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Summary Background In the wake of the SARS-CoV-2 pandemic and unprecedented global demand, clinicians are struggling to source adequate access to personal protective equipment. Respirators can be in short supply, though are necessary to protect workers from SARS-CoV-2 exposure. Rapid decontamination and reuse of respirators may provide relief for the strained procurement situation. Method In this study, we investigated the suitability of 70°C dry heat and microwave-generated steam (MGS) for reprocessing of FFP2/N95-type respirators, and Type-II surgical face masks. Staphylococcus aureus was used as a surrogate as it is less susceptible than enveloped viruses to chemical and physical processes. Results We observed >4 log10 reductions in the viability of dry S. aureus treated by dry heat for 90 min at 70°C and >6 log10 reductions by MGS for 90 s. After 3 reprocessing cycles, neither process was found to negatively impact the bacterial or NaCl filtration efficiency of the respirators that were tested. However, MGS was incompatible with Type-II surgical masks tested, as we confirmed that bacterial filtration capacity was completely lost following reprocessing. MGS was observed to be incompatible with some respirator types due to arcing observed around some types of metal nose clips and by loss of adhesion of clips to the mask. Conclusion Considering the advantages and disadvantages of each approach, we propose a reprocessing personal protective equipment/face mask workflow for use in medical areas.

Cationic biocides are widely utilized for surface disinfection. Photosensitizers such as toluidine blue O (TBO) produce reactive oxygen species following light excitation and are being investigated as novel biocides for similar applications. Aspergillus brasiliensis conidia contain melanin which protects against environmental stressors. The negative charge and antioxidant properties of melanin may confer resistance to photosensitizers and other biocides. In this study, the yeasticidal and fungicidal activity benzalkonium chloride (BZC), sodium dichloroisocyanurate (NaDCC) and TBO with red light were examined using quantitative suspension tests. All three biocides were highly effective against Candida albicans and > 5·0 log10 reductions in viability were attainable within 5 minutes. Wild‐type A. brasiliensis conidia were highly tolerant to treatment and 0·4 log10 reductions in viability were observed within the same time frame when treated with TBO or BZC. NaDCC was markedly more effective. Inhibition of melanin biosynthesis by culturing with 100 μg ml−1 kojic acid resulted in a hypopigmented phenotype with significantly increased sensitivity to all three biocides. These observations indicate that melanin is a significant contributor towards A. brasiliensis tolerance of biocides and photosensitizers and demonstrate that cationic biocides are poorly suited to applications where the control of A. brasiliensis is required.

Although numerous online resources for gross anatomy are available, most feature two-dimensional photographs generated by traditional cameras. To determine whether the incorporation of light field photographs (images with an adjustable focal point) into an online anatomy resource would result in improved learning beyond traditional photographs, two online learning modules on the gross anatomy of the orbit were created. The modules were identical in content except for the type of photography used (traditional = control; light field = experimental). Students were randomly assigned into two groups and viewed one of the two learning modules. Pre- and post-quizzes comprised of a mixture of questions involving a low and high degree (rated by experienced faculty) of spatial difficulty were administered. A survey was distributed to assess student evaluations of the module. Students (N = 49; 26 control, 23 experimental) demonstrated increased quiz scores from pre- (control = 34.6 ± 15.6%, experimental = 24.3 ± 16.5%) to post-quizzes (control = 77.3 ± 20.7%, experimental = 71.3 ± 17.9%, P

Incidence rates of a third head of biceps brachii muscle have been shown to vary based on race, sex, and side of the body. Traditionally, males were thought to have higher incidences than females, and the right limb was thought to most frequently contain an additional head of biceps brachii. Additionally, innervation of this third head has been unclear, with musculocutaneous nerve, median nerve, or a combination of both providing nerve supply. Here we present findings of the dissection of 23 cadavers (n = 46 limbs), in which 6 limbs demonstrated a third head of biceps brachii. Of the 6 limbs with a third head, 3 were left and 3 were right limbs, with one cadaver having the extra muscle head bilaterally. Incidence rates in females in the current study were observed to be higher than expected (20.8%), while males showed a 4.5% occurrence. All 6 of the additional heads of biceps brachii observed were innervated by musculocutaneous nerve. Together these data show a higher than expected number of female cadavers with a third head of biceps brachii, equal incidence between sides of the body, and uniform innervation by musculocutaneous nerve. These findings challenge our traditional understanding of the third head of biceps brachii and suggests a need for additional study of this complex anatomical variation. Keywords: Biceps brachii, Third head, Innervation, Sex, Cadaver, Variation

Personal computer use for educational purposes by the healthcare professions students has become ubiquitous. Although the effect of computer-based dissection instructions has been studied, there is a paucity of information regarding student browsing habits of information available on the Internet. Although current students have favorable attitudes toward accessing anatomical information online, web browsing habits have not yet been investigated specifically in the dissection laboratory setting. The purpose of this study was to describe the browsing habits of the healthcare professions students in the gross anatomy setting using a retrospective analysis. Files containing web browser history were retrieved from desktop computers in the gross anatomy laboratory and custom code was written to parse them into comma separated value files. Each web address was categorized and descriptive statistics was calculated. Browser history for 24 computers was analyzed from June 2013 to January 2015. During this period, students accumulated 100,857 webpage visits. Most often, students performed a Google search for anatomy (22.0% of all visits) and non-anatomy related (20.6% of all visits) information. Students also used the web browser to access various entertainment (16.4% of all visits) and productivity related services (15.9% of all visits). This analysis revealed a large volume of webpage visits by the healthcare professions students in the gross anatomy laboratory. A wide diversity of anatomy and non-anatomy related webpages were visited. Future analyses could be directed at examination of when in relation to class time students accessed the information, how browsing habits change over time, and what anatomical structures were most commonly searched for.

Background Despite rescheduling of cannabis to Schedule 2 and amendments to the law permitting legal availability of cannabis for the treatment of medical conditions, access to cannabis for medical use remains challenging for patients in the United Kingdom (UK). Recreational use is widespread despite laws stating users can be sentenced to prison for up to 5 years for possession. Objective The aim of the study was to develop a model for a legal cannabis market in the UK building upon the results of a preceding study in which a UK population sample determined that pharmacies are the most suitable primary legal vendor of cannabis as opposed to regulated shops or the black market. Methods An online survey was developed using Qualtrics software and advertised via the Multidisciplinary Association for Psychedelic Studies’ Facebook, Twitter and Instagram social media accounts and monthly newsletter. Results Three hundred and ninety seven individuals, a majority having used cannabis at least once, consented to participate in the study. The participants concluded that there is enough evidence for cannabis to be prescribed to treat a range of medical conditions. In addition to pharmacies providing cannabis to patients with a prescription, a majority of participants supported cannabis being sold in pharmacies for harm reduction purposes and allowing access to medicinal cannabis in cases where supporting evidence is insufficient to merit a prescription. Participants supported greater integration between dispensing pharmacies and mental health services. Overall, the participants did not oppose a consultation or screening for potential cannabis users prior to obtaining access from licensed vendors. UK participants were supportive of the concept of a cannabis card, which users can present to licensed vendors such as pharmacies, with specific recommendations (such as strains relevant to a patient’s medical condition) being coded into the card. A majority of participants supported the existence of shisha-type bars for the purchase and onsite consumption of cannabis and determined that such vendors should not be part of a pharmacy chain of stores or regulated by pharmacy regulators. The participants generally preferred that laws regarding public consumption are in line with existing smoking legislation. Participants determined that it should be legally permitted to grow cannabis at home for personal medical and non-medical purposes but not to sell for profit. Conclusion The results are suggestive of a regulatory system that medical and non-medical cannabis users can use which aims to maximise therapeutic applications, minimise harms and respect individual liberty.

Objective: The purpose of this study was to investigate the utilization and perception of live blogged sessions of a physical therapy (PT) conference. Methods: Sessions at an international PT conference were covered in real time using a live-blogging platform. Session coverage could be viewed remotely using computers and mobile devices. Viewers could interact with the content by clicking on links and using the comment feature. Sessions could also be replayed following their conclusion. An online survey of user perceptions was made available the week following the conference. Results: Twenty-four sessions were live blogged with an average session length of 67 min (range: 27–120). On average, live sessions received 27 views (range: 2–65), 18 clicks (range: 2–36), and 2 comments (range: 0–10). The average time spent viewing a live session was 28 min (32% of viewers 1 min). Following the conference, session replays totaled 7206 views and 2910 clicks. The average survey respondent (n = 17) watched five live sessions (range: 1–17) and found the updates easy to read (4.5 on a scale of 5.0). When asked if they learned something from the coverage, 94% of respondents said yes and 94% said they would view if available for an upcoming conference. Discussion: Live blogging extended the viewing audience and facilitated viewer engagement. Survey respondents found the coverage educational, of high quality, and would participate again in the future.

Hepcidin belongs to the antimicrobial peptide family but has weak activity with regards to bacterial killing. The regulatory function of hepcidin in humans serves to maintain an iron-restricted environment that limits the growth of pathogens; this study explored whether hepcidin affected bacterial iron homeostasis and oxidative stress using the model organism Escherichia coli. Using the Miller assay it was determined that under low iron availability exposure to sub-inhibitory doses of hepcidin (4-12μM) led to 2-fold and 4-fold increases in the expression of ftnA and bfd, respectively (P < 0.05), in both a wild type (WT) and Δfur (ferric uptake regulator) background. Quantitative real-time PCR analysis of oxyR and sodA, treated with 4 or 8 μM of hepcidin showed that expression of these genes was significantly (P < 0.05) increased, whereas expression of lexA was unchanged, indicating that hepcidin likely mediated oxidative stress but did not induce DNA damage.

In brief: In a preliminary study to evaluate possible causes of exhaustion, 48 runners who collapsed during or after an ultramarathon race were questioned about their training methods. The training profiles were compared with those of matched controls who had finished the same race without collapsing. Possible contributing factors found among the collapsed runners included inadequate training, failing to carbohydrate load, not eating a prerace breakfast, prerace illness, and hypothermia (during one race, which was run in cold, wet, windy conditions). The authors suggest that regardless of athletic ability or previous racing experience, runners may be prone to collapse during or after ultramarathon races if their prerace training and preparation are inadequate.

Background:Contemporary research indicates that the legal classifications of cannabis (Schedule 2, Class B), 3,4-methylenedioxymethamphetamine (MDMA) (Schedule 1, Class A) and psilocybin (Schedule 1, Class A) in the United Kingdom are not entirely based on considerations of harm and therapeutic utility. The legal classifications of the substances discussed are typically determined by legislators such as Parliament and, therefore, may be a reflection of the views or perceived views of the general public.Objective:The aim of the study was to provide an indication of the underlying psychology regarding the legislated sale of alcohol, tobacco, cannabis, MDMA and psilocybin in pharmacies according to a UK general population sample.Methods:A sample of 105 UK nationals was selected for the survey. Participants were asked questions on perceived relative harm of the five substances. After viewing contemporary information on reported relative harm and therapeutic applications, the participants were asked questions related to using the pharmacy retail model for the sale of the substances discussed. Participants who opposed the substances being sold primarily in pharmacies were asked to explain their rationale according to a predetermined list of options for each of the five drugs. Participants were also asked whether they consider it a human right to be legally permitted to consume the substances.Results:The participants' perceptions of relative harm (tobacco > MDMA > psilocybin > alcohol > cannabis) were not in agreement with the relative harm reported in the literature (alcohol > tobacco > cannabis > MDMA > psilocybin). Principal objections to the currently illicit substances being legally available in pharmacies include it sending the wrong message; it feels wrong; it is too dangerous; disliking the smell of cannabis; disapproval of the people; and not liking the idea of people using psychoactive drugs for entertainment or to have mystical/religious experiences. Overall, the participants determined that being legally permitted to consume the substances discussed is an issue of relevance to human rights. A majority of the male participants concluded that being legally permitted to consume alcohol, tobacco, cannabis and Psilocybe mushrooms is a human right in contrast to the majority of female participants who solely considered alcohol consumption to be a human right.Conclusions:The data suggest that the legal classifications may not simply be based on considerations of harm. Misperceptions of the dangers, biases and non-health-related aversions likely contribute to the continuation of policies that do not reflect the state of scientific research.

Background: Wiki platform use has potential to improve student learning by improving engagement with course material. A student-created wiki was established to serve as a repository of study tools for students in a medical school curriculum. There is a scarcity of information describing student-led creation of wikis in medical education. Objective: The aim is to characterize website traffic of a student-created wiki and evaluate student perceptions of usage via a short anonymous online survey. Methods: Website analytics were used to track visitation statistics to the wiki and a survey was distributed to assess ease of use, interest in contributing to the wiki, and suggestions for improvement. Results: Site traffic data indicated high usage, with a mean of 315 (SD 241) pageviews per day from July 2011 to March 2013 and 74,317 total user sessions. The mean session duration was 1.94 (SD 1.39) minutes. Comparing Fall 2011 to Fall 2012 sessions revealed a large increase in returning visitors (from 12,397 to 20,544, 65.7%) and sessions via mobile devices (831 to 1560, 87.7%). The survey received 164 responses; 88.0% (162/184) were aware of the wiki at the time of the survey. On average, respondents felt that the wiki was more useful in the preclinical years (mean 2.73, SD 1.25) than in the clinical years (mean 1.88, SD 1.12; P