Longer Total Interhospital Transfer Times for Rural Sepsis Patients Not Associated with Increased Mortality.

Objectives: Sepsis is a time-sensitive condition, and many rural emergency department (ED) sepsis patients are transferred to tertiary hospitals. The objective of this study was to determine whether longer transport times during interhospital transfer are associated with higher sepsis mortality or increased hospital length-of-stay (LOS).

Methods: A cohort of rural adult (age ≥ 18y) sepsis patients transferred between hospitals were identified in the TELEmedicine as a Virtual Intervention for Sepsis Care in Emergency Departments (TELEVISED) parent study.

Biomarkers.

Background: The apolipoprotein E (ApoE) Ɛ4 allele is associated with a significant risk for both late-onset Alzheimer's Disease (AD) development and cerebral amyloidosis, but the degree to which cerebrospinal fluid (CSF) apoE glycosylation affects disease progression is unclear. The objective of this study was to examine the relationship of CSF apoE glycosylation with t-tau, p-tau181, and Aβ1-42 CSF levels, and to delineate the effect of the APOE4+ genotype (vs E4-) on glycosylation.

Method: Total glycosylation and apoE isoform-specific glycosylation were analyzed in baseline plasma and CSF samples from a longitudinal cohort of older individuals (n=188, ages 55 - 89) from the Alzheimer's Disease Neuroimaging Initiative (ADNI).

Biomarkers.

Background: Our study aims to determine if urine dicarboxylic acids (DCA) concentrations might be associated with specific brain region volumes in older cognitively healthy (CH) adults.

Method: We recruited CH study participants (> 65 years) and acquired MRI data analyzed using NeuroQuant. Urine DCAs were quantified using GC-MS.

Public Health.

Background: Randomized clinical trials for AD increasingly use composite continuous cognitive endpoints to establish efficacy. While these endpoints provide necessary research and clinical evidence, they do not inform the potential impact on incident MCI/AD. Similarly, studies designed with disease progression as an endpoint fail to incorporate within-person longitudinal cognitive and functional changes in assessment of disease risk, often relying on baseline measures only, or explore cognitive and functional performance change in separate analyses, independent of conversion.

Developing Topics.

Background: Chronic air pollution exposure increases accelerates cognitive aging and AD risk. Synapse loss in AD correlates with decreased cognitive ability. In rodents, inhaled air pollutants decreased glutamatergic synapses, decreasing excitatory postsynaptic currents (EPSCs), while increasing total levels of AMPA and NMDA receptor protein.

The relationship of sex and aortic diameter at the time of acute type A aortic dissection.

Objective: Evaluate sex differences in patients undergoing repair of acute type A aortic dissection (ATAAD).

Methods: Sex-stratified, single-center cohort study of patients undergoing ATAAD repair from 1997 to 2022. The primary outcome was aortic diameter at time of presentation with ATAAD.

Visions by WIMIN: Imposter Phenomenon.

The imposter phenomenon (IP) is a destructive set of beliefs, traits, and experiences in which high-achieving individuals fail to internalize their accomplishments and falsely perceive themselves as frauds. IP is a function of underrepresentation and contributes to and perpetuates a cycle of low self-worth, perfectionism, and anxiety, all of which negatively affect job performance and reinforce the IP cycle. Mitigating the deleterious effects of IP requires first naming this phenomenon and recognizing the patterns of IP.

Rhinorrhea Recurrence After Posterior Nasal Nerve Cryoablation: A Multicenter Cohort Study.

Background: Posterior nasal nerve (PNN) cryoablation improves chronic rhinitis (CR) symptoms in 70-80% of cases, including clear thin rhinorrhea (CTR). This study's purpose was to determine time to and degree of CTR recurrence following cryoablation.

Methods: A multicenter retrospective cohort study was conducted on patients who underwent PNN cryoablation to treat CR-related CTR refractory to ipratropium bromide nasal spray (IBNS).

Increased cerebrospinal fluid and plasma apoE glycosylation is associated with reduced levels of Alzheimer's disease biomarkers.

The apolipoprotein E ( ) ε4 allele is the strongest genetic risk factor for Alzheimer's disease (AD). ApoE is glycosylated with an O-linked Core-1 sialylated glycan at several sites, yet the impact and function of this glycosylation on AD biomarkers remains unclear. We examined apoE glycosylation in a cohort of cerebrospinal fluid (CSF, n=181) and plasma (n= 178) samples from the Alzheimer's Disease Neuroimaging Initiative (ADNI) stratified into 4 groups: cognitively normal (CN), Mild Cognitive Impairment (MCI), progressors and non-progressors based on delayed word recall performance over 4 years.

The St. Jude Global Academy: A Multifaceted Education Program to Expand Pediatric Oncology Workforce Capacity.

There is currently a global shortage of healthcare professionals equipped to handle the rising burden of childhood cancer. St. Jude Global is an initiative to improve survival rates of children with cancer worldwide while improving access to quality care.

Pulmonary neuroendocrine neoplasms: the molecular landscape, therapeutic challenges, and diagnosis and management strategies.

Lung neuroendocrine neoplasms are a group of diverse, heterogeneous tumours that range from well-differentiated, low-grade neuroendocrine tumours-such as typical and atypical carcinoids-to high-grade, poorly differentiated aggressive malignancies, such as large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC). While the incidence of SCLC has decreased, the worldwide incidence of other pulmonary neuroendocrine neoplasms has been increasing over the past decades. In addition to the standard histopathological classification of lung neuroendocrine neoplasms, the introduction of molecular and sequencing techniques has led to new advances in understanding the biology of these diseases and might influence future classifications and staging that can subsequently improve management guidelines in the adjuvant or metastatic settings.

When automation fails - Investigating cognitive stability and flexibility in a multitasking scenario.

Managing multiple tasks simultaneously often results in performance decrements due to limited cognitive resources. Task prioritization, requiring effective cognitive control, is a strategy to mitigate these effects and is influenced by the stability-flexibility dilemma. While previous studies have investigated the stability-flexibility dilemma in fully manual multitasking environments, this study explores how cognitive control modes interact with automation reliability.

Blood DNA virome associates with autoimmune diseases and COVID-19.

Aberrant immune responses to viral pathogens contribute to pathogenesis, but our understanding of pathological immune responses caused by viruses within the human virome, especially at a population scale, remains limited. We analyzed whole-genome sequencing datasets of 6,321 Japanese individuals, including patients with autoimmune diseases (psoriasis vulgaris, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), pulmonary alveolar proteinosis (PAP) or multiple sclerosis) and coronavirus disease 2019 (COVID-19), or healthy controls. We systematically quantified two constituents of the blood DNA virome, endogenous HHV-6 (eHHV-6) and anellovirus.

ZIC1 is a context-dependent medulloblastoma driver in the rhombic lip.

Transcription factors are frequent cancer driver genes, exhibiting noted specificity based on the precise cell of origin. We demonstrate that ZIC1 exhibits loss-of-function (LOF) somatic events in group 4 (G4) medulloblastoma through recurrent point mutations, subchromosomal deletions and mono-allelic epigenetic repression (60% of G4 medulloblastoma). In contrast, highly similar SHH medulloblastoma exhibits distinct and diametrically opposed gain-of-function mutations and copy number gains (20% of SHH medulloblastoma).

Infiltrating plasma cells maintain glioblastoma stem cells through IgG-Tumor binding.

Glioblastoma is a highly aggressive primary brain tumor with glioblastoma stem cells (GSCs) enforcing the intra-tumoral hierarchy. Plasma cells (PCs) are critical effectors of the B-lineage immune system, but their roles in glioblastoma remain largely unexplored. Here, we leverage single-cell RNA and B cell receptor sequencing of tumor-infiltrating B-lineage cells and reveal that PCs are aberrantly enriched in the glioblastoma-infiltrating B-lineage population, experience low level of somatic hypermutation, and are associated with poor prognosis.

Categorizing Stigma as a Barrier to Support Following Nonfatal Overdose: A Qualitative Study.

Objectives: Stigma is known to be a major barrier to treatment for people who use drugs (PWUD). This study uses the Stigma and Health Discrimination Framework to analyze how different forms of stigma shape experiences in the wake of an overdose incident, and perceptions of the efficacy and utility of postoverdose interventions among a sample of PWUD in Dayton, Ohio-a location with a high overdose rate.

Methods: Interviews were conducted with 23 individuals who self-reported past-month illicit opioid, crack/cocaine, or methamphetamine use who had experienced or witnessed a drug overdose in the past 6 months.

Service preferences among postpartum women (non-)affected by different types of intimate partner violence: insights from the cross-sectional study INVITE.

Background: Women in the postpartum period are at greater risk of intimate partner violence (IPV), which may cause physical, sexual, or psychological harm and have a long-lasting negative impact on mother and child. Seeking help in case of IPV in the postpartum period can be difficult.

Objective: The purpose of this study was to examine service preferences among postpartum women in Germany (non-)affected by IPV.

The effect of temporary CSF diversion modality on shunt-dependency following aneurysmal subarachnoid hemorrhage: A nationwide assessment.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) carries a high economic cost and clinical morbidity in the United States. Beyond prolonged admissions and poor post-injury functional status, there is an additional cost of chronic shunt-dependent hydrocephalus for many aSAH patients. Adjuvant lumbar drain (LD) placement has been hypothesized to promote clearance of subarachnoid blood from the cisternal space, with an ultimate effect of decreasing shunt placement rates.

Genetic Variants Associated With Preeclampsia and Maternal Serum sFLT1 Levels.

Background: Elevated maternal serum sFLT1 (soluble fms-like tyrosine kinase 1) has a key role in the pathophysiology of preeclampsia. We sought to determine the relationship between the maternal and fetal genome and maternal levels of sFLT1 at 12, 20, 28, and 36 weeks of gestational age (wkGA).

Methods: We studied a prospective cohort of nulliparous women (3968 mother-child pairs).

Age-friendly CMS measure implementation: Leveraging geriatric quality programs in an age-friendly health system.

The age-friendly approach ensures older adults receive care that optimizes their well-being, particularly through episodes of illness and at end-of-life. Geriatric clinical quality organizations, including NICHE, establish age-friendly standards and provide education and implementation resources to healthcare organizations. The Centers for Medicare and Medicaid Services will require organizations participating in the inpatient prospective payment system and the long-term care hospital payment system to submit data about compliance with the Age-Friendly Measure starting in 2025.