Preventative treatment of tuberous sclerosis complex with sirolimus: Phase I safety and efficacy results.

Objective: Tuberous sclerosis complex (TSC) results from overactivity of the mechanistic target of rapamycin (mTOR). Sirolimus and everolimus are mTOR inhibitors that treat most facets of TSC but are understudied in infants. We sought to understand the safety and potential efficacy of preventative sirolimus in infants with TSC.

Does inhaler adherence really matter in severe asthma?

Inhaled therapies, primarily the inhaled corticosteroid (ICS), have been the cornerstone of asthma treatment since the 1960s. They have been shown to reduce symptom burden, morbidity and mortality, and potentially avoid unnecessary and unscheduled healthcare. However, some people have severe asthma, defined by an inability to gain or maintain consistent disease control despite appropriate use of high dose ICS-containing inhalers.

'Hidden' work and lost opportunities: nursing research and impact case studies submitted to REF2021.

Aims: (1) Identify and characterise the nursing contribution to impact case studies submitted to Research Excellence Framework (REF) 2021 across all Units of Assessment and compare this to those submitted to REF 2014; (2) Identify and characterise those impact case studies of relevance to nursing that did not include a nurse in the research team; (3) Compare the characteristics of impact case studies identified in Aim 2 with those that did include a nurse in the research team.

Design: Desk-based analysis of REF2021 published data.

Methods: We searched the REF2021 impact database with the term nurs* then sorted case studies into categories representing the involvement of nurses on the research team.

Evidencing the challenges of care delivery for people with intellectual disability and epilepsy in England by using the Step Together toolkit.

Background: People with intellectual disability (PwID) and epilepsy have increased premature and potentially preventable mortality. This is related to a lack of equitable access to appropriate care. The Step Together guidance and toolkit, developed with patient, clinical, charity and commissioning stakeholders, allows evaluation and benchmarking of essential epilepsy service provision for PwID in eight key domains, at a care system level.

Profiles of cardiometabolic risk and acculturation indicators among South Asians in the US: latent class analysis of the MASALA study.

Background: South Asians (SA) represent the fastest growing US immigrant group, and previous studies have indicated that they face disproportionately high burden of cardiometabolic disease. Cardiometabolic disease manifests as a syndemic or synergistic epidemic encompassing multiple disease clusters influenced by biological, social, and psychological factors stemming from the acculturative process. This process may exacerbate morbidity within immigrant subgroups.

Physiologically based pharmacokinetic modeling of metal nanoparticles for risk assessment of inhalation exposures: a state-of-the-science expert panel review.

A critical review of the current state-of-the-science for the physiologically based pharmacokinetic (PBPK) modeling of metal nanoparticles and their application to human health risk assessment for inhalation exposures was conducted. A systematic literature search was used to identify four model groups (defined as a primary publication along with multiple supplementary publications) subject to review. Using a recent guideline document from the Organization for Economic Cooperation and Development (OECD) for PBPK model evaluation, these model groups were critically peer-reviewed by an independent panel of experts to identify those to be considered for modeling and simulation application.

Photoperiod, food restriction and memory for objects and places in mice.

The suprachiasmatic nucleus (SCN) contains a population of cell-autonomous circadian oscillators essential for entrainment to daily light-dark (LD) cycles. Synchrony among SCN oscillators is modified by photoperiod and determines functional properties of SCN clock cycling, including its amplitude, phase angle of entrainment, and free running periodicity (τ). For many species, encoding of daylength in SCN output is critical for seasonal regulation of metabolism and reproduction.

A scoping review of stroke services within the Philippines.

Background: Stroke is a leading cause of mortality and disability. In higher-income countries, mortality and disability have been reduced with advances in stroke care and early access to rehabilitation services. However, access to such services and the subsequent impact on stroke outcomes in the Philippines, which is a lower- and middle-income countries (LMIC), is unclear.

Stroke rehabilitation in urban and rural settings in the Philippines: Protocol for an interview and visual elicitation study.

Introduction: There is a lack of community-based rehabilitation for stroke in the Philippines, and research on this topic is limited. Different challenges may be encountered in urban and rural settings. The aim of the Tulong, Ugnayan ng Lingap At gabaY (TULAY) project is to develop a context-appropriate, community-based stroke support programme, consisting of self-management and training resources to augment the rehabilitation and recovery process.

Characterising mobility and pressure exposure in community dwelling residents with pressure ulcers using monitoring technology and intelligent algorithm.

Aim: Individuals in the community with reduced mobility are at risk of exposure to prolonged lying and sitting postures, which may cause pressure ulcers. The present study combines continuous pressure monitoring technology and intelligent algorithms to evaluate posture, mobility, and pressure profiles in a cohort of community dwelling patients, who had acquired pressure ulcers.

Materials And Methods: This study represents a secondary analysis of the data from the Quality Improvement project 'Pressure Reduction through COntinuous Monitoring In the community SEtting (PROMISE)'.

The electronic structure of diatomic nickel oxide.

The nature of the Ni-O bond is relevant to catalytic and environmental applications. The vibrational frequency and electronic structure of NiO were calculated using CASSCF, icMRCI+Q, CCSD(T), and DFT. CASSCF predicted a quintet state (Σ) ground state for the equilibrium bond distance with a state crossing at 1.

Successfully initiating an escalation of care in acute ward settings-A qualitative observational study.

Aims: To address knowledge gaps by (i) developing a theoretical understanding of escalation and (ii) identifying escalation success factors.

Design: Non-participant observations were used to examine deteriorating patient escalation events.

Methods: Escalation event data were collected by a researcher who shadowed clinical staff, between February 16th 2021 and March 17th 2022 from two National Health Service Trusts.

The effect of a dynamic lighting schedule on neurobehavioral performance during a 45-day simulated space mission.

Study Objectives: We previously reported that during a 45-day simulated space mission, a dynamic lighting schedule (DLS) improved circadian phase alignment and performance assessed once on selected days. This study aimed to evaluate how DLS affected performance on a 5-minute psychomotor vigilance task (PVT) administered multiple times per day on selected days.

Methods: Sixteen crewmembers (37.

Do Religion and Spirituality Buffer the Effect of Childhood Trauma on Depressive Symptoms? Examination of a South Asian Cohort from the USA.

Asian Americans have been identified as a racial group that is disproportionately affected by childhood trauma. The goal of this study was  to assess if religion/spirituality moderate the effects of childhood trauma on adult depressive symptoms among a sample of South Asians in the USA. Our analysis drew from the study on stress, spirituality, and health (SSSH) questionnaire fielded in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 990) during 2016-2018.

'There was a pivotal moment'. The dynamics, transitions, adaptations and trajectories of nursing at the front-line in the UK during the COVID-19 pandemic.

Using qualitative interview data (n = 142 interviews) generated with 50 nurses, over the course of the COVID-19 pandemic, this paper traces the trajectories of nurses in the UK and attempts to unpick the interplay between structure and agency in their narratives. Interviews were inductively analysed for themes and an additional narrative analysis was undertaken to preserve the form of each participant's narrative. We argue that nurses' pandemic trajectories occurred within the 'psychological vulnerability-stigma nexus' which operates within health and social care providers in the UK and whilst constraining nurses' agency at times it could also provide an impetus to act agentically.

Experiences of an inpatient penicillin allergy de-labelling pathway: capturing the patient voice.

Background: Non-allergist-delivered penicillin allergy de-labelling (PADL) is supported by UK and other national guidelines but is not yet routine practice in UK hospitals. Those who have undergone PADL report high rates of acceptance, but it is unknown why some continue to avoid penicillin, and why some decline testing.

Objectives: To explore the experiences of patients recently approached for penicillin allergy (penA) assessment and de-label by non-allergists in a UK hospital to determine the barriers and enablers to patient acceptance of PADL.

Non-allergist healthcare workers views on delivering a penicillin allergy de-labelling inpatient pathway: identifying the barriers and enablers.

Background: Non-allergist delivered PADL is supported by UK and World Health Organization guidelines but is not yet routine in UK hospitals. Understanding the views of healthcare workers (HCWs) on managing patients with penA records and exploring perspectives on delivering a PADL inpatient pathway are required to inform the development of non-allergist delivered PADL pathways.

Objective: To explore the perspectives of non-allergist HCWs working in medical specialties on managing patients with penA records, and to explore the enablers and barriers to embedding PADL as a standard of care for inpatients.

The flow of anisotropic nanoparticles in solution and in blood.

The alignment of anisotropic nanoparticles in flow has been used for a range of applications such as the preparation of strong fibres and the assembly of in-plane aligned 1D-nanoobjects that are used for electronic devices, sensors, energy and biological application. Important is also the flow behaviour of nanoparticles that were designed for nanomedical applications such as drug delivery. It is widely observed that non-spherical nanoparticles have longer circulation times and a more favourable biodistribution.

The Experience of Physical Recovery and Physical Rehabilitation Following Hospital Discharge for Intensive Care Survivors-A Qualitative Systematic Review.

Background: Over 120,000 people in the UK survive critical illness each year, with over 60% of these experiencing mobility issues and reduced health-related quality of life after discharge home. This qualitative systematic review aimed to explore critical care survivors' perceptions, opinions, and experiences of physical recovery and physical rehabilitation following hospital discharge.

Methods: This review followed the Joanna Briggs Institute (JBI) methodology with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was conducted between January 2020 and June 2022.

Improving escalation of deteriorating patients through cognitive task analysis: Understanding differences between work-as-prescribed and work-as-done.

Background: Appropriate care escalation requires the detection and communication of in-hospital patient deterioration. Although deterioration in the ward environment is common, there continue to be patient deaths where problems escalating care have occurred. Learning from the everyday work of health care professionals (work-as-done) and identifying performance variability may provide a greater understanding of the escalation challenges and how they overcome these.