Evaluating the effects, implementation experience and political economy of primary healthcare facility autonomy reforms within counties in Kenya: a mixed methods study protocol.

Introduction: There is a growing emphasis on improving primary health care services and granting frontline service providers more decision-making autonomy. In October 2023, Kenya enacted legislation mandating nationwide facility autonomy. There is limited understanding of the effects of health facility autonomy on primary health care (PHC) facilities performance.

Starting a cultural collective for mothers of children with disabilities: A case study.

Background: Caring for children with disabilities in Tanzania involves significant challenges, including stigma, limited support and mental health risks. A cultural collective for caretakers of children with disabilities enrolled at a primary school was established to address these issues.

Objectives: The study aims to explore the experiences of caregivers who started a cultural collective and to assess its impact on their lives in the short term.

Implementing a Responsible Conduct of Research Curriculum for an Undergraduate Summer Clinical Research Program in Quantitative Sciences.

Objectives: Instilling the principles of ethical and responsible medical research is critical for educating the next generation of clinical researchers. We developed a responsible conduct of research (RCR) workshop and associated curriculum for undergraduate trainees in a quantitative clinical research program.

Methods: Topics in this 7-module RCR workshop are relevant to undergraduate trainees in quantitative fields, many of whom are learning about these concepts for the first time.

Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center's Experience and an Effectiveness Evaluation.

Rationale & Objective: Remote patient monitoring (RPM) could improve the quality and efficiency of acute kidney injury (AKI) survivor care. This study described our experience with AKI RPM and characterized its effectiveness.

Study Design: A cohort study matched 1:3 to historical controls.

Telehealth for Goals of Care Conversations in Advanced CKD: A Mixed-Methods Pilot Study of US Veterans and Their Clinicians.

Rationale & Objective: Engaging patients with advanced chronic kidney disease (CKD) in goals of care (GOC) conversations is essential to align life-sustaining treatments with patient preferences. This pilot study described the feasibility of engaging older Veterans with advanced CKD in GOC conversations via telehealth by (1) comparing patient characteristics, including life-sustaining treatment note completion rates and preferences by visit modality, and (2) exploring Veteran and clinician perspectives surrounding telehealth GOC conversations.

Study Design: Mixed-method convergent design including a prospective, quantitative observational cohort analysis (n = 40) and qualitative, semi-structured interviews with 4 clinicians and 11 Veterans.

Association of diethylhexyl phthalate exposure with serum thyroid hormone levels: a systematic review and meta-analysis.

Objective: Evidence suggests that diethylhexyl phthalate (DEHP) may disrupt thyroid hormone homeostasis by targeting multiple components of the hypothalamic-pituitary-thyroid (HPT) axis, potentially harming human health. However, the relationship between DEHP exposure and thyroid function remains debated. We performed a meta-analysis to clarify the association between DEHP exposure and thyroid function.

Outcome Measures to Evaluate Functional Recovery in Survivors of Respiratory Failure: A Scoping Review.

Background: Respiratory failure is a life-threatening condition affecting millions of individuals in the United States annually. Survivors experience persistent functional impairments, decreased quality of life, and cognitive impairments. However, no established standard exists for measuring functional recovery among survivors of respiratory failure.

Automated xeno-free chondrogenic differentiation from human embryonic stem cells: Enhancing efficiency and ensuring high-quality mass production.

Introduction: Repairing damaged cartilage poses significant challenges, particularly in cases of congenital cartilage defects such as microtia or congenital tracheal stenosis, or as a consequence of traumatic injury, as the regenerative potential of cartilage is inherently limited. Stem cell therapy and tissue engineering offer promising approaches to overcome these limitations in cartilage healing. However, the challenge lies in the size of cartilage-containing organs, which necessitates a large quantity of cells to fill the damaged areas.

Digital healthcare services in community pharmacies in Switzerland: Pharmacist and patient acceptability, and pharmacist readiness-the Pneumoscope™ pilot study.

Background: The integration of artificial intelligence (AI)-based pharmaceutical services in community pharmacy (CP) settings has the potential to enhance point-of-care services and improve informed patient access to healthcare. The Pneumoscope™, an innovative AI-powered digital stethoscope that analyses lung sounds to detect specific respiratory pathologies, could be a valuable tool for pharmacists in conducting respiratory screening. To understand how this device can be implemented in the healthcare system, this exploratory research aims to assess the acceptability of pharmacists and patients, and the pharmacists' readiness to use the Pneumoscope™ in CPs for respiratory disease management.

Multiple, Single Trait GWAS and Supervised Machine Learning Reveal the Genetic Architecture of Fraxinus excelsior Tolerance to Ash Dieback in Europe.

Common ash (Fraxinus excelsior) is under intensive attack from the invasive alien pathogenic fungus Hymenoscyphus fraxineus, causing ash dieback at epidemic levels throughout Europe. Previous studies have found significant genetic variation among genotypes in ash dieback susceptibility and that host phenology, such as autumn yellowing, is correlated with susceptibility of ash trees to H. fraxineus; however, the genomic basis of ash dieback tolerance in F.

Plasma proteomic biomarkers as mediators or moderators for the association between poor cardiovascular health and white matter microstructural integrity: The UK Biobank study.

Introduction: The plasma proteome's mediating or moderating roles in the association between poor cardiovascular health (CVH) and brain white matter (WM) microstructural integrity are largely unknown.

Methods: Data from 3953 UK Biobank participants were used (40-70 years, 2006-2010), with a neuroimaging visit between 2014 and 2021. Poor CVH was determined using Life's Essential 8 (LE8) and reversing standardized z-scores (LE8 ).

White matter hyperintensities and TDP-43 pathology in Alzheimer's disease.

Introduction: Greater white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) are seen with transactive response DNA-binding protein 43 (TDP-43) pathology in frontotemporal lobar degeneration (FTLD-TDP). WMH associations with TDP-43 pathology in Alzheimer's disease (AD-TDP) remain unclear.

Methods: A total of 157 participants from Mayo Clinic Rochester with autopsy-confirmed AD, known TDP-43 status, and antemortem fluid-attenuated inversion recovery (FLAIR) MRI were included.

Dosage Optimization Using Physiologically Based Pharmacokinetic Modeling for Pediatric Patients with Renal Impairment: A Case Study of Meropenem.

The pharmacokinetics of renally eliminated antibiotics can be influenced by changes associated with renal function and development in a growing subject. Little is known about the effects of renal insufficiency on the pharmacokinetics of meropenem in pediatric subjects. The aim of this study was to develop a physiologically based pharmacokinetic (PBPK) model of meropenem for pediatric patients that can be used to optimize meropenem dosing in pediatric patients with renal impairment (RI).

Ga-Pentixafor PET/CT for the assessment of therapeutic outcomes following superselective adrenal arterial embolization in patients with primary aldosteronism.

Background: Superselective adrenal artery embolization (SAAE) represents a novel therapeutic strategy for managing primary aldosteronism (PA). Currently, the evaluation of its efficacy is primarily restricted to clinical indicators, with a notable deficiency in imaging evaluation methodologies. In recent years, several studies have investigated the application of Ga-Pentixafor PET/CT for the classification of PA.

Scientific production on electrical burns: a bibliometric analysis (1946-2023).

Electrical burns constitute a serious public health challenge. It is crucial to identify trends, advancements, and possible future research areas in this field. The aim is to analyze the scientific production on electrical burns using bibliometric methods.

Protective role of triiodothyronine in sepsis‑induced cardiomyopathy through phospholamban downregulation.

Sepsis is often a cause of mortality in patients admitted to the intensive care unit. Notably, the heart is the organ most susceptible to the impact of sepsis and this condition is referred to as sepsis‑induced cardiomyopathy (SIC). Low triiodothyronine (T3) syndrome frequently occurs in patients with sepsis, and the heart is one of the most important target organs for the action of T3.

Knowledge and occupational practices of beauticians and barbers in the transmission of viral hepatitis: A mixed-methods study in Volta Region of Ghana.

Background: Hepatitis B and C viral (HBV and HCV) infections are endemic in Ghana. Also, the National Policy on Viral Hepatitis stipulates that there is unreliable data, limited knowledge, and a deficiency in research on viral hepatitis, especially among some high-risk workers in the eastern part of the country. This study therefore assessed the knowledge level and occupational practices of street beauticians and barbers in the transmission of HBV and HCV in the Volta Region of Ghana.

The mechanism of amyloid fibril growth from Φ-value analysis.

Amyloid fibrils are highly stable misfolded protein assemblies that play an important role in several neurodegenerative and systemic diseases. Although structural information of the amyloid state is now abundant, mechanistic details about the misfolding process remain elusive. Inspired by the Φ-value analysis of protein folding, we combined experiments and molecular simulations to resolve amino-acid contacts and determine the structure of the transition-state ensemble-the rate-limiting step-for fibril elongation of PI3K-SH3 amyloid fibrils.

A human oral commensal-mediated protection against Sjögren's syndrome with maintenance of T cell immune homeostasis and improved oral microbiota.

Sjögren's syndrome (SS) is a prevalent systemic autoimmune disease with substantial impacts on women's health worldwide. Although oral Haemophilus parainfluenzae is reduced in SS, its significance remains unclear. This study aimed to elucidate the pathophysiological role of H.

Association of plasma biomarkers of Alzheimer's pathology and neurodegeneration with gait performance in older adults.

Background: Declining gait performance is seen in aging individuals, due to neural and systemic factors. Plasma biomarkers provide an accessible way to assess evolving brain changes; non-specific neurodegeneration (NfL, GFAP) or evolving Alzheimer's disease (Aβ 42/40 ratio, P-Tau181).

Methods: In a population-based cohort of older adults, we evaluate the hypothesis that plasma biomarkers of neurodegeneration and Alzheimer's Disease pathology are associated with worse gait performance.

The Learning Curve in Urogynecology and Functional Urology: A Systematic Review.

Introduction And Hypothesis: When adopting new methods, surgeons may experience a period of complexity and longer operation times because of their inexperience. This period is known as the "learning curve." This study was aimed at systematically reviewing the current literature on functional urology learning curves.

Patient preferences for drug therapy in inflammatory arthritis: protocol for a living systematic review and evidence map to inform clinical practice guidelines.

Introduction: The pharmacological management of inflammatory arthritis often requires choices that involve trade-offs between benefits, risks and other attributes such as administration route, frequency and cost. This living systematic review aims to inform international clinical guidelines on inflammatory arthritis by creating an evidence map of patient preference studies concerning the trade-offs in pharmacological management of inflammatory arthritis.

Methods And Analysis: We will include published and peer-reviewed full-text studies in any language that quantitatively assess preferences of patients for the pharmacological management of inflammatory arthritis (rheumatoid arthritis, spondyloarthritis and juvenile idiopathic arthritis).

Investigating male factors and their relationships with reproductive health outcomes: a case-control study protocol for Towards Optimal Fertility, Fathering, and Fatherhood studY (TOFFFY) in Singapore.

Introduction: Despite the global prevalence of low fertility rates, male contributions to fertility and reproductive health outcomes have been understudied. This study aims to investigate the male contribution to fertility and explore the underlying biological mechanisms. Specifically, we aim to (1) identify male factors associated with successful pregnancy, (2) develop a fertility index incorporating modifiable factors for both males and females to predict pregnancy rate and (3) explore the relationship of male modifiable factors with semen parameters and molecular characteristics.

High-Intensity End-of-Life Care Among Young and Middle-Aged Hispanic Adults With Cancer in Puerto Rico.

Background: Timely palliative and hospice care, along with advanced care planning, can reduce avoidable high-intensity care and improve quality of life at the end of life (EoL).

Objective: We examined patterns of care at EoL and evaluated predictors of high-intensity care at EoL among adults aged 18-64 with cancer.

Methods: Using data from the Puerto Rico Central Cancer Registry-Health Insurance Linkage Database, we examined 1359 patients diagnosed with cancer in 2010-2019, who died of cancer between 2017 and 2019 at 64 years and younger, and who were enrolled in Medicaid or private health insurance in last 30 days before death.