Concepts of Suffering at the End of Life Amongst Emergency, Palliative Care and Geriatric Medicine Physicians in Malaysia.

Background: Palliative Care, Geriatrics and Emergency physicians are exposed to death, terminally ill patients and distress of patients and their families. As physicians bear witness to patients' suffering, they are vulnerable to the costs of caring-the emotional distress associated with providing compassionate and empathetic care to patients. If left unattended, this may culminate in burnout and compromise professional identity.

A systematic review on the influence of coagulopathy and immune activation on New Onset Atrial Fibrillation in patients with sepsis.

Introduction: New Onset Atrial Fibrillation (NOAF) is the most common arrhythmia in intensive care. Complications of NOAF include thromboembolic events such as myocardial infarction and stroke, which contribute to a greater risk of mortality. Inflammatory and coagulation biomarkers in sepsis are thought to be associated with NOAF development.

"I sometimes feel like I can't win!": An exploratory mixed-methods study of women's body image and experiences of exercising in gym settings.

Despite an increase in gym memberships, women are less active than men and little is known about the barriers women face when navigating gym spaces. This study explored women's body image and experiences exercising in gyms. Two-hundred and seventy-nine women (84% current gym-goers; 68.

Simultaneous Unbinned Differential Cross-Section Measurement of Twenty-Four Z+jets Kinematic Observables with the ATLAS Detector.

Z boson events at the Large Hadron Collider can be selected with high purity and are sensitive to a diverse range of QCD phenomena. As a result, these events are often used to probe the nature of the strong force, improve Monte Carlo event generators, and search for deviations from standard model predictions. All previous measurements of Z boson production characterize the event properties using a small number of observables and present the results as differential cross sections in predetermined bins.

Measurement of Λ_{b}^{0}, Λ_{c}^{+}, and Λ Decay Parameters Using Λ_{b}^{0}→Λ_{c}^{+}h^{-} Decays.

A comprehensive study of the angular distributions in the bottom-baryon decays Λ_{b}^{0}→Λ_{c}^{+}h^{-}(h=π,K), followed by Λ_{c}^{+}→Λh^{+} with Λ→pπ^{-} or Λ_{c}^{+}→pK_{S}^{0} decays, is performed using a data sample of proton-proton collisions corresponding to an integrated luminosity of 9  fb^{-1} collected by the LHCb experiment at center-of-mass energies of 7, 8, and 13 TeV. The decay parameters and the associated charge-parity (CP) asymmetries are measured, with no significant CP violation observed. For the first time, the Λ_{b}^{0}→Λ_{c}^{+}h^{-} decay parameters are measured.

Laterality and performance in elite male golfers.

Human beings display laterilised behaviour. In sport, including golf, players adopt a right- or left-handed stance. There may be advantages in going against convention in the position of the dominant hand relative to golf stance.

Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial.

Background: The Pre-EMPT study aimed to determine if structured exercise could reduce length of stay, post-operative complications and improve fitness and health-related quality of life (HQRL) in patients undergoing neoadjuvant chemotherapy (NAC) and oesophagectomy.

Methods: A prospective non-randomised trial compared a standard care pathway (control) to a structured prehabilitation exercise programme (intervention) commenced before NAC and surgery for oesophageal adenocarcinoma. Length of hospital stay and post-operative complications were recorded.

The Role of Surfactant in Electrocatalytic Carbon Dioxide Reduction in the Absence of Metal Cations.

Carbon dioxide electroreduction does not occur on Au when metal cations are absent from the electrode surfaces. Here we show that the electroreduction can be enabled without metal cations, albeit with low efficiency, by the presence of cationic surfactants on Au. The findings demonstrate that in addition to possibly stabilizing CO reduction intermediates the presence of surfactants plays a role in suppressing the competing reactions.

Sex-dependent modulation of caerulein-induced acute pancreatitis in C57BL/6J mice.

Acute pancreatitis (AP) is a life-threatening condition, with a higher mortality rate in men than women and in which estrogens might play a protective role. This study aimed to investigate sex-dependent differences in a mouse model of caerulein-induced AP. Thirty-six C57BL/6J mice (19 females and 17 males) were treated intraperitoneally with phosphate-buffered saline or caerulein, and sacrificed 12 hours, 2 days, or 7 days after the last injection.

Molecular and Electronic Structures at Electrochemical Interfaces from Resonant X-Ray Diffraction.

An original approach to characterize electrochemical interfaces at the atomic level, a challenging topic toward the understanding of electrochemical reactivity, is reported. We employed surface resonant X-ray diffraction experiments combined with their simulation using first-principle density functional theory calculations and were thus able to determine the molecular and electronic structures of the partially ionic layer facing the electrode surface, as well as the charge distribution in the surface metal layers. Pt(111) in an acidic medium at an applied potential excluding specific adsorption was studied.

Demographic and clinical characteristics of older people with multimorbidity accessing primary healthcare in Malawi: A cross-sectional study.

Background: Multimorbidity is a growing global concern, affecting patient outcomes and healthcare costs. In low- and middle-income countries, data on multimorbidity in primary care beyond prevalence is limited. Our study explored the demographic and clinical characteristics of multimorbidity among older people attending primary health care in Malawi.

Unlikely Double Trouble: Two Cases of Haemobilia From One Motor Vehicle Accident.

Blunt abdominal trauma frequently results in visceral injury to either solid or hollow organs; however, injury to the gallbladder is rare. This is most likely due to the anatomical position of the gallbladder, which is well-insulated posterior to the liver and rib cage. Gallbladder injuries can be in the form of avulsion, contusion, or laceration.

The mCHEST Score for Incident Atrial Fibrillation: MESA (Multi-Ethnic Study of Atherosclerosis).

Background: Assessing individuals' risk of developing incident atrial fibrillation (AF) is important for making preventive and screening strategies.

Objectives: The performance of the mCHEST score for predicting incident AF has scarcely been evaluated, especially in a multi-ethnic population.

Methods: Participants from the MESA (Multi-Ethnic Study of Atherosclerosis were enrolled in the present study, which involved population of different ethnicities (Caucasian, African-American, Chinese-American, and Hispanic) aged between 45 and 84 from 6 communities in the United States.

Systematic review and meta-analysis of the pelvic organ prolapse and vaginal prolapse among the global population.

Background: Pelvic organ prolapse (POP) occurs when one or more pelvic organs (uterus, bowel, bladder or top of the vagina) descend from their normal position and bulge into the vagina. Symptoms include pelvic discomfort, fullness, and changes in bladder or bowel function. Treatment ranges from conservative approaches to surgery, depending on symptom severity.

Does bladder outflow obstruction obfuscate the traditional clinical factors that are used to assess the risk of prostate cancer at rapid-access diagnostic clinics?

Objectives: To understand whether bladder outflow obstruction influences the association between traditional clinical predictive factors, particularly prostate-specific antigen (PSA) density and clinically significant prostate cancer (csPCa). This will help facilitate effective and evidence-based triaging of patients in rapid-access clinics.

Materials And Methods: We retrospectively analysed prospectively collected data from 307 suspected prostate cancer patients who underwent diagnostic biopsy from 2019 to 2023 at a single, high-volume, specialist cancer centre.

SPIRIT-DEFINE explanation and elaboration: recommendations for enhancing quality and impact of early phase dose-finding clinical trials protocols.

Unlabelled: Transparent and accurate reporting in early phase dose-finding (EPDF) clinical trials is crucial for informing subsequent larger trials. The SPIRIT statement, designed for trial protocol content, does not adequately cover the distinctive features of EPDF trials. Recent findings indicate that the protocol contents in past EPDF trials frequently lacked completeness and clarity.

CONSORT-DEFINE explanation and elaboration: recommendations for enhancing reporting quality and impact of early phase dose-finding clinical trials.

Unlabelled: Early phase dose-finding (EPDF) trials are key in the development of novel therapies, with their findings directly informing subsequent clinical development phases and providing valuable insights for reverse translation. Comprehensive and transparent reporting of these studies is critical for their accurate and critical interpretation, which may improve and expedite therapeutic development. However, quality of reporting of design characteristics and results from EPDF trials is often variable and incomplete.

Antipsychotic medication non-adherence and its determinants among out-patients with schizophrenia.

Introduction: While antipsychotics are key requirement in acute and long-term management of schizophrenia, medication adherence remains a major unmet need in its care. This paper assessed the prevalence of oral antipsychotic non-adherence among outpatients with schizophrenia and its associated clinico-demographic factors.

Method: Three hundred and ten adult outpatients (18-64 years of age) were cross-sectionally interviewed after being diagnosed of schizophrenia using ICD-10 criteria, and the diagnosis confirmed with the Mini International Neuropsychiatric Interview (MINI).

The sense of safety theoretical framework: a trauma-informed and healing-oriented approach for whole person care.

Objectives: This research describes four aspects of the development of the Sense of Safety Theoretical Framework for whole person care: exploring the meaning of the phrase "sense of safety"-the whole person ; the range of human experience that impacts sense of safety-whole person ; the dynamics that build sense of safety-the healing ; and the personal and cross-disciplinary trauma-informed practitioner that facilitate sense of safety.

Methods: This qualitative participatory study was conducted in two phases. Researchers iteratively explored the concept of sense of safety using focus groups and semi-structured interviews.

Durvalumab, Tremelimumab, and Platinum Chemotherapy in Mutation-Positive NSCLC: An Open-Label Phase 2 Trial (ILLUMINATE).

Introduction: -mutant NSCLC is associated with low mutation burden and low levels of PD-L1 expression. We conducted a phase 2 trial to determine the efficacy of durvalumab, tremelimumab, and platinum-pemetrexed in mutant NSCLC after progression with EGFR tyrosine kinase inhibitors (TKIs).

Methods: Participants were treated with induction durvalumab, tremelimumab, and platinum-pemetrexed, followed by durvalumab-pemetrexed maintenance.

Nonlinear Harmonics: A Gateway to Enhanced Image Contrast and Material Discrimination.

Recent advancements in atomic force microscopy (AFM) have enabled detailed exploration of materials at the molecular and atomic levels. These developments, however, pose a challenge: the data generated by microscopic and spectroscopic experiments are increasing rapidly in both size and complexity. Extracting meaningful physical insights from these datasets is challenging, particularly for multilayer heterogeneous nanoscale structures.

Adverse Cardiovascular Risk Profile and Increased Diurnal Salivary Cortisol in Girls With Turner Syndrome: An Exploratory Study.

Patients with Turner Syndrome (TS) and those exposed to high concentrations of glucocorticoids have a number of characteristics in common, including an increased risk of cardiovascular disease. Pediatric TS patients underwent studies of salivary cortisol (SC) and cortisone (SCn), body composition, continuous glucose monitoring, vascular function, and ambulatory blood pressure (BP). Biochemical indicators of cardiovascular risk were also measured.

Clinical Presentation and Course of Pulmonary Involvement in Chronic Nonbacterial Osteomyelitis.

Objective: Pulmonary involvement in chronic nonbacterial osteomyelitis (CNO) is rare. Limited awareness results in diagnostic challenges, especially because malignancy or infection needs to be considered.

Methods: Based on a survey shared among centers participating in the Kerndokumentation Deutsches Rheumaforschungszentrum (Germany), this study investigated clinical and imaging presentations, demographic features, treatment response and outcomes of pulmonary involvement in CNO (pCNO).

Influence of religion and spirituality on head and neck cancer patients and their caregivers: a protocol for a scoping review.

Introduction: Head and neck cancers (HNC) are devastating, thus imposing a negative impact on the appearance of an individual as well as vital activities such as eating, swallowing, speaking, and breathing. Therefore, HNC patients undergo distress, while their caregivers become overburdened. Religion and spirituality can be helpful for patients and their caregivers from diverse cultural backgrounds to cope with cancer.