Development of a method to use standard hospital gamma cameras as triage whole body monitors in UK emergencies.

This paper outlines the process by which a medical gamma camera can be utilised to support assessment of internal radionuclides for the public. While hospital based gamma cameras are able to detect photopeaks, they are often limited to an energy range of 40-540 keV. However, radionuclides with photopeak energies above 540 keV can still be detected as the partial collection of photon energy increases the count rate at lower energies.

Investigating the Salience of Clinical Meaningfulness and Clinically Meaningful Outcomes in Metastatic Breast Cancer Care Delivery.

Purpose: As metastatic breast cancer (mBC) treatment evolves, there is a need to understand how clinical meaningfulness, or a meaningful change in a patient's daily life, and clinically meaningful outcomes inform patient-centered care. Partnering with key stakeholders ensures patient-centered research incorporates the knowledge and expertise of advisors with lived experience. We describe a multistakeholder engagement approach to examine how people living with mBC (PLWmBC), caregivers, and health care providers interpret clinical meaningfulness and clinically meaningful outcomes and their influence on mBC treatment decision making and care.

Enhancing survival after ionizing radiation exposure through mitigation of pyroptosis.

• Pyroptosis, an inflammatory cell death, has been implicated in the pathogenesis of total body irradiation (TBI) so we investigated time course and cell type involvement of key mediators in a murine model. • Pyroptotic mediators were most highly expressed at day 3 post TBI with immune cells from ileum being preferentially activated. • We also investigated the effectiveness of MCC950, a potent pyroptosis inhibitor, in our murine model showing a survival benefit at 50 mg/kg regardless of sex.

Assessment of high-dose acetylcysteine in acute high-risk paracetamol (acetaminophen) ingestion.

Background: Prompt acetylcysteine treatment with standard doses (300 mg/kg over 21 h in divided doses) is almost universally effective in preventing hepatotoxicity after paracetamol (acetaminophen) overdose. However, hepatotoxicity is reported despite early treatment when paracetamol concentrations exceed 300 mg/L (1,985 μmol/L) at 4 h. Prior studies evaluating high-dose acetylcysteine to treat high-risk ingestions have shown mixed results.

Integrating electronic geriatric assessment and frailty screening for adults with acute myeloid leukemia to drive personalized treatment decisions.

Purpose: Evidenced based guidelines for patients with Acute Myeloid Leukemia (AML) acknowledge increasing importance of frailty assessment when deciding on treatment, yet comprehensive geriatric assessment (GA) results are not easily incorporated into clinic workflows and the electronic health record. This study assessed the feasibility of electronic GA use in a real-world environment.

Methods: Patients with AML, ≥ 60 years and at a treatment decision-making point were recruited at three academic institutions.

Goals, preferences, and concerns of patients with acute myeloid leukemia at time of treatment decision.

Introduction: Current cancer value-based models require documentation of patient goals of care and an evidence-based treatment course commensurate with patient goals. This feasibility study assessed the utility of an electronic tablet-based questionnaire to elicit patient goals, preferences, and concerns at a treatment decision making time point in patients with acute myeloid leukemia.

Materials And Methods: Seventy-seven patients were recruited from three institutions prior to seeing the physician for treatment decision-making visit.

A Study Design to Harmonize Patient-Reported Outcomes Across Data Sets.

Purpose: Using patient-reported outcomes (PROs) provides important insights from the patient's perspective and can be valuable to monitor and manage treatment-related adverse events during cancer treatment. Additionally, the digital administration of PROs (electronic PROs [ePROs]) provides real-time updates to clinical care teams on treatment-related symptoms in-between clinic visits. However, given the variability in the methodology and timing of the data collection, using and harmonizing these data across different systems remains challenging.

Delivering an iterative Communication Partner Training programme to multidisciplinary healthcare professionals: A pilot implementation study and process evaluation.

Background: Despite evidence that Communication Partner Training (CPT) can enable health professionals to communicate more effectively with people with aphasia (PWA), an evidence-practice gap exists. To address this, a tailored implementation intervention was developed and trialled to improve health professionals' implementation of communication strategies in a subacute setting.

Aims: To explore the outcomes and perceived feasibility, acceptability and potential effectiveness of an iterative CPT implementation intervention on multidisciplinary healthcare professionals' communication with PWA.

Mechanosensor transient receptor potential vanilloid member 4 (TRPV4) regulates mouse cholangiocyte secretion and bile formation.

Mechanosensitive signaling has emerged as a mechanism for the regulation of cholangiocyte transport and bile formation. The mechanical effect of fluid-flow, or shear, at the apical membrane of cholangiocytes regulates secretion through a process involving increases in [Ca] and activation of Ca-activated Cl channels. However, the initiating steps translating shear force to increases in intracellular calcium concentration ([Ca]) are unknown.

Secure Base Provision: A New Approach to Examining Links Between Maternal Caregiving and Infant Attachment.

This observational study addressed a critical gap in the understanding of the precursors of infant attachment by examining whether a new conceptualization of maternal caregiving behavior, secure base provision (SBP), explained variance in attachment above and beyond variance explained by sensitivity. Participants included 83 low-socioeconomic status (SES), 4.5-month-old infants (56% male) and their mothers.

Loss of E-cadherin Enhances IGF1-IGF1R Pathway Activation and Sensitizes Breast Cancers to Anti-IGF1R/InsR Inhibitors.

Insulin-like growth factor 1 (IGF1) signaling regulates breast cancer initiation and progression and associated cancer phenotypes. We previously identified E-cadherin () as a repressor of IGF1 signaling and in this study examined how loss of E-cadherin affects IGF1R signaling and response to anti-IGF1R/insulin receptor (InsR) therapies in breast cancer. Breast cancer cell lines were used to assess how altered E-cadherin levels regulate IGF1R signaling and response to two anti-IGF1R/InsR therapies.

Enhanced reactive oxygen species through direct copper sulfide nanoparticle-doxorubicin complexation.

CuS-based nanostructures loading the chemotherapeutic agent doxorubicin (DOX) exerted excellent cancer photothermal chemotherapy under multi-external stimuli. The DOX loading was generally designed through electrostatic interaction or chemical linkers. However, the interaction between DOX molecules and CuS nanoparticles has not been investigated.

Obstetric Transport.

Obstetric transport is a specialized medical transport for maternal, fetal, and neonatal concerns. Perinatal regionalization of care provides a broader geographic availability of obstetric services with defined levels of maternal and neonatal care so that women can be transported to centers with increased resources and capabilities to reduce morbidity and mortality. The Emergency Medical Treatment and Active Labor Act provides regulatory guidance for care of laboring women who require transfer to a higher level of care.

Direct Dry-Grinding Synthesis of Monodisperse Lipophilic CuS Nanoparticles.

Copper sulfide nanoparticles, effective absorbers of near-infrared light, are recently attracting broad interest as a photothermal coupling agent for cancer therapy. Lipophilic copper sulfide nanoparticles are preferred for high performance biomedical applications due to high tissue affinity. Synthesis of lipophilic copper sulfide nanoparticles requires complicated multi-step processes under severe conditions.

Maternal-fetal transfer of anti-N-methyl-D-aspartate receptor antibodies.

Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a neuroautoimmune disease commonly associated with ovarian teratomas. It is characterized by neuropsychiatric symptoms, seizures, and autonomic instability. Few cases are described in pregnancy, and little is known about potential fetal effects.

One-pot formation of multifunctional Pt-conducting polymer intercalated nanostructures.

A novel multifunctional Pt nanoparticle@PPy nanofiber intercalated structure (Pt NP@PPy NF) has been synthesized facilely in one-pot. Pt NPs, with size and facet control, were nicely assembled and embedded into the polymer nanofiber network. Polyvinylpyrrolidone (PVP) was used during the synthesis process which would assist the self-assembly of the metal nanoparticles and polymer backbones into the intercalated structure.

Phage-Like Streptococcus pyogenes Chromosomal Islands (SpyCI) and Mutator Phenotypes: Control by Growth State and Rescue by a SpyCI-Encoded Promoter.

We recently showed that a prophage-like Streptococcus pyogenes chromosomal island (SpyCI) controls DNA mismatch repair and other repair functions in M1 genome strain SF370 by dynamic excision and reintegration into the 5' end of mutL in response to growth, causing the cell to alternate between a wild type and mutator phenotype. Nine of the 16 completed S. pyogenes genomes contain related SpyCI integrated into the identical attachment site in mutL, and in this study we examined a number of these strains to determine whether they also had a mutator phenotype as in SF370.

Detection of creatine kinase macroenzymes.

Background: It is vital to detect macroenzymes in patients' plasma or serum since their presence may lead to spurious elevation of enzyme activity, thereby causing diagnostic confusion. Our service for macroenzyme detection has been made available to laboratories throughout the UK. This report describes our laboratory's experience with macro-creatine kinase (CK) detection over a 10-year period.

ERG dependence distinguishes developmental control of hematopoietic stem cell maintenance from hematopoietic specification.

Although many genes are known to be critical for early hematopoiesis in the embryo, it remains unclear whether distinct regulatory pathways exist to control hematopoietic specification versus hematopoietic stem cell (HSC) emergence and function. Due to their interaction with key regulators of hematopoietic commitment, particular interest has focused on the role of the ETS family of transcription factors; of these, ERG is predicted to play an important role in the initiation of hematopoiesis, yet we do not know if or when ERG is required. Using in vitro and in vivo models of hematopoiesis and HSC development, we provide strong evidence that ERG is at the center of a distinct regulatory program that is not required for hematopoietic specification or differentiation but is critical for HSC maintenance during embryonic development.

Soft tissue sarcoma with metastasis to the stomach: a case report.

Soft tissue sarcomas are unusual malignancies comprising 1% of cancer diagnoses in the United States. Undifferentiated pleomorphic sarcoma accounts for approximately 5% of sarcomas occurring in adults. The most common site of metastasis is the lung, with other sites being bone, the brain, and the liver.

Unusual case of dysphagia in a male.

Plummer Vinson Syndrome, a triad of dysphagia, esophageal web, and iron-deficiency anemia, is a rarely reported diagnosis in current literature. The exact etiology of the syndrome remains controversial, but it has been linked to complicated nutritional deficiencies, autoimmune disorders, and hereditary factors, and has a remarkably high female to male ratio. This paper describes an atypical case presentation in a 53-year-old male with a remote history of peptic ulcer disease surgery.

Genome sequence of a nephritogenic and highly transformable M49 strain of Streptococcus pyogenes.

The 1,815,783-bp genome of a serotype M49 strain of Streptococcus pyogenes (group A streptococcus [GAS]), strain NZ131, has been determined. This GAS strain (FCT type 3; emm pattern E), originally isolated from a case of acute post-streptococcal glomerulonephritis, is unusually competent for electrotransformation and has been used extensively as a model organism for both basic genetic and pathogenesis investigations. As with the previously sequenced S.

Phage-associated mutator phenotype in group A streptococcus.

Defects in DNA mismatch repair (MMR) occur frequently in natural populations of pathogenic and commensal bacteria, resulting in a mutator phenotype. We identified a unique genetic element in Streptococcus pyogenes strain SF370 that controls MMR via a dynamic process of prophage excision and reintegration in response to growth. In S.