period of accustomization, the subjects performed the same test wearing a prosthesis with microprocessor control of swing phase damping (the Intelligent Prosthesis). OUTCOME MEASURES: The three-dimensional trajectory (sway) of a retroreflective marker attached to the forehead was measured by a video-based motion analysis system, and used as a measure of gait quality. The ratio of the sway for the complex task over the simple task (the 'automation index') was used as a measure of the degree of automation of gait. RESULTS: No significant differences were found in the automation index between the two devices. However, the total sway for the conventional prosthesis was significantly higher. Sway during the complex distracting task was significantly higher than during the simple task. CONCLUSIONS: The microprocessor-controlled prosthesis was not found to be less cognitively demanding than a conventional prosthesis.

The future of nursing education. Ten trends to watch.

The millennium has become the metaphor for the extraordinary challenges and opportunities available to the nursing profession and to those academic institutions responsible for preparing the next generation of nurses. Signal change is all around us, defining not only what we teach, but also how we teach our students. Transformations taking place in nursing and nursing education have been driven by major socioeconomic factors, as well as by developments in health care delivery and professional issues unique to nursing. Here are 10 trends to watch, described in terms of their impact on nursing education.

Mammographic considerations for patients undergoing ancillary surgical procedures in the breast: a need for pre- and postoperative mammograms.

Mammographic evaluation of the pre- and postoperative breast has been primarily emphasized for patients undergoing diagnostic breast biopsies and breast-conserving surgery. There is limited literature addressing ancillary surgical procedures involving breast tissue that may complicate mammographic evaluation of the breasts during breast cancer screening. We present mammographic diagnostic dilemmas after ancillary surgical procedures in the breast. The placement and removal of devices, such as central venous access ports and pacemakers, may result in scarring that may appear suspicious for malignancy on mammography. In addition, the placement of devices can obscure lesions that are being followed mammographically. These cases illustrate the need for the application of a basic principle of breast surgery, that of pre- and postoperative mammography, to ancillary surgery of the breast to allow optimal mammographic evaluation of women who are breast screening candidates.

Contralateral reexpansion pulmonary edema.

Reexpansion pulmonary edema (RPE) is an unusual complication of thoracentesis. Significant morbidity can result, and death is reported in 20% of cases. It is typically manifested as edema within a lung that has recently been reexpanded. Few reports document contralateral edema formation. We present a case of recurrent left-sided pulmonary edema after repeated drainage of a right-sided pleural effusion due to hepatic hydrothorax. We believe this is the first reported case of recurrence and only the fifth overall case of contralateral RPE. We also review the pathophysiology, treatment, and case reports of contralateral RPE. Physicians should be aware of the complications of thoracentesis, particularly RPE, given the significant morbidity and mortality associated with it.

Evidence of elevated intracellular calcium levels in weaver homozygote mice.

1. A mutation in the G-protein-linked, inwardly rectifying K+ channel GIRK2 leads to the loss of cerebellar and dopaminergic mesencephalic neurons in weaver mice. The steps leading to cell death are not well understood but may involve constitutive influx of Na+ and Ca2+ into the neurons. 2. We found that resting [Ca2+]i was dramatically higher in cerebellar neurons from weaver mice compared to wild-type neurons. 3. High-K+ stimuli elicited much smaller changes in [Ca2+]i in weaver cerebellar neurons compared to wild-type neurons. 4. weaver cerebellar granule cells could be rescued from cell death by the GIRK2wv cationic channel blocker, QX-314. 5. QX-314 lowered resting intracellular Ca2+ levels in weaver cerebellar granule cells. 6. These results suggest that changes in resting [Ca2+]i levels and alterations in K+ channel function are most likely to contribute to the developmental abnormalities and increased cerebellar cell death observed in weaver mice.

Cell-to-cell variation in store-operated calcium entry in HEK-293 cells and its impact on the interpretation of data from stable clones expressing exogenous calcium channels.

To investigate the effect of cell-to-cell variation in store-operated calcium entry (SOCE) on the evaluation of data from stable cell clones selected following gene transfection, we measured SOCE in 2700 individual HEK-293 cells from the parent population and in 1900 individual cells from a clonal subpopulation of HEK-293 cells. We applied statistical resampling techniques to model conditions where one would compare the average SOCE in n control clones to the average SOCE in n experimental clones (n = 1-200). For an overexpression experiment with n = 1, there is a 27% chance of observing a 100% or higher difference in SOCE between clones, with n = 10 there is a 34% probability of observing a 20% or greater difference in SOCE, and with n = 100, there is less than a 10% chance of seeing a 10% or greater difference in SOCE, based solely on random selection of clones from the parent HEK-293 cell population. To assure that the degree of cell-to-cell variation was predictive of the degree of clone-to-clone variation, we measured SOCE in 270 clones, each arising from a single cell, and found the variation to be very similar to that observed for individual cells.

How Long Have Nonlinear Effects Been Known in the Field of Catalysis?

The similarities and differences between nonlinear effects in asymmetric synthesis (see diagram), predicted 60 years ago by W. Langenbeck, and the long-known amplification phenomenon in stoichiometric reactions with chiral starting materials are discussed.