Nebulized aminoglycosides for ventilator-associated pneumonia: Methodological considerations and lessons from experimental studies.

Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma.

Advancements in liver retraction techniques for laparoscopic gastrectomy.

Traditionally, liver retraction for laparoscopic gastrectomy is done manual methods, such as the placement of retractors through the accessory ports and using a Nathanson retractor. However, these techniques often posed issues including extra abdominal incisions, risk of liver injury or ischaemia, and the potential for compromised visualization. Over the years, the development of innovative liver retraction techniques has significantly improved the safety and efficacy of laparoscopic gastrectomy and similar other hiatal procedures.

Unusual presentation of medication-induced atrial fibrillation: A case report.

This case highlights that atrial fibrillation can occur as an adverse effect of tamsulosin even in younger patients at lower doses, challenging the conventional understanding that this complication primarily affects older individuals on higher doses. Clinicians should remain vigilant for this potential side effect across all patient demographics to ensure prompt identification and management.

Management of Patients with Myocardial Injury After Noncardiac Surgery: A Retrospective Chart Review.

Background: Myocardial injury after noncardiac surgery (MINS) is associated with an increased incidence of cardiac morbidity and mortality. Little is known about how these patients are managed.

Methods: We performed a single-centre retrospective chart review of patients referred to a postoperative clinic with the diagnosis of MINS.

A Hybrid Rehabilitation Program for Adults with Peripheral Artery Disease (HY-PAD): A Pre-Post Intervention Study to Assess Its Feasibility.

Background: Supervised exercise programs improve walking impairment and quality of life (QoL) in patients with peripheral artery disease (PAD). However, such programs are underutilized, due to their limited accessibility. A feasible and effective exercise program is needed.

Pharmaco-Invasive Strategy Vs Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction in Latin America: A Meta-Analysis.

Background: Primary percutaneous coronary intervention (PCI) is the established treatment for ST-segment elevation myocardial infarction (STEMI), but often it is not readily available in low-resource settings. We assessed the safety and efficacy of the pharmaco-invasive strategy compared to primary PCI for STEMI in Latin America.

Methods: MEDLINE, Embase, and Latin American and Caribbean Health Sciences Literature (LILACS) were searched for the period from their inception to September 2023, for studies that compared a pharmaco-invasive strategy vs primary PCI in Latin America.

CompSafeNano project: NanoInformatics approaches for safe-by-design nanomaterials.

The CompSafeNano project, a Research and Innovation Staff Exchange (RISE) project funded under the European Union's Horizon 2020 program, aims to advance the safety and innovation potential of nanomaterials (NMs) by integrating cutting-edge nanoinformatics, computational modelling, and predictive toxicology to enable design of safer NMs at the earliest stage of materials development. The project leverages Safe-by-Design (SbD) principles to ensure the development of inherently safer NMs, enhancing both regulatory compliance and international collaboration. By building on established nanoinformatics frameworks, such as those developed in the H2020-funded projects NanoSolveIT and NanoCommons, CompSafeNano addresses critical challenges in nanosafety through development and integration of innovative methodologies, including advanced models, approaches including machine learning (ML) and artificial intelligence (AI)-driven predictive models and 1st-principles computational modelling of NMs properties, interactions and effects on living systems.

Making malaria control a priority: a lesson for today's malaria community.

For malaria control to be successful, experience has shown that success is more likely where all involved feel the attempt must not be allowed to fail, and that success can be the only acceptable outcome. Importantly, all those at the top must have such commitment, and, in particular, this should also include the funder, the source of finance of the attempt. That would be malaria control treated as a priority.

When synthetic biology meets medicine.

In recent years, the world has faced significant challenges with the coronavirus disease 2019 (COVID-19) pandemic, as well as other infectious diseases such as Zika and Ebola. Furthermore, the rapid rise of non-communicable diseases such as diabetes, heart disease, and cancer has placed tremendous strain on healthcare resources and systems. Unfortunately, advancements in drug development, diagnostics, and therapeutics have struggled to keep pace with the emergence and progression of diseases, necessitating the exploration of new technologies for the discovery and development of biomedicines and biotherapies.

Vitamin D deficiency presenting as seizures.

Vitamin D deficiency is commonly seen in the general population, likely due to lack of adequate exposure to sunlight as well as lack of sufficient dietary intake. However, severe hypocalcemia secondary to vitamin D deficiency, manifesting as seizures is uncommon. We present a series of such cases encountered by us in the time frame of June 2020 to Dec 2021 (the first wave of the Covid-19 pandemic associated with a lockdown) during which patients of varying age groups presented with seizures.

Addressing the overuse of hospital emergency departments in the Portuguese NHS: a new paradigm.

The escalating trend of inappropriate visits to Emergency Departments (ED) has led to significant concerns, including resource misallocation, compromised patient care, and an increased burden on healthcare workers. Portugal faces a notable challenge, reporting one of the highest ED visit rates, with an annual average of approximately 6 million ED visits from 2013 to 2023. In response, the "Call First, Save Lives" pilot project was launched by the Portuguese NHS Executive Board, in 2023, at the Local Health Unit (LHU) of Póvoa de Varzim/Vila do Conde.

Do Child-Turcotte-Pugh and nutritional assessments predict survival in cirrhosis: A longitudinal study.

Background: Cirrhotic patients face heightened energy demands, leading to rapid glycogen depletion, protein degradation, oxidative stress, and inflammation, which drive disease progression and complications. These disruptions cause cellular damage and parenchymal changes, resulting in vascular alterations, portal hypertension, and liver dysfunction, significantly affecting patient prognosis.

Aim: To analyze the association between Child-Turcotte-Pugh (CTP) scores and different nutritional indicators with survival in a 15-year follow-up cohort.

The sociolinguistic foundations of language modeling.

In this article, we introduce a sociolinguistic perspective on language modeling. We claim that language models in general are inherently modeling , and we consider how this insight can inform the development and deployment of language models. We begin by presenting a technical definition of the concept of a variety of language as developed in sociolinguistics.

Experiences and overall impact reported by people living with obesity: results from a multinational study.

Objectives: To explore the impact of obesity on clinical outcomes, health-related quality of life, emotional well-being, and work productivity in people/patients with obesity across six countries by body mass index and the presence of complications.

Methods: Adelphi Real World Obesity Disease Specific Programme™ captured data related to physicians and their consulting people/patients with obesity on a weight management program or anti-obesity medication in Brazil, Canada, China, Japan, Kingdom of Saudi Arabia, and the United Arab Emirates from April to December 2022. Physicians reported data for up to eight qualifying people/patients with obesity.

Understanding trends in osteoporosis drug prescribing: implications for reducing futile biomedical research.

Introduction: Osteoporosis is a significant geriatric condition, considering its impact on fracture-related morbidity and mortality, particularly among older women. The interplay of clinical evidence, diagnostic tools availability, and broader societal attitudes toward aging and treatment efficacy affect medical attitude and prescribing behaviors. Using the example of osteoporosis in France and England, the study aims to unravel the intricacies of medical decision-making in geriatric care, offering insights into the evolving landscape of healthcare policy and practice, which in turn can help reduce futile biomedical research.

Cleft Lip and Palate Research in the United Kingdom: Advances in Clinical Psychological Knowledge and Future Directions.

In 2012, the James Lind Alliance (JLA) worked with individuals with cleft lip and/or palate (CL/P), their families and clinicians to identify priority areas for future research. This article reviews progress conducted in the United Kingdom in the 3 JLA priorities most closely related to Clinical Psychology. It then builds upon the original priorities to identify 4 future directions, based on contemporary literature and in-depth discussions between clinical and research experts.

The Public Mental Health Framework: thinking about law as preventive medicine.

Health, mental health, and well-being are not 'natural' but are shaped by social and environmental factors. This article aims to reorient the development of all laws and policies to do more to prevent mental ill-health and promote well-being as a core function of the contemporary state. It introduces a new conceptual and empirical model, the Public Mental Health Framework, based on three areas of research: (i) the social determinants of health and mental health, which include social structures and daily living conditions (such as poverty, inequality, education, employment, discrimination, adverse childhood experiences, and crime); (ii) health and human rights; and (iii) the intermediate social model of disability.

Evaluating the impact, implementation experience and political economy of primary care networks in Kenya: protocol for a mixed methods study.

Background: Primary care networks (PCNs) are increasingly being adopted in low- and middle-income countries (LMICs) to improve the delivery of primary health care (PHC). Kenya has identified PCNs as a key reform to strengthen PHC delivery and has passed a law to guide its implementation. PCNs were piloted in two counties in Kenya in 2020 and implemented nationally in October 2023.

Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants.

Background: Mechanisms underlying the association of life-course adiposity with incident hypertension in adulthood have not been comprehensively investigated. In this study, we aimed to investigate the potential biochemical and metabolomic mechanisms underlying the association between adiposity and incident hypertension.

Methods: A total of 180,527 participants from the UK Biobank aged 37 to 73 years were included.

New job, new habits? A multilevel interrupted time series analysis of changes in diet, physical activity and sleep among young adults starting work for the first time.

Background: The workplace is an important determinant of health that people are exposed to for the first-time during adolescence or early adulthood. This study investigates how diet, physical activity, and sleep change as people aged 16-30 years transition into work and whether this varies for different individuals and job types.

Methods: Multilevel linear regression models assessed changes in fruit and vegetable intake, sleep duration, and physical activity among 3,302 UK Household Longitudinal Study (UKHLS) participants aged 16-30 years, who started work for the first time between 2015 and 2023.

Exploring variation in the six-month review for stroke survivors: a national survey of current practice in England.

Background: The Six-Month Review (6MR) was introduced in the United Kingdom to provide a holistic, systematic review of the ongoing needs faced by stroke survivors. However, a theoretical underpinning regarding how it should work is lacking, potentially leading to wide variation in service provision. This study aimed to understand the current degree of variation in 6MR delivery across England and explore the potential driving factors.