Health equity innovation in precision medicine: data stewardship and agency to expand representation in clinicogenomics.

Most forms of clinical research examine a very minute cross section of the patient journey. Much of the knowledge and evidence base driving current genomic medicine practice entails blind spots arising from underrepresentation and lack of research participation in clinicogenomic databases. The flaws are perpetuated in AI models and clinical practice guidelines that reflect the lack of diversity in data being used.

Demystifying Death: Reflections on End-of-Life Doula Work.

End-of-life doulas (EOLDs) represent a portion of a broader mobilization of end-of-life care practitioners to normalize discussions of death and assist dying persons and their caregivers in navigating the dying process. EOLDs primarily focus on creating a supportive environment for the dying and their loved ones. Research on the burgeoning care profession has documented the backgrounds and services of EOLD work; however, literature has overlooked EOLDs' personal reflections on their work.

Design and Framework of a Technology-Based Closed-Loop Referral Project for Care Coordination of Social Determinants of Health.

Screening for social determinants of health (SDOH) has been mandated by health systems nationwide. However, a gap exists in closed-loop referral for care coordination between health care and social services. This article presents the framework of a technology-based project to facilitate closed-loop referral between health care and social service agencies in Greater Houston by leveraging and connecting the existing care coordination technology infrastructure.

Dataset on characterisation and stability of gingival retraction cord lignocaine-adrenaline nanogel optimised using central composite design.

This study aims to characterise and assess the stability of an optimised lignocaine-adrenaline nanogel using central composite design (CCD). Compatibility studies were conducted using Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) and Ultraviolet-visible (UV-vis) spectroscopy. Eighteen lignocaine-adrenaline Nanoemulsion (LANE) formulations derived using CCD were characterised for particle size, polydispersity index (PDI), zeta potential and pH.

Using the Preparation Phase of the Multiphase Optimization Strategy to Design an Antiextremism Program in Bahrain: Formative and Pilot Research.

Background: Extremism continues to raise concerns about conflict and violent attacks that can lead to deaths, injuries, trauma, and stress. Adolescents are especially vulnerable to radicalization by extremists. Given its location in a region that often experiences extremism, Bahrain developed 4 peaceful coexistence lessons and 4 antiextremism lessons to be implemented as part of their Drug Abuse Resistance Education (D.

Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study.

Introduction: Since February 2020, over 104 million people in the United States have been diagnosed with SARS-CoV-2 infection, or COVID-19, with over 8.5 million reported in the state of Texas. This study analyzed social determinants of health as predictors for readmission among COVID-19 patients in Southeast Texas, United States.

Dying a 'Good' Death: The Work, Care, and Support of End-of-Life Doulas.

End-of-life doulas (EOLDs) are a growing population of care providers who focus on the wishes of the dying person in order to cultivate an environment of comfort, peace, and support from the point of terminal diagnosis, during the dying process, and following death. The purpose of this study was to document the time commitment of EOLDs to dying persons and their loved ones during the dying process, as well as their experiences navigating family dynamics working towards increased acceptance of death. A mixed-methods approach was utilized to gather data on EOLDs, consisting of a quantitative survey with 618 respondents and subsequent qualitative interviews conducted with 39 participants.

A qualitative analysis of barriers to opioid agonist treatment for racial/ethnic minoritized populations.

Introduction: Clinical guidelines strongly recommend opioid agonist treatment (OAT) as first-line treatment for opioid use disorder (OUD). However, racial/ethnic minoritized patients are less likely to receive OAT compared to non-Hispanic White patients. Reasons for this treatment gap must be elucidated to address racial/ethnic disparities in OAT.

Validation of a Simplified Digital Periodontal Health Screening Module for General Dental Practitioners.

As a silent disease, individuals at risk of periodontitis are not easily identified until the disease has become severe. Early detection at the community level is essential, especially for general dental practitioners. The aim of this study was to design a comprehensive, user-friendly tool to screen patients' periodontal health at community level and to evaluate users' acceptance of its use.

Vascular compression of Duodenum: A case report of superior mesenteric artery syndrome.

Superior mesenteric artery (SMA) passes over the third part of duodenum and can cause its obstruction when the aorto-mesenteric angle is hyper acute. Although the condition is rare, the diagnosis can be made using radiography and the treatment consists of division of ligament of Treitz and duodenojejunostomy. We present a case of SMA syndrome in an elderly lady, who was managed successfully with surgery.

A Guide to Implementing Immune Checkpoint Inhibitors within a Cancer Program: Experience from a Large Canadian Community Centre.

The increased use of immune checkpoint inhibitors across cancer programs has created the need for standardized patient assessment, education, monitoring, and management of immune-related adverse events (irAEs). At William Osler Health System in Brampton, Ontario, a practical step-wise approach detailing the implementation of cancer immunotherapy in routine practice was developed. The approach focuses on four key steps: (1) identification of patient educators; (2) development of patient education materials; (3) development of patient monitoring tools; (4) involvement and education of multidisciplinary teams.

Remote, proactive, telephone based management of toxicity in outpatients during adjuvant or neoadjuvant chemotherapy for early stage breast cancer: pragmatic, cluster randomised trial.

Objective: To evaluate the effectiveness of remote proactive management of toxicities during chemotherapy for early stage breast cancer.

Design: Pragmatic, cluster randomised trial.

Setting: 20 cancer centres in Ontario, Canada, allocated by covariate constrained randomisation to remote management of toxicities or routine care.

Using lean management approach in improving clinical team leader handover process: nursing services.

This report describes the result of the study using lean management approach in improving clinical team leader handover process in nursing services at Sultan Bin Abdulaziz Humanitarian City, the largest rehabilitation facility in the Middle East with 511-bed capacity and more than 20 nursing inpatient units. Clinical handover refers to the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another pehealthcare system is a crson or professional group on a temporary or permanent basis. It is in fact a valuable and essential part of the care processes in the hospitals.

End-of-Life Doulas: Documenting Their Backgrounds and Services.

This is an exploratory study to document the demographic characteristics, backgrounds, and services provided by trained and certified INELDA end-of-life doulas. Like birth doulas, end-of-life doulas represent a divergent, yet complementary form of care for dying persons. The purpose of end-of-life care is to facilitate comfort of the dying person and their closest family members.

Induction of Short-Term Sensitization by an Aversive Chemical Stimulus in Zebrafish Larvae.

Larval zebrafish possess a number of molecular and genetic advantages for rigorous biological analyses of learning and memory. These advantages have motivated the search for novel forms of memory in these animals that can be exploited for understanding the cellular and molecular bases of vertebrate memory formation and consolidation. Here, we report a new form of behavioral sensitization in zebrafish larvae that is elicited by an aversive chemical stimulus [allyl isothiocyanate (AITC)] and that persists for ≥30 min.

Communication between nurse care managers and patients who take opioids for chronic pain: Strategies for exploring aberrant behavior.

Objective: One approach to potential misuse of prescription opioids by patients with chronic pain is team-based collaborative primary care, with primary care visits complemented by frequent visits with nurse care managers (NCMs) specializing in addiction care. However, little is known about the communication strategies NCMs employ in these visits. This study aimed to describe strategies NCMs used with patients when discussing aberrancies encountered during opioid monitoring.

Reasons for Opioid Discontinuation and Unintended Consequences Following Opioid Discontinuation Within the TOPCARE Trial.

Objective: To identify reasons for opioid discontinuation and post-discontinuation outcomes among patients in the Transforming Opioid Prescribing in Primary Care (TOPCARE) study.

Design: In TOPCARE, an intervention to improve adherence to opioid prescribing guidelines, randomized intervention primary care providers (PCPs) received nurse care manager support, an electronic registry, academic detailing, and electronic tools, and control PCPs received electronic tools only.

Setting: Four Boston safety net primary care practices.

Early European experience with the Venus P-valve®: filling the gap in percutaneous pulmonary valve implantation.

Aims: Our aim was to report the first five cases of percutaneous implantation of the Venus P-valve® in Europe.

Methods And Results: We successfully implanted Venus P-valves in five consecutive cases in patients whose anatomy was thought to be unfavourable for currently available percutaneous valve prostheses and who had relative contraindications to surgical valve replacement. The procedures were performed at Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

An analysis of inhibitory functioning in individuals with chronic posttraumatic stress disorder.

Cognitive abnormalities in posttraumatic stress disorder (PTSD) may be a function of underlying inhibitory deficits. Prepulse inhibition (PPI) and attentional blink (AB) are paradigms thought to assess inhibition. Using a sample of 28 individuals with PTSD compared to 20 trauma-exposed and 19 healthy individuals, PPI was examined using white noise that was preceded by a tone, and AB was examined using a presentation of letters in a stream of numbers.

Cleavage of nicotinamide adenine dinucleotide by the ribosome-inactivating protein from Momordica charantia.

The interaction of momordin, a type 1 ribosome-inactivating protein from Momordica charantia, with NADP(+) and NADPH has been investigated by X-ray diffraction analysis of complexes generated by co-crystallization and crystal soaking. It is known that the proteins of this family readily cleave the adenine-ribose bond of adenosine and related nucleotides in the crystal, leaving the product, adenine, bound to the enzyme active site. Surprisingly, the nicotinamide-ribose bond of oxidized NADP(+) is cleaved, leaving nicotinamide bound in the active site in the same position but in a slightly different orientation to that of the five-membered ring of adenine.

Post-operative sinus formation due to Mycobacterium abscessus: a case report.

Mycobacterium abscessus is ubiquitously found rapidly growing mycobacteria. Although it is an uncommon pathogen, it has been known to cause cutaneous infection following inoculation, minor trauma or surgery. This communication reports an immuno-competent patient developing multiple sinuses due to Mycobacterium abscessus in the post- operative period.

An unusual case of paratesticular mesothelioma on the site of previously excised epididymal adenomatoid tumour.

Introduction: Malignant paratesticular tumours are rare. We report a case of paratesticular malignant mesothelioma in a patient who had excision of an adenomatoid tumour on the same site in 2 occasions previously.

Presentation Of Case: A middle aged man who had an adenomatoid tumour excised from his left hemiscrotum fifteen years previously was referred with a suspicious left epididymal lump.