A National Survey of Caregiver Needs and Experiences When Attending the Emergency Department.

Objectives: Despite being a frequent entry point of care, it remains unknown if families' needs are being met across pediatric emergency departments (PEDs). Study objectives were to describe caregivers' perceived overall PED experience and needs and to what extent these needs were met.

Methods: This descriptive, cross-sectional survey with medical record review was conducted in 10 Canadian PEDs.

Associate Psychological Practitioners (APPs) in primary care: modelling the impact.

Background: The 'Associate Psychological Practitioner' (APP) is an innovative new role that expands the psychological workforce and addresses the rising demand for mental health services in England, yet the impact of this role on NHS workforce capacity has yet to be modelled.

Aim: We modelled the impact of the APP role in Primary Care in terms of additional capacity to provide mental health care and the impact on General Practitioner (GP) capacity within the sector.

Method: Workforce experts of the NHS Workforce Repository and Planning Tool (WRaPT) team used a modelling tool to determine future state scenarios of APPs working across all Primary Care Networks (PCNs) within a region and the associated change on the baseline workforce.

Advances in microfluidic platforms for tumor cell phenotyping: from bench to bedside.

Heterogeneities among tumor cells significantly contribute towards cancer progression and therapeutic inefficiency. Hence, understanding the nature of cancer through liquid biopsies and isolation of circulating tumor cells (CTCs) has gained considerable interest over the years. Microfluidics has emerged as one of the most popular platforms for performing liquid biopsy applications.

Assessment of Continuous Pulse Oximetry Monitoring in Infants With Bronchiolitis in the Pediatric Emergency Department: A Cross-Sectional Study.

Purpose Bronchiolitis guidelines recommend intermittent pulse oximetry monitoring for stable infants. Continuous pulse oximetry can lead to harm for some infants with bronchiolitis but is still frequently used in emergency departments (EDs) for infants who do not require oxygen supplementation. Measuring continuous pulse oximetry use from medical charts can be challenging.

Transformation to a Patient Centred Medical Home in an Urban Aboriginal Community Controlled Health Service: A Qualitative Study Using Normalisation Process Theory.

Rationale: The Patient-Centred Medical Home (PCMH) is a model of team-based care that is patient centred, coordinated, accessible, and focused on quality and safety. To learn how this model of healthcare works in an Indigenous primary health care setting in Australia, we explored the experiences of health staff in an urban Aboriginal Community Controlled Health Service (ACCHS) transitioning to an adapted model of a PCMH. Normalisation Process Theory (NPT) was applied to better understand factors enabling and inhibiting implementation of the PCMH, and the work required to deliver it.

Evaluation of Apparent Metabolizable Energy and Apparent Ileal Amino Acid Digestibility of Spirulina () in Broiler Chickens and Laying Hens.

Our study objective was to determine the apparent metabolizable energy (AME) and apparent ileal amino acid digestibility (AIAAD) of spirulina fed to broiler chickens and laying hens using the difference method. In both experiments, birds were either fed corn-soybean meal basal diets, containing no spirulina and formulated to provide the nutrient requirements of either broilers or layers, or fed test diets consisting of 25% spirulina and 75% of the appropriate basal diet. Titanium dioxide was added to all diets as an indigestible marker.

Variations in kinase and effector signaling logic in a bacterial two component signaling network.

The general stress response (GSR) protects bacteria from a wide range of stressors. In , GSR activation is coordinated by HWE/HisKA2 family histidine kinases (HKs), which can exhibit non-canonical structure and function. For example, while most light-oxygen-voltage sensor-containing HKs are light activated dimers, the RT-HK has inverted "dark on, light off" signaling logic with a tunable monomer/dimer equilibrium.

Gating residues govern ligand unbinding kinetics from the buried cavity in HIF-2α PAS-B.

While transcription factors have been generally perceived as "undruggable," an exception is the HIF-2 hypoxia-inducible transcription factor, which contains an internal cavity that is sufficiently large to accommodate a range of small-molecules, including the therapeutically used inhibitor belzutifan. Given the relatively long ligand residence times of these small molecules and the lack of any experimentally observed pathway connecting the cavity to solvent, there has been great interest in understanding how these drug ligands exit the buried receptor cavity. Here, we focus on the relevant PAS-B domain of hypoxia-inducible factor 2α (HIF-2α) and examine how one such small molecule (THS-017) exits from the buried cavity within this domain on the seconds-timescale using atomistic simulations and ZZ-exchange NMR.

Navigating the online food environment: policy pathways for promoting food access, transparency, and healthy food choices online.

The internet is drastically changing how U.S. consumers shop for groceries, order food from restaurants, and interact with food marketing.

Modular synthesis of aryl amines from 3-alkynyl-2-pyrones.

The synthesis of aryl amines from 3-alkynyl-2-pyrones and various amines is described. Mechanistically, the aryl amines are proposed to arise from the 3-alkynyl-2-pyrone substrates through their selective opening in a 1,6-fashion by secondary amines followed by decarboxylation and an unexpected rearrangement. The proposed mechanism is supported by quantum chemical transition-state calculations, which are consistent with the regiochemical outcome.

'Our culture makes us strong': Understanding and working with community strengths among Aboriginal people in western Sydney.

Background: Strengths-based approaches to health care are often seen as an alternative to deficit-based approaches and are common in Aboriginal health settings. Despite this, there is little existing research that describes Aboriginal peoples' perspectives about the strengths of their communities. This paper describes cultural strengths and resources as understood by Aboriginal people living in western Sydney.

Optogenetic control of phosphate-responsive genes using single component fusion proteins in .

Blue light illumination can be detected by Light-Oxygen-Voltage (LOV) photosensing proteins and translated into a range of biochemical responses, facilitating the generation of novel optogenetic tools to control cellular function. Here, we develop new variants of our previously described VP-EL222 light-dependent transcription factor and apply them to study the phosphate-responsive signaling () pathway in the budding yeast , exemplifying the utilities of these new tools. Focusing first on the VP-EL222 protein itself, we quantified the tunability of gene expression as a function of light intensity and duration, and demonstrated that this system can tolerate the addition of substantially larger effector domains without impacting function.

Mapping of a novel locus Ra conferring extreme resistance against potato virus A in cultivated potato (Solanum tuberosum L.).

The Ra extreme resistance against potato virus A was mapped to the upper of chromosome 4 in tetraploid potato. Potato virus A (PVA) is one of the major viruses affecting potato worldwide and can cause serious disease symptoms and yield losses. Previously, we determined that potato cultivar Barbara harbors Ry (genotype: Ryryryry) and Ra (genotype: Rararara) that each independently confer extreme resistance to PVA.

Identification of small-molecule ligand-binding sites on and in the ARNT PAS-B domain.

Transcription factors are challenging to target with small-molecule inhibitors due to their structural plasticity and lack of catalytic sites. Notable exceptions include naturally ligand-regulated transcription factors, including our prior work with the hypoxia-inducible factor (HIF)-2 transcription factor, showing that small-molecule binding within an internal pocket of the HIF-2α Per-Aryl hydrocarbon Receptor Nuclear Translocator (ARNT)-Sim (PAS)-B domain can disrupt its interactions with its dimerization partner, ARNT. Here, we explore the feasibility of targeting small molecules to the analogous ARNT PAS-B domain itself, potentially opening a promising route to modulate several ARNT-mediated signaling pathways.

Interplay of size, deformability, and device layout on cell transport in microfluidics.

Microfluidics have been widely used for cell sorting and capture. In this work, numerical simulations of cell transport in microfluidic devices were studied considering cell sizes, deformability, and five different device designs. Among these five designs, deterministic lateral displacement device (DLD) and hyperuniform device (HU) performed better in promoting cell-micropost collision due to the continuously shifted micropost positions as compared with regular grid, staggered, and hexagonal layout designs.

Acute kidney injury after colorectal surgery with prophylactic ureteral stents.

Background: After colorectal surgery, acute kidney injury (AKI) results from a complex interplay of multiple independent causes and preventive measures that occur during the hospitalization. Prophylactic stenting for ureter identification has been identified as a potential cause, but the evidence is conflicting, possibly because of differing baseline characteristics and procedure-related approaches.

Objective: This retrospective cohort study assesses the role of stents in the etiology of AKI after determining the independent predictors of AKI.

Interferon-signaling pathways are upregulated in people with HIV with abnormal pulmonary diffusing capacity (DL CO ).

Objective: People with HIV (PWH) are at greater risk of developing lung diseases even when they are antiretroviral therapy (ART)-adherent and virally suppressed. The most common pulmonary function abnormality in PWH is that of impaired diffusing capacity of the lungs for carbon monoxide (DL CO ), which is an independent risk factor for increased mortality in PWH. Earlier work has identified several plasma biomarkers of inflammation and immune activation to be associated with decreased DL CO .

Dollar store policy opportunities in Baltimore City: community member and policy maker perspectives.

Introduction: There are currently over 50 dollar stores in Baltimore City, Maryland. Community perceptions of over-saturation and resulting neighborhood impacts have garnered recent attention. A Maryland State Senate Bill required further study of dollar stores in Baltimore City to inform future policy.

Late-stage benzenoid-to-troponoid skeletal modification of the cephalotanes exemplified by the total synthesis of harringtonolide.

Skeletal modifications enable elegant and rapid access to various derivatives of a compound that would otherwise be difficult to prepare. They are therefore a powerful tool, especially in the synthesis of natural products or drug discovery, to explore different natural products or to improve the properties of a drug candidate starting from a common intermediate. Inspired by the biosynthesis of the cephalotane natural products, we report here a single-atom insertion into the framework of the benzenoid subfamily, providing access to the troponoid congeners - representing the reverse of the proposed biosynthesis (i.