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D-dimer is routinely measured to exclude the diagnosis of venous thromboembolism and is its main biomarker. Appropriate age-adjusted D-dimer testing improves D-dimer specificity, could decrease inappropriate CT pulmonary angiograms in the older person, and prevent unnecessary radiation exposure. A "COVID-19 blood battery", designed to increase the efficiency of evaluation of COVID-19 suspected patients is used in our institution. It includes D-dimers which are elevated in COVID-19 infections and potentially an index of severe infection. These 3 very frail patients presented late to the emergency department, all acutely and non-specifically unwell, with high prevalence of comorbidities and were transferred in by ambulance. They were triaged to the COVID-19 pathway of our hospital, and subsequently had negative COVID-19 swabs. All had an incidental finding of markedly elevated D-dimers, with potential causes of their symptoms other than pulmonary embolus. They were transferred to an acute geriatric ward specifically designated to manage older patients (>75years) who had negative nasopharyngeal swab results. They were all ultimately diagnosed with extensive pulmonary emboli with evidence of raised pulmonary pressures on CTPA and/or echocardiogram. It is possible that these patients had false negative COVID-19 swabs. Allowing for the novel nature of COVID-19, prospective evaluation for new symptoms and complications such as thromboembolic disease in those affected by milder symptoms should be considered. In the absence of clinical improvement following treatment of other conditions in frail older patients, D-dimer testing could be indicated with pursuit of specific diagnostic evaluation for venous thromboembolism when significantly elevated. [ABSTRACT FROM AUTHOR]

Moving visual fields can have strong destabilising effects on balance, particularly when visually perceived motion does not correspond to postural movements. This study investigated relationships between visual field dependence (VFD), as assessed using the roll vection test, and reported dizziness, falls and sway under eyes open, eyes closed and optokinetic conditions. Ninety five falls clinic attendees undertook the roll vection test (i.e. attempted to align a rod to the vertical while exposed to a rotating visual field). Sway was assessed under different visual conditions by centre of pressure movement. Participants also completed questionnaires on space and motion discomfort, fear of falling, depression and anxiety. Thirty four (35.8%) participants exhibited VFD, i.e. had an error >6.5º in the roll vection test. Compared to participants without VFD, participants with VFD demonstrated less movement of the centre of pressure across all visual conditions, were more likely to report space and motion discomfort and to have suffered more multiple falls in the past year. VFD was independent of fear of falling, anxiety and depression. VFD in a falls clinic population is associated with reduced sway possibly due to a stiffening strategy to maintain stance, dizziness symptoms and an increased risk of falls. [ABSTRACT FROM AUTHOR]

Extrinsic interference is routinely faced in systems engineering, and a common solution is to rely on a broad class of filtering techniques to afford stability to intrinsically unstable systems or isolate particular signals from a noisy background. Experimentalists leading the development of a new generation of quantum-enabled technologies similarly encounter time-varying noise in realistic laboratory settings. They face substantial challenges in either suppressing such noise for high-fidelity quantum operations or controllably exploiting it in quantum-enhanced sensing or system identification tasks , due to a lack of efficient, validated approaches to understanding and predicting quantum dynamics in the presence of realistic time-varying noise. In this work we use the theory of quantum control engineering and experiments with trapped 171Yb+ ions to study the dynamics of controlled quantum systems. Our results provide the first experimental validation of generalized filter-transfer functions casting arbitrary quantum control operations on qubits as noise spectral filters. We demonstrate the utility of these constructs for directly predicting the evolution of a quantum state in a realistic noisy environment as well as for developing novel robust control and sensing protocols. These experiments provide a significant advance in our understanding of the physics underlying controlled quantum dynamics, and unlock new capabilities for the emerging field of quantum systems engineering. [ABSTRACT FROM AUTHOR]

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Plasma levels of gastro-entero-pancreatic hormones were examined during 20 migrainous episodes in 17 subjects, each sample being matched with a control from the same individual taken at least one week later. No significant differences were noted in plasma levels of gastrin or vasoactive intestinal peptide (VIP). Plasma insulin levels were, however, significantly lower in the migraine samples (p<0.025). Plasma levels of glucagon were also suppressed when measured with either the N- (<0.0025) or C-terminal (p<0.0005) reactive antibodies. A non-significant (0.05

The proteins of pregnant and foetal sheep and newborn lamb serum were examined by paper electrophoresis. The following changes in serum protein constitution were observed in foetal serum between 81 and 129 days of gestation and in newborn lamb serum up to 19 days after birth: (1) The serum albumin of the foetus was initially lower than that of the mother but rose steadily throughout gestation, and eventually reached a higher level than that of the mother. (2) The α -globulin content of the foetal serum was higher than that of the maternal serum throughout the antenatal period, but fell steadily with increasing foetal age. (3) At 81 days of gestation about one third of the total protein of the foetal serum consisted of α -globulin. The level dropped steadily as parturition approached. (4) The foetal β -globulin rose steadily as gestation continued. (5) The presence of certain degrees of haemolysis in the foetal blood samples collected makes it difficult to draw conclusions about changes occurring in the serum β -globulin of the foetus during intrauterine life. (6) Shortly after birth, and following ingestion of colostrum, a high level of γ-globulin was present in lamb serum. The appearance of γ-globulin in the serum was accompanied by a drop in the albumin level. The serum γ-globulin continued to increase, the albumin to decrease, for several days, after which a reversal of this trend occurred, and the γ-globulin level fell while the albumin level rose. (7) The α -globulin of lamb serum did not appear to undergo any change during the immediate postnatal period. The α -globulin fell sharply however, and the β -globulin rose steadily to reach 12·8 per cent. of the total serum protein 19 days after birth. No conclusions could be drawn about the serum β -globulin changes, if any, occurring after birth. (8) Under the electrophoretic conditions employed, a separation of sheep serum albumin into two, sometimes three, distinct components took place. [ABSTRACT FROM AUTHOR]

The relative distribution of protein-bound polysaccharide in the protein components of pregnant and foetal sheep serum was examined by paper electrophoresis. The foetal α and α -globulins of the foetus were found to be particularly rich in these substances. With increasing foetal age a marked fall in the proportion of the total serum polysaccharide associated with α -globulin was observed. [ABSTRACT FROM AUTHOR]

Aim Emergency dental care is a vital service that new graduates should be prepared to offer. There are few published data relating to emergency dental care education. To assess this, and to gain a profile of accident and emergency departments (A&E) in dental schools, an online survey was sent to all of the dental schools in the Republic of Ireland and the UK.Setting The survey addressed the school's A&E curriculum, teaching methods, undergraduate exposure and departmental details.Results The majority of A&E departments operated during normal working hours with a minority offering an out-of-hours service. Teaching of A&E topics, and undergraduate experience, vary significantly between schools. A&E departments were diversely named and exhibited significant regional variation. Approximately half employed a triage system. It is unclear what represents an adequate level of undergraduate exposure, and more research is required in this area.Conclusions Assessment of undergraduates following time in clinic is an important component of any A&E module. We consider a reflective portfolio to represent a suitable form of assessment, and would recommend their introduction. In addition, we recommend that dental hospitals consider a nurse-led triage system. [ABSTRACT FROM AUTHOR]