Multifaceted approach to reduce duplicate therapy errors in the emergency department.

Medication errors continue to pose a significant risk to patient safety, accounting for half of the avoidable harm in healthcare systems around the world. In emergency departments (EDs), factors such as high patient loads and emergent nature of care increase the likelihood of such errors. An audit conducted at the ED of Changi General Hospital Singapore from January 2019 to July 2022 revealed that the duplicate therapy error comprised 31% of all reported medication errors.

Perforated imprinting on high moisture meat analogue confers long range mechanical anisotropy resembling meat cuts.

Meat cuts, when cooked and masticated, separate into fibrous structures because of the long-range mechanical anisotropy (LMA) exhibited by muscle fascicles, which is not fully recapitulated in alternative proteins produced using molecular alignment technology like high moisture extrusion. We have developed a scalable perforated micro-imprinting technology to greatly enhance LMA in high moisture meat analogue (HMMA). By imprinting 1 mm thick HMMA sheets with perforated patterns (optimized by AI), we observed up to 5 × more anisotropic separation of fibrous structures in a one-dimensional pulling LMA analysis, to match the fibrousness of the cooked chicken breast, duck breast, pork loin and beef loin.

Focusing on autism symptoms masks sex-specific needs of autistic children: An example from the Sydney Child Neurodevelopment Research Registry.

Studies have shown that there is a difference between biological sex at birth in autism spectrum disorder. There remains a lack of understanding about how the symptoms of autism differ between assigned males at birth and assigned females at birth. We looked at the presence of sex differences in a large group of autistic toddlers, children and adolescents, who were seen in a large diagnosis and assessment clinic.

Cellular RNA interacts with MAVS to promote antiviral signaling.

Antiviral signaling downstream of RIG-I-like receptors (RLRs) proceeds through a multi-protein complex organized around the adaptor protein mitochondrial antiviral signaling protein (MAVS). Protein complex function can be modulated by RNA molecules that provide allosteric regulation or act as molecular guides or scaffolds. We hypothesized that RNA plays a role in organizing MAVS signaling platforms.

Confinement-sensitive volume regulation dynamics via high-speed nuclear morphological measurements.

Diverse tissues in vivo present varying degrees of confinement, constriction, and compression to migrating cells in both homeostasis and disease. The nucleus in particular is subjected to external forces by the physical environment during confined migration. While many systems have been developed to induce nuclear deformation and analyze resultant functional changes, much remains unclear about dynamic volume regulation in confinement due to limitations in time resolution and difficulty imaging in PDMS-based microfluidic chips.

Establishing Core elements for a Prehospital Emergency Care Systems Evaluation Tool (PECSET) for systems in early stages of development: A Delphi consensus.

Objectives: International Prehospital Emergency Care (PEC) standards have been primarily developed by and for high resource settings. Most PEC systems in Asia, which are still in the early stages of development, struggle to achieve these standards. There is a need for an evaluation tool which can define achievable basic building blocks for PEC systems in low resource settings to improve quality of PEC.

Moderate mitral regurgitation in association with ventricular septal defect in children: Does it warrant mitral valve repair?

Background: The management of ventricular septal defect (VSD) alongside mitral regurgitation (MR) in pediatric patients remains a contentious issue due to the intricacies of cardiac surgery and the need to minimize ischemic time. Despite observations of MR regression following VSD closure, definitive guidelines for this patient subset are lacking, particularly concerning the management of the subgroup of patients with moderate MR. The objective of the study is to explore the factors influencing the choice between surgical intervention and conservative management for the mitral valve (MV) in VSD patients with moderate MR.

Comparing two large data repositories to understand the differences in demographics, health history, and behavioral attributes in populations.

Introduction: This study conducted a comparative analysis between two large data repositories, the All of Us (AoU) medical data and BigMouth dental data repositories.

Methods: The comparison analysis includes variables related to behavioral and systemic health, health literacy, and overall health status across race, ethnicity, and gender. The analytic approach used descriptive statistics, Chi-square, odds ratio, and 95% confidence intervals; significant comparisons were measured with Cohen's D effect sizes.

Accuracy of symptom checker for the diagnosis of sexually transmitted infections using machine learning and Bayesian network algorithms.

Background: A significant proportion of individuals with symptoms of sexually transmitted infection (STI) delay or avoid seeking healthcare, and digital diagnostic tools may prompt them to seek healthcare earlier. Unfortunately, none of the currently available tools fully mimic clinical assessment or cover a wide range of STIs.

Methods: We prospectively invited attendees presenting with STI-related symptoms at Melbourne Sexual Health Centre to answer gender-specific questionnaires covering the symptoms of 12 common STIs using a computer-assisted self-interviewing system between 2015 and 2018.

SurgeryLLM: a retrieval-augmented generation large language model framework for surgical decision support and workflow enhancement.

SurgeryLLM, a large language model framework using Retrieval Augmented Generation demonstrably incorporated domain-specific knowledge from current evidence-based surgical guidelines when presented with patient-specific data. The successful incorporation of guideline-based information represents a substantial step toward enabling greater surgeon efficiency, improving patient safety, and optimizing surgical outcomes.

Geometry-Corrected Quadratic Optimization Algorithm for NDDO-Descendant Semiempirical Models.

The long-held assumption that the optimization of parameters for NDDO-descendant semiempirical methods may be performed without precise geometry optimization is assessed in detail; the relevant equations for the analytical evaluation of the geometry-corrected derivatives of molecular properties that account for changes in the optimum geometry are then presented. The first and second derivatives calculated from our implementation of MNDO are used for a limited reparameterization of 1,113 CHNO molecules taken from the PM7 training set, demonstrating an improvement over the PARAM program used in the optimization of parameters for the PMx methods.

Prevalence and associations of problematic smartphone use with smartphone activities, psychological well-being, and sleep quality in a household survey of Singapore adults.

Introduction: Despite the many benefits of smartphones, researchers have raised concerns over problematic smartphone use (PSU) and its negative effects on physical and psychological well-being. Studies examining PSU and its impact among adults remain limited. Hence, we aim to examine the prevalence of PSU among adults in Singapore, and explore its associations with smartphone activities, sleep quality, and psychological well-being, as well as age and gender-related differences in these associations.

Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.

Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.

Characterization of a novel SNP identified in Australian group A isolates derived from the M1 lineage.

Group A (GAS) is a human-adapted pathogen responsible for a variety of diseases. The GAS M1 lineage has contributed significantly to the recently reported increases in scarlet fever and invasive infections. However, the basis for its evolutionary success is not yet fully understood.

Neurophobia amongst medical students: Hype or reality.

Introduction: 'Neurophobia' is a well reported phenomenon in the literature where in medical students and junior doctors have an inherent nervousness or 'fear' of neurology and neurosurgery

Research Question: Why do less medical students choose neurology and neurosurgery as a career and identify if neurophobia is an ingrained belief or learned behaviour?

Materials And Methods: We developed a questionnaire to assess medical student views and beliefs in connection with a career in neurosurgery. Specifically we examined the following domains: considering a career in neurology and neurosurgery, confidence with neuro anatomy and pathology, traits associated with neurosurgeons and neurologists and finally, their perceived barriers to a neuro career.

Results: 264 medical students completed the survey.

Study Protocol for a Randomized Controlled Trial Investigating the Effects of the Daily Consumption of Ruminant Milk on Digestive Comfort and Nutrition in Older Women: The YUMMI Study.

Background: Age-related changes can lead to dietary insufficiency in older adults. The inclusion of high-quality, nutrient-dense foods such as ruminant milks can significantly improve health outcomes. However, many older adults worldwide do not meet daily milk intake recommendations because of digestive discomfort and health concerns.

An MRI-Derived Formula for Estimating the Native Joint Line Position in the Presence of Distal Femoral Bone Loss.

Background  In the presence of distal femoral condyle bone loss, estimation and restoration of the joint line (JL) position can be guided by extraarticular bony landmarks with the aid of mathematical formulas that rely on the innate correlations between periarticular measurements. To prevent JL elevation, the formula should incorporate the thickness of distal femoral articular cartilage. The aim of this study was to derive a formula to estimate native JL position.

False-positive dengue non-structural protein 1 in pregnancy.

Dengue is a vector-borne infection, which contributes to significant morbidity and mortality in endemic areas. It manifests rapidly within 2 wk from febrile, critical to recovery phase. The point-of-care test (POCT) comprises the non-structural protein 1 (NS1) antigen, IgM and IgG, which aids rapid diagnosis, leading to timely treatment.

Characterizing Nodal Gamma-Delta T-Cell Lymphoma: Clinicopathological and Molecular Insights.

Peripheral T-cell lymphomas with gamma-delta phenotype (GDTCL) are rare lymphoid malignancies. Beyond the well-recognized entities of extranodal lymphomas with gamma-delta phenotype as defined by the 5th edition of the WHO Classification of Hematolymphoid Tumors and 2022 International Consensus Classification, there is a group of poorly-defined gamma-delta T-cell lymphomas with predominantly nodal presentation, termed as nodal GDTCL (nGDTCL). In this study, we present a series of 12 cases of EBV-negative nGDTCL, highlighting the clinical, histopathological and molecular features of this rare entity.

Targeting Daily Positive Events to Improve Emotional and Functional Well-Being in Adults With Fibromyalgia: Insights From the LARKSPUR Randomized Controlled Trial.

Background: Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties, affecting individuals across all age groups. Positive affect (PA) interventions have shown promise in enhancing emotional well-being and pain management in patients with diverse chronic pain conditions. However, the efficacy of internet-delivered PA interventions for individuals with fibromyalgia remains understudied.

Bivalent boosters and risk of post-acute sequelae following vaccine-breakthrough SARS-CoV-2 Omicron infection: a cohort study.

Background: Vaccination has been shown to attenuate the risk of post-acute sequelae following SARS-CoV-2 infection. However, no prior population-based studies have evaluated if updated bivalent boosters reduce risk of post-acute sequelae following Omicron-variant infection, versus ancestral vaccines.

Methods: National databases were utilised to construct a population-based cohort of adult individuals infected during Omicron-predominant transmission.

Influenza vaccine effectiveness against hospitalizations and emergency department or urgent care encounters for children, adolescents, and adults during the 2023-2024 season, United States.

Background: The 2023-2024 influenza season had predominant influenza A(H1N1)pdm09 virus activity, but A(H3N2) and B viruses co-circulated. Seasonal influenza vaccine strains were well-matched to these viruses.

Methods: Using health care encounters data from health systems in 8 states, we evaluated influenza vaccine effectiveness (VE) against influenza-associated medical encounters from October 2023-April 2024.

Exploring student acceptance of learning technologies in anatomy education: A mixed-method approach.

Anatomical education is transitioning from the time-honored cadaveric dissection to a blend of learner-centered and technology-enhanced learning approaches. In view of the increased use of various technologies for teaching and learning human anatomy, the aim of this study is to explore students' acceptance of four learning technologies using the technology acceptance model (TAM). This work was conducted at a graduate medical school in Singapore with first-year MD Program students.