Lenacapavir: Patient and healthcare provider perceptions and the potential role for a twice-yearly injectable HIV treatment.

Background: The twice-yearly, long-acting lenacapavir (LA LEN) antiretroviral therapy (ART), when combined with an optimised background regimen, provides a subcutaneous injectable treatment option for people with HIV. This study aimed to understand the preferences, barriers and facilitators for uptake and implementation of LA LEN, with a view to informing clinical implementation.

Methods: In-depth qualitative interviews and focus groups with purposively sampled people with HIV and healthcare workers (HCWs) from UK HIV services were conducted.

Managing cognitive impairment in people with HIV.

Purpose Of Review: To describe patient-centred multiciplinary management and care of people with HIV presenting with cognitive disorders.

Recent Findings: In the era of effective antiretroviral therapy a comprehensive, multifactorial approach to assessing and managing cognitive impairment in people with HIV is required. The complexity of cognitive disorders in this population demands more than current guidelines offer, which focus primarily on HIV management, overlooking broader clinical, psychological, and social factors.

Non-pharmaceutical interventions for people living with HIV with cognitive impairment: A scoping review.

Background: Cognitive impairment (CI) in HIV is often of multifactorial causation, and remains a prominent issue in the age of effective combination antiretroviral therapy (cART), affecting approximately 14% of people living with HIV. Despite the 2018 BHIVA directive stating the importance of commencing rehabilitation strategies in people living with HIV with CI, no types of cognitive rehabilitations or other non-pharmaceutical interventions are specifically recommended. This scoping review aimed to describe the types of and evidence relating to the non-pharmaceutical interventions which have been examined in people living with HIV with CI.

The Development and Piloting of an Early Youth-Engagement (EYE) Model to Improve Engagement of Young People in First Episode Psychosis Services: A Mixed Methods Study.

Aim: Psychosis is associated with significant health and societal costs. Early intervention in psychosis services (EIP) are highly effective in promoting recovery, yet substantial proportions of young people disengage. The current study aimed to develop and evaluate a novel engagement intervention in EIP services.

Cardiac Arrest Due to Pulmonary Embolism Without Clinical Features of Deep Vein Thrombosis in a Young Female: A Rare Presentation of May-Thurner Syndrome.

Deep vein thrombosis (DVT) is a serious condition with a high disease burden. Pulmonary embolism is one of the disastrous complications of DVT. The etiology of DVT includes factors responsible for hypercoagulation, venous injury, and factors causing stasis in the deep veins.

Cognitive impairment in people living with HIV: mechanisms, controversies, and future perspectives.

Despite the dramatic decrease in HIV-associated neurocognitive impairment (NCI) in the combined antiretroviral treatment (cART) era, subtler neuropsychological complications remain prevalent. In this review, we discuss the changing pathophysiology of HIV-associated NCI, considering recent evidence of HIV neuropathogenesis, and the pivotal role of cART. Furthermore, we address the multifactorial nature of NCI in people living with HIV, including legacy and ongoing insults to the brain, as well as host-specific factors.

Understanding the lived experience research priorities for improving health-related quality of life in people living with HIV with cognitive impairment.

Background: People living with HIV experience higher rates of cognitive impairment (CI), and at younger ages, than the general population. These individuals report poor health-related quality of life (HRQL), however, interventions aimed at assisting people living with HIV to live well with CI do not currently exist and represent an important un-met need in this population.

Objective: This study aimed to identify the lived experience research priorities for improving HRQL and identify interventions to support priority areas.

People with HIV and healthcare workers views on screening for cognitive impairment in people with HIV: A qualitative study.

Objectives: People with HIV are an ageing population with an increased risk of cognitive impairment. Although cognitive impairment is dependent upon assessment, the acceptability of screening for cognitive impairment is unclear. This study aimed to explore the views of people with HIV and healthcare workers regarding routine screening for cognitive impairment.

AI-clinician collaboration via disagreement prediction: A decision pipeline and retrospective analysis of real-world radiologist-AI interactions.

Clinical decision support tools can improve diagnostic performance or reduce variability, but they are also subject to post-deployment underperformance. Although using AI in an assistive setting offsets many concerns with autonomous AI in medicine, systems that present all predictions equivalently fail to protect against key AI safety concerns. We design a decision pipeline that supports the diagnostic model with an ecosystem of models, integrating disagreement prediction, clinical significance categorization, and prediction quality modeling to guide prediction presentation.

How are HIV services in the UK currently identifying and managing patients with cognitive impairment? Results of a national survey.

Objectives: The 2018 British HIV Association (BHIVA) Standards of Care state that people living with HIV should be questioned annually for symptoms of cognitive or memory decline. If symptoms are identified, screening should be considered and services offered if impairment is detected. We examined the availability of services, along with current practices related to the screening and management of cognitive impairment in people living with HIV, in UK HIV services.

Health-Related Quality of Life in People Living With HIV With Cognitive Symptoms: Assessing Relevant Domains and Associations.

This study aimed to validate and assess a comprehensive set of illness-specific health-related quality of life (HRQL) domains in people living with HIV (PLWH) with cognitive symptoms. One hundred and three HIV patients with cognitive symptoms ( = 93 male, 90.3%) were identified from two UK HIV clinics and complete a series of validated scales measuring seven HRQL domains identified as important to HRQL by PLWH with cognitive impairment.

Comparison of Warming Capabilities Between Buddy Lite, enFlow, and Thermal Angel for US Army Medical Personnel in Austere Conditions: A Literature Review.

US Army Forward Surgical Elements (FSEs) are highly mobile teams that provide damage control surgery (DCS) and damage control resuscitation (DCR) in austere locations that often lack standard hospital utilities (electricity, heat, food, and water). FSEs rely on portable battery-operated intravenous (IV) fluid warmers to remain light and mobile. However, their ability to warm blood in a massive resuscitation requires additional analysis.

Intoxications in an Australian Emergency Department Involving 'Nitazene' Benzylbenzimidazole Synthetic Opioids (Etodesnitazene, Butonitazene and Protonitazene).

Benzimidazole synthetic opioids are highly potent μ-opioid receptor agonists with heroin-like effects, including dose-dependent respiratory depression and a high risk of abuse and toxicity. Benzimidazoles were first detected in 2019 in Europe and Canada, with analytical confirmation of etodesnitazene, protonitazene and butonitazene in 2021. We report the first detections of these compounds in Australia, in two patients presenting with drug toxicity to Emergency Departments (EDs) in the state of Victoria.

"A fog that impacts everything": a qualitative study of health-related quality of life in people living with HIV who have cognitive impairment.

Background: Cognitive impairment (CI) in people living with HIV (PLWH) is an important health concern in the context of an ageing HIV population. Impacting 14-28% of PLWH, CI is associated with lower health-related quality of life (HRQoL), however, evaluation of the illness-specific factors comprising HRQoL in PLWH with CI have not been assessed.

Objective: We sought to contribute evidence toward an understanding of HRQoL and identify domains of HRQoL in PLWH with CI.

Structured medicines reviews in HIV outpatients: a feasibility study (The MOR Study).

Objectives: Polypharmacy in people living with HIV (PLWH) increases the risks of medicine-related problems (events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes). We aimed to examine the feasibility and acceptability of a Medicines Management Optimisation Review (MOR) toolkit in HIV outpatients.

Methods: This was a multi-centre randomized controlled study across four HIV centres.

Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review study.

Quality of life (QoL) is recognized as an essential end point in the disease management of chronic conditions such as HIV with calls to include good QoL as a 'fourth 90' in the 90-90-90 testing and treatment targets introduced by World Health Organization in 2016. Cognitive impairments impact a broad spectrum of experiences and are a common issue effecting people living with HIV (PLWH). Despite this, few studies have examined QoL in PLWH who also have a cognitive disorder.

Pulmonary Health Effects of Indoor Volatile Organic Compounds-A Meta-Analysis.

Volatile organic compounds (VOCs) are commonly found in consumer products, including furniture, sealants and paints. Thus, indoor VOCs have become a public health concern, especially in high-income countries (HICs), where people spend most of their time indoors, and indoor and outdoor air exchange is minimal due to a lack of ventilation. VOCs produce high levels of reaction with the airway epithelium and mucosa membrane and is linked with pulmonary diseases.

Breeding at higher latitude is associated with higher photoperiodic threshold and delayed reproductive development in a songbird.

Many seasonally breeding animals exhibit a threshold day length (critical photoperiod; CPP) for gonadal growth, and populations breeding at higher latitudes typically have a higher CPP. Much less is known about latitudinal variation in CPP in migratory population that winter away from their breeding range and must time their reproduction to match favorable conditions at their destination. To address the relationship between migration, breeding latitude, and CPP, we held two closely related songbird populations in a common environment.

Evaluation of a Combined HIV and Geriatrics Clinic for Older People Living with HIV: The Silver Clinic in Brighton, UK.

As life expectancy in people living with HIV (PLWH) has increased, the focus of management has shifted to preventing and treating chronic illnesses, but few services exist for the assessment and management of these individuals. Here, we provide an initial description of a geriatric service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen in the clinic between 2016 and 2019.

Digitizing U.S. Air Force Medical Standards for the Creation and Validation of a Readiness Decision Support System.

Introduction: Deployment-limiting medical conditions are the primary reason why service members are not medically ready. Service-specific standards guide clinicians in what conditions are restrictive for duty, fitness, and/or deployment requirements. The Air Force (AF) codifies most standards in the Medical Standards Directory (MSD).

Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV.

As the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen by the clinic.

Correction to: The U&I study: study protocol for a feasibility randomised controlled trial of a pre-cognitive behavioural therapy digital 'informed choice' intervention to improve attitudes towards uptake and implementation of CBT for psychosis.

Following publication of the original article [1], the authors reported a typing mistake in the spelling of author Iain O'Leary. The original article has been corrected.

The U&I study: study protocol for a feasibility randomised controlled trial of a pre-cognitive behavioural therapy digital 'informed choice' intervention to improve attitudes towards uptake and implementation of CBT for psychosis.

Background: At least 40% of people with psychosis have persistent distressing symptoms despite optimal medication treatment. Cognitive behaviour therapy for psychosis (CBTp) is the only NICE-recommended individual therapy for psychosis, with effects on symptoms, distress and quality of life. Yet <10% of service-users receive it and 94% of trusts struggle to provide it.

A-Band Titin Truncation in Zebrafish Causes Dilated Cardiomyopathy and Hemodynamic Stress Intolerance.

Background Truncating variants in the TTN gene ( TTNtv) are common in patients with dilated cardiomyopathy (DCM) but also occur in the general population. Whether TTNtv are sufficient to cause DCM or require a second hit for DCM manifestation is an important clinical issue. Methods We generated a zebrafish model of an A-band TTNtv identified in 2 human DCM families in which early-onset disease appeared to be precipitated by ventricular volume overload.