Autonomy support in prenatal consultation: A quantitative observation study in maternity care.

Introduction: Maternity care professionals need to guide women through an increasing number of decision-making processes during pregnancy. Professionals tend to focus more on providing information than on decision support. According to the self-determination theory (SDT), professionals could help women make their own choices by fulfilling their three basic psychological needs: autonomy, competence, and relatedness through autonomy-supportive interactions.

Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England: protocol for a retrospective cross-sectional study.

Introduction: Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.

Ramadan intermittent fasting for patients with gastrointestinal and hepatobiliary diseases: practical guidance for health-care professionals.

Ramadan intermittent fasting can pose challenges and risks for some groups of patients. Based on a narrative literature review and our clinical expertise, we provide practical guidance for clinicians managing patients with gastrointestinal and hepatobiliary conditions who wish to fast during Ramadan. Following the established International Diabetes Federation and Diabetes and Ramadan International Alliance risk stratification framework, we categorised patients' risk as low or moderate, high, or very high.

Automated characterisation of cerebral microbleeds using their size and spatial distribution on brain MRI.

Cerebral microbleeds (CMBs) are small, hypointense hemosiderin deposits in the brain measuring 2-10 mm in diameter. As one of the important biomarkers of small vessel disease, they have been associated with various neurodegenerative and cerebrovascular diseases. Hence, automated detection, and subsequent extraction of clinically useful metrics (e.

Cardiotoxicity evaluation of two-drug fixed-dose combination therapy under CiPA: a computational study.

The Comprehensive Proarrhythmia Assay (CiPA) evaluates drug-induced torsade de pointes (TdP) risk, with qNet commonly used to classify drugs into low-, intermediate-, and high-risk categories. While most studies focus on single-drug effects, 2-drug fixed-dose combination (FDC) therapy is widely used for cardiovascular disease management. We aimed to develop the CiPA-based methodology to predict adverse effects of FDC therapy.

β-alanine supplementation in adults with overweight and obesity: a randomized controlled feasibility trial.

Objective: Overweight and obesity are characterized by excess adiposity and systemic, chronic, low-grade inflammation, which is associated with several metabolic disorders. The aim of this study was to assess the feasibility and tolerability of β-alanine supplementation and to explore the effects on cardiometabolic health and cardiovascular, hepatic, and renal function in adults with overweight and obesity.

Methods: A total of 27 adults (44% female; mean [SD], age: 58 [10] years, BMI: 31.

The Impact of Age and Sex on the Expression and Severity of Borderline Symptoms in Individuals With Borderline Personality Disorder: An Iranian Study.

Reports of sex and age differences in the presentation of borderline symptoms have been limited to the Western literature and have not systematically compared adolescents with emerging and older adults with borderline personality disorder (BPD). This study aimed to examine the impact of age and sex on the expression of borderline symptoms in adolescents, young adults, and older adults with BPD. A sample of 493 Iranian individuals with a confirmed diagnosis of BPD was segregated into 2 age groups: 134 young people aged 12-25 (mean = 17.

Evaluating student understanding of core pharmacokinetic concepts.

Both educators and graduates have expressed concern about a perceived pharmacology knowledge gap that includes difficulty applying fundamental principles to clinical and research problems. Consequently, we sought to determine the extent to which current students can explain the meaning of, and appropriately apply, a subset of core concepts, and to identify any misconceptions arising from the responses. Of the twenty-four pharmacology core concepts arising from the recent international collaboration, four pharmacokinetic concepts were chosen, namely drug bioavailability, drug clearance, volume of distribution, and steady-state concentration.

Visual feature processing in a large stroke cohort: evidence against modular organization.

Mid-level visual processing represents a crucial stage between basic sensory input and higher-level object recognition. The conventional model posits that fundamental visual qualities like color and motion are processed in specialized, retinotopic brain regions (e.g.

Quantifying the portrayal of alcohol-related A&E attendances and prevention in the British medical documentary series '24 hours in A&E'.

Background: Alcohol misuse is linked to numerous health and socioeconomic harms. Edutainment and docutainment television programmes can act as health promotion tools, influencing health perceptions and behaviours. Inaccurate portrayals can engender misinformation.

Association between clinical and MRI-detected imaging findings for people with midfoot pain, a cross-sectional study.

Background: Midfoot pain is common but poorly understood, with radiographs often indicating no anomalies. This study aimed to describe bone, joint and soft tissue changes and to explore associations between MRI-detected abnormalities and clinical symptoms (pain and disability) in a group of adults with midfoot pain, but who were radiographically negative for osteoarthritis.

Methods: Community-based participants with midfoot pain underwent an MRI scan of one foot and scored semi-quantitatively using the Foot OsteoArthritis MRI Score (FOAMRIS).

Genomic re-sequencing reveals mutational divergence across genetically engineered strains of model archaea.

Unlabelled: Archaeal molecular biology has been a topic of intense research in recent decades as their role in global ecosystems, nutrient cycles, and eukaryotic evolution comes to light. The hypersaline-adapted archaeal species and serve as important model organisms for understanding archaeal genomics, genetics, and biochemistry, in part because efficient tools enable genetic manipulation. As a result, the number of strains in circulation among the haloarchaeal research community has increased in recent decades.

Tele-medicine and its impact on academic medical centers: A narrative review.

Telemedicine is a potential complementary modality with remarkable benefits for future healthcare delivery when incorporated appropriately. This review article examines the importance of telemedicine in various types of healthcare facilities and its utility in remote and underserved settings. PubMed, Google Scholar, Scopus, and Embase databases were used for the literature review.

Impulsivity behaviors and white matter mediate the relationship between genetic risk for cannabis use disorder and early cannabis use in adolescents.

Background And Aim: Cannabis use disorder (CUD) is strongly influenced by genetic factors; however the mechanisms underpinning this association are not well understood. This study investigated whether a polygenic risk score (PRS) based on a genome-wide association study for CUD in adults predicts cannabis use in adolescents and whether the association can be explained by inter-individual variation in structural properties of brain white matter or risk-taking behaviors.

Design And Setting: Longitudinal and cross-sectional analyses using data from the IMAGEN cohort, a European longitudinal study integrating genetic, neuroimaging and behavioral measures.

Evaluating student understanding of pharmacodynamics core concepts.

Pharmacodynamics is an essential subdiscipline of pharmacology that underpins safe and effective prescribing and therapeutic decision-making, as well as drug discovery and development. The exponential increase in the number of therapeutic drugs has prompted members of the pharmacology educator community to question existing pharmacology curricula focused on individual drugs and move toward a curriculum focused on conceptual understanding. A first step towards conceptual understanding is to establish what students currently know about pharmacodynamic core concepts.

Deconditioning in quiescent Crohn's Disease patients with heightened fatigue perception.

Background & Objective: IBD fatigue aetiology is poorly understood. This study quantified body composition and physical function alongside proton magnetic resonance imaging (1H MRI) and spectroscopy (31P MRS) measures of organ structure and function in quiescent Crohn's Disease patients (CD) and healthy volunteers (HV), to identify a physiological basis for IBD fatigue.

Methods: Body composition was determined using DEXA and 1H MRI.

Elective peri-operative management of adults taking glucagon-like peptide-1 receptor agonists, glucose-dependent insulinotropic peptide agonists and sodium-glucose cotransporter-2 inhibitors: a multidisciplinary consensus statement: A consensus statement from the Association of Anaesthetists, Association of British Clinical Diabetologists, British Obesity and Metabolic Surgery Society, Centre for Perioperative Care, Joint British Diabetes Societies for Inpatient Care, Royal College of Anaesthetists, Society for Obesity and Bariatric Anaesthesia and UK Clinical Pharmacy Association.

Introduction: Glucagon-like peptide-1 receptor agonists, dual glucose-dependent insulinotropic peptide receptor agonists and sodium-glucose cotransporter-2 inhibitors are used increasingly in patients receiving peri-operative care. These drugs may be associated with risks of peri-operative pulmonary aspiration or euglycaemic ketoacidosis. We produced a consensus statement for the peri-operative management of adults taking these drugs.

The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review.

Processed electroencephalography (pEEG) is increasingly used to titrate the depth of anesthesia. Whether such intra-procedural pEEG monitoring can offer additional information on cerebral perfusion or acute focal or global cerebral ischemia is unknown. This scoping review aimed to provide a narrative analysis of the current literature reporting the potential role of pEEG in adults with acute cerebral ischemia.

Airway pressures generated by high flow nasal cannula in patients with acute hypoxemic respiratory failure: a computational study.

Introduction And Objectives: High flow nasal cannula (HFNC) therapy is an increasingly popular mode of non-invasive respiratory support for the treatment of patients with acute hypoxemic respiratory failure (AHRF). Previous experimental studies in healthy subjects have established that HFNC generates flow-dependent positive airway pressures, but no data is available on the levels of mean airway pressure (mP) or positive end-expiratory pressure (PEEP) generated by HFNC therapy in AHRF patients. We aimed to estimate the airway pressures generated by HFNC at different flow rates in patients with AHRF, whose functional lung volume may be significantly reduced compared to healthy subjects due to alveolar consolidation and/or collapse.

Structural basis of THC analog activity at the Cannabinoid 1 receptor.

Tetrahydrocannabinol (THC) is the principal psychoactive compound derived from the cannabis plant Cannabis sativa and approved for emetic conditions, appetite stimulation and sleep apnea relief. THC's psychoactive actions are mediated primarily by the cannabinoid receptor CB. Here, we determine the cryo-EM structure of HU210, a THC analog and widely used tool compound, bound to CB and its primary transducer, G.

Low-temperature vacuum evaporation as a novel dehydration process for the long-term preservation of transplantable human corneal tissue.

Globally there is a shortage of available donor corneas with only 1 cornea available for every 70 needed. A large limitation to corneal transplant surgery is access to quality donor tissue due to inadequate eye donation services and infrastructure in many countries, compounded by the fact that there are few available long-term storage solutions for effectively preserving spare donor corneas collected in countries with a surplus. In this study, we describe a novel technology termed low-temperature vacuum evaporation (LTVE) that can effectively dry-preserve surplus donor corneal tissue, allowing it to be stored for approximately 5 years, shipped at room temperature, and stored on hospital shelves before rehydration prior to ophthalmic surgery.

Investigating Neurometabolite Changes in Response to Median Nerve Stimulation.

Background: Rhythmic median nerve stimulation (MNS) at 10 Hz has been shown to cause a substantial reduction in tic frequency in individuals with Tourette syndrome. The mechanism of action is currently unknown but is hypothesized to involve entrainment of oscillations within the sensorimotor cortex.

Objective: We used functional magnetic resonance spectroscopy (fMRS) to explore the dynamic effects of MNS on neurometabolite concentrations.

On Medical Tourism Overseas: Ethical Analysis of the Duties of NHS Doctors in Managing the Negative Health Consequences of Accessing Medical Treatments Abroad.

Introduction: An increasing number of UK residents are travelling overseas to access medical treatments, the negative health consequences of which are largely managed by NHS doctors.

Methods: This paper performs an ethical analysis, using the ethical framework of principlism, of the duties of NHS doctors in managing these negative health consequences of medical tourism overseas.

Findings: While the doctor's duty to respect patient autonomy contains a negative duty to not interfere with their choice to access medical treatment overseas, it also contains a positive duty to ensure this choice is informed.

Feasibility within-subject RCT of neuromuscular electrical stimulation; an Intervention to Maintain and improve neuroMuscular function during period of Immobility (IMMI).

Introduction: Neuromuscular electrical stimulation (NMES) is a potentially effective intervention to improve outcomes after a fragility fracture, but its feasibility in this group has not been established.

Methods: A feasibility study was conducted in two phases: 1) in the hospital only, and 2) hospital, rehabilitation centres, and participants' homes. Patients with fragility fracture were randomised to receive NMES for 6 weeks/discharge either to the right or left leg, with the other leg serving as control.

The clinical and cost effectiveness of a STAndardised DIagnostic Assessment for children and adolescents with emotional difficulties: the STADIA multi-centre randomised controlled trial.

Background: Standardised Diagnostic Assessment tools, such as the Development and Well-Being Assessment (DAWBA), may aid detection and diagnosis of emotional disorders but there is limited real-world evidence of their clinical or cost effectiveness.

Methods: We conducted a multicentre, two-arm parallel group randomised controlled trial in eight large National Health Service Trusts in England providing multidisciplinary specialist Child and Adolescent Mental Health Services (CAMHS). Participants (5-17 year-olds with emotional difficulties referred to CAMHS) were randomly assigned (1:1), following referral receipt, to either receive the DAWBA and assessment-as-usual (intervention group) or assessment-as-usual (control group).