Peripheral oxygen saturation levels as a guide to avoid hyperoxia: an observational study.

Background: As iatrogenic hyperoxia has been related to adverse outcomes in critically ill patients, guidelines advise to titrate oxygen to physiological levels. In the prehospital setting where partial arterial oxygen (PaO) values are often not readily available, titration of oxygen is based on peripheral oxygen saturations (SpO2). In this study we aimed to investigate the efficacy of SpO guided oxygen titration in the prevention of hyperoxia.

Cross-agency working when conducting a pragmatic RCT for older victims of crime: our experiences and lessons learned.

Background: With the population ageing, more victims of community crime are likely to be older adults. The psychological impact of crime on older victims is significant and sustained, but only feasibility trials have been published regarding potential interventions. The integration of public health and care services and cross-agency working is recommended, but there is little information on how this should be undertaken.

An exceptionally rare case of a diffuse midline glioma with concomitant H3.1 K27M and G34R mutations in the HIST1H3C (H3C3) gene.

Histone mutations (H3 K27M, H3 G34R/V) are molecular features defining subtypes of paediatric-type diffuse high-grade gliomas (HGG) (diffuse midline glioma (DMG), H3 K27-altered, diffuse hemispheric glioma (DHG), H3 G34-mutant). The WHO classification recognises in exceptional cases, these mutations co-occur. We report one such case of a 2-year-old female presenting with neurological symptoms; MRI imaging identified a brainstem lesion which was biopsied.

Evaluating catastrophic health expenditures among patients with long bone fractures in Ghana's major teaching hospitals: a hospital-based analysis.

Background: In low and middle-income countries like Ghana, out-of-pocket (OOP) payments remain a significant barrier to healthcare access, often leading to catastrophic health expenditures (CHE). This study evaluates the incidence of CHE among patients treated for long bone fractures at Ghana's major teaching hospitals, providing insight into the economic burdens faced by these patients.

Methods: This cross-sectional study analyzed data from 2,980 patients with long bone fractures treated at four major teaching hospitals in Ghana from July 2017 to July 2020.

Resistance mechanisms to immune checkpoint inhibitors: updated insights.

The last decade has witnessed unprecedented succusses with the use of immune checkpoint inhibitors in treating cancer. Nevertheless, the proportion of patients who respond favorably to the treatment remained rather modest, partially due to treatment resistance. This has fueled a wave of research into potential mechanisms of resistance to immune checkpoint inhibitors which can be classified into primary resistance or acquired resistance after an initial response.

Larviciding for malaria control and elimination in Africa.

Background: Global progress toward malaria elimination and eradication goals has stagnated in recent years, with many African countries reporting increases in malaria morbidity and mortality. Insecticide-treated nets and indoor residual spraying are effective, but the emergence and increased intensity of insecticide resistance and the challenge of outdoor transmission are undermining their impact. New tools are needed to get back on track towards global targets.

The association between type 2 diabetes and asthma incidence: a longitudinal analysis considering genetic susceptibility.

Background: The prevalence of type 2 diabetes (T2D) and asthma is rising, yet evidence regarding the relationship between T2D and asthma, particularly in the context of genetic predispositions, remains limited.

Methods: This study utilized data from the UK Biobank longitudinal cohort, involving 388,775 participants. A polygenic risk score (PRS) for asthma was derived from genome-wide association studies summary.

Urban and rural residence: their influence on food group consumption in Iran.

Background: Urbanization is expanding in Iran, leading to the emergence of three distinct socio-geographical areas: urban, rural, and suburban areas. These different areas may exhibit significant variations in dietary patterns. This study investigates the association between people's place of residence and their consumption of different food groups.

A qualitative systematic review of umbilical cord care practices in Nigeria.

Background: Umbilical cord care is an important aspect of newborn health, and different practices exist around the world, often influenced by cultural, healthcare infrastructure, and socioeconomic factors. The objective of this systematic review is to synthesize current literature on umbilical cord care practices in Nigeria, with an emphasis on the impact of cultural beliefs, healthcare infrastructure, and socioeconomic factors.

Methods: A comprehensive search for literature was performed across PubMED, MEDLINE and Google scholar for studies published between 2010 and 2023.

Smoking cessation is a protective factor for lung cancer onset and mortality: a population-based prospective cohort study.

Background: Smoking is a pivotal modifiable risk factor for lung cancer (LC). Previous studies have indicated that a smoking cessation program might be incorporated into the LC screening program. However, the effects of smoking cessation and its duration with the age at onset (AAO) of LC, all-cause mortality, and LC-specific mortality remain unclear.

A conceptual model for advanced/metastatic gastric or gastroesophageal junction cancer: a review of qualitative studies and results from patient interviews.

Background: Despite approvals of new first-line immunotherapies for advanced/metastatic gastric cancer/gastroesophageal junction cancer (aGC/GEJC), patients' median survival is around 14 months and their health-related quality of life (HRQoL) is affected by disease-related symptoms and treatment-related side effects. Using a targeted literature review (TLR) and patient interviews, this study identified disease- and treatment-related concepts that are important to patients with aGC/GEJC and their HRQoL.

Methods: A TLR was conducted to identify primary qualitative studies from 2018 to 2021 on patients' experiences with aGC/GEJC.

Interobserver and intraobserver variability among different vendors for mitral valve assessment: implications for transcatheter mitral valve repair.

Purpose: Pre-procedural imaging is critical for transcatheter mitral valve repair planning in patients with mitral valve disease. As differences among various measurement techniques for valve evaluation are still poorly understood, we sought to assess the intra- and interobserver agreement of complex measurements derived from a prototype mitral evaluation tool (Siemens) and a commercially available tool (CVI42) using both saddle- and D-shaped mitral annulus techniques.

Materials And Methods: Multiphasic cardiac computed tomography angiography data were loaded into each software.

Seeking optimal non-pharmacological interventions for sarcopenia: a systematic review and network meta-analysis.

Background: With the acceleration of aging, sarcopenia has become a reality of concern today. This study aimed to evaluate the efficacy of various non-pharmacologic interventions and find the optimal interventions for sarcopenia.

Methods: PubMed, Medline OVID, EMBASE, Scopus, and Cochrane were searched from 1 January 2000 to 25 October 2023, with language restrictions to English.

Opportunities and limitations of B cell depletion approaches in SLE.

B cell depletion with rituximab, a chimeric monoclonal antibody that selectively targets B cells by binding CD20, has been used off label in severe and resistant systemic lupus erythematosus (SLE) for over two decades. Several biological mechanisms limit the efficacy of rituximab, including immunological reactions towards the chimeric molecule, increased numbers of residual B cells, including plasmablasts and plasma cells, and a post-treatment surge in B cell-activating factor (BAFF) levels. Consequently, rituximab induces remission in only a proportion of patients, and safety issues limit its use.

Association between early age body mass index and the risk of adulthood cardiovascular diseases: a systematic review and meta-analysis.

Background: Several studies have attempted to demonstrate the associations between body mass index (BMI) in early age and cardiovascular diseases (CVDs). However, their findings were inconsistent and inconclusive, indicating the need for further investigation.

Methods: We conducted a systematic review and meta-analysis of studies focusing on BMI in early age (age from 2 to 22) in relation to CVDs in adulthood, including coronary artery disease (CHD), ischemic and hemorrhagic stroke, myocardial infarction and heart failure.

Rightward brain structural asymmetry in young children with autism.

To understand the neural mechanism of autism spectrum disorder (ASD) and developmental delay/intellectual disability (DD/ID) that can be associated with ASD, it is important to investigate individuals at an early stage with brain, behavioural and also genetic measures, but such research is still lacking. Here, using the cross-sectional sMRI data of 1030 children under 8 years old, we employed developmental normative models to investigate the atypical development of gray matter volume (GMV) asymmetry in individuals with ASD without DD/ID, ASD with DD/ID and individuals with only DD/ID, and their associations with behavioral and clinical measures and transcription profiles. By extracting the individual deviations of patients from the typical controls with normative models, we found a commonly abnormal pattern of GMV asymmetry across all ASD children: more rightward laterality in the inferior parietal lobe and precentral gyrus, and higher individual variability in the temporal pole.

Daratumumab plus lenalidomide/dexamethasone in untreated multiple myeloma: analysis of key subgroups of the MAIA study.

In the MAIA study (median follow-up, 56.2 months), daratumumab plus lenalidomide and dexamethasone (D-Rd) significantly improved progression-free survival (PFS) and overall survival versus lenalidomide and dexamethasone (Rd) alone in transplant-ineligible newly diagnosed multiple myeloma (NDMM). In this post hoc analysis of clinically important subgroups in MAIA (median follow-up, 64.

Open lower limb fracture reconstruction in the elderly population: the experience of a major trauma centre.

Purpose: Management of the elderly patients presenting with open lower limb fractures is challenging due to physiological changes and pre-existing co-morbidities. The aim of this study was to assess the compliance with the British Orthopaedic Association's Standards for Trauma Number 4 (BOAST 4) guidelines in this patient group.

Methods: The study included a retrospective analysis of all the patients aged > 65 years old admitted with open lower limb fracture between 2017 and 2019 to a major trauma centre (MTC) in East of England.

Management of post-operative anaemia in patients undergoing surgery for colorectal cancer: a qualitative focus group-based study.

Background: Optimal management of anaemia following surgery for colorectal cancer remains unclear. Peri-operative anaemia is common in patients undergoing resectional surgery for colorectal cancer. A significant amount of research has been conducted into the management of pre-operative anaemia; however, little work has investigated post-operative anaemia.

A novel human fetal lung-derived alveolar organoid model reveals mechanisms of surfactant protein C maturation relevant to interstitial lung disease.

Alveolar type 2 (AT2) cells maintain lung health by acting as stem cells and producing pulmonary surfactant. AT2 dysfunction underlies many lung diseases, including interstitial lung disease (ILD), in which some inherited forms result from the mislocalization of surfactant protein C (SFTPC) variants. Lung disease modeling and dissection of the underlying mechanisms remain challenging due to complexities in deriving and maintaining human AT2 cells ex vivo.

Clinical practice recommendations for the diagnosis and management of X-linked hypophosphataemia.

X-linked hypophosphataemia (XLH) is a rare metabolic bone disorder caused by pathogenic variants in the PHEX gene, which is predominantly expressed in osteoblasts, osteocytes and odontoblasts. XLH is characterized by increased synthesis of the bone-derived phosphaturic hormone fibroblast growth factor 23 (FGF23), which results in renal phosphate wasting with consecutive hypophosphataemia, rickets, osteomalacia, disproportionate short stature, oral manifestations, pseudofractures, craniosynostosis, enthesopathies and osteoarthritis. Patients with XLH should be provided with multidisciplinary care organized by a metabolic bone expert.

Genetic proxies for clinical traits are associated with increased risk of severe COVID-19.

Routine use of genetic data in healthcare is much-discussed, yet little is known about its performance in epidemiological models including traditional risk factors. Using severe COVID-19 as an exemplar, we explore the integration of polygenic risk scores (PRS) into disease models alongside sociodemographic and clinical variables. PRS were optimized for 23 clinical variables and related traits previously-associated with severe COVID-19 in up to 450,449 UK Biobank participants, and tested in 9,560 individuals diagnosed in the pre-vaccination era.

Continental influx and pervasive matrilocality in Iron Age Britain.

Roman writers found the relative empowerment of Celtic women remarkable. In southern Britain, the Late Iron Age Durotriges tribe often buried women with substantial grave goods. Here we analyse 57 ancient genomes from Durotrigian burial sites and find an extended kin group centred around a single maternal lineage, with unrelated (presumably inward migrating) burials being predominantly male.

Long-lived entanglement of molecules in magic-wavelength optical tweezers.

Realizing quantum control and entanglement of particles is crucial for advancing both quantum technologies and fundamental science. Substantial developments in this domain have been achieved in a variety of systems. In this context, ultracold polar molecules offer new and unique opportunities because of their more complex internal structure associated with vibration and rotation, coupled with the existence of long-range interactions.

De novo designed proteins neutralize lethal snake venom toxins.

Snakebite envenoming remains a devastating and neglected tropical disease, claiming over 100,000 lives annually and causing severe complications and long-lasting disabilities for many more. Three-finger toxins (3FTx) are highly toxic components of elapid snake venoms that can cause diverse pathologies, including severe tissue damage and inhibition of nicotinic acetylcholine receptors, resulting in life-threatening neurotoxicity. At present, the only available treatments for snakebites consist of polyclonal antibodies derived from the plasma of immunized animals, which have high cost and limited efficacy against 3FTxs.