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Regional comprehensive universities with access-oriented missions provide critical pathways for increasing the number and diversity of STEM graduates. The BOND program at California State University, Fresno supports the transition to college for first-time, full-time freshmen in selected STEM majors. BOND incorporates a learning community, active learning, and early course-based research experiences. Compared to comparison groups, students that participate in BOND are 1.93 times more likely to persist in STEM into their fourth year despite similar academic achievement in introductory STEM courses. A higher proportion of BOND students also engage with campus resources that support their first and second year on campus, which suggests that appropriate support builds persistence through the challenges of a STEM degree. This study highlights the importance of providing support strategies and resources in the first year for STEM retention, counter to the traditional narrative of "weeding out" students in their first year on campus.

Abstract Introduction Poor sleep health is associated with increased asthma morbidity and mortality. Accelerometers have been validated to assess sleep parameters though studies using this method in patients with asthma are sparse and none have compared mild to difficult-to-treat asthma populations. Methods We performed a retrospective analysis from two recent in-house trials comparing sleep metrics between patients with mild and difficult-to-treat asthma. Participants wore accelerometers for 24-hours/day for seven days. Results Of 124 participants (44 mild, 80 difficult-to-treat), no between-group differences were observed in sleep-window, sleep-time, sleep efficiency or wake time. Sleep-onset time was ~ 40 min later in the difficult-to-treat group (p = 0.019). Discussion Broadly, we observed no difference in accelerometer-derived sleep-metrics between mild and difficult-to-treat asthma. This is the largest analysis of accelerometer-derived sleep parameters in asthma and the first comparing groups by asthma severity. Sleep-onset initiation may be delayed in difficult-to-treat asthma but a dedicated study is needed to confirm.

Background: Longitudinal studies highlight the importance of early intervention and timely device fitting for language development in children with congenital or early acquired hearing loss. Due to the variability in hearing loss, comorbidities, family circumstances, and service access, individualised monitoring of listening development is essential to inform decision-making. The Functional Listening Index—Paediatric (FLI-P), a 64-item hierarchical checklist of listening skills, has been validated for children with hearing loss aged 0–6 years. This study aimed to develop benchmarks for the FLI-P in typically hearing children, allowing for comparison with individual children with hearing loss. Methods: FLI-P scores were obtained from parents/caregivers of 561 typically hearing children aged 0–72 months. Each child’s FLI-P score was categorised into a 6-month age block, with a minimum of 36 data points per block. Quantile regression was employed to establish percentiles of FLI-P scores by age. Results: FLI-P scores were successfully recorded for all 561 children. Regression analysis determined that the 16th and 84th percentiles of FLI-P scores corresponded to approximately ±1 standard deviation from the median score for each age group. A graphical representation of these percentile trajectories was created to facilitate comparison between children with hearing loss and the normative data. Conclusion: A normative dataset of FLI-P scores from typically hearing children has been established, allowing for comparisons with the scores and developmental trajectories of individual children with hearing loss. The study demonstrates how FLI-P can guide early intervention decisions and effectively monitor progress.

Background: There is uncertainty about the utility of multiphase computed tomography (CT) compared with single-phase CT in the routine examination of patients with visible haematuria (VH). Objective: To compare the accuracies of single nephrographic phase (NP) CT and four-phase CT in detecting urothelial carcinoma (UC). Design, setting, and participants: This was a single-centre, prospective, paired, noninferiority study of patients with painless VH referred for CT before cystoscopy between September 2019 and June 2021. Patients were followed up for 1 yr to ascertain UC diagnosis. Intervention: All patients underwent four-phase CT (control), from which single NP CT (experimental) was extracted. Both were independently assessed for UC. Outcome measurements and statistical analysis: The primary outcome was the difference in accuracy between the control and experimental CT using a 7.5% noninferiority limit. Histologically verified UC defined a positive reference standard. Secondary outcomes included differences in sensitivity, specificity, negative (NPV) and positive (PPV) predictive values, and area under the curve (AUC). All results are reported per patient. Results and limitations: Of the 308 patients included, UC was diagnosed in 45 (14.6%). The difference in accuracy between the control and experimental CT was 1.9% (95% confidence interval −2.8 to 6.7), demonstrating noninferiority. Sensitivity was 93.3% versus 91.1%, specificity was 83.7% versus 81.8%, NPV was 98.7% versus 98.2%, PPV was 49.4% versus 46.1%, and AUC was 0.96 versus 0.94 for the control versus experimental CT. Limitations included a low number of UC cases and no definite criteria for selecting a noninferiority limit. Conclusions: The accuracy of NP CT is not inferior to that of four-phase CT for detecting UC. Patient summary: This study shows that a computed tomography (CT) examination with only one contrast phase is no worse than a more complex CT examination for detecting cancer in the urinary tract among patients presenting with visible blood in the urine.

Abstract Background Difficult-to-control asthma associated with elevated body mass index (BMI) is challenging with limited treatment options. The effects of pulmonary rehabilitation (PR) in this population are uncertain. Methods This is a randomised controlled trial of an eight-week asthma-tailored PR programme versus usual care (UC) in participants with difficult-to-control asthma and BMI ≥ 25 kg/m2. PR comprised two hours of education and supervised exercise per week, with encouragement for two individual exercise sessions. Primary outcome was difference in change in Asthma Quality of Life Questionnaire (AQLQ) in PR versus UC groups between visits. Secondary outcomes included difference in change in Asthma Control Questionnaire-6 (ACQ6), and a responder analysis comparing proportion reaching minimum clinically important difference for AQLQ and ACQ6. Results 95 participants were randomised 1:1 to PR or UC. Median age was 54 years, 60% were female and median BMI was 33.8 kg/m2. Mean (SD) AQLQ was 3.9 (+/-1.2) and median (IQR) ACQ6 2.8(1.8–3.6). 77 participants attended a second visit and had results analysed. Median (IQR) change in AQLQ was not significantly different: 0.3 (− 0.2 to 0.6) in PR and − 0.1 (− 0.5 to 0.4) in UC, p = 0.139. Mean change in ACQ6 was significantly different: − 0.4 (95% CI − 0.6 to − 0.2) in PR and 0 (− 0.3 to + 0.3) in UC, p = 0.015, but below minimum clinically important difference. In ACQ6 responder analysis, minimum clinically important difference was reached by 18 PR participants (54.5%) versus 10 UC (22.7%), p = 0.009. Dropout rate was 31% between visits in PR group, and time to completion was significantly prolonged in PR group at 94 (70–107) days versus 63 (56–73) in UC, p

Constructivist teaching approaches rely on students to be active participants in their learning. A flipped classroom is a constructivist approach that requires the students to complete pre-learning activities outside of class. Thus, in class the students can practice and engage in team-based discussions and teacher guided learning. We delivered evidence-based practice (EBP) concepts to entry level occupational therapy (OT) students in a doctoral program using a constructivist approach, that included a flipped classroom model and reliance on team-based strategies. We used the Evidence Based Practice Confidence (EPIC) Scale to assess the change in students’ confidence in EBP. Students demonstrated statistically significant differences in their confidence for EBP after the course. Evaluation of the changes in EPIC Scale scores indicates that a flipped classroom and team-based activities are effective approaches to teach EBP for entry level OT doctoral students.

Purpose of Review: Magnesium is an essential mineral for bone metabolism, but little is known about how magnesium intake alters fracture risk. We conducted a narrative review to better understand how magnesium intake, through supplementation, diet, or altering the concentration of dialysate magnesium, affects mineral bone disease and the risk of fracture in individuals across the spectrum of kidney disease. Sources of Information: Peer-reviewed clinical trials and observational studies. Methods: We searched for relevant articles in MEDLINE and EMBASE databases. The methodologic quality of clinical trials was assessed using a modified version of the Downs and Black criteria checklist. Key Findings: The role of magnesium intake in fracture prevention is unclear in both the general population and in patients receiving maintenance dialysis. In those with normal kidney function, 2 meta-analyses showed higher bone mineral density in those with higher dietary magnesium, whereas 1 systematic review showed no effect on fracture risk. In patients receiving maintenance hemodialysis or peritoneal dialysis, a higher concentration of dialysate magnesium is associated with a lower concentration of parathyroid hormone, but little is known about other bone-related outcomes. In 2 observational studies of patients receiving hemodialysis, a higher concentration of serum magnesium was associated with a lower risk of hip fracture. Limitations: This narrative review included only articles written in English. Observed effects of magnesium intake in the general population may not be applicable to those with chronic kidney disease particularly in those receiving dialysis.

As a prevalent medical problem that burdens millions of patients across the world, chronic wounds pose a challenge to the healthcare system. These wounds, often existing as a comorbidity, are vulnerable to infections. Consequently, infections hinder the healing process and complicate clinical management and treatment. While antibiotic drugs remain a popular treatment for infected chronic wounds, the recent rise of antibiotic-resistant strains has hastened the need for alternative treatments. Future impacts of chronic wounds are likely to increase with aging populations and growing obesity rates. With the need for more effective novel treatments, promising research into various wound therapies has seen an increased demand. This review summarizes photodynamic therapy, probiotics, acetic acid, and essential oil studies as developing antibiotic-free treatments for chronic wounds infected with Pseudomonas aeruginosa. Clinicians may find this review informative by gaining a better understanding of the state of current research into various antibiotic-free treatments. Furthermore. this review provides clinical significance, as clinicians may seek to implement photodynamic therapy, probiotics, acetic acid, or essential oils into their own practice.

The need for entirely online instruction as a result of the COVID-19 pandemic has raised many questions about university faculty readiness for online instruction and how to effectively support university faculty in integrating mobile technology into their practice. Previous research suggests subtypes of university faculty technology integration and in turn, a need for diversified approaches to professional development. However, such research is both limited and contested, and thus further research is needed. This multistudy examined whether there are qualitatively distinct faculty subtypes for mobile technology integration (Study 1: N = 83, Study 2: N = 45) based on their knowledge, self-efficacy, and attitudes towards mobile technology, and whether such subtypes, if indeed were present, were meaningfully associated with an adoption of mobile technology in the following semester. Findings from the latent profile analysis suggest five university faculty subtypes: Technology Enthusiasts, Knowledgeable Adopters, Prospective Adopters, Knowledgeable Skeptics, and Non-Adopters. Study 2 validates Study 1 findings. Findings illustrate that technology professional development opportunities only have value for certain university faculty groups and that resources would be better targeted elsewhere for faculty groups such as non-adopters. We discuss the implications of these findings for future efforts to support university faculty mobile technology integration.

Objective: this paper aims to present the evidence for the role of diet in the prevention and treatment of depression, review the potential underlying mechanisms and provide practice recommendations for mental health clinicians., Methods: A literature review was conducted through searches of PubMed with the search terms 'depression', 'diet', 'prevention', 'treatment' and 'mechanisms' and combinations thereof. Additional articles were identified through hand searching., Results: Greater adherence to several healthy dietary patterns, traditional diets such as the Mediterranean diet and other diets such as the DASH diet are associated with or can treat symptoms of depression. Several limitations of the research were noted, many of which relate to inherent challenges of studying diet. Mechanisms by which dietary intervention can influence mood include the gut microbiome, modulation of inflammatory processes, reduction in oxidative stress and modulation of hypothalamic-pituitary-adrenal axis function. Recommendations for mental health clinicians to enable translation of the evidence into practice are provided., Conclusion: Diet can play an important role in preventing and treating depression. Mental health clinicians are well placed to provide dietary counselling and to use clinical judgement in choosing the specific approach that reflects the needs of the patient but are encouraged to refer to a specialist dietitian where necessary., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: H.M.S. has received research funding from DSM Pharmaceuticals, the Rome Foundation, VSL Pharmaceuticals; non-financial support from VSL Pharmaceuticals; and consulting fees from Dietitian Connection, Dietitians Australia and Microba. S.B.T. was a contractor to Nutrition Research Australia; and has received consulting fees from the British Dietetic Association, Dietitian Connection, Dietitians Australia, Education in Nutrition, the Royal Australian and New Zealand College of Psychiatrists (Tasmania Branch), the University of Newcastle, Australia and the University of Technology Sydney, Australia. C.C. and R.O. have no conflicts of interests to declare. F.N.J. has received competitive grant or research support from the Brain and Behaviour Research Institute, the NHMRC, Australian Rotary Health, the Geelong Medical Research Foundation, the Ian Potter Foundation, The University of Melbourne; industry support for research from Meat and Livestock Australia, Woolworths Limited, the A2 Milk Company, Be Fit Foods, Bega Cheese; philanthropic support from the Fernwood Foundation, Wilson Foundation, the JTM Foundation, the Serp Hills Foundation, the Roberts Family Foundation, the Waterloo Foundation; and travel support and speakers’ honoraria from Sanofi-Synthelabo, Janssen Cilag, Servier, Pfizer, Network Nutrition, Angelini Farmaceutica, Eli Lilly and Metagenics. F.N.J. has written two books for commercial publication. T.R. has received philanthropic support from the Fernwood Foundation, Wilson Foundation, and the Roberts Family Foundation; industry support from Be Fit Foods; and consultancy fee, speakers honoraria and travel support from Fondation Fondamental, Culinary Medicine UK, Field Doctor UK, and Next Media.

Purpose: Establishing a record of key contributions of early Black ophthalmologists can help illuminate future generations. We aimed to identify major physician pioneers in ophthalmology, delineate their contributions, and place their ascendance in a historical context to understand the institutional and cultural barriers they overcame to achieve success., Methods: PubMed and other databases were searched, along with death notices and archeological records, using "Black," "African American," "eye surgeon," "Negro," "Journal of the National Medical Association" and other search terms. Librarians from the Library of Congress, National Institutes of Health, and key ophthalmology training institutions were consulted, as were the American Academy of Ophthalmology and American Board of Ophthalmology. Family members and colleagues of selected deceased pioneers were interviewed., Results: Many early pioneers emerged from historically Black institutions, as Black students and practitioners were then typically excluded elsewhere. Mentorship is a key theme that emerged in the careers of many pioneers and the Black ophthalmologists they trained., Conclusions: Black ophthalmologists have contributed tremendously to eye-care practice, education, and innovation. Efforts to recruit and train Black ophthalmologists should include highlighting the roles of Black pioneers, increasing educational and training access for the underrepresented in medicine at the institutional level, and expanding pathway and mentorship programs. NOTE: Publication of this article is sponsored by the American Ophthalmological Society., (Published by Elsevier Inc.)

Immunogenicity limits the persistence of off-the-shelf, allogeneic cell therapies and transplants. While ablation of human leukocyte antigen (HLA) removes most T cell and humoral alloreactivity, no solution has enabled universal protection against the resulting natural killer (NK) cell response. Here, we engineered Trans Antigen Signaling Receptors (TASR) as a new class of NK inhibitory ligands and discovered CD300a, a previously inaccessible receptor, as a functional target. CD300a TASR outperformed leading alternative strategies in focused screens, including CD47 and HLA-E, and was solely capable of universally protecting allogeneic T cells against a large human cohort (45/45 donors), spanning diverse demographics and NK cell phenotypes. A model allogeneic T cell therapy co-expressing an anti-CD19 Chimeric Antigen Receptor (CAR) and CD300a TASR, produced using multiplexed non-viral integration, exhibited enhanced B cell killing potency under allogeneic immune pressure. CD300 TASR represents a universal solution to NK alloreactivity, broadening the population that could be effectively treated by next-generation allogeneic cell therapies., (Copyright © 2024 American Society of Hematology.)

Background: Opioid overdose is a global health crisis, affecting over 27 million individuals worldwide, with more than 100,000 drug overdose deaths in the United States in 2022-2023. This protocol outlines the development of the PneumoWave chest biosensor, a wearable device being designed to detect respiratory depression in real time through chest motion measurement, intending to enhance early intervention and thereby reduce fatalities., Objective: The study aims to (1) differentiate opioid-induced respiratory depression (OIRD) from nonfatal opioid use patterns to develop and refine an overdose detection algorithm and (2) examine participants' acceptability of the chest biosensor., Methods: The study adopts an observational design over a 6-month period. The biosensor, a small device, will be worn by consenting participants during injecting events to capture chest motion data. Safe injecting facilities (SIF) in Melbourne, Victoria (site 1), and Sydney, New South Wales (site 2), which are legally sanctioned spaces where individuals can use preobtained illicit drugs under medical supervision. Each site is anticipated to recruit up to 100 participants who inject opioids and attend the SIF. Participants will wear the biosensor during supervised injecting events at both sites. The biosensor will attempt to capture data on an anticipated 40 adverse drug events. The biosensor's ability to detect OIRD will be compared to the staff-identified events that use standard protocols for managing overdoses. Measurements will include (1) chest wall movement measured by the biosensor, securely streamed to a cloud, and analyzed to refine an overdose detection algorithm and (2) acute events or potential overdose identified by site staff. Acceptability will be measured by a feedback questionnaire as many times as the participant is willing to throughout the study., Results: As of April 2024, a total of 47 participants have been enrolled and data from 1145 injecting events have already been collected, including 10 overdose events. This consists of 17 females and 30 males with an average age of 45 years. Data analysis is ongoing., Conclusions: This protocol establishes a foundation for advancing wearable technology in opioid overdose prevention within SIFs. The study will provide chest wall movement data and associated overdose data that will be used to train an algorithm that allows the biosensor to detect an overdose. The study will contribute crucial insights into OIRD, emphasizing the biosensor's potential step forward in real-time intervention strategies., International Registered Report Identifier (irrid): DERR1-10.2196/57367., (©Basak Tas, Will Lawn, Marianne Jauncey, Mark Bartlett, Paul Dietze, Daniel O'Keefe, Nico Clark, Bruce Henderson, Catriona Cowan, Osian Meredith, John Strang. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 10.09.2024.)

This paper addresses the marginalisation of tāngata kāpō Māori (blind and low-vision Indigenous New Zealanders) in health- and vision-related research, despite New Zealand's commitments to international conventions. Utilising a pūrākau-based approach, it challenges existing colonial narratives and emphasises the importance of Māori perspectives. We advocate for Māori self-determination over research processes. This paper shares insights from a systematic review and the development of a declaration for engaging with tāngata kāpō Māori, reflecting the 3-year collaborative process. The Materials and Methods section details a Kaupapa Māori-grounded data collection, prioritising relationships and cultural practices. Feedback loops with participants and forums ensure accurate representation. In conclusion, the study underscores NZ government obligations and presents the "3Rs" framework-relationships, respect, and reciprocity-as essential for meaningful research engagements with tāngata kāpō Māori. The findings contribute valuable insights to guide future research practices, advocating for the inclusion and recognition of tāngata kāpō Māori rights in practice and research.

Bioluminescence emitted from a luciferase-catalyzed oxidation of luciferin has been broadly utilized to report on biological events, predominantly through relative changes in the light output. Recent advances in protein engineering and synthetic chemistry have yielded bioluminescent systems with markedly improved brightness and bioavailability. These developments have enabled not only the detection of biological events at far lower expression levels but also new opportunities utilizing bioluminescence to power photochemistry in cells. Regardless of the application, bioluminescence analyses have leaned heavily on the use of luminometers to measure the light output of a system. Current luminometers report the light output of a sample in relative units, limiting the ability to compare data between instruments and preventing the absolute power of a bioluminescent system from being quantified. Luminescent solution calibrants comprising luciferases and their cognate luciferins that have been characterized for absolute light output would enable calibration of any given luminometer for absolute photon counting. To this end, we have built a custom light detection apparatus and used it alongside wavelength-matched LED light sources emitting at 450 and 561 nm to characterize the absolute power of a series of NanoLuc and firefly luciferase solutions, respectively. This approach revealed that these two common luciferases produce 3.72 × 10 -18 and 7.25 × 10 -20 watts/molecule, respectively. Components of these luminescent solution calibrants are commercially available and produce stable bioluminescent signals over 2-5 min, enabling any luminometer to be calibrated for power measurements of bioluminescence emitted by these two luciferases in units of watts or photons per second., Competing Interests: The authors declare the following competing financial interest(s): All authors are employees of Promega., (© 2023 The Authors. Published by American Chemical Society.)

Introduction: Atrial fibrillation (AF) is associated with a fivefold increased risk of stroke. Oral anticoagulation reduces the risk of stroke, but AF is elusive. A machine learning algorithm (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)) developed to predict incident AF within 6 months using data in primary care electronic health records (EHRs) could be used to guide AF screening. The objectives of the FIND-AF pilot study are to determine yields of AF during ECG monitoring across AF risk estimates and establish rates of recruitment and protocol adherence in a remote AF screening pathway., Methods and Analysis: The FIND-AF Pilot is an interventional, non-randomised, single-arm, open-label study that will recruit 1955 participants aged 30 years or older, without a history of AF and eligible for oral anticoagulation, identified as higher risk and lower risk by the FIND-AF risk score from their primary care EHRs, to a period of remote ECG monitoring with a Zenicor-ECG device. The primary outcome is AF diagnosis during ECG monitoring, and secondary outcomes include recruitment rates, withdrawal rates, adherence to ECG monitoring and prescription of oral anticoagulation to participants diagnosed with AF during ECG monitoring., Ethics and Dissemination: The study has ethical approval (the North West-Greater Manchester South Research Ethics Committee reference 23/NW/0180). Findings will be announced at relevant conferences and published in peer-reviewed journals in line with the Funder's open access policy., Trial Registration Number: NCT05898165., Competing Interests: Competing interests: CPG reports personal fees from AstraZeneca, Amgen, Bayer, Boehrinher-Ingelheim, Daiichi Sankyo, Vifor, Pharma, Menarini, Wondr Medical, Raisio Group and Oxford University Press. He has received educational and research grants from BMS, Abbott, the British Heart Foundation, National Institute of Health Research, Horizon 2020, and from the European Society of Cardiology, outside the submitted work. AJC reports personal fees from Abbott, Bayer, BMS, Sanofi, Milestone, Boston Scientific, InCarda and Menarini. YMN reports a study grant from Bayer. GYHL is consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, Anthos. No fees are received personally. GYHL is corincipal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 899871., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

This article forms part of a series looking at management of patients with tooth wear. Articulated study casts can be essential in assisting the clinician to plan and communicate proposed treatment to the dental technician and patient. Their production is often seen as straightforward, but a lack of attention to detail can quickly lead to articulated casts that do not replicate the patient clinical presentation. This in turn will lead to inaccurate planning and potentially a suboptimal treatment outcome. This article discusses a collection of the clinical records needed to produce accurate articulated study casts, which can be utilised for tooth wear planning. It also aims to present the evidence base for the recommendations outlined., (© 2023. The Author(s).)

In clinical settings, oxygen therapy is administered to preterm neonates and to adults with acute and chronic conditions such as COVID-19, pulmonary fibrosis, sepsis, cardiac arrest, carbon monoxide poisoning, and acute heart failure. In non-clinical settings, divers and astronauts may also receive supplemental oxygen. In addition, under current standard cell culture practices, cells are maintained in atmospheric oxygen, which is several times higher than what most cells experience in vivo. In all the above scenarios, the elevated oxygen levels (hyperoxia) can lead to increased production of reactive oxygen species from mitochondria, NADPH oxidases, and other sources. This can cause cell dysfunction or death. Acute hyperoxia injury impairs various cellular functions, manifesting ultimately as physiological deficits. Chronic hyperoxia, particularly in the neonate, can disrupt development, leading to permanent deficiencies. In this review, we discuss the cellular activities and pathways affected by hyperoxia, as well as strategies that have been developed to ameliorate injury. • Hyperoxia promotes overproduction of reactive oxygen species (ROS). • Hyperoxia dysregulates a variety of signaling pathways, such as the Nrf2, NF-κB and MAPK pathways. • Hyperoxia causes cell death by multiple pathways. • Antioxidants, particularly, mitochondria-targeted antioxidants, have shown promising results as therapeutic agents against oxygen toxicity in animal models., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Objective: Atrial fibrillation (AF) is common and is associated with an increased risk of stroke. We aimed to systematically review and meta-analyse multivariable prediction models derived and/or validated in electronic health records (EHRs) and/or administrative claims databases for the prediction of incident AF in the community., Methods: Ovid Medline and Ovid Embase were searched for records from inception to 23 March 2021. Measures of discrimination were extracted and pooled by Bayesian meta-analysis, with heterogeneity assessed through a 95% prediction interval (PI). Risk of bias was assessed using Prediction model Risk Of Bias ASsessment Tool and certainty in effect estimates by Grading of Recommendations, Assessment, Development and Evaluation., Results: Eleven studies met inclusion criteria, describing nine prediction models, with four eligible for meta-analysis including 9 289 959 patients. The CHADS (Congestive heart failure, Hypertension, Age>75, Diabetes mellitus, prior Stroke or transient ischemic attack) (summary c-statistic 0.674; 95% CI 0.610 to 0.732; 95% PI 0.526-0.815), CHA 2 DS 2 -VASc (Congestive heart failure, Hypertension, Age>75 (2 points), Stroke/transient ischemic attack/thromboembolism (2 points), Vascular disease, Age 65-74, Sex category) (summary c-statistic 0.679; 95% CI 0.620 to 0.736; 95% PI 0.531-0.811) and HATCH (Hypertension, Age, stroke or Transient ischemic attack, Chronic obstructive pulmonary disease, Heart failure) (summary c-statistic 0.669; 95% CI 0.600 to 0.732; 95% PI 0.513-0.803) models resulted in a c-statistic with a statistically significant 95% PI and moderate discriminative performance. No model met eligibility for inclusion in meta-analysis if studies at high risk of bias were excluded and certainty of effect estimates was 'low'. Models derived by machine learning demonstrated strong discriminative performance, but lacked rigorous external validation., Conclusions: Models externally validated for prediction of incident AF in community-based EHR demonstrate moderate predictive ability and high risk of bias. Novel methods may provide stronger discriminative performance., Systematic Review Registration: PROSPERO CRD42021245093., Competing Interests: Competing interests: MGDB was a committee member of the NICE guideline (NG196) atrial fibrillation: diagnosis and management. CPG has received grants for research from Abbott and Bristol Myers Squibb; consulting fees from Astrazeneca, Bayer and Daiichi Sankyo; honoraria for speaking at meetings and educational events from Astrazeneca, Wondr Medical and Menarini; support for attending meetings from Bayer and Bristol Myers Squibb; and has acted as an advisory board member for Amgen, Astrazeneca, Bayer, Daiichi Sankyo and Menarini. All other authors declare no competing interests, or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Atrial fibrillation (AF) is increasingly common, though often undiagnosed, leaving many people untreated and at elevated risk of ischaemic stroke. Current European guidelines do not recommend systematic screening for AF, even though a number of studies have shown that periods of serial or continuous rhythm monitoring in older people in the general population increase detection of AF and the prescription of oral anticoagulation. This article discusses the conflicting results of two contemporary landmark trials, STROKESTOP and the LOOP, which provided the first evidence on whether screening for AF confers a benefit for people in terms of clinical outcomes. The benefit and efficiency of systematic screening for AF in the general population could be optimized by targeting screening to only those at higher risk of developing AF. For this purpose, evidence is emerging that prediction models developed using artificial intelligence in routinely collected electronic health records can provide strong discriminative performance for AF and increase detection rates when combined with rhythm monitoring in a clinical study. We consider future directions for investigation in this field and how this could be best aligned to the current evidence base to target screening in people at elevated risk of stroke., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

MRL/lpr mice have been extensively used as a murine model of lupus. Disease progression in MRL/lpr mice can differ among animal facilities, suggesting a role for environmental factors. We noted a phenotypic drift of our in-house colony, which was the progeny of mice obtained from The Jackson Laboratory (JAX; stocking number 000485), that involved attenuated glomerulonephritis, increased splenomegaly, and reduced lymphadenopathy. To validate our in-house mice as a model of lupus, we compared these mice with those newly obtained from JAX, which were confirmed to be genetically identical to our in-house mice. Surprisingly, the new JAX mice exhibited a similar phenotypic drift, most notably the attenuation of glomerulonephritis. Interestingly, our in-house colony differed from JAX mice in body weight and kidney size (both sexes), as well as in splenic size, germinal center formation, and level of anti-dsDNA auto-IgG in the circulation (male only). In addition, we noted differential expression of microRNA (miR)-21 and miR-183 that might explain the splenic differences in males. Furthermore, the composition of gut microbiota was different between in-house and new JAX mice at early time points, which might explain some of the renal differences (e.g., kidney size). However, we could not identify the reason for attenuated glomerulonephritis, a shared phenotypic drift between the two colonies. It is likely that this was due to certain changes of environmental factors present in both JAX and our facilities. Taken together, these results suggest a significant phenotypic drift in MRL/lpr mice in both colonies that may require strain recovery from cryopreservation., (Copyright © 2022 The Authors.)

A convenience sample of 154 edentulous patients referred for implant provision at a Regional National Health Service Dental Hospital in the North West of England were identified. The cephalometric radiographs that were taken as part of the patient baseline investigation were assessed. Digital tracing was used to measure the anterior maxillary and mandibular bone height and ridge angle with respect to the maxillary and mandibular planes. The mean height of the bone in the maxilla was found to be 14 mm, and the mean ridge angle for the anterior maxillary residual ridge is 104°. The mean height of bone in the mandible was 18 mm, while the mean ridge angle for the anterior mandibular residual ridge was 77°. Using the Cawood and Howell classification demonstrated that class VI mandibles were the most common. The cross-sectional shape of the mandible varied, with the triangular shape most common. Although there was adequate bone stock for implant placement in these cases, the mandibular residual ridge resorption presents a lingual inclination to the residual bone. The limited residual ridge position and inclination would dictate that conventional implant placement could be challenging.

In England in the early twentieth century, mental observation wards in workhouses developed as a parallel service to the asylums for emergency mental health admissions under the 1890 Lunacy Act, particularly in urban areas and especially London on account of local policy. The purpose of the wards was initial patient assessment and early discharge or certification, and there was controversy between their medical supporters and the Board of Control about any extension of their remit which might usurp the role of the mental hospitals. Their significance declined with changing policy in the NHS era, as more emergency admissions went to mental hospitals, and local treatment units emerged. This article explores the history of these services in the context of the changing legal and policy frameworks.