Assessing the implementation of a tertiary care comprehensive pediatric asthma education program using electronic medical records and decision support tools.

Background: Self-management education is integral for proper asthma management. However, there is an accessibility gap to self-management education following asthma hospitalizations. Most pediatric patients and their families receive suboptimal or no education.

Multiple variants of the type VII secretion system in Gram-positive bacteria.

Type VII secretion systems (T7SS) are found in bacteria across the Bacillota and Actinomycetota phyla and have been well described in , and pathogenic mycobacteria. The T7SS from Actinomycetota and Bacillota share two common components, a membrane-bound EccC/EssC ATPase and EsxA, a small helical hairpin protein of the WXG100 family. However, they also have additional phylum-specific components, and as a result they are termed the T7SSa (Actinomycetota) and T7SSb (Bacillota), respectively.

Picosecond laser filament-guided electrical discharges in air at 1 kHz repetition rate.

Laser-induced filaments have been shown to reduce the voltage necessary to initiate electrical discharges in atmospheric air and guide their propagation over long distances. Here we demonstrate the stable generation of laser filament-guided electrical discharge columns in air initiated by high energy (up to 250 mJ) 1030 nm wavelength laser pulses of 7 ps duration at repetition rates up to 1 kHz and we discuss the processes leading to breakdown. A current proportional to the laser pulse energy is observed to arise as soon as the laser pulse arrives, initiating a high impedance phase of the discharge.

Multivariable prognostic modelling to improve prediction of colorectal cancer recurrence: the PROSPeCT trial.

Objective: Improving prognostication to direct personalised therapy remains an unmet need. This study prospectively investigated promising CT, genetic, and immunohistochemical markers to improve the prediction of colorectal cancer recurrence.

Material And Methods: This multicentre trial (ISRCTN 95037515) recruited patients with primary colorectal cancer undergoing CT staging from 13 hospitals.

Robotic transanal minimally invasive surgery (r-TAMIS): perioperative and short-term outcomes for local excision of rectal cancers.

Background: Transanal minimally invasive surgery (TAMIS) is an advanced technique for excision of early rectal cancers. Robotic TAMIS (r-TAMIS) has been introduced as technical improvement and potential alternative to total mesorectal excision (TME) in early rectal cancers and in frail patients. This study reports the perioperative and short-term oncological outcomes of r-TAMIS for local excision of early-stage rectal cancers.

Influence of diffusion weighted imaging and contrast enhanced T1 sequences on the diagnostic accuracy of magnetic resonance enterography for Crohn's disease.

Objectives: To evaluate the additional diagnostic benefit of diffusion weighted imaging (DWI) and contrast enhanced (CE) images during MR enterography (MRE) of Crohn's disease.

Methods: Datasets from 73 patients (mean age 32; 40 male) (28 new-diagnosis, 45 relapsed) were read independently by two radiologists selected from a pool of 13. Radiologists interpreted datasets using three sequential sequence blocks: (1) T2 weighted and steady state free precession gradient echo (SSFP) images alone (T2^); (2) T2 weighted and SSFP images with DWI (T2 + DWI^) and; (3) T2 weighted images, SSFP, DWI and post-contrast enhanced (CE) T1 images (T2 + DWI + CE^), documenting presence, location, and activity of small bowel disease.

Paris classification of colonic polyps using CT colonography: prospective cohort study of interobserver variation.

Background: The Paris classification categorises colorectal polyp morphology. Interobserver agreement for Paris classification has been assessed at optical colonoscopy (OC) but not CT colonography (CTC). We aimed to determine the following: (1) interobserver agreement for the Paris classification using CTC between radiologists; (2) if radiologist experience influenced classification, gross polyp morphology, or polyp size; and (3) the extent to which radiologist classifications agreed with (a) colonoscopy and (b) a combined reference standard.

Criminal justice interventions for preventing radicalisation, violent extremism and terrorism: An evidence and gap map.

Background: Criminal justice agencies are well positioned to help prevent the radicalisation of individuals and groups, stop those radicalised from engaging in violence, and reduce the likelihood of terrorist attacks. This Evidence and Gap Map (EGM) presents the existing evidence and gaps in the evaluation research.

Objectives: To identify the existing evidence that considers the effectiveness of criminal justice interventions in preventing radicalisation, violent extremism and terrorism.

Diagnostic performance of sonographic activity scores for adult terminal ileal Crohn's disease compared to magnetic resonance and histological reference standards: experience from the METRIC trial.

Objectives: The simple ultrasound activity score for Crohn's disease (SUS-CD) and bowel ultrasound score (BUSS) are promising intestinal ultrasound (IUS) indices of CD, but studied mainly in small settings with few sonographers. We compared SUS-CD and BUSS against histological and magnetic resonance enterography (MRE) reference standards in a post hoc analysis of a prospective multicentre, multireader trial.

Methods: Participants recruited to the METRIC trial (ISRCTN03982913) were studied, including those with available terminal ileal (TI) biopsies.

Dynamics of Nanosecond Laser Pulse Propagation and of Associated Instabilities in a Magnetized Underdense Plasma.

The propagation and energy coupling of intense laser beams in plasmas are critical issues in inertial confinement fusion. Applying magnetic fields to such a setup has been shown to enhance fuel confinement and heating. Here we report on experimental measurements demonstrating improved transmission and increased smoothing of a high-power laser beam propagating in a magnetized underdense plasma.

Defining the Middle Corona.

The middle corona, the region roughly spanning heliocentric distances from 1.5 to 6 solar radii, encompasses almost all of the influential physical transitions and processes that govern the behavior of coronal outflow into the heliosphere. The solar wind, eruptions, and flows pass through the region, and they are shaped by it.

Oxford cognitive screen: A critical review and independent psychometric evaluation.

The Oxford cognitive screen (OCS) is a stroke-specific cognitive screening assessment. Although the test developers have provided psychometric information for the assessment, the OCS has received minimal external scrutiny, with which to triangulate the underpinning psychometrics. The purpose of this study is to provide a critical review and independent validation of the OCS.

PROTOCOL: Criminal justice interventions for preventing terrorism and radicalisation: An evidence and gap map.

This is the protocol for a Campbell systematic review. The objectives are as follows: to identify the existing evidence that considers the effectiveness of criminal justice interventions in preventing terrorism and radicalisation and to identify existing gaps in the evidence where new primary research could be undertaken and where future synthesis could be conducted.

Role extension in advanced ultrasound practice: A framework approach and case study.

Introduction: Role extension into novel areas of ultrasound practice can be challenging for health care professionals. Expansion into existing areas of advanced practice typically occurs using established processes and accredited training; however, in areas where there is no formal training, there can be a lack of support for how to develop new and progressive clinical roles.

Topic Description: This article presents how the use of a framework approach for establishing areas of advanced practice can support individuals and departments with safely and successfully developing new roles in ultrasound.

Optimizing pediatric asthma education using virtual platforms during the COVID-19 pandemic.

Background: We compared patient and caregiver knowledge and confidence for managing asthma, and participant experiences when comprehensive asthma education was delivered in person versus in the virtual setting.

Methods: We performed a multi-methods study using structured surveys and qualitative interviews to solicit feedback from patients and caregivers following participation in a comprehensive asthma education session between April 2018 and October 2021. We compared participant knowledge and confidence for managing asthma as well as user experience when the education was attended in-person or virtually.

Transport of an intense proton beam from a cone-structured target through plastic foam with unique proton source modeling.

Laser-accelerated proton beams are applicable to several research areas within high-energy density science, including warm dense matter generation, proton radiography, and inertial confinement fusion, which all involve transport of the beam through matter. We report on experimental measurements of intense proton beam transport through plastic foam blocks. The intense proton beam was accelerated by the 10ps, 700J OMEGA EP laser irradiating a curved foil target, and focused by an attached hollow cone.

Factors associated with future hospitalization among children with asthma: a systematic review.

Objective: Asthma is a leading cause of emergency department (ED) visits and hospitalizations in children, though many could be prevented. Our study objective was to identify factors from the published literature that are associated with future hospitalization for asthma beyond 30 days following an initial asthma ED visit.

Data Sources: We searched CINAHL, CENTRAL, MEDLINE, and Embase for all studies examining factors associated with asthma-related hospitalization in children from January 1, 1992 to February 7, 2022.

Influence of oral contrast type and volume on patient experience and quality of luminal distension at MR Enterography in Crohn's disease: an observational study of patients recruited to the METRIC trial.

Objectives: To compare the distention quality and patient experience of oral mannitol and polyethylene glycol (PEG) for MRE.

Methods: This study is a retrospective, observational study of a subset of patients enrolled in a multicentre, prospective trial evaluating the diagnostic accuracy of MRE for small bowel Crohn's. Overall and segmental MRE small bowel distention, from 105 patients (64 F, mean age 37) was scored from 0 = poor to 4 = excellent by two experienced observers (68 [65%] mannitol and 37 [35%] PEG).

Interobserver variation in the interpretation of magnetic resonance enterography in Crohn's disease.

Objectives: To evaluate interobserver variability for diagnosis of disease presence and extent of small bowel and colonic Crohn's disease using MR enterography (MRE).

Methods: Data from the first 73 consecutive patients (mean age 32, 33F, 28 new diagnosis, 45 suspected relapse) recruited to a multicentre, prospective diagnostic accuracy trial evaluating MRE for small bowel Crohn's disease were each read independently by three (from a pool of 20) radiologists. Radiologists documented presence and segmental location of small bowel Crohn's disease and recorded morphological mural/extramural parameters for involved segments.

Incorporating effects of age on energy dynamics predicts nonlinear maternal allocation patterns in iteroparous animals.

Iteroparous parents face a trade-off between allocating current resources to reproduction versus maximizing survival to produce further offspring. Parental allocation varies across age and follows a hump-shaped pattern across diverse taxa, including mammals, birds and invertebrates. This nonlinear allocation pattern lacks a general theoretical explanation, potentially because most studies focus on offspring number rather than quality and do not incorporate uncertainty or age-dependence in energy intake or costs.

Colorectal Cancer: Performance and Evaluation for CT Colonography Screening- A Multicenter Cluster-randomized Controlled Trial.

Background Most radiologists reporting CT colonography (CTC) do not undergo compulsory performance accreditation, potentially lowering diagnostic sensitivity. Purpose To determine whether 1-day individualized training in CTC reporting improves diagnostic sensitivity of experienced radiologists for 6-mm or larger lesions, the durability of any improvement, and any associated factors. Materials and Methods This prospective, multicenter cluster-randomized controlled trial was performed in National Health Service hospitals in England and Wales between April 2017 and January 2020.

Influence of spatial-intensity contrast in ultraintense laser-plasma interactions.

Increasing the intensity to which high power laser pulses are focused has opened up new research possibilities, including promising new approaches to particle acceleration and phenomena such as high field quantum electrodynamics. Whilst the intensity achievable with a laser pulse of a given power can be increased via tighter focusing, the focal spot profile also plays an important role in the interaction physics. Here we show that the spatial-intensity distribution, and specifically the ratio of the intensity in the peak of the laser focal spot to the halo surrounding it, is important in the interaction of ultraintense laser pulses with solid targets.

Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis.

Background: Appendicitis remains a difficult disease to diagnose, and imaging adjuncts are commonly employed. Magnetic resonance imaging (MRI) is an imaging test that can be used to diagnose appendicitis. It is not commonly regarded as a first-line imaging test for appendicitis, but the reported diagnostic accuracy in some studies is equivalent to computed tomography (CT) scans.