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Guidance and Resources for Family Medicine Scholarship [Family Medicine Updates]




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[Neuroscience] Reimagining Cortical Connectivity by Deconstructing Its Molecular Logic into Building Blocks

Comprehensive maps of neuronal connectivity provide a foundation for understanding the structure of neural circuits. In a circuit, neurons are diverse in morphology, electrophysiology, gene expression, activity, and other neuronal properties. Thus, constructing a comprehensive connectivity map requires associating various properties of neurons, including their connectivity, at cellular resolution. A commonly used approach is to use the gene expression profiles as an anchor to which all other neuronal properties are associated. Recent advances in genomics and anatomical techniques dramatically improved the ability to determine and associate the long-range projections of neurons with their gene expression profiles. These studies revealed unprecedented details of the gene–projection relationship, but also highlighted conceptual challenges in understanding this relationship. In this article, I delve into the findings and the challenges revealed by recent studies using state-of-the-art neuroanatomical and transcriptomic techniques. Building upon these insights, I propose an approach that focuses on understanding the gene–projection relationship through basic features in gene expression profiles and projections, respectively, that associate with underlying cellular processes. I then discuss how the developmental trajectories of projections and gene expression profiles create additional challenges and necessitate interrogating the gene–projection relationship across time. Finally, I explore complementary strategies that, together, can provide a comprehensive view of the gene–projection relationship.




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Osteoporosis Canada guideline on screening for men likely low value [Letters]




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Management of opioid use disorder: 2024 update to the national clinical practice guideline [Guideline]

Background

In an evolving landscape of practices and policies, reviewing and incorporating the latest scientific evidence is necessary to ensure optimal clinical management for people with opioid use disorder. We provide a synopsis of the 2024 update of the 2018 National Guideline for the Clinical Management of Opioid Use Disorder, from the Canadian Research Initiative in Substance Matters.

Methods

For this update, we followed the United States Institute of Medicine’s Standards for Developing Trustworthy Clinical Practice Guidelines and used the Appraisal of Guidelines Research and Evaluation—Recommendation Excellence tool to ensure guideline quality. We carried out a comprehensive systematic literature review, capturing the relevant literature from Jan. 1, 2017, to Sept. 14, 2023. We drafted and graded recommendations according to the Grading of Recommendations, Assessments, Development and Evaluation approach. A multidisciplinary external national committee, which included people with living or lived experience of opioid use disorder, provided input that was incorporated into the guideline.

Recommendations

From the initial 11 recommendations in the 2018 guideline, 3 remained unchanged, and 8 were updated. Specifically, 4 recommendations were consolidated into a single revised recommendation; 1 recommendation was split into 2; another recommendation was moved to become a special consideration; and 2 recommendations were revised. Key changes have arisen from substantial evidence supporting that methadone and buprenorphine are similarly effective, particularly in reducing opioid use and adverse events, and both are now considered preferred first-line treatment options. Slow-release oral morphine is recommended as a second-line option. Psychosocial interventions can be offered as adjunctive treatment but should not be mandatory. The guideline reaffirms the importance of avoiding withdrawal management as a standalone intervention and of incorporating evidence-based harm reduction services along the continuum of care.

Interpretation

This guideline update presents new recommendations based on the latest literature for standardized management of opioid use disorder. The aim is to establish a robust foundation upon which provincial and territorial bodies can develop guidance for optimal care.




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"Steroids in severe community-acquired pneumonia". S. Ananth, A.G. Mathioudakis, J. Hansel. Breathe 2024; 20: 240081.




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Steroids in severe community-acquired pneumonia

There is conflicting evidence regarding the use of steroids in severe community-acquired pneumonia (CAP), with previous randomised controlled trials limited by small sample sizes. ESCAPe and CAPE COD are two recently published large trials on steroids in severe CAP. ESCAPe assessed the initiation of methylprednisolone within 72–96 h of hospital admission, while CAPE COD studied the use of hydrocortisone within 24 h of the development of severe CAP. ESCAPe did not show any differences in all-cause 60-day mortality or any of its secondary outcomes. CAPE COD showed that hydrocortisone improved all-cause 28-day mortality and reduced the risk of intubation or vasopressor-dependent shock. Important differences between the trials included the steroid regimens used, timing of steroid administration and baseline characteristics, with more diabetic patients included in ESCAPe. The results of CAPE COD support the initiation of hydrocortisone within 24 h of developing severe CAP, but more research is needed to evaluate long-term outcomes and optimum dosing regimens for steroids in severe CAP.




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Squid Game Season 2 Will Be All About Divisions—and the Fight to Overcome Them



Netflix's mega-violent mega-hit series returns December 26.





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New research to better understand the biological factors of suicidal behaviour

New research to better understand the biological factors of suicidal behaviour Researchers at the University of Glasgow are embarking on two new PhD projects to better understand the impact that biological factors may have on suicidal behaviour.




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'Renowned' restructuring firm acquired by major sector player

A "renowned" restructuring advisory business has been acquired by a major player.




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Housebuilder completes 'one of the largest' new Highland homes projects since 1970s

A rural housing project branded as ‘truly transformative’ has been completed




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RPG Cast – Episode 617: “Yoko Taro Made This While Queuing for His Raid”

Chris has a normal amount of coffee on his shirt. Kelley conks her cat on the head with a controller. And Josh thinks Maglam Lord is a contraceptive device.

The post RPG Cast – Episode 617: “Yoko Taro Made This While Queuing for His Raid” appeared first on RPGamer.




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RPG Cast – Episode 677: “My Parents Thought Final Fantasy Tactics Was a Strategy Guide”

Kelley "accidentally" barbecues her horse. Josh slaps "Trails" onto Horizon: Forbidden West to get Americans to play it. Jason has to go get a tako taco.

The post RPG Cast – Episode 677: “My Parents Thought Final Fantasy Tactics Was a Strategy Guide” appeared first on RPGamer.



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In strategy game Sintopia you harvest a whole civilisation's souls for your own custom-built hell

One of my favourite satires is the Screwtape Letters, an epistolary novel by Narnia scribe C.S. Lewis. It consists of messages from an oily elder demon to his nephew about how to correctly groom the soul of an unsuspecting human being. It's a claustrophobic send-up of managerial politics and nepotism, with World War 1 unfolding in the background. A real pick-me-up. Sintopia is the Two Point incarnation of that premise - in other words, brighter and breezier and definitely more slapstick than Christian. It puts you in charge of a world divided between Earth and hell, and challenges you to ensure a steady movement of optimally sinful souls between one and the other. Say your prayers and watch the trailer.

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Alan Wake 2 still hasn't quite made its money back, according to Remedy's latest financials

Remedy's Alan Wake 2 has now "recouped most of its development and marketing expenses", CEO Tero Virtala has announced in a business review for January-September 2024. Speaking as somebody who would quite like there to be more Alan Wake games - or at least, moderately weird and pretty decent blockbuster singleplayer horror games - I am both pleased by this news and a little troubled that Remedy's eldritch forest fable (which came out in October 2023) has yet to break even.

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Baldur’s Gate 3's reactivity didn’t ruin Veilguard's linearity for me - it let me enjoy it more

Minor spoilers for the first few hours of Veilguard and heavy spoilers for Baldur’s Gate 3

For all the things I ended up enjoying about Dragon Age: The Veilguard, it isn’t much of an RPG. What little roleplaying it does offer revolves around what flavour of supportive hero you prefer, and you can count the number of impactful dialogue decisions on a three-fingered hand. This might sound utterly damning in the wake of Baldur's Gate 3’s incredible reactivity, and if I approached games as some sort of tedious comparative intellectual exercise rather than just, y’know, seeing how I felt about them, then I suppose it would be. Weirdly, though, the recent memory of Baldur’s Gate 3 didn’t diminish my time with Veilguard at all. It was actually the opposite: it freed Dragon Age from having to carry the torch for a certain period in Bioware’s history, and let me enjoy Veilguard for what it was.

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Call Of Duty: Black Ops 6 campaign review: a military shooter that comes disguised as other, better games

As a yearly blockbuster, Call of Duty, through sheer expense and effort, would like you to think it is the Die Hard of video games. Or, depending on the setting, the Saving Private Ryan of video games. But it is barely Black Hawk Down. This latest campaign in Call Of Duty: Black Ops 6 reminds me more of the forgettable Netflix shootfests that thumbnail their way across your TV screen as you try to find some gritty nothing to aid you in zoning out of life. Still, there is an anecdotal contingent of casual sofa sitters for whom Call Of Duty is the game. A balls-to-the-wall shooter to return to every winter and rinse through in a weekend. Ed has already gestured at its multiplayer, announcing: "yup, it's COD", like a deeply tired Captain Birdseye inspecting the day's catch, wondering when his life will change. But never mind that. How does the single player story mode hold up? Some are calling it the best campaign in years. And I guess that's true, in the sense that it is the least worst.

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You can now make video clips using Steam's built-in game recording feature, as an update rolls it out to all users

Steam's built-in game recording feature has been usable in beta since the summer, but it has now been properly launched for every user, following a client update to Steam yesterday. It's basically another method of capturing funny ragdoll glitches and posting them on the "lol-games-are-dumb" channel of your friend's Discord. Or for posting that flukey knife throw in Call Of Duty to Twitter, as if you really meant to kill the man from across the map all along. Or saving a clip for your personal records, like the footage of that time you yeeted an innocent citizen off the 50-foot wall of a castle town in Dragon's Dogma 2. We all do that, right? Right?

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Here are the patents Nintendo and the Pokémon Company are suing Palworld about, according to Pocketpair

Palworld developers Pocketpair have finally revealed which patents Nintendo and the Pokémon Company are suing them about. It looks like they're focusing on the act of throwing capsular items to catch or release monsters, together with the usage of monsters as mounts.

If you've somehow yet to encounter Palworld, it's a bestselling survival game that takes hefty - some would say, scandalous - inspiration from Pokémon, with players poaching Pokésque critters using magic spheres, and deploying them as soldiers and minions.

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What's on your bookshelf?: Liminal biscuit filling edition

My brain is still thawing for the comment freeze, and thus there is sadly no cool industry person to talk to us about books this week. I'm currently reading Tony Tulathimutte’s Rejection. Jia Tolentino wrote about it for the New Yorker. Jia Tolentino also writes very good books. But enough about books, tell me about books! One's you've read, preferably, but I will also accept books you've formed opinions on based on their covers, as is good and proper. Book for now!

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Ubisoft is being sued over The Crew in a lawsuit that compares the server shutdown to a bumperless pinball machine

"Imagine you buy a pinball machine, and years later, you enter your den to go play it, only to discover that all the paddles are missing, the pinball and bumpers are gone, and the monitor that proudly displayed your unassailable high score is removed". As reported by Polygon, that's an argument put forth by a new lawsuit against Ubisoft, filed by two Californian players of The Crew. They're suing the company in a proposed class action lawsuit over shutting down the racing game's servers, rendering it unplayable.

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San Antonio truck driver pleads guilty in fatal human smuggling case

Police officers work on a crime scene after 10 undocumented immigrants being smuggled into the U.S. were found dead inside a sweltering 18-wheeler trailer parked behind a Walmart store in San Antonio. Photo by Ray Whitehouse/Reuters

A 61-year-old San Antonio man pleaded guilty to two federal charges in the human smuggling incident that led to the deaths of 10 undocumented immigrants this summer.

James Matthew Bradley Jr., who appeared before a U.S. magistrate judge Monday, pleaded guilty to “one count of conspiracy to transport aliens resulting in death and one count of transporting aliens resulting in death,” according to a statement from the U.S. Attorney’s Office for the Western District of Texas.

The office added that Bradley’s “admission of guilt” meant he packed dozens of unauthorized immigrants into a tractor-trailer for financial gain, adding that the suspect confirmed that details from court documents were “factually correct.”

On July 23, San Antonio Police Department officers responded to a call from a Walmart employee shortly past midnight. Once officers arrived, they found 39 immigrants at the scene. Of those carried in the tractor-trailer, eight were found dead in the rear of the trailer, while two died later at nearby hospitals, the statement said.

Survivors of the incident said there was no air conditioning in the overheated trailer and had to take turns to breath through a hole in the back of the truck for air. Bradley also initially told investigators that he was unaware of the immigrants in the trailer until he had stopped at the Walmart in San Antonio for bathroom break.

The attorney’s office also said Bradley faces up to life in prison with the charges and that he is scheduled to be sentenced in January 2018. Immigrants said there were up to 200 people transported on the trailer and that different fees were quoted to them for the ride north from the U.S.-Mexico border, the statement added.

Jason Buch of San Antonio Express-News told the NewsHour earlier this year that Border Patrol agents in Laredo, Texas, reported an uptick of immigrants using tractor-trailers to get pass checkpoints at the border.

“People are usually going on to major metropolitan areas or regions of the country that employ a lot of immigrant laborers, so, areas with large agriculture industries or construction booms,” Buch said.

The NewsHour’s John Yang learned more about the July human smuggling case and immigration politics from Jason Buch of San Antonio Express News.

Shane M. Folden, special agent in charge of homeland security investigations in San Antonio, said in the statement that the proceeding “helps to close the door on one of the conspirators responsible for causing the tragic loss of life and wreaking havoc on those who survived this horrific incident.”

“This case is a glaring reminder that alien smugglers are driven by greed and have little regard for the health and well-being of their human cargo, which can prove to be a deadly combination,” he added.

Bradley’s co-defendant Pedro Silva Segura was also indicted last month with faces two counts of conspiracy and two counts of transporting undocumented immigrants resulting in serious bodily injury and placing lives in jeopardy.

Segura, 47, is an undocumented immigrant who resides in Laredo, Texas.

The post San Antonio truck driver pleads guilty in fatal human smuggling case appeared first on PBS NewsHour.




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The JUICE spacecraft may be visible on a near-Earth flyby next week

On 19 and 20 August, the JUICE mission will make the first ever attempt to get a gravitational boost from both Earth and the moon on its way to Jupiter




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AI can use tourist photos to help track Antarctica’s penguins

Scientists used AI to transform tourist photos into a 3D digital map of Antarctic penguin colonies – even as researchers debate whether to harness or discourage tourism in this remote region




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Are we really ready for genuine communication with animals through AI?

Thanks to artificial intelligence, understanding animals may be closer than we think. But we may not like what they are going to tell us, says RSPCA chief executive Chris Sherwood




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This robot can build anything you ask for out of blocks

An AI-assisted robot can listen to spoken commands and assemble 3D objects such as chairs and tables out of reusable building blocks




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Trump Builds New Administration

Friday on the RealClearPolitics radio show -- weeknights at 6:00 p.m. on SiriusXM's POTUS Channel 124 and then on Apple, Spotify, and here on our website -- Tom Bevan, Andrew Walworth, and Carl Cannon look at the latest count to determine the final popular vote and House majority.




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Pokemon set to break Guinness World Record with huge 24-hour livestream



The Pokemon Company is teaming up with content creators to stage a 24-hour unboxing live stream for its new Scarlet & Violet - Surging Sparks card set as you Gotta Catch 'Em All




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Equity overload: Federal department keeps 294 DEI staffers on payroll, most with six-figure salaries

The Health and Human Services Department employs 294 people whose jobs focus on diversity, and the department maintains seven separate "minority health" offices spread across its various agencies, according to a new report that suggests it will be tough for the incoming Trump administration to unwind it all.




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'Free, fair and fast': Officials quietly begin certifying presidential election results

Local officials are beginning to certify the results of this year's presidential election in a process that, so far, has been playing out quietly, in stark contrast to the tumultuous certification period four years ago that followed then-President Donald Trump's loss.




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Prada's out-of-this-world spacesuit for NASA

Kurt “CyberGuy" Knutsson discusses how Axiom Space and luxury designer Prada are collaborating on NASA's Artemis III spacesuit design.



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Great British summer of sport - your guide to how each event is ready for return of crowds







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Laura Kenny leaves heartache behind to lead England to Commonwealth team pursuit bronze

  • Day 2 action at the Birmingham Commonwealth Games
  • Local boy Fraser stars as England retain gymnastics team title
  • England's Yee wins first gold of Games in men's triathlon
  • Cyclist Fachie equals Scottish record of five Commonwealth golds
  • Olympic champion Duffy wins women's triathlon
  • England's Taylor-Brown second, Scotland's Potter third
  • ]]>



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    • structure:sport
    • topics:events/birmingham-commonwealth-games-2022




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    Pilot cybersecurity training program for women to recruit third cohort

    A pilot program aimed at training women and non-binary persons for careers in cybersecurity will soon start recruiting its third group of students. The program, offered to students in computer science and related courses in seven Canadian post-secondary institutions, should start looking for candidates next month for the fall academic year, said Vivian Lee, team […]

    The post Pilot cybersecurity training program for women to recruit third cohort first appeared on ITBusiness.ca.




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    Geomagnetic storm expected to hit Earth following autumnal equinox

    A coronal mass ejection could strike the Earth's magnetosphere this week and cause a geomagnetic storm due to conditions caused by the autumnal equinox.



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    WATCH: Wild drunk driver chased by police in terrifying 80mph pursuit on narrow lanes



    Police were in pursuit for half an hour down narrow country lanes




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    PC Building Simulator can be snagged for free on the EGS (until 14th)

    And the Epic Games Achievements system will start to roll out next week.




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    Physicists Find Evidence for Superfluidity in Low-Density Neutron Matter

    An accurate description of low-density nuclear matter is crucial for explaining the physics of neutron star crusts, according to a team of theoretical physicists led by Argonne National Laboratory’s Dr. Alessandro Lovato.

    The post Physicists Find Evidence for Superfluidity in Low-Density Neutron Matter appeared first on Sci.News: Breaking Science News.




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    Mosquito-borne illnesses are spiking across the world

    Climate change is extending mosquito season and helping to drive outbreaks of dengue fever, Oropouche virus and eastern equine encephalitis




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    Chronic fatigue syndrome could be quickly diagnosed via a blood test

    Levels of certain cells, fatty molecules and proteins in the blood are different in people with chronic fatigue syndrome than in those without it, which could help doctors spot the condition sooner




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    CBD shows promise as pesticide for mosquitoes

    Mosquito larvae die after consuming hemp leaves because they react strongly to the cannabidiol in the foliage. The discovery might lead to the development of a new pesticide to control mosquito numbers




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    Snoring isn't just a nuisance, it's dangerous. Why can't we treat it?

    Snoring is often viewed as harmless, at least to the snorer, but we are now uncovering its potentially serious effects on cardiovascular health. And finding ways to stop is surprisingly challenging




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    This surprisingly creative trick helps children eat more fruit and veg

    Weaving tales of magical fruit and vegetables into your children's stories may encourage them to eat healthy snacks




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    The complete guide to cooking oils and how they affect your health

    From seed oils to olive oil, we now have an overwhelming choice of what to cook with. Here’s how they all stack up, according to the scientific evidence