Objectives: Suboptimal intrapartum electronic fetal heart rate monitoring using cardiotocography has remained a persistent problem (EFM-CTG). We aimed to identify the range of influences on the safety of using EFM-CTG in practice.
Design: Scoping review to identify influences related to the practice of intrapartum EFM.
Background: The latest generation of computed tomography (CT) systems based on photon-counting detector promises significant improvements in several clinical applications, including chest imaging.
Purpose: The aim of the study is to evaluate the image quality of ultra-high-resolution (UHR) photon-counting detector CT (PCD-CT) of the lung using four sharp reconstruction kernels.
Material And Methods: This retrospective study included 25 patients (11 women and 14 men; median age, 71 years) who underwent unenhanced chest CT from April to May 2023.
Background: Lung cancer is a leading cause of cancer-related mortality. Non-small cell lung cancer (NSCLC) comprises 85% of cases with rising incidence among never-smokers (NS). This study seeks to compare clinical, imaging, pathology, and outcomes between NS and ever-smokers (S) NSCLC patients to identify significant differences if any.
View Article and Find Full Text PDFBackground: Lung cancer is a leading cause of cancer-related mortality worldwide, with non-small cell lung cancer (NSCLC) comprising 85% of cases. Due to the lack of early clinical signs, metastasis often occurs before diagnosis, impacting treatment and prognosis. Cardiovascular disease (CVD) is a common comorbidity in lung cancer patients, with shared risk factors exacerbating outcomes.
View Article and Find Full Text PDFArtificial Intelligence (AI) has been proposed to improve workflow for coronary artery calcium scoring (CACS), but simultaneous demonstration of improved efficiency, accuracy, and clinical stability have not been demonstrated. 148 sequential patients who underwent routine calcium-scoring computed tomography were retrospectively evaluated using a previously validated AI model (syngo. CT CaScoring VB60, Siemens Healthineers, Forscheim, Germany).
View Article and Find Full Text PDFPreoperative anemia is common and associated with worse outcomes in cardiac surgery including acute kidney injury, red blood cell transfusion, cardiovascular complications, stroke, infection, and death. Patient blood management programs, which include dedicated clinical programs to diagnose and treat anemia in advance of surgery (ie, preoperative anemia programs), have been highlighted as a means to optimize the blood health of each patient, thereby decreasing risk for allogeneic transfusion and improving clinical outcomes. However, there remain implementation challenges for preoperative anemia programs, including difficulties with education of patients and staff, short lead times to address anemia, infrastructure and staffing limitations, lack of clear leadership or ownership of preoperative anemia, the need to develop treatment algorithms and ensure appropriate infusion therapy support, lack of capital support, and insurance/reimbursement concerns, amongst others.
View Article and Find Full Text PDFIntroduction: Prior laboratory-based studies have identified significant analgesic effects of acute alcohol. Despite providing excellent experimental control, these studies are limited regarding the range of alcohol exposure that can be practically and ethically achieved. This study capitalized on the heterogeneity in breath alcohol concentration (BrAC) resulting from naturalistic alcohol use at a public event to improve understanding of alcohol analgesia.
View Article and Find Full Text PDFAlthough the CXCL12/CXCR4 pathway has been prior investigated for its prometastatic and immuno- suppressive roles in the tumor microenvironment, evidence on the spatiotemporal regulation of these hallmarks has been lacking. Here, we demonstrate that CXCL12 forms a gradient specifically around cancer cell intravasation doorways, also known as Tumor Microenvironment of Metastasis (TMEM) doorways, thus facilitating the chemotactic translocation of prometastatic tumor cells expressing CXCR4 toward the perivascular TMEM doorways for subsequent entry into peripheral circulation. Fur- thermore, we demonstrate that the CXCL12-rich micro-environment around TMEM doorways may cre- ate immunosuppressive niches, whereby CD8 T cells, despite being attracted to these regions, often exhibit reduced effector functions, limiting their efficacy.
View Article and Find Full Text PDFBackground: Some patients express concerns regarding receipt of allogeneic blood transfusions from donors potentially vaccinated against SARS-CoV-2 (COVID-19). However, limited information exists about patients' expression of these concerns or how to address them during the blood transfusion consent process. In this study, we describe our experience of working collaboratively with patients with vaccine-related transfusion concerns prior to elective surgery, summarizing treatment decisions and clinical outcomes.
View Article and Find Full Text PDFThe acute toxicity (sometimes called "overdose" or "poisoning") crisis has affected Canadians across all stages of life, including youth, adults and older adults. Our biological risks and exposures to substances change as we age. Based on a national chart review study of coroner and medical examiner data on acute toxicity deaths in 2016 and 2017, this analysis compares the burden of deaths and circumstances of death, locations of acute toxicity event and death, health history and substances contributing to death of people, by sex and life stage.
View Article and Find Full Text PDFOf the approximately 25 directly imaged planets to date, all are younger than 500 Myr, and all but six are younger than 100 Myr (ref. ). Eps Ind A (HD209100, HIP108870) is a K5V star of roughly solar age (recently derived as 3.
View Article and Find Full Text PDFSeaweed farming is widely promoted as an approach to mitigating climate change despite limited data on carbon removal pathways and uncertainty around benefits and risks at operational scales. We explored the feasibility of climate change mitigation from seaweed farming by constructing five scenarios spanning a range of industry development in coastal British Columbia, Canada, a temperate region identified as highly suitable for seaweed farming. Depending on growth rates and the fate of farmed seaweed, our scenarios sequestered or avoided between 0.
View Article and Find Full Text PDFThe impact of ocean warming on fish and fisheries is vigorously debated. Leading theories project limited adaptive capacity of tropical fishes and 14-39% size reductions by 2050 due to mass-scaling limitations of oxygen supply in larger individuals. Using the world's hottest coral reefs in the Persian/Arabian Gulf as a natural laboratory for ocean warming - where species have survived >35.
View Article and Find Full Text PDFActa Obstet Gynecol Scand
September 2024
Accurate measuring, mapping, and monitoring of mangrove forests support the sustainable management of mangrove blue carbon in the Asia-Pacific. Remote sensing coupled with modeling can efficiently and accurately estimate mangrove blue carbon stocks at larger spatiotemporal extents. This study aimed to identify trends in remote sensing/modeling employed in estimating mangrove blue carbon, attributes/variations in mangrove carbon sequestration estimated using remote sensing, and to compile research gaps and opportunities, followed by providing recommendations for future research.
View Article and Find Full Text PDFIntroduction: There is a lack of evidence that the benefits of screening for atrial fibrillation (AF) outweigh the harms. Following the completion of the Screening for Atrial Fibrillation with ECG to Reduce stroke (SAFER) pilot trial, the aim of the main SAFER trial is to establish whether population screening for AF reduces incidence of stroke risk.
Methods And Analysis: Approximately 82 000 people aged 70 years and over and not on oral anticoagulation are being recruited from general practices in England.
Objective: The UK falls behind other European countries in the early detection of developmental dysplasia of the hip (DDH) and screening strategies differ for early detection. Clinical detection of DDH is challenging and recognised to be dependent on examiner experience. No studies exist assessing the number of personnel currently involved in such assessments.
View Article and Find Full Text PDFBackground: Ketamine has emerged as one of the most promising therapies for treatment-resistant depression. However, inter-individual variability in response to ketamine is still not well understood and it is unclear how ketamine's molecular mechanisms connect to its neural and behavioral effects.
Methods: We conducted a single-blind placebo-controlled study, with participants blinded to their treatment condition.
Background: System problems, known as operational failures, can greatly affect the work of GPs, with negative consequences for patient and professional experience, efficiency, and effectiveness. Many operational failures are tractable to improvement, but which ones should be prioritised is less clear.
Aim: To build consensus among GPs and patients on the operational failures that should be prioritised to improve NHS general practice.
Health Promot Chronic Dis Prev Can
March 2024
Introduction: The GAIA (Global Alignment on Immunisation Safety Assessment in Pregnancy) consortium was established in 2014 with the aim of creating a standardised, globally coordinated approach to monitoring the safety of vaccines administered in pregnancy. The consortium developed twenty-six standardised definitions for classifying obstetric and infant adverse events. This systematic review sought to evaluate the current state of adverse event reporting in maternal vaccine trials following the publication of the case definitions by GAIA, and the extent to which these case definitions have been adopted in maternal vaccine safety research.
View Article and Find Full Text PDFObjective: To gain consensus on the definitions and descriptions of the domains of the Outcome Measures in Rheumatology (OMERACT) core domain set for rheumatology trials evaluating shared decision making (SDM) interventions.
Methods: Following the OMERACT Handbook methods, our Working Group (WG), comprised of 90 members, including 17 patient research partners (PRPs) and 73 clinicians and researchers, had six virtual meetings in addition to email exchanges to develop draft definitions and descriptions. The WG then conducted an international survey of its members to gain consensus on the definitions and descriptions.
Objectives: Shared decision making (SDM) is a central tenet in rheumatic and musculoskeletal care. The lack of standardization regarding SDM instruments and outcomes in clinical trials threatens the comparative effectiveness of interventions. The Outcome Measures in Rheumatology (OMERACT) SDM Working Group is developing a Core Outcome Set for trials of SDM interventions in rheumatology and musculoskeletal health.
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