Healthy at Home for COPD: An Integrated Digital Monitoring, Treatment, and Pulmonary Rehabilitation Intervention.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs.

Objective: Demonstrate the feasibility of a multimodal, digitally enhanced remote monitoring, treatment, and tele-pulmonary rehabilitation intervention among patients with COPD.

Clinical and public safety risks associated with cannabis legalization and frequency of cannabis use among forensic mental health patients.

Background: There are ongoing concerns regarding the impact of Canada's cannabis legalization and commercialization on vulnerable persons such as those with serious forms of mental illness, including persons with schizophrenia-spectrum disorders and users of forensic mental health services. The primary objective of this study was to investigate the potential harms and mental health-related impacts associated with cannabis legalization on a sample of forensic patients in Ontario (N = 187).

Methods: Using a pseudo-prospective design, we investigated the frequency of cannabis use over a four-year period encompassing two years preceding and two years following the legislative change.

Diagnostic and Prognostic Markers for Pancreatitis and Pancreatic Ductal Adenocarcinoma.

Diagnostic markers are desperately needed for the early detection of pancreatic ductal adenocarcinoma (PDA). We describe sets of markers expressed in temporal order in mouse models during pancreatitis, PDA initiation and progression. Cell type specificity and the differential expression of PDA markers were identified by screening single cell (sc) RNAseq from tumor samples of a mouse model for PDA (KIC) at early and late stages of PDA progression compared to that of a normal pancreas.

Understanding barriers to well-child visit attendance among racial and ethnic minority parents.

Objectives: To assess racial and ethnic minority parents' perceptions about barriers to well-child visit attendance.

Methods: For this cross-sectional qualitative study, we recruited parents of pediatric primary care patients who were overdue for a well-child visit from the largest safety net healthcare organization in central Massachusetts to participate in semi-structured interviews. The interviews focused on understanding potential knowledge, structural, and experiential barriers for well-child visit attendance.

Rationale and Design of Healthy at Home for COPD: an Integrated Remote Patient Monitoring and Virtual Pulmonary Rehabilitation Pilot Study.

Chronic Obstructive Pulmonary Disease (COPD) is a common, costly, and morbid condition. Pulmonary rehabilitation, close monitoring, and early intervention during acute exacerbations of symptoms represent a comprehensive approach to improve outcomes, but the optimal means of delivering these services is uncertain. Logistical, financial, and social barriers to providing healthcare through face-to-face encounters, paired with recent developments in technology, have stimulated interest in exploring alternative models of care.

Contributors to Physician Burnout and Well-Being in Forensic Psychiatrists in Canada.

The experience of burnout in forensic psychiatrists has not been well studied, with most studies focusing on the experiences of forensic nurses, the impact of vicarious trauma and compassion fatigue in forensic mental health professionals, and the risk of posttraumatic stress disorder related to workplace exposures. This study reports on a national survey (34% response rate) conducted with forensic psychiatrists across Canada to understand the rate of, and contributors to, burnout and professional fulfillment. Just over half of the physician respondents reported experiencing burnout, which is in line with other recent surveys in Canada that have indicated elevated levels of burnout since the onset of the pandemic.

Key transcriptional effectors of the pancreatic acinar phenotype and oncogenic transformation.

Proper maintenance of mature cellular phenotypes is essential for stable physiology, suppression of disease states, and resistance to oncogenic transformation. We describe the transcriptional regulatory roles of four key DNA-binding transcription factors (Ptf1a, Nr5a2, Foxa2 and Gata4) that sit at the top of a regulatory hierarchy controlling all aspects of a highly differentiated cell-type-the mature pancreatic acinar cell (PAC). Selective inactivation of Ptf1a, Nr5a2, Foxa2 and Gata4 individually in mouse adult PACs rapidly altered the transcriptome and differentiation status of PACs.

A Comprehensive Framework to Advance Equity, Diversity, and Inclusion in a Forensic Service.

Minority and Indigenous populations have disproportionate representation within forensic mental health services. Social determinants of health and systemic discrimination have contributed to the difficulties these populations have in accessing care, as well as significant differences in care trajectories. In addition, staffing and structural equity, diversity, and inclusion (EDI) challenges permeate forensic systems as in other health care settings.

HTLV-1 Hbz protein, but not hbz mRNA secondary structure, is critical for viral persistence and disease development.

Human T-cell leukemia virus type 1 (HTLV-1) is the etiologic cause of adult T-cell leukemia/lymphoma (ATL) and encodes a viral oncoprotein (Hbz) that is consistently expressed in asymptomatic carriers and ATL patients, suggesting its importance in the development and maintenance of HTLV-1 leukemic cells. Our previous work found Hbz protein is dispensable for virus-mediated T-cell immortalization but enhances viral persistence. We and others have also shown that hbz mRNA promotes T-cell proliferation.

Evolution of a physician wellness, engagement and excellence strategy: lessons learnt in a mental health setting.

Objective: This study aims to evaluate the impact of several organisational initiatives implemented as part of a physician engagement, wellness and excellence strategy at a large mental health hospital. Interventions that were examined include: communities of practice, peer support programme, mentorship programme and leadership and management programme for physicians.

Methods: A cross-sectional study, guided by the Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance evaluation framework, was conducted with physicians at a large academic mental health hospital in Toronto, Canada.

Risk, resilience, and recovery in forensic mental health: An integrated conceptual model.

In this paper we describe a novel, integrated conceptual model that brings together core elements across structured tools assessing risk for future violence, protective factors, and progress in treatment and recovery in forensic mental health settings. We argue that the value of such a model lies in its ability to improve clinical efficiencies and streamline assessment protocols, facilitate meaningful participation of patients in assessment and treatment planning activities and increase the accessibility of clinical assessments to principal users of this information. The four domains appearing in the model (treatment engagement, stability of illness and behavior, insight, and professional and personal support) are described, and common clinical manifestations of each domain within a forensic context are illustrated.

Prioritizing Child Health: Promoting Adherence to Well-Child Visits in an Urban, Safety-Net Health System During the COVID-19 Pandemic.

Background: After discovering racial/ethnic disparities in adherence to well-child visits, UMass Memorial Health worked to identify and mitigate barriers to adherence for patients and families across 53 primary care practices in central Massachusetts.

Methods: When the systemwide goal to reduce racial/ethnic disparities in well-child visit adherence was established, a multidisciplinary team of leaders from UMass Memorial Health worked together to engage patients and stakeholders to identify obstacles to adherence. Transportation, language, and scheduling were identified as barriers.

THE CONCISE GUIDE TO PHARMACOLOGY 2021/22: Introduction and Other Protein Targets.

The Concise Guide to PHARMACOLOGY 2021/22 is the fifth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of nearly 1900 human drug targets with an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (www.guidetopharmacology.

Do carers and comforters require lead aprons during general radiographic examinations?

Introduction: Carers and comforters frequently remain with children during paediatric general radiographic examinations. As well as improving the likelihood of overall success of the procedure, this can be important for minimising stress and anxiety of the child. Wearing lead aprons can contribute to additional stress and anxiety about the procedure for both carer and child, specifically due to radiation risk.

Gα15 in early onset of pancreatic ductal adenocarcinoma.

The GNA15 gene is ectopically expressed in human pancreatic ductal adenocarcinoma cancer cells. The encoded Gα15 protein can promiscuously redirect GPCR signaling toward pathways with oncogenic potential. We sought to describe the distribution of GNA15 in adenocarcinoma from human pancreatic specimens and to analyze the mechanism driving abnormal expression and the consequences on signaling and clinical follow-up.

Lipopolysaccharide from the commensal microbiota of the breast enhances cancer growth: role of S100A7 and TLR4.

The role of commensal bacterial microbiota in the pathogenesis of human malignancies has been a research field of incomparable progress in recent years. Although breast tissue is commonly assumed to be sterile, recent studies suggest that human breast tissue may contain a bacterial microbiota. In this study, we used an immune-competent orthotopic breast cancer mouse model to explore the existence of a unique and independent bacterial microbiota in breast tumors.

Advancing physician wellness, engagement and excellence in a mental health setting: a Canadian perspective.

This article describes the development and implementation of wellness initiatives within a large Canadian academic mental health hospital, based on the Mental Health Commission of Canada's workplace standards for mental health. To support the implementation of an organizational framework for physician wellness, a needs assessment of Centre for Addiction and Mental Health physicians (N = 181) was conducted between 21 November and 5 December 2017, including measuring physician burnout rates using two items on the Maslach Burnout Inventory tool. Based on findings, and the organizational wellness framework, a multi-pronged wellness approach was developed, improving physician supports at the individual, team and organizational levels.

AXL Is a Key Factor for Cell Plasticity and Promotes Metastasis in Pancreatic Cancer.

Pancreatic ductal adenocarcinoma (PDA), a leading cause of cancer-related death in the United States, has a high metastatic rate, and is associated with persistent immune suppression. AXL, a member of the TAM (TYRO3, AXL, MERTK) receptor tyrosine kinase family, is a driver of metastasis and immune suppression in multiple cancer types. Here we use single-cell RNA-sequencing to reveal that AXL is expressed highly in tumor cells that have a mesenchymal-like phenotype and that AXL expression correlates with classic markers of epithelial-to-mesenchymal transition.

Gq-Gi-PLCβ in cells: More than the sum of its reconstituted parts.

The recent paper by Pfeil et al., "Heterotrimeric G Protein Subunit Gαq Is a Master Switch for Gβγ-Mediated Calcium Mobilization by Gi-Coupled GPCRs", opens another path from biochemical in vitro reconstitution to understanding the complex regulation of calcium signaling inside the cell.

Concerted cell and in vivo screen for pancreatic ductal adenocarcinoma (PDA) chemotherapeutics.

PDA is a major cause of US cancer-related deaths. Oncogenic Kras presents in 90% of human PDAs. Kras mutations occur early in pre-neoplastic lesions but are insufficient to cause PDA.