Access, relationships, quality and safety (ARQS): a qualitative study to develop an Indigenous-centred understanding of virtual care quality.

Background: Among Indigenous peoples in Canada, access to high-quality healthcare remains an important determinant of health. The shift to virtual and remote-based approaches, expedited during the COVID-19 pandemic, influenced the ways in which individuals accessed care and the quality of care received. This study sought to determine which elements are required for effective and sustainable virtual care approaches for delivery of primary care to Indigenous patients and develop quality indicators grounded in Indigenous community and experience.

Survival and Toxicities after Yttrium-90 Transarterial Radioembolization of Cholangiocarcinoma in the RESiN Registry.

Purpose: To report outcomes in patients with intrahepatic cholangiocarcinoma treated with yttrium-90 resin microspheres (transarterial radioembolization [TARE]) from a multicenter, prospective observational registry.

Materials And Methods: Ninety-five patients (median age, 67 years [interquartile range {IQR}, 59-74]; 50 men) were treated in 27 centers between July 2015 and August 2020. Baseline demographic characteristics included imaging findings, performance status, and previous systemic or locoregional treatments.

Synthesis, Characterization, and Structural Analysis of [Al(NON)(H)(SiHPh)] ( = Li, Na, K, Rb, Cs) Compounds, Made Via Oxidative Addition of Phenylsilane to Alkali Metal Aluminyls.

We report the oxidative addition of phenylsilane to the complete series of alkali metal () aluminyls [{Al(NON)}] ( = Li, Na, K, Rb, and Cs). Crystalline products () have been isolated as ether or THF adducts, [(L)][Al(NON)(H)(SiHPh)] ( = Li, Na, K, Rb, L = EtO, = 1; = Cs, L = THF, = 2). Further to this series, the novel rubidium rubidiate, [{Rb(THF)}(Rb{Al(NON)(H)(SiHPh)})] [Rb{Al(NON)(H)(SiHPh)}], was isolated during an attempted recrystallization of Rb[Al(NON)(H)(SiHPh)] from a hexane/THF mixture.

Exosomal TAR DNA binding protein 43 profile in canine model of amyotrophic lateral sclerosis: a preliminary study in developing blood-based biomarker for neurodegenerative diseases.

Objective: Blood-based biomarkers provide a crucial information in the progress of neurodegenerative diseases with a minimally invasive sampling method. Validated blood-based biomarker application in people with amyotrophic lateral sclerosis would derive numerous benefits. Canine degenerative myelopathy is a naturally occurring animal disease model to study the biology of human amyotrophic lateral sclerosis.

Low-Dose Hemibody Radiation, a Treatment Option for Recurrent Prostate Cancer: A Phase 2 Single-Arm Trial.

Purpose: Nontargeted low-dose ionizing radiation has been proposed as a cancer therapeutic for several decades; however, questions remain about the duration of hematological changes and optimal dosing regimen. Early studies delivering fractionated low doses of radiation to patients with cancer used varying doses and schedules, which make it difficult to standardize a successful dose and scheduling system for widespread use. The aim of this phase 2 two-stage trial was to determine whether low-dose radiation therapy (LD-RT) reduced prostate-specific antigen (PSA) in patients with recurrent prostate cancer in efforts to delay initiation of conventional therapies that are known to decrease quality of life.

Mobile Health Apps for Patient-Centered Care: Review of United States Rheumatoid Arthritis Apps for Engagement and Activation.

Background: Rheumatoid arthritis (RA) is a highly dynamic and individualized disease in terms of its patterns of symptomatic flare-ups and periods of remission. Patient-centered care (PCC) aligns patients' lifestyle goals with their preferences for managing symptoms and side effects through the selection of therapies appropriate for disease management. Mobile health (mHealth) apps have the potential to engage and activate patients in PCC.

Effect of bimedial recession on near-distance disparity in esotropia.

Background: Esotropia may be associated with a difference in the deviation at near and distance fixation termed near-distance disparity (NDD). Convention suggests patients with NDD may benefit more from bilateral medial rectus recessions (BMR) as opposed to a unilateral recession/resection (RR). The aim of this study is to establish the effect of BMR for the treatment of esotropia on both the near and distance deviation and NDD.

Chemical Modifications Suppress Anharmonic Effects in the Lattice Dynamics of Organic Semiconductors.

The lattice dynamics of organic semiconductors has a significant role in determining their electronic and mechanical properties. A common technique to control these macroscopic properties is to chemically modify the molecular structure. These modifications are known to change the molecular packing, but their effect on the lattice dynamics is relatively unexplored.

Overall survival and toxicity of Y90 radioembolization for hepatocellular carcinoma patients in Barcelona Clinic Liver Cancer stage C (BCLC-C).

Introduction: National Comprehensive Cancer Network HCC guidelines recommend Y90 to treat BCLC-C patients only in select cases given the development of systemic regimens. We sought to identify ideal candidates for Y90 by assessing survival and toxicities in this patient group.

Materials And Methods: The Radiation-Emitting Selective Internal radiation spheres in Non-resectable tumor registry is a prospective observational study (NCT: 02,685,631).

A two-staged classifier to reduce false positives: On device detection of atrial fibrillation using phase-based distribution of poincaré plots and deep learning.

Background: Mobile Cardiac Outpatient Telemetry (MCOT) can be used to screen high risk patients for atrial fibrillation (AF). These devices rely primarily on algorithmic detection of AF events, which are then stored and transmitted to a clinician for review. It is critical the positive predictive value (PPV) of MCOT detected AF is high, and this often leads to reduced sensitivity, as device manufacturers try to limit false positives.

Boiling over.

An emergent encoding of aggressive motivation in neurons of the hypothalamus.

Improving Methods of Identifying Anaphylaxis for Medical Product Safety Surveillance Using Natural Language Processing and Machine Learning.

We sought to determine whether machine learning and natural language processing (NLP) applied to electronic medical records could improve performance of automated health-care claims-based algorithms to identify anaphylaxis events using data on 516 patients with outpatient, emergency department, or inpatient anaphylaxis diagnosis codes during 2015-2019 in 2 integrated health-care institutions in the Northwest United States. We used one site's manually reviewed gold-standard outcomes data for model development and the other's for external validation based on cross-validated area under the receiver operating characteristic curve (AUC), positive predictive value (PPV), and sensitivity. In the development site 154 (64%) of 239 potential events met adjudication criteria for anaphylaxis compared with 180 (65%) of 277 in the validation site.

Testing network autocorrelation without replicates.

In this paper, we propose a portmanteau test for whether a graph-structured network dataset without replicates exhibits autocorrelation across units connected by edges. Specifically, the well known Ljung-Box test for serial autocorrelation of time series data is generalized to the network setting using a specially derived central limit theorem for a weakly stationary random field. The asymptotic distribution of the test statistic under the null hypothesis of no autocorrelation is shown to be chi-squared, yielding a simple and easy-to-implement procedure for testing graph-structured autocorrelation, including spatial and spatial-temporal autocorrelation as special cases.

Additives influence 3D printer emission profiles: Implications for working safely with polymer filament composites.

It is critical to thoroughly investigate, characterize, and understand the unique emission profiles of common and novel polymer feedstocks used in fused filament fabrication (FFF) 3D printers as these products become increasingly ubiquitous in consumer and industrial environments. This work contributes unique insights regarding the effects of polymer composite feedstocks with metal, ceramic, or carbonaceous particle additives on particulate emissions in a variety of filaments under various print conditions, including print temperature. In addition to active characterization of particulate size and concentration following the ANSI/CAN/UL 2904 method, particulate sampling and subsequent analysis by scanning electron microscopy revealed agglomeration behavior that may have important health implications.

Therapeutic gene editing of T cells to correct CTLA-4 insufficiency.

Heterozygous mutations in result in an inborn error of immunity with an autoimmune and frequently severe clinical phenotype. Autologous T cell gene therapy may offer a cure without the immunological complications of allogeneic hematopoietic stem cell transplantation. Here, we designed a homology-directed repair (HDR) gene editing strategy that inserts the cDNA into the first intron of the genomic locus in primary human T cells.

Device agnostic AI-based analysis of ambulatory ECG recordings.

Deep Convolutional Neural Networks (DCNNs) have been shown to provide improved performance over traditional heuristic algorithms for the detection of arrhythmias from ambulatory ECG recordings. However, these DCNNs have primarily been trained and tested on device-specific databases with standardized electrode positions and uniform sampling frequencies. This work explores the possibility of training a DCNN for Atrial Fibrillation (AF) detection on a database of single‑lead ECG rhythm strips extracted from resting 12‑lead ECGs.

Regio- and Stereoselectivity of the Norrish-Yang Photocyclization of Dialkyl 1,2-Diketones: Solution versus Solid State Photochemistry of Two Polymorphs.

As shown by X-ray crystallography, crystals of 3β-acetoxy-16,17-seco-17,20-dioxopregn-5-ene-16-nitrile are dimorphic. The regioselectivity of the Norrish-Yang type II photocyclization under visible light of this steroidal 1,2-diketone, which bears primary, secondary, and tertiary nonequivalent abstractable γ-hydrogens, dramatically increases in the crystalline state of both polymorphs. X-ray crystallography and molecular mechanics calculations reveal crystal structure-solid state photochemistry relationships.

Improving the quality of family meeting documentation in the ICU at the end of life.

Objective: Improve documentation quality of end-of-life family meetings in a tertiary intensive care unit (ICU).

Design: Before-and-after interventional quality improvement project between October 2018 and February 2020 utilising an electronic pro-forma record.

Setting: Australian, University affiliated, mixed medical-surgical 22 bed adult ICU.

From co-design to co-production: Approaches, enablers, and constraints in developing a public health, capacity-building solution.

Introduction: Investigating how co-designed knowledge can be translated to co-produce a public health capacity-building solution for difficult-to-engage population groups drawing on the co-production experience of a prevention-focused, capacity-building mental health solution targeting primary producers.

Design: A qualitative study undertaken in rural and regional Victoria involving members of the design working group including project team (7px), digital design team (5px), marketing team (3px), and funding partner representatives. The study design involved reflective practice to collect data to identify the phases of co-production and assess the design working group members' experiences.

Determining massage dose-response to improve cancer-related symptom cluster of pain, fatigue, and sleep disturbance: A 7-arm randomized trial in palliative cancer care.

Background: The efficacy of various massage doses in palliative cancer care settings is still debated, and no specific protocol is available.

Aim: Evaluating response to various massage doses for symptom cluster of pain-fatigue-sleep.

Design: A 7-arm randomized-controlled trial with weekly massage for 4 weeks depending on the prescribed dose (15-, 30-, or 60-min; 2× or 3×/week) and a 4-week follow-up.

Small Bowel Congenital Anomalies: A Review and Update.

The small intestine is a complex organ system that is vital to the life of the individual. There are several congenital anomalies that occur and present most commonly in infancy; however, some may not present until adulthood. Most congenital anomalies of the small intestine will present with obstructive symptoms, whereas some may present with vomiting, abdominal pain, and/or gastrointestinal bleeding.

Distinct mechanism of cervical cancer cell death caused by the investigational new drug SHetA2.

Drug-targetable vulnerabilities of cancer cells include their dependence on heat shock proteins (HSPs) to support elevated mitochondrial metabolism and counteract cell death factors. The investigational new drug SHetA2 targets these vulnerabilities in ovarian and endometrial cancer cells by disrupting complexes of the mortalin HSP with its client proteins (mitochondrial support proteins, metabolic enzymes, p53) leading to mitochondrial leakage of cytochrome c and apoptosis-inducing factor (AIF), and caspase-dependent apoptosis. Our objective was to evaluate the roles of mitochondrial damage and another SHetA2-target HSP protein, cytoplasmic heat shock cognate 70 (hsc70), in the mechanism of SHetA2 killing of cervical cancer cells.