Diagnosis of Alcohol Use Disorder and Alcohol-Associated Liver Disease.

Harmful alcohol use and alcohol use disorder (AUD) are common worldwide, and rates of alcohol-associated liver disease (ALD) are also increasing. AUD is a disease that is treatable and can be diagnosed and managed, and recovery from AUD through abstinence or reductions in drinking is possible. Management of AUD among individuals with ALD is increasingly being addressed via integrated medical and psychosocial treatment teams that can support reductions in drinking and prevent progression of liver disease.

Optimizing evidence-based practice implementation: a case study on simulated patient protocols in long-term opioid therapy.

Background: Substantial work has been done to update or create evidence-based practices (EBPs) in the changing health care landscape. However, the success of these EBPs is limited by low levels of clinician implementation.

Objective: The goal of this study is to describe the use of standardized/simulated patient/person (SP) methodology as a framework to develop implementation bundles to increase the effectiveness, sustainability, and reproducibility of EBPs across health care clinicians.

Using Mobile and Remote Simulation as a Research Methodology for Health Care Delivery Research.

Mobile and remote simulation can be used as a research methodology to collect data in simulated environments to answer research questions pertaining to health care delivery. This research methodology can exponentially increase the reachable target study participants and provide generalizable conclusions. Using a large-scale national study in the United States as an exemplar, this article outlines the technology and equipment required to conduct mobile and remote simulations for research purposes.

Models of care in secure services for people with intellectual and developmental disability: Implementing the Walkway to Wellness.

Background: Changes to policy around inpatient services for people with intellectual and developmental disability (IDD) who offend, have led to a need for services to reconsider their models of care. This has led to calls for more tailored, patient-centred care models, with less reliance solely on offence-related treatment programmes which can be unsuitable for a growing proportion of patients with more complex cognitive and behavioural difficulties. In response, the Walkway to Wellness (W2W) was developed at one National Health Service Trust providing secure services to people with IDD, with the intention of delivering a more collaborative, co-produced and goal-oriented care model that was better understood by staff and patient stakeholders.

Closing the Care Gap: Management of Alcohol Use Disorder in Patients with Alcohol-associated Liver Disease.

Alcohol-associated liver disease (ALD)-related morbidity and mortality are rising in the United States. Although effective medications and behavioral interventions are available for the treatment of patients with alcohol use disorder (AUD), patients with ALD are profoundly undertreated for AUD. This article reviews the management of AUD in patients with ALD, with a focus on appropriate screening and diagnosis, management of alcohol withdrawal syndrome, pharmacotherapy for AUD, alcohol biomarkers, and behavioral interventions.

A Simulated Patient Protocol for Implementing Evidence-Based Practices in Health Care Delivery.

Background: Substantial work has been done to update or create evidence-based practices (EBPs) in the changing health care landscape. However, the success of these EBPs is limited by low levels of clinician implementation. The goal of this study is to describe the use of simulated patient (SP) methodology as a framework to develop implementation bundles to increase the effectiveness, sustainability, and reproducibility of EBPs across health care clinicians.

Innovative Research Methods: Using Simulation to Evaluate Health Care Policy.

Health care policies have the potential to improve patient outcomes, access to care, and reduce health disparities. However, new policy is often tested in the field, where unintended consequences are paid for by patients. In this perspective, we argue that health care simulations, which can elucidate the potential for policy to hinder clinicians' ability to provide high-quality care, are a complement to large-scale policy evaluations in the field.

Diagnosis and management of hepatic encephalopathy: A summary for patients.

Content available: Author Interview and Audio Recording.

Patients With Acute-on-Chronic Liver Failure Have Greater Healthcare Resource Utilization After Liver Transplantation.

Background & Aims: Although liver transplantation (LT) has been demonstrated to provide survival benefit for patients with acute-on-chronic liver failure (ACLF), data are lacking regarding resource utilization for this population after LT.

Methods: We retrospectively reviewed data from 10 centers in North America of patients transplanted between 2018 and 2019. ACLF was identified by using the European Association for the Study of the Liver-Chronic Liver Failure criteria.

Risk Factors for Posttransplantation Mortality in Recipients With Grade 3 Acute-on-Chronic Liver Failure: Analysis of a North American Consortium.

Although liver transplantation (LT) yields survival benefit for patients with acute-on-chronic liver failure grade 3 (ACLF-3), knowledge gaps remain regarding risk factors for post-LT mortality. We retrospectively reviewed data from 10 centers in the United States and Canada for patients transplanted between 2018 and 2019 and who required care in the intensive care unit prior to LT. ACLF was identified using the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) criteria.

EGFR transactivates RON to drive oncogenic crosstalk.

Crosstalk between different receptor tyrosine kinases (RTKs) is thought to drive oncogenic signaling and allow therapeutic escape. EGFR and RON are two such RTKs from different subfamilies, which engage in crosstalk through unknown mechanisms. We combined high-resolution imaging with biochemical and mutational studies to ask how EGFR and RON communicate.

Treatment and Prevention of Acute Hepatitis B Virus.

This article reviews the incidence of acute hepatitis B virus (HBV) infection, its clinical course, strategies to prevent acute HBV infection in susceptible individuals, and the management of patients with acute HBV.

Multiphoton imaging and Raman spectroscopy of the bovine vertebral endplate.

The interface between the intervertebral disc and the vertebral body is important to the discs' biomechanics and physiology, and is widely implicated in its pathology. This study aimed to explore biochemically and structurally the bony endplate, cartilage endplate and intervertebral disc, below the nucleus and below the annulus in healthy bovine tails. Multiphoton imaging and spontaneous Raman spectroscopy were employed.

Multidisciplinary Team Management of Hepatocellular Carcinoma Is Standard of Care.

Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, but unlike other leading causes of cancer death, HCC is increasing in mortality and burden of management. Management of HCC is unique because it usually arises in a diseased liver, which itself may be a driver of mortality. Multidisciplinary teams (MDTs) for the management of complex diseases are becoming more common, but are especially needed in the management of patients with HCC.

Employing photoluminescence to rapidly follow aggregation and dispersion of cellulose nanofibrils.

Photoluminescence of cellulose, and other polysaccharides, has long been presumed to be due to contamination of the material by other autofluorescent compounds - such as lignin, or proteins. This is attributed to the lack of known fluorescent chemical groups present in the molecular structure of polysaccharides and the weak emission intensity when compared to typical fluorophores. However, recent research suggests that the observed luminescence may actually be due to transitions involving the n orbitals containing lone electron pairs present in oxyl groups, stabilised by the molecular forces between the polysaccharide chains.

Cautionary study on the effects of pay for performance on quality of care: a pilot randomised controlled trial using standardised patients.

Background: Due to the difficulty of studying incentives in practice, there is limited empirical evidence of the full-impact pay-for-performance (P4P) incentive systems.

Objective: To evaluate the impact of P4P in a controlled, simulated environment.

Design: We employed a simulation-based randomised controlled trial with three standardised patients to assess advanced practice providers' performance.

Systematic Review of Yoga and Balance: Effect on Adults With Neuromuscular Impairment.

This systematic review examines the efficacy of yoga as a neuromuscular intervention for community-dwelling populations at risk for falls to determine its utility for use in occupational therapy intervention. Populations included older adults and adults with traumatic brain injury (TBI), cerebrovascular accident (CVA), dementia and Alzheimer's disease (AD)-type dementia, multiple sclerosis (MS), and Parkinson's disease (PD). Benefits of yoga include improved posture control, improved flexibility of mind and body, relaxation, and decreased anxiety and stress.

In situ chemically specific mapping of agrochemical seed coatings using stimulated Raman scattering microscopy.

Providing sufficient, healthy food for the increasing global population is putting a great deal of pressure on the agrochemical industry to maximize crop yields without sustaining environmental damage. The growth and yield of every plant with sexual reproduction, depends on germination and emergence of sown seeds, which is affected greatly by seed disease. This can be most effectively controlled by treating seeds with pesticides before they are sown.

Assessment of Compressive Raman versus Hyperspectral Raman for Microcalcification Chemical Imaging.

We experimentally implement a compressive Raman technology (CRT) that incorporates chemometric analysis directly into the spectrometer hardware by means of a digital micromirror device (DMD). The DMD is a programmable optical filter on which optimized binary filters are displayed. The latter are generated with an algorithm based on the Cramer-Rao lower bound.

True Molecular Scale Visualization of Variable Clustering Properties of Ryanodine Receptors.

Signaling nanodomains rely on spatial organization of proteins to allow controlled intracellular signaling. Examples include calcium release sites of cardiomyocytes where ryanodine receptors (RyRs) are clustered with their molecular partners. Localization microscopy has been crucial to visualizing these nanodomains but has been limited by brightness of markers, restricting the resolution and quantification of individual proteins clustered within.

Potential Impact of Risk and Loss Aversion on the Process of Accepting Kidneys for Transplantation.

Behavioral economic theory suggests that people make decisions based on maximizing perceived value; however, this may be influenced more by the risk of loss rather than of potential gain. Additionally, individuals may seek certainty over uncertainty. These are termed loss aversion and risk aversion, respectively.

Angels and Demons: Using Behavioral Types in a Real-Effort Moral Dilemma to Identify Expert Traits.

In this article, we explore how independently reported measures of subjects' cognitive capabilities, preferences, and sociodemographic characteristics relate to their behavior in a real-effort moral dilemma experiment. To do this, we use a unique dataset, the Chapman Preferences and Characteristics Instrument Set (CPCIS), which contains over 30 standardized measures of preferences and characteristics. We find that simple correlation analysis provides an incomplete picture of how individual measures relate to behavior.