Transitioning to high-sensitivity troponin: 1-year mortality outcomes in patients with suspected acute coronary syndrome presenting to emergency departments.

Background: Switching from a conventional to a high-sensitivity cardiac troponin (hs-cTn) assay enables detection of smaller amounts of myocardial damage, but the clinical benefit is unclear. We investigated whether switching to a hs-cTnI assay with a sex-specific 99th centile diagnostic threshold was associated with lower 1-year death or new myocardial infarction (MI) in patients with suspected acute coronary syndrome (ACS).

Methods: This pre-post study included nine tertiary hospitals in Australia.

A pre and post evaluation of the communication and interaction training programme for professionals in dementia care.

Background: NICE guidelines advocate that healthcare professionals should aim to use non-pharmacological and person-centred approaches as primary strategies to reduce or prevent distress in people living with dementia who reside within care settings. However, despite these recommendations, recent studies have illustrated that there is still a requirement for healthcare professionals to have adequate opportunities to access training programmes and guidance on how to effectively use non-pharmacological approaches in dementia care settings. Communication and Interaction Training (CAIT) was developed to train healthcare professionals in dementia care on how to apply person-centred principles to effectively reduce or negate distress in people living with dementia in a non-invasive manner.

The potential regulation of the miR-17-92a cluster by miR-21.

MicroRNAs (miRNA,miRs) are small noncoding RNAs that are ubiquitously expressed in all mammalian cells. Their primary function is the regulation of nascent RNA transcripts by direct binding to regions on the target. There is now exciting data to suggest that these miRNAs can bind to other miRNAs, and this may have a broader impact on gene regulation in disease states.

Manual Uterine Aspiration Simulation for Emergency Medicine Learners.

Introduction: Manual uterine aspiration is a potentially lifesaving procedure for treating patients with hemorrhagic complications of early pregnancy loss. While early pregnancy loss is a common diagnosis seen in the emergency department, manual uterine aspiration education is lacking for emergency medicine physicians.

Methods: We designed a 90-minute procedural skills training session for 30 emergency medicine learners.

ReNeu: A Pivotal, Phase IIb Trial of Mirdametinib in Adults and Children With Symptomatic Neurofibromatosis Type 1-Associated Plexiform Neurofibroma.

Purpose: Pharmacologic therapies for neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PNs) are limited; currently, none are US Food and Drug Administration-approved for adults.

Methods: ReNeu is an open-label, multicenter, pivotal, phase IIb trial of mirdametinib in 58 adults (≥18 years of age) and 56 children (2 to 17 years of age) with NF1-PN causing significant morbidities. Patients received mirdametinib capsules or tablets for oral suspension (2 mg/m twice daily, maximum 4 mg twice daily), regardless of food intake, in 3 weeks on/1 week off 28-day cycles.

Planned Home Births in the United States Have Outcomes Comparable to Planned Birth Center Births for Low-Risk Birthing Individuals.

Objective: There are lingering concerns in the United States about home birth. We used 2 large (n = 50,043; n = 62,984), national community birth registries to compare maternal and neonatal outcomes for planned home versus planned birth center births.

Methods: To compare outcomes by intended birth site, we used logistic regressions, controlling for demographic and pregnancy risk variables.

In-Person Healthcare Simulation: An Umbrella Review of the Literature.

Given the large accumulation of research focused on the effectiveness of in-person simulation-based education (SBE), this umbrella review-or systematic review of systematic reviews-was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines to analyze collective findings and close identified literature gaps. This study presents a descriptive analysis of the most effective modalities, methods, and measurements of in-person SBE, as well as major themes that emerged during analysis as it relates to SBE outcomes.The major patterns or themes that emerged confirm for the first time a longstanding sentiment in the literature, specifically the following: a need to produce higher-quality research with greater rigor, larger sample sizes, more randomized controlled trials, mixed methods, and longitudinal studies.

An Algorithm for Modeling Thermoplastic Spherulite Growth Using Crystallization Kinetics.

Crystallization kinetics were used to develop a spherulite growth model, which can determine local crystalline distributions through an optimization algorithm. Kinetics were used to simulate spherulite homogeneous nucleation, growth, and heterogeneous nucleation in a domain discretized into voxels. From this, an overall crystallinity was found, and an algorithm was used to find crystallinities of individual spherulites based on volume.

Vasospasm and subsequent stroke from paraneoplastic syndrome in a pediatric patient with an intracranial mature teratoma: a case report.

Teratomas account for 18-20% of all intracranial germ cell tumors and mostly occur in the pineal region with only a few cases of pediatric sellar and suprasellar teratomas described in the literature. Here, we present a case of a child with an intracranial mature teratoma with pancreatic features causing vasospasm and subsequent stroke, found to be positive for CDKN2A-an independent variant associated with malignancy and small vessel disease leading to stroke.

Neonatal morbidity and mortality in birth centers in the United States 2018-2021: An observational study of low-risk birthing individuals.

Background: Many studies reporting neonatal outcomes in birth centers include births with risk factors not acceptable for birth center care using the evidence-based CABC criteria. Accurate comparisons of outcomes by birth setting for low-risk patients are needed.

Methods: Data from the public Natality Detailed File from 2018 to 2021 were used.

The MIDAS touch: Frameworks for procedural model innovation and validation.

Background: Simulation-based procedural practice is crucial to emergency medicine skills training and maintenance. However, many commercial procedural models are either nonexistent or lacking in key elements. Simulationists often create their own novel models with minimal framework for designing, building, and validation.

Suitability of Gelatin Methacrylate and Hydroxyapatite Hydrogels for 3D-Bioprinted Bone Tissue.

Background: Complex bone defects are challenging to treat. Autografting is the gold standard for regenerating bone defects; however, its limitations include donor-site morbidity and increased surgical complexity. Advancements in 3D bioprinting (3DBP) offer a promising alternative for viable bone grafts.

A therapeutically targetable positive feedback loop between lnc-HLX-2-7, HLX, and MYC that promotes group 3 medulloblastoma.

Recent studies suggest that long non-coding RNAs (lncRNAs) contribute to medulloblastoma (MB) formation and progression. We have identified an lncRNA, lnc-HLX-2-7, as a potential therapeutic target in group 3 (G3) MBs. lnc-HLX-2-7 RNA specifically accumulates in the promoter region of HLX, a sense-overlapping gene of lnc-HLX-2-7, which activates HLX expression by recruiting multiple factors, including enhancer elements.

Sex differences in a mouse model of diet-induced obesity: the role of the gut microbiome.

Background: Recent decades have seen an exponential rise in global obesity prevalence, with rates nearly doubling in a span of 40 years. A comprehensive knowledge base regarding the systemic effects of obesity is required to create new preventative and therapeutic agents effective at combating the current obesity epidemic. Previous studies of diet-induced obesity utilizing mouse models have demonstrated a difference in bodyweight gain by sex.

miRNA-211 maintains metabolic homeostasis in medulloblastoma through its target gene long-chain acyl-CoA synthetase 4.

The prognosis of childhood medulloblastoma (MB) is often poor, and it usually requires aggressive therapy that adversely affects quality of life. microRNA-211 (miR-211) was previously identified as an important regulator of cells that descend from neural cells. Since medulloblastomas primarily affect cells with similar ontogeny, we investigated the role and mechanism of miR-211 in MB.

Predicting intratumoral fluid pressure and liposome accumulation using physics informed deep learning.

Liposome-based anticancer agents take advantage of the increased vascular permeability and transvascular pressure gradients for selective accumulation in tumors, a phenomenon known as the enhanced permeability and retention(EPR) effect. The EPR effect has motivated the clinical use of nano-therapeutics, with mixed results on treatment outcome. High interstitial fluid pressure (IFP) has been shown to limit liposome drug delivery to central tumour regions.

Distance simulation in the health professions: a scoping review.

Background: Distance simulation is defined as simulation experiences in which participants and/or facilitators are separated from each other by geographic distance and/or time. The use of distance simulation as an education technique expanded rapidly with the recent COVID-19 pandemic, with a concomitant increase in scholarly work.

Methods: A scoping review was performed to review and characterize the distance simulation literature.

Sex differences in a mouse model of diet-induced obesity: the role of the gut microbiome.

Background: Recent decades have seen an exponential rise in global obesity prevalence, with rates nearly doubling in a span of forty years. A comprehensive knowledge base regarding the systemic effects of obesity is required to create new preventative and therapeutic agents effective at combating the current obesity epidemic. Previous studies of diet-induced obesity utilizing mouse models have demonstrated a difference in bodyweight gain by sex.

Race, ethnicity, and indications for primary cesarean birth: Associations within a national birth center registry.

Background: Racial and ethnic disparities in cesarean rates in the United States are well documented. This study investigated whether cesarean inequities persist in midwife-led birth center care, including for individuals with the lowest medical risk.

Methods: National registry records of 174,230 childbearing people enrolled in care in 115 midwifery-led birth center practices between 2007 and 2022 were analyzed for primary cesarean rates and indications by race and ethnicity.

A Nationwide Study of Emergency Nurses' Triage Decisions for Potential Acute Coronary Syndrome.

Introduction: This study aimed to identify the symptoms used to assess angina, determine how emergency nurses make triage decisions for potential acute coronary syndrome, and determine emergency nurses' initial actions.

Methods: This was a cross-sectional, survey-based design. Emergency nurses were recruited through a posting on the Emergency Nurses Association website and through postcards.

Dental extractions do not predict further use of dental general anesthesia in people with disabilities: A longitudinal analysis.

Objectives: This paper describes treatments completed under dental general anesthesia (DGA) for a cohort of adults with disabilities. This patient cohort was followed up a number of years later to determine outcomes and identify factors that predict further use of DGA.

Methods: A retrospective patient record review and cross-sectional survey was carried out on a convenience sample of 64 patients who had previously received dental treatment under general anesthesia.