The Prominent Subarachnoid Space in Children: How has a Normal Variant Become Medicolegally Life-Threatening Pathology?

A prominent subarachnoid space (SAS) in infants under 24 months is a very common finding and is a normal variant that can be associated with macrocephaly. This must be differentiated from various pathological conditions that also cause a prominent SAS, including a reduction in brain volume, obstruction to the cerebrospinal fluid (CSF) or malformations of the skull. The inappropriate labelling of normal SAS prominence as enlargement due to pathology and misrepresentation of published literature by some author groups has created confusion medicolegally, contributing to inappropriate conclusions that a normal prominent SAS may cause subdural haemorrhage (SDH) and brain injury.

The rising use of cognitive enhancement drugs and predictors of use during COVID-19: findings from a cross-sectional survey of students and university staff in the UK.

Background: The use of psychoactive substances to increase cognitive performance while studying has been termed 'pharmacological cognitive enhancement' (PCE). In previous years, several large-scale national surveys have focused on their use by students at university, including drug types, prevalence rates, and predictive factors. The recent coronavirus pandemic brought about widespread structural changes for UK universities, as students were forced to adapt to home-based learning and in many cases reduced academic support.

Forensic mental health: envisioning a more empirical future.

Forensic mental health services provide crucial interventions for society. Such services provide care for people with mental disorders who commit violent and other serious crimes, and they have a key role in the protection of the public. To achieve these goals, these services are necessarily expensive, but they have been criticised for a high-cost, low-volume approach, for lacking consistent standards of care, and for neglecting human rights and other ethical considerations.

Quantitative Measurement Technique for Anodic Corrosion of BDD Advanced Oxidation Electrodes.

Electrochemical advanced oxidation (EAO) systems are of significant interest due to their ability to treat a wide range of organic contaminants in water. Boron doped diamond (BDD) electrodes have found considerable use in EAO. Despite their popularity, no laboratory scale method exists to quantify anodic corrosion of BDD electrodes under EAO conditions; all are qualitative using techniques such as scanning electron microscopy, electrochemistry, and spectroscopy.

Association of amisulpride and recovery room length of stay among patients with postoperative nausea and vomiting following outpatient surgery.

Study Objective: Postoperative nausea and vomiting (PONV) is a common sequela of surgery in patients undergoing general anesthesia. Amisulpride has shown promise in its ability to treat PONV. The objective of this study was to determine if amisulpride is associated with significant changes in PACU efficiency within a fast-paced ambulatory surgery center.

Design and Pilot Study of a High-Fidelity Medical Simulation of a Hospital-Wide Cybersecurity Attack.

Background: Cybersecurity incidents affecting hospitals have grown in prevalence and consequence over the last two decades, increasing the importance of cybersecurity preparedness and response training to minimize clinical disruptions. This work describes the development, execution, and post-exercise assessment of a novel simulation scenario consisting of four interlocking intensive care unit (ICU) patient scenarios. This simulation was designed to demonstrate the management of acute pathologies without access to conventional treatment methods during a cybersecurity incident in order to raise clinician awareness of the increasing incidence and patient safety implications of such events.

Constructing synthetic datasets with generative artificial intelligence to train large language models to classify acute renal failure from clinical notes.

Objectives: To compare performances of a classifier that leverages language models when trained on synthetic versus authentic clinical notes.

Materials And Methods: A classifier using language models was developed to identify acute renal failure. Four types of training data were compared: (1) notes from MIMIC-III; and (2, 3, and 4) synthetic notes generated by ChatGPT of varied text lengths of 15 (GPT-15 sentences), 30 (GPT-30 sentences), and 45 (GPT-45 sentences) sentences, respectively.

Ransomware Cyberattack Associated With Cardiac Arrest Incidence and Outcomes at Untargeted, Adjacent Hospitals.

Objectives: Healthcare ransomware cyberattacks have been associated with major regional hospital disruptions, but data reporting patient-oriented outcomes in critical conditions such as cardiac arrest (CA) are limited. This study examined the CA incidence and outcomes of untargeted hospitals adjacent to a ransomware-infected healthcare delivery organization (HDO).

Design Setting And Patients: This cohort study compared the CA incidence and outcomes of two untargeted academic hospitals adjacent to an HDO under a ransomware cyberattack during the pre-attack (April 3-30, 2021), attack (May 1-28, 2021), and post-attack (May 29, 2021-June 25, 2021) phases.

Two-state model of energy dissipation at metal surfaces.

The rates and pathways of chemical reactions at metal surfaces can be strongly influenced by energy dissipation due to the nonadiabatic excitation of metallic conduction electrons. The introduction of frictional forces to account for this dissipation has been quite successful in situations for which the nonadiabatic coupling is weak. However, in cases where nonadiabatic coupling is strong, such as when electron transfer occurs, the friction model is likely to break down.

Arsenic, cadmium, lead, antimony bioaccessibility and relative bioavailability in legacy gold mining waste.

Bioaccessibility and relative bioavailability of As, Cd, Pb and Sb was investigated in 30 legacy gold mining wastes (calcine sands, grey battery sands, tailings) from Victorian goldfields (Australia). Pseudo-total As concentration in 29 samples was 1.45-148-fold higher than the residential soil guidance value (100 mg/kg) while Cd and Pb concentrations in calcine sands were up to 2.

An evaluation of properly operated NSF/ANSI-53 Pb certified drinking water filters in Benton Harbor, MI.

Communities across the United States and particularly in the Midwest continue to grapple with the complications associated with aging infrastructure. This includes the presence of lead (Pb)-bearing plumbing components such as lead service lines, downstream galvanized iron pipes, and Pb/tin solder. The community of Benton Harbor, MI, experienced six Pb action level exceedances between 2018 and 2021, leading to increasing community concern and a request from the state of Michigan for the US Environmental Protection Agency involvement.

Impaired striatal glutamate/GABA regulation in violent offenders with antisocial personality disorder and psychopathy.

Men with antisocial personality disorder (ASPD) with or without psychopathy (+/-P) are responsible for most violent crime in society. Development of effective treatments is hindered by poor understanding of the neurochemical underpinnings of the condition. Men with ASPD with and without psychopathy demonstrate impulsive decision-making, associated with striatal abnormalities in functional neuroimaging studies.

Topical Calcineurin Inhibitors in the Management of Chronic Pruritus in Older Adults: A Research Letter.

In this study, we aimed to analyze the literature to date on the utilization of topical calcineurin inhibitors in the management of pruritus among older adults, ages 65 and older. The 16 studies included in the final analysis demonstrated that topical calcineurin inhibitors are well tolerated across ages and are effective in treating a wide variety of chronic pruritic conditions. Collectively, these findings support that topical calcineurin inhibitors should be considered a safe, plausible option for managing age-associated itch.

Neural correlates of aggression in personality disorders from the perspective of DSM-5 maladaptive traits: a systematic review.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD) focusing on a maladaptive trait model utilized to diagnose several personality disorders. Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are two conditions categorized by AMPD that exhibit high rates of violence and aggression. Several of the traits outlined in the AMPD, including hostility, impulsivity, risk-taking, and callousness, have been previously linked to aggression in BPD and ASPD.

Knowledge and attitudes about conduct disorder of professionals working with young people: The influence of occupation and direct and indirect experience.

Background: Knowledge and attitudes of professionals both pose a potential barrier to diagnosis and treatment of mental disorders. However, knowledge and attitudes about conduct disorder in professionals working with young people are poorly understood. Little is known about the impact of occupation, direct and indirect (training and education) experience, or the interrelationship between knowledge and attitudes.

Delays in transferring patients from prisons to secure psychiatric hospitals: An international systematic review.

Background: Transfer to a psychiatric hospital of prisoners who need inpatient treatment for a mental disorder is an important part of prison healthcare in the UK. It is an essential factor in ensuring the principle of equivalence in the treatment of prisoners. In England and Wales, delays in transferring unwell prisoners to hospital were identified by the 2009 Bradley Report.

High levels of pesticides found in illicit cannabis inflorescence compared to licensed samples in Canadian study using expanded 327 pesticides multiresidue method.

Background: As Cannabis was legalised in Canada for recreational use in 2018 with the implementation of the Cannabis Act, Regulations were put in place to ensure safety and consistency across the cannabis industry. This includes the requirement for licence holders to demonstrate that no unauthorized pesticides are used to treat cannabis or have contaminated it. In this study, we describe an expanded 327 multi-residue pesticide analysis in cannabis inflorescence to confirm if the implementation of the Cannabis Act is providing safer licensed products to Canadians in comparison to those of the illicit market.

Reviewing performance of NSF/ANSI 53 certified water filters for lead removal.

Properly certified NSF/ANSI 53 water filters are distributed as a temporary measure to protect residents from risk of exposure to elevated lead (Pb) levels resulting from water system changes and various activities. Water consumers and other stakeholders have raised questions on the performance of these filters in field settings, particularly in cases where water Pb levels exceeded the NSF/ANSI 53 challenge water level of 150 µg/L and when Pb phosphate nanoparticles (≤ 200 nm) were present in drinking water. This literature review summarizes findings from 23 studies that evaluated the ability of NSF/ANSI 53 post-2007 certified filters to reduce soluble and/or particulate Pb from water.

Machine Learning Prediction Models to Reduce Length of Stay at Ambulatory Surgery Centers Through Case Resequencing.

The post-anesthesia care unit (PACU) length of stay is an important perioperative efficiency metric. The aim of this study was to develop machine learning models to predict ambulatory surgery patients at risk for prolonged PACU length of stay - using only pre-operatively identified factors - and then to simulate the effectiveness in reducing the need for after-hours PACU staffing. Several machine learning classifier models were built to predict prolonged PACU length of stay (defined as PACU stay ≥ 3 hours) on a training set.

Legal and human rights issues in the use of electronic monitoring (using GPS 'tracking' technology) in forensic mental health settings in the UK.

Electronic monitoring (EM) of individuals has been used by the criminal justice system for the past thirty years, and in the UK, use is on the increase. Its use has been justified as an alternative to prison to reduce recidivism and allowing early release of prisoners, however, the evidence base for this remains mixed. In 2010, it was employed for the first time in a forensic psychiatry setting.

Ransomware Attack Associated With Disruptions at Adjacent Emergency Departments in the US.

Importance: Cyberattacks on health care delivery organizations are increasing in frequency and sophistication. Ransomware infections have been associated with significant operational disruption, but data describing regional associations of these cyberattacks with neighboring hospitals have not been previously reported, to our knowledge.

Objective: To examine an institution's emergency department (ED) patient volume and stroke care metrics during a month-long ransomware attack on a geographically proximal but separate health care delivery organization.

Patient and Parent Well-Being and Satisfaction With Diabetes Care During a Comparative Trial of Mobile Self-Monitoring Blood Glucose Technology and Family-Centered Goal Setting.

Patient engagement in the process of developing a diabetes treatment plan is associated with person-centered care and improved treatment outcomes. The objective of the present study was to evaluate the self-reported patient and parent-centered satisfaction and well-being outcomes associated with the three treatment strategies utilized in a comparative effectiveness trial of technology-enhanced blood glucose monitoring and family-centered goal setting. We evaluated data from 97 adolescent-parent pairs at baseline and 6-months during the randomized intervention.

Sodium in the skin: a summary of the physiology and a scoping review of disease associations.

A large and growing body of research suggests that the skin plays an important role in regulating total body sodium, challenging traditional models of sodium homeostasis that focused exclusively on blood pressure and the kidney. In addition, skin sodium may help to prevent water loss and facilitate macrophage-driven antimicrobial host defence, but may also trigger immune dysregulation via upregulation of proinflammatory markers and downregulation of anti-inflammatory processes. We performed a systematic search of PubMed for published literature on skin sodium and disease outcomes and found that skin sodium concentration is increased in patients with cardiometabolic conditions including hypertension, diabetes and end-stage renal disease; autoimmune conditions including multiple sclerosis and systemic sclerosis; and dermatological conditions including atopic dermatitis, psoriasis and lipoedema.