Contemporary treatment patterns of overweight and obesity: insights from the Mass General Brigham health care system.

Objective: The objective of this study was to describe the prevalence of obesity, obesity-related conditions (ORCs), and antiobesity medication (AOM) eligibility and prescribing practice among eligible patients in a large health care system.

Methods: In this cross-sectional analysis of the multicenter Mass General Brigham health care system (Boston, Massachusetts) spanning 2018 to 2022, adults eligible for AOMs (BMI ≥ 30 kg/m or BMI 27-29.9 kg/m with ≥1 ORC) were identified.

Independent Contributions of Callous-Unemotional Behaviors and Quantitative Autistic Traits to Aggression in Early Childhood.

Objective: Callous-unemotional (CU) behaviors and quantitative autistic traits (QATs), heritable domains implicated in social development, are both associated with reduced prosocial behavior and increased aggression at their clinical extremes. However, they are hypothesized to contribute to aggression through separate mechanisms. This study tested whether CU behaviors and QATs exhibited distinct profiles of heritable influences as well as independent contributions to early childhood aggression in a general population sample with enhanced sensitivity to clarify these relationships.

Fibroblast matrix implants-a better alternative for incisional hernia repair?

The standard surgical procedure for abdominal hernia repair with conventional prosthetic mesh still results in a high recurrence rate. In the present study, we propose a fibroblast matrix implant (FMI), which is a three-dimensional (3D) poly-L-lactic acid scaffold coated with collagen (matrix) and seeded with fibroblasts, as an alternative mesh for hernia repair. The matrix was seeded with fibroblasts (cellularized) and treated with a conditioned medium (CM) of human Umbilical Cord Mesenchymal Stem Cells (hUC-MSC).

Weak Scale Supersymmetry Emergent from the String Landscape.

Superstring flux compactifications can stabilize all moduli while leading to an enormous number of vacua solutions, each leading to different 4-d laws of physics. While the string landscape provides at present the only plausible explanation for the size of the cosmological constant, it may also predict the form of weak scale supersymmetry which is expected to emerge. Rather general arguments suggest a power-law draw to large soft terms, but these are subject to an anthropic selection of a not-too-large value for the weak scale.

Clinical Decision Support for Hypertension Management in Chronic Kidney Disease: A Randomized Clinical Trial.

Importance: Chronic kidney disease (CKD) affects 37 million adults in the United States, and for patients with CKD, hypertension is a key risk factor for adverse outcomes, such as kidney failure, cardiovascular events, and death.

Objective: To evaluate a computerized clinical decision support (CDS) system for the management of uncontrolled hypertension in patients with CKD.

Design, Setting, And Participants: This multiclinic, randomized clinical trial randomized primary care practitioners (PCPs) at a primary care network, including 15 hospital-based, ambulatory, and community health center-based clinics, through a stratified, matched-pair randomization approach February 2021 to February 2022.

Implementation of a Scalable Online Weight Management Programme in Clinical Settings: Protocol for the PROPS 2.0 Programme (Partnerships for Reducing Overweight and Obesity with Patient-Centered Strategies 2.0).

Introduction: There is an urgent need for scalable strategies for treating overweight and obesity in clinical settings. PROPS 2.0 (Partnerships for Reducing Overweight and Obesity with Patient-Centered Strategies 2.

Primary care patients' and providers' perspectives about an online weight management program integrated with population health management: Post-intervention qualitative results from the PROPS study.

Objective: To assess patients' and providers' attitudes about the online weight management program and population health management approach in the PROPS Study, which examined the effectiveness of these strategies in primary care.

Methods: We conducted semi-structured interviews with 22 patients and nine providers. Using thematic analysis, we analyzed transcripts of the interviews to identify key themes.

Evading the Toll booth: How "silent" flagellins may bind yet fail to activate TLR5.

The nature of flagellin-Toll-like receptor 5 (TLR5) interactions, depending on binding to and activation of TLR5, may hold a key to the distinct differences in gut microbiome and intestinal immune function in different populations around the world (see related Research Article by Clasen .).

Childhood adiposity, serum metabolites and breast density in young women.

Background: Childhood adiposity is inversely associated with young adult percent dense breast volume (%DBV) and absolute dense breast volume (ADBV), which could contribute to its protective effect for breast cancer later in life. The objective of this study was to identify metabolites in childhood serum that may mediate the inverse association between childhood adiposity and young adult breast density.

Methods: Longitudinal data from 182 female participants in the Dietary Intervention Study in Children (DISC) and the DISC 2006 (DISC06) Follow-Up Study were analyzed.

A New Teaching Tool for Peer Review of Charting and Care in the Emergency Department.

Poor documentation, incomplete medical decision-making, missing progress notes, and inappropriate care play a major role in medical malpractice cases. We introduced a new quality improvement (QI) process focused on evaluating and improving documentation and clinical care. We hypothesized that a modified, simplified QI scoring rubric would demonstrate inter-rater reliability among attending physicians and provide a useful new standardized tool for both QI departmental review and peer review.

Gender Differences in the Amount and Type of Student Participation During In-Person and Virtual Classes in Academic Medicine Learning Environments.

This cohort study examines gender differences in the amount and type of student participation during in-person and virtual classes in graduate-level academic medicine learning environments.

Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.

Introduction: The purpose of this study is to incorporate behavioural economic principles and user-centred design principles into a multicomponent intervention for the management of uncontrolled hypertension (HTN) in chronic kidney disease (CKD) in primary care.

Methods And Analysis: This is a multicentre, pragmatic, controlled trial cluster-randomised at the clinician level at The Brigham and Women's Practice -Based Research Network of 15 practices. Of 220 total clinicians, 184 were eligible to be enrolled, and the remainder were excluded (residents and clinicians who see urgent care or walk-in patients); no clinicians opted out.

The Association Between Active Transportation and Serum Total 25-Hydroxyvitamin D Levels Among US Childbearing-Aged Women.

Background: Serum total 25-hydroxyvitamin D (25[OH]D) and physical activity (PA) both play important roles in maternal-fetal health. However, a high prevalence of vitamin D and PA insufficiency has been observed in women of childbearing age. Active transportation may increase overall PA levels and potentially boost serum 25(OH)D levels.

The mannose receptor (CD206) identifies a population of colonic macrophages in health and inflammatory bowel disease.

To understand the contribution of mononuclear phagocytes (MNP), which include monocyte-derived intestinal macrophages, to the pathogenesis of inflammatory bowel disease (IBD), it is necessary to identify functionally-different MNP populations. We aimed to characterise intestinal macrophage populations in patients with IBD. We developed 12-parameter flow cytometry protocols to identify and human intestinal MNPs.

Wound healing potential of human umbilical cord mesenchymal stem cell conditioned medium: An and study in diabetes-induced rats.

Background And Aim: Human umbilical cord mesenchymal stem cells (hUC-MSCs) and its conditioned medium (CM) promote wound healing. This study investigated the wound healing potential of hUC-MSC CM and using diabetic animal models.

Materials And Methods: The CM from hUC-MSC CM prepared under hypoxic conditions (hypoxic hUC-MSC) was evaluated for stimulating rat fibroblast growth, collagen production (), and wound healing in animal models ().

The association of urine osmolality with decreased kidney function and/or albuminuria in the United States.

Background: Decreased kidney function is commonly caused by hypovolemia. When hypovolemic, the kidney reabsorbs water resulting in concentrated urine. Osmolality is a measure of urine concentration which is more objective than self-reported fluid intake.

Impact of a focused trauma course on retention of provider skills, knowledge and confidence at a regional hospital in the Dominican Republic.

Introduction: Road traffic accidents are a public health epidemic, causing significant morbidity and mortality in low- and middle-income countries. The Dominican Republic (DR) ranks among the highest road traffic fatality rates in the world. There is no formalized trauma curriculum in the DR.

Structure, Function, and Thermal Adaptation of the Biotin Carboxylase Domain Dimer from 2-Oxoglutarate Carboxylase.

2-Oxoglutarate carboxylase (OGC), a unique member of the biotin-dependent carboxylase family from the order Aquificales, captures dissolved CO via the reductive tricarboxylic acid (rTCA) cycle. Structure and function studies of OGC may facilitate adaptation of the rTCA cycle to increase the level of carbon fixation for biofuel production. Here we compare the biotin carboxylase (BC) domain of OGC with the well-studied mesophilic homologues to identify features that may contribute to thermal stability and activity.

Transport Time and Mortality in Critically Ill Patients with Severe Traumatic Brain Injury.

Purpose: Severe traumatic brain injury (TBI) is a major cause of morbidity and mortality in critically ill patients. Pre-hospital care and transportation time may impact their outcomes.

Methods: Using the British Columbia Trauma Registry, we included 2,860 adult (≥18 years) patients with severe TBI (abbreviated injury scale head score ≥4), who were admitted to an intensive care unit (ICU) in a centre with neurosurgical services from January 1, 2000 to March 31, 2013.

Improving the Assessment of Resident Competency: Physical Medicine and Rehabilitation Milestones 2.0.

In 2015, the Accreditation Council for Graduate Medical Education published the Physical Medicine and Rehabilitation Milestones 1.0 as part of the Next Accreditation System. This was the culmination of more than 20 yrs of work on the part of the Accreditation Council for Graduate Medical Education to improve graduate medical education competency assessments.

Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change: A Randomized Clinical Trial.

Importance: Online programs may help with weight loss but have not been widely implemented in routine primary care.

Objective: To compare the effectiveness of a combined intervention, including an online weight management program plus population health management, with the online program only and with usual care.

Design, Setting, And Participants: Cluster randomized trial with enrollment from July 19, 2016, through August 10, 2017, at 15 primary care practices in the US.

Hepatocyte and Islet Cell Cotransplantation on Poly-L-Lactide Matrix for the Treatment of Liver Cirrhosis.

The human autologous hepatocyte matrix implant is a promising alternative procedure to counter liver damage. We assessed the outcome of human hepatocytes isolation from cirrhotic liver compared to the clinical and histological scores of disease severity. A total of 11 patients with various clinical scores (CTP and MELD) and histological score (Metavir, fibrosis) of liver cirrhosis were included in the hepatocyte matrix implant clinical phase I study.

Evaluation of 3D PLLA scaffolds coated with nano-thick collagen as carrier for hepatocytes.

Orthotopic liver transplantation is presently the most effectual method for the treatment of end-stage liver diseases. Though, one major issue is the restricted number of donor organs that are accessible. Hence, liver tissue engineering is under investigation with the goal of restoring liver functions.