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Background Limited research indicated patients were largely amenable to seeing medical students pre-pandemic. However, the COVID-19 pandemic has highlighted the potential risk of nosocomial transmission and harm to patients from students. Patient opinions regarding these risks remain unexplored, which impacts elicitation of informed consent. We aim to identify these, and explore whether reflection on the risks and benefits of direct student interaction influenced patients’ attitudes. For guidance, we further explored measures to reduce perceived infection risk. Method We designed an original questionnaire for a cross-sectional study, completed by 200 inpatients from 25 wards between 18/02 and 16/03/2022 at Derriford Hospital, Plymouth. Patients in intensive care, with active COVID-19 infection or unable to comprehend the study information were excluded. The responses of a guardian were recorded for inpatients under 16. 17 questions were included - the initial question, reporting willingness to talk with and be examined by students, was repeated following nine questions exploring risks and benefits of student interaction. A further four questions addressed reducing the perceived infection risk. Data is summarised using frequencies and percentages, and with Wilcoxon signed-rank and rank-sum tests of association. Results 85.4% (169/198) of participants gave an initial positive response to seeing medical students, and despite a third of participants changing their response 87.9% (174/197) remained willing after the survey resulting in no significant change. Furthermore, 87.2% (41/47) of those who perceived themselves at severe risk of harm from COVID-19 remained happy to see students. Participants reported reassurance knowing students were: fully vaccinated (76.0%); wearing masks (71.5%); lateral flow test negative within the last week (68.0%) and wearing gloves and gown (63.5%). Conclusion This study demonstrated the willingness of patients to engage in medical education despite recognised risks. Patient reflection on the risks and benefits of student interaction did not significantly reduce numbers willing to see students. Even those perceiving a risk of serious harm remained happy to have direct student contact – a demonstration of altruism in medical education. This suggests informed consent should include discussion of infection control measures, risks and benefits to patients and students, and offer alternatives to direct inpatient contact.

This study assessed the nutrient composition, physicochemical, functional and sensory properties of flour blends prepared from cooking banana, pigeon pea and orange fleshed sweet potato flour blends for use as complementary food. Fourteen blends were generated using the simplex centroid mixture design. All data obtained were subjected to analysis of variance and the mean values were separated using Duncan’s Multiple Range Test. The protein, crude fibre, crude fat, ash and carbohydrate of the blends were significantly (p≤0.05) different with values ranging from 10.60-21.65%, 0.36-1.24%, 1.2-1.43%, 0.77 – 2.25% and 65.86 -75.36%, respectively. There was no significant (p≤0.05) difference in the moisture content, total carotenoid content and pH value of the blends. The L* value (40.77 to 45.25) showed no significant (p≤0.05) difference while the redness (a*) and yellowness (b*) value were significantly (p≤0.05) different with values ranging from 2.32 – 4.59 and 11.88 – 15.88 respectively. There was a significant (p≤0.05) difference in the bulk density (0.73 – 0.78 g/ml), water absorption capacity (122.05-178.10%), swelling power (6.21 – 8.48%) and solubility (3.77-7.30%) values. Gruels obtained from the flour blends had sensory scores of above 6.00 (on a 9-point Hedonic scale), signifying high acceptability for all the sensory attributes evaluated.

A deep vein thrombosis (DVT) is the term given to a medical condition in which a blood clot forms in a vein. DVTs most commonly form in the legs but may also present, although infrequently, in other areas of the body such as the arms or abdomen.1 According to Virchow’s triad, the predisposing factors to thrombosis are prolonged stasis, hypercoagulable states and endothelial injury.2 DVTs are vitally important to diagnose as clots can disintegrate and travel, or embolise, to the lungs where they may ultimately prove fatal. Clots located above the popliteal vein are classified as proximal DVTs, while clots which form below the popliteal vein are classified as distal DVTs.3 To locate a suspected acute DVT, ultrasound scans (USS) are performed. There are two main types of USS: proximal USS, which examines the upper region of the …

Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are clinically and molecularly heterogeneous clonal myeloid disorders with a poor prognosis especially in the relapsed refractory setting and in patients above the age of 60. While allogeneic hematopoietic stem cell transplantation (ASCT) is a potentially curative approach, high relapse, morbidity, and mortality rates necessitate the development of alternative therapies. Immune checkpoint inhibitors unmask tumoral immune tolerance and have demonstrated efficacy in the treatment of chemotherapy-resistant hematologic and solid malignancies. The rationale for the investigation of those agents in AML and MDS is supported by an observed increased expression of programmed cell death 1 protein (PD-1) and ligand 1 (PD-L1) in the hematopoietic microenvironment of AML and MDS, and its association with low TP53 and a poor prognosis. Early clinical experience in combination with a hypomethylating agent has shown encouraging responses; however, larger clinical trials are needed to determine the role of checkpoint inhibition in myeloid malignancies.

Importance Racial bias is associated with the allocation of advanced heart failure therapies, heart transplants, and ventricular assist devices. It is unknown whether gender and racial biases are associated with the allocation of advanced therapies among women. Objective To determine whether the intersection of patient gender and race is associated with the decision-making of clinicians during the allocation of advanced heart failure therapies. Design, Setting, and Participants In this qualitative study, 46 US clinicians attending a conference for an international heart transplant organization in April 2019 were interviewed on the allocation of advanced heart failure therapies. Participants were randomized to examine clinical vignettes that varied 1:1 by patient race (African American to white) and 20:3 by gender (women to men) to purposefully target vignettes of women patients to compare with a prior study of vignettes of men patients. Participants were interviewed about their decision-making process using the think-aloud technique and provided supplemental surveys. Interviews were analyzed using grounded theory methodology, and surveys were analyzed with Wilcoxon tests. Exposure Randomization to clinical vignettes. Main Outcomes and Measures Thematic differences in allocation of advanced therapies by patient race and gender. Results Among 46 participants (24 [52%] women, 20 [43%] racial minority), participants were randomized to the vignette of a white woman (20 participants [43%]), an African American woman (20 participants [43%]), a white man (3 participants [7%]), and an African American man (3 participants [7%]). Allocation differences centered on 5 themes. First, clinicians critiqued the appearance of the women more harshly than the men as part of their overall impressions. Second, the African American man was perceived as experiencing more severe illness than individuals from other racial and gender groups. Third, there was more concern regarding appropriateness of prior care of the African American woman compared with the white woman. Fourth, there were greater concerns about adequacy of social support for the women than for the men. Children were perceived as liabilities for women, particularly the African American woman. Family dynamics and finances were perceived to be greater concerns for the African American woman than for individuals in the other vignettes; spouses were deemed inadequate support for women. Last, participants recommended ventricular assist devices over transplantation for all racial and gender groups. Surveys revealed no statistically significant differences in allocation recommendations for African American and white women patients. Conclusions and Relevance This national study of health care professionals randomized to clinical vignettes that varied only by gender and race found evidence of gender and race bias in the decision-making process for offering advanced therapies for heart failure, particularly for African American women patients, who were judged more harshly by appearance and adequacy of social support. There was no associated between patient gender and race and final recommendations for allocation of advanced therapies. However, it is possible that bias may contribute to delayed allocation and ultimately inequity in the allocation of advanced therapies in a clinical setting.

Effects of milking frequency on milk yield, dry matter intake (DMI) and effeciency of feed utilization for milk production was investigated in West African Dwarf (WAD) goats at Abeokuta in the humid zone of South Western Nigeria. Seventeen WAD goats were fed a ration comprising (on dry matter basis) 50% grass (Pennisetum purpureum) and 50% concentrate (17% crude protein) at 5% body weight. The study involved hand milking once (at 6.00 am), twice (at 6.00am and 6.00pm) and thrice (at 6.00 am, 2.00 pm and 10.00 pm) daily for 21 and 35 days covering two periods, from June-October 2004 (Trial I) and April-July 2005 (Trial II) in a randomised complete block design. Kids were separated from their dams at day 14 and artificially reared. Compared to twice (2x) daily milking (322.2 mL/day), the milk yield for once (1x) daily milking (181.5 mL/day) was significantly (p0.05). As lactation progressed, day of lactation significantly (p0.05). Milking frequency had significant effect (p