Decentralized clinical trials are better for the participants and for the planet: the case study of a double-blind randomized controlled trial in Singapore (PROMOTE study).

Introduction: Novel technologies have enabled the decentralization of many aspects of clinical trials, but little research has been done on the impact of these changes on the participant experience, trial operations, or the environment.

Methods: A fully decentralized clinical trial conducted in Singapore is used as a case study to evaluate the operational outcomes, environmental impact (via life cycle assessment), and participants experience (qualitative interviews) of the decentralized model compared to a traditional study with in-person visits.

Results: The decentralized study achieved high participant retention rates (97%) and high completion rates for clinical data, even for biological samples.

Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting.

Introduction: Adults over the age of 65 are at a higher risk for diagnostic errors due to a myriad of reasons. In primary care settings, a large contributor of diagnostic errors are breakdowns in information gathering and synthesis throughout the patient-provider encounter. Diagnostic communication interventions, such as the Agency for Healthcare Research and Quality's "Be the Expert on You" note sheet, may require adaptations to address older adults' unique needs.

Comparison of outcomes between resurfaced and unresurfaced patella in total knee arthroplasty using medial congruent liners: A retrospective study.

Introduction: Total knee replacements are becoming more prevalent. There is still a lot of controversy regarding patellar resurfacing. Surgeons advocating for resurfacing state reduced risk for anterior knee pain and need for future revision surgery.

Individual characteristics influencing the general population's level of knowledge of end-of-life practices: a cross-sectional study.

Background: Informed end-of-life decision-making requires a high level of death literacy. We still know little about the general population's level of knowledge and its determinants.

Aim: To assess knowledge of the general population regarding the legal status and definitions of various end-of-life practices, and to compare the level of knowledge according to individual characteristics known to influence death literacy.

Experiences and overall impact reported by people living with obesity: results from a multinational study.

Objectives: To explore the impact of obesity on clinical outcomes, health-related quality of life, emotional well-being, and work productivity in people/patients with obesity across six countries by body mass index and the presence of complications.

Methods: Adelphi Real World Obesity Disease Specific Programme™ captured data related to physicians and their consulting people/patients with obesity on a weight management program or anti-obesity medication in Brazil, Canada, China, Japan, Kingdom of Saudi Arabia, and the United Arab Emirates from April to December 2022. Physicians reported data for up to eight qualifying people/patients with obesity.

Striving for early effective glycaemic and weight management in type 2 diabetes: A narrative review.

Despite the recognition by key guidelines that achieving early glycaemic control has important benefits in individuals with type 2 diabetes (T2D) and that addressing excess adiposity is one of the central components of comprehensive person-centred T2D care, a substantial proportion of individuals with T2D do not meet their metabolic treatment goals. Prior treatment paradigms were limited by important treatment-associated risks such as hypoglycaemia and body weight gain. Therefore, a more conservative, sequential approach to treatment was typically utilized.

Association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy: A retrospective cohort study from British Columbia, Canada.

Aims: We measured the association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy (OAT) for opioid use disorder.

Design: Retrospective cohort study using the British Columbia Provincial Overdose Cohort, a linked administrative database.

Setting: We used data from British Columbia, Canada, from January 2015 through February 2020.

The asymmetry engine: how plants harness asymmetries to shape their bodies.

Plant development depends on growth asymmetry to establish body plans and adapt to environmental stimuli. We explore how plants initiate, propagate, and regulate organ-wide growth asymmetries. External cues, such as light and gravity, and internal signals, including stochastic cellular growth variability, drive these asymmetries.

Population-Based Analysis of the Risk of Mycobacterial Infections Associated With Immune Checkpoint Inhibitors.

In this population-based study, we examined the risk of nontuberculous mycobacterial disease associated with immune checkpoint inhibitors among people with cancer. Using a nested case-control design, we identified 184 cases and 714 matched controls; there was no significant association on conditional logistic regression (adjusted odds ratio, 0.51 [95% confidence interval, .

Occupational Therapist-Teacher Collaboration in Inclusive Education in Québec: A Qualitative Descriptive Study.

In inclusive schools, collaboration between occupational therapists (OTs) and teachers has the potential to build capacities among these school-team members working with students with disabilities. Current evidence supports multi-tiered delivery models, such that OT interventions are integrated within the context of school life. Collaboration, however, is a complex multifaceted phenomenon that poses systemic, organizational, or interpersonal challenges.

Food supply toxicants and additives alter the gut microbiota and risk of metabolic disease.

Metabolic disease is rising along with both global industrialization and the use of new commercial, agricultural, and industrial chemicals and food additives. Exposure to these compounds may contribute to aspects of metabolic disease such as obesity, diabetes, and fatty liver disease. Ingesting compounds in the food supply is a key route of human exposure, resulting in the interaction between toxicants or additives and the intestinal microbiota.

Peritoneal dialysis and kidney transplantation: Your questions answered.

Peritoneal dialysis (PD) and kidney transplantation are important therapeutic options in patients with advanced kidney disease. This article delineates the relationship between PD and kidney transplantation in several key domains, including: (1) Comparative merits and limitations of PD versus center-based hemodialysis prior to kidney transplantation, (2) Patient outcomes after kidney transplantation in individuals receiving PD prior to kidney transplantation, (3) Perioperative management strategies of patients receiving PD at the time of kidney transplantation, and (4) The relative advantages and clinical outcomes of PD use following kidney allograft failure compared to other modalities. This article aims to provide comprehensive guidance for optimizing care across the PD-kidney transplant transitions continuum.

": A Photovoice Exploration of Diabetes Self-Management for Older Persons in Rural Ontario, Canada.

Objective: To explore diabetes self-management for older adults in rural Ontario.

Methods: Fourteen adults, 65 and older, with diabetes, participated in this study using a participatory, art-based approach involving photovoice and semi-structured interviews. Data underwent hermeneutic phenomenology analysis.

Multispecies comparisons support a startle response origin for a novel vibrational signal in the cricket tribe Lebinthini.

Many animals communicate using call and response signals, but the evolutionary origins of this type of communication are largely unknown. In most cricket species, males sing and females walk or fly to calling males. In the tribe Lebinthini, however, males produce calls that trigger a vibrational reply from females, and males use the substrate vibrations to find the responding female.

Institutions of Care: A Qualitative Study with Ancestral Black Nova Scotian Nurses in Healthcare.

Background: Ancestral Black Nova Scotian (ABNS) nurses are a culturally distinct group yet, little is known about their experiences. Available literature suggests that ABNS nurses are underrepresented in nursing and that they encounter discrimination throughout the health system. Understanding the experiences of ABNS nurses facilitates addressing antiBlack racism in nursing and healthcare.

Robotic surgery for paediatric neurogenic lower urinary tract dysfunction: a systematic review.

Objective: To evaluate in a systematic review the outcomes, benefits, and limitations of robot-assisted surgeries for paediatric neurogenic lower urinary tract dysfunction (LUTD), as robot-assisted techniques have emerged as a potential alternative, offering enhanced precision, dexterity, and visualisation.

Methods: This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier CRD42023464849) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included studies of paediatric patients (aged <18 years) with neurogenic LUTD undergoing robot-assisted continence surgery, assessing safety and efficacy.

Enhancing Li Deposition Behavior through Valence Gradient-Assisted Iron Layer.

Uncontrolled lithium (Li) dendrite formation presents major safety risks and challenges in the Li host design. A novel approach is introduced, using a valence gradient in iron nanoparticles (Fe, Fe, Fe) to stabilize the anodes. An Fe component, with fast Li diffusion, ensures a steady supply of Li to Fe and Fe components, which have slower Li diffusion.

A review of clinical applications of pharmacokinetic simulations for a 2-month long-acting injectable formulation of aripiprazole.

Aripiprazole 2-month ready-to-use (Ari 2MRTU) is a long-acting injectable antipsychotic that was approved for use in Europe in March 2024, for the maintenance treatment of schizophrenia in adult patients stabilized with aripiprazole; it is administered via gluteal intramuscular injection once every two months. This review examines population pharmacokinetic model-based simulations relevant to the use of Ari 2MRTU in Europe, accompanied by expert commentary that contextualizes the simulations and highlights the potential implications of the availability of Ari 2MRTU for patients, caregivers, and clinicians. Various simulations conducted across 8 weeks (representing the first dosing interval), or 32 weeks (representing maintenance dosing) demonstrated an aripiprazole exposure profile for Ari 2MRTU that was similar to aripiprazole once-monthly (AOM), but with an extended dosing interval.

Perioperative and periprocedural management of GLP-1 receptor-based agonists and SGLT2 inhibitors: narrative review and the STOP-GAP and STOP DKA-2 algorithms.

The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major 21 century breakthroughs in diabetes and obesity medicine but there are important safety considerations regarding the perioperative and periprocedural management of individuals who are treated with these agents. GLP-1RAs have been linked to an increased risk of retained gastric contents and pulmonary aspiration while SGLT2i can be associated with diabetic ketoacidosis. This manuscript provides a narrative review of the available evidence for perioperative and periprocedural risks in people prescribed GLP-1RAs and SGLT2i.

Sulfate and Dissolved Organic Carbon Concentrations Drive Distinct Microbial Community Patterns in Prairie Wetland Ponds.

Prairie wetland ponds on the Great Plains of North America offer a diverse array of geochemical scenarios that can be informative about their impact on microbial communities. These ecosystems offer invaluable ecological services while experiencing significant stressors, primarily through drainage and climate change. In this first study systematically combining environmental conditions with microbial community composition to identify various niches in prairie wetland ponds, sediments had higher microbial abundance but lower phylogenetic diversity in ponds with lower concentrations of dissolved organic carbon ([DOC]; 10-18 mg/L) and sulfate ([SO ]; 37-58 mg/L) in water.

Impact of Phosphorylation and O-GlcNAcylation on the Binding Affinity of R4 Tau Peptide to Microtubule and Its Conformational Preference upon Dissociation.

Tau is a microtubule (MT)-associated protein that binds to and stabilizes the MTs of neurons. Due to its intrinsically disordered nature, it undergoes several post-translational modifications (PTMs) that are intricately linked to both the physiological and pathophysiological roles of Tau. Prior research has shown phosphorylation and O-GlcNAcylation to have contrasting effects on Tau aggregation; however, the precise molecular mechanisms and potential synergistic effects of these modifications remain elusive.

Effectiveness of emotion-focused therapy: Main results of a practice-research network study.

Background: Emotion-Focused Therapy is one of the evidence-based psychotherapies for a range of psychological problems. While most evidence was gained from randomized controlled studies or process research at university settings, there is a need for more outcome research conducted within practitioner-researcher networks assessing the effectiveness of Emotion-Focused Therapy in private practice.

Methods: A total of  = 70 clients with a variety of psychiatric disorders have been included in the bi-national practitioner researcher network for Emotion-focused Therapy Switzerland-Germany.

Characterization of SARS-CoV-2 Entry Genes in Skeletal Muscle and Impacts of In Vitro Versus In Vivo Infection.

Background: COVID-19 has been associated with both respiratory (diaphragm) and non-respiratory (limb) muscle atrophy. It is unclear if SARS-CoV-2 infection of skeletal muscle plays a role in these changes. This study sought to: 1) determine if cells comprising skeletal muscle tissue, particularly myofibres, express the molecular components required for SARS-CoV-2 infection; 2) assess the capacity for direct SARS-CoV-2 infection and its impact on atrophy pathway genes in myogenic cells; and 3) in an animal model of COVID-19, examine the relationship between viral infection of skeletal muscle and myofibre atrophy within the diaphragm and limb muscles.

Secondary Immunodeficiency.

The field of medicine is constantly changing and, as healthcare providers, we are fortunate to be practicing in a time when patients are living longer and novel therapeutic options continue to evolve. However, these new advances may be associated with adverse effects that practitioners need to be aware of. Some of these impair the immune system leading to secondary immunodeficiencies (SID) that increase host susceptibility to infections and other complications.