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Intravenous and intranasal ketamine have been shown to be effective therapeutic options in patients suffering from treatment-resistant depression (TRD). The use of sublingual (SL), rapid dissolve ketamine tablets (RDT) offers a novel approach for delivery for mental health indications. This study assessed the effectiveness and safety of self-administration of off-label, SL, rapid dissolve ketamine tablets (RDT) at-home for depression and anxiety. Intake scores on the Generalized Anxiety Disorder Screener (GAD-7) and Patient Health Questionnaire (PHQ-9) were compared to scores after treatments of three doses of ketamine RDT, and after six doses of ketamine RDT. After three doses of SL ketamine, 47.6% of patients showed a significant decrease in PHQ-9 scores, and 47.6% of patients showed a significant reduction in GAD-7 scores. Reduction rates were higher in those patients who completed a clinically recommended six doses of RDT ketamine. This study demonstrates that SL ketamine is a novel, safe, and effective treatment for TRD and treatment-resistant anxiety. SL ketamine offers an alternative therapeutic approach to IV ketamine when treating those with TRD.

The demand for inpatient medical services increases during influenza season. A scoring system capable of identifying influenza patients at low risk death or ICU admission could help clinicians make hospital admission decisions.Hospitalized patients with laboratory confirmed influenza were identified over 3 influenza seasons at 25 Ontario hospitals. Each patient was assigned a score for 6 pneumonia severity and 2 sepsis scores using the first data available following their registration in the emergency room. In-hospital mortality and ICU admission were the outcomes. Score performance was assessed using the area under the receiver operating characteristic curve (AUC) and the sensitivity and specificity for identifying low risk patients (risk of outcome or=0.80). The Pneumonia Severity Index (AUC 0.78, 95% CI 0.72-0.83) and the Mortality in Emergency Department Sepsis score (AUC 0.77, 95% 0.71-0.83) demonstrated fair predictive ability (AUC>or=0.70) for in-hospital mortality. The best predictor of ICU admission was SMART-COP (AUC 0.73, 95% CI 0.67-0.79). All other scores were poor predictors (AUC

Translation of culturally specific terms is considered a challenging activity. The current study explores the Kurdish translations of cultural terms found in the novel Animal farm written by George Orwell in 1945 and translated by three different translators. The study particularly attempts to identify the type of cultural terms according to Newmark's (1988) taxonomy. In addition, the study uses Venuti's (1995) strategies of domestication and foreignization to identify the three translator's choices, and uses Newmark's (1988) translation procedures to operationalize those two strategies. The results of the study reveal that all the five main categories of cultural terms were discovered including ecology, material culture (artefact), social culture (work and leisure), social organizations as well as gestures and habits. Material culture was the most frequent category of cultural terms found in the data. The translators employed various procedures, with cultural equivalent being the most common and deletion being the least. Furthermore, the translators' tendencies towards domestication and foreignization vary. Translator 1 demonstrates a greater inclination towards foreignization, while Translators 2 and 3 lean more towards domestication, with a notable similarity in their preferences. This study will be a contribution to the field of literary translation by offering insights concerning domestication and foreignization in translating CTs from English into Kurdish. [ABSTRACT FROM AUTHOR]

Advanced Air Mobility (AAM) represents a collaborative vision shared by NASA, regulatory agencies, and global industry leaders, aimed at establishing a robust and reliable air transportation ecosystem, which is expected to facilitate safe and efficient movement of both people and cargo within urban, suburban, and regional environments. This paper presents a holistic review and analysis encompassing various aircraft designs, including different propulsion system designs and architectures (electric, hybrid electric, turboelectric, etc.), for different AAM aircraft applications, and state-of-the-art air traffic management, cybersecurity, and infrastructure strategies. Recent academic and industry literature on these aspects is critically reviewed and summarized, and a compilation of the aircraft models currently in development is also provided. The aircraft designs are categorized into a set of core groups, which include lift + cruise, tilt-wing, tiltrotor, multirotor, and rotorcraft, to analyze the existing literature systematically. For each of these core groups, literature on different propulsion system designs and architectures is reviewed and analyzed. Next, these core groups, including their variations based on propulsion system designs and architectures, are analyzed through a set of evaluation lenses. This provides a comprehensive insight into their respective strengths, weakness, and gaps in design considerations. The identified lenses include range and payload, performance, environmental impact, feasibility, traffic and infrastructure, noise, vehicle safety, and cybersecurity. Finally, directions for future research in AAM aircraft and overall ecosystem development are identified. In general, a more in-depth, quantitative analysis on the various evaluation lenses identified in this study and appropriate consideration to all these evaluation lenses at the design and development stage are highly recommended. This type of holistic approach will drive AAM aircraft designs towards convergence and help build an efficient, affordable, and sustainable AAM ecosystem. • A compilation of state-of-the-art AAM aircrafts developed by the industry. • Comprehensive evaluation of various AAM aircraft designs, including rotor configuration and propulsion architectures. • Evaluation of the key components of the overall AAM ecosystem specific to vehicle operation. • Discussion on the research outlook for all the evaluation lenses analyzed in the study. [ABSTRACT FROM AUTHOR]

Background We aimed to assess the risk of subsequent infection among patients colonized by CPE. Methods The Toronto Invasive Bacterial Diseases Network (TIBDN) has conducted population-based surveillance for CPE colonization/infection in Toronto and Peel region, Ontario, Canada, since CPE were first identified (2007). All laboratories report all CPE isolates to TIBDN. Clinical data are collected via patient interview and hospital chart review. Initially colonized patients are followed for 5y; subsequent CPE infection is defined as an episode with onset >3 days after initial detection of CPE colonization that meets National Healthcare Safety Network criteria for infection with a clinical isolate of CPE. Results From 2007 to 2018, 790 persons with CPE colonization/infection were identified. Among 364 cases colonized at identification, 42 (12%) subsequently had at least one clinical isolate, and 23 (6%) had an infection: 8 with bacteremia (primary or secondary), 7 UTI, 5 pneumonia, and 3 other. The median time from identification of colonization to infection was 21 days (IQR 7–38), with a probability of developing an infection of 7% at 3 months, and 18% by 3 years (figure). In 305 cases with data available to date, older persons, those admitted to the ICU, and those with current/recent invasive medical devices were more likely to develop infection (table). Gender, underlying conditions and other procedures were not associated with risk of infection. There was a trend to infections being more likely in patients colonized with K. pneumoniae (52% vs. 35%, P = 0.13). Conclusion The risk of subsequent infection in our cohort was 18%, with highest risk in the first 3 months; most infections occurred in patients requiring intensive care unit admission and invasive medical devices. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]