Identifying mortality risks in patients with opioid use disorder using brief screening assessment:Secondary mental health clinical records analysis

BACKGROUND: Risk assessments are widely used, but their ability to predict outcomes in opioid use disorder (OUD) treatment remains unclear. Therefore, the aim was to investigate if addiction-specific brief risk screening is effective in identifying high mortality risk groups and if subsequent clinical actions following risk assessment impacts on mortality levels.  METHODS: Opioid use disorder (OUD) patients were identified in the South London and Maudsley Case Register. Deaths were identified through database linkage to the national mortality dataset. Cox and competing-risk regression were used to model associations between brief risk assessment domains and all-cause and overdose mortality in 4488 OUD patients, with up-to 6-year follow-up time where 227 deaths were registered. Data were stratified by admission to general mental health services.  RESULTS: All-cause mortality was significantly associated with unsafe injecting (HR 1.53, 95% CI 1.10-2.11) and clinically appraised likelihood of accidental overdose (HR 1.48, 95% CI 1.00-2.19). Overdose-mortality was significantly associated with unsafe injecting (SHR 2.52, 95% CI 1.11-5.70) and clinically appraised suicidality (SHR 2.89, 95% CI 1.38-6.03). Suicidality was associated with a twofold increase in mortality risk among OUD patients who were not admitted to mental health services within 2 months of their risk assessment (HR 2.03, 95% CI 1.67-3.24).  CONCLUSIONS: Diagnosis-specific brief risk screening can identify OUD patient subgroups at increased risk of all-cause and overdose mortality. OUD patients, where suicidality is evident, who are not admitted into services are particularly vulnerable

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Clinical Performance of Indirect Composite Onlays as Esthetic Alternative to Stainless Steel Crowns for Rehabilitation of a Large Carious Primary Molar

Objective: The aim of the present study was to evaluate the clinical performance of indirect resin composite onlays (IRC onlay) compared to stainless steel crowns (SSCs), as an esthetic alternative for rehabilitation of extensively carious primary molars. Study design: Fifty pediatric patients each received either IRC onlay or SSC randomly on extensively carious endodontically treated primary molars. All the restorations were evaluated at baseline and then every 6 months till 36 months using ‘modified FDI criteria’ for retention, marginal integrity, occlusion, proximal contact, secondary caries and gingival health. The dental chair side treatment time and post-operative acceptability were also evaluated for both the groups. Results: The cumulative survival rate of IRC onlays was 82.9% compared to 90.7% for SSCs over a time period of 36 months. The difference between the two study groups at various time intervals in terms of retention, marginal integrity, secondary caries, proximal contact, occlusion and gingival health was not statistically significant (p&amp;gt;0.05). The IRC onlays required significantly less mean chair side treatment time and were preferred the most by parents and children as per VAS scores compared to SSCs. Conclusion: IRC onlays are an acceptable esthetic alternative to SSCs and may be considered for use in aesthetically conscious children/parents as per their preference.</jats:p

Clinical evaluation of nares-vocal cord distance and its correlation with various external body parameters

Background and Aims: The optimal visualisation of vocal cords during fibreoptic intubation may be utilised for the nares-vocal cord distance (NVD) estimation. The present study was conducted to measure NVD and to correlate with various external body parameters. Methods: This study was conducted on 50 males and 50 females. We measured NVD and analysed its relationship with height, nares to tragus of ear distance (NED), nares to angle of mandible distance (NMD), sternal length (SL), thyro-mental distance (TMD), sterno-mental distance (SMD) and arm span (AS). Results: The mean NVD of the males was 18.5 ± 1.5 cm, and that of the females was 15.9 ± 1.1 cm. The relationship between the NVD and body height (males P = 0.001, r = 0.463, females P = 0.000, r = 0.555), SL (males P = 0.000, r = 0.463, females P < 0.000, r = 0.801) or AS (males P = 0.000, r = 0.561, females P = 0.000, r = 0.499) showed a significant correlation but NED, NMD, TMD, SMD did not. After combining male and female groups, (n = 100), the correlation of NVD with external body parameters is as follows SL (r = 0.887), height (r = 0.791), AS (r = 0.769), weight (r = 0.531), SMD (r = 0.466), NED (r = 0.459), NMD (r = 0.391), TMD (r = 0.379). Conclusion: The relationship of NVD to external body parameters had strong correlation in all parameters in the combined group; whereas when gender was taken into consideration NVD correlated significantly only with SL, height and AS

Magnetic bead purification of labeled DNA fragments for high-throughput capillary electrophoresis sequencing

We have developed an automated purification method for terminator sequencing products based on a magnetic bead technology. This 384-well protocol generates labeled DNA fragments that are essentially free of contaminates for less than $0.005 per reaction. In comparison to laborious ethanol precipitation protocols, this method increases the phred20 read length by forty bases with various DNA templates such as PCR fragments, Plasmids, Cosmids and RCA products. Our method eliminates centrifugation and is compatible with both the MegaBACE 1000 and ABI Prism 3700 capillary instruments. As of September 2001, this method has produced over 1.6 million samples with 93 percent averaging 620 phred20 bases as part of Joint Genome Institutes Production Process

Magnetic bead purification of labeled DNA fragments for high-throughput capillary electrophoresis sequencing

We have developed an automated purification method for terminator sequencing products based on a magnetic bead technology. This 384-well protocol generates labeled DNA fragments that are essentially free of contaminates for less than $0.005 per reaction. In comparison to laborious ethanol precipitation protocols, this method increases the phred20 read length by forty bases with various DNA templates such as PCR fragments, Plasmids, Cosmids and RCA products. Our method eliminates centrifugation and is compatible with both the MegaBACE 1000 and ABI Prism 3700 capillary instruments. As of September 2001, this method has produced over 1.6 million samples with 93 percent averaging 620 phred20 bases as part of Joint Genome Institutes Production Process