Harboemcnulty8134

improving patient outcomes.The description of genetic alterations in tumours is of increasing importance. In human genetics, and in pathology reports, sequence alterations are given using the human genome variation society (HGVS) guidelines for the description of such variants. However, there is less adherence to these guidelines for sequence variations in histone genes. Due to early cleavage of the N-terminal methionine in most histones, the description of histone sequence alterations follows their own nomenclature and differs from the HGVS-compliant numbering by omitting this first amino acid. Next generation sequencing reports, however, follow the HGVS guidelines and as a result, an unambiguous description of sequence variants in histones cannot be provided. The coexistence of these two nomenclatures leads to confusions for pathologists, oncologists, and researchers. This review provides an overview of tumour entities with sequence alterations of the H3-3A gene (HGNC ID = HGNC4764), highlights the problems associated with the coexistence of these two nomenclatures, and proposes a standard for the reporting of histone sequence variants that allows an unambiguous description of these variants according to HGVS principles. We hope that scientific journals will adopt the new notation, and that both geneticists and pathologists will include it in their reports. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.

To use data from electronic health records (EHRs) to describe the demographic, clinical and functional correlates of childhood sexual abuse (CSA) in patients with severe mental illness (SMI), and compare their clinical outcomes (admissions and receipt of antipsychotic medications) to those of patients with no recorded history of CSA.

We applied a string-matching technique to clinical text records of 7000 patients with SMI (non-organic psychotic disorders or bipolar disorder), identifying 619 (8.8%) patients with a recorded history of CSA. Data were extracted from both free-text and structured fields of patients' EHRs.

Comorbid diagnoses of major depressive disorder, post-traumatic stress disorder and personality disorders were more prevalent in patients with CSA. Positive psychotic symptoms, depressed mood, self-harm, substance use and aggression were also more prevalent in this group, as were problems with relationships and living conditions. The odds of inpatient admissions were higher in patients with CSA than in those without (adjusted OR=1.95, 95% CI 1.64-2.33), and they were more likely to have spent more than 10days per year as inpatients (adjusted OR=1.32, 95% CI 1.07-1.62). Telaprevir supplier Patients with CSA were more likely to be prescribed antipsychotic medications (adjusted OR=2.48, 95% CI 1.69-3.66) and be given over 75% of the maximum recommended daily dose (adjusted OR=1.72, 95% CI 1.44-2.04).

Data-driven approaches are a reliable, promising avenue for research on childhood trauma. Clinicians should be trained and skilled at identifying childhood adversity in patients with SMI, and addressing it as part of the care plan.

Data-driven approaches are a reliable, promising avenue for research on childhood trauma. Clinicians should be trained and skilled at identifying childhood adversity in patients with SMI, and addressing it as part of the care plan.The COVID-19 pandemic provided a commercial opportunity for traders marketing a range of ultraviolet (UV) radiation products for home-use disinfection. Due to concerns about the efficacy of such products and the potential for harmful levels of UV exposure to people, a range of products were purchased from on-line trading platforms. Spectral irradiance measurements were carried out to determine whether the products could be effective against the SARS-CoV-2 virus and whether they were likely to exceed internationally agreed exposure limits. It was concluded that many of the devices were not effective and many of those that were potentially effective presented a risk to users.

To identify organizational complementarities of adoption and use of electronic health records (EHRs) and assess what organizational strategies were associated with more advanced EHR use.

Primary survey data of US hospitals combined with secondary data from the American Hospital Association Annual Survey and IT Supplement.

In this cross-sectional study, we describe hospital organizational practices around EHR adoption and use and identify how these practices coalesce into distinct strategies. We then assess the association between those organizational strategies and adoption of advanced EHR functions.

Primary data collection consisted of surveys sent to 797 US acute care hospitals in 2018-2019, with 451 complete respondents.

There was significant variation in hospital organizational practices for EHR adoption and use. Factor analysis identified practices in three domains leadership engagement, human capital, and systems integration. Hospitals in the top quartile of the leadership engagement factor welue from their EHR investment may find it useful to know that there is an association between adoption of more advanced EHR functions, and engaging senior leadership as well as building connectivity between clinical and administrative systems.The Model for End-Stage Liver Disease score may have eliminated racial disparities on the waitlist for liver transplantation (LT), but disparities prior to waitlist placement have not been adequately quantified. We aimed to analyze differences in patients who are listed for LT, undergo transplantation, and die from end-stage liver disease (ESLD), stratified by state and race/ethnicity. We analyzed two databases retrospectively - the Center for Disease Control Wide-ranging OnLine Data for Epidemiologic Research (CDC WONDER) and the United Network for Organ Sharing (UNOS) databases from 2014-2018. We included patients aged 25-64 years who had a primary cause of death of ESLD and listed for transplant in the CDC WONDER and UNOS databases, respectively. Our primary outcome was the ratio of listing for LT to death from ESLD - listing to death ratio (LDR). Our secondary outcome was the transplant to listing and transplant to death ratios. Chi-squared and multivariable linear regression evaluated for differences between race/ethnicity. 135,367 patients died of ESLD, 54,734 patients were listed for transplant, and 26,571 underwent transplant. Patients were mostly male and White. The national LDR was 0.40, significantly lowest in Black patients (0.30), p less then 0.001. The national transplant to listing ratio was 0.48, highest in Black patients (0.53), p less then 0.01. The national transplant to death ratio was 0.20, lowest in Black patients (0.16), p less then 0.001. States that had an above-mean LDR had a lower transplant to listing ratio, but higher transplant to death ratio. Multivariable analysis confirmed Black race is significantly associated with a lower LDR and transplant to death ratio. Conclusion Black patients face a disparity in access to LT due to low listing rates for transplant relative to deaths from ESLD.The implementation of evidence-based psychotherapies often requires significant commitments of time and expense from mental health providers. Psychotherapy protocols with rapid and efficient training and supervision requirements may have higher levels of uptake in publicly funded clinics. Family-focused therapy (FFT) is a 4-month, 12-session treatment for bipolar and psychosis patients consisting of psychoeducation, communication training, and problem-solving skills training. In a pilot randomized trial, we compared two methods of training community clinicians in FFT (a) high intensity (n = 24), consisting of a 6-hour in-person didactic workshop followed by telephone supervision for every session with training cases; or (b) low-intensity training (n = 23), consisting of a 4-hour online workshop covering the same material as the in-person workshop followed by telephone supervision after every third session with training cases. Of 47 clinician participants, 18 (11 randomly assigned to high intensity, 7 to low) enrolled 34 patients with mood or psychotic disorders (mean age 16.5 ± 2.0 years; 44.1% female) in an FFT implementation phase. Expert supervisors rated clinicians' fidelity to the FFT manual based on taped family sessions. We detected no differences in fidelity scores between clinicians in the two training conditions, nor did patients treated by clinicians in high- versus low-intensity training differ in end-of-treatment depression or mania symptoms. Levels of parent/offspring conflict improved in both conditions. Although based on a pilot study, the results suggest that low-intensity training of community clinicians in FFT is feasible and can result in rapid achievement of fidelity benchmarks without apparent loss of treatment efficacy.Harvesting microalgae from liquid culture is a difficult issue to solve and is most commonly done through settling. However, settling is a slow process on its own and generally needs to be induced chemically or by introducing stress to the culture. Polymeric, cationic substances, such as cationised starch and chitosan, are often used for flocculation and settling. These large, positively charged molecules form large clusters with suspended particles in the liquid medium. In the present study, three natural organic flocculants (cationic starch, chitosan and acacia tannin S5T) were tested to harvest microalgal cultures grown in wastewater. Two microalgal species, one strain of Chlorella vulgaris and one strain of Scenedesmus obliquus, were cultured in municipal wastewater for different lengths of time, and settled using either cationic starch, chitosan or acacia tannin S5T. Results indicated that S5T worked with approximately the same efficiency in the two assayed species, although it requires a relatively high dosage to function (about 300 mg L-1 ), while the other two flocculants varied from species to species.

Prior studies have established an association between a history of abuse and the development of migraine. This cross-sectional observational study explored the relationship between self-reported abuse history with migraine-related sensory hypersensitivity symptoms.

In total, 588 adult patients with migraine from the American Registry for Migraine Research completed questionnaires Generalized Anxiety Disorder-7, Patient Health Questionnaire-2 for depression, Photosensitivity Assessment Questionnaire, Hyperacusis Questionnaire, and Allodynia Symptom Checklist. Using four binary screening questions, patients were asked to self-report if they believed they had suffered emotional, physical, or sexual abuse in their lifetime. Differences in questionnaire scores between groups with and without a history of abuse were determined. Regression models adjusted for age, sex, and basic headache features analyzed the relationship between abuse history and sensory hypersensitivity symptoms. Moderation analysis explored telated sensory hypersensitivity symptoms. To reduce the impact of abuse on migraine symptoms, future studies should explore mechanistic connections between abuse and migraine-associated symptoms.