Combined Solid Organ Transplant and Transfusion-Associated Graft-Versus-Host Disease in a Lung Transplant Recipient: An Uncertain Culprit With Lethal Complications.

Although graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation, it is rare after solid organ transplantation (SOT) or blood transfusion. We present a rare case of SOT-derived and/or transfusion-associated graft-versus-host disease (TA-GVHD) in a 66-year-old man with interstitial lung disease who underwent bilateral lung transplantation (LT) from a 12-year-old female donor and required three units of packed red blood cells intraoperatively. He presented with signs and symptoms consistent with GVHD, and a bone marrow biopsy revealed an XX karyotype.

Widespread occurrence of benzimidazole resistance single nucleotide polymorphisms in the canine hookworm, Ancylostoma caninum, in Australia.

Canine hookworm (Ancylostoma caninum), a gastrointestinal nematode of domestic dogs, principally infects the small intestine of dogs and has the potential to cause zoonotic disease. In greyhounds and pet dogs in the USA, A. caninum has been shown to be resistant to multiple anthelmintics.

Gabapentinoid use and the risk of fractures in patients with inflammatory arthritis: nested case-control study in the Clinical Practice Research Datalink Aurum.

Background: Gabapentinoids are increasingly prescribed in inflammatory arthritis (IA), despite no trial evidence for efficacy at managing pain in this population. Observational studies in non-IA populations suggest gabapentinoids are associated with fractures but are limited by methodological heterogeneity/potential residual confounding. Patients with IA generally have an increased risk of fracture so may be particularly vulnerable.

IL-33 is associated with alveolar dysfunction in patients with viral lower respiratory tract disease.

Interleukin (IL)-33 is released following tissue damage, causing airway inflammation and remodelling via reduced IL-33 (IL-33)/serum stimulation-2 (ST2) and oxidised IL-33 (IL-33)/receptor for advanced glycation end products (RAGE)/epidermal growth factor receptor (EGFR) pathways. This study aimed to identify associations of IL-33 with clinical outcomes and pathological mechanisms during viral lower respiratory tract disease (LRTD). Ultra-sensitive immunoassays were developed to measure IL-33, IL-33 and IL-33/sST2 complexes in samples from patients hospitalised with COVID-19.

Evaluation of an intervention package developed to reduce pre-registration nursing student attrition rates: A mixed method study.

Background: Higher educational institutions strive to recruit and retain student nurses into pre-registration programmes to support a sustainable nursing workforce. Attrition rates for student nurses are high and escalating, with around one in three nursing students in the United Kingdom failing to complete their degree programmes. Risk factors for student attrition include the attributes students bring to their study environment, as well as their behaviours and academic outputs.

Early career family physician perspectives on their residency experience and practice choices in Canada: a qualitative study.

Background: Though there are more family physicians in Canada than ever before, and residency programs are expanding, gaps in access to comprehensive care remain. This study aimed to describe and understand the role residency training experiences played in shaping practice choices, including the provision of comprehensive community-based care, among early career family physicians.

Methods: A secondary analysis of sixty-three (63) qualitative interviews was conducted on data from a larger mixed method study on practice patterns and choices of early career Canadian family physicians.

TRBC1-CAR T cell therapy in peripheral T cell lymphoma: a phase 1/2 trial.

Relapsed/refractory peripheral T cell lymphomas (PTCLs) are aggressive tumors with a poor prognosis. Unlike B cell lymphomas, treatment of PTCL has not benefited from advances in immunotherapy. This is largely due to a lack of suitable target antigens that discriminate malignant from normal T cells, thus avoiding severe immunosuppression consequent to depletion of the entire T cell compartment.

Association of advance care planning with hospital use and costs at the end of life: a population-based retrospective cohort study.

Objective: To investigate associations between the availability and timing of digitally available advance care planning (ACP) documents and hospital use and costs during the last 6 months of life.

Design: Retrospective population-based cohort study using data linkage.

Setting: 11 public hospitals in Queensland, Australia.

Understanding the Intersection of Identity and Cancer Experience Among Racially, Ethnically, Gender and Sexual Minoritized Adolescents and Young Adults With Cancer.

Objectives: Adolescents and young adults (AYAs, 18-39 years) with cancer identifying as racially/ethnically minoritized or 2SLGBTQIA+ (Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, asexual and "+" referring to other queer identities) have been underrepresented in cancer research. This study explores the aspects of identity that hold significance for these minoritized AYAs and how these facets impact their healthcare experiences.

Methods: Eligible participants comprised English-speaking AYAs who self-identified as racially/ethnically minoritized and/or 2SLGBTQIA+, were diagnosed with cancer between the ages of 15-39, currently aged > 18, and had received or were receiving cancer care within Canadian healthcare system.

OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial.

Background: General practitioners (GP) and community pharmacists need information about hospital discharge patients' medicines to continue their management in the community. This necessitates effective communication, collaboration, and reliable information-sharing. However, such handover is inconsistent, and whilst digital systems are in place to transfer information at transitions of care, these systems are passive and clinicians are not prompted about patients' transitions.

Clinician perspectives and recommendations regarding design of clinical prediction models for deteriorating patients in acute care.

Background: Successful deployment of clinical prediction models for clinical deterioration relates not only to predictive performance but to integration into the decision making process. Models may demonstrate good discrimination and calibration, but fail to match the needs of practising acute care clinicians who receive, interpret, and act upon model outputs or alerts. We sought to understand how prediction models for clinical deterioration, also known as early warning scores (EWS), influence the decision-making of clinicians who regularly use them and elicit their perspectives on model design to guide future deterioration model development and implementation.

The relationship between obesity and patient-reported outcome measures in people with polymyalgia rheumatica.

Objective: To examine the association between obesity and patient-reported outcome measures (PROMs) in a primary care-based cohort of people with PMR.

Methods: The PMR Cohort Study recruited people with incident PMR from 382 general practices. Self-completed questionnaires (0, 12, 24 months) captured a range of PROMs for pain, stiffness, anxiety, depression, fatigue, function and quality of life, alongside data on BMI.

Google Internet searches related to inflammatory arthritis: An observational study using Google Trends data.

Objective: The Internet has transformed how patients access health information. We examined Google search engine data to understand which aspects of health are most often searched for in combination with inflammatory arthritis (IA).

Methods: Using Google Trends data (2011-2022) we determined the relative popularity of searches for 'patient symptoms' (pain, fatigue, stiffness, mood, work) and 'treat-to-target' (disease-modifying drugs, steroids, swelling, inflammation) health domains made with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (AxSpA) in the UK/USA.

Laying train tracks en route: How institutional education leaders navigate complexity during mandated curriculum change.

Introduction: Institutional education leaders serve key roles in leading major curricular change within residency education, yet little is known about how they accomplish these goals on the ground. Change management principles have predominantly been developed and described in the hierarchical context of management science and corporate settings. However, the non-hierarchical, complex and adaptive features of health professions education may render these traditional change management models inadequate.

Management of refractory disease and persistent symptoms in inflammatory arthritis: qualitative framework analysis of interviews with patients and healthcare professionals.

Objectives: This study aims to explore patients' and clinicians' experiences in managing and living with refractory disease (RD) and persistent physical and emotional symptoms (PPES) in patients with RA or polyarticular JIA from their perspectives through interviews and/or focus groups.

Methods: A qualitative exploration with 25 patients and 32 multidisciplinary rheumatology healthcare professionals (HCPs) was conducted to obtain participants respective understanding and experiences of managing RD/PPES and its impact on the patient-professional relationship. A pragmatic epistemology approach with framework analysis was employed.

Evaluating automated machine learning platforms for use in healthcare.

Objective: To describe development and application of a checklist of criteria for selecting an automated machine learning (Auto ML) platform for use in creating clinical ML models.

Materials And Methods: Evaluation criteria for selecting an Auto ML platform suited to ML needs of a local health district were developed in 3 steps: (1) identification of key requirements, (2) a market scan, and (3) an assessment process with desired outcomes.

Results: The final checklist comprising 21 functional and 6 non-functional criteria was applied to vendor submissions in selecting a platform for creating a ML heparin dosing model as a use case.

Achieving large-scale clinician adoption of AI-enabled decision support.

Computerised decision support (CDS) tools enabled by artificial intelligence (AI) seek to enhance accuracy and efficiency of clinician decision-making at the point of care. Statistical models developed using machine learning (ML) underpin most current tools. However, despite thousands of models and hundreds of regulator-approved tools internationally, large-scale uptake into routine clinical practice has proved elusive.

Role of CYP9E2 and a long non-coding RNA gene in resistance to a spinosad insecticide in the Colorado potato beetle, Leptinotarsa decemlineata.

Spinosads are insecticides used to control insect pests, especially in organic farming where limited tools for pest management exist. However, resistance has developed to spinosads in economically important pests, including Colorado potato beetle (CPB), Leptinotarsa decemlineata. In this study, we used bioassays to determine spinosad sensitivity of two field populations of CPB, one from an organic farm exposed exclusively to spinosad and one from a conventional farm exposed to a variety of insecticides, and a reference insecticide naïve population.