Pipe Distribution as a Harm Reduction Service for People Who Use Methamphetamine.

Background: Methamphetamine use is disproportionately high in rural settings, with rates increasing during the COVID-19 pandemic. While syringe service programs reduce disease transmission among people who inject drugs, limited research exists around the value of smoking equipment, specifically pipes, in minimizing harms associated with rural methamphetamine use.

Methods: We conducted semi-structured interviews with people who use methamphetamine in rural southern Illinois.

I Don't Believe a Person Has to Die When Trying to Get High: Overdose Prevention and Response Strategies in Rural Illinois.

Background: Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths.

Methods: Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service providers) from rural southern Illinois.

How the rural risk environment underpins hepatitis C risk: Qualitative findings from rural southern Illinois, United States.

Background: Hepatitis C virus (HCV) infection has increased among persons who inject drugs (PWID) in the United States with disproportionate burden in rural areas. We use the Risk Environment framework to explore potential economic, physical, social, and political determinants of hepatitis C in rural southern Illinois.

Methods: Nineteen in-depth semi-structured interviews were conducted with PWID from August 2019 through February 2020 (i.

Structural and community changes during COVID-19 and their effects on overdose precursors among rural people who use drugs: a mixed-methods analysis.

Background: Drug overdose rates in the United States have been steadily increasing, particularly in rural areas. The COVID-19 pandemic and associated mitigation strategies may have increased overdose risk for people who use drugs by impacting social, community, and structural factors.

Methods: The study included a quantitative survey focused on COVID-19 administered to 50 people who use drugs and semi-structured qualitative interviews with 17 people who use drugs, 12 of whom also participated in the quantitative survey.

The Impact of the COVID-19 Pandemic on Drug Use Behaviors, Fentanyl Exposure, and Harm Reduction Service Support among People Who Use Drugs in Rural Settings.

Background: The COVID-19 pandemic has worsened the opioid overdose crisis in the US. Rural communities have been disproportionately affected by opioid use and people who use drugs in these settings may be acutely vulnerable to pandemic-related disruptions due to high rates of poverty, social isolation, and pervasive resource limitations.

Methods: We performed a mixed-methods study to assess the impact of the pandemic in a convenience sample of people who use drugs in rural Illinois.

Interruption of the Ascending Aorta-Biventricular Surgical Repair.

Interruption of the ascending aorta is an extremely rare anomaly defined by a point of interruption between the intrapericardial and extrapericardial aorta and can be explained by developmental errors proximal to the embryologic right aortic sac. Herein, we present a case of interruption of the ascending aorta and describe a successful biventricular surgical repair of this unique anomaly.

Interdisciplinary care of children with trisomy 13 and 18.

Children with trisomy 13 and 18 (previously deemed "incompatible with life") are living longer, warranting a comprehensive overview of their unique comorbidities and complex care needs. This Review Article provides a summation of the recent literature, informed by the study team's Interdisciplinary Trisomy Translational Program consisting of representatives from: cardiology, cardiothoracic surgery, neonatology, otolaryngology, intensive care, neurology, social work, chaplaincy, nursing, and palliative care. Medical interventions are discussed in the context of decisional-paradigms and whole-family considerations.

Increased Hepatic Stiffness in Young Adults After Biventricular Repair of Congenital Heart Disease.

Background: This study evaluated hepatic stiffness by shear wave elastography to investigate subclinical hepatic changes in a cohort of patients with congenital biventricular heart disease (BHD).

Methods: The BHD patients and age-matched healthy controls were prospectively recruited for hepatic ultrasonography and shear wave elastography. Real-time B-mode imaging with Doppler was performed for celiac axis, superior mesenteric artery, and main portal vein, and hepatic shear wave elastography was assessed.

Rhenium and technetium complexes of thioamide derivatives of pyridylhydrazine that bind to amyloid-β plaques.

Age-associated deposition of amyloid-β in cerebral blood vessels, a condition referred to as cerebral amyloid angiopathy, can contribute to stroke and dementia. This research aimed to design new radioactive technetium-99 m complexes that bind to amyloid-β plaques that have the potential to assist in diagnosis of cerebral amyloid angiopathy using single-photon-emitted computed tomography (SPECT) imaging. Six new pyridylthiosemicarbazide ligands containing either benzofuran or styrylpyridyl functional groups that are known to selectively bind to amyloid plaques were prepared.

Introducing a competency based Fellowship programme for psychiatry in Australia and New Zealand.

Objectives: The aim of this paper is to summarise the new psychiatry Fellowship programme and its rationale, highlighting the new inclusions, revised assessment structure, the benefits and structure of the programme.

Conclusions: The 2012 Fellowship programme is based on the CanMEDs educational framework. The Royal Australian and New Zealand College of Psychiatrists (RANZCP) underwent a comprehensive process, adapting the CanMEDs competencies to a psychiatric framework and mapping the curriculum to Fellowship competencies, learning outcomes and developmental descriptors of the various stages of training.

Trajectory to Fellowship: further examination of the road to becoming a psychiatrist.

Objectives: In 2003 a revised RANZCP training program was implemented. This involved a revised training structure with Basic (years 1-3) and Advanced (years 4-5) requirements. All summative assessments occur during Basic Training and generalist or sub-specialty streams are available in Advanced Training.

Reflections on training in psychiatry.

Objective: There is limited information as to whether graduates from postgraduate specialist medical training programmes in Australia and New Zealand feel prepared for practice, and none regarding the Royal Australian and New Zealand College of Psychiatrists' (RANZCP) training programme. The aims of this study were: to assess the effectiveness of the RANZCP training programme in producing psychiatrists who feel prepared for their roles; and to obtain Fellowship applicants' perceptions of the training programme.

Methods: Applicants for Fellowship (i.

Increased hepatic stiffness as consequence of high hepatic afterload in the Fontan circulation: a vascular Doppler and elastography study.

Unlabelled: Hepatic dysfunction is a recognized complication after Fontan palliation of congenital heart disease. We sought to quantitatively measure hepatic stiffness and vascular Doppler indices using ultrasound (US) and shear wave elastography (SWE) in a Fontan cohort. Subjects were prospectively recruited for echocardiography and real-time hepatic duplex US with SWE for hepatic stiffness (kPa).

Outcomes of congenital diaphragmatic hernia in the modern era of management.

Objective: To identify clinical factors associated with pulmonary hypertension (PH) and mortality in patients with congenital diaphragmatic hernia (CDH).

Study Design: A prospective cohort of neonates with a diaphragm defect identified at 1 of 7 collaborating medical centers was studied. Echocardiograms were performed at 1 month and 3 months of age and analyzed at a central core by 2 cardiologists independently.

Trajectory to fellowship: an analysis of the current pathway to becoming a psychiatrist.

Objective: This study sought to examine the pathway and barriers to attaining The Royal Australian and New Zealand College of Psychiatrists'(RANZCP) Fellowship for those undergoing the current training program, which was implemented in November 2003. This program involved a new training structure, with basic (years 1-3) and advanced (years 4-5) requirements. All formal assessments occur during Basic Training, while either generalist or sub-specialty streams are available during Advanced Training.

Patent ductus arteriosus closure using the Amplatzer® vascular plug II for all anatomic variants.

Objectives: To evaluate the safety and efficacy of the Amplatzer® Vascular Plug II (AVPII) for closure of the patent ductus arteriosus (PDA).

Background: The PDA has significant anatomic variation. No device has proven applicable to all PDAs.

Safety of cardiac magnetic resonance and contrast angiography for neonates and small infants: a 10-year single-institution experience.

Background: With increasing applications of cardiac magnetic resonance (CMR) and magnetic resonance angiography (MRA) for evaluation of congenital heart disease (CHD), safety of this technology in the very young is of particular interest.

Objective: We report our 10-year experience with CMR in neonates and small infants with particular focus on the safety profile and incidence of adverse events (AEs).

Materials And Methods: We reviewed clinical, anesthesia and nursing records of all children ≤120 days of age who underwent CMR.

Reduced global longitudinal and radial strain with normal left ventricular ejection fraction late after effective repair of aortic coarctation: a CMR feature tracking study.

We sought to determine whether global and regional left ventricular (LV) strain parameters were altered in repaired coarctation of the aorta (COA) with normal LV ejection fraction (EF) when compared with healthy adult controls, and whether such alterations were related to LV hypertrophy (LVH). We identified 81 patients after COA repair (31 female, age 25 ± 8.5 years) with inclusion criteria at follow-up CMR of: age ≥13 years, time post-repair ≥10 years, no aortic valve disease, LV-EF >50%).

Ultrasound contrast and real-time perfusion in conjunction with supine bicycle stress echocardiography for comprehensive evaluation of surgically corrected congenital heart disease.

Aims: We sought to evaluate the efficacy of ultrasound contrast (UC) and low mechanical index real-time perfusion (RTP) in the haemodynamic and anatomic assessment of repaired congenital heart disease (CHD) at rest and during supine bicycle stress echocardiography (BSE).

Methods And Results: Patients with CHD (n = 51, median age 21.5 years) were prospectively studied.

Sonothrombolysis of intra-catheter aged venous thrombi using microbubble enhancement and guided three-dimensional ultrasound pulses.

Background: Central venous and arterial catheters are a major source of thromboembolic disease in children. The investigators hypothesized that guided high-mechanical index (MI) impulses from diagnostic three-dimensional (3D) ultrasound during an intravenous microbubble infusion could dissolve these thrombi.

Methods: An in vitro system simulating intracatheter thrombi was created and then treated with guided high-MI impulses from 3D ultrasound, using low-MI microbubble sensitive imaging pulse sequence schemes to detect the microbubbles.

Is combined atrial volumetrics by two-dimensional echocardiography a suitable measure for quantitative assessment of the hemodynamic significance of patent ductus arteriosus in neonates and infants?

Background: Patent ductus arteriosus (PDA) is a common cardiac problem in neonates and infants, but determination of its hemodynamic significance can be challenging. We hypothesized that combined left (LA) and right atrial (RA) volumes physiologically best reflect hemodynamically significant patent ductus arteriosus (HSPDA), and utilized two-dimensional echocardiography (2DE) derived atrial volumes to test this hypothesis.

Methods: 2DE examinations with good-quality images in 138 neonates <3 months corrected gestational age with PDA, and 50 normal neonates without PDA were selected.