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Background and Purpose: Antipsychotics such as olanzapine are associated with significant metabolic dysfunction, attributed to gut microbiome dysbiosis. A recent notion that most psychotropics are detrimental to the gut microbiome has arisen from consistent findings of metabolic adverse effects. However, unlike olanzapine, the metabolic effects of lurasidone are conflicting. Thus, this study investigates the contrasting effects of olanzapine and lurasidone on the gut microbiome to explore the hypothesis of 'gut neutrality' for lurasidone exposure. Experimental Approach: Using Sprague–Dawley rats, the effects of olanzapine and lurasidone on the gut microbiome were explored. Faecal and blood samples were collected weekly over a 21‐day period to analyse changes to the gut microbiome and related metabolic markers. Key Results: Lurasidone triggered no significant weight gain or metabolic alterations, instead positively modulating the gut microbiome through increases in mean operational taxonomical units (OTUs) and alpha diversity. This novel finding suggests an underlying mechanism for lurasidone's metabolic inertia. In contrast, olanzapine triggered a statistically significant decrease in mean OTUs, substantial compositional variation and a depletion in short‐chain fatty acid abundance. Microbiome depletion correlated with metabolic dysfunction, producing a 30% increase in weight gain, increased pro‐inflammatory cytokine expression, and increased blood glycaemic and triglyceride levels. Conclusion and Implications: Our results challenge the notion that all antipsychotics disrupt the gut microbiome similarly and highlights the potential benefits of gut‐neutral antipsychotics, such as lurasidone, in managing metabolic side effects. Further research is warranted to validate these findings in humans to guide personalised pharmacological treatment regimens for schizophrenia. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) recurrence following surgical resection remains a significant clinical challenge, necessitating reliable predictive models to guide personalised interventions. In this study, we sought to harness the power of artificial intelligence (AI) to develop a robust predictive model for HCC recurrence using comprehensive clinical datasets. Methods: Leveraging data from 958 patients across multiple centres in Australia and Hong Kong, we employed a multilayer perceptron (MLP) as the optimal classifier for model generation. Results: Through rigorous internal cross‐validation, including a cohort from the Chinese University of Hong Kong (CUHK), our AI model successfully identified specific pre‐surgical risk factors associated with HCC recurrence. These factors encompassed hepatic synthetic function, liver disease aetiology, ethnicity and modifiable metabolic risk factors, collectively contributing to the predictive synergy of our model. Notably, our model exhibited high accuracy during cross‐validation (.857 ±.023) and testing on the CUHK cohort (.835), with a notable degree of confidence in predicting HCC recurrence within accurately classified patient cohorts. To facilitate clinical application, we developed an online AI digital tool capable of real‐time prediction of HCC recurrence risk, demonstrating acceptable accuracy at the individual patient level. Conclusion: Our findings underscore the potential of AI‐driven predictive models in facilitating personalised risk stratification and targeted interventions to mitigate HCC recurrence by identifying modifiable risk factors unique to each patient. This model aims to aid clinicians in devising strategies to disrupt the underlying carcinogenic network driving recurrence. [ABSTRACT FROM AUTHOR]

Background: Eosinophilic oesophagitis (EOE) is a known cause of food bolus obstruction (FBO) with rising incidence and prevalence. Aims: To assess the rates of EOE in adult cases presenting with an FBO via prospective biopsy collection during index endoscopy. Methods: Oesophageal FBO cases requiring gastroscopy between February 2014 and January 2021 at a single institution with a unified policy to perform biopsies on FBO cases were analysed using medical records, endoscopy and histology. Statistical analysis was undertaken to compare those with and without EOE as their final diagnosis, including the timing of oesophageal biopsy and the season that cases presented. Results: One hundred ninety FBO presentations were analysed, 15 patients presented twice and one patient presented four times within the 7‐year study period. Men represented 72% of cases. A total of 78% of cases had biopsies collected at an index or scheduled follow‐up endoscopy. EOE was the cause of the FBO in 28% (53/190) of presentations. FBO secondary to EOE was more likely to occur in the spring and summer months (Australian September to March), with 39% (19 of 49) of cases presenting in spring attributable to EOE. Conclusion: EOE affects a significant proportion of patients presenting with FBO (28%); a high biopsy rate of 78% in FBO cases provides an opportunity for prompt diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background Pulmonary embolism ( PE) is associated with significant morbidity and mortality. PE is a heterogeneous entity that causes a wide variety of clinical presentations, making it imperative to establish which clinical symptoms, signs and biomarkers can influence the pretest probability of PE to aid clinicians and reduce over testing. Aim To analyse the clinical parameters used by clinicians to order a computed tomography pulmonary angiogram ( CTPA) and establish which were associated with the presence of PE. Methods Medical records of patients who underwent CTPA from December 2015 to March 2016 were extracted. Patient demographics, clinical symptoms, diagnostic and radiological results were analysed. Results The study included 150 CTPA studies. Of the studies, 25 were positive for PE and 125 were negative. There was no significant relationship between the presence or character of chest pain and a positive CTPA result ( P = 0.216). Previous history of venous thromboembolism ( VTE) ( P < 0.0001), one or more risk factors for VTE and positive troponin ( P < 0.002) were all predictive of PE. None of the patients with a negative D-dimer had a positive CTPA. Conclusion This study supports the negative predictive value of the D-dimer for excluding PE and demonstrates that the strongest pretest predictors of PE in our population are a prior history of VTE, risk factors for VTE and elevated troponin. None of the parameters that often generate requests for CTPA, including vital signs or the presence of chest pain, was associated with the presence of PE in our study population. [ABSTRACT FROM AUTHOR]

The article focuses on the online learning resource developed to supplement basic clinical skills learning of undergraduate medical students at Queen's University Belfast in Northern Ireland. A recent survey of Queen's University students showed that the online learning tool benefited their learning of basic skills in a blended approach. It provides greater transparency of learning outcomes and improves awareness of the school's curricula. It also lists the other benefits of the online tool.

Treatment-resistant depression continues to pose a major medical challenge, as up to one-third of patients with major depressive disorder fail to have an adequate response to standard pharmacotherapies. An improved understanding of the complex circuitry underlying depressive disorders has fostered an explosion in the development of new, nonpharmacological approaches. Each of these treatments seeks to restore normal brain activity via electrical or magnetic stimulation. In this article, the authors discuss the ongoing evolution of neurostimulatory treatments for treatment-resistant depression, reviewing the methods, efficacy, and current research on electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizure therapy, focal electrically administered stimulated seizure therapy, transcranial direct current stimulation, chronic epidural cortical stimulation, and vagus nerve stimulation. Special attention is given to deep brain stimulation, the most focally targeted approach. The history, purported mechanisms of action, and current research are outlined in detail. Although deep brain stimulation is the most invasive of the neurostimulatory treatments developed to date, it may hold significant promise in alleviating symptoms and improving the quality of life for patients with the most severe and disabling mood disorders. [ABSTRACT FROM AUTHOR]

The document titled "Author Index" is a list of authors and their corresponding page numbers in the Journal of Gastroenterology & Hepatology. It includes a diverse range of authors from various backgrounds and countries. This index can be helpful for library patrons conducting research to quickly locate articles written by specific authors in the journal. However, without further investigation, the significance or context of the list is not clear. [Extracted from the article]

This paper assesses the relationship between decision utility and experienced utility of recreational nature visits. The former is measured as the travel cost to reach that site as routinely used by the travel cost method (TCM), and the latter is operationalized through visit‐related subjective well‐being (SWB). As such, the analysis is a test of convergent validity by examining whether ex ante TCM‐based assessment of recreational value reflecting decision utility corresponds to stated ex post SWB, reflecting experienced utility. It explores to what extent utility revealed by counts of nature visits are associated with self‐reported, visit‐related SWB relating to that same visited site. The analysis uses two existing datasets providing information on (i) 3672 recreational visits to green/blue spaces in England over the course of four years and (ii) 5937 recreational visits to bluespace sites across 14 European countries over one year. Results show a positive association between travel cost and visit‐related SWB while controlling for trip frequency and a large set of covariates, suggesting convergent validity of the two utility concepts. A breakdown by travel mode suggests this relationship only holds for trips involving motorized transport and is not present for habitual, chore‐like walking visits to the recreational site. [ABSTRACT FROM AUTHOR]

This paper provides an outline of a new interdisciplinary project called FixOurFood, funded through UKRI's 'Transforming UK food systems' programme. FixOurFood aims to transform the Yorkshire food system to a regenerative food system and will work to answer two main questions: (1) What do regenerative food systems look like? (2) How can transformations be enabled so that we can achieve a regenerative food system? To answer these questions, FixOurFood will work with diverse stakeholders to change the Yorkshire food system and use the learning to inform change efforts in other parts of the UK and beyond. Our work will focus on shifting trajectories towards regenerative dynamics in three inter‐related systems of: healthy eating for young children, hybrid food economies and regenerative farming. We do this by a set of action‐orientated interventions in schools and the food economy, metrics, policies and deliverables that can be applied in Yorkshire and across the UK. This article introduces the FixOurFood project and concludes by assessing the potential impact of these interventions and the importance we attach to working with stakeholders in government, business, third sector and civil society. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of secondary screening using non‐invasive prenatal testing (NIPT) in a routine NHS setting including test performance, turn‐around times (TATs) and no‐call (failure to obtain result) rates. To examine the influence of maternal and fetal characteristics on test performance. Design: Retrospective cohort. Setting: London teaching hospital. Sample: A total of 8651 pregnancies undergoing screening for fetal trisomy using NIPT provided by an NHS cell‐free DNA screening laboratory – the SAFE laboratory. Methods: Screening test evaluation and TATs. Univariate and multivariate logistic regression analysis to identify significant predictors of no‐call results and reported by low fetal fraction (<2%), very high fetal fraction (>40%) and processing failure. Main outcome measures: Test performance, TATs and no‐call rates, factors affecting no‐call results. Results: Average TAT was 4.0 days (95% CI 4.0–4.2 days). Test sensitivities for trisomies 21 and 13/18 were 98.9% (95% CI 95.9–99.9%) and 90.4% (95% CI 80.0–96.8%), respectively. The overall no‐call rate was 32/8651 (0.37%, 95% CI 0.26–0.52%). The overall risk of a no‐call result was influenced by gestational age, dichorionic twin pregnancy, history of malignancy and pregnancies affected by trisomy 13/18, but not by maternal weight or use of low‐molecular‐weight heparin. Conclusions: High‐throughput NIPT can be effectively embedded into a public health NHS setting. TATs of 4 days and no‐calls of <0.5% were well within clinically desirable tolerances. Gestational age, maternal weight, assisted reproductive techniques, use of low‐molecular‐weight heparin and past history of malignancy did not have major impacts on test no‐call rates and should not constitute reasons for withholding the option of NIPT from women. Turn‐around times of 4 days, no‐call (test failure) rates of 0.37% and highly accurate NIPT can be successfully embedded in the NHS. Turn‐around times of 4 days, no‐call (test failure) rates of 0.37% and highly accurate NIPT can be successfully embedded in the NHS. [ABSTRACT FROM AUTHOR]

Abstract: Background/Aims: We sought to determine factors associated with the overall survival from relapse (OSR) of acute myeloid leukaemia (AML) after allogeneic haemopoietic stem cell transplantation (alloHSCT) and the effect of first salvage therapy and subsequent graft‐versus‐host disease (GVHD) on OSR. Methods: Data on 386 patients from nine Australian centres with relapsed AML post‐alloHSCT were collected retrospectively. OSR was calculated using the Kaplan–Meier method. Univariate and multivariate analyses were conducted using the log‐rank test and proportional hazards modelling, respectively and a prognostic index for OSR was derived from multivariate modelling. Results: On multivariate analysis, relapse within 6 months (hazard ratio (HR) 2.4, P < 0.001) and grade 3–4 acute GVHD preceding relapse (HR 2.0, P = 0.004), were associated with inferior OSR. Patients with 1–2 factors had inferior OSR compared to those with zero factors (all patients: HR 2.3, P < 0.001, patients given salvage: HR 1.8, P < 0.001). The first salvage therapy used post‐relapse was donor cell therapy (DCT) (second alloHSCT or donor lymphocyte infusion) in 75, re‐induction chemotherapy (CT) in 103, radiotherapy in 8 and interferon‐α in 6. Although re‐induction CT death rate was low (2%), survival after CT was inferior to DCT (HR 1.9, P < 0.001). No survival benefit was seen for patients who developed GVHD following salvage therapy (P = 0.405). Conclusion: Patients with AML who relapse beyond 6 months from alloHSCT without prior grade 3–4 acute GVHD have a better outcome from salvage therapy. Salvage treatments employing DCT as the initial treatment of AML relapse confer a survival advantage over CT. [ABSTRACT FROM AUTHOR]

Objective Primary Endocrine Therapy (PET) is a good alternative to surgery for breast cancer in older frailer women. Overall survival rates are equivalent although rates of local control are inferior. There is little research regarding the decision support needs of older patients faced with this choice. This qualitative study aimed to explore these among older breast cancer patients offered a choice of treatment, as the basis to develop an appropriate decision support tool. Methods Semi-structured interviews were undertaken with older women (>75 years) with breast cancer who had been offered a choice of PET or surgery at diagnosis. Women's involvement in their treatment decision and support for the process were explored and analysed using framework analysis. Results Thirty-three interviews were undertaken (median age 82, range 75-95 years, 22 PET, 11 surgery). Most women, regardless of treatment choice, wanted tailored information about the different treatment options, their impact on independence, the practicalities of treatment and the risk of recurrence and spread. Surgery was the treatment of choice in women wanting optimal disease control; those choosing PET felt that they were 'too old' for surgery and wanted minimal disruption. Conclusions Older women described making active treatment decisions. However, some knowledge was inaccurate. Women wanted information and decision support from their clinicians along with a specific tailored information booklet to support this process. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

While imitatio Christi has widely been recognised as a narrative element of the Martyrdom of Polycarp, other possible literary allusions have been under-explored. This article examines the presence of allusions to the death of Socrates in the Martyrdom of Polycarp. Socrates was often used in Christian apologetic contexts, thus its possible presence in Martyrdom of Polycarp is not surprising. This article seeks to understand the narrative function of Socratic allusions, especially relating to the text's construction of martyrdom and its Christology. It posits that imitatio Christi and imitatio Socratis function together apologetically to demonstrate the reasonableness of Christian worship of Jesus. [ABSTRACT FROM AUTHOR]

This paper will focus on the turn-taking patterns of Deaf signers and will compare them with turn-taking patterns found in spoken interaction. Turn-taking in the conversation of hearing people has been the subject of considerable attention, but the way conversation is organised by Deaf conversationalists has received less attention. This paper reports on a small project involving conversational data obtained from two Deaf friendship groups, one all-female and one all-male. Our main aim was to establish whether Deaf interactants orient to a one-at-a-time model of turn-taking, or whether there was any evidence to suggest they can also orient to a more collaborative model. It has been assumed by researchers in the field of Deaf Studies that Deaf interactants orient to a one-at-a-time model since, where the medium of communication is visual rather than sound based, participants can attend to only those sources of talk that they can see. The paper also examines the data to see if there are any gender differences in the way Deaf interactants organise conversation. [ABSTRACT FROM AUTHOR]

Objective To use multiple immunofluorescence to compare the in vivo and in vitro expression of tissue‐specific proteins in BPH. Materials and methods Pure populations of prostate epithelial and stromal cells were produced using standard methods. Serum‐free media for epithelial cells were compared. Co‐localization of proteins was compared in frozen‐tissue sections and cultured cells by simultaneous multiple immunofluorescence, and recorded using a high‐resolution charge‐coupled device camera. Results In contrast to the other serum‐free media tested, epithelial cells grew without squamous differentiation or vacuolation in prostate epithelial growth medium (PrEGM, Clonetics, BioWhittaker UK Ltd., Berks, UK). These cells were predominantly of a basal phenotype, with some cells showing a luminal phenotype. Most of the stromal cells had features of myofibroblasts, but smooth muscle cells and fibroblasts also were present. Conclusion PrEGM is a commercially available serum‐free medium in which primary cultures of prostate epithelial cells can be propagated reproducibly. This study provides a comprehensive description of tissue‐specific protein expression in BPH in vivo and in vitro. The use of simultaneous multiple immunofluorescence to study co‐localization has resulted in a more precise definition of phenotype than has previously been possible, thereby establishing the relevance of the in vitro model system BPH. [ABSTRACT FROM AUTHOR]