COVID-19-Associated Carotid Atherothrombosis and Stroke.

We present a radiology-pathology case series of 3 patients with coronavirus disease 2019 (COVID-19) with acute ischemic stroke due to fulminant carotid thrombosis overlying mild atherosclerotic plaque and propose a novel stroke mechanism: COVID-associated carotid atherothrombosis.

Deriving a clinical prediction rule to target sexual healthcare to women attending British General Practices.

Some women attending General Practices (GPs) are at higher risk of unintended pregnancy (RUIP) and sexually transmitted infections (STI) than others. A clinical prediction rule (CPR) may help target resources using psychosocial questions as an acceptable, effective means of assessment. The aim was to derive a CPR that discriminates women who would benefit from sexual health discussion and intervention. Participants were recruited to a cross-sectional survey from six GPs in a city in South-East England in 2016. On arrival, female patients aged 16-44 years were invited to complete a questionnaire that addressed psychosocial factors, and the following self-reported outcomes: 2+ sexual partners in the last year (2PP) and RUIP. For each sexual risk, psychosocial questions were retained from logistic regression modelling which best discriminated women at risk using the C-statistic. Sensitivity and specificity were established in consultation with GP staff. The final sample comprised N = 1238 women. 2PP was predicted by 11 questions including age, binge-drinking weekly, ever having a partner who insulted you often, current smoking, and not cohabiting (C-statistic = 0.83, sensitivity = 73% and specificity = 77%). RUIP was predicted by 5 questions including sexual debut <16 years, and emergency contraception use in the last 6 months (C-statistic = 0.70, sensitivity = 69% and specificity = 57%). 2PP was better discriminated than RUIP but neither to a clinically-useful degree. The finding that different psychosocial factors predicted each outcome has implications for prevention strategies. Further research should investigate causal links between psychosocial factors and sexual risk.

Diamond-shaped optical fiber delivery system.

OBJECTIVE: Physicians who use laser systems are looking for new fiberoptic delivery systems with better performance. We searched for a delivery system with high power and with a tip of high durability that may be reused many times. SUMMARY BACKGROUND DATA: The delivery systems currently found on the market can burn and break easily. The surgeon may either finish the surgery with a damaged delivery system, or have to switch to a new one during surgery, thus increasing the inconvenience and cost of the surgery. METHODS: Distal tips of fibers used with Nd:YAG and diode lasers have been shaped and polished according to their specific function, including excision, vaporization, and coagulation of tissue. RESULTS: We have developed several prototypes of optical fiber delivery systems, and in particular, we have developed a prototype of a delivery system, called the Diamond-Shaped Optical Fiber Delivery System, or Diamond. By making the tip of an optical fiber diamond shaped, we are able to obtain greater mechanical resistance than that of other delivery systems that were tested in our laboratory. In the Colorectal Unit, we applied it in surgical procedures such as perianal fistulectomy, hemorrhoidectomy, and excision of condilomata acuminata and pilonidal cyst and sinuses. During cutting and coagulating, the system performed well with no technical problems. CONCLUSIONS: A new delivery system (Diamond) gave satisfactory performance during surgical operations. Its main component, the diamond-shaped distal end, provided high durability and was reused many times, thus improving the quality of operations and reducing expenses greatly.

Shiftwork and the older worker.

The number of workers employed on shiftwork is large, and it appears to be increasing. The impact of shiftwork on the occupational safety and health of workers is complex and involves both biological and behavioral variables. Current conceptual models propose that the impact of shiftwork, where night work is involved, increases with exposure. At some point the worker is said to reach a tolerance limit beyond which shiftwork is no longer safe. Sleep variables have proven to be sensitive markers for the effects of night shiftwork. Data from U.S. workers show a statistically significant interaction among age, gender, and shift for the workday sleep length of workers on permanent day, afternoon/evening, and night shifts. Sleep length declines with age for both male and female night workers, as well as for male workers on afternoon/evening shifts. In addition, female night workers in the 18-49 age range sleep significantly less than same-age male night workers. Nap behavior also varies with shift, but age and gender effects do not appear to account for the variance. The results support the assumption that most night shiftworkers are at risk even though they often give the appearance of being able to tolerate nocturnal work hours. However, it is not yet clear how age and gender are related to the social, circadian, and environmental factors that influence the sleep length of shiftworkers.

Simultaneous heating and temperature measurements by an infrared laser beam.

A method of simultaneous heating and temperature measuring of a gas absorber by means of an ir CO(2) laser is proposed and tested. The proposed method is relatively simple and direct. In this experiment the temperature on the beam axis as a function of the beam intensity, the beam radius, and the absorber mixture is measured. A good agreement is obtained between the experimental results and theoretical predictions based on the level scheme and the physical characteristics of the absorber. The temperature measurement proposed in the present paper is an additional experimental tool in investigating excitation processes in the ir region.