Markerrosen1766
Across Asia the brick-kiln industry is expanding. In Nepal, urban dwelling has increased in recent years, raising requirement for low-cost, mass produced bricks to meet the population needs. Working equids (WEs) play a key role in non-mechanised kilns. Assessing the welfare of these equids is the starting point to addressing concerns. In line with One Welfare principles, the health and welfare of animals, people and the kiln environment are interlinked.
In December 2019, 119 WEs were assessed in seven brick kilns in three districts of Nepal, using the Equid Assessment Research and Scoping tool, developed by The Donkey Sanctuary. The objective was to measure welfare at the start of the brick kiln season.
Horses were the predominant species of WE. Hazardous housing and environments were seen in all kilns. Behaviour responses were mixed. Owner responses and animal examination indicated poor working conditions. Signs of harmful practice were evident in most animals. The majority were underweight, with poor general health, skin alterations and musculoskeletal issues.
The welfare of equids prior to starting brick kiln work is poor, posing significant concerns for the actual working period. Intervention to enhance health and welfare is required.
The welfare of equids prior to starting brick kiln work is poor, posing significant concerns for the actual working period. Intervention to enhance health and welfare is required.
Current management of AKI, a potentially fatal disorder that can also initiate or exacerbate CKD, is merely supportive. Therefore, deeper understanding of the molecular pathways perturbed in AKI is needed to identify targets with potential to lead to improved treatment.
We performed single-cell RNA sequencing (scRNA-seq) with the clinically relevant unilateral ischemia-reperfusion murine model of AKI at days 1, 2, 4, 7, 11, and 14 after AKI onset. Using real-time quantitative PCR, immunofluorescence, Western blotting, and both chromogenic and single-molecule
hybridizations, we validated AKI signatures in multiple experiments.
Our findings show the time course of changing gene expression patterns for multiple AKI stages and all renal cell types. We observed elevated expression of crucial injury response factors-including kidney injury molecule-1 (Kim1), lipocalin 2 (Lcn2), and keratin 8 (Krt8)-and of several novel genes (
,
, and
) not previously examined in kidney pathologies. AKI induced proximolecular pathways that are perturbed in AKI. The results fully define AKI-associated dedifferentiation programs, potential pathologic ligand-receptor crosstalk, novel genes, and the improved injury response in younger mice, and highlight potential targets of kidney injury.
Conversion of 25-hydroxyvitamin D (25[OH]D) to the active form of vitamin D occurs primarily in the kidney. Observational studies suggest 25(OH)D clearance from the circulation differs by kidney function and race. However, these potential variations have not been tested using gold-standard methods.
We administered intravenous, deuterated 25(OH)D
(d-25[OH]D
) in a pharmacokinetic study of 87 adults, including 43 with normal eGFR (≥60 ml/min per 1.73 m
), 24 with nondialysis CKD (eGFR <60 ml/min per 1.73 m
), and 20 with ESKD treated with hemodialysis. We measured concentrations of d-25(OH)D
and deuterated 24,25-dihydroxyvitamin D
at 5 minutes and 4 hours after administration, and at 1, 4, 7, 14, 21, 28, 42, and 56 days postadministration. We calculated 25(OH)D clearance using noncompartmental analysis of d-25(OH)D
concentrations over time. We remeasured 25(OH)D clearance in a subset of 18 participants after extended oral vitamin-D
supplementation.
The mean age of the study cohort was 64 ydroxyvitamin D3 During Vitamin D3 Supplementation (CLEAR-PLUS), NCT03576716.The environmental impact of training has been poorly recognised for many years. With the emergence of high-profile climate activists and a wider appreciation of the need for sustainable healthcare, training within radiology can no longer be excused from its responsibility to consider the environment in its actions. In this paper, we aim to evaluate the environmental impact of the travel undertaken by trainees within the Peninsula training programme, with the aim of developing practices and providing suggestions (evidence-based where possible) on how to improve the impact on the environment of trainee travel. We envisage that many of the lessons and suggestions may be transferrable to other training schemes in the UK and further afield. During the early months of 2020, in addition to the environmental crisis, COVID-19 escalated to a pandemic resulting in the alteration of working practices across the UK (and the rest of the world). This led to many environmentally beneficial working practices being adopted in Radiology in the South West Peninsula Deanery, and throughout this paper we have evaluated these changes and used our collective experience of these to inform our suggestions on how to improve the environmental sustainability of Medical and Radiological training.
COVID-19 has necessitated the reduction in conventional face-to-face patient consultation to reduce the risk of novel coronavirus SARS-CoV-2 transmission. Traditional pathways to risk assess for deep venous thrombosis (DVT) would involve face-to-face assessment to formulate an appropriate management plan following an initial presentation usually in secondary care or in-hospital settings. Appropriate antithrombotic measures can prevent complication of DVT such as pulmonary embolism with prompt early diagnosis and treatment.
This observational, pilot study evaluates the possibility of combining telemedicine technology and a virtual examination pathway for remote triage and assessment of patients with suspected DVT.
Piloting and development of a virtual risk assessment pathway for DVT involves various challenges and multidisciplinary co-ordination.
Advances in telecommunication technology can enable clinicians, specialist nurses and hospital departments to develop a virtual examination pathway for remote triage and assessment of patients with suspected DVT. This pathway is not a replacement for conventional 'face-to-face' evaluation, but we believe the template can be explored and refined to act as a blueprint for future applications even when the pandemic has stabilised.
Advances in telecommunication technology can enable clinicians, specialist nurses and hospital departments to develop a virtual examination pathway for remote triage and assessment of patients with suspected DVT. This pathway is not a replacement for conventional 'face-to-face' evaluation, but we believe the template can be explored and refined to act as a blueprint for future applications even when the pandemic has stabilised.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that appeared in Wuhan, China in January 2020 and caused a global pandemic drastically changing everyday life. Currently, there are vaccine candidates in clinical trials and development, so it is only a matter of time before one is authorised for human use.
We collected public opinion survey results about attitudes towards SARS-CoV-2 vaccination conducted in 2020 in 26 European countries.
The pooled surveys were conducted on a total of 24970 participants; on average only 58% (n=14365/24970) of responders across Europe were willing to get a SARS-CoV-2 vaccine once it becomes available, 16% (n=3998/24970) were neutral, and 26% (n=6607/24970) were not planning to vaccinate against SARS-CoV-2. Such a low vaccination response could make it exceedingly difficult to reach the herd immunity threshold for SARS-CoV-2 through vaccination.
It is very important to start conducting educational public health activities on the topic of vaccination as soon as possible, before a vaccine becomes available, in order to improve attitudes towards SARS-CoV-2 vaccination. Only by educating the general public about the benefits, safety and efficacy of vaccines can we hope to avoid the unnecessary prolongation of the COVID-19 pandemic.
It is very important to start conducting educational public health activities on the topic of vaccination as soon as possible, before a vaccine becomes available, in order to improve attitudes towards SARS-CoV-2 vaccination. Only by educating the general public about the benefits, safety and efficacy of vaccines can we hope to avoid the unnecessary prolongation of the COVID-19 pandemic.
We sought to investigate whether admission hyperglycaemia is associated with complications in patients who had an acute ischaemic stroke (AIS) treated with intravenous recombinant tissue plasminogen activator and, if so, whether complications during hospitalisation modify the effect of hyperglycaemia on 3-month poor outcome after thrombolysis.
Patients who were diagnosed with AIS after thrombolysis between July 2016 and January 2019 were enrolled in this study. Five prespecified complications, including infections, brain oedema, deep vein thrombosis (DVT), haemorrhagic transformation (HT) and gastrointestinal bleeding, were recorded during hospitalisation.
Of 388 patients, 143 (36.86%) presented with hyperglycaemia. Patients with hyperglycaemia were more likely to experience one or more complications than patients without hyperglycaemia. After adjustment for potential confounders, hyperglycaemia was associated with brain oedema (OR 2.39; 95% CI 1.08 to 5.30), HT (OR 2.16, 95% CI 1.06 to 4.41), symptomate effect of hyperglycaemia on the poor outcome at 3 months in ischaemic stroke.The initial period adjusting to the roles and responsibilities of a new foundation doctor can be a challenging and anxious time for graduating medical students and new trainees. Over recent years, many educational initiatives such as shadowing placements, assistantships and compulsory induction programmes have been implemented to improve medical student preparedness for clinical practice. Despite this, many graduates still report a lack of confidence and preparedness when starting their clinical placements, specifically within the context of on-call shifts. Bleep Roulette simulation sessions are progressively being used to further bridge the gap from student to trainee and ensure trainees develop prioritisation, organisational and clinical reasoning skills, improving trainee efficiency during an on-call shift. In this article, we provide 10 tips for medical educators, detailing how to design an efficacious Bleep Roulette session for final year medical students and new foundation trainees.
The clinical course of acute low back pain (LBP) is generally favourable; however, there is significant variability in the prognosis of these patients. A clinical prediction model to predict the likelihood of pain recovery at three time points for patients with acute LBP has recently been developed. The aim of this study is to conduct a broad validation test of this clinical prediction model, by testing its performance in a new sample of patients and a different setting.
The validation study with a prospective cohort design will recruit 420 patients with recent onset non-specific acute LBP, with moderate pain intensity, seeking care in the emergency departments of hospitals in São Paulo, Brazil. Polyinosinic acid-polycytidylic acid cost The primary outcome measure will be days to recovery from pain. The predicted probability of pain recovery for each individual will be computed based on predictions of the development model and this will be used to test the performance (calibration and discrimination) in the validation dataset.
The findings of this study will better inform about the performance of the clinical prediction model, helping both clinicians and patients.
