Improving Advanced Care Planning Discussions at an Internal Medicine Clinic.

Objective: The project aimed to standardize advanced care planning (ACP) at an internal medicine clinic by initiating physician-patient communication regarding the patient's knowledge, understanding, and openness to pursuing advanced medical directives.

Methods: Data collection was conducted from February 1 to April 1, 2024, with the study concluding on April 24, 2024. ACP was facilitated through an initial standardized six-question pre-intervention survey in both English and Spanish.

Amyloid accelerator polyphosphate fits as the mystery density in α-synuclein fibrils.

Aberrant aggregation of α-Synuclein is the pathological hallmark of a set of neurodegenerative diseases termed synucleinopathies. Recent advances in cryo-electron microscopy have led to the structural determination of the first synucleinopathy-derived α-Synuclein fibrils, which contain a non-proteinaceous, "mystery density" at the core of the protofilaments, hypothesized to be highly negatively charged. Guided by previous studies that demonstrated that polyphosphate (polyP), a universally conserved polyanion, significantly accelerates α-Synuclein fibril formation, we conducted blind docking and molecular dynamics simulation experiments to model the polyP binding site in α-Synuclein fibrils.

Key Opinion Leaders' Interviews to Inform the Future of Benefit-Risk Planning in the Medical Total Product Life Cycle of Global Pharmaceutical and Medical Device Organizations.

Background And Objectives: Key opinion leader (KOL) interviews were conducted by the Benefit-Risk Assessment Planning (BRAP) Taskforce to seek expert opinion mainly from industry and regulatory bodies, about the current status and future direction of benefit-risk assessment (BRA) planning in the lifecycle of medical product development. The findings from these interviews are intended to help communication concerning planning for BRA between industry and regulators and shape future guidance.

Methods: Key opinion leader interviews consisted of 5 questions related to BRA planning, which were administered to volunteers (mainly clinicians and statisticians) within a pool of experienced pharmaceutical and medical device professionals representing academia, industry, regulatory agencies and a patient group.

Amyloid Accelerator Polyphosphate Implicated as the Mystery Density in α-Synuclein Fibrils.

Aberrant aggregation of α-Synuclein is the pathological hallmark of a set of neurodegenerative diseases termed synucleinopathies. Recent advances in cryo-electron microscopy have led to the structural determination of the first synucleinopathy-derived α-Synuclein fibrils, which contain a non-proteinaceous, "mystery density" at the core of the protofilaments, hypothesized to be highly negatively charged. Guided by previous studies that demonstrated that polyphosphate (polyP), a universally conserved polyanion, significantly accelerates α-Synuclein fibril formation, we conducted blind docking and molecular dynamics simulation experiments to model the polyP binding site in α-Synuclein fibrils.

A Survey to Assess the Current Status of Structured Benefit-Risk Assessment in the Global Drug and Medical Device Industry.

Background: This industry survey was conducted to gain insight into the ways structured Benefit-Risk assessment (sBRA) of medical products is approached across drug or medical device developing companies, including frameworks and methods that are currently used and areas where future work is being planned.

Methods: A survey containing 28 questions covering five key areas of sBRA was set-up and shared with representatives from the participating companies. Each company was asked to complete a single survey response including inputs across the company's multidisciplinary key representatives involved in benefit-risk assessment.

Phosphorylations and Acetylations of Cytochrome Control Mitochondrial Respiration, Mitochondrial Membrane Potential, Energy, ROS, and Apoptosis.

Cytochrome (Cyt) has both life-sustaining and cellular death-related functions, depending on subcellular localization. Within mitochondria, Cyt acts as a single electron carrier as part of the electron transport chain (ETC). When released into the cytosol after cellular insult, Cyt triggers the assembly of the apoptosome, committing the cell to intrinsic apoptosis.

Diffractive optical computing in free space.

Structured optical materials create new computing paradigms using photons, with transformative impact on various fields, including machine learning, computer vision, imaging, telecommunications, and sensing. This Perspective sheds light on the potential of free-space optical systems based on engineered surfaces for advancing optical computing. Manipulating light in unprecedented ways, emerging structured surfaces enable all-optical implementation of various mathematical functions and machine learning tasks.

Terbinafine-Induced Liver Injury: A Case Report.

Hepatic injuries attributable to terbinafine usage are a well-documented yet infrequent phenomenon. This case study details the clinical presentation and management of a 70-year-old Hispanic female, with no previous medical history, subsequently hospitalized for progressive jaundice, right upper quadrant abdominal discomfort, and worsening pruritus. A comprehensive review of her prior records revealed a recent terbinafine prescription for onychomycosis, which she took consistently for five weeks and then self-discontinued four weeks before her current admission.

Structural analysis and functional evaluation of the disordered ß-hexosyltransferase region from .

codes for an industrially important membrane bound ß-hexosyltransferase (BHT), (BglA, UniprotKB: Q564N5) that has applications in the production of natural fibers such as galacto-oligosaccharides (GOS) and natural sugars found in human milk. When heterologously expressed by GS115, BHT is found both membrane bound and soluble secreted into the culture medium. structural predictions and crystal structures support a glycosylated homodimeric enzyme and the presence of an intrinsically disordered region (IDR) with membrane binding potential within its novel N-terminal region (1-110 amino acids).

Distinct microbial communities degrade cellulose diacetate bioplastics in the coastal ocean.

Cellulose diacetate (CDA) is a promising alternative to conventional plastics due to its versatility in manufacturing and low environmental persistence. Previously, our group demonstrated that CDA is susceptible to biodegradation in the ocean on timescales of months. In this study, we report the composition of microorganisms driving CDA degradation in the coastal ocean.

Factors Affecting Anxiety-Related Symptoms, Diagnosis, and Treatment Among Collegiate Student-Athletes in the National College Health Assessment.

Context: Increased attention continues to be placed on best practices for assisting student-athletes who show symptoms of a mental health illness. One of the most common mental health concerns for student-athletes is feeling overwhelmed or anxious. Early recognition of these symptoms can help student-athletes find early intervention.

Molecular Processes Leading to Shear Banding in Entangled Polymeric Solutions.

The temporal and spatial evolution of shear banding during startup and steady-state shear flow was studied for solutions of entangled, linear, monodisperse polyethylene C3000H6002 dissolved in hexadecane and benzene solvents. A high-fidelity coarse-grained dissipative particle dynamics method was developed and evaluated based on previous NEMD simulations of similar solutions. The polymeric contribution to shear stress exhibited a monotonically increasing flow curve with a broad stress plateau at intermediate shear rates.

Cytochrome c lysine acetylation regulates cellular respiration and cell death in ischemic skeletal muscle.

Skeletal muscle is more resilient to ischemia-reperfusion injury than other organs. Tissue specific post-translational modifications of cytochrome c (Cytc) are involved in ischemia-reperfusion injury by regulating mitochondrial respiration and apoptosis. Here, we describe an acetylation site of Cytc, lysine 39 (K39), which was mapped in ischemic porcine skeletal muscle and removed by sirtuin5 in vitro.

Trends in Collegiate Student-Athlete Mental Health in the National College Health Assessment, 2011-2019.

Context: Recently, the athletic training community has paid increased attention to collegiate student-athlete mental health, mental health treatment-seeking behavior, and the effects of mental health factors on athletic and academic performance. Ongoing efforts to better educate and equip athletic trainers to help student-athletes in this regard should result in improved mental health-related outcomes.

Objective: To examine changes in the mental health of student-athletes over the past decade compared with that of nonathlete students.

Atomistic Simulation of Flow-Induced Microphase Separation and Crystallization of an Entangled Polyethylene Melt Undergoing Uniaxial Elongational Flow and the Role of Kuhn Segment Extension.

Atomistic simulations of the linear, entangled polyethylene CH melt undergoing steady-state and startup conditions of uniaxial elongational flow (UEF) over a wide range of flow strength were performed using a united-atom model for the atomic interactions between the methylene groups constituting the polymer macromolecules. Rheological, topological, and microstructural properties of these nonequilibrium viscoelastic materials were computed as functions of strain rate, focusing on regions of flow strength where flow-induced phase separation and flow-induced crystallization were evident. Results of the UEF simulations were compared with those of prior simulations of planar elongational flow, which revealed that uniaxial and planar flows exhibited essentially a universal behavior, although over strain rate ranges that were not completely equivalent.

Abnormal enteric nervous system and motor activity in the ganglionic proximal bowel of Hirschsprung's disease.

Hirschsprung's disease (HSCR) is a congenital defect in which the enteric nervous system (ENS) does not develop in the distal bowel, requiring surgical removal of the portions of bowel without ENS ganglia ('aganglionic') and reattachment of the 'normal' proximal bowel with ENS ganglia. Unfortunately, many HSCR patients have persistent dysmotility (e.g.

Solving integral equations in free space with inverse-designed ultrathin optical metagratings.

As standard microelectronic technology approaches fundamental limitations in speed and power consumption, novel computing strategies are strongly needed. Analogue optical computing enables the processing of large amounts of data at a negligible energy cost and high speeds. Based on these principles, ultrathin optical metasurfaces have been recently explored to process large images in real time, in particular for edge detection.

Effects of pubertal growth variation on knee mechanics during walking in female and male adolescents.

Introduction: Puberty substantially alters the body's mechanical properties, neuromuscular control, and sex differences therein, likely contributing to increased, sex-biased knee injury risk during adolescence. Female adolescents have higher risk for knee injuries than male adolescents of similar age engaging in similar physical activities, and much research has investigated sex differences in mechanical risk factors. However, few studies address the considerable variation in pubertal growth (timing, pace), knee mechanics, and injury susceptibility within sexes, or the impact of such growth variation on mechanical injury risk.

Microstructural evolution and reverse flow in shear-banding of entangled polymer melts.

The temporal and spatial evolution of shear banding under startup of shear flow was simulated for highly entangled, linear, monodisperse polyethylene melts of differing molecular weight, CH, CH, and CH, using a high-fidelity coarse-grained dissipative particle dynamics method. It was determined that shear stress was dominated by segmental orientation of entangled strands at low shear rates, but at a critical shear rate below the reciprocal of the Rouse time, flow-induced disentanglement resulted in the onset of chain tumbling that reduced the average degree of orientation, leading to a regime of decreasing shear stress, with a commensurate onset of increasing average chain extension imposed by the strong flow kinematics that ultimately drove the steady-state shear stress higher. During startup of shear flow, shear band development began immediately after the maximum in the first normal stress difference, where distinct fast and slow bands formed.

A Rare Case of Phentermine-Induced Nonischemic Cardiomyopathy.

Obesity is a global epidemic with steadily increasing prevalence in most countries. Weight loss is generally challenging for patients to tackle in the face of the temptation to overeat and avoid physical activity. Hence, clinicians and patients alike are likely to steer toward the use of .

Mathematical operations and equation solving with reconfigurable metadevices.

Performing analog computations with metastructures is an emerging wave-based paradigm for solving mathematical problems. For such devices, one major challenge is their reconfigurability, especially without the need for a priori mathematical computations or computationally-intensive optimization. Their equation-solving capabilities are applied only to matrices with special spectral (eigenvalue) distribution.