Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial.

Importance: For hospitalized critically ill adults with suspected sepsis, procalcitonin (PCT) and C-reactive protein (CRP) monitoring protocols can guide the duration of antibiotic therapy, but the evidence of the effect and safety of these protocols remains uncertain.

Objective: To determine whether decisions based on assessment of CRP or PCT safely results in a reduction in the duration of antibiotic therapy.

Design, Setting, And Participants: A multicenter, intervention-concealed randomized clinical trial, involving 2760 adults (≥18 years), in 41 UK National Health Service (NHS) intensive care units, requiring critical care within 24 hours of initiating intravenous antibiotics for suspected sepsis and likely to continue antibiotics for at least 72 hours.

Novel Nanocomposite of Carbonized Chitosan-Zinc Oxide-Magnetite for Adsorption of Toxic Elements from Aqueous Solutions.

Herein, a novel nanocomposite (carbonized chitosan-zinc oxide-magnetite, CCZF) was developed to effectively remove toxic elements in water remediation. Combining the high adsorption capacities of chitosan with the magnetic properties of magnetite and the chemical stability of zinc oxide, the combination of these unique properties makes it an efficient and versatile material that offers a sustainable solution for water purification. The (CCZF) nanocomposite was synthesized through the coprecipitation method and characterized using various techniques, including scanning electron microscopy (SEM), transmission electron microscopy (TEM), Brunauer-Emmett-Teller (BET) analysis, X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and zeta potential analysis.

Assessment of knowledge and awareness of stroke among Arabic speaking adults: unveiling the current landscape in seven countries through the first international representative study.

Introduction: While several studies have examined stroke public knowledge and awareness in individual countries within the Middle East and North Africa (MENA) region, none have provided a comprehensive cross-country assessment.

Purpose: To assess public stroke knowledge and awareness among Arabic-speaking adults in seven MENA countries and identify associated factors.

Materials And Methods: An online cross-sectional survey was self-administered by the public population in Iraq, Lebanon, Sudan, Jordan, United Arab Emirates, Syria, and Saudi Arabia (April 2021-2023).

Biofabrication and biomanufacturing in Ireland and the UK.

As we navigate the transition from the Fourth to the Fifth Industrial Revolution, the emerging fields of biomanufacturing and biofabrication are transforming life sciences and healthcare. These sectors are benefiting from a synergy of synthetic and engineering biology, sustainable manufacturing, and integrated design principles. Advanced techniques such as 3D bioprinting, tissue engineering, directed assembly, and self-assembly are instrumental in creating biomimetic scaffolds, tissues, organoids, medical devices, and biohybrid systems.

Animal-assisted intervention services across UK intensive care units: A national service evaluation.

Background: Animal-assisted interventions (AAI) can provide psychological support to critical care patients during their intensive care unit (ICU) admission. However, there are currently no data on AAI services across UK ICUs. The current study therefore aims to (i) determine how many ICUs in the UK offer services, (ii) characterise available services and (iii) explore and review local documentation for service oversight.

Blood methylation biomarkers are associated with diabetic kidney disease progression in type 1 diabetes.

Background: DNA methylation differences are associated with kidney function and diabetic kidney disease (DKD), but prospective studies are scarce. Therefore, we aimed to study DNA methylation in a prospective setting in the Finnish Diabetic Nephropathy Study type 1 diabetes (T1D) cohort.

Methods: We analysed baseline blood sample-derived DNA methylation (Illumina's EPIC array) of 403 individuals with normal albumin excretion rate (early progression group) and 373 individuals with severe albuminuria (late progression group) and followed-up their DKD progression defined as decrease in eGFR to <60 mL/min/1.

Cannabis use in youth is associated with chronic inflammation.

Background: Markers of inflammation and cannabis exposure are associated with an increased risk of mental disorders. In the current study, we investigated associations between cannabis use and biomarkers of inflammation.

Methods: Utilizing a sample of 914 participants from the Avon Longitudinal Study of Parents and Children, we investigated whether interleukin-6 (IL-6), tumor necrosis factor (TNF), C-reactive protein (CRP), and soluble urokinase plasminogen activator receptor (suPAR) measured at age 24 were associated with past year daily cannabis use, less frequent cannabis use, and no past year cannabis use.

Airway total bacterial density, microbiota community composition and relationship with clinical parameters in bronchiectasis.

Background And Objective: This study explored the relationship between total bacterial density, airway microbiota composition and clinical parameters in bronchiectasis. We determined changes with time during clinical stability and following antibiotic treatment of a pulmonary exacerbation.

Methods: We conducted a multicentre longitudinal cohort study of UK participants with CT confirmed bronchiectasis.

Application of microarray patches for the transdermal administration of psychedelic drugs in micro-doses.

Throughout history, psychedelic compounds have been used for religious, spiritual and recreational purposes. A plethora of studies have reported the use of psychedelic compounds in the treatment of various conditions, such as alcoholism, addictions, depressive state to borderline schizophrenia, personality disorder, among other mental disorders. Psychedelic microdosing, a common technique in recent years, involves the consumption of small doses of psychedelic drugs for therapeutic purposes.

Non-adherence to immunosuppressive medications in kidney transplant recipients- a systematic scoping review.

Background: Rejection and graft failure remain common in kidney transplant recipients. Non-adherence to immunosuppressive medications is considered a major contributary factor to reduced long-term graft survival, particularly in younger people. Improvements in clinical practice based on adherence studies has been minimal.

Glucocorticoid treatment and new-onset hyperglycaemia and diabetes in people living with chronic obstructive pulmonary disease: A systematic review and meta-analysis.

Introduction: In people living with chronic obstructive pulmonary disease (COPD), we aimed to estimate: (1) the prevalence of glucocorticoid-induced hyperglycaemia (GIH); (2) whether the prevalence of GIH varies by age, baseline diabetes status, treatment duration, ascertainment of glycaemia, definition of hyperglycaemia, study design and year of publication; and (3) the relative risk (RR) of new-onset hyperglycaemia in exposed vs non-exposed to systemic glucocorticoids.

Methods: We searched electronic databases until 9 November 2023 for randomised controlled trials and observational studies including adults diagnosed with COPD, with or without diabetes at baseline, using systemic glucocorticoids equivalent to prednisolone ≥5 mg/day for ≥3 days if exposed. Hyperglycaemia was defined as a blood glucose above a study-specific cut-off.

Olive mill wastewater: From by-product to smart antioxidant material.

Olive mill wastewater (OMWW) is a byproduct of olive oil extraction that represents a critical environmental concern due to its potential adverse effects on ecosystems. Given these premises, spray-dried microparticles were designed and developed using maltodextrins as carriers to encapsulate OMWW bioactive compounds. The microparticles were manufactured using an easily scalable and sustainable spray-drying process.

Microbiological analysis of donor human milk over seven years from the Hearts Milk Bank (United Kingdom).

When maternal milk is unavailable, donor human milk (DHM) from human milk banks (HMBs) is the optimal alternative, as recommended by the World Health Organisation. The microbiota of DHM could contain opportunistic pathogens, which means rigorous microbiological screening for DHM, prior to pasteurisation, is recommended to safeguard recipients. Here, an analysis of 6863 DHM samples from 1419 donors at the Hearts Milk Bank between 2017 and 2023 showed approximately 70.

Sensitive electrochemical sensor of levofloxacin using boron-doped diamond (BDD) electrode modified with TiCT (MXene) material.

Overuse of levofloxacin (LEV) is often associated with bacterial resistance and serious health problems, underscoring the need for reliable sensing and monitoring of LEV molecules. Therefore, this study aimed to investigate LEV using boron-doped diamond (BDD) and boron-doped diamond modified with MXene (TiCT) (BDD-MXene) electrode. The successful deposition of MXene on the BDD surface was confirmed using scanning electron microscope (SEM).

Targeting the PREX2/RAC1/PI3Kβ Signaling Axis Confers Sensitivity to Clinically Relevant Therapeutic Approaches in Melanoma.

Metastatic melanoma remains a major clinical challenge. Large-scale genomic sequencing of melanoma has identified bona fide activating mutations in RAC1, which are associated with resistance to BRAF-targeting therapies. Targeting the RAC1-GTPase pathway, including the upstream activator PREX2 and the downstream effector PI3Kβ, could be a potential strategy for overcoming therapeutic resistance, limiting melanoma recurrence, and suppressing metastatic progression.

Exploring drug consumption rooms as 'inclusion health interventions': policy implications for Europe.

People who use drugs are among the most socially excluded groups in Europe. Qualitative research on Drug Consumption Rooms (DCRs) has reported various benefits to clients, including increased feelings of well-being, safety and connection, however, few studies have explored in-depth client narratives of belonging and social inclusion. In this article, we explore this literature and describe the ways in which DCRs foster social inclusion and feelings of belonging amongst their clients.

Sickness absence trajectories among young and early midlife employees with psychological distress: the contributions of social and health-related factors in a longitudinal register linkage study.

Purpose: Psychological distress has been associated with sickness absence (SA), but less is known about whether there are distinct patterns in the development of SA among people with psychological distress. We examined trajectories of short- and long-term SA among employees with psychological distress and how social and health-related factors are associated with them.

Methods: We used the employer's register data on all-cause short- (≤ 10 working days) and long-term (> 10 working days) SA with a two-year follow-up.

Dual gene set enrichment analysis (dualGSEA); an R function that enables more robust biological discovery and pre-clinical model alignment from transcriptomics data.

Gene set enrichment analysis (GSEA) tools can identify biological insights within gene expression-based studies. Although their statistical performance has been compared, the downstream biological implications that arise when choosing between the range of pairwise or single sample forms of GSEA methods remain understudied. We compare the statistical and biological results obtained from various pre-ranking methods/options for pairwise GSEA, followed by a stand-alone comparison of GSEA, single sample GSEA (ssGSEA) and gene set variation analysis (GSVA).

Impact of edentulism on community-dwelling adults in low-income, middle-income and high-income countries: a systematic review.

Objectives: This study aims to comprehensively explore the consequences of edentulism on community-dwelling adults in low-income, middle-income and high-income countries.

Design: Systematic review and Synthesis Without Meta-Analysis (SWiM).

Data Sources: MEDLINE, Embase, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to 21 March 2023, in addition to grey literature searches, reference cross-checking and study recommendations.

Is there truth in fiction? Lessons from readers' responses to dementia fiction.

This paper addresses the question 'is there truth in fiction?', by synthesising a range of disciplinary approaches to the issue, as well as drawing on empirical research carried out with readers of fiction about dementia (hereafter, dementia fiction). We argue that fiction-perhaps because of its fictional status and apparatus-invites readers to consider its truth value, to explore the possibilities of human experience and interrogate issues relative to their subjective experience, community or society. The findings have significant implications for the Medical Humanities' use of fictional texts to explore lived medical conditions and experiences, as well as claims made about the potential for fiction to affect real-world understandings, awareness and empathy around the conditions depicted.