Awareness and perceptions of Long COVID among people in the REACT programme: Early insights from a pilot interview study

BACKGROUND

Long COVID is a patient-made term describing new or persistent symptoms experienced following SARS-CoV-2 infection. The Real-time Assessment of Community Transmission-Long COVID (REACT-LC) study aims to understand variation in experiences following infection, and to identify biological, social, and environmental factors associated with Long COVID. We undertook a pilot interview study to inform the design, recruitment approach, and topic guide for the REACT-LC qualitative study. We sought to gain initial insights into the experience and attribution of new or persistent symptoms and the awareness or perceived applicability of the term Long COVID.

METHODS

People were invited to REACT-LC assessment centres if they had taken part in REACT, a random community-based prevalence study, and had a documented history of SARS-CoV-2 infection. We invited people from REACT-LC assessment centres who had reported experiencing persistent symptoms for more than 12 weeks to take part in an interview. We conducted face to face and online semi-structured interviews which were transcribed and analysed using Thematic Analysis.

RESULTS

We interviewed 13 participants (6 female, 7 male, median age 31). Participants reported a wide variation in both new and persistent symptoms which were often fluctuating or unpredictable in nature. Some participants were confident about the link between their persistent symptoms and COVID-19; however, others were unclear about the underlying cause of symptoms or felt that the impact of public health measures (such as lockdowns) played a role. We found differences in awareness and perceived applicability of the term Long COVID.

CONCLUSION

This pilot has informed the design, recruitment approach and topic guide for our qualitative study. It offers preliminary insights into the varied experiences of people living with persistent symptoms including differences in symptom attribution and perceived applicability of the term Long COVID. This variation shows the value of recruiting from a nationally representative sample of participants who are experiencing persistent symptoms.

A compact Class D RF power amplifier for mobile nuclear magnetic resonance systems

A 20 MHz Class D amplifier with an output of 100 W of RF power has been developed. The compact size printed circuit board area of 50 cm² and efficiency of 73% make it suitable for mobile nuclear magnetic resonance (NMR) systems. Test results show that the rise and ring down times of the amplifier are less than 0.2 μs, and it is capable of producing constant amplitude pulses as short as 2 μs. Experiments using a Carr Purcell Meiboom Gill pulse sequence with a NMR MOUSE sensor confirm that the Class D amplifier is suitable for mobile NMR applications.

Comparison of four target volume definitions for pancreatic cancer. Guidelines for treatment of the lymphatics and the primary tumor

BACKGROUND AND PURPOSE

Target volume definitions for radiotherapy in pancreatic ductal adenocarcinoma (PDAC) vary substantially. Some groups aim to treat the primary tumor only, whereas others include elective lymph nodes (eLNs). eLNs close to the primary tumor are often included unintentionally within the treatment volume, depending on the respective treatment philosophies. We aimed to measure the percentages of anatomical coverage of eLNs by comparing four different contouring guidelines.

PATIENTS AND METHODS

Planning target volumes (PTVs) were contoured using planning computed tomography (CT) scans of 11 patients with PDAC based on the Oxford, RTOG (Radiation Therapy Oncology Group), Michigan, and SCALOP (Selective Chemoradiation in Advanced Localised Pancreatic Cancer trial) guidelines. Clinical target volumes (CTVs) included the peripancreatic, para-aortic, paracaval, celiac trunk, superior mesenteric, and portal vein lymph node areas. Volumetric comparisons of the coverage of all eLN regions were conducted to illustrate the differences between the four contouring strategies.

RESULTS

The PTV sizes of the RTOG and Oxford guidelines were comparable. The SCALOP and Michigan PTV sizes were similar to each other and significantly smaller than the RTOG and Oxford PTVs. A large variability of eLN coverage was found for the various subregions according to the respective contouring strategies.

CONCLUSION

This is the first study to directly compare the percentage of anatomical coverage of eLNs according to four PTVs in the same patient cohort. Potential practical consequences are discussed in detail.

Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes--a randomized controlled trial

OBJECTIVE

This study sought to examine the effects of a 3-month programme of dietary advice to restrict carbohydrate intake compared with reduced-portion, low-fat advice in obese subjects with poorly controlled Type 2 diabetes.

RESEARCH DESIGN AND METHODS

One hundred and two patients with Type 2 diabetes were recruited across three centres and randomly allocated to receive group education and individual dietary advice. Weight, glycaemic control, lipids and blood pressure were assessed at baseline and 3 months. Dietary quality was assessed at the end of study.

RESULTS

Weight loss was greater in the low-carbohydrate (LC) group (-3.55 +/- 0.63, mean +/- sem) vs. -0.92 +/- 0.40 kg, P = 0.001) and cholesterol : high-density lipoprotein (HDL) ratio improved (-0.48 +/- 0.11 vs. -0.10 +/- 0.10, P = 0.01). However, relative saturated fat intake was greater (13.9 +/- 0.71 vs. 11.0 +/- 0.47% of dietary intake, P < 0.001), although absolute intakes were moderate.

CONCLUSIONS

Carbohydrate restriction was an effective method of achieving short-term weight loss compared with standard advice, but this was at the expense of an increase in relative saturated fat intake.

Geographical distribution of breast cancers on the mammogram: an interval cancer database

Auditing interval cancers is an important part of a breast screening radiologist's continuing education. We set out to determine whether the position of interval cancers on the mammogram differs from those detected at screening. The 773 interval cancers so far identified, and the first 200 screen detected cancers, have been entered onto a Microsoft Access 97 database developed to record pathological and radiological features, including the position of the cancer on a stylized diagram using a "point and click" system. Reports were generated showing positions of all interval cancers by classification and reader. The distribution of true interval cancers is statistically different from screen detected cancers on both views. The distribution of the false negative and screen detected cancers only differs on the oblique view. False negative and true interval cancers are of the same distribution on both craniocaudal and oblique views. However, these differences do not appear to be practically useful when applied to individual readers. We have developed a database that allows systematic recording of pathological and radiological information regarding breast cancers. Additionally, it can record the geographic position of the cancer with minimal memory requirements. Statistical differences in the distribution of false negative and screen detected cancers have been demonstrated and the stylized diagrams reinforce the importance of the conventional review areas. Although this has not identified any "blind spots" in our own readers, it nevertheless provides film readers with a tool to audit their own work.

2,4-Dichlorophenoxyacetic acid (2,4-D) does not cause polyneuropathy in the rat

2,4-Dichlorophenoxyacetic acid (2,4-D), a component of Agent Orange, was injected intraperitoneally into adult male Fisher rats for 3-12 weeks. During the period of study gait and toe-spreading reflexes remained normal and distal motor latencies, motor and mixed nerve conduction velocities and amplitudes remained similar (P greater than 0.05) in animals receiving 2,4-D or vehicle. This study suggests that 2,4-D is not toxic to peripheral nerves in the rat.