A prospectively deployed deep learning-enabled automated quality assurance tool for oncological palliative spine radiation therapy.

Background: Palliative spine radiation therapy is prone to treatment at the wrong anatomic level. We developed a fully automated deep learning-based spine-targeting quality assurance system (DL-SpiQA) for detecting treatment at the wrong anatomic level. DL-SpiQA was evaluated based on retrospective testing of spine radiation therapy treatments and prospective clinical deployment.

Organization of primary care and early MOUD discontinuation.

Unlabelled: Primary care clinic structures and operations may influence early MOUD discontinuation. Flexible scheduling can improve early MOUD retention but must be balanced with clinic efficiency. Multidisciplinary teams can improve retention but require additional resources.

Measuring the impact of a pastoral care intervention to increase referrals and improve the quality of chaplain documentation in patient records.

The complexity of patient care demands that health care teams collaborate effectively. This means that when pastoral care staff engage with patients, they need to communicate their findings to other members of the multidisciplinary team to maximize patient benefits. In 2016, an Australian hospital found that pastoral care staff were able to visit only 30% of admitted patients, and that documentation of pastoral care visits was minimal.

Perceived unmet needs and impact on quality of life of patients living with advanced bladder cancer and their caregivers: results of a social media listening study conducted in five European countries.

Background: Advanced bladder cancer (aBC) is a significant health concern in Europe and has a poor prognosis. Patients with aBC face numerous unmet needs and challenges that significantly impact their quality of life (QoL). This study aims to analyze social media data from five European countries to address gaps in our understanding of the unmet needs, challenges, and impact on QoL in European patients with aBC and their caregivers.

Perceptions of indirect treatment comparisons as an evidence base in oncology decision-making: results of an international survey of health technology assessment and payer decision-makers.

Health technology assessment (HTA) and payer organizations are often faced with early decision-making in oncology. To design and conduct robust indirect treatment comparisons (ITCs), it is important to better understand HTA and payer decision-maker perceptions of ITCs. Here we aim to describe what individuals with HTA and payer experience see as the acceptability of ITCs for HTA and payer organization coverage and reimbursement decision-making.

A qualitative exploration of participants' perspectives and experiences of novel digital health infrastructure to enhance patient care in remote communities within the Home Health Project.

The Home Health Project, set on Clare Island, five kilometres off the Irish Atlantic coast, is a pilot exploration of ways in which various forms of technology can be utilised to improve healthcare for individuals living in isolated communities. The integration of digital health technologies presents enormous potential to revolutionise the accessibility of healthcare systems for those living in remote communities, allowing patient care to function outside of traditional healthcare settings. This study aims to explore the personal experiences and perspectives of participants who are using digital technologies in the delivery of their healthcare as part of the Home Health Project.

Promoting healthful and diverse eating behaviours through an extracurricular culinary skills intervention in Philadelphia.

In the current study we evaluated an afterschool nutrition education programme, called Vetri Cooking Lab (VCL), for promoting healthy and diverse eating habits among at-risk children in the Greater Philadelphia area. To understand potential programme impacts, we conducted a longitudinal analysis of survey data collected before and after participation in VCL. Main study included cooking confidence, cooking knowledge, changes in dietary consumption behaviours, and changes in vegetable preferences.

Small molecule modulation of insulin receptor-insulin like growth factor-1 receptor heterodimers in human endothelial cells.

Objectives: The insulin receptor (IR) and insulin like growth factor-1 receptor (IGF-1R) are heterodimers consisting of two extracellular α-subunits and two transmembrane β -subunits. Insulin αβ and insulin like growth factor-1 αβ hemi-receptors can heterodimerize to form hybrids composed of one IR αβ and one IGF-1R αβ. The function of hybrids in the endothelium is unclear.

Insulin receptor signalling in PDGFRβ-expressing cells influences systemic metabolism and negatively impacts lipid storage.

Pericytes are vascular mural cells that support the microvasculature; their dysfunction contributes to diabetic retinopathy and has been linked to obesity in humans. To explore the role of pericyte insulin signalling on systemic metabolism we utilised male mice from our previously described PIR (PIRKO) mouse line which has insulin receptor (Insr) knockout in PDGFRβ-expressing cells. These animals exhibit systemic insulin resistance from as early as 8-weeks of age, despite no change in body weight or activity level, and show altered body composition and hepatosteatosis.

Seasonal and depth-dependent thermoregulatory benefits of burrows for wombats - The largest burrowing marsupials.

Mammals use burrows to behaviourally thermoregulate, save water, and avoid predation. The advantages of burrows vary not only seasonally but also with burrow depth. To quantify these effects, we used biophysical ecological models, which predict an animal's energetic and hydric costs within a characterised microclimate.

Induction of defence response in peanut elicited by sp. CHEP5: A biological strategy for control of smut disease caused by in the field.

Peanut is susceptible to many diseases; among them, peanut smut disease caused by is the most damaging, causing yield losses of 30%. Fungicide treatment is not effective to control this disease. In this scenario, biological control would be an alternative to diminish the disease.

Real-World Treatment Patterns, Sequencing, and Outcomes in Patients with Locally Advanced or Metastatic Urothelial Carcinoma Receiving Avelumab First-Line Maintenance in the United States.

For patients with locally advanced/metastatic urothelial carcinoma (la/mUC), first-line (1L) treatment with platinum-based chemotherapy (PBC) followed by avelumab 1L maintenance (1LM) is a recommended therapy per treatment guidelines in patients without disease progression. However, contemporary real-world (rw) data among patients receiving this treatment are necessary to understand clinical outcomes and optimal treatment sequencing. This retrospective cohort study analyzed rw treatment patterns and clinical outcomes, including overall survival (rwOS) and progression-free survival (rwPFS), in patients with la/mUC receiving avelumab 1LM.

Echocardiographic screening for heart failure and optimization of the care pathway for individuals with pacemakers: a randomized controlled trial.

Individuals with pacemakers are at increased risk of left ventricular systolic dysfunction (LVSD). Whether screening for and optimizing the medical management of LVSD in these individuals can improve clinical outcomes is unknown. In the present study, in a multicenter controlled trial (OPT-PACE), we randomized 1,201 patients (717 men) with a pacemaker to echocardiography screening or usual care.

Split-Dose Cisplatin in Patients With Locally Advanced or Metastatic Urothelial Carcinoma: A Systematic Literature Review and Network Meta-Analysis.

Background: Gemcitabine plus cisplatin (GC) is a highly active and commonly used regimen in locally advanced/metastatic urothelial carcinoma (la/mUC). With GC, cisplatin is dosed at 70 mg/m on day 1 of a 3-week cycle; however, for many patients, impaired renal or cardiac function, neuropathy, or poor performance status (PS) can preclude the use of cisplatin. A promising alternative is split-dose GC, in which the cisplatin dose is divided over 2 days.

Distinct, common and synergistic effects of insulin and IGF-1 receptors on healthy murine ageing.

Objective: Reduced IGF-1 signalling is an evolutionarily conserved mediator of longevity, yet the magnitude of this effect is substantially larger in organisms retaining a common insulin and IGF-1 receptor. Whether this reflects the failure to simultaneously reduce IGF-1 and insulin signalling in mammalian model systems remains unexplored, as is the associated impact on markers of healthy ageing. We set out to address these uncertainties.

Plasma MERTK is causally associated with infection mortality.

Background: Infectious diseases are a major cause of mortality in spite of existing public health, anti-microbial and vaccine interventions. We aimed to define plasma proteomic associates of infection mortality and then apply Mendelian randomisation (MR) to yield biomarkers that may be causally associated.

Methods: We used UK Biobank plasma proteomic data to associate 2923 plasma proteins with infection mortality before 31st December 2019 (240 events in 52,520 participants).

Evaluating Operation Good Food & Beverages, a Black Youth-Driven Public Advocacy Campaign.

Background: Food and beverage (F&B) marketing practices that contradict health guidelines are particularly concerning for children and adolescents, who are developmentally more susceptible than adults to persuasive advertising and to Black communities, due to ethnically-targeted marketing, contributing to higher rates of obesity and other diet-related chronic diseases. Accordingly, here we evaluated Operation Good Food and Beverages (OGF&B), an online social marketing campaign calling for shifting toward more marketing of healthier F&B to Black youth and Black communities.

Methods: OGF&B was developed and implemented by a multidisciplinary team of academic, advocacy, and advertising partners and active for four months in 2022 during the COVID-19 pandemic.

PROMOTE: An Innovative Curriculum to Enhance the Maternity Care Workforce.

Background And Objectives: Maternal morbidity and mortality disproportionally affect marginalized populations in both rural and urban settings. While the workforce of family physicians (FPs) who provide maternity care is declining, an enhanced obstetrics (OB) curriculum during residency training can help prepare future FPs to provide competent pregnancy care, particularly in marginalized communities.

Methods: We developed an innovative OB curriculum-PROMOTE: Primary care obstetrics and maternal outcomes training enhancement-in an urban underserved residency program in Pennsylvania that directly addressed barriers previously known to impact maternity care practice.

HIV-1 control in vivo is related to the number but not the fraction of infected cells with viral unspliced RNA.

In the absence of antiretroviral therapy (ART), a subset of individuals, termed HIV controllers, have levels of plasma viremia that are orders of magnitude lower than non-controllers (NC) who are at higher risk for HIV disease progression. In addition to having fewer infected cells resulting in fewer cells with HIV RNA, it is possible that lower levels of plasma viremia in controllers are due to a lower fraction of the infected cells having HIV-1 unspliced RNA (HIV usRNA) compared with NC. To directly test this possibility, we used sensitive and quantitative single-cell sequencing methods to compare the fraction of infected cells that contain one or more copies of HIV usRNA in peripheral blood mononuclear cells (PBMC) obtained from controllers and NC.

Teeth with vital pulps and stage III periodontitis unresponsive to therapy exhibit a pulpal inflammatory profile similar to symptomatic irreversible pulpitis.

Aim: The aim of this study is to investigate the expression of inflammatory biomarkers (TNF-α, IL-10, IL-1β) and the pulpitis-associated miRNA (miR-30a-5p and miR-128-3p) in pulp tissue samples from unrestored teeth with a vital normal pulp (NP), teeth with symptomatic irreversible pulpitis (IP) and in unrestored teeth with periodontal disease, unresponsive to periodontal therapy, and a vital pulp (EP).

Methodology: Thirty patients were included in this observational study (10 teeth with NP, 10 teeth with IP, 10 teeth with EP). Dental pulp tissues samples were collected from patients during root canal treatment (RCT).

The diabetic myocardial transcriptome reveals Erbb3 and Hspa2 as a novel biomarkers of incident heart failure.

Aims: Diabetes mellitus (DM) increases heart failure incidence and worsens prognosis, but its molecular basis is poorly defined in humans. We aimed to define the diabetic myocardial transcriptome and validate hits in their circulating protein form to define disease mechanisms and biomarkers.

Methods And Results: RNA-sequencing data from the Genotype-Tissue Expression (GTEx) project was used to define differentially expressed genes (DEGs) in right atrial (RA) and left ventricular (LV) myocardium from people with vs.

Factors associated with receipt of systemic anticancer treatment for locally advanced or metastatic urothelial carcinoma in England: a population-based study.

Introduction: Systemic anticancer therapy for locally advanced or metastatic urothelial carcinoma (la/mUC) is associated with efficacy benefits, including longer overall survival (OS), but many patients remain untreated. This observational, real-world, national study aimed to investigate factors associated with receiving systemic anticancer therapy for la/mUC in England.

Patients And Methods: Adults diagnosed with la/mUC between 2013 and 2019 were identified in the National Cancer Registration Dataset and followed until March 2021.

Using site-directed mutagenesis to further the understanding of insulin receptor-insulin like growth factor-1 receptor heterodimer structure.

Type 2 diabetes is characterised by the disruption of insulin and insulin-like growth factor (IGF) signalling. The key hubs of these signalling cascades - the Insulin receptor (IR) and Insulin-like growth factor 1 receptor (IGF1R) - are known to form functional IR-IGF1R hybrid receptors which are insulin resistant. However, the mechanisms underpinning IR-IGF1R hybrid formation are not fully understood, hindering the ability to modulate this for future therapies targeting this receptor.