GP emigration from Ireland: an analysis of data from key destination countries.

Background: Ireland is experiencing a general practitioner (GP) workforce crisis, facing an ageing workforce, a growing population with increased life expectancy, and increased complexity of patients. The GP crisis threatens access to primary care in Ireland, as well as Ireland's aim to transform into a primary-care centred system of universal healthcare via the proposed "Sláintecare" healthcare reforms. The challenges faced are common to many countries as health systems seek to expand their medical workforce post-pandemic.

A meta-analytic investigation of the effect of sleep deprivation on inhibitory control.

Sleep deprivation may have a deleterious effect on inhibitory control; however, this effect is not consistent across studies. To arrive at an overall estimate of the relationship between sleep deprivation and inhibitory control, this report used meta-analysis to summarise the magnitude of the effects of sleep deprivation on inhibitory control as measured by the Go/No-Go and Stop Signal Tasks. These are two widely used tasks in the literature.

New Research on Veterans Treatment Courts: An Overview of the .

Justice-involved veterans return to civilian life with a variety of mental and physical health challenges that often go untreated and increase their risk for self-harm and involvement in the criminal-legal system. Veterans Treatment Courts (VTC) were created to respond to the unique problems of justice-involved veterans by attempting to coordinate services and support with the U.S.

An international Delphi consensus on patient preparation for metabolic and bariatric surgery.

Global obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources.

Satiety Hormone LEAP2 After Low-Calorie Diet With/Without Endobarrier Insertion in Obesity and Type 2 Diabetes Mellitus.

Context: The liver/foregut satiety hormone liver-expressed antimicrobial peptide 2 (LEAP2) is an inverse agonist at the acyl ghrelin receptor (GHSR), increasing after food intake and decreasing after bariatric surgery and short-term nonsurgical weight loss, but effects of long-term dietary weight loss are unknown.

Objective: The objective of this study was to examine and compare the effects of these interventions on fasting and postprandial plasma LEAP2 and investigate potential metabolic mediators of changes in plasma LEAP2.

Methods: Plasma LEAP2 was measured in a previously published 2-year trial comparing standard medical management (SMM) (including 600-kcal/day deficit) with duodenal-jejunal bypass liner (DJBL, Endobarrier) insertion (explanted after 1 year) in adults with obesity and inadequately controlled type 2 diabetes mellitus.

Machine Learning Reveals Demographic Disparities in Palliative Care Timing Among Patients With Traumatic Brain Injury Receiving Neurosurgical Consultation.

Background: Timely palliative care (PC) consultations offer demonstrable benefits for patients with traumatic brain injury (TBI), yet their implementation remains inconsistent. This study employs machine learning methods to identify distinct patient phenotypes and elucidate the primary drivers of PC consultation timing variability in TBI management, aiming to uncover disparities and inform more equitable care strategies.

Methods: Data on admission, hospital course, and outcomes were collected for a cohort of 232 patients with TBI who received both PC consultations and neurosurgical consultations during the same hospitalization.

No Veteran Left Behind? Perspectives on VTC Eligibility Criteria for Justice-Involved Veterans in Multiple Jurisdictions Across the United States.

The explosive growth of veterans treatment courts (VTCs) in the United States has raised questions concerning which justice-involved veterans (JIV) are eligible and ultimately selected for participation. For instance, should VTCs be more inclusive in their selection processes, and is it possible to do so within existing court parameters? Using data from 145 interviews of team members working in 20 VTCs across the country, this study explores the perceptions of those personnel on a range of factors impacting eligibility determinations of JIV. These include the decision-making processes of VTC teams, determinations of the nexus between a veteran's military service and their offending behavior, and the capacity of jurisdictions to provide treatment and services to all JIV, either through Veterans Affairs programs or community providers.

A call for research to address the threat of paper mills.

Research paper mills are covert organizations that provide low-quality or fabricated manuscripts to paying clients. As members of the United2Act Research Working Group, we propose 5 key research questions on paper mills that require resourcing and support.

Treatment Intensification With Either Fludarabine, AraC, G-CSF and Idarubicin, or Cladribine Plus Daunorubicin and AraC on the Basis of Residual Disease Status in Older Patients With AML: Results From the NCRI AML18 Trial.

Purpose: To evaluate the survival benefit of chemotherapy intensification in older patients with AML who have not achieved a measurable residual disease (MRD)-negative remission.

Methods: Five hundred twenty-three patients with AML (median age, 67 years; range, 51-79) without a flow cytometric MRD-negative remission response after a first course of daunorubicin and AraC (DA; including 165 not in remission) were randomly assigned between up to two further courses of DA or intensified chemotherapy-either fludarabine, cytarabine, granulocyte colony-stimulating factor and idarubicin (FLAG-Ida) or DA with cladribine (DAC).

Results: Overall survival (OS) was not improved in the intensification arms (DAC DA: hazard ratio [HR], 0.

Redox Dynamic Interactions of Arsenic(III) with Green Rust Sulfate in the Presence of Citrate.

Arsenic is a global pollutant. Recent studies found that Fe(II) can oxidize As(III), but the extent of oxidation with mixed-valent iron minerals and the mechanisms involved are unknown. In this study, we investigated whether As(III) can be oxidized under reducing conditions using green rust sulfate (GR-SO), an Fe mineral containing both Fe(II) and Fe(III).

Satisfactory outcomes following a second autologous hematopoietic cell transplantation for multiple myeloma in poor stem cell mobilizers: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT.

Autologous hematopoietic cell transplants (auto-HCTs) remain the standard of care for transplant-eligible MM patients. The general practice has been to undergo upfront apheresis following induction to collect sufficient number of CD34+ cells to facilitate two auto-HCTs. However, 5-30% of MM patients do not initially mobilise a sufficient number of hematopoietic stem cells and are classified as poor mobilizers (PM).

The research literature is an unsafe workplace.

Research is conducted in workplaces that can present safety hazards. Where researchers work in laboratories, safety hazards can arise through the need to operate complex equipment that can become unsafe if faulty or broken. The research literature also represents a workplace for millions of scientists and scholars, where publications can be considered as key research equipment.

Coronary Sinus Narrowing for Treating Refractory Angina: REDUCER-I Multicenter "Real-World" Observational Study Primary Endpoint Analysis.

Background: Patients with refractory angina are often ineligible for revascularization and have poor quality of life despite optimal medical therapy. The coronary sinus (CS) Reducer (Shockwave Medical Inc) was safe and effective in the treatment of refractory angina in the COSIRA (Coronary Sinus Reducer for Treatment of Refractory Angina) randomized sham-controlled trial.

Objectives: This study sought to perform the primary endpoint analysis of the complete REDUCER-I (An Observational Study of the Neovasc Reducer System) study cohort.

Navigating the Landscape of B Cell Mediated Immunity and Antibody Monitoring in SARS-CoV-2 Vaccine Efficacy: Tools, Strategies and Clinical Trial Insights.

Correlates of Protection (CoP) are biomarkers above a defined threshold that can replace clinical outcomes as primary endpoints, predicting vaccine effectiveness to support the approval of new vaccines or follow up studies. In the context of COVID-19 vaccination, CoPs can help address challenges such as demonstrating vaccine effectiveness in special populations, against emerging SARS-CoV-2 variants or determining the durability of vaccine-elicited immunity. While anti-spike IgG titres and viral neutralising capacity have been characterised as CoPs for COVID-19 vaccination, the contribution of other components of the humoral immune response to immediate and long-term protective immunity is less well characterised.

Activation of Heme Metabolism Promotes Tissue Health After Intraarticular Injury or Surgical Exposure.

Posttraumatic osteoarthritis (PTOA) is a well-recognized public health burden without any disease modifying treatment. This occurs despite noted advances in surgical care in the past 50 years. Mitochondrial oxidative damage pathways initiate PTOA after severe injuries like intraarticular fracture that often require surgery and contribute to PTOA after less severe injuries that may or may not require surgery like meniscal injuries.

Graduate Medical Education Financing in the US Department of Veterans Affairs.

Background: The US Department of Veterans Affairs (VA) partners with 250 sponsors of graduate medical education (GME), annually providing $850 million for 11,000 full-time equivalent resident positions that support veteran patient care and provide educational opportunities for trainees from affiliated academic programs. Knowledge of VA GME financing is vital to maintain these partnerships.

Observations: In response to increased scrutiny from several federal oversight bodies, the VA revised its GME reimbursement policy and procedures, including implementing new resident tracking and auditing mechanisms.

Paper mill challenges: past, present, and future.

Paper mills are fraudulent organizations that make money by writing fake manuscripts and offering authorship slots for sale to academic customers. Mill activity differs in scale to individual academic misconduct: many thousands of fake paper mill manuscripts have been successfully published in peer-reviewed journals. Despite this, paper mill activity is still relatively unrecognized outside the publishing industry.

Robust and persistent B-cell responses following SARS-CoV-2 vaccine determine protection from SARS-CoV-2 infection.

Introduction: A clear immune correlate of protection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has not been defined. We explored antibody, B-cell, and T-cell responses to the third-dose vaccine and relationship to incident SARS-CoV-2 infection.

Methods: Adults in a prospective cohort provided blood samples at day 0, day 14, and 10 months after the third-dose SARS-CoV-2 vaccine.

National introduction of one-anastomosis gastric bypass in the UK National Bariatric Surgery Registry - a cohort study.

Aim: There is a paucity of evidence regarding the national introduction of newer bariatric metabolic surgery procedures. This study assessed the impact of introducing one-anastomosis gastric bypass (OAGB) in bariatric surgical practice in the UK on 30-day postoperative morbidity and early postoperative weight loss.

Methods: Patients who underwent primary BMS in the UK National Bariatric Surgical Registry (2010-2019) were identified.