How can we help? Medical students' views on their role in the COVID-19 pandemic.

BACKGROUND: The ongoing COVID-19 pandemic has resulted in a sharp rise in demand for healthcare workers worldwide. This has been coupled with reduced numbers of available medical professionals due to confirmed or suspected infections with SARS-CoV-2. To counteract these shortages, governments of several countries have considered the enrolment of medical students into the workforce in order to help to tackle the ongoing crisis. METHODS: Questionnaire-based study assessing the perceived role of medical students in assisting in the COVID-19 pandemic. The primary aim was to determine factors contributing to the willingness of medical students to actively assist in the pandemic. The secondary aim was to evaluate their perspectives regarding the associated changes in medical education. RESULTS: Out of 760 responses, 71.18% of medical students were willing to assist the medical workforce during the pandemic. Clinical year students were more likely to help in a medical capacity than pre-clinical students (OR = 0.384, 95%CI [0.167, 0.883, P < 0.05)]. Respondents concerned about their own well-being were less likely to engage in clinical work (OR = 0.680, 95%CI [0.491, 0.941], P < 0.020). Students who agreed that online lectures will negatively impact their education were inclined to think that the academic year should be extended (95%CI [0.065, 0.271], P = 0.001). CONCLUSIONS: Most students are willing to help in both a medical and non-medical capacity. Their primary concerns when working in a medical setting are the risk of infecting their relatives and patients, lack of protective equipment and necessary knowledge as well as legal uncertainty whilst working without a medical qualification.

Neuromuscular reinnervation efficacy using a YFP model.

INTRODUCTION: The gold standard reconstruction for facial reanimation is the functional muscle transfer. The reinnervation of a muscle is never complete, and clinical results are variable with 20% not achieving a satisfactory outcome. We hypothesise that this may be due to a mismatch between the characteristics of the donor nerve and transferred muscle. METHOD: 81 YFP-16 and 14 YFP-H mice were studied in three intervention groups over three time periods. Two parameters were investigated: the number and surface area of reinnervated neuromuscular junctions and regenerating axons. An assessment was made of motor unit proportions. RESULTS: All cases of nerve repair and nerve graft, the neuromuscular junctions (NMJ) were completely reinnervated by regenerating axons. The number and calibre of the regenerating axons were significantly different from controls for both intervention groups. The motor units were smaller in both intervention groups. DISCUSSION: Reinnervation occurs after nerve repair or graft; however, the arbour was reinnervated by large numbers of much smaller axons. These axons showed some evidence of remodelling in the repair group, but not in the graft group. Neither group achieved the parameters of the control group. There were persistent qualitative changes to the morphology of both axons and junctions. Imaging documented both synkinesis and alterations that resemble those seen in ageing. CONCLUSION: Overall, the efficacy of reinnervation is very high with all NMJ reoccupied by regenerating axons. The way small axons are remodelled is different in the nerve repairs compared with the nerve grafts.

The outcomes of digital tip amputation replacement as a composite graft in a paediatric population.

UNLABELLED: Limited studies exist on the outcome of replacing an amputated fingertip as a composite graft. We report the outcomes and predictors for composite graft survival along with the long-term morbidity. A retrospective review of all patients <16 years who underwent composite graft replacement of an amputated fingertip was performed. Long-term morbidity was evaluated through a standardized parental questionnaire. A total of 120 patients were identified, of whom 97 were eligible for inclusion. Parental questionnaires were completed for 42 (43%) patients. There was a 10% complete and 34% partial graft survival rate. Patients aged ⩽4 were significantly more likely to have complete graft take than those >4. Of the patients, 17% developed post-operative complications; 48% of patients reported a hook-nail deformity and 17% reported cold intolerance. Only 5% of patients reported any functional difficulties long term. The rate of complete composite graft survival in a paediatric population is low, although the long-term function of these patients is good. LEVEL OF EVIDENCE: 3.

The influence of essential oils on the process of wound healing: a review of the current evidence.

This paper reports on a literature review of evidence on the influence of essential oils on wound healing and their potential application in clinical practice. It focuses mainly on tea tree, lavender, chamomile, thyme and ocimum oils.

Lipid hydroperoxide measurement by oxidation of Fe2+ in the presence of xylenol orange. Comparison with the TBA assay and an iodometric method.

Study of the role of hydroperoxides and lipid peroxidation in disease requires simple and sensitive methods for direct hydroperoxide measurement. We report on a technique for measuring hydroperoxide which relies upon the rapid hydroperoxide-mediated oxidation of Fe2+ under acidic conditions. Fe3+ forms a chromophore with xylenol orange which absorbs strongly at 560 nm, yielding an apparent E560 (for H2O2, butyl hydroperoxide and cumene hydroperoxide) of 4.3 X 10(4) M-1 cm-1. The assay was validated in a study of liposomal lipid peroxidation and shown to give results comparable with those obtained by an iodometric method or by measuring conjugated dienes. The assay involving thiobarbituric acid, by comparison, underestimates lipid peroxidation and does not measure hydroperoxide per se.

Abnormal redox status without increased lipid peroxidation in sugar cataract.

In conflict with a previous report, we find that phenolic inhibitors of lipid peroxidation (butylated hydroxytoluene [BHT] and butylated hydroxyanisole [BHA]) do not have significant inhibitory effect on galactosemic cataract formation. This is consistent with the lack of enhancement of stable products of lipid peroxidation (measured by the thiobarbituric acid assay) in the lenses of galactosemic rats. This does not imply that oxidative stress plays no role in galactosemic cataract formation (indeed, we find that galactosemic lens homogenates contain increased amounts of an Fe2+ oxidant, possibly a peroxide), but rather that BHT- and BHA-inhibitable lipid peroxidation specifically has no role to play. In instances where drugs appear to inhibit galactosemic cataract formation, other effects caused by the drugs, e.g., inhibition of feeding or induction of general detoxification pathways, must be considered.

Hydrogen peroxide production during experimental protein glycation.

The accumulation of hydrogen peroxide (H2O2) during incubations of protein with glucose (experimental glycation) has previously been too low for direct measurement although it is suggested to be the precursor of protein-damaging hydroxylating agents. We have thus developed a simple H2O2-measuring technique which relies upon the rapid peroxide-mediated oxidation of Fe2+ to Fe3+ (catalysed by sorbitol) under acidic conditions followed by reaction of the latter cation with the dye, xylenol orange. We have used the method to demonstrate that incubation mixtures of protein and glucose generates nanomolar levels of hydrogen peroxide in the presence of protein under physiological conditions of pH and temperature.

Antioxidant characteristics of some potential anticataract agents. Studies of aspirin, paracetamol, and bendazac provide support for an oxidative component of cataract.

It is conceivable that drugs with anticataract potential possess antioxidant activity. Using defined chelating agents and reducing agents in a number of assays for antioxidant activity, we have demonstrated that paracetamol, aspirin, bendazac, and its metabolite 5-hydroxybendazac possess substantial reducing and/or metal-chelating activity. We found that paracetamol and 5-hydroxybendazac reduced the diphenylpicrylhydrazyl free radical; inhibited butyl peroxide-induced erythrocyte lysis as well as the haematin-catalyzed oxidative coupling of 4-aminoantipyrine and phenol by butyl peroxide. Furthermore, paracetamol, bendazac, and aspirin competed with 3-(2-pyridyl)-5,6-Diphenyl-1,2,4-triazine-4', 4"-disulphonic acid (ferrozine) for ferrous ion.