Early warning systems for identifying severe maternal outcomes: findings from the WHO global maternal sepsis study.

Background: Infections and sepsis are leading causes of morbidity and mortality in women during pregnancy and the post-pregnancy period. Using data from the 2017 WHO Global Maternal Sepsis Study, we explored the use of early warning systems (EWS) in women at risk of sepsis-related severe maternal outcomes.

Methods: On April 27, 2023, we searched the literature for EWS in clinical use or research in obstetric populations.

International consensus to define outcomes for trials of chemoradiotherapy for anal cancer (CORMAC-2): defining the outcomes from the CORMAC core outcome set.

Variation in outcomes definitions and reporting limit the utility of clinical trial results. The Core Outcome Research Measures in Anal Cancer (CORMAC) project developed a core outcome set (COS) for chemoradiotherapy trials for anal squamous cell carcinoma (ASCC) through an international healthcare professional and patient consensus process. The CORMAC-COS comprises 19 outcomes across 4 domains (disease activity, survival, toxicity, life impact).

Prevalence of anxiety and depression in former elite athletes: a systematic review and meta-analysis.

Objectives: To summarise the evidence regarding the prevalence of anxiety and depression in former elite athletes compared with the general population.

Design: Systematic review and meta-analysis.CRD42022347359.

Determinants of gender-equitable attitudes among adult men in a health education program: a cross-sectional study in Southern Malawi.

Background: Malawi ranks 142 out of 170 countries on the UN's Gender Inequality Index (GII). Women and men in Malawi have unequal access to and control over resources. Previous research has primarily examined gender roles and norms from a women's perspective, but few studies have investigated men's attitudes and behaviors regarding gender equality.

Clinical and patient-reported outcomes in women offered oncoplastic breast-conserving surgery as an alternative to mastectomy: ANTHEM multicentre prospective cohort study.

Background: Oncoplastic breast-conserving surgery may be a better option than mastectomy, but high-quality comparative evidence is lacking. The aim of the ANTHEM study (ISRCTN18238549) was to explore clinical and patient-reported outcomes in a multicentre cohort of women offered oncoplastic breast-conserving surgery as an alternative to mastectomy with or without immediate breast reconstruction.

Methods: Women with invasive/pre-invasive breast cancer who were offered oncoplastic breast-conserving surgery with volume replacement or displacement techniques to avoid mastectomy were recruited prospectively.

Comparing FFR-Guided Complete Revascularization and Conservative Management for Non-Culprit Lesions in STEMI Patients With Multivessel Disease: A Systematic Review and Meta-Analysis.

Background: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease, the optimal management strategy for non-culprit lesions is a subject of ongoing debate. There has been an increasing use of physiology-guidance to assess the extent of occlusion in non-culprit lesions, and hence the need for stenting. Fractional flow reserve (FFR) is commonly used as a technique.

Weekly dihydroartemisinin-piperaquine versus monthly sulfadoxine-pyrimethamine for malaria chemoprevention in children with sickle cell anaemia in Uganda and Malawi (CHEMCHA): a randomised, double-blind, placebo-controlled trial.

Background: In many sub-Saharan African countries, it is recommended that children with sickle cell anaemia receive malaria chemoprevention with monthly sulfadoxine-pyrimethamine or daily proguanil as the standard of care. However, the efficacy of these interventions is compromised by high-grade antifolate resistance of Plasmodium falciparum and poor adherence. We aimed to compare the efficacy of weekly dihydroartemisinin-piperaquine and monthly sulfadoxine-pyrimethamine for the prevention of clinical malaria in children with sickle cell anaemia in areas with high-grade sulfadoxine-pyrimethamine resistance of P falciparum in Uganda and Malawi.

Building global collaborative research networks in paediatric critical care: a roadmap.

Paediatric critical care units are designed for children at a vulnerable stage of development, yet the evidence base for practice and policy in paediatric critical care remains scarce. In this Health Policy, we present a roadmap providing strategic guidance for international paediatric critical care trials. We convened a multidisciplinary group of 32 paediatric critical care experts from six continents representing paediatric critical care research networks and groups.

Testing the Proteus Effect in Autistic and Neurotypical Participants.

This study examined the Proteus effect in autistic and neurotypical participants via the video game, The Sims. Thirty-two participants (16 autistic, 16 neurotypical) participated in a free-play session of The Sims, playing as either an attractive or unattractive avatar. In line with predictions, participants who had played as the attractive avatar negotiated for a significantly larger share of a fictional pot of money during a post-play economic game.

Periorbital Microcystic Adnexal Carcinoma With Distant Metastases.

Purpose: Microcystic adnexal carcinoma (MAC) is a locally aggressive adnexal carcinoma of the head and neck, which has a high tendency for recurrence. MAC rarely has distant metastasis, with only one previously reported case originating from the periorbital region. We present a patient with periorbital MAC with distant metastasis and a review of all reported patients with metastatic disease.

The relationship between muscle mass changes and protein or energy intake in critically ill children: A systematic review and meta-analysis.

Survivorship after pediatric critical illness is high in developed countries, but many suffer physical morbidities afterwards. The increasing focus on follow-up after critical illness has led to more pediatric studies reporting muscle mass changes (using ultrasound), albeit with different results. A systematic literature review was undertaken examining muscle mass changes, assessed by ultrasound of the quadriceps femoris muscle in children who are critically ill.

Linking Foraging Behaviour and Habitat Preferences During Moult Across Multiple Populations of Red-Throated Diver.

Understanding the habitat use of individuals can facilitate methods to measure the degree to which populations will be affected by potential stressors. Such insights can be hard to garner for marine species that are inaccessible during phases of their annual cycles. Here, we quantify the link between foraging habitat and behaviour in an aquatic bird of high conservation concern, the red-throated diver () across three breeding populations (Finland, Iceland and Scotland) during their understudied moult period.

Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos(t)ide analogue therapy.

Background & Aims: The dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos(t)ide analogue (NA) treatment and its relationship with liver disease are poorly understood. We aimed to study longitudinal VL patterns and their associations with CHB clinical outcomes.

Methods: Utilising large scale, routinely collected electronic health records from six centres in England, collated by the National Institute for Health and Care Research Health Informatics Collaborative (NIHR HIC), we applied latent class mixed models to investigate VL trajectory patterns in adults receiving NA treatment.

Above knee amputation following periprosthetic joint infection after total knee arthroplasty: a fatal outcome.

Primary total knee arthroplasty (TKA) is a successful and cost-effective procedure for which demand is increasing annually. Outcomes are generally good with satisfaction rates of 70%, so the procedure is commonly used in osteoarthritis management to improve mobility and alleviate pain. Above knee amputation (AKA) is a devastating complication of TKA.

Intergenerational risk of preterm birth in First Nations Australians: a population-based cohort study from the Northern Territory, Australia.

Background: PTB increases the risk of health problems such as chronic renal disease and diabetes in later life and adverse impacts are inversely correlated with gestational age at birth. Rates of PTB in the Northern Territory (NT) of Australia are amongst the highest nationally and globally, with First Nations babies most affected. This study assessed the magnitude and potential drivers of intergenerational PTB recurrence in the NT.

Perceptions, opportunities and barriers of social engagement among the Chinese older adults: a qualitative study.

Background: Understanding and promoting healthy aging are increasingly important as China transitions into an aging society. Our study examines the challenges and opportunities faced by the older adults in urban areas regarding social engagement, potentially informing the development of effective, context-sensitive interventions and policies.

Methods: The study is based on in-depth interviews with 30 participants from a Northern city in Mainland China regarding their daily lives, attitudes towards and subjective experiences of aging, and involvement in social activities.

Heteroaryl-Directed Iridium-Catalyzed Enantioselective C-H Alkenylations of Secondary Alcohols.

Under iridium-catalyzed conditions, 2-aza-aryl-substituted secondary alcohols undergo C(sp)-H addition reactions to alkynes to provide alkenylated tertiary alcohols. The processes occur with very high regio- and enantioselectivity. An analogous addition to styrene is shown to provide a prototype C(sp)-H alkylation process.

Reductive Zincke Reaction: Opening of Pyridinium Rings to δ-Amino Ketones via Transfer Hydrogenation.

The Zincke reaction and Birch reduction have been one of the few reactions that allow for ring opening of pyridines ever since the discovery of pyridine more than a century ago. This paper presents a new addition to the list of pyridine ring-opening reactions, reductive Zincke reaction, which affords saturated δ-amino ketones. Under the catalysis of a simple rhodium complex, pyridinium salts with diverse substituents are reduced with formic acid, ring-opened with water, transaminated with a secondary amine and further reduced to afford a wide range of δ-amino ketones, including those in which the alkane chain of the ketones is selectively deuterated or fluorinated.

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

Conditional Relay Activation of Theranostic Prodrug by Pretargeting Bioorthogonal Trigger and Fluorescence-Guided Visible Light Irradiation.

Bioorthogonalized light-responsive click-and-uncage platform has enabled precise cell surface engineering and timed payload release, but most of such photoactivatable prodrugs have "always-on" photoactivity leading to the dark toxicity. On the other hand, the conditionally activatable photocage is limited to the application of fluorogenic probe/photosensitizer liberation. Herein, we devise a conditionally activatable theranostic platform based on the tetrazine (Tz)-boron-dipyrromethene (BODIPY) construct, in which tetrazine serves as a quencher motif to disable both the fluorescence and photoresponsivity of BODIPY.

Investigation of cardiac substructure automatic segmentation methods on synthetically generated 4D cone-beam CT images.

Background: STereotactic Arrhythmia Radioablation (STAR) is a novel noninvasive method for treating arrythmias in which external beam radiation is directed towards subregions of the heart. Challenges for accurate STAR targeting include small target volumes and relatively large patient motion, which can lead to radiation related patient toxicities. 4D Cone-beam CT (CBCT) images are used for stereotactic lung treatments to account for respiration-related patient motion.

Oxygen uptake efficiency slope at anaerobic threshold can predict peak VO in adult congenital heart disease.

Introduction: Assessment of exercise capacity by cardiopulmonary exercise testing (CPET) in adults with congenital heart disease (CHD) is important for prognostication and preoperative assessment. Peak oxygen uptake (PVO) is used commonly, but can be challenging due to the difficulties of undertaking maximal CPET testing in this population. We explored whether oxygen uptake efficiency slope (OUES) at ventilatory anaerobic threshold (VAT), the point during CPET at which OUES becomes strongly correlated with PVO, and is more reliably available from submaximal CPET, can predict PVO in adults with CHD.