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Here we present a case of acute ovarian cyst haemorrhage in a young female during induction therapy for acute myelomonocytic leukaemia (AMML). A patient undergoing chemotherapy on the AML19 trial for AMML developed severe abdominal pain and haemodynamic compromise during cycle 2 of fludarabine, cytarabine and idarubicin. The patient was found to have a large ruptured haemorrhagic ovarian cyst on computed tomography. She was managed conservatively due to relative haematological contraindications to surgery and haemodynamic stability following transfer to the high dependency unit. The patient had recently discontinued anticoagulation for pulmonary emboli due to thrombocytopenia. This highlights the importance of recognising coexistent pathology in patients undergoing high intensity chemotherapy.

Lecture capture tends to polarise the views of academic staff. Some view it as encouraging non-attendance at lectures. Others view it as a valuable adjunct, allowing students to revisit the lecture experience and providing opportunities for clarification and repetition of key points. However, data supporting either of these stances remains scarce. Irrespective of these views, a more pertinent question pertains to the impact of lecture attendance and the use of recordings on student achievement. Findings remain unclear due to methodological issues, inconsistent findings, and a lack of differentiation of students by year of study. This paper investigated the impact of attendance, lecture recording, and student attainment across four years of an undergraduate programme. For first year students, attendance and recording use were positive predictors of performance. For weaker students, supplementary recording use was beneficial but only better students use of the recordings helped overcome the impact of low attendance. For second year students, attendance and recording use were positively correlated with, but no longer predictive of, achievement. There was no relationship for honours year students. We found no compelling evidence for a negative effect of recording use, or that attendance and recording use were related. We suggest focusing on improving lecture attendance through monitoring whilst also providing recordings for supplementary use, particularly in first year. Finally, our findings highlight the need to consider third variables such as year of study and first language when conducting and comparing lecture capture research.

BackgroundVeterinary work is considered high risk and involves working with a range of hazards, including large animals, high workload and long hours. A key potential hazard is making home visits and providing out-of-hours emergency care, where vets often work alone, without support and must travel long distances. The current study aimed to examine UK veterinary perceptions of safety culture, lone working and on-call tasks to gain a deeper understanding of the risk and hazards involved.MethodsAn online mixed-methods survey was used to gather quantitative data relevant to practice safety culture and qualitative data regarding veterinary perception of lone working and on-call work. A sample of 76 UK veterinarians were recruited.ResultsThe quantitative results suggest that there may be practice safety culture issues around a lack of communication and discussion pertaining to safety, particularly in terms of maintaining personal safety. Key themes within the qualitative data included the pressure to treat patients, potentially at personal risk, and feeling unsafe when meeting clients alone and in remote locations.ConclusionThese findings indicate that personal safety requires more attention and discussion within veterinary practices, and that safety protocols and requirements should be shared with clients.

Student employability is a key aspect of higher education, with multiple strategies utilised by Higher Education Institutions to support the employability of their graduates. However, little work has been done to examine, and compare, different types of work experience. To advise students appropriately, it is important to understand the factors that might influence the perceived value of work experience. The current Scottish study investigated three aspects of work experience within the context of the Social Sciences—type (internship or volunteer role), location (extra- or co-curricular) and duration (six months or two years)—and compared stakeholder (student, academic, employer) perception of work experience. The study utilised an experimental vignette design, presenting 175 participants (62 students, 57 employers, 56 academics) with CV excerpts that varied according to the variables of interest. Quantitative and qualitative items were also presented to explore perceptions of work experience. The results indicate that extracurricular experience was viewed more favourably by all stakeholders. The type of experience was an influence, with internships viewed more positively when the job role was a high-level graduate role. The duration of experience did not produce a main effect. There were no significant differences in stakeholder perception of work experience. The qualitative data indicated that the relevancy of both experience and degree topic was important for employability, along with interpersonal and professional skills. These findings may support educators in providing students with advice regarding their activities outside the classroom, with an emphasis on extracurricular and internship experience, tied to student career aspirations, recommended.

PurposeThe world of work is becoming digital, a process accelerated by the recent COVID-19 pandemic and resultant remote working guidelines. Online internships have become more popular in this context, and yet there remains a lack of research investigating how these internships are perceived across stakeholders. The purpose of this paper was to begin to address this research gap by exploring academic, student and employer perceptions of online internships with a focus on employability.Design/methodology/approachThe research explored 156 stakeholders (53 students, 50 academics and, 53 employer/professionals) perceptions via a mixed-methods online study encompassing quantitative responses to internship vignettes, alongside open-ended questions designed to explore stakeholder attitudes in more depth.FindingsStakeholder groups reported similar attitudes towards online internships. Overall, online internships were viewed as valid, flexible, work experience, linked to skill development and likely to enhance student employability. However, concerns were raised regarding communication protocols and development, intern isolation and a lack of organisational immersion.Practical implicationsBased on the research, the authors make three recommendations to continue to enhance and develop the online internship experience: ensure multiple methods of regular communication between student and organisation, attempt virtual immersion in the organisation and assign each intern additional support beyond their immediate supervisor.Originality/valueBased on a holistic and novel analysis of key stakeholders' viewpoints, this paper provides much needed insights and evidence on how to design and quality assure effective online internship practice.

Sensory stimuli become easier to detect or distinguish with practice. It is generally assumed that the task-relevant stimulus dimension becomes increasingly more salient as a result of attentively performing the task at a level that is neither too easy nor too difficult. However, here we show improved auditory frequency discrimination following training with physically identical tones that were impossible to discriminate. We also show that learning transfers across tone frequencies and across modalities: training on a silent visuospatial computer game improved thresholds on the auditory discrimination task. We suggest that three processes are necessary for optimal perceptual learning: sensitization through exposure to the stimulus, modality- and dimension-specific attention, and general arousal.

Background:During the SARS-CoV-2 virus pandemic, University Hospital Birmingham NHS Trust Oncology Department incorporated the ultrahypofractionated regime of 26Gy/5 fractions alongside the moderate hypofractionated regime of 40Gy/15 fractions as part of local adjuvant breast radiotherapy treatment (RT) for eligible patients. We conducted a local study to assess the real-life experience of patients undergoing ultrahypofractionated schedule to compare feasibility and toxicity to the fast-forward trial during the COVID − 19 pandemic.Methods:A single institution, retrospective, qualitative study. Patients included had early-stage breast cancer and received adjuvant radiotherapy between 23 March 2020 and 31 May 2020, a total of 211 patients. Inclusion was irrespective of any other neoadjuvant/adjuvant treatments. Data were collected retrospectively for treatment dose, boost dose and toxicity.Results:Of the total 211 patients, 85 were treated with 26Gy in 5# and 19 patients received a boost as per the fast-forward protocol. Of these 85 patients, 15·9% did not report any skin toxicity post-treatment. 63·5% of patients reported RTOG Grade 1, 15·9% had RTOG Grade 2, and 1·6% reported RTOG Grade 3 skin toxicity. 3·2% of the patients could not be contacted for follow-up. Of the 19 patients who received a breast boost, 10·53% reported no skin changes. 78·9% reported Grade 1 skin toxicity. Both Grades 2a and 2b skin toxicity were reported by 5·26% each. The patient demographics and tumour characteristics in our study cohort were comparable to those within the fast-forward trial. In terms of post-RT skin toxicity, fewer patients reported any toxicity in the UHB patient cohort versus those in the trial, and the number of Grade 2/3 toxicities reported was also low. A delay in toxicity reporting from 2 weeks for 40Gy/15 to 3 weeks for 26Gy/5 was observed.Conclusion:Our study concluded that offering ultrahypofractionation was convenient for patients; reducing the number of hospital visits during the SARS-CoV-2 virus pandemic appeared safe in terms of acute post-RT-related skin toxicity. The reduced hospital visits limited exposure of patients and staff to the SARS-CoV-2 virus while also ensuring efficient use of Radiotherapy Department resources. Local follow-up protocols have been amended to ensure review at 3 weeks for the 26Gy/5 schedule to acknowledge the delay in acute toxicity development. To date, there is only 5-year toxicity and relapse data available from the fast-forward trial; therefore, hypofractionation schedules should be offered to patients as long as they fulfil the criteria and understand the limitations of the study as well as accelerated peer review processes in the face of the pandemic.

Background Detection of bacteremia directly from blood may improve time to clinical diagnosis and initiation of appropriate antibiotic therapy for hospitalized patients. Administration of empiric antibiotic therapy, whether prior to standard of care (SOC) or research study blood collection, adds to challenges in bacterial recovery. Strategies to improve detection were explored in this pilot study to inform future clinical trial design (CTD) on Enterobacteriaceae (ENT) detection directly from blood. One of the objectives was to assess effects of prior antibiotic administration on novel assay performance. Methods Confirmed ENT bacteremic (Protocol A (P-A), n = 26), and suspected bacteremic (Protocol B (P-B), n = 25) participants were enrolled into one of two IRB approved protocols after obtaining informed consent. Fresh whole blood (20 mL) was collected within 12 hours of SOC blood culture positivity (P-A) or 20 hours of SOC blood culture collection (P-B), and divided: 10 mL inoculated into a lytic media collection vessel (P-A and B); and 10 mL into a BD BACTEC™ Bottle (P-A) as a control, or an Isolator™ lysis centrifugation tube (P-B) for quantification. For collection vessels, a 3-hour amplification step in lytic growth medium followed by cleanup and concentration steps was employed. Processed samples were tested using an investigational assay for universal bacterial detection on the Accelerate Pheno™ system. Results were analyzed manually and with proprietary software. Descriptive statistics were performed to inform future CTD. Results Empiric antibiotic therapy was initiated prior to blood collection in 89% (P-A) and 36% (P-B) of participants. Improved detection sensitivity was achieved in P-B over P-A, when a study sample was obtained prior to empiric antibiotic therapy initiation (Table 1). Conclusion Prior antibiotic administration and low bacterial load in clinical samples affects ability to detect ENT directly from blood. Multiple factors are critical to address in future CTD to increase sensitivity of detecting ENT directly from blood including: (1) Targeting study samples prior to antibiotic therapy initiation and (2) Using enzymatic methods to neutralize antibiotics present in the blood. Disclosures M. Fuchs, Accelerate Diagnostics, Inc.: Employee, Salary. S. Kim, Accelerate Diagnostics, Inc.: Employee, Salary. S. Metzger, NIH: Grant Investigator, Grant recipient. Accelerate Diagnostics, Inc.: Employee, Salary.