The effect of multi-leaf collimator leaf width on VMAT treatment plan quality.

Background: The advent of volumetric modulated arc therapy (VMAT) in radiotherapy has made it one of the most commonly used techniques in clinical practice. VMAT is the delivery of intensity modulated radiation therapy (IMRT) while the gantry is in motion, and existing literature has shown it has decreased treatment delivery times and the number of monitor units without sacrificing coverage. It has previously been shown that for IMRT, multi-leaf collimators (MLC) with narrower leaf widths produce demonstrably higher treatment plan quality.

Statin-induced necrotising myositis with heart failure: a lesson in cautious prescribing of common drugs.

Statins are widely prescribed for both the primary and secondary prevention of cardiovascular diseases. However, muscle-related side effects, including weakness, pain and myopathy, are common side effects of statins, reported in up to 5% of users. Here, we present the case of a rare but severe complication of statin use, statin-induced necrotising myositis, which manifested as severe muscle weakness, heart failure and significant morbidity.

Smartphone-Based Pupillometry Using Machine Learning for the Diagnosis of Sports-Related Concussion.

Quantitative pupillometry has been proposed as an objective means to diagnose acute sports-related concussion (SRC). To assess the diagnostic accuracy of a smartphone-based quantitative pupillometer in the acute diagnosis of SRC. Division I college football players had baseline pupillometry including pupillary light reflex (PLR) parameters of maximum resting diameter, minimum diameter after light stimulus, percent change in pupil diameter, latency of pupil constriction onset, mean constriction velocity, maximum constriction velocity, and mean dilation velocity using a smartphone-based app.

The Comprehensive Resilience-building psychosocial Intervention (CREST) for people with dementia in the community: a feasibility and acceptability study.

Background: A dementia diagnosis can lead to a decline in cognitive, social, and physical health, but people with dementia can live meaningful lives and participate actively in society with psychosocial support. This single-arm, non-randomised feasibility study explored the feasibility and acceptability of a Comprehensive REsilience-building psychoSocial intervenTion (CREST) for people with dementia, their caregivers, General Practitioners (GPs), and the public.

Methods: Nine people with dementia and their primary caregivers living in the community (n = 9 dyads) completed the CREST intervention which had three components (cognitive stimulation therapy [CST], physical exercise, and dementia education).

An embedded qualitative study of the experiences of people with dementia, their caregivers and volunteer older adults who participated in the CREST resilience-building psychosocial intervention.

Background: A novel Complex REsilience-building psychoSocial intervenTion (CREST) targeted at people with dementia, their informal carers, general practitioners and the wider community with the aim of increasing resilience and strengthening the personal attributes or external assets of people with dementia living at home, in the community, was developed. It included three components: cognitive stimulation therapy (CST), physical exercise and dementia education. A non-randomised feasibility study was conducted of the CREST intervention, the aim of which was to inform the design of a future randomised controlled trial.

Influence of Preexisting Conditions and Concussion History on Postconcussion Symptom Severity and Recovery Time in Collegiate Athletes.

Mental health conditions and concussion history reported by a collegiate athlete may contribute to prolonged recovery and symptom severity after concussion. This work examined the potential associations among concussion history, preexisting conditions, and sex relative to initial symptom severity and recovery duration following sport-related concussion (SRC) in a cohort of Division 1 National Collegiate Athletic Association athletes. This prospective cohort study analyzed symptom severity, recovery, and return-to-play (RTP) times reported post-SRC using data collected as part of the Pac-12 Concussion Assessment, Research and Education Affiliated Program and Health Analytics Program.

Tipping the Scales: Indiscriminate Use of Interval Scales to Rate Diverse Dysarthric Features.

Purpose: Error related to incorrect use of rating scales is problematic in the assessment and treatment of dysarthria. The main purpose of this project was to determine scale fit for cardinal speech features of hypokinetic dysarthria. A secondary aim was to determine rater reliability for the two different scales explored.

Open-source hardware and software for the measurement, characterization, reporting, and correction of geometric distortion in MRI.

Background: Geometric distortion is a serious problem in MRI, particularly in MRI guided therapy. A lack of affordable and adaptable tools in this area limits research progress and harmonized quality assurance.

Purpose: To develop and test a suite of open-source hardware and software tools for the measurement, characterization, reporting, and correction of geometric distortion in MRI.

Modelling future bone mineral density: Simplicity or complexity?

Background: Osteoporotic fractures are a major global public health issue, leading to patient suffering and death, and considerable healthcare costs. Bone mineral density (BMD) measurement is important to identify those with osteoporosis and assess their risk of fracture. Both the absolute BMD and the change in BMD over time contribute to fracture risk.

Diagnosis of Sports-Related Concussion Using Symptom Report or Standardized Assessment of Concussion.

Importance: The Sports Concussion Assessment Tool-5 (SCAT5) has been recommended for concussion evaluation and utilizes both a subjective reported symptom grading scale and objective measures of concussion including a cognitive evaluation: the Standardized Assessment of Concussion (SAC). The SAC includes testing for orientation, immediate memory, concentration, and delayed recall; a 10-word list is used to assess immediate memory and delayed recall.

Objective: To determine the diagnostic accuracy of components of the SCAT5 and to provide a framework for clinical interpretation.

Recovery duration and concussion severity in sport- and non-sport-related concussion among Pac-12 collegiate athletes: a retrospective cohort study.

Objectives: To examine non-sport- and sport-related concussion severity, clinical care frequency and delayed reporting in relation to recovery duration among collegiate athletes.

Design: Retrospective cohort study.

Setting: Pac-12 varsity collegiate athletes.

Alienation in the Teaching Hospital: How Physician Non-Greeting Behaviour Impacts Medical Students' Learning and Professional Identity Formation.

Introduction: Clinical workplaces offer unrivalled learning opportunities if students get pedagogic and affective support that enables them to confidently participate and learn from clinical activities. If physicians do not greet new students, the learners are deprived of signals of social respect and inclusion. This study explored how physicians' non-greeting behaviour may impact medical students' participation, learning, and professional identity formation in clinical placements.

Key Factors Impacting a Medical Ventilator Supply Chain During the COVID- 19 Pandemic: Lessons for Pandemic Preparedness.

Objectives: Future pandemics may cause more severe respiratory illness in younger age groups than COVID-19, requiring many more mechanical ventilators. This publication synthesizes the experiences of diverse contributors to Medtronic's mechanical ventilator supply chain during the pandemic, serving as a record of what worked and what didn't, while identifying key factors affecting production ramp-up in this healthcare crisis.

Method: In-depth, one-on-one interviews (n = 17) were held with key Medtronic personnel and suppliers.

Virtual rehabilitation for patients with osteoporosis or other musculoskeletal disorders: a systematic review.

This study aims to identify effective ways to design virtual rehabilitation to obtain physical improvement (e.g. balance and gait) and support engagement (i.

Super-resolution neural networks improve the spatiotemporal resolution of adaptive MRI-guided radiation therapy.

Background: Magnetic resonance imaging (MRI) offers superb non-invasive, soft tissue imaging of the human body. However, extensive data sampling requirements severely restrict the spatiotemporal resolution achievable with MRI. This limits the modality's utility in real-time guidance applications, particularly for the rapidly growing MRI-guided radiation therapy approach to cancer treatment.

Nominal Differences in Acute Symptom Presentation and Recovery Duration of Sport-Related Concussion Between Male and Female Collegiate Athletes in the PAC-12.

Background: Sport-related concussion (SRC) is a heterogenous injury that often presents with varied symptoms and impairment. Recently, research has focused on identifying subtypes, or clinical profiles of concussion to be used in assessing and treating athletes with SRC. The purpose of this study was to investigate sex differences in clinical profiles, recovery duration, and initial symptom severity after SRC in a cohort of collegiate athletes in the Pacific-12 Conference (Pac-12).

Towards a core outcome set for dysarthria after stroke: What should we measure?

Objective: To identify and agree on what outcome domains should be measured in research and clinical practice when working with stroke survivors who have dysarthria.

Design: Delphi process, two rounds of an online survey followed by two online consensus meetings.

Setting: UK and Australia.

Bone mineral density and fractures in patients with rheumatoid arthritis: the DXA-HIP project.

Objectives: RA is a chronic disabling disease affecting 0.5-1% of adults worldwide. People with RA have a greater prevalence of multimorbidity, particularly osteoporosis and associated fractures.

SARS-CoV-2 transmission risk for common group activities and settings: a living scoping review.

Background: While the modes of transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are well studied, the risk of transmission in various group settings or activities is less clear. This living scoping review aims to summarize the risk factors of coronavirus disease 2019 (COVID-19) spread in common group activities (e.g.

The complexity of multidisciplinary respiratory care in amyotrophic lateral sclerosis.

Unlabelled: Motor neurone disease/amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder with no known cure, where death is usually secondary to progressive respiratory failure. Assisting people with ALS through their disease journey is complex and supported by clinics that provide comprehensive multidisciplinary care (MDC). This review aims to apply both a respiratory and a complexity lens to the key roles and areas of practice within the MDC model in ALS.

Prevalence of Low Bone Mass and Osteoporosis in Ireland: the Dual-Energy X-Ray Absorptiometry (DXA) Health Informatics Prediction (HIP) Project.

Osteoporosis is a common disease that has a significant impact on patients, healthcare systems, and society. World Health Organization (WHO) diagnostic criteria for postmenopausal women were established in 1994 to diagnose low bone mass (osteopenia) and osteoporosis using dual-energy X-ray absorptiometry (DXA)-measured bone mineral density (BMD) to help understand the epidemiology of osteoporosis, and identify those at risk for fracture. These criteria may also apply to men ≥50 years, perimenopausal women, and people of different ethnicity.