Examining the association between fentanyl use and perceived adequacy of methadone dose: A retrospective cohort study.

Background: People exposed to fentanyl may report that the dose of methadone in the commonly accepted therapeutic range feels too low. We examined self-reported methadone dose adequacy.

Methods: We conducted a retrospective cohort study of individuals prescribed methadone at a dose of at least 60mg daily using data from three community-recruited prospective cohort studies of people who use drugs in Vancouver, Canada from December 2016 through March 2020.

Predictive model of neurodevelopmental outcome in neonatal hypoxic ischemic encephalopathy.

Objectives: To build an early, prognostic model for adverse outcome in infants with hypoxic ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH) based on brain magnetic resonance images (MRI), electrophysiological tests and clinical assessments were performed during the first 5 days of life.

Methods: Retrospective study of 182 neonates with HIE and managed with TH. The predominant pattern of HIE brain injury on MRI performed following cooling was scored by neuroradiologists.

Identifying Needs and Support Services for Family Caregivers of Older Community-Based Family Members: Mixed-Method Research Findings.

A recent Canadian study conducted in one province identified family caregiver support needs and essential support services when caring for older community-based family members requiring assistance with activities of daily living. Weekly interviews of 150 volunteer caregivers over 6 months identified 11 support needs and 5 essential support services. Scoping literature reviews of the 11 needs found they had all been identified before.

Comparison of treatments for equine laryngeal hemiplegia using computational fluid dynamic analysis in an equine head model.

Introduction: Computational fluid dynamics (CFD) is gaining momentum as a useful mechanism for analyzing obstructive disorders and surgeries in humans and warrants further development for application in equine surgery. While advancements in procedures continue, much remains unknown about the specific impact that different surgeries have on obstructive airway disorders. The objective of this study was to apply CFD analysis to an equine head inhalation model replicating recurrent laryngeal neuropathy (RLN) and four surgical procedures.

"Fear of the unknown": Health, disability, and stakeholder perspectives on the behavioral and social drivers of vaccination in children with disability in Fiji.

Vaccinating children with disability in low- and middle-income countries, such as Fiji, is a key priority for equity. This study aimed to understand the social and behavioral drivers of vaccine uptake among children with disability in Fiji, from the perspectives of health, disability, and community stakeholders. Five qualitative focus groups were conducted with 22 stakeholders, including healthcare workers, disability service providers and advocates, and community and faith leaders (female n = 17, 77%).

Multiple introductions of NRCS-A to the neonatal intensive care unit drive neonatal bloodstream infections: a case-control and environmental genomic survey.

The NRCS-A strain has emerged as a global cause of late-onset sepsis associated with outbreaks in neonatal intensive care units (NICUs) whose transmission is incompletely understood. Demographic and clinical data for 45 neonates with and 90 with other coagulase-negative staphylococci (CoNS) isolated from sterile sites were reviewed, and clinical significance was determined. isolated from 27 neonates at 2 hospitals between 2017 and 2022 underwent long-read (ONT) (=27) and short-read (Illumina) sequencing (=18).

An Information-Theoretic Method for Identifying Effective Treatments and Policies at the Beginning of a Pandemic.

Identifying effective treatments and policies early in a pandemic is challenging because only limited and noisy data are available and biological processes are unknown or uncertain. Consequently, classical statistical procedures may not work or require strong structural assumptions. We present an information-theoretic approach that can overcome these problems and identify effective treatments and policies.

Cardiovascular Safety of Anti-CGRP Monoclonal Antibodies in Older Adults or Adults With Disability With Migraine.

Importance: Monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) or its receptor (anti-CGRP mAbs) offer effective migraine-specific preventive treatment. However, concerns exist about their potential cardiovascular risks due to CGRP blockade.

Objective: To compare the incidence of cardiovascular disease (CVD) between Medicare beneficiaries with migraine who initiated anti-CGRP-mAbs vs onabotulinumtoxinA in the US.

Influence of Tacticity on the Self-Assembly of Poly(ethylene glycol)--poly(lactic acid) Block Copolymers.

Lactide, possessing two stereocenters and thus three distinct configurations (DD, DL, and LL), serves as a captivating building block for polymers and self-assembly. Notably, polylactide (PLA) exhibits stereocomplexation, displaying heightened interactions between different configurations compared with interactions within the same configuration. This characteristic renders PLA an intriguing subject for investigating self-assembly behavior.

Factors to consider when designing post-hospital interventions to support critical illness recovery: Systematic review and qualitative evidence synthesis.

Background: Survivors of intensive care unit (ICU) admission experience significant deficits in health-related quality of life due to long-term physical, psychological, and cognitive sequelae of critical illness, which may persist for many years. There has been a proliferation of post-hospital interventions in recent years which aim to support ICU-survivors, however there is currently limited evidence to inform optimal approach. We therefore aimed to synthesise factors which impacted the implementation of these interventions from the perspective of healthcare providers, patients, and their carers, and to compare different intervention designs.

Consumer perspectives of the group itself in group-delivered programs for people with chronic pain: a systematic review and meta-synthesis.

Group-delivered programs for chronic pain are evidence-based and frequently used. The contribution of group factors to outcomes is unclear and there are no integrated findings on consumer perceptions of the group itself in programs for people with chronic pain. The aim of this systematic review was to search and synthesise qualitative data specifically related to the group itself in studies investigating group-delivered programs for people with chronic pain (PROSPERO, CRD42023382447).

Towards transcervical ultrasound-guided transoral robotic surgery.

Background: In the context of transoral robotic surgery (TORS) for oropharyngeal squamous carcinoma (OPSCC), preoperative imaging and intraoperative visualization plays a pivotal role in optimizing resection margins. Prior work has demonstrated the ability of transoral ultrasound (US) in identifying OPSCC margins and vascular structures. This study evaluates the effectiveness of transcervical ultrasound (TUS), as well as other preoperative imaging modalities, in evaluating OPSCC volumes and compares this to post TORS pathological OPSCC volumes.

The molecular reach of antibodies crucially underpins their viral neutralisation capacity.

Key functions of antibodies, such as viral neutralisation, depend on high-affinity binding. However, viral neutralisation poorly correlates with antigen affinity for reasons that have been unclear. Here, we use a new mechanistic model of bivalent binding to study  >45 patient-isolated IgG1 antibodies interacting with SARS-CoV-2 RBD surfaces.

The structural influence of the oncogenic driver mutation N642H in the STAT5B SH2 domain.

The point mutation N642H of the signal transducer and activator of transcription 5B (STAT5B) protein is associated with aggressive and drug-resistant forms of leukemia. This mutation is thought to promote cancer due to hyperactivation of STAT5B caused by increased stability of the active, parallel dimer state. However, the molecular mechanism leading to this stabilization is not well understood as there is currently no structure of the parallel dimer.

Equitable and effective clinical guidance development and dissemination: trauma aims to lead the way.

Thirty-four per cent of deaths among Americans aged 1-46 are due to injury, and many of these deaths could be prevented if all hospitals performed as well as the highest-performing hospitals. The Institute of Medicine and the National Academies of Science, Engineering and Medicine have called for learning health systems, with emphasis on clinical practice guidelines (CPGs) as a means of limiting preventable deaths. Reduction in mortality has been demonstrated when evidence-based trauma CPGs are adhered to; however, guidelines are variably updated, redundant, absent, inaccessible, or perceived as irrelevant.

Evaluating Active Learning Strategies for Automated Classification of Patient Safety Event Reports in Hospitals.

Patient safety event (PSE) reports, which document incidents that compromise patient safety, are fundamental for improving healthcare quality. Accurate classification of these reports is crucial for analyzing trends, guiding interventions, and supporting organizational learning. However, this process is labor-intensive due to the high volume and complex taxonomy of reports.

An expert consensus statement on biomarkers of ageing for use in intervention studies.

Biomarkers of ageing serve as important outcome measures in longevity-promoting interventions. However, there is limited consensus on which specific biomarkers are most appropriate for human intervention studies. This work aimed to address this need by establishing an expert consensus on biomarkers of ageing for use in intervention studies via the Delphi method.

Determining the time to cholangiocarcinoma in pediatric-onset PSC-IBD.

Primary sclerosing cholangitis (PSC) is a risk factor for cholangiocarcinoma. When a child is diagnosed with both PSC and inflammatory bowel disease (IBD), evidence-based information on counseling families and risk management of developing cholangiocarcinoma is limited. In this case series (PubMed/collaborators), we included patients with PSC-IBD who developed cholangiocarcinoma and contacted authors to determine an event curve specifying the time between the second diagnosis (IBD or PSC) and a diagnosis of cholangiocarcinoma.

Carbon nanotubes as neuroprotective agents.

Carbon nanotubes, an emerging class of carbon nanomaterials, possess tremendous potential for application in biotechnology and biomedicine particularly in neurological disorders. Carbon nanotubes owing to their fascinating properties have the potential to revolutionize medicine and technology, particularly in the realm of drug delivery, biosensing, bioimaging, and as therapeutic agents to tackle complex neurological disorders such as Alzheimer's and Parkinson's disease. In this review, a summary of the use of carbon nanotubes for neuropathological outcomes such as alleviating oxidative stress and amyloid formation, which are well-studied molecular outcomes associated with Alzheimer's and Parkinson's disease.

Selecting High-Risk Patients With Pediatric Crohn's Disease for Top-Down Anti-TNF as per the 2021 ECCO-ESPGHAN Guidelines: A 5-Year Nationwide Retrospective Analysis From Scotland (2016-2020).

Background: The 2021 ECCO-ESPGHAN guideline on the medical management of pediatric Crohn's disease promotes early risk stratification and top-down anti-TNF for patients deemed high risk of severe disease course.

Aims: We aimed to objectively assess the risk-benefit profile of the guideline's risk stratification policy and guidance on top-down anti-TNF in a nationwide population-based cohort study.

Methods: Using a prospectively identified nationwide cohort of all new pediatric patients (<17 years) diagnosed with Crohn's disease in Scotland between January 1, 2016 and December 31, 2020 and retrospectively applying the current management algorithm, we explored the guideline's ability to accurately risk stratify patients.

A Bi-Cultural Multidisciplinary Approach to Achieving Excellence in Care for Indigenous Māori: Report From the Wānanga, Auckland, 2023.

Aims: To explore the alignment of nursing and healthcare practice illustrated in the Fundamentals of Care framework with Māori (Indigenous person of Aotearoa, New Zealand) worldviews using Indigenous methods.

Design: Discursive report.

Methods: In October 2023, around 50 healthcare professionals and Māori leaders from across Aotearoa, New Zealand, attended a wānanga, an Indigenous Māori approach for sharing knowledge and engaging in in-depth discussion and deliberation.

Representation of Asian ethnic subgroups in Aotearoa's regulated health workforce pre-registration students.

Aim: To provide a socio-demographic profile of Asian students enrolled in their first year of a health professional programme in polytechnics and universities in Aotearoa New Zealand and to explore differences in enrolment rates (ERs) within Asian sub-groups and by socio-economic deprivation, citizenship status, urban/rural location and gender.

Methods: Ethnic group/sub-group and socio-demographic characteristics of students enrolling within 21 health professional programmes were collected and averaged over 5 years (2016-2020). Age- and ethnicity-matched denominator data from the 2018 Census were used to calculate yearly ERs and ratios (ERR) using generalised linear modelling with the European ethnic group as the reference.

Evaluating the Influence of Morphological Features on the Vulnerability of Lipid-Rich Plaques During Stenting.

Lipid-rich atheromas are linked to plaque rupture in stented atherosclerotic arteries. While fibrous cap thickness is acknowledged as a critical indicator of vulnerability, it is likely that other morphological features also exert influence. However, detailed quantifications of their contributions and intertwined effects in stenting are lacking.