The Galactic magnetar SGR 1935+2154 has been reported to produce the first example of a bright millisecond-duration radio burst (FRB 200428) similar to the cosmological population of fast radio ...bursts (FRBs). The detection of a coincident bright X-ray burst represents the first observed multiwavelength counterpart of an FRB. However, the search for similar emission at optical wavelengths has been hampered by the high inferred extinction on the line of sight. Here, we present results from the first search for second-timescale emission from the source at near-infrared (NIR) wavelengths using the Palomar Gattini-IR observing system in the J band, enabled by a novel detector readout mode that allows short exposure times of 0.84 s with 99.9% observing efficiency. With a total observing time of 12 hr ( 47,728 images) during its 2020 outburst, we place median 3 limits on the second-timescale NIR fluence of 18 Jy ms (13.1 AB mag). The corresponding extinction-corrected limit is 125 Jy ms for an estimated extinction of AJ = 2.0 mag. Our observations were sensitive enough to easily detect an NIR counterpart of FRB 200428 if the NIR emission falls on the same power law as observed across its radio to X-ray spectrum. We report nondetection limits from epochs of four simultaneous X-ray bursts detected by the Insight-HXMT and NuSTAR telescopes during our observations. These limits provide the most stringent constraints to date on fluence of flares at ∼1014 Hz, and constrain the fluence ratio of the NIR emission to coincident X-ray bursts to RNIR 0.025 (fluence index 0.35).
We report second-timescale infrared photometry of the nova V1674 Her using Palomar Gattini-IR. These observations constitute the first infrared and highest temporal resolution data (resolution of ~ ...0.84 s) of the nova reported to date. PGIR observed in this fast readout mode for more than an hour on three nights between 3 and 6 days after discovery. We searched for periodic variability using a Lomb-Scargle periodogram and did not detect anything down to a three sigma upper limit of 0.093 mag. This suggests that the periodic variability detected in the nova by Patterson et al. 2021 was lower by at least a factor of about 1.65 in the first week of the eruption.
The Galactic magnetar SGR1935+2154 has been reported to produce the first known example of a bright millisecond duration radio burst (FRB 200428) similar to the cosmological population of fast radio ...bursts (FRBs), bolstering the association of FRBs to active magnetars. The detection of a coincident bright X-ray burst has revealed the first observed multi-wavelength counterpart of a FRB. However, the search for similar emission at optical wavelengths has been hampered by the high inferred extinction on the line of sight. Here, we present results from the first search for second-timescale emission from the source at near-infrared wavelengths using the Palomar Gattini-IR observing system in J-band, made possible by a recently implemented detector read-out mode that allowed for short exposure times of 0.84 s with 99.9% observing efficiency. With a total observing time of 12 hours (47728 images) on source, we place median \(3\,\sigma\) limits on the second-timescale emission of \(< 20\) mJy (13.1 AB mag). We present non-detection limits from epochs of four simultaneous X-ray bursts detected by the Insight-{\it HXMT} and {\it NuSTAR} telescopes during our observing campaign. The limits translate to an extinction corrected fluence limit of \(< 125\) Jy ms for an estimated extinction of \(A_J = 2.0\) mag. These limits provide the most stringent constraints to date on the fluence of flares at frequencies of \(\sim 10^{14}\) Hz, and constrain the ratio of the near-infrared (NIR) fluence to that of coincident X-ray bursts to \(R_{\rm NIR} < 2.5 \times 10^{-2}\). Our observations were sensitive enough to easily detect a near-infrared counterpart of FRB 200428 if the NIR emission falls on the same power law as that observed across its radio to X-ray spectrum. The non-detection of NIR emission around the coincident X-ray bursts constrains the fluence index of the brightest burst to be steeper than \(0.35\).
Dealing with insistent patient demand for antibiotics is an all too common part of a General Practitioner's daily routine. This study explores the extent to which portable Immersive Virtual Reality ...technology can help us gain an accurate understanding of the factors that influence a doctor's response to the ethical challenge underlying such tenacious requests for antibiotics (given the threat posed by growing anti-bacterial resistance worldwide). It also considers the potential of such technology to train doctors to face such dilemmas.
Twelve experienced GPs and nine trainees were confronted with an increasingly angry demand by a woman to prescribe antibiotics to her mother in the face of inconclusive evidence that such antibiotic prescription is necessary. The daughter and mother were virtual characters displayed in immersive virtual reality. The specific purposes of the study were twofold: first, whether experienced GPs would be more resistant to patient demands than the trainees, and second, to investigate whether medical doctors would take the virtual situation seriously.
Eight out of the 9 trainees prescribed the antibiotics, whereas 7 out of the 12 GPs did so. On the basis of a Bayesian analysis, these results yield reasonable statistical evidence in favor of the notion that experienced GPs are more likely to withstand the pressure to prescribe antibiotics than trainee doctors, thus answering our first question positively. As for the second question, a post experience questionnaire assessing the participants' level of presence (together with participants' feedback and body language) suggested that overall participants did tend towards the illusion of being in the consultation room depicted in the virtual reality and that the virtual consultation taking place was really happening.
The role of the Urology Specialist Therapeutic Radiographer (USTR) was introduced to support a busy NHS uro-oncology practice. Key objectives were to improve patient preparedness for and experience ...of radiotherapy, focussed on prostate cancer. Pre-radiotherapy information seminars were developed, and on-treatment patient review managed by the USTRs. To evaluate the revamped patient pathway and direct further improvements, a patient experience survey was designed.
An 18-point patient questionnaire was produced. The questionnaire captured patient experience and preparedness; pre, during and at completion of treatment. The patient population comprised men receiving radiotherapy for primary prostate cancer within one UK Trust.
Two-hundred and fifty-one responses were received. Seventy-three percent of patients felt completely prepared for radiotherapy, higher in those who attended a seminar (77%) compared to those who did not (61%). Eighty-nine and eighty-six percent of respondents were completely satisfied with verbal and written information received prior to commencing radiotherapy respectively. Seventy-three percent of responders would have found additional resources helpful.
With respect to on-treatment clinics; eighty-five percent were seen on time or within 20 minutes, eighty-three percent felt fully involved in decisions regarding their care and ninety-one percent reported complete satisfaction with the knowledge of the health care professional reviewing them.
The follow-up process was completely understood by eighty-eight percent and overall patient experience rated excellent by eighty-five percent of responders.
The revamped pathway implemented by USTRs has achieved high levels of satisfaction at all stages of the prostate patient's radiotherapy. By diversifying the format of information giving, the USTRs hope to further meet the information needs of patients.
Validation of a prostate cancer radiotherapy pathway which employs USTRs and utilises a patient preparation seminar. This model could support the introduction of Specialist Therapeutic Radiographers in other Trusts and treatment sites.
Pediatric obesity rates in the United States remain at an all-time high. Pediatric primary care clinicians and registered dietitians can help treat childhood obesity, and motivational interviewing ...(MI) has shown promising effects in prior trials.
We randomized 18 pediatric primary care practices to receive the Brief Motivational Interviewing to Reduce BMI or BMI2+ intervention or continue with usual care (UC). Practices were recruited through the American Academy of Pediatrics Pediatric Research in Office Settings network. The intervention comprised 4 components1: in-person and telehealth MI counseling by pediatric clinicians; 4 recommended sessions,2 6 telephone MI counseling sessions from a registered dietitian,3 text message reminders and tailored motivational messages, and4 parent educational materials. The main outcome was the change in the percentage of the 95th percentile of BMI. The study was conducted 2017 through 2021.
There was a significant treatment x time interaction (b = 0.017, 95% confidence interval: 0.0066-0.027) for the main outcome, favoring the UC group, with youth in the intervention arm showing a greater relative increase in their percent of the 95th percentile.
There was no overall benefit of the intervention and, contrary to expectations, youth in the intervention arm gained more weight, based on percent of the distance from the 95th percentile than matched youth from UC practices. The absolute excess weight gain among intervention relative to UC youth was small, approximately 0.5 BMI units and 1 kg over 2 years. We offer several potential explanations for these unexpected findings.
Transperineal ultrasound (TPUS) is used clinically for directly assessing prostate motion. Factors affecting accuracy and precision in TPUS motion estimation must be assessed to realise its full ...potential.
Patients were imaged using volumetric TPUS during the Clarity-Pro trial (NCT02388308). Prostate motion was measured online at patient set-up and offline by experienced observers. Cone beam CT with markers was used as a comparator and observer performance was also quantified. The influence of different clinical factors was examined to establish specific recommendations towards efficacious ultrasound guided radiotherapy.
From 330 fractions in 22 patients, offline observer random errors were 1.5 mm, 1.3 mm, 1.9 mm (left–right, superior-inferior, anteroposterior respectively). Errors increased in fractions exhibiting poor image quality to 3.3 mm, 3.3 mm and 6.8 mm. Poor image quality was associated with inconsistent probe placement, large anatomical changes and unfavourable imaging conditions within the patient. Online matching exhibited increased observer errors of: 3.2 mm, 2.9 mm and 4.7 mm. Four patients exhibited large systematic residual errors, of which three had poor quality images. Patient habitus showed no correlation with observer error, residual error, or image quality.
TPUS offers the unique potential to directly assess inter- and intra-fraction motion on conventional linacs. Inconsistent image quality, inexperienced operators and the pressures of the clinical environment may degrade precision and accuracy. Experienced operators are essential and cross-centre standards for training and QA should be established that build upon current guidance. Greater use of automation technologies may further minimise uncertainties.
Primary care remains an underused venue for prevention and management of paediatric overweight and obesity. A prior trial demonstrated a significant impact of paediatrician/nurse practitioner ...(Ped/NP)-and registered dietitian (RD)-delivered motivational interviewing (MI) on child body mass index (BMI). The study described here will test the effectiveness of an enhanced version of this primary care-based MI counselling intervention on child BMI.
This cluster randomised effectiveness trial includes 24 Ped/NPs from 18 paediatric primary care practices that belong to the American Academy of Pediatrics (AAP) national Pediatric Research in Office Settings (PROS) practice-based research network. To date, practices have been randomised (nine to intervention and nine to usual care). Intervention Ped/NPs have been trained in MI, behavioural therapy, billing/coding for weight management and study procedures. Usual care Ped/NPs received training in billing/coding and study procedures only. Children 3- 11 years old with BMI
the 85th percentile were identified via electronic health records (EHRs). Parents from intervention practices have been recruited and enrolled. Over about 2 years, these parents are offered approximately 10 MI-based counselling sessions (about four in person sessions with their child's Ped/NP and up to six telephonic sessions with a trained RD). The primary outcome is change in child BMI (defined as per cent from median BMI for age and sex) over the study period. The primary comparison is between eligible children in intervention practices whose parents enrol in the study and all eligible children in usual care practices. Data sources will include EHRs, billing records, surveys and counselling call notes.
Institutional Review Board approval was obtained from the AAP. All Ped/NPs provided written informed consent, and intervention group parents provided consent and Health Insurance Portability and Accountability Act (HIPAA) authorisation. Findings will be disseminated through peer-reviewed publications, conference presentations and appropriate AAP channels.
NCT03177148; Pre-results.
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