Pediatric cardiac surgical site infections: A single-center quality improvement initiative.

Objective: Pediatric cardiac surgery site infections (SSI) represent significant morbidity. Our institution reported elevated SSI rates of 3.48 per 100 cases over a 5-year period above target rates of 2.

MIBiG 4.0: advancing biosynthetic gene cluster curation through global collaboration.

Specialized or secondary metabolites are small molecules of biological origin, often showing potent biological activities with applications in agriculture, engineering and medicine. Usually, the biosynthesis of these natural products is governed by sets of co-regulated and physically clustered genes known as biosynthetic gene clusters (BGCs). To share information about BGCs in a standardized and machine-readable way, the Minimum Information about a Biosynthetic Gene cluster (MIBiG) data standard and repository was initiated in 2015.

Variable recruitment of distal tuft dendrites shapes new hippocampal place fields.

Hippocampal pyramidal neurons support episodic memory by integrating complementary information streams into new 'place fields'. Distal tuft dendrites are widely thought to initiate place field formation by locally generating prolonged, globally-spreading spikes known as plateau potentials. However, the hitherto experimental inaccessibility of distal tuft dendrites in the hippocampus has rendered their function entirely unknown.

Diabetes specialist intervention in general practices in areas of deprivation and ethnic diversity: A qualitative evaluation (QUAL-ECLIPSE).

Aim: To assess patients' and healthcare professionals' perspectives of a specialist-led Diabetes Risk-based Assessment Clinic (DIRAC) for people with diabetes at high risk of complications (PWDHRC) in areas of deprivation in Coventry, UK.

Methods: A qualitative evaluation of a pilot trial, comprising a specialist team intervention (DIRAC), was undertaken in seven GP practices through observations of weekly virtual or occasional face-to-face patient consultations and monthly interventionists' meetings. Semi-structured interviews were carried out post-intervention, with PWDHRC, primary care clinicians and diabetes specialists (interventionists).

Clinicoradiological outcomes after radical radiotherapy for lung cancer in patients with interstitial lung disease.

Objective: Interstitial lung disease (ILD) is relatively common in patients with lung cancer with an incidence of 7.5%. Historically pre-existing ILD was a contraindication to radical radiotherapy owing to increased radiation pneumonitis rates, worsened fibrosis and poorer survival compared with non-ILD cohorts.

A pulmonary vein atlas for radiotherapy planning.

Background And Purpose: Cardiac arrhythmia is a recognised potential complication of thoracic radiotherapy, but the responsible cardiac substructures for arrhythmogenesis have not been identified. Arrhythmogenic tissue is commonly located in the pulmonary veins (PVs) of cardiology patients with arrhythmia, however these structures are not currently considered organs-at-risk during radiotherapy planning. A standardised approach to their delineation was developed and evaluated.

Brain insulin signaling suppresses lipolysis in the absence of peripheral insulin receptors and requires the MAPK pathway.

Objectives: Insulin's ability to counterbalance catecholamine-induced lipolysis defines insulin action in adipose tissue. Insulin suppresses lipolysis directly at the level of the adipocyte and indirectly through signaling in the brain. Here, we further characterized the role of brain insulin signaling in regulating lipolysis and defined the intracellular insulin signaling pathway required for brain insulin to suppress lipolysis.

Using the socio-ecological model to appraise perspectives on health workforce retention and intention to leave in Malawi and Tanzania: a qualitative longitudinal study.

Introduction: The chronic health workforce shortage poses a significant setback to achieving universal health coverage. Health authorities continually develop and implement human resources for health policies and interventions to alleviate the crisis, including retention policies. However, the success of such policies and interventions is tangential to the alignment with health workers' expectations.

Pandemic, Epidemic, Endemic: B Cell Repertoire Analysis Reveals Unique Anti-Viral Responses to SARS-CoV-2, Ebola and Respiratory Syncytial Virus.

Immunoglobulin gene heterogeneity reflects the diversity and focus of the humoral immune response towards different infections, enabling inference of B cell development processes. Detailed compositional and lineage analysis of long read IGH repertoire sequencing, combining examples of pandemic, epidemic and endemic viral infections with control and vaccination samples, demonstrates general responses including increased use of in both Zaire Ebolavirus (EBOV) and COVID-19 patient cohorts. We also show unique characteristics absent in Respiratory Syncytial Virus or yellow fever vaccine samples: EBOV survivors show unprecedented high levels of class switching events while COVID-19 repertoires from acute disease appear underdeveloped.

Compartment-specific tuning of dendritic feature selectivity by intracellular Ca release.

Dendritic calcium signaling is central to neural plasticity mechanisms that allow animals to adapt to the environment. Intracellular calcium release (ICR) from the endoplasmic reticulum has long been thought to shape these mechanisms. However, ICR has not been investigated in mammalian neurons in vivo.

Adaptive stimulus selection for consolidation in the hippocampus.

Associative memories guide behavioural adaptation by binding together outcome-predictive sensory stimuli. However, in a feature-rich environment, only a subset of stimuli may predict a desired outcome. How neural circuits enable behavioural adaptation by selectively and durably representing subsets of sensory stimuli that are pertinent to a specific outcome is not known.

Firearm Acoustic Detection in Hartford, Connecticut: Outcomes of a Trauma Center - Law Enforcement Collaboration.

Introduction Firearm homicide is a leading cause of violence-related death in the United States.Unfortunately, more than 80% of illegal firearm discharges are never reported to police by traditional means.ShotSpotter (Newark, California) is an acoustic firearm event detection system that can localize gunfire, prompting police, and subsequent emergency medical services (EMS) presence.

Coincidental splenic irradiation and risk of functional hyposplenism in oesophageal cancer treatment.

Introduction: Definitive chemoradiotherapy (dCRT) and radical radiotherapy are central to the management of distal oesophageal carcinoma. This study sought to establish whether the spleen receives a significant incidental radiation dose when treating distal oesophageal carcinoma with the standardised dCRT or radical radiotherapy doses.

Methods: In this single-centre retrospective study, all patients (n = 34) with distal oesophageal cancer, treated with either dCRT or radical radiotherapy over an 18-month period using a volumetric modulated arc therapy (VMAT) planning technique, were included.

Sodium in the dermis colocates to glycosaminoglycan scaffold, with diminishment in type 2 diabetes mellitus.

Background: Dietary sodium intake mismatches urinary sodium excretion over prolonged periods. Our aims were to localize and quantify electrostatically bound sodium within human skin using triple-quantum-filtered (TQF) protocols for MRI and magnetic resonance spectroscopy (MRS) and to explore dermal sodium in type 2 diabetes mellitus (T2D).

Methods: We recruited adult participants with T2D (n = 9) and euglycemic participants with no history of diabetes mellitus (n = 8).

Factors influencing acceptance of robotics in hospital pharmacy: a longitudinal study using the Extended Technology Acceptance Model.

Objectives: To explore factors influencing hospital pharmacy staff acceptance of a pharmacy robotic dispensing system during implementation and over time.

Methods: A single centred, prospective, longitudinal cohort quantitative study was conducted in an Australian tertiary public hospital using the Extended Technology Acceptance Model (ETAM). Staff were surveyed during the implementation of a pharmacy dispensing robot (May 2016) and again after working with the system for fifteen months (August 2017).

Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent Radiotherapy during the COVID-19 Pandemic.

Patients treated with curative-intent lung radiotherapy are in the group at highest risk of severe complications and death from COVID-19. There is therefore an urgent need to reduce the risks associated with multiple hospital visits and their anti-cancer treatment. One recommendation is to consider alternative dose-fractionation schedules or radiotherapy techniques.

The Use of Immersive and Virtual Reality Technologies to Enable Nursing Students to Experience Scenario-Based, Basic Life Support Training-Exploring the Impact on Confidence and Skills.

The link between effective basic life support and survival following cardiac arrest is well known. Nurses are often first responders at in-hospital cardiac arrests and receive annual basic life support training to ensure they have the adequate skills, and student nurses are taught this in preparation for their clinical practice. However, it is clear that some nurses still lack confidence and skills to perform basic life support in an emergency situation.

Collaborative implementation of stereotactic ablative body radiotherapy: A model for the safe implementation of complex radiotherapy techniques in Australia.

Introduction: Stereotactic ablative radiotherapy (SABR) for lung cancer is a modality of treatment that has improved outcomes for lung cancer patients. However, radiotherapy for lung cancer is underutilized and fewer than half of elderly patients with non-small cell lung cancer (NSCLC) receive active treatment. The purpose of this study is to report on a collaboration in implementing an NSCLC SABR (stereotactic ablative body radiation) program safely, efficiently, and uniformly across several centers, including regional sites.

A Functional Angle of Up to 35° at the Distal Interphalangeal Joint Can Be Achieved with Headless Compression Screw Fusion.

Background: Arthrodesis of the distal interphalangeal (DIP) joint reliably improves symptomatic arthritis. A range of successful surgical techniques including tension band wiring, plate fixation and headless compression screws have been described and produce stable painless unions. For best functional outcome, the fusion angle should be between 10 and 61 degrees.

Recent Insights into Corticostriatal Circuit Mechanisms underlying Habits: Invited review for Current Opinions in Behavioral Sciences.

Habits have been studied for decades, but it was not until recent years that experiments began to elucidate the underlying cellular and circuit mechanisms. The latest experiments have been enabled by advances in cell-type specific monitoring and manipulation of activity in large neuronal populations. Here we will review recent efforts to understand the neural substrates underlying habit formation, focusing on rodent studies on corticostriatal circuits.

Quantitative Evaluation of Head and Neck Cancer Treatment-Related Dysphagia in the Development of a Personalized Treatment Deintensification Paradigm.

Purpose: To test the hypothesis that quantifying swallow function with multiple patient-reported outcome (PRO) instruments is an important strategy to yield insights in the development of personalized deintensified therapies seeking to reduce the risk of head and neck cancer (HNC) treatment-related dysphagia (HNCTD).

Methods And Materials: Irradiated HNC subjects seen in follow-up care (April 2015 to December 2015) who prospectively completed the Sydney Swallow Questionnaire (SSQ) and the MD Anderson Dysphagia Inventory (MDADI) concurrently on the web interface to our Oncospace database were evaluated. A correlation matrix quantified the relationship between the SSQ and MDADI.

Striatal fast-spiking interneurons selectively modulate circuit output and are required for habitual behavior.

Habit formation is a behavioral adaptation that automates routine actions. Habitual behavior correlates with broad reconfigurations of dorsolateral striatal (DLS) circuit properties that increase gain and shift pathway timing. The mechanism(s) for these circuit adaptations are unknown and could be responsible for habitual behavior.