Doctors', Patients' and Physician Associates' Perceptions of the Physician Associate Role in the Emergency Department.

Introduction: The Emergency Department (ED) has seen increased patient attendance and difficulty meeting demands. New healthcare professions such as Physician Associates (PAs) are being utilised to complement the existing medical workforce. Despite the growth of their professions in the United Kingdom, little evidence is available about the perceptions of their roles.

Correction to: The contribution of physician associates or assistants to the emergency department: A systematic scoping review.

[This corrects the article DOI: 10.1002/emp2.12989.

Comparing physician associates and foundation year 1 doctors-in-training undertaking emergency medicine consultations in England: a quantitative study of outcomes.

Objectives: To compare the contribution of physician associates (PAs) to the outcomes of emergency medicine consultations with that of foundation year 1 doctors-in-training (FY1s).

Design: A quantitative study using retrospective chart review of adult patients seen by PAs or FY1s from August 2018 to January 2020 using 16 months of anonymised clinical record data.

Setting: One emergency department (ED) in England.

The contribution of physician associates or assistants to the emergency department: A systematic scoping review.

Background: New health care professionals, such as the physician associate or assistant (PA), have expanded the ability of health systems to meet the needs of the population in both primary and secondary health care settings. Although PAs are widely deployed in the emergency department (ED), their role in the ED has not previously been formally described. This systematic scoping review synthesizes and critically analyzes existing literature on the impact and perception of the role of PAs working in the ED.

Echocardiographic reference intervals in healthy UK deerhounds and prevalence of preclinical dilated cardiomyopathy: a prospective, longitudinal study.

Background: Sighthounds have high echocardiographic (ECHO) left ventricular volumes. Establishing robust breed-specific ECHO reference intervals (RI) for screening is important. End-diastolic volume index (EDVI), end-systolic volume index (ESVI) and ejection fraction (EF) reference ranges derived by Simpson's method of discs are not available for deerhounds.

Minor neurological signs and behavioural function at age 2 years in neonatal hypoxic ischaemic encephalopathy (HIE).

Background: Neurodevelopmental follow-up in Neonatal Hypoxic Ischaemic Encephalopathy (HIE) typically focusses on major neuromotor (cerebral palsy, CP) and severe cognitive impairment. Outcomes in those without major neuromotor impairment are less well explored.

Objectives: To examine behavioural, cognitive and neurological outcomes after neonatal HIE, in a clinical cohort of children without CP, at age 2 years.

ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring: A systematic review and meta-analysis.

Background: Allergic diseases have increased worldwide in the last 2 decades, with children suffering the highest burden of the condition. The ω-3 long-chain poly-unsaturated fatty acid (LCPUFA) possesses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies.

Objective: A systematic review and meta-analysis of the most recent follow-ups of randomized clinical trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring.

The effectiveness of ω-3 polyunsaturated fatty acid interventions during pregnancy on obesity measures in the offspring: an up-to-date systematic review and meta-analysis.

Background: The potential role of ω-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy on subsequent risk of obesity outcomes in the offspring is not clear and there is a need to synthesise this evidence.

Objective: A systematic review and meta-analysis of randomised controlled trials (RCTs), including the most recent studies, was conducted to assess the effectiveness of ω-3 LCPUFA interventions during pregnancy on obesity measures, e.g.

Prenatal Intake of Vitamins and Allergic Outcomes in the Offspring: A Systematic Review and Meta-Analysis.

Background: Allergic diseases have seen a rise worldwide, with children suffering the highest burden. Thus, early prevention of allergic diseases is a public health priority.

Objective: To synthesize the evidence from randomized controlled trials (RCTs) assessing the effect of vitamin interventions during pregnancy on developing allergic diseases in offspring.

Systemic psychotherapy with families where someone has an autism spectrum condition.

Background: Families play an important role in facilitating the development and well-being of children with autism spectrum conditions.

Objectives: After setting the scene with a clinical example, and providing a brief discussion of the current thinking about the aetiology of Autism spectrum conditions, this paper provides a review of the literature regarding the practice of systemic psychotherapy with families in which a child has an autism spectrum condition (ASC).

Methods: A search of databases and journals revealed a large number of opinion papers regarding how family therapists might work with families of children with ASCs and a smaller number of papers that describe or explore actual clinical practice.

Elevated Intracranial Pressure and Cerebral Edema following Permanent MCA Occlusion in an Ovine Model.

Introduction: Malignant middle cerebral artery (MCA) stroke has a disproportionately high mortality due to the rapid development of refractory space-occupying cerebral edema. Animal models are essential in developing successful anti-edema therapies; however to date poor clinical translation has been associated with the predominately used rodent models. As such, large animal gyrencephalic models of stroke are urgently needed.

Effect of long-term (2 years) exposure of mouse brains to global system for mobile communication (GSM) radiofrequency fields on astrocytic immunoreactivity.

This study was designed to determine whether long-term (2 years) brain exposure to mobile telephone radiofrequency (RF) fields produces any astrocytic activation as these glia react to a wide range of neural perturbations by astrogliosis. Using a purpose-designed exposure system at 900 MHz, mice were given a single, far-field whole body exposure at a specific absorption rate of 4 W/kg on five successive days per week for 104 weeks. Control mice were sham-exposed or freely mobile in a cage to control any stress caused by immobilization in the exposure module.

Different effects of adding white noise on cognitive performance of sub-, normal and super-attentive school children.

Objectives: Noise often has detrimental effects on performance. However, because of the phenomenon of stochastic resonance (SR), auditory white noise (WN) can alter the "signal to noise" ratio and improve performance. The Moderate Brain Arousal (MBA) model postulates different levels of internal "neural noise" in individuals with different attentional capacities.

Building strengths with the Six Es of medication management.

The authors provide a template of focused skills drawn from various psychotherapy modalities for integration into follow-up psychopharmacology appointments. Titled the Six E model, this approach includes strategies to elicit an agenda, externalize the presenting problem, seek exceptions, engage empathetically, utilize enactments, and offer education. The template was trialed in a child and adolescent outpatient residency clinic under the guidance of two attendings.

Substance P antagonists as a novel intervention for brain edema and raised intracranial pressure.

Increased intracranial pressure (ICP) following acute brain injury requires the accumulation of additional water in the intracranial vault. One source of such water is the vasculature, although the mechanisms associated with control of blood-brain barrier permeability are unclear. We have recently shown that acute brain injury, such as neurotrauma and stroke, results in perivascular accumulation of the neuropeptide, substance P.

"Can waiting awaken the resting brain?" A comparison of waiting- and cognitive task-induced attenuation of very low frequency neural oscillations.

The default mode network (DMN) is characterised by coherent very low frequency (VLF) neural oscillations in the resting brain. The attenuation of this activity has been demonstrated following the transition from rest to performance of a broad range of cognitive goal-directed tasks. Whether the activity of resting state VLF oscillations is attenuated during non-cognitive goal-directed tasks such as waiting for rewarding outcomes is not known.

Human adult dental pulp stem cells enhance poststroke functional recovery through non-neural replacement mechanisms.

Human adult dental pulp stem cells (DPSCs), derived from third molar teeth, are multipotent and have the capacity to differentiate into neurons under inductive conditions both in vitro and following transplantation into the avian embryo. In this study, we demonstrate that the intracerebral transplantation of human DPSCs 24 hours following focal cerebral ischemia in a rodent model resulted in significant improvement in forelimb sensorimotor function at 4 weeks post-treatment. At this time, 2.

Cushing's mechanism maintains cerebral perfusion pressure in experimental subarachnoid haemorrhage.

Mortality following subarachnoid haemorrhage (SAH) is high, especially within the first 48 h. Poor outcome is predicted by high intracranial pressure which causes diminished cerebral perfusion pressure unless a compensatory increase in mean arterial blood pressure occurs. Therefore blood pressure elevation can be protective following subarachnoid haemorrhage despite the potential for rebleeding.

A surgical model of permanent and transient middle cerebral artery stroke in the sheep.

Background: Animal models are essential to study the pathophysiological changes associated with focal occlusive stroke and to investigate novel therapies. Currently used rodent models have yielded little clinical success, however large animal models may provide a more suitable alternative to improve clinical translation. We sought to develop a model of acute proximal middle cerebral artery (MCA) ischemic stroke in sheep, including both permanent occlusion and transient occlusion with reperfusion.

Neuropathological changes in a lamb model of non-accidental head injury (the shaken baby syndrome).

Non-accidental head injury (NAHI), also termed the "shaken baby syndrome", is a major cause of death and severe neurological dysfunction in children under three years of age, but it is debated whether shaking alone is sufficient to produce brain injury and mortality or whether an additional head impact is required. In an attempt to resolve this question, we used a lamb model of NAHI since these animals have a relatively large gyrencephalic brain and weak neck muscles resembling those of a human infant. Three anaesthetised lambs of lower body weight than others in the experimental group died unexpectedly after being shaken, proving that shaking alone can be lethal.

An electrophysiological monetary incentive delay (e-MID) task: a way to decompose the different components of neural response to positive and negative monetary reinforcement.

Background: The ability to anticipate and then secure future rewards and avoid future punishments by responding effectively to environmental demands is at the core of successful decision making. Disruptions to these processes have been shown to be implicated in a number of psychiatric conditions. In the current paper we use the electrophysiological monetary incentive delay task (e-MID) to decompose the neural response to (i) reinforcement anticipation, (ii) reinforcement-contingent target processing and (iii) reinforcement-related feedback.

Further investigations into the speed of cerebral swelling following blunt cranial trauma.

An anesthetized sheep model of traumatic brain injury (TBI) has been developed to assess early changes in intracranial pressure (ICP) following closed head injury. Immediately after TBI, a transient (<10 min) hypertensive response occurred, followed by significant and prolonged systemic hypotension. ICP demonstrated a biphasic response, being seven times baseline values of 8 ± 2 mm Hg 10 min after injury, decreasing to 25 ± 2 mm Hg by 30 min, and then increasing to values exceeding 30 mm Hg by 4 h postinjury.

Electrophysiological markers of the motivational salience of delay imposition and escape.

Background: The ubiquitous tendency to choose immediate over delayed rewards can, in extremis, lead to maladaptive preferences for smaller sooner over larger later rewards (i.e., impulsive choice) in certain pathological groups.

Automatic nonsubjective estimation of antigen content visualized by immunohistochemistry using color deconvolution.

We describe a method for the automatic, nonsubjective estimation of 3,3' diaminobenzidine (DAB) in digital images obtained from routine central nervous system immunohistochemistry using freely available, platform-independent public domain image processing software. This technique estimates the amount of antigen visualized but does not measure antigen content directly. Combined with whole brain section high-resolution scanning, a "virtual dissection" (extracting the region of interest) makes it possible to estimate relative antigen content in either subcellular structures, specific brain regions, or in whole tissue sections at magnifications up to 40×.