Development and Piloting of Implementation Strategies to Support Delivery of a Clinical Intervention for Postpartum Hemorrhage in Four sub-Saharan Africa Countries.

Introduction: Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality. A new clinical intervention (E-MOTIVE) holds the potential to improve early PPH detection and management. We aimed to develop and pilot implementation strategies to support uptake of this intervention in Kenya, Nigeria, South Africa, and Tanzania.

Vitreoretinopathy in Asymptomatic Children With CTNNB1 Syndrome.

Importance: Previous studies have identified familial exudative vitreoretinonpathy (FEVR) in patients with CTNNB1 syndrome based on severe congenital ocular phenotypes. However, ophthalmoscopy may not be sufficient to detect vision-threatening vitreoretinopathy in all patients.

Objective: To report a consecutive retrospective case series of 11 patients with CTNNB1 variants who had previously unremarkable ophthalmoscopic examination results and to describe their detailed ophthalmic phenotypes.

Effects of Actissist, a digital health intervention for early psychosis: A randomized clinical trial.

Schizophrenia affects 24 million people worldwide. Digital health interventions drawing on psychological principles have been developed, but their effectiveness remains unclear. This parallel, assessor-blinded, randomized clinical trial aimed to investigate whether a cognitive behaviour therapy-informed digital health intervention (Actissist app) confers added benefit on psychotic symptoms over and above remote symptom monitoring (ClinTouch app).

Fast Zernike fitting of freeform surfaces using the Gauss-Legendre quadrature.

Zernike polynomial orthogonality, an established mathematical principle, is leveraged with the Gauss-Legendre quadrature rule in a rapid novel approach to fitting data over a circular domain. This approach provides significantly faster fitting speeds, in the order of thousands of times, while maintaining comparable error rates achieved with conventional least-square fitting techniques. We demonstrate the technique for fitting mid-spatial-frequencies (MSF) prevalent in small-tool-manufacturing typical of aspheric and freeform optics that are poised to soon permeate a wide range of optical technologies.

A systematic review of behaviour change interventions to improve maternal health outcomes in sub-Saharan Africa.

The rate of decline in the global burden of avoidable maternal deaths has stagnated and remains an issue of concern in many sub-Saharan Africa countries. As per the most recent evidence, an average maternal mortality ratio (MMR) of 223 deaths per 100,000 live births has been estimated globally, with sub-Saharan Africa's average MMR at 536 per 100,000 live births-more than twice the global average. Despite the high MMR, there is variation in MMR between and within sub-Saharan Africa countries.

Perceptions and experiences of the prevention, detection, and management of postpartum haemorrhage: a qualitative evidence synthesis.

Background: Postpartum haemorrhage (PPH), defined as blood loss of 500 mL or more after childbirth, is the leading cause of maternal mortality worldwide. It is possible to prevent complications of PPH with timely and appropriate detection and management. However, implementing the best methods of PPH prevention, detection and management can be challenging, particularly in low- and middle-income countries.

Factors influencing staff attitudes to COVID-19 vaccination in care homes in England: a qualitative study.

Background: The COVID-19 pandemic disproportionately affected people living and working in UK care homes causing high mortality rates. Vaccinating staff members and residents is considered the most effective intervention to reduce infection and its transmission rates. However, uptake of the first dose of the COVID-19 vaccine in care homes was variable.

Associations between postrace atrial fibrillation and measures of performance, racing history and airway disease in horses.

Background: Atrial fibrillation (AF) is the most common performance limiting arrhythmia in racehorses. High dose exercise and airway disease promote AF in humans. Few studies have investigated epidemiological factors associated with AF in horses.

Electromyography (EMG) Analysis of Multi-Regional Lower Extremity and Trunk Musculature During Sidelying Hip Abduction With Frontal Plane Stabilization.

Sidelying hip abduction (SHA) is a common exercise utilized in rehabilitation to strengthen the gluteus medius (GMed). Alterations in the exercise can produce different patterns of muscular activity. No studies have examined the effect of mechanical pelvic stabilization during SHA.

Clonal expansion and rapid characterization of ST1788, an otherwise uncommon strain spreading in Wales, UK.

A multidrug-resistant strain of () sequence type (ST) 1788, an otherwise uncommon ST worldwide, was isolated from 65 patients at 11 hospitals and 11 general practices across South and West Wales, UK, between February 2019 and November 2021. A collection of 97 ST1788 isolates (including 94 from Wales) was analysed to investigate the diversity and spread across Wales and to identify molecular marker(s) to aid development of a strain-specific real-time PCR. Whole genome sequencing (WGS) was performed with Illumina technology and the data were used to perform phylogenetic analyses.

Protection of β2GPI Deficient Mice from Thrombosis Reflects a Defect in PAR3-facilitated Platelet Activation.

Background: Antibodies to β2-glycoprotein I (β2GPI) cause thrombosis in antiphospholipid syndrome, however the role of β2GPI itself in regulation of coagulation pathways is not well understood.

Methods: We developed β2GPI-deficient mice by deleting exon 2 and 3 of using CRISPR/Cas9 and compared the propensity of wild-type (WT) and mice to develop thrombosis using rose bengal and FeCl -induced carotid thrombosis, laser-induced cremaster arteriolar injury, and inferior vena cava (IVC) stasis models. We also compared tail bleeding times and assessed platelet activation in WT and mice in the absence and presence of exogenous β2GPI.

Potential blindness from nutritional xerophthalmia in autistic patients.

Background: Vitamin A is vital to retinal rod function and epithelial cell differentiation. Although uncommon in the developed world, vitamin A deficiency (VAD) secondary to poor diets or gastrointestinal disease has been reported and can lead to xerophthalmia, which is characterized by night blindness and a spectrum of ocular surface changes. Patients with autism spectrum disorder have been shown to have restrictive diets secondary to sensory issues leading to rejection of foods except for those of certain color or texture.

The protein kinases of Dictyostelia and their incorporation into a signalome.

Protein kinases are major regulators of cellular processes, but the roles of most kinases remain unresolved. Dictyostelid social amoebas have been useful in identifying functions for 30% of its kinases in cell migration, cytokinesis, vesicle trafficking, gene regulation and other processes but their upstream regulators and downstream effectors are mostly unknown. Comparative genomics can assist to distinguish between genes involved in deeply conserved core processes and those involved in species-specific innovations, while co-expression of genes as evident from comparative transcriptomics can provide cues to the protein complement of regulatory networks.

Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage.

Background: Delays in the detection or treatment of postpartum hemorrhage can result in complications or death. A blood-collection drape can help provide objective, accurate, and early diagnosis of postpartum hemorrhage, and delayed or inconsistent use of effective interventions may be able to be addressed by a treatment bundle.

Methods: We conducted an international, cluster-randomized trial to assess a multicomponent clinical intervention for postpartum hemorrhage in patients having vaginal delivery.

Factors influencing postpartum haemorrhage detection and management and the implementation of a new postpartum haemorrhage care bundle (E-MOTIVE) in Kenya, Nigeria, and South Africa.

Background: Postpartum haemorrhage (PPH) is the leading cause of global maternal deaths, accounting for 30-50% of maternal deaths in sub-Saharan Africa. Most PPH-related deaths are preventable with timely detection and initiation of care, which may be facilitated by using a clinical care bundle. We explore influences on current PPH detection and management and on the future implementation of a new PPH bundle (E-MOTIVE) in low-resource, high-burden settings.

Use of a Sprayable Sex Pheromone Formulation in Landscape-Level Control of Populations.

(SBW) is a major defoliating pest of balsam fir and spruce in eastern North America. As part of an integrated management strategy for SBW, we evaluated the effectiveness of mating disruption as a landscape-level population control tactic. Using a sprayable formulation (CONFOUND) containing a synthetic sex pheromone blend, we treated five 300 ha blocks in Northern New Brunswick with an aerially applied microencapsulated mixture.

How do autistic people fare in adult life and can we predict it from childhood?

This study describes social, mental health, and quality of life outcomes in early adulthood, and examines childhood predictors in the Special Needs and Autism Project (SNAP), a longitudinal population-based cohort. Young autistic adults face variable but often substantial challenges across many areas of life. Prediction of outcomes is important to set expectations and could lead to the development of targeted early intervention.

Detection and management of postpartum haemorrhage: Qualitative evidence on healthcare providers' knowledge and practices in Kenya, Nigeria, and South Africa.

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal death globally. Most PPH deaths can be avoided with timely detection and management; however, critical challenges persist. A multi-country cluster-randomised trial (E-MOTIVE) will introduce a clinical care bundle for early detection and first-response PPH management in hospital settings.

In active UC, upadacitinib induced and maintained remission.

Danese S, Vermeire S, Zhou W, et al. Lancet. 2022;399:2113-28.

Room for a Specialist?

When the Associate Specialist grade shut in 2008 it left an untenable situation in which some Specialty Doctors were providing the most senior levels of care for patients without recognition of that seniority. Hence in 2021, the Specialist Grade was created as a new national grade for senior specialist and specialty (SAS) doctors. The post provides autonomous working and recognition of seniority for SAS doctors.

Novel RNAseq-Informed Cell-type Markers and Their Regulation Alter Paradigms of Developmental Control.

Cell differentiation is traditionally monitored with a few marker genes, which may bias results. To understand the evolution and regulation of the spore, stalk, cup and basal disc cells in Dictyostelia, we previously performed RNAseq on purified cell-types of taxon-group representative dictyostelids. Using promoter- constructs in , we here investigate the spatio-temporal expression pattern of 29 cell-type specific genes.

Therapist-supported online cognitive therapy for post-traumatic stress disorder (PTSD) in young people: protocol for an early-stage, parallel-group, randomised controlled study (OPTYC trial).

Introduction: Post-traumatic stress disorder (PTSD) is a disabling psychiatric condition that affects a significant minority of young people exposed to traumatic events. Effective face-to-face psychological treatments for PTSD exist. However, most young people with PTSD do not receive evidence-based treatment.