Suicide Screening Among Adolescents with a History of Mental or Physical Abuse- Evaluating the Effectiveness of Suicide Screening: A Scoping Review

Purpose The purpose of this scoping review is to gather evidence on best practice for the administration of pediatric suicide screening in a variety of healthcare settings

Patient Compliance with Colorectal Cancer Screening: A Scoping Review

Purpose/Background Colorectal cancer (CRC) is a leading cause of cancer deaths for women and men. Routine screening based on current national guidelines can decrease morbidity and mortality. Unfortunately, patient compliance with CRC screening remains low. This scoping review will evaluate the literature and examine the association between colorectal cancer screening modality and patient compliance. Methods Individual searches within PubMed, EBSCO, and Medline were completed using MeSh with the following key words: colorectal cancer screening, patient compliance, stool-based screening, direct visualization, and others. A literature review was completed for 10 critically appraised articles published between 2010 and 2020. The association of the modality of CRC screening, patient compliance, and patient education was assessed and compared. A summary evaluation table was composed to determine the associations between CRC screening and patient compliance. Results The articles included consisted of four systematic reviews/meta-analysis, three randomized controlled trials, one controlled trial without randomization, and two cohort/case-control studies. Of the study sample (N=10), all but one demonstrated statistically significant findings concerning patient education, CRC screening, and compliance. Noninvasive stool-based studies have a higher patient compliance rate than direct visualization tests. Direct visualization tests offer same-session detection and biopsy with polyp removal leading to decreased mortality. Implications for Nursing Practice Results provided in this scoping review highlight the importance of colorectal cancer screening in decreasing mortality. Patient compliance can be improved with comprehensive education, discussing the risks and benefits of screenings, and evaluating individual health beliefs or fears. Patients still hesitant with direct visualization tests should begin with noninvasive studies. All positive screenings from stool-based screenings require follow-up with a colonoscopy

Bi-Weekly Follow-Up of Adult Patients Diagnosed With Schizophrenia to Increase Treatment Adherence: A Scoping Review

Purpose/Background Schizophrenia is a complex psychiatric disorder that can significantly affect a patient’s psychological state. Because of this, medication nonadherence is reported as one of the most common causes of relapse and rehospitalization in patients diagnosed with schizophrenia. Although long-acting injectable (LAI) antipsychotics can help provide more continuous treatment, they do not address other factors that affect treatment adherence. This scoping review will evaluate existing literature to assess if a multimodal approach, such as increased patient follow-ups in addition to scheduled, current-practice LAI treatment and management, may increase treatment adherence in adult patients diagnosed with schizophrenia. Methods A database search was conducted using CINAHL, PubMed Clinical Queries, Cochrane Library, Sage, and Medline Ovid from the dates 2013-2022. Articles were chosen if they were based on scientific research involving human subjects and if they provided full free-text access. Both quantitative and observational studies were used to provide alternate perspectives on medication interventions and health outcomes. Results After conducting a systematic database search, 117 articles were selected, and after applying exclusion criteria, ten articles were chosen to be included in this scoping review. The articles illustrated that LAIs decrease hospital length of stay and increase treatment adherence, but multimodal approaches were not adequately examined to determine their effectiveness. Implications for Practice The results of this scoping review support that LAIs are generally superior to oral antipsychotics in the treatment of adult patients with schizophrenia. However, there is not enough literature to determine the effectiveness of bi-weekly follow-ups in combination with LAI treatment to increase treatment adherence in adults diagnosed with schizophrenia. The implementation of bi-weekly follow-ups for schizophrenic patients still holds promise, but more studies are required to evaluate the effectiveness of LAI treatments and accompanying interventions to increase treatment adherence

Type I-E CRISPR-cas systems discriminate target from non-target DNA through base pairing-independent PAM recognition

This is the final version of the article. Available from the publisher via the DOI in this record.Discriminating self and non-self is a universal requirement of immune systems. Adaptive immune systems in prokaryotes are centered around repetitive loci called CRISPRs (clustered regularly interspaced short palindromic repeat), into which invader DNA fragments are incorporated. CRISPR transcripts are processed into small RNAs that guide CRISPR-associated (Cas) proteins to invading nucleic acids by complementary base pairing. However, to avoid autoimmunity it is essential that these RNA-guides exclusively target invading DNA and not complementary DNA sequences (i.e., self-sequences) located in the host's own CRISPR locus. Previous work on the Type III-A CRISPR system from Staphylococcus epidermidis has demonstrated that a portion of the CRISPR RNA-guide sequence is involved in self versus non-self discrimination. This self-avoidance mechanism relies on sensing base pairing between the RNA-guide and sequences flanking the target DNA. To determine if the RNA-guide participates in self versus non-self discrimination in the Type I-E system from Escherichia coli we altered base pairing potential between the RNA-guide and the flanks of DNA targets. Here we demonstrate that Type I-E systems discriminate self from non-self through a base pairing-independent mechanism that strictly relies on the recognition of four unchangeable PAM sequences. In addition, this work reveals that the first base pair between the guide RNA and the PAM nucleotide immediately flanking the target sequence can be disrupted without affecting the interference phenotype. Remarkably, this indicates that base pairing at this position is not involved in foreign DNA recognition. Results in this paper reveal that the Type I-E mechanism of avoiding self sequences and preventing autoimmunity is fundamentally different from that employed by Type III-A systems. We propose the exclusive targeting of PAM-flanked sequences to be termed a target versus non-target discrimination mechanism.This work was financially supported by an NWO Vidi grant to SJJB (864.11.005). RNJ and BW are supported by the National Institutes of Health (GM 103500) and the Montana State University Agricultural Experimental Station. ES, KAD and KS are supported by an NIH grant RO1 GM10407, a program grant in Molecular and Cell Biology from Presidium of Russian Academy of Sciences and a Russian Foundation for Basic Research grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Developing and validating a cardiovascular risk score for patients in the community with prior cardiovascular disease

OBJECTIVE: Patients with atherosclerotic cardiovascular disease (CVD) vary significantly in their risk of future CVD events; yet few clinical scores are available to aid assessment of risk. We sought to develop a score for use in primary care that estimates short-term CVD risk in these patients. METHODS: Adults aged <80 years with prior CVD were identified from a New Zealand primary care cohort study (PREDICT), and linked to national mortality, hospitalisation and dispensing databases. A Cox model with an outcome of myocardial infarction, stroke or CVD death within 2 years was developed. External validation was performed in a cohort from the UK. RESULTS: 24 927 patients, 63% men, 63% European, median age 65 years (IQR 58-72 years), experienced 1480 CVD events within 2 years after a CVD risk assessment. A risk score including ethnicity, comorbidities, body mass index, creatine creatinine and treatment, in addition to established risk factors used in primary prevention, predicted a median 2-year CVD risk of 5.0% (IQR 3.5%-8.3%). A plot of actual against predicted event rates showed very good calibration throughout the risk range. The score performed well in the UK cohort but overestimated risk for those at highest risk, who were predominantly patients defined as having heart failure. CONCLUSIONS: The PREDICT-CVD secondary prevention score uses routine measurements from clinical practice that enable it to be implemented in a primary care setting. The score will facilitate risk communication between primary care practitioners and patients with prior CVD, particularly as a resource to show the benefit of risk factor modification

Understanding the impact of legislation on 'reduction of disease risk' claims on food and drinks: The REDICLAIM project

The Nutrition and Health Claims Regulation (EC No. 1924/2006) has established a common framework for the regulation of nutrition and health claims used on foods across the European Union. This regulation aims to provide the European food industry opportunities for product innovation whilst protecting consumer interests with respect to controlling misleading advertising and promoting public health. However, in order to satisfy the approval of new health claims procedure particularly for new 'reduction of disease risk' claims [Article 14(1)(a) claims], significant research activity is required by industry to scientifically substantiate the claims they wish to make. There is a need to establish whether the implementation of this legislation is in fact driving product innovation and the development of healthy foods or whether it forms a barrier to such developments. The EU-funded REDICLAIM project is currently considering these issues. This article describes the project's preliminary results and outlines the further programme of work

Paleoecology and evolutionary response of planktonic foraminifera to the mid-Pliocene Warm Period and Plio-Pleistocene bipolar ice sheet expansion

The Pliocene-Recent is associated with many important climatic and paleoceanographic changes, which have shaped the biotic and abiotic nature of the modern world. The closure of the Central American Seaway and the development and intensification of Northern Hemisphere ice sheets had profound global impacts on the latitudinal and vertical structure of the oceans, triggering the extinction and radiation of many marine groups. In particular, marine calcifying planktonic foraminifera, which are highly sensitive to water column structure, exhibited a series of extinctions as global temperatures fell. By analyzing high-resolution (∼ 5 kyr) sedimentary records from the Eastern Equatorial Pacific Ocean, complemented with global records from the novel Triton dataset, we document the biotic changes in this microfossil group, within which three species displayed isochronous co-extinction, and species with cold-water affinity increased in dominance as meridional temperature gradients steepened. We suggest that these changes were associated with the terminal stages of the closure of the Central American Seaway, where following the sustained warmth of the mid-Pliocene Warm Period, bipolar ice sheet expansion initiated a world in which cold- and deep-dwelling species became increasingly more successful. Such global-scale paleoecological and macroevolutionary variations between the Pliocene and the modern icehouse climate would suggest significant deviations from pre-industrial baselines within modern and future marine plankton communities as anthropogenic climate forcing continues

Assessing cognitive dysfunction in Parkinson’s: An online tool to detect visuo-perceptual deficits

BACKGROUND: People with Parkinson’s disease (PD) who develop visuo-perceptual deficits are at higher risk of dementia, but we lack tests that detect subtle visuoperceptual deficits and can be performed by untrained personnel. Hallucinations are associated with cognitive impairment and typically involve perception of complex objects. Changes in object perception may therefore be a sensitive marker of visuo-perceptual deficits in PD. Objective: We developed an online platform to test visuo-perceptual function. We hypothesised that (1) visuo-perceptual deficits in PD could be detected using online tests, (2) object perception would be preferentially affected, and (3) these deficits would be caused by changes in perception rather than response bias. METHODS: We assessed 91 people with PD and 275 controls. Performance was compared using classical frequentist statistics. We then fitted a hierarchical Bayesian signal detection theory model to a subset of tasks. RESULTS: People with PD were worse than controls at object recognition, showing no deficits in other visuoperceptual tests. Specifically, they were worse at identifying skewed images (P <.0001); at detecting hidden objects (P 5.0039); at identifying objects in peripheral vision (P <.0001); and at detecting biological motion (P 5.0065). In contrast, people with PD were not worse at mental rotation or subjective size perception. Using signal detection modelling, we found this effect was driven by change in perceptual sensitivity rather than response bias. CONCLUSIONS: Online tests can detect visuo-perceptual defi- cits in people with PD, with object recognition particularly affected. Ultimately, visuo-perceptual tests may be developed to identify at-risk patients for clinical trials to slow PD dementia