Background: We aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG).
Methods: A 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives. The scope and purpose of the guideline were agreed by the SIG by consensus.
Objectives: To develop a transferable process, CATALYST (challenging antibiotic allergystatus), to assess and challenge penicillin allergy status of inpatients within an NHS Foundation Hospital.
Methods: A multidisciplinary team (MDT) steering group reviewed existing literature and protocols enabling penicillin allergy assessment, challenge and de-labelling. Using this, they identified five key steps forming the basis of CATALYST: clinical assessment of the nature of allergy; inclusion/exclusion criteria; consent; direct oral penicillin challenge; and removal of allergy label.
J Midwifery Womens Health
November 2022
Early access to prenatal care is a crucial component in reducing poor perinatal outcomes. Institutional barriers such as insurance enrollment, clinic wait times, and systemic racism dramatically influence perinatal care engagement. The Early Care model seeks to address these barriers through a collaborative care model with licensed midwives and certified nurse-midwives.
View Article and Find Full Text PDFJ Midwifery Womens Health
November 2021
Astrophotonics is an emerging field that focuses on the development of photonic components for astronomical instrumentation. With ongoing advancements, astrophotonic solutions are already becoming an integral part of existing instruments. A recent example is the €60M ESO GRAVITY instrument at the Very Large Telescope Interferometer, Chile, that makes heavy use of photonic components.
View Article and Find Full Text PDFCelestially, positronium (Ps) has been observed only through gamma-ray emission produced by its annihilation. However, in its triplet state, a Ps atom has a mean lifetime long enough for electronic transitions to occur between quantum states. This produces a recombination spectrum observable in principle at near IR wavelengths, where angular resolution greatly exceeding that of the gamma-ray observations is possible.
View Article and Find Full Text PDFIntegrated photonic spectrographs offer an avenue to extreme miniaturization of astronomical instruments, which would greatly benefit extremely large telescopes and future space missions. These devices first require optimization for astronomical applications, which includes design, fabrication, and field testing. Given the high costs of photonic fabrication, multi-project wafer (MPW) silicon nitride (SiN) offerings, where a user purchases a portion of a wafer, provide a convenient and affordable avenue to develop this technology.
View Article and Find Full Text PDFNear-infrared wavelength observations are crucial for understanding numerous fields of astrophysics, such as supernova cosmology and positronium annihilation detection. However, current ground-based observations suffer from an enormous background due to OH emission in the upper atmosphere. One promising way to solve this problem is to use ring-resonator filters to suppress OH emission lines.
View Article and Find Full Text PDFBackground: An estimated 1.4 million persons in the United States identify as transgender or nonbinary, signifying that their gender identity does not correspond with their assigned sex at birth. Individuals assigned female at birth may seek gender-affirming hormone therapy with testosterone.
View Article and Find Full Text PDFIn systematic reviews that lack data amenable to meta-analysis, alternative synthesis methods are commonly used, but these methods are rarely reported. This lack of transparency in the methods can cast doubt on the validity of the review findings. The Synthesis Without Meta-analysis (SWiM) guideline has been developed to guide clear reporting in reviews of interventions in which alternative synthesis methods to meta-analysis of effect estimates are used.
View Article and Find Full Text PDFIntroduction: The midwifery profession in the United States demonstrates a significant lack of diversity. The critical need to address the lack of racial and ethnic diversity in the midwifery workforce is well recognized; little attention, however, has been given to gender diversity. This study focused on gender diversity within midwifery, specifically with regard to men who are midwives.
View Article and Find Full Text PDFBackground: Management of bone and joint infection commonly includes 4-6 weeks of intravenous (IV) antibiotics, but there is little evidence to suggest that oral (PO) therapy results in worse outcomes.
Objective: To determine whether or not PO antibiotics are non-inferior to IV antibiotics in treating bone and joint infection.
Design: Parallel-group, randomised (1 : 1), open-label, non-inferiority trial.
This article focuses on the provision of gender-affirming care and preventive care for transfeminine individuals-those assigned male at birth who identify as female or on the feminine spectrum. To meet the learning needs of health care providers less familiar with gender-affirming care, this article begins with an overview of gender identity concepts. Initiation and management of feminizing gender-affirming hormone therapy is then covered in detail, including common gender-affirming medications and their adverse effects, diagnostic criteria, psychosocial evaluation, initial physical examination and laboratory work, and recommendations for follow-up visits and laboratory monitoring.
View Article and Find Full Text PDFBackground: The management of complex orthopedic infections usually includes a prolonged course of intravenous antibiotic agents. We investigated whether oral antibiotic therapy is noninferior to intravenous antibiotic therapy for this indication.
Methods: We enrolled adults who were being treated for bone or joint infection at 26 U.
J Neural Transm (Vienna)
February 2018
Impulse control disorders (ICDs) in Parkinson's disease (PD) are considered dopaminergic treatment side effects. Cognitive and affective factors may increase the risk of ICD in PD. The aim is to investigate risky decision-making and associated cognitive processes in PD patients with ICDs within a four-stage conceptual framework.
View Article and Find Full Text PDFDecisions in public health should be based on the best available evidence, reviewed and appraised using a rigorous and transparent methodology. The Project on a Framework for Rating Evidence in Public Health (PRECEPT) defined a methodology for evaluating and grading evidence in infectious disease epidemiology, prevention and control that takes different domains and question types into consideration. The methodology rates evidence in four domains: disease burden, risk factors, diagnostics and intervention.
View Article and Find Full Text PDFBackground: The aim was to assess the feasibility of a single-centre, single-blind, randomized, crossover design to explore the effects of two slow-release dopamine agonists, ropinirole and pramipexole, on cued recall in Parkinson's disease. As the design required a switch from the prescribed agonist (pramipexole-to-ropinirole, or ropinirole-to-pramipexole), the primary objectives were to (a) examine the efficacy of processes and procedures used to manage symptoms during the washout period and (b) to use cued recall estimates to inform a power calculation for a definitive trial. Secondary objectives were to assess consent and missing data rates, acceptability of clinical support for the OFF sessions, experience of the OFF sessions and of agonist switching, barriers-to-participation for patients and informal caregivers.
View Article and Find Full Text PDFFiber Bragg gratings in multicore fibers can be used as compact and robust filters in astronomical and other research and commercial applications. Strong suppression at a single wavelength requires that all cores have matching transmission profiles. These gratings cannot be inscribed using the same method as for single-core fibers because the curved surface of the cladding acts as a lens, focusing the incoming UV laser beam and causing variations in exposure between cores.
View Article and Find Full Text PDFBackground: Physical inactivity levels are rising worldwide with major implications for the health of the population and the prevalence of non-communicable diseases. Exercise referral schemes (ERS) continue to be a popular intervention utilised by healthcare practitioners to increase physical activity. We undertook a systematic review of views studies in order to inform guidance from the UK National Institute of Health and Care Excellence (NICE) on exercise referral schemes to promote physical activity.
View Article and Find Full Text PDFObjective: According to a still-controversial view of recognition, projections between the perirhinal cortex and the medial subdivision of the mediodorsal thalamic nucleus (mMDT) support the mnemonic processes underlying familiarity, whereas a separate extended hippocampal system is critical for the recollection of episodic details during recognition.
Method: In this study, we examined item recognition, familiarity, and recollection for faces and words in a patient (OG) with a right-sided lesion centered on the mMDT, which encroached on the central medial midline nucleus and may have resulted in partial disconnection of the mammillothalamic tract. On the basis of OG's neuropathology, the dual-process signal-detection (DPSD) high-threshold theory and the material-specific hypothesis of long-term memory together predicted a material-specific impairment in familiarity for novel facial memoranda, with a lesser decline in recollection of novel faces at short retention intervals.
Medicated, non-dementing mild-to-moderate Parkinson's disease (PD) patients usually show recall/recollection impairments but have only occasionally shown familiarity impairments. We aimed to assess two explanations of this pattern of impairment. Recollection typically improves when effortful planning of encoding and retrieval processing is engaged.
View Article and Find Full Text PDFThe Project on a Framework for Rating Evidence in Public Health (PRECEPT) is an international collaboration of public health institutes and universities which has been funded by the European Centre for Disease Prevention and Control (ECDC) since 2012. Main objective is to define a framework for evaluating and grading evidence in the field of public health, with particular focus on infectious disease prevention and control. As part of the peer review process, an international expert meeting was held on 13-14 June 2013 in Berlin.
View Article and Find Full Text PDFFiber Bragg gratings in multicore fibers have significant potential as compact and robust filters for research and commercial applications. With the aid of an innovative, flat-fielded Mach-Zehnder interferometer, we demonstrate deep (>30 dB) narrow (100 pm at 3 dB; 90 pm at 10 dB) notches in the outer 6 cores of a 7-core fiber at a constant wavelength ( ± 15 pm). This is a crucial step in the development of FBGs operating within multimode fibers that carry an arbitrary number of spatial modes.
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