Statewide neurology inpatient whole body and brain 18F-fluorodeoxyglucose positron emission tomography utilisation patterns demonstrate avenues for optimisation.

18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) can provide unique insights; however, access may be difficult. In this 2-year statewide study of all neurology inpatient admissions, 27.9% (41/147) of PET (any field of view) demonstrated significant abnormalities.

Copying in medical documentation: developing an evidence-based approach.

Background: Electronic medical records (EMRs) provide multiple efficiencies in communication to clinicians. The ability to copy and paste text in an EMR can be useful; however, it also conveys a risk of inaccurate documentation. Studies in international settings have described such overuse of copying to result in 'note bloat', with the dilution of relevant clinical information and potential clinical detriment.

Out of area placements for people with "Personality Disorder": Making the case for a local intensive psychotherapeutic alternative.

Objectives: The use of Out of Area (OoA) psychiatric placements for people with "Personality Disorder" (PD) is widespread in the UK. An innovative local intensive psychotherapeutic service, adapted to the transdiagnostic presentations of the most complex PD patients, likely to be placed out of the area, was devised in the English County of Devon. This paper reports the findings of a Freedom of Information (FOI) request to commissioners attempting to quantify PD OoA placements in England and the cost offset of the local therapeutic alternative to OoA placements in Devon.

Medication shortage behaviour change with multidisciplinary clinician-designed digital notification intervention.

Objectives: To evaluate the effect of a clinician-designed digital notification system on the use of intravenous paracetamol during a medication shortage.

Methods: An in-house digital notification platform was designed through multidisciplinary collaboration. A 4-week pre- and post-implementation methodology was employed to evaluate the effect of the intervention.

Large language models can effectively extract stroke and reperfusion audit data from medical free-text discharge summaries.

Introduction: Audits are an integral part of effective modern healthcare. The collection of data for audits can be resource intensive. Large language models (LLM) may be able to assist.

Protracted Course of Staphylococcus lugdunensis Septic Arthritis in Native Knee Joint.

is a coagulase-negative bacteria of the Staphylococcus family. It is a highly invasive organism with similar virulence to . It is commonly associated with bacteremia and infections of the skin, soft tissues, joints, and bones.

Push or pull? Digital notification platform implementation reduces dysglycaemia.

Pushing selected information to clinicians, as opposed to the traditional method of clinicians pulling information from an electronic medical record, has the potential to improve care. A digital notification platform was designed by clinicians and implemented in a tertiary hospital to flag dysglycaemia. There were 112 patients included in the study, and the post-implementation group demonstrated lower rates of dysglycaemia (2.

Translational artificial intelligence-led optimization and realization of estimated discharge with a supportive weekend interprofessional flow team (TAILORED-SWIFT).

Weekend discharges occur less frequently than discharges on weekdays, contributing to hospital congestion. Artificial intelligence algorithms have previously been derived to predict which patients are nearing discharge based upon ward round notes. In this implementation study, such an artificial intelligence algorithm was coupled with a multidisciplinary discharge facilitation team on weekend shifts.

Improving the Prediction of Persistent High Health Care Utilizers: Retrospective Analysis Using Ensemble Methodology.

Background: A small proportion of high-need patients persistently use the bulk of health care services and incur disproportionate costs. Population health management (PHM) programs often refer to these patients as persistent high utilizers (PHUs). Accurate PHU prediction enables PHM programs to better align scarce health care resources with high-need PHUs while generally improving outcomes.

Assessing the Value of Unsupervised Clustering in Predicting Persistent High Health Care Utilizers: Retrospective Analysis of Insurance Claims Data.

Background: A high proportion of health care services are persistently utilized by a small subpopulation of patients. To improve clinical outcomes while reducing costs and utilization, population health management programs often provide targeted interventions to patients who may become persistent high users/utilizers (PHUs). Enhanced prediction and management of PHUs can improve health care system efficiencies and improve the overall quality of patient care.

The Parliamentary Scholar Scheme: a way to engage doctors in healthcare policy and politics.

The Royal College of Psychiatrists' Parliamentary Scholar Scheme gives higher trainees in psychiatry the opportunity to spend 1 day a week in the House of Lords working alongside a peer with an interest in health. This article describes the work of the House of Lords and Parliament using examples from the experiences of 2017-2018 scholars and outlines ways doctors can get more involved in policy and politics.

Six key topics informal carers of patients with breathlessness in advanced disease want to learn about and why: MRC phase I study to inform an educational intervention.

Introduction: Breathlessness is a common symptom of advanced disease placing a huge burden on patients, health systems and informal carers (families and friends providing daily help and support). It causes distress and isolation. Carers provide complex personal, practical and emotional support yet often feel ill-prepared to care.

Chiral metallohelices enantioselectively target hybrid human telomeric G-quadruplex DNA.

The design and synthesis of metal complexes that can specifically target DNA secondary structure has attracted considerable attention. Chiral metallosupramolecular complexes (e.g.

Clinicians' Views of Educational Interventions for Carers of Patients With Breathlessness Due to Advanced Disease: Findings From an Online Survey.

Context: Carers' needs in advanced disease, and specifically in relation to breathlessness, are well evidenced. Publications on educational interventions for carers of patients with advanced disease that focus on symptoms are scarce and absent for breathlessness.

Objectives: To establish current education provided by clinicians for carers of patients with breathlessness in advanced disease, views about educating carers about breathlessness, and relevant outcomes for a future randomized controlled trial of an educational intervention for carers.

Asymmetric triplex metallohelices with high and selective activity against cancer cells.

Small cationic amphiphilic α-helical peptides are emerging as agents for the treatment of cancer and infection, but they are costly and display unfavourable pharmacokinetics. Helical coordination complexes may offer a three-dimensional scaffold for the synthesis of mimetic architectures. However, the high symmetry and modest functionality of current systems offer little scope to tailor the structure to interact with specific biomolecular targets, or to create libraries for phenotypic screens.

Chiral metallohelical complexes enantioselectively target amyloid β for treating Alzheimer's disease.

Stereochemistry is a very important issue for the pharmaceutical industry and can determine drug efficacy. The design and synthesis of small molecules, especially chiral molecules, which selectively target and inhibit amyloid-β (Aβ) aggregation, represent valid therapeutic strategies for treatment of Alzheimer's disease (AD). Herein we report that two triple-helical dinuclear metallosupramolecular complexes can act as a novel class of chiral amyloid-β inhibitors.

Optically pure heterobimetallic helicates from self-assembly and click strategies.

Single diastereomer, diamagnetic, octahedral Fe(II) tris chelate complexes are synthesised that contain three pendant pyridine proligands pre-organised for coordination to a second metal. They bind Cu(I) and Ag(I) with coordination geometry depending on the identity of the metal and the detail of the ligand structure, but for example homohelical (ΔFe,ΔCu) configured systems with unusual trigonal planar Cu cations are formed exclusively in solution as shown by VT-NMR and supported by DFT calculations. Similar heterobimetallic tris(triazole) complexes are synthesised via clean CuAAC reactions at a tris(alkynyl) complex, although here the configurations of the two metals differ (ΔFe,ΛCu), leading to the first optically pure heterohelicates.

Jahn-Teller effects on π-stacking and stereoselectivity in the phenylethaniminopyridine tris-chelates Cu(NN')3(2+).

Optically pure phenylethaniminopyridine (S(C)-L) tris-chelates of Fe(II) and other first row transition metal systems have previously been shown to give exclusively the fac structures in the solid state. Here it is shown by powder X-ray diffraction that the complex [CuL(3)][ClO(4)](2) crystallises exclusively as the mer isomer, although--for a given absolute configuration of the ligand--of the same helicity (Δ/Λ) as that displayed by the other metal complexes. The similar ligand R(C)-L(F), which contains a peripheral (19)F spin label, gave [CuL(F)(3)][ClO(4)](2) which also adopts exclusively the mer structure in the crystal, but is shown by NMR spectroscopy to have a fac:mer ratio of 1:6 in solution at low temperature.

Optically pure, water-stable metallo-helical 'flexicate' assemblies with antibiotic activity.

The helicates--chiral assemblies of two or more metal atoms linked by short or relatively rigid multidentate organic ligands--may be regarded as non-peptide mimetics of α-helices because they are of comparable size and have shown some relevant biological activity. Unfortunately, these beautiful helical compounds have remained difficult to use in the medicinal arena because they contain mixtures of isomers, cannot be optimized for specific purposes, are insoluble, or are too difficult to synthesize. Instead, we have now prepared thermodynamically stable single enantiomers of monometallic units connected by organic linkers.

Approaches to the synthesis of optically pure helicates.

Methods by which helical bimetallic assemblies may be accessed as single isomers are described and reviewed. While there are a number of notable successes, the conclusion is made that no existing approach satisfies the criteria which will allow these fascinating compounds to emerge from the synthetic research laboratory environment to practical application in e.g.

Origins of stereoselectivity in optically pure phenylethaniminopyridine tris-chelates M(NN')3(n+) (M = Mn, Fe, Co, Ni and Zn).

One-pot reactions of 2-pyridinecarboxaldehyde, chiral phenylethanamines and Fe(II) give single diastereomer fac diimine complexes at thermodynamic equilibrium so that no chiral separations are required (d.r. > 200 : 1).

Comments on "Synthesis and characterisation of enantiopure copper(II) complexes with chiral bidentate ligands".

Intramolecular π-stacking plays a role in diastereomerically pure Fe(II) complexes of certain pyridine/imines, but contrary to a recent report, no such interaction is present in the Cu(II) analogues and the stereoselectivity is as yet unknown.