Exploring Physician and Patient Perspectives on Expectations and Role Models Towards Chronic Pain Treatment in General Practice: A Qualitative Cross-Sectional Study.

Approximately 7.4% of the German population matched the criteria of impeding, chronic non-cancer-related pain in 2014. Guidelines emphasize the importance of a holistic treatment approach.

Polygenic risk discriminates Lewy body dementia from Alzheimer's disease.

Introduction: Lewy body dementia (LBD) shares genetic risk factors with Alzheimer's disease (AD), including apolipoprotein E (APOE), but is distinguishable at the genome-wide level. Polygenic risk scores (PRS) may therefore improve diagnostic classification.

Methods: We assessed diagnostic classification using AD-PRS excluding APOE (AD-PRS ), APOE risk score (APOE-RS), and plasma phosphorylated tau 181 (p-tau181), in 83 participants with LBD, 27 with positron emission tomography amyloid beta (Aβ)positive mild cognitive impairment or AD (MCI+/AD), and 57 controls.

Hepatopulmonary syndrome from liver disease associated with autosomal recessive polycystic kidney disease.

Hepatopulmonary syndrome (HPS) is a life-threatening complication of chronic liver disease (CLD) that currently can be managed only by liver transplant. Though uncommon, some children with kidney disease have coexistent CLD and hence are at risk of developing HPS. Paediatric cases of HPS are rarely described in the nephrology literature.

Beyond COVID-19, the case for collecting, analysing and using sex-disaggregated data and gendered data to inform outbreak response: a scoping review.

Introduction: Understanding sex and gender differences during outbreaks is critical to delivering an effective response. Although recommendations and minimum requirements exist, the incorporation of sex-disaggregated data and gender analysis into outbreak analytics and response for informed decision-making remains infrequent. A scoping review was conducted to provide an overview of the extent of sex-disaggregated data and gender analysis in outbreak response within low- and middle-income countries (LMICs).

Canadian Stroke Best Practice Recommendations: Vascular cognitive impairment, 7th edition practice guidelines update, 2024.

The Canadian Stroke Best Practice Recommendations (CSPR) 7th edition includes this new module on the diagnosis and management of vascular cognitive impairment (VCI) with or without neurodegenerative disease. An expert writing group and people with VCI lived experience (PWLE) reviewed current evidence. Existing recommendations were reviewed and revised, and new recommendations added.

Advanced Markers for Hemodynamic Monitoring in Cardiogenic Shock and End-Stage Heart Failure: A Mini Review.

Right heart catheterization (RHC) provides critical hemodynamic insights by measuring atrial, ventricular, and pulmonary artery pressures, as well as cardiac output (CO). Although the use of RHC has decreased, its application has been linked to improved outcomes. Advanced hemodynamic markers such as cardiac power output (CPO), aortic pulsatility index (API), pulmonary artery pulsatility index (PAPi), right atrial pressure to pulmonary capillary wedge pressure ratio (RAP/PCWP) and right ventricular stroke work index (RVSWI) have been introduced to enhance risk stratification in cardiogenic shock (CS) and end-stage heart failure (HF) patients.

Immunotherapy on ICU: a narrative review.

Background: Patients with cancer account for 15% of all admissions to critical care and so an understanding of the pathophysiology and anticipated complications of specialist treatment is essential for the intensive care clinician. The development of chimeric antigen receptor T-cell therapy for haematological malignancies and immune checkpoint inhibitors for solid organ tumours has led to significant improvements in the prognosis of those patients whose tumours respond. This review is intended to provide the non-specialist with an understanding of the current concepts in pathophysiology, diagnosis and management of complications due to chimeric antigen receptor T-cell therapy and immune checkpoint inhibitors for malignant disease.

Workplace physical activity, sitting time, and menopause symptoms.

Objective: Increasing numbers of women are in employment during the menopause; however, menopause symptoms can negatively impact capacity to work. Aspects of the work environment, such as the amount of time spent in physical activity (PA) and sitting, may influence symptoms, yet this is unexplored. This study aimed to explore relationships between workplace PA and sitting, and menopause symptom severity.

The effect of mindfulness-based cognitive therapy on PTSD and depression symptoms in trauma-exposed black adults: Pilot randomized controlled trial results.

Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, post-traumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in PTSD via MBCT across two prior pilot studies in veterans. Studies examining the effects of MBCT among trauma-exposed Black adults remains limited, and examination of effects across specific PTSD clusters is almost nonexistent.

Association of continuous renal replacement therapy downtime with fluid balance gap and clinical outcomes: a retrospective cohort analysis utilizing EHR and machine data.

Background: Fluid balance gap (FBgap-prescribed vs. achieved) is associated with hospital mortality. Downtime is an important quality indicator for the delivery of continuous renal replacement therapy (CRRT).

Patterns of diuretic titration during inpatient management of acute decompensated heart failure.

Introduction: Hospitalization rates for acute decompensated heart failure (ADHF) have increased, resulting in 6.5 million hospital days annually. Despite this, optimal diuretic strategies for managing ADHF remain unclear, highlighting the need to analyze diuretic practice patterns in ADHF treatment.

Effects of a responsive parenting intervention on Black mothers' depressive symptoms postpartum: Secondary analysis of a randomized clinical trial.

Objective: This study examined whether a responsive parenting (RP) intervention for first-time Black mothers had secondary benefits for their mental health by reducing their postpartum depressive symptoms.

Method: In total, 212 first-time Black mothers participated in the Sleep Strong African American Families randomized control trial. Mothers were randomized to the RP condition or a safety control condition at 1-week postpartum.

The design and evaluation of a bone health teaching module for secondary school students in NSW, Australia.

Issue Addressed: The growing prevalence of osteoporosis requires preventative management starting from an early age as peak bone mass is typically reached by age 30. However, current Australian adolescents are not adequately addressing key osteoprotective factors. Alarmingly, around 17% have insufficient vitamin D levels, 55% consume insufficient dietary calcium, and 79% are insufficiently active.

Free-Breathing Ungated Radial Simultaneous Multi-Slice Cardiac T1 Mapping.

Background: Modified Look-Locker imaging (MOLLI) T1 mapping sequences are acquired during breath-holding and require ECG gating with consistent R-R intervals, which is problematic for patients with atrial fibrillation (AF). Consequently, there is a need for a free-breathing and ungated framework for cardiac T1 mapping.

Purpose: To develop and evaluate a free-breathing ungated radial simultaneous multi-slice (SMS) cardiac T1 mapping (FURST) framework.

Extracellular vesicles released by ALL patients contain HNE-adducted proteins: Implications of collateral damage.

Off-target neuronal injury is a serious side-effect observed in cancer survivors. It has previously been shown that pediatric acute lymphoblastic leukemia (ALL) survivors have a decline in neurocognition compared to healthy age-matched counterparts. Elevated oxidative stress has been documented to be a mediator in off-target tissue damage in cancer survivors.

Identifying Priority Science Information Needs for Managing Public Lands.

Public lands worldwide provide diverse resources, uses, and values, ranging from wilderness to extractive uses. Decision-making on public lands is complex as a result and is required by law to be informed by science. However, public land managers may not always have the science they need.

Cystic Fibrosis Screening Efficacy and Seasonal Variation in California: 15-Year Comparison of IRT Cutoffs Versus Daily Percentile for First-Tier Testing.

The California Genetic Disease Screening Program (GDSP) employs a fixed immunoreactive trypsinogen (IRT) cutoff followed by molecular testing to screen newborns for cystic fibrosis (CF). The cutoffs approximate a 1.6% yearly IRT screen-positive rate; however, seasonal variation in IRT population means has led us to develop a model to establish fixed IRT cutoffs that anticipate seasonal variation and minimize missed cases below cutoff.

Parameter estimation from an Ornstein-Uhlenbeck process with measurement noise.

We investigate the impact of noise on parameter fitting for an Ornstein-Uhlenbeck process, focusing on the effects of multiplicative and thermal noise on the accuracy of signal separation. To address these issues, we propose algorithms and methods that can effectively distinguish between thermal and multiplicative noise and improve the precision of parameter estimation for optimal data analysis. Specifically, we explore the impact of both multiplicative and thermal noise on the obfuscation of the actual signal and propose methods to resolve them.

ROBUST DISCOVERY OF MUTATIONAL SIGNATURES USING POWER POSTERIORS.

Mutational processes, such as the molecular effects of carcinogenic agents or defective DNA repair mechanisms, are known to produce different mutation types with characteristic frequency profiles, referred to as mutational signatures. Non-negative matrix factorization (NMF) has successfully been used to discover many mutational signatures, yielding novel insights into cancer etiology and targeted therapies. However, the NMF model is only a rough approximation to reality, and even small departures from this assumed model can have large negative effects on the accuracy and reliability of the results.

Perspectives of Caregivers on Access to Health Care for Children with CKD.

Introduction: Inequitable access to health care based on demographic factors such as ethnicity, socioeconomic status and geographical location has been consistently found in children with chronic kidney disease (CKD). However, little is known about the perspectives of caregivers on accessing health care. We described caregivers' perspectives on accessing health care for children with CKD from socioeconomically disadvantaged backgrounds and/or rural or remote areas.

Subverting parental overreach: Children endorse defiance and deception as legitimate modes of moral resistance and social opposition.

This research examined how children evaluate the legitimacy of various sorts of rules as well as children's reasoning about the legitimacy of covertly defying and lying to parents to resist those rules. We asked U.S.