Performance of an Electronic Health Record-Based Automated Pulmonary Embolism Severity Index Score Calculator: Cohort Study in the Emergency Department.

Background: Studies suggest that less than 4% of patients with pulmonary embolisms (PEs) are managed in the outpatient setting. Strong evidence and multiple guidelines support the use of the Pulmonary Embolism Severity Index (PESI) for the identification of acute PE patients appropriate for outpatient management. However, calculating the PESI score can be inconvenient in a busy emergency department (ED).

Tofacitinib versus Vedolizumab Among Bio-naïve Patients with Ulcerative Colitis: A Real-World Propensity-Weighted Comparison.

Background And Aims: Over the last decade, treatment options for moderate-to-severe ulcerative colitis (UC) have expanded. However, comparative studies between these agents are limited, especially among biologic-naïve patients. We aimed to compare the persistence, effectiveness and safety of tofacitinib and vedolizumab as the first advanced treatment for patients with UC.

Axion Minicluster Streams in the Solar Neighborhood.

A consequence of QCD axion dark matter being born after inflation is the emergence of small-scale substructures known as miniclusters. Although miniclusters merge to form minihalos, this intrinsic granularity is expected to remain imprinted on small scales in our galaxy, leading to potentially damaging consequences for the campaign to detect axions directly on Earth. This picture, however, is modified when one takes into account the fact that encounters with stars will tidally strip mass from the miniclusters, creating pc-long tidal streams that act to refill the dark matter distribution.

Long-term outcomes and predictors of vedolizumab persistence in ulcerative colitis.

Background: Long-term vedolizumab (VDZ) outcomes in real-world cohorts have been largely limited to 1-year follow-up, with few bio-naïve patients or objective markers of inflammation assessed.

Objectives: We aimed to assess factors affecting VDZ persistence including clinical, biochemical and faecal biomarker remission at 1, 3 and 5 years.

Design: We performed a retrospective, observational, cohort study.

Optimizing Use of High-Sensitivity Troponin for Risk-Stratification of Acute Pulmonary Embolism.

Background:  High-sensitivity troponin T (HS-TnT) may improve risk-stratification in hemodynamically stable acute pulmonary embolism (PE), but an optimal strategy for combining this biomarker with clinical risk-stratification tools has not been determined.

Study Hypothesis:  We hypothesized that different HS-TnT cutoff values may be optimal for identifying (1) low-risk patients who may be eligible for outpatient management and (2) patients at increased risk of clinical deterioration who might benefit from advanced PE therapies.

Methods:  Retrospective analysis of hemodynamically stable patients in the University of Michigan acute ED-PE registry with available HS-TnT values.

Real-world Cohort Study on the Effectiveness and Safety of Filgotinib Use in Ulcerative Colitis.

Background: Filgotinib is a small molecule with preferential inhibition of Janus kinase type 1, approved for the treatment of ulcerative colitis in Scotland in May 2022. We present the first real-world experience on its use in clinical practice.

Methods: In this retrospective, observational, cohort study we assessed patients with active ulcerative colitis who received filgotinib in NHS Lothian, Scotland.

Prediction of in-hospital deterioration in normotensive pulmonary embolism remains elusive: external validation of the calgary acute pulmonary embolism score.

Acute pulmonary embolism (PE) is a frequently diagnosed condition. Prediction of in-hospital deterioration is challenging with current risk models. The Calgary Acute Pulmonary Embolism (CAPE) score was recently derived to predict in-hospital adverse PE outcomes but has not yet been externally validated.

Adverse Clinical Outcomes Among Patients With Acute Low-risk Pulmonary Embolism and Concerning Computed Tomography Imaging Findings.

Importance: Most patients presenting to US emergency departments (EDs) with acute pulmonary embolism (PE) are hospitalized, despite evidence from multiple society-based guidelines recommending consideration of outpatient treatment for those with low risk stratification scores. One barrier to outpatient treatment may be clinician concern regarding findings on PE-protocol computed tomography (CTPE), which are perceived as high risk but not incorporated into commonly used risk stratification tools.

Objective: To evaluate the association of concerning CTPE findings with outcomes and treatment of patients in the ED with acute, low-risk PE.

Multiple infliximab biosimilar switches appear to be safe and effective in a real-world inflammatory bowel disease cohort.

Background: Switching from originator infliximab (IFX) to biosimilar IFX is effective and safe. However, data on multiple switching are scarce. The Edinburgh inflammatory bowel disease (IBD) unit has undertaken three switch programmes: (1) Remicade to CT-P13 (2016), (2) CT-P13 to SB2 (2020), and (3) SB2 to CT-P13 (2021).

Effect of pulmonary embolism response team on advanced therapies administered: The University of Michigan experience.

Background: Pulmonary Embolism Response Teams (PERT) were employed at multiple institutions to bridge the gap between varied treatment options for acute PE and unclear evidence for optimal management. There is limited data regarding the impact of PERT on the use of advanced therapies and clinical outcomes.

Methods: We performed a retrospective single-center cohort study comparing patients that presented to the ED with an acute PE before and after the creation of PERT in June 2017 at our institution.

COVID-19 contagious health care personnel 5-day early return-to-work program.

Background: COVID-19 contagious health care personnel (HCP) who are self-isolating for a 10-day period increases burden to workforce shortages. Implementation of a 5-day early return-to-work (RTW) program may reduce self-isolation periods, without increasing transmission risk, during the COVID-19 pandemic.

Design And Methods: This observational cohort quality improvement study included newly diagnosed COVID-19 HCP at a multifacility health care system.

Rates, predictive factors and effectiveness of ustekinumab intensification to 4- or 6-weekly intervals in Crohn's disease.

Background: The UNITI trial reports efficacy of ustekinumab (UST) dose intensification in Crohn's disease (CD) from 12- to 8-weekly, but not 4-weekly. We aimed 1) to assess the cumulative incidence of UST dose intensification to 4- or 6-weekly, 2) to identify factors associated with dose intensification, and 3) to assess the effectiveness of this strategy.

Methods: We performed a retrospective, observational cohort study in NHS Lothian including all UST treated CD patients (2015-2020).

Placental delayed villous maturation is associated with fetal congenital heart disease.

Background: The placenta is crucial for the overall development and lifelong health of the fetus. Abnormal placental development and function occur in pregnancies with fetal congenital heart disease. However, studies that use standardized diagnostic criteria and incorporate control populations are lacking.

Detection and control of an ongoing international outbreak of hepatitis A among the Irish Traveller community beginning September 2020.

Hepatitis A virus (HAV) infection is a notifiable disease in Ireland, with national coverage of clinical and laboratory surveillance. In December 2020, a cluster of 11 HAV cases among the Irish Traveller community was detected. The outbreak investigation identified 61 total HAV cases from September 2020 to November 2021.

Healthcare personnel early return-to-work program after higher-risk SARS-CoV-2 exposure: A learning health system quality improvement project.

Background: Incidence of health care personnel (HCP) with a higher-risk SARS-CoV-2 exposure and subsequent 14-day quarantine period adds substantial burden on the workforce. Implementation of an early return-to-work (RTW) program may reduce quarantine periods for asymptomatic HCP and reduce workforce shortages during the COVID-19 pandemic.

Methods: This observational quality improvement study included asymptomatic HCP of a multi-facility health care system with higher-risk workplace or non-household community SARS-CoV-2 exposure ≤4 days.

New Definition of the Neutrino Floor for Direct Dark Matter Searches.

The neutrino floor is a theoretical lower limit on WIMP-like dark matter models that are discoverable in direct detection experiments. It is commonly interpreted as the point at which dark matter signals become hidden underneath a remarkably similar-looking background from neutrinos. However, it has been known for some time that the neutrino floor is not a hard limit, but can be pushed past with sufficient statistics.

An evaluation of virtual ethics discussion groups as a method of learning on a pharmacist Independent Prescribing (IP) programme.

Background And Purpose: A postgraduate body within Queen's University Belfast (QUB) has offered a pharmacist Independent Prescribing (IP) programme to pharmacists living locally in Northern Ireland (NI) since 2006. In 2016, this course was modified and delivered by the School of Pharmacy within QUB for a non-local population of pharmacists from Great Britain (GB). In order to substitute face-to-face, live training in NI, distance learning methods were employed for one of the modules that involved studying ethical dilemmas.

Workflow Improvement and the Use of PDSA Cycles: An Exploration Using Screening, Brief Intervention, and Referral to Treatment (SBIRT) Integration.

Background And Objectives: The purpose of the study was to use a best practice quality improvement process to identify and eliminate barriers to Screening, Brief Intervention, and Referral to Treatment (SBIRT) integration in a Federally Qualified Health Center. SBIRT provides an initial method for addressing mental health and substance abuse concerns of patients. The method is very useful in integration of behavioral health screening in primary care.

Investigation of a foodborne outbreak of Shigella sonnei in Ireland and Northern Ireland, December 2016: the benefits of cross-border collaboration and commercial sales data.

Objectives: To describe a cross-border foodborne outbreak of Shigella sonnei that occurred in Ireland and Northern Ireland (NI) in December 2016 whilst also highlighting the valuable roles of sales data and international collaboration in the investigation and control of this outbreak.

Study Design: A cross-border outbreak control team was established to investigate the outbreak.

Methods: Epidemiological, microbiological, and environmental investigations were undertaken.

A Matched Case-Control Analysis of Clinical Outcomes for Patients With Inflammatory Bowel Disease and Rectal Cancer Treated With Pelvic Radiation Therapy.

Purpose: Inflammatory bowel disease (IBD) is a known risk factor for rectal cancer, and RT is often an important part of therapy for these patients. Previously published studies have raised concerns for increased rates of RT toxicity in patients with IBD. We performed a matched case-control analysis to assess RT-related toxicity in a large sample of U.