Psychological Screening of Medical School Applicants and Medical Students.

Should medical schools psychologically screen medical school applicants and students? Arguably, psychological screening could be used to identify at-risk candidates who have psychological conditions that make them more likely to act unprofessionally. In this column we analyse the arguments for and against such screening. We argue that psychological testing should be used by medical schools as part of a program to support students so that they are at less risk of engaging in poor professional behaviour.

Impact of Heart Transplant Allocation Changes on Waitlist Mortality and Clinical Practice in Pediatric and Adult Patients With Congenital Heart Disease and Cardiomyopathy.

Background: The United Network of Organ Sharing made changes to the priority for allocation of hearts for transplantation (HT) in 2016 for pediatric patients and 2018 for adult patients. Although recent work has evaluated the impact of the revised allocation systems on mechanical circulatory support practices and waitlist outcomes, there are limited data that focus more specifically on the impact of the allocation changes on patients with congenital heart disease (CHD) or cardiomyopathy and how these relationships might differ in pediatric and adult patients.

Methods: The United Network of Organ Sharing database was queried for pediatric (<18 years of age) and adult (18-50 years of age) patients with a CHD or cardiomyopathy diagnosis listed for HT.

Outcomes for Children With Congenital Heart Disease Undergoing Ventricular Assist Device Implantation: An ACTION Registry Analysis.

Background: There are no contemporary reports that highlight the national outcomes for children with congenital heart disease (CHD) undergoing ventricular assist device (VAD) implantation.

Objectives: This study sought to evaluate differences in VAD outcomes for children with CHD to those with non-CHD as well as those with univentricular CHD to those with biventricular CHD.

Methods: Data for CHD and non-CHD patients from the multicenter ACTION (Advanced Cardiac Therapies Improving Outcomes Network) undergoing VAD implantation from April 2018 to February 2023 were included.

Phenotypic Plasticity During Organofluorine Degradation Revealed by Adaptive Evolution.

A major factor limiting the biodegradation of organofluorine compounds has been highlighted as fluoride anion toxicity produced by defluorinating enzymes. Here, two highly active defluorinases with different activities were constitutively expressed in Pseudomonas putida ATCC 12633 to examine adaption to fluoride stress. Each strain was grown on α-fluorophenylacetic acid as the sole carbon source via defluorination to mandelic acid, and each showed immediate fluoride release and delayed growth.

Socio-economic disparities in the psychosocial and economic impacts of the COVID-19 pandemic on children and young people in Australia.

Aims: While COVID-19 no longer presents a global health emergency, the indirect (non-infection) impacts of the pandemic may exacerbate health inequalities in years to come. We examined the socio-economic distribution of the impacts of the pandemic on the psychosocial and economic well-being of children, young people and their families.

Methods: The CoRonavIruS Health Impact Survey (CRISIS) was conducted in seven existing longitudinal cohorts, together involving n = 3072 participants aged 0-19 years.

On-demand treatment of hereditary angioedema attacks: patient-reported utilization, barriers, and outcomes.

Background: Hereditary angioedema (HAE) is clinically characterized by recurrent attacks of cutaneous and submucosal swelling.

Objective: To investigate real-world timing, potential barriers, and impact of delaying on-demand treatment (OD) of HAE attacks METHODS: Patients with HAE (type I or II) aged ≥12 years with ≥1 treated (Treated Cohort) or untreated (Untreated Cohort) attack in the past 3 months were recruited by the US HAE Association. Respondents completed a 20-minute, self-reported, online survey about their last HAE attack.

Clinical and Biomarker Determinants for Recurrent Stroke in Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Background And Objectives: Despite effective secondary prevention, including oral anticoagulant (OAC) therapy, the risk of recurrent stroke (RS) in patients with atrial fibrillation (AF) remains substantial with an annualized risk of 3.2%-6.5% per year.

Cervical spine positioning patterns amongst hand surgeons: A critical analysis of surgical posture.

Aim: This study aims to assess the cervical spine positioning of consultant and trainee hand surgeons during standardised hand surgeries, focusing on the prevalence of sustained end-range postures, particularly cervical spine flexion.

Background: Surgeons often perform procedures that require maintenance of sustained postures for prolonged periods of time. Hand surgeons may be at increased risk of sustained end of range postures, particularly cervical spine flexion.

Unraveling the mysteries of parsonage turner syndrome: A journey towards optimal management. A systematic review.

Aims: Parsonage Turner Syndrome (PTS) is a peripheral neuropathy manifesting as sudden onset pain, muscle weakness, and atrophy. This review aims to analyse long-term outcomes reported in adult patients with PTS, and establish an optimised management approach.

Methods: A comprehensive literature search was performed using MEDLINE, PubMed, and the Cochrane Library.

Discovery of 6-Fluoro-5-{4-[(5-fluoro-2-methyl-3-oxo-3,4-dihydroquinoxalin-6-yl)methyl]piperazin-1-yl}--methylpyridine-2-carboxamide (AZD9574): A CNS-Penetrant, PARP1-Selective Inhibitor.

PARP inhibitors have attracted considerable interest in drug discovery due to the clinical success of first-generation agents such as olaparib, niraparib, rucaparib, and talazoparib. Their success lies in their ability to trap PARP to DNA; however, first-generation PARP inhibitors were not strictly optimized for trapping nor for selectivity among the PARP enzyme family. Previously we described the discovery of the second-generation PARP inhibitor AZD5305, a selective PARP1-DNA trapper.

An Early Supported Discharge (ESD) Model of Care for Older Adults Admitted to Hospital: A Descriptive Cohort Study.

Background: Early supported discharge (ESD) facilitates early discharge from acute hospitals with continued rehabilitation in the home environment from a multi-disciplinary team at the same intensity as would be received in the inpatient setting. Emerging evidence suggests it can have a positive impact on the care of older adults on discharge from the acute hospital setting to home. This study aims to characterize an inreach model of ESD for older adults discharged from four hospitals in the Mid-West of Ireland and describe its impact on clinical and process outcomes at 30 and 180 days.

Evaluation of a mobile application to decrease opioid misuse in patients undergoing cesarean section: a randomized controlled trial.

Background: Opioid misuse and addiction are at epidemic levels in the United States. Postoperative opioid prescription is inconsistent and often excessive, including for cesarean section patients. Technology, such as mobile applications and clinical decision support tools, can be used to decrease opioid use and misuse among patients, and to determine more appropriate prescribing practices for specific procedures.

Parents' mental health after termination of pregnancy for foetal anomaly - a systematic review.

Aims/background: Terminating a desired pregnancy due to foetal anomalies has been linked to significant distress. It is however less clear what long-term psychological implications the parents face in the aftermath. This systematic review aimed to explore the mental health outcomes of parents after the termination of pregnancy due to foetal anomaly (TOPFA) after gestational week 12 + 0.

"I Felt Supported, Empowered, and Encouraged": Early Findings from a Community Initiative to Strengthen and Support Families Through the First 1,000 Days of Life.

Purpose: Evaluation of the First 1,000 Days Suncoast Family Navigation program aimed to (1) describe the social needs of families in Southwest Florida and (2) measure the program's impact on client-reported mental health and social support outcomes.

Design: A multi-method design was employed, including quantitative data collected through an online social care referral network and longitudinal surveys, supplemented by qualitative key informant interview data.

Methods: A convenience sample of 538 parents who submitted online assistance request forms to First 1,000 Days between August 2020 and January 2024 were included.

The Association Between Surgeons' Intention to Work with Patients from Diverse Cultures and their Awareness of Ethno-Racial Orthopedic Health Care Disparities.

Objectives: Surgeons' awareness of ethno-racial disparities in orthopedic care is critical to the implementation and success of efforts to reduce them. We examine the association between surgeons' self-reported intentions to enhance their ability to work with orthopedic patients from diverse cultures and their awareness of disparities.

Methods: Seventy U.

Understanding tumour growth variability in breast cancer xenograft models identifies PARP inhibition resistance biomarkers.

Understanding the mechanisms of resistance to PARP inhibitors (PARPi) is a clinical priority, especially in breast cancer. We developed a novel mathematical framework accounting for intrinsic resistance to olaparib, identified by fitting the model to tumour growth metrics from breast cancer patient-derived xenograft (PDX) data. Pre-treatment transcriptomic profiles were used with the calculated resistance to identify baseline biomarkers of resistance, including potential combination targets.

Frailty screening with comprehensive geriatrician-led multidisciplinary assessment for older adults during emergency hospital attendance in Ireland (SOLAR): a randomised controlled trial.

Background: Multidisciplinary comprehensive geriatric assessment (CGA) improves outcomes in hospitalised older adults but there is limited evidence on its effectiveness in the emergency department. We aimed to assess the benefits of CGA in the emergency department for older adults living with frailty.

Methods: In this randomised controlled trial, we enrolled older adults (≥75 years) who presented to the emergency department with medical complaints at University Hospital Limerick (Limerick, Ireland).

Negative Pressure Wound Therapy with Instillation for Periprosthetic Infection after Breast Reconstruction: A Systematic Review.

Background: Periprosthetic infection after breast reconstruction is not uncommon and can result in loss of the implant pocket and negative patient outcomes. Management of these infections typically involves removal of the prosthesis, treatment with antibiotics, and delayed reconstruction upon infection resolution. The impact of adjunctive use of negative pressure wound therapy with instillation and dwell (NPWTi-d) on breast pocket salvage rates, time to implant reinsertion, and related outcomes was examined.