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Introduction The COVID-19 pandemic has resulted in many people experiencing bereavement in challenging circumstances. In April 2020 at a large London Trust, a “Bereavement Welfare Hub” (BWH) was established to offer support and advice by telephone to relatives and carers of all adults who died as inpatients. Data from these calls has been used to examine and learn from experiences of the bereaved at this time. Methods Data from BWH call records regarding 809 adults who died at the Trust in March - May 2020 were collated and analysed quantitatively. A random selection of 149 call records were examined using thematic analysis. Results 809 adults died at the Trust between March and May 2020. The mean age at death was 76 (SD=14) and 86% of deaths occurred on medical wards (outside intensive care). Bereavement calls were completed in 663 (82%) of cases. From analysis of call records, several themes that influenced the bereavement experience were identified. These included support from family and community, communication and contact with the dying person, support from bereavement services and ability to carry out usual rituals associated with dying. Conclusions Age is a significant risk factor for death from COVID-19 and the majority of deaths have occurred on medical wards. Improving hospital care of dying patients during the pandemic or at any time is relevant to geriatricians and other healthcare professionals working with older people. Our analysis identifies several factors which positively or negatively influenced the experiences of people bereaved during the first wave of COVID-19. From these findings, recommendations have been made which have the potential to improve the bereavement experience, particularly during the pandemic era.

We have investigated the relationship between the function of the genehindsight(hnt), which is the Drosophila homolog ofRas Responsive Element Binding protein-1(RREB-1), and the EGFR signaling pathway. We report thathntmutant embryos are defective in EGFR signaling dependent processes, namely chordotonal organ recruitment and oenocyte specification. We also show the temperature sensitive hypomorphic allelehntpebbledis enhanced by the hypomorphic MAPK allelerolled(rl1). We find thathntoverexpression results in ectopicDPax2expression within the embryonic peripheral nervous system, and we show that this effect is EGFR-dependent. Finally, we show that the canonical U-shaped embryonic lethal phenotype ofhnt,which is associated with premature degeneration of the extraembyonic amnioserosa and a failure in germ band retraction, is rescued by expression of several components of the EGFR signaling pathway (sSpi,Ras85DV12,pntP1) as well as the caspase inhibitorp35. Based on this collection of corroborating evidence, we suggest that an overarching function ofhntinvolves the positive regulation of EGFR signaling.

Seven patients with atherosclerotic coronary artery disease documented by coronary angiography and exercise stress testing were treated with the American Heart Association Step II Diet, a walking program, and combination drug therapy with niacin, cholestyramine, gemfibrozil, and/or lovastatin. As a result of this intervention, there was a mean weight loss of 24.7 pounds, a mean reduction in cholesterol from 297 mg% to 167 mg%, a mean increase in high density lipoprotein cholesterol from 33 mg% to 55 mg%, and a mean reduction in triglyceride levels from 248 mg% to 58 mg%. Repeat exercise stress testing and coronary angiography were performed 2 years after the initial catheterization. Photographs of end-diastolic frames were compared utilizing the same views with the same magnification. In six of the seven patients, there was a mean increase in luminal area at the greatest stenosis of 1.3 mm2 in eight lesions present at initial catheterization. In four of these six patients, there was evidence for improvement in coronary blood flow manifested by improvement in electrocardiogram (ECG) exercise stress testing and/or exercise thallium stress testing. In one patient, there was a mean decrease in luminal area at greatest stenosis of 1.35 mm2 in two lesions and the development of an additional plaque in an area which was previously normal. In addition, this patient had evidence for progression by ECG exercise stress testing. Aggressive risk factor modification can reverse what were previously considered "fixed" atherosclerotic lesions in selected patients.