Healthcare worker views on antimicrobial resistance in chronic respiratory disease.

Background And Objective: Antimicrobial resistance (AMR) is a global crisis, however, relatively little is known regarding its impact in chronic respiratory disease and the specific challenges faced by healthcare workers across the world in this field. We aimed to assess global healthcare worker views on the challenges they face regarding AMR in chronic respiratory disease.

Methods: An online survey was sent to healthcare workers globally working in chronic respiratory disease through a European Respiratory Society clinical research collaboration (AMR-Lung) focussed on AMR in chronic lung disease.

The fibronectin-targeting PEG-FUD imaging probe shows enhanced uptake during fibrogenesis in experimental lung fibrosis.

Progressive forms of interstitial lung diseases, including idiopathic pulmonary fibrosis (IPF), are deadly disorders lacking non-invasive biomarkers for assessment of early disease activity, which presents a major obstacle in disease management. Excessive extracellular matrix (ECM) deposition is a hallmark of these disorders, with fibronectin being an abundant ECM glycoprotein that is highly upregulated in early fibrosis and serves as a scaffold for the deposition of other matrix proteins. Due to its role in active fibrosis, we are targeting fibronectin as a biomarker of early lung fibrosis disease activity via the PEGylated fibronectin-binding polypeptide (PEG-FUD).

Internalizing and externalizing symptoms in individuals with neurofibromatosis type 1: a systematic review and meta-analysis.

Background: Individuals with neurofibromatosis type 1 (NF1) frequently report psychosocial problems, among which internalizing and externalizing symptoms are the most poorly understood due to limited research and inconsistent evidence. This hinders the overall attendance of their psychosocial needs and has a major impact on their quality of life. Thus, this systematic review and meta-analysis was conducted to synthesize existing findings on the degree to which individuals with NF1 experience internalizing and externalizing symptoms, compared with the unaffected population, and explore moderators of the group disparities.

Rehabilitation success and related costs following stroke in a regional hospital: a retrospective analysis based on the Australian National Subacute and Non-Acute Patient (AN-SNAP) classification.

Background: Evidence is limited on the factors influencing successful stroke rehabilitation in regional contexts. Additionally, the relationship between rehabilitation costs following acute stroke, based on Australian National Subacute and Non-Acute Patient (AN-SNAP) casemix classification, and rehabilitation success remains unclear.

Objective: This retrospective cohort study investigated the factors contributing to improved functional outcomes following stroke rehabilitation in an Australian regional hospital, also evaluating the respective average daily and total payments.

The risks of adverse events with mirtazapine for adults with major depressive disorder: a systematic review with meta-analysis and trial sequential analysis.

Background: Mirtazapine is used to treat depression worldwide, and the effects of mirtazapine on depression rating scales are well-known. Our primary objective was to assess the risks of adverse events with mirtazapine for major depressive disorder.

Methods: We searched relevant sources from inception to 7 March 2024 for randomised clinical trials comparing mirtazapine versus placebo in adults with major depressive disorder.

Impact of COVID-19 on Antimicrobial Stewardship Activities in Hospitalised Children: A Scoping Review.

Aim: COVID-19 has brought unprecedented challenges to the healthcare system. The rapid spread of the virus, laboratory burn-out, exhausted staff, diagnostic uncertainty and lack of guidelines cumulatively disrupted hospital antimicrobial stewardship (AMS) programs. This scoping review evaluated how the COVID-19 pandemic has impacted the implementation of AMS, particularly within the context of clinical audits.

Antimicrobial peptide glatiramer acetate targets Pseudomonas aeruginosa lipopolysaccharides to breach membranes without altering lipopolysaccharide modification.

Antimicrobial peptides (AMPs) are key components of innate immunity across all domains of life. Natural and synthetic AMPs are receiving renewed attention in efforts to combat the antimicrobial resistance (AMR) crisis and the loss of antibiotic efficacy. The gram-negative pathogen Pseudomonas aeruginosa is one of the most concerning infecting bacteria in AMR, particularly in people with cystic fibrosis (CF) where respiratory infections are difficult to eradicate and associated with increased morbidity and mortality.

First-line cadonilimab plus chemotherapy in HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a randomized, double-blind, phase 3 trial.

Programmed cell death protein-1 (PD-1) inhibitors plus chemotherapy have been the standard of care in the first-line treatment of advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma; however, the survival benefits are modest in patients with low programmed death ligand 1 (PD-L1) expression. Here we investigated the efficacy and safety of cadonilimab (PD-1/cytotoxic T lymphocyte antigen-4 (CTLA-4) bispecific antibody) plus chemotherapy as first-line treatment in G/GEJ adenocarcinoma. The prespecified interim analysis is reported here.

Empowering African Expertise: Enhancing Safety Data Integration and Signal Detection for COVID-19 Vaccines Through the African Union Smart Safety Surveillance Joint Signal Management Group.

Introduction: The COVID-19 pandemic accelerated new vaccine development. Limited safety data necessitated robust global safety surveillance to accurately identify and promptly communicate potential safety issues. The African Union Smart Safety Surveillance (AU-3S) program established the Joint Signal Management (JSM) group to support identification of potential vaccine safety concerns in five pilot countries (Ethiopia, Ghana, Kenya, Nigeria, South Africa), accounting for approximately 35% of the African population.

Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.

Patient Perceptions of Provider Race Concordance and Quality of Chronic Illness Care.

Background: Black people are more likely to have hypertension and report lower quality of care than White people. Patient-provider race concordance could improve perceived quality of care, potentially lessening disparities.

Objective: Investigate the association between patient-provider race concordance and patient-perceived quality of chronic disease care, as measured by the Patient Assessment of Chronic Illness Care (PACIC) scale.

An Exploratory Investigation of Heritage and Educational Language Exposures as Factors in Medical Student Spanish Language Proficiency.

Background: Prior to enrolling in medical Spanish courses, students typically acquire their Spanish skills either through formal second language education only (L2 learners) or by being exposed to Spanish during childhood at home (heritage learners).

Objective: To categorize the language exposures of medical students who participated in a medical Spanish course and explore the associations of exposures with their medical language proficiency score on the Physician Oral Language Observation Matrix (POLOM).

Setting And Participants: Forty-one fourth-year medical students (2021-2022) self-reported demographics and prior language exposures and participated in videorecorded POLOM-rated Spanish standardized patient encounters.

Longitudinal evolution of the transdiagnostic prodrome to severe mental disorders: a dynamic temporal network analysis informed by natural language processing and electronic health records.

Modelling the prodrome to severe mental disorders (SMD), including unipolar mood disorders (UMD), bipolar mood disorders (BMD) and psychotic disorders (PSY), should consider both the evolution and interactions of symptoms and substance use (prodromal features) over time. Temporal network analysis can detect causal dependence between and within prodromal features by representing prodromal features as nodes, with their connections (edges) indicating the likelihood of one feature preceding the other. In SMD, node centrality could reveal insights into important prodromal features and potential intervention targets.

Harnessing artificial intelligence for enhanced veterinary diagnostics: A look to quality assurance, Part II External validation.

Artificial intelligence (AI) is emerging as a valuable diagnostic tool in veterinary medicine, offering affordable and accessible tests that can match or even exceed the performance of medical professionals in similar tasks. Despite the promising outcomes of using AI systems (AIS) as highly accurate diagnostic tools, the field of quality assurance in AIS is still in its early stages. Our Part I manuscript focused on the development and technical validation of an AIS.

Cohort profile: the BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) cohort study.

Purpose: Bangladesh has experienced a rapid epidemiological transition from communicable to non-communicable diseases (NCDs) in recent decades. There is, however, limited evidence about multidimensional determinants of NCDs in this population. The BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) study is a household-based prospective cohort study established to investigate biological, behavioural, environmental and broader determinants of NCDs.

Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren's disease.

Objectives: The objectives are to evaluate variation in systemic disease activity (European Alliance of Associations For Rheumatology (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI)) over time at group and individual patient level and to assess associations of ESSDAI low disease activity (LDA) with other outcome measures in a standard-of-care cohort of patients with Sjögren's disease (SjD).

Methods: Patients with SjD participating in a prospective longitudinal study (REgistry of Sjögren Syndrome LongiTudinal cohort) fulfilling the 2016 American College of Rheumatology/EULAR classification criteria with ≥2 years of follow-up were included. ESSDAI was assessed at least yearly, up to 5 years.

Post-traumatic stress disorder (PTSD) symptom clusters associated with an indicator of heart rate variability: The ADVANCE cohort study.

Background: Heart rate variability (HRV) is governed by of sympathetic and parasympathetic regulatory systems. Post-Traumatic Stress Disorder (PTSD) may influence these systems and consequently affect cardiovascular functioning.

Methods: The sample consisted of 860 UK male military personnel approximately half of who had sustained physical combat injuries in Afghanistan.

Intra-patient comparison of microarchitecture of tumour negative lymph nodes from oesophageal cancer patients - Results from the MRC Oe02 trial.

Background: Regional lymph node (LN) status is a key prognostic factor in oesophageal cancer (OeC). Tumour-derived antigens can activate immune reactions in LNs, potentially reflecting the host's anti-tumour immune response. It remains unclear whether this response is homogeneous across all tumour negative LNs (LNneg) within individual OeC patients.

When multiple instance learning meets foundation models: Advancing histological whole slide image analysis.

Deep multiple instance learning (MIL) pipelines are the mainstream weakly supervised learning methodologies for whole slide image (WSI) classification. However, it remains unclear how these widely used approaches compare to each other, given the recent proliferation of foundation models (FMs) for patch-level embedding and the diversity of slide-level aggregations. This paper implemented and systematically compared six FMs and six recent MIL methods by organizing different feature extractions and aggregations across seven clinically relevant end-to-end prediction tasks using WSIs from 4044 patients with four different cancer types.

Artificial intelligence-enhanced comprehensive assessment of the aortic valve stenosis continuum in echocardiography.

Background: Transthoracic echocardiography (TTE) is the primary modality for diagnosing aortic stenosis (AS), yet it requires skilled operators and can be resource-intensive. We developed and validated an artificial intelligence (AI)-based system for evaluating AS that is effective in both resource-limited and advanced settings.

Methods: We created a dual-pathway AI system for AS evaluation using a nationwide echocardiographic dataset (developmental dataset, n = 8427): 1) a deep learning (DL)-based AS continuum assessment algorithm using limited 2D TTE videos, and 2) automating conventional AS evaluation.

Characterisation of pregnancy-induced alterations in apolipoproteins and their associations with maternal metabolic risk factors and offspring birth outcomes: a preconception and longitudinal cohort study.

Background: Apolipoproteins as an integral part of lipoproteins are crucial for the transport and metabolism of lipids. However, there is a lack of longitudinal studies to quantify the concentrations of maternal apolipoproteins from preconception to postpartum and their associations with maternal metabolic health and offspring birth outcomes.

Methods: Quantification of apolipoproteins was performed on maternal plasma samples (N = 243 trios) collected at preconception, 26-28 weeks' pregnancy, and three months postpartum in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort study.

Effects of Ramadan intermittent fasting on hormones regulating appetite in healthy individuals: A systematic review and meta-analysis.

Background And Aims: This systematic review and meta-analysis aimed to examine the effect of Ramadan intermittent fasting on appetite-regulating hormones including leptin, ghrelin, insulin, gastrin, glucagon-like peptide-1, peptide YY, and cholecystokinin.

Methods: We searched the MEDLINE, Embase, Cochrane Library, CINAHL, Google Scholar, and Web of Science databases to identify relevant research on appetite-regulating hormones during Ramadan intermittent fasting, published until the end of March 2024.

Results: Data from 16 eligible studies comprising 664 participants (341, 51.

Sex Differences in Long COVID.

Importance: A substantial number of individuals worldwide experience long COVID, or post-COVID condition. Other postviral and autoimmune conditions have a female predominance, but whether the same is true for long COVID, especially within different subgroups, is uncertain.

Objective: To evaluate sex differences in the risk of developing long COVID among adults with SARS-CoV-2 infection.

Cerebral Microbleeds and Amyloid Pathology Estimates From the Amyloid Biomarker Study.

Importance: Baseline cerebral microbleeds (CMBs) and APOE ε4 allele copy number are important risk factors for amyloid-related imaging abnormalities in patients with Alzheimer disease (AD) receiving therapies to lower amyloid-β plaque levels.

Objective: To provide prevalence estimates of any, no more than 4, or fewer than 2 CMBs in association with amyloid status, APOE ε4 copy number, and age.

Design, Setting, And Participants: This cross-sectional study used data included in the Amyloid Biomarker Study data pooling initiative (January 1, 2012, to the present [data collection is ongoing]).