Publications by authors named "Fleming J"

The integration of artificial intelligence (AI) into healthcare represents a paradigm shift with the potential to enhance patient care and streamline clinical operations. This commentary explores the Canadian perspective on key organizational considerations for nurse executives, emphasizing the critical role they play in fostering the establishment of AI governance structures and advancing the front-line adoption of AI in nursing practice. The discussion delves into five domains of consideration, analyzing recent developments and implications for nursing executives.

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There has been a significant paradigm shift in the clinical management of lower-grade glioma patients given the recent updates to the 2021 World Health Organization classification along with long-term results from randomized phase III clinical trials. As a result, we are now better able to diagnose and assign patients to the most appropriate treatment course. This review provides a comprehensive summary of the most robust and reliable molecular biomarkers for adult lower-grade gliomas and discusses current challenges facing this patient population that future correlative biology studies combined with advancements in technologies could help overcome.

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Objective: African American women with breast cancer experience disproportionately poor survival outcomes, primarily due to the high prevalence of the deadliest subtype; triple-negative breast cancer (TNBC). The CRYβB2 gene is upregulated in tumors from African American patients across all breast cancer subtypes, including TNBC, and is associated with worse survival rates. This study investigated the effect of CRYβB2 on the invasion of TNBC cells and the underlying mechanisms contributing to this phenotype.

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Delivery of radiotherapy (RT) at ultra-high dose rates or FLASH radiotherapy (FLASH-RT) is an emerging treatment option for patients with cancer that could increase survival outcomes and quality of life. In vivo data across a multitude of normal tissues and associated tumors have been published demonstrating the FLASH effect while bringing attention to the need for additional research. Combination of FLASH-RT with other treatment options including spatially fractionated RT, immunotherapy, and usage in the setting of reirradiation could also provide additional benefit.

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Ground reaction forces (GRFs) are known to be high during front foot contact of fast bowling deliveries in cricket. There is a lack of published data on the GRFs during follow through foot contacts. The aim of this study was to quantify and compare peak GRFs and impulse of the delivery stride and the follow through of fast bowling deliveries.

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Background: New vaccines for pregnant women have recently been introduced in some high-income countries to protect infants in early life. Implementing maternal immunisation (MI) successfully in low- and middle-income countries will require planning and adaptations to immunisation and maternal health programs. To inform cost of MI delivery studies, we gathered perspectives from key stakeholders in five countries (Bangladesh, Ghana, Kenya, Mozambique, and Nepal) regarding health system requirements, opportunities, and challenges to introducing new maternal vaccines into routine health programs.

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Batteries based on sulfur cathodes offer a promising energy storage solution due to their potential for high performance, cost-effectiveness, and sustainability. However, commercial viability is challenged by issues such as polysulfide migration, volume changes, uneven phase nucleation, limited ion transport, and sluggish sulfur redox kinetics. Addressing these challenges requires insights into the structural, morphological, and chemical evolution of phases, the associated volume changes and internal stresses, and ion and polysulfide diffusion within the battery.

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New respiratory syncytial virus (RSV) maternal vaccines have begun roll out in some countries, with efforts in progress to broaden access worldwide and shorten the timeline to access for low- and middle-income countries (LMICs). Prior to new maternal immunization (MI) introductions, countries will need to evaluate their capacity and readiness for successful introduction. The World Health Organization's Maternal Immunization and Antenatal Care Situation Analysis (MIACSA) project (2016-2019) developed a checklist for countries to self-evaluate their capacity to introduce new maternal vaccines.

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Intraductal papillary mucinous neoplasms (IPMN) are commonly detected pancreatic cysts that may transform into pancreatic ductal adenocarcinoma (PDAC). Predicting which IPMNs will progress to PDAC remains a clinical challenge. Moreover, identifying those clinically evident IPMNs for which a surveillance approach is best is a dire clinical need.

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Patients with Hereditary Spastic Paraplegia (HSP) report reduced quality of life (QoL) compared to the general population. Generic QoL measures do not address disease-specific aspects such as spasticity, access to specialty HSP clinics, and bladder symptoms. We designed and validated a HSP-specific QoL scale (HSPQoL), intended for use in standard clinical settings and clinical trials.

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Adoptive T-cell immunotherapy holds great promise for the treatment of viral complications in immunocompromised patients resistant to standard anti-viral strategies. We present a retrospective analysis of 78 patients from 19 hospitals across Australia and New Zealand, treated over the last 15 years with "off-the-shelf" allogeneic T cells directed to a combination of Epstein-Barr virus (EBV), cytomegalovirus (CMV), BK polyomavirus (BKV), John Cunningham virus (JCV) and/or adenovirus (AdV) under the Australian Therapeutic Goods Administration's Special Access Scheme. Most patients had severe post-transplant viral complications, including drug-resistant end-organ CMV disease, BKV-associated haemorrhagic cystitis and EBV-driven post-transplant lymphoproliferative disorder.

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Background: Preventing disc degeneration remains a clinical challenge; patients experiencing chronic lumbar discogenic pain have limited treatment options. Minimally invasive intradiscal procedures such as allogeneic nucleus pulposus (NP) injection have the potential to fill the treatment gap between failed conservative care and spine surgery.

Objectives: Our study sought to evaluate the magnitude and durability of improvement in back function in patients with chronic lumbar discogenic pain followed for 6 months after a single intradiscal injection of minimally manipulated, off-the-shelf processed NP allograft (VIA Disc NP®, VIVEX Biologics, Inc.

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Individuals with neurofibromatosis type 1 and schwannomatosis (NF) often face difficult reproductive choices when family planning; however, their experiences and the barriers and enablers to reproductive decision-making are poorly understood. The purpose of this study was to explore the opinions and experiences of individuals with NF in Australia and inform the development of practice recommendations and resources. Focus groups with adults with NF were conducted using a semi-structured interview schedule developed by the research team.

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Article Synopsis
  • Prospective memory (PM) impairment is a frequent issue following moderate to severe traumatic brain injury (TBI), often treated with compensatory strategy training (COMP) and rehabilitation.
  • This study investigates how COMP affects white matter integrity in TBI patients, using advanced diffusion MRI techniques to assess brain changes.
  • Results show that the COMP group experienced less neural degeneration compared to those receiving routine care, suggesting that the intervention may help preserve brain function post-injury.
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Background: Restoration of full elbow extension following trauma is difficult and influenced by the injury profile, surgeon preference, patient and environmental factors. The literature suggests that orthotic interventions are effective in improving contractures when movement plateaus despite normal therapeutic interventions. It is not known if extension orthotic intervention is more superior to standard treatment regardless of when it is commenced.

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Introductory classes are often a student's first exposure to foundational knowledge, careers, and faculty in an academic major. The characteristics of introductory exercise science courses, as well as faculty impressions of course benefits and areas for improvement, were explored in this study. Electronic survey data from 181 universities around the United States were analyzed.

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Article Synopsis
  • - This study investigates the link between alcohol consumption and falls among people with HIV (PWH), highlighting that falls are a major health issue, especially for older adults and PWH.
  • - Researchers categorized participants (315 PWH, mostly male, average age 52) into drinking levels (none, non-hazardous, hazardous) and analyzed the relationship between their drinking habits and fall incidents using various statistical methods.
  • - Findings revealed that hazardous drinkers had a significantly higher risk of falls and recurrent falls compared to non-hazardous drinkers, but the amount of alcohol consumed daily in grams did not show a clear connection to fall risk.
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Background/objectives: The folate Recommended Daily Allowance (RDA) for pregnant women is 600 μg/day dietary folate equivalents, which is equivalent to approximately 400 μg folic acid. Many prenatal supplements contain much higher doses of folic acid. The body's ability to reduce synthetic folic acid to the metabolically active form may be exceeded with high levels of supplementation.

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Purpose: In pain assessment, the commonly used Numeric Rating Scale (NRS) offers an incremental 0-to-10 range of response options. But this broad range often leads to discordant evaluations between nurses and their patients. This study aimed to compare the NRS to the three-category Interventional Pain Assessment (IPA) scale, validate the IPA scale in an inpatient setting, and determine RN and patient scale preferences.

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Rhabdomyolysis is a relatively rare condition caused by the damage and release of myocyte contents. It occurs most commonly secondary to strenuous exercise. Rhabdomyolysis carries the risk of life-threatening negative sequelae such as acute kidney injury or death.

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The sacroiliac joint (SIJ) is the largest diarthrodial joint in the human body and accounts for approximately 20% of all low back pain, which is commonly seen in patients with lumbosacral fusions. Despite this, SIJ dysfunction often poses a challenging diagnosis depending on clinical evaluation, imaging, and image-guided joint injection. SIJ fusion is an effective and safe method of treatment, with minimally invasive approaches fitting well within the armamentarium of interventional radiologists treating chronic pain and other musculoskeletal conditions.

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Key Points: Peripheral blood biomarkers may have value in monitoring kidney transplant recipients after treatment of acute rejection. The donor-derived cellfree DNA may be more sensitive to identifying antibody-mediated rejection and gene expression profile may be more sensitive to identifying acute cellular rejection.

Background: Persistent rejection is an increasingly recognized barrier to long-term kidney allograft survival.

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The teachings of the Catholic Church on human sexuality, contraception and the treatment of infertility are well established and clearly explained in many Church documents, including Humanae vitae and Familiaris consortio. In 2022, a book was published in Italian which reported on a seminar organised by an Academy of the Catholic Church about the ethics of life. Titled the Theological Ethics of Life (abbreviated 'ETV' in Italian), the conclusion of chapter VII contains statements about contraception and assisted reproductive technologies (ART) which, though somewhat difficult to interpret, appear to be controversial with regard to accepted Church teaching on these subjects.

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