Stroke incidence in heart failure and atrial fibrillation: population cohort study.

Background: Heart failure (HF) is a risk factor for stroke among people with atrial fibrillation (AF). Prognosis following a HF diagnosis is often poor, but this is not accounted for in existing stroke risk scores.

Aim: To examine stroke incidence in people with HF and AF compared to AF alone, considering the competing risk of death.

Morbid obesity: Optimizing neuraxial analgesia and cesarean delivery outcomes.

The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.

Real-World Use and Outcomes of Hard-To-Heal Wounds Managed With Porcine Placental Extracellular Matrix.

Real-world data are a highly valuable resource in determining the efficacy of novel products in challenging populations, especially in wound care. This study retrospectively analyzed the real-world performance of porcine placental extracellular matrix (PPECM; InnovaMatrix® AC, Convatec Triad Life Sciences, LLC, Memphis, TN, USA), a novel cellular, acellular, and matrix-like product for the management of hard-to-heal wounds. The US Wound Registry (USWR), which comprises aggregated and structured electronic health records from 502 wound practices, provided a deidentified dataset collected from October 10, 2022 to March 25, 2024, containing 76,278 patients (248,278 wounds).

Structural determinants of inverted Alu-mediated backsplicing revealed by -MaP and -JuMP.

Biogenesis of circular RNA usually involves a backsplicing reaction where the downstream donor site is ligated to the upstream acceptor site by the spliceosome. For this reaction to occur, it is hypothesized that these sites must be in proximity. Inverted repeat sequences, such as Alu elements, in the upstream and downstream introns are predicted to base-pair and represent one mechanism for inducing proximity.

Team Time as a wellbeing intervention for NHS staff: a qualitative evaluation of implementation during the COVID-19 pandemic.

Background: Support for NHS staff was vital during the COVID-19 pandemic and Team Time was developed as an adaptation of Schwartz Rounds™ - a well-evidenced, facilitated group intervention. Building on the existing evidence base for Schwartz Rounds implementation, this study aims to understand the key factors associated with Team Time implementation and sustainability in this context.

Methods: Twenty semi-structured interviews were conducted within 10 NHS acute, community and mental health organisations that ran Team Time during the pandemic: six with no prior experience of Schwartz Rounds and four that ran Schwartz Rounds prior to the pandemic.

Burnout and retention of general practice supervisors: Prevalence, risk factors and self-care.

Background And Objectives: Burnout is common in primary care doctors. The aim of this study was to explore burnout, self-care and retention in general practice supervision in Australia.

Method: The sample comprised 267 general practice supervisors from all Australian states and territories.

An outbreak of dengue virus type 3 on Mer Island in the Torres Strait, Australia in 2024.

In early 2024, there were eight confirmed cases of locally acquired dengue on Mer Island in the Torres Strait. This dengue outbreak prompted an in-community public health response which included active case finding, health promotion and vector control. This was the first detected dengue outbreak in the Torres Strait since 2017.

The Contribution of Free Sugars to Energy Intake in Mid to Late Childhood: Comparisons Between Nutrient and Food Group Intakes and Antecedents of Diets High and Low in Free Sugars.

High intakes of free sugars may have negative effects on health perhaps associated with their effect on nutrient and food group intakes. The primary aim of the study was to compare nutrient and food group intakes between children with habitual high or low intakes of free sugars to identify which foods could be targeted to improve the diets of children consuming excess free sugars. The secondary aim was to assess antecedents for a child being in the high free sugars group compared with the low to identify the age at which an intervention would be most effective.

Chromogenic Photonic Crystal Detectors for Monitoring Small Molecule Diffusion at Solid-Solid Interfaces Using Stimuli-Responsive Shape Memory Polymers.

In situ monitoring of small molecule diffusion at solid-solid interfaces is challenging, even with sophisticated equipment. Here, novel chromogenic photonic crystal detectors enabled by integrating bioinspired structural color with stimuli-responsive shape memory polymer (SMP) for detecting trace amounts of small molecule interfacial diffusion are reported. Colorless macroporous SMP membranes with deformed macropores can recover back to the "memorized" photonic crystal microstructures and the corresponding iridescent structural colors when triggered by diffused small molecules.

Assessing multidimensional fidelity in a pilot optimization trial: A process evaluation of four intervention components supporting medication adherence in women with breast cancer.

Adherence to adjuvant endocrine therapy in women with breast cancer is low. We conducted a 24-1 fractional factorial pilot optimization trial to test four intervention components supporting medication adherence [text messages, information leaflet, acceptance and commitment therapy (ACT), self-management website], in the preparation phase of the multiphase optimization strategy. Guided by the National Institute of Health Behavior Change Consortium fidelity framework, we investigated fidelity of design, training, delivery, receipt, and enactment of four intervention components.

Improvement of variant reclassification in genetic neurodevelopmental conditions.

Purpose: Limited knowledge about disease mechanisms, few published cases, and the lack of functional assessment of variants for neurodevelopmental genetic disorders challenge diagnostic classification for variants and increase the frequency of variants of uncertain significance (VUS). Because inheritance patterns aid in variant interpretation for neurodevelopmental conditions, genetic testing including only the proband leads to larger numbers of VUS than testing strategies that include the parents.

Methods: We reinterpreted genetic variants submitted to the Simons Searchlight research registry using American College of Medical Genetics and Genomics variant interpretation guidelines, familial cascade testing, and literature curation with annual VUS reevaluation.

Brief imagery based metacognitive intervention for flashforwards in psychosis: a fixed baseline case series.

Background: Distressing mental images are common in people with psychosis. The central role of metacognitive difficulties in psychosis suggests that metacognitive interventions with imagery properties could play a central role in managing distressing mental imagery. A brief imagery-based metacognitive intervention was developed to target the control mechanism of distressing mental images in psychosis.

Early Mobility After Cardiac Surgery: A Quality Improvement Project.

Background: Coronary artery bypass graft surgery is one of the most common cardiac procedures performed worldwide. The longer these patients remain in bed, the greater their risk of postoperative complications and prolonged length of stay.

Local Problem: At the authors' institution, the average length of stay after coronary artery bypass graft surgery was 7.

Taxonomy-based prompt engineering to generate synthetic drug-related patient portal messages.

Objective: The objectives of this study were to: (1) create a corpus of synthetic drug-related patient portal messages to address the current lack of publicly available datasets for model development, (2) assess differences in language used and linguistics among the synthetic patient portal messages, and (3) assess the accuracy of patient-reported drug side effects for different racial groups.

Methods: We leveraged a taxonomy for patient- and clinician-generated content to guide prompt engineering for synthetic drug-related patient portal messages. We generated two groups of messages: the first group (200 messages) used a subset of the taxonomy relevant to a broad range of drug-related messages and the second group (250 messages) used a subset of the taxonomy relevant to a narrow range of messages focused on side effects.

Neuropsychological Outcomes in 6-Year-Old Children of Women With Epilepsy: A Prospective Nonrandomized Clinical Trial.

Importance: Antiseizure medications (ASMs) are potential teratogens commonly prescribed for multiple indications. ASM fetal exposure can impair neurodevelopment. Folate improves pregnancy outcomes, but higher doses may pose risks.

Error Traps in Developing a Pediatric Enhanced Recovery After Surgery (ERAS) Program.

Enhanced recovery after surgery (ERAS) pathways have been shown to improve patient outcomes, increase patient satisfaction, and decrease costs. First created and implemented in the adult population, these pathways are now commonplace and continue to expand in the pediatric realm. While there are many proven benefits to ERAS pathways, there continue to be challenges to their proper implementation and long-term success.

Characterizing patient portal use of people with cognitive impairment and potentially inappropriate medications.

Background: People with cognitive impairment commonly use central nervous system-active potentially inappropriate medications (CNS-PIM), increasing risk of adverse outcomes. Patient portals may be a promising tool for facilitating medication-related conversations. Little is known about portal use by this population related to medications.

Oxygen control in cell culture - Your cells may not be experiencing what you think!

Oxygen (O)-controlled cell culture has been pivotal in studying mammalian mechanisms of O sensing, regulation, and utilization. We posit, however, that O-controlled cell culture is paradoxically not controlling O. There is overwhelming evidence that the pericellular O is lower than the surrounding gas phase due to cellular O consumption.

Limosilactobacillus reuteri ameliorates maternal separation stress in newborn mice and alters subsequent adult behaviour.

Maternal separation (MS) in mice results in behavioral deficits and gut microbiota dysbiosis that all persist into adulthood. Limosilactobacillus reuteri DSM 17938 modulates gut microbiota, alters systemic metabolites, and facilitates immune regulation. To assess the effect of DSM 17938 on biochemical and behavioural stress-associated changes, newborn mice were exposed to unpredictable MS (MSU) daily from day 7 to day 20 of life, with intragastric administration of DSM 17938 or PBS as control.

Solid tumor immunotherapy using NKG2D-based adaptor CAR T cells.

NKG2D ligands (NKG2DLs) are broadly expressed in cancer. To target these, we describe an adaptor chimeric antigen receptor (CAR) termed NKG2D/Dap10-12. Herein, T cells are engineered to co-express NKG2D with a fusion protein that comprises Dap10 joined to a Dap12 endodomain.