Does remission of type 2 diabetes matter? A qualitative study of healthcare professionals' perspectives and views about supporting remission in primary care.

Background: Trials conducted in highly selected populations have shown that type 2 diabetes (T2D) remission is possible, but the feasibility and acceptability of supporting remission in routine clinical practice remain uncertain.

Aim: We explored primary care professionals' perceptions and understandings of T2D remission and their views about supporting remission within routine clinical care.

Methods: Semi-structured interviews were conducted with 14 GPs and nine nurses working in Scottish general practices.

A Digital Tool for Clinical Evidence-Driven Guideline Development by Studying Properties of Trial Eligible and Ineligible Populations: Development and Usability Study.

Background: Clinical guideline development preferentially relies on evidence from randomized controlled trials (RCTs). RCTs are gold-standard methods to evaluate the efficacy of treatments with the highest internal validity but limited external validity, in the sense that their findings may not always be applicable to or generalizable to clinical populations or population characteristics. The external validity of RCTs for the clinical population is constrained by the lack of tailored epidemiological data analysis designed for this purpose due to data governance, consistency of disease or condition definitions, and reduplicated effort in analysis code.

Prevalence and patient characteristics associated with cardiovascular disease risk factor screening in UK primary care for people with severe mental illness: an electronic healthcare record study.

Background: People with severe mental illness (SMI) are at increased risk of cardiovascular disease (CVD), and initiatives for CVD risk factor screening in the UK have not reduced disparities.

Objectives: To describe the annual screening prevalence for CVD risk factors in people with SMI from April 2000 to March 2018, and to identify factors associated with receiving no screening and regular screening.

Methods: We identified adults with a diagnosis of SMI (schizophrenia, bipolar disorder or 'other psychosis') from UK primary care records in Clinical Practice Research Datalink.

Antibiotic prescribing for care-home residents: a population-based, cross-classified multilevel analysis in Scotland, UK.

Background: There is wide variation in antibiotic prescribing across care-homes for older people, with implications for resident outcomes and antimicrobial resistance.

Objective: To quantify variation in antibiotic prescribing and associations with resident, care-home and general practice characteristics.

Design: Population-based analyses using administrative data.

Primary care transformation in Scotland: a comparison two cross-sectional national surveys of general practitioners' views in 2018 and 2023.

Background: The 2018 Scottish GP contract established GP Clusters and multidisciplinary team (MDT) expansion. Qualitative studies have suggested sub-optimal progress.

Aim: To quantify progress since the introduction of the new contract.

Benzodiazepine and z-drug prescribing in critical care survivors and the risk of rehospitalisation or death due to falls/trauma and due to any cause: a retrospective matched cohort study using the UK Clinical Practice Research Datalink.

Purpose: Benzodiazepines and z-drugs are often prescribed to critical care survivors due to high prevalence of mental health problems and insomnia. However, their safety has not been studied in this population.

Methods: Retrospective cohort study of 28,678 adult critical care survivors hospitalised in 2010 and 2018: 4844 prescribed benzodiazepines or z-drugs, matched to 23,834 unexposed survivors using UK Clinical Practice Research Datalink linked datasets.

Self-monitoring of blood pressure following a stroke or transient ischaemic attack (TASMIN5S): a randomised controlled trial.

Background: Blood pressure (BP) control following stroke is important but currently sub-optimal. This trial aimed to determine whether self-monitoring of hypertension with telemonitoring and a treatment escalation protocol, results in lower BP than usual care in people with previous stroke or transient ischaemic attack (TIA).

Methods: Unblinded randomised controlled trial, comparing a BP telemonitoring-based intervention with control (usual care) for hypertension management in 12 primary care practices in England.

Using HIV and Hepatitis C Molecular Epidemiology to Investigate Assisted Partner Services Recruitment Among People Who Inject Drugs in Kenya.

Sexual and/or injecting partners of people who inject drugs (PWID) may have an elevated risk of HIV infection either from sharing a transmission network or an epidemiological environment. We estimated the degree of similarity between HIV and hepatitis C (HCV) sequences from PWID and their partners to assess whether partner-based recruitment identifies sexual or injecting partners within transmission networks. We used assisted partner services (APS) to recruit sexual and injecting partners of PWID living with HIV in Kenya and evaluated trends in the TN93 distances (an adjusted measure of sequence similarity) of the HIV-1 and HCV sequences from partner pairs.

A phylogenetic assessment of HIV-1 transmission trends among people who inject drugs from Coastal and Nairobi, Kenya.

Although recent modeling suggests that needle-syringe programs (NSPs) have reduced parenteral HIV transmission among people who inject drugs (PWID) in Kenya, the prevalence in this population remains high (∼14-20%, compared to ∼4% in the larger population). Reducing transmission or acquisition requires understanding historic and modern transmission trends, but the relationship between the PWID HIV-1 sub-epidemic and the general epidemic in Kenya is not well understood. We incorporated 303 new (2018-21) HIV-1 sequences from PWID and their sexual and injecting partners with 2666 previously published Kenyan HIV-1 sequences to quantify relative rates and direction of HIV-1 transmissions involving PWID from the coast and Nairobi regions of Kenya.

Protective Behaviors Following Digital COVID-19 Exposure Notifications, Washington State, September 1, 2021, to March 1, 2022.

Context: Digital exposure notification (EN) systems were widely used to supplement public health case investigations and contact tracing during the 2019 coronavirus disease (COVID-19) pandemic. In Washington State, the state Department of Health (DOH) implemented one such system, WA Notify, which generated ENs based on smartphone Bluetooth proximity detection. However, the privacy preserving measures of this technology prevented collection of information on how users responded after seeing an EN on their device.

Care home resident identification: A comparison of address matching methods with Natural Language Processing.

Background: Care home residents are a highly vulnerable group, but identifying care home residents in routine data is challenging. This study aimed to develop and validate Natural Language Processing (NLP) methods to identify care home residents from primary care address records.

Methods: The proposed system applies an NLP sequential filtering and preprocessing of text, then the calculation of similarity scores between general practice (GP) addresses and care home registered addresses.

Experience and challenges delivering hepatitis C virus treatment for people who inject drugs in Kenya.

Despite having a higher risk of hepatitis C virus (HCV) infections, people who inject drugs (PWID) in sub-Saharan Africa (SSA) have limited access to HCV treatment. There is scarce literature on treatment delivery modalities that overcome logistical and financial barriers. We utilized different service delivery modalities to provide direct-acting antivirals (DAAs) to PWIDs infected with HCV through methadone clinics and needle and syringe program (NSP) sites in Kenya.

New horizons in systems engineering and thinking to improve health and social care for older people.

Existing models for the safe, timely and effective delivery of health and social care are challenged by an ageing population. Services and care pathways are often optimised for single-disease management, while many older people are presenting with multiple long-term conditions and frailty. Systems engineering describes a holistic, interdisciplinary approach to change that is focused on people, system understanding, design and risk management.

Integration of Jail Booking and HIV Surveillance Data to Facilitate Care Coordination.

Many people with HIV (PWH) in jail have not been well engaged in HIV treatment in the community. This study aimed to assess the impact of a data exchange paired with care coordination for PWH on HIV outcomes after jail release. We developed an automated process to match jail booking records with HIV surveillance data.

Impact of six-month COVID-19 travel moratorium on Plasmodium falciparum prevalence on Bioko Island, Equatorial Guinea.

Importation of malaria infections is a suspected driver of sustained malaria prevalence on areas of Bioko Island, Equatorial Guinea. Quantifying the impact of imported infections is difficult because of the dynamic nature of the disease and complexity of designing a randomized trial. We leverage a six-month travel moratorium in and out of Bioko Island during the initial COVID-19 pandemic response to evaluate the contribution of imported infections to malaria prevalence on Bioko Island.

Newborn community health advancements among Ethiopian Orthodox Christian women in North Gondar, Ethiopia: community-based randomised trial protocol.

Introduction: Despite significant progress over past decades, neonatal and infant morbidity and mortality remain unacceptably high in Ethiopia. Simple interventions have been shown to improve the health of children and reduce mortality. These include promotion of exclusive breast feeding for the first 6 months of life, immunisation and utilisation of available newborn healthcare services, which are proven to improve newborn survival.

Potential deprescribing indications for antidepressants between 2012 and 2019: repeated cross-sectional analysis in two Scottish health boards.

Background: Antidepressants have a pivotal role in the treatment of many psychiatric disorders, but there are concerns about long-term use and adverse effects. The objectives of this study were (1) to examine time trends in antidepressant use, (2) to estimate the prevalence of long-term and potential high-risk antidepressant use, and (3) to examine patient characteristics associated with potential deprescribing indications (PDIs) (i.e.

Pizza3: A general simulation framework to simulate food-mechanical and food-deconstruction problems.

Current mesh-based simulation approaches face significant challenges in continuously modeling the mechanical behaviors of foods through processing, storage, deconstruction, and digestion. This is primarily due to the limitations of continuum mechanics in dealing with systems characterized by free boundaries, substantial deformations, mechanical failures, and non-homogenized mechanical properties. The dynamic nature of food microstructure and the transformation of the food bolus, in relation to its composition, present formidable obstacles in computer-aided food design.

Ligand-Dependent and G Protein-Dependent Properties for the Sweet Taste Heterodimer, TAS1R2/1R3.

The heterodimeric sweet taste receptor, TAS1R2/1R3, is a class C G protein-coupled receptor (GPCR) that couples to gustducin (Gt), a G protein (GP) specifically involved in taste processing. This makes TAS1R2/1R3 a possible target for newly developing low caloric ligands that taste sweet to address obesity and diabetes. The activation of TAS1R2/1R3 involves the insertion of the GαP C-terminus of the GP into the GPCR in response to ligand binding.

Low-Frequency Oscillations in Mid-rostral Dorsolateral Prefrontal Cortex Support Response Inhibition.

Executive control of movement enables inhibiting impulsive responses critical for successful navigation of the environment. Circuits mediating stop commands involve prefrontal and basal ganglia structures with fMRI evidence demonstrating increased activity during response inhibition in the dorsolateral prefrontal cortex (dlPFC)-often ascribed to maintaining task attentional demands. Using direct intraoperative cortical recordings in male and female human subjects, we investigated oscillatory dynamics along the rostral-caudal axis of dlPFC during a modified Go/No-go task, probing components of both proactive and reactive motor control.