Notes

DICOM 3D visitors, virtual truth or perhaps 3 dimensional producing -- an airplane pilot usability review with regard to examining the preferred choice of orthopaedic doctors.
This survey highlights rheumatologists' perception in the delivery of future care and anxiety they faced. As demonstrated by this survey, the National Institute for Health and Care Excellence (NICE) guidance did not influence clinician decision making in some aspects of patient care. Underutilization of tele-rheumatology in this survey should be considered whilst planning the restoration of rheumatology services in the post-COVID era. Key points • COVID-19 has generated significant concerns among rheumatology community about their mental well-being. • In over 50% of cases, rheumatologists stopped IV biologic drugs as per patients' wishes during the first wave of the pandemic. • Tele-rheumatology has been used more widely during the pandemic, but the extent of its use in the post-COVID era is less clear. Evolving evidence will determine its future wider use.
Cataract surgery represents a significant workload for ophthalmologists in Ireland. Post-operative shared care with community optometrists can reduce the need for hospital follow-up appointments.

Eight years after the introduction of a shared-care pathway, we wished to quantify the proportion of patients discharged to the community for post-operative follow-up, and the number that re-present to the hospital due to cataract-related issues.

We collected data on all patients who underwent cataract surgery in our centre over a three month period. Electronic patient records were used to establish whether the patient was discharged on the day of surgery, and whether they re-attended the department post-operatively. Post-operative complications were recorded.

394 cataract procedures were carried out over the three months. 369 patients were discharged to an optometrist for their post-operative care. Of those, 38 were re-referred or re-presented to the hospital ophthalmic service. 21 of these had a post-operative complication. Complications included seven cases of post-operative uveitis, 5 patients with cystoid macular oedema, one retinal detachment and one retained lens fragment.

Community optometrist-led post-operative care for uncomplicated patients is an effective way of reducing the workload associated with cataract surgery. Re-referral pathways must be in place to facilitate timely management of post-operative complications.
Community optometrist-led post-operative care for uncomplicated patients is an effective way of reducing the workload associated with cataract surgery. Re-referral pathways must be in place to facilitate timely management of post-operative complications.The phenotypic description is the oldest method for animal taxonomic studies. In this study, we report phenotypic traits of discriminant power to assign sheep individuals into Awassi breed or other exotic breeds found in Jordan. Twenty-two and 19 phenotype traits for ewes and rams, respectively, were utilized using multivariate and discriminant analyses. Seven traits, out of them, for ewes and five for rams were qualitative traits body color, nose shape, horn presence, ear shape, wattles presence, udder shape, and teat placement. The other 15 traits were quantitative traits body weight, head width, head length, chest depth, chest girth, shoulder width, withers height, foreleg height, shin circumference, body length, rump width, rump length, rump height, rear leg height, and udder height. The traits were taken on 1697 and 652 adult ewes and rams of different breeds, respectively. The breeds were predefined as Awassi and three exotic breeds Chios, Assaf, and improved Awassi sheep. The results indicated a significant relationship of the 21 and 16 studied traits in assigning and discriminating individual's sheep into their correct breed. The analysis revealed the clustering of the three strains of Awassi sheep in Jordan as the Baladi, the Naemi, and the Saqri. The genetic distances have also confirmed the findings. However, the potential of gene flow between Awassi strains and the exotic breed was reported. The phenotypic traits with discriminant power would be utilized in a guideline for sheep taxonomy in general and for Awassi sheep in particular.Extensive research has demonstrated the transactional nature of parent-child psychopathology, with limited studies examining these effects during late adolescence and none, to our knowledge, longitudinally during the COVID-19 pandemic. The current study examined the cross-lagged effects of parent and adolescent internalizing symptoms during the COVID-19 pandemic and the moderating role of avoidant coping. A sample of 291 adolescents (Age mean = 18.27; 53% female; 61% White) and their parents rated their own anxiety and depressive symptoms and coping during the first two months following stay-at-home orders during the COVID-19 pandemic. Parent internalizing symptoms at the first assessment predicted adolescent internalizing symptoms at the second assessment. Adolescent avoidant coping style moderated this effect of parent internalizing symptoms on adolescent internalizing symptoms in the subsequent month, such that parent internalizing symptoms predicted child internalizing symptoms only among adolescents with moderate to high rates of avoidant coping. Follow-up analyses indicated different patterns when examining depressive and anxiety symptoms separately. The results highlight complex family dynamics between adolescents and their parents and begin to differentiate how individual characteristics impact the response to a significant life event such as the COVID-19 pandemic.Coping that is adaptive in low-stress environments can be ineffective or detrimental in the context of poverty. Identifying coping profiles among adolescents facing varying levels of stress can increase understanding of when and for whom coping may be most adaptive. The present study applied latent profile analysis (LPA) to identify coping profiles in two distinct samples of adolescents a community sample of youth aged 11-16 years (N = 374, Mage = 13.14, 53% girls), and a low-SES sample of youth aged 12-18 years (N = 304, Mage = 14.56, 55% girls). The ten coping subscales of the Responses to Stress Questionnaire were included as indicators in the LPAs (problem solving, emotion regulation, emotion expression, acceptance, positive thinking, cognitive restructuring, distraction, denial, wishful thinking, and avoidance). Five profiles were identified in the community sample Inactive, Low Engagement, Cognitive, Engaged, and Active Copers. All but the Low Engagement Copers profile were also identified in the low-SES sample, suggesting that adolescents employ similar coping strategies across contexts, but fewer low-SES adolescents engage in lower levels of coping. Profiles differed by gender and symptoms of internalizing psychopathology. Inactive copers in both samples were more likely to be male. Engaged Copers reported the lowest symptom levels whereas Active Copers reported higher symptoms. Cognitive Copers reported higher levels of anxious and depressive symptoms in the low-SES sample only, suggesting that this pattern of coping may be protective only in less stressful contexts. Elucidating within-person coping patterns is a promising avenue for targeting interventions to those most likely to benefit.The 2019 novel coronavirus (COVID-19) has quickly become one of the most dire international pandemic crises since the 1918 Spanish flu. Evidence for COVID-19 pharmacological therapies has shown rapid growth and a diverse array of results, but an assessment of the value of each piece of evidence must be reinforced. This article aims to review utilized therapies, the evidence level supporting these therapies, as well as drugs under investigation for the treatment of COVID-19. Primary scrutinized therapies include antiviral regimens, such as remdesivir, hydroxychloroquine/chloroquine, lopinavir/ritonavir, immunomodulating drugs, such as corticosteroids and interleukin (IL) inhibitors, and other therapies including convalescent plasma. Only one therapy, dexamethasone, has shown a mortality benefit in randomized controlled trials and summarized evidence for other therapies show limited positive results. Reviewing these therapies in a historical way shows how limited evidence can drive therapy decisions. A broad summary of available evidence can assist clinicians in a return to hierarchical assessments of evidence which can lead to safer patient outcomes, improved distribution of resources, and better targets for appropriate therapy decisions.
Quality improvement (QI) tools can identify and address health disparities. This paper describes the use of resident prescriber profiles in a novel QI curriculum to identify racial and ethnic differences in antidepressant and antipsychotic prescribing.

The authors extracted medication orders written by 111 psychiatry residents over an 18-month period from an electronic medical record and reformatted these into 6133 unique patient encounters. Binomial logistic models adjusted for covariates assessed racial and ethnic differences in antipsychotic or antidepressant prescribing in both emergency and inpatient psychiatric encounters. A multinomial model adjusted for covariates then assessed racial and ethnic differences in primary diagnosis. Models also examined interactions between gender and race/ethnicity.

Black (adjusted OR 0.66; 95% CI, 0.50-0.87; p < 0.01) and Latinx (adjusted OR, 0.65; 95% CI, 0.49-0.86; p < 0.01) patients had lower odds of receiving antidepressants relative to White patients derve as a powerful tool to promote resident QI learning around the effects of structural racism on clinical care.
The peritoneum is a predilection site for gastric cancer metastases. Current standard treatment for gastric cancer patients with synchronous peritoneal metastases is palliative systemic therapy. Eflornithine However, its efficacy is largely unknown. The aim of this study was to investigate the incidence, treatment and survival patterns of gastric cancer patients with synchronous peritoneal metastases in the Netherlands.

All newly diagnosed gastric adenocarcinoma patients with synchronous peritoneal metastases between 1999 and 2017 were selected from the Netherlands Cancer Registry (NCR). Incidence, treatment and survival patterns were analyzed.

In total, 3,773 patients were identified from the NCR. The incidence of synchronous peritoneal metastases in gastric cancer patients increased from 18% in 2008 to 27% in 2017. The use of systemic therapy increased from 15% in 1999-2002 to 43% in 2013-2017 (p < 0.001). The median survival of the entire cohort did not significantly increase over time. Median survival of patients treated with systemic therapy increased from 7.4months in 1999-2002 to 9.4months in 2013-2017 (p = 0.005). In contrast, median survival of patients not treated with systemic therapy decreased from 3.3months in 1999-2002 to 2.1months in 2013-2017 (p < 0.001). Some clinical and pathological data such as the extent of the peritoneal metastases were not available.

Synchronous peritoneal metastases are increasingly diagnosed in gastric cancer patients. In recent years, more patients were treated with systemic treatment and survival of these patients increased. However, as survival of the entire group did not improve over time, the effect of systemic therapy remains unknown.
Synchronous peritoneal metastases are increasingly diagnosed in gastric cancer patients. In recent years, more patients were treated with systemic treatment and survival of these patients increased. However, as survival of the entire group did not improve over time, the effect of systemic therapy remains unknown.
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