Substructure-Specific Antibodies Against Fentanyl Derivatives.

Structural variants of the synthetic opioid fentanyl are a major threat to public health. Following an investigation showing that many derivatives are poorly detected by commercial lateral flow and related assays, we created hapten conjugate vaccines using an immunogenic virus-like particle carrier and eight synthetic fentanyl derivatives designed to mimic the structural features of several of the more dangerous analogues. Immunization of mice elicited strong antihapten humoral responses, allowing the screening of hundreds of hapten-specific hybridomas for binding strength and specificity.

The effect of a Veterans Affairs rapid rehousing and homelessness prevention program on long-term housing instability.

Objective: To evaluate the effect of enrolling in Supportive Services for Veteran Families (SSVF) on short- and long-term housing outcomes among Veterans experiencing housing instability.

Study Setting And Design: We analyzed data from the Department of Veterans Affairs (VA) electronic health record (EHR) between October 2015 and December 2018 using the target trial emulation framework. Veterans were included in one or more trials if they were 18 years or older, had recent evidence of housing instability, had received care in VA for at least 1 year, and had never before enrolled in SSVF.

Characterization of Human CD8αβ Interaction With Classical and Unconventional MHC Molecules.

The CD8 co-receptor exists as both an αα homodimer, expressed on subsets of specialized lymphoid cells, and as an αβ heterodimer, which is the canonical co-receptor on cytotoxic T-cells, tuning TCR thymic selection and antigen-reactivity in the periphery. However, the biophysical parameters governing human CD8αβ interactions with classical MHC class I (MHCI) and unconventional MHC-like molecules have not been determined. Using hetero-dimerized Fc-fusions to generate soluble human CD8αβ, we demonstrate similar weak binding affinity to multiple different MHCI alleles compared with CD8αα.

Joint British Societies' position statement on cardiology training in the United Kingdom.

Cardiology training in the UK is facing significant challenges due to a range of factors. Recent curriculum changes have further compounded this issue and significantly risk the ability to produce adequately trained consultants capable of managing patients with increasingly complex cardiovascular disease. The introduction of mandatory dual accreditation in general internal medicine (GIM) alongside cardiology, by design, results in significantly reduced training opportunities, including procedural and subspecialty exposure.

Type 2 myocardial infarction: challenges in diagnosis and treatment.

The Fourth Universal Definition of Myocardial Infarction recommends a classification based on aetiology, in recognition that the underlying pathophysiology of myocardial infarction influences the approach to investigation and treatment. Type 1 myocardial infarction occurs due to atherosclerotic plaque rupture with thrombosis, whereas type 2 myocardial infarction occurs due to an imbalance in myocardial oxygen supply or unmet need in myocardial oxygen demand, without atherothrombosis, usually in the context of another acute illness. In this state-of-the-art review, the diagnosis, investigation, and treatment of patients with type 2 myocardial infarction are considered, with general advice for clinical practice and a consideration of future research directions.