Expanding Access to Continuous Glucose Monitoring Through Empowering Primary Care: A Joint Endocrinology-Primary Care Quality Improvement Project.

Background: Despite guideline recommendations to offer continuous glucose monitoring (CGM) to all patients with diabetes using insulin, prescription rates for CGM remain low in primary care.

Objective: This quality improvement project aimed to improve access to CGM in primary care for patients with type 2 diabetes on insulin.

Design: This was a quality improvement project conducted by a joint endocrinology/primary care team at a single primary care community health clinic.

Computed tomography in initially unstable thoracoabdominal trauma can safely enhance triage.

Introduction: Computed tomography (CT) imaging of hemodynamically abnormal trauma patients undergoing aggressive resuscitation is controversial. Our study investigated outcomes for hemodynamically abnormal thoracoabdominal trauma undergoing CT prior to definitive therapy.

Methods: Hemodynamically abnormal (HR≥120 bpm, SBP<90 mmHg) patients arriving to our Level I trauma center between 2015 and 2022 were reviewed.

Identification of Potential Therapeutic Targets Against Anthrax-Toxin-Induced Liver and Heart Damage.

Anthrax represents a disease resulting from infection by toxin-secreting bacteria, . This research aimed to identify new therapeutic targets to combat anthrax. We performed assays to assess cell viability, apoptosis, glycogen consumption, and compound uptake and release in hepatocytes and cardiomyocytes responding to anthrax toxins.

The efficacy of intra-articular corticosteroid injections for elbow arthritis: a retrospective cohort study.

Purpose: The goal of this study was to report the duration of pain relief and need for subsequent surgical intervention following intra-articular steroid injection of the elbow in the setting of arthritis.

Methods: The authors' institutional database was accessed to identify patients who underwent a corticosteroid injection of the elbow for arthritis. For included patients, demographic information, steroid dosage, duration of symptoms relief, complications, and progression to surgical management were recorded.

Glycoprotein 130 Antagonism Counteracts Metabolic and Inflammatory Alterations to Enhance Right Ventricle Function in Pulmonary Artery Banded Pigs.

Background: Right ventricular dysfunction (RVD) is a risk factor for death in multiple cardiovascular diseases, but RV-enhancing therapies are lacking. Inhibition of glycoprotein-130 (GP130) signaling with the small molecule SC144 improves RV function in rodent RVD via anti-inflammatory and metabolic mechanisms. However, SC144's efficacy and molecular effects in a translational large animal model of RVD are unknown.

17β-Estradiol Counteracts Pathological Microtubule Remodeling To Enhance Cardiac Function.

The female-predominate sex hormone 17β-estradiol exerts cardioprotective effects via multiple mechanisms. Available data demonstrate 17β-estradiol modulates microtubule dynamics , but its effects on pathogenic microtubule remodeling in pressure-overloaded cardiomyocytes are unexplored. Here, we show 17β-estradiol directly blunts microtubule polymerization , counteracts endothelin-mediated microtubule remodeling in iPSC-cardiomyocytes, and mitigates microtubule stabilization in pulmonary artery banded right ventricular cardiomyocytes.

The "magic" of looking at that score: A multilevel investigation of therapist review of client symptom measures and client clinical outcome.

Randomized controlled trials have shown that using client feedback obtained from routine outcome monitoring can lead to better clinical outcomes in psychotherapy. However, existing randomized controlled trial studies did not address the between-person and within-person effects of routine outcome monitoring simultaneously. To fill this critical gap, this study conducted a multilevel analysis to explore the effect of therapist utilization of client symptom outcome data in a naturalistic practice setting.

The pregnant moms' empowerment program - Mexico enhances mental health for women exposed to intimate partner violence: a pilot randomized controlled trial.

Purpose: Given the lack of available and effective interventions to address the detrimental consequences of perinatal exposure to intimate partner violence (IPV) on maternal mental health, and reported very low access to IPV-related mental health services in Mexico, we examined the feasibility and efficacy of a culturally adapted, virtual, brief group psychosocial intervention designed to improve maternal mental and physical health and reduce IPV revictimization for pregnant women exposed to IPV. In this pilot randomized controlled trial, we evaluated maternal outcomes after participation in the Pregnant Moms' Empowerment Program (PMEP) in Mexico.

Methods: Women were recruited from social service agencies and health centers in the community, as well as social media advertisements that targeted pregnant women living in Mexico.

Bioconversion of aflatoxin-contaminated groundnut press cake by larvae of black soldier fly Hermetia illucens results in a complete mass balance for aflatoxin B.

Groundnuts are considered as one of the most important cultivated food crops globally. Groundnuts are used for vegetable oil production, which generate a variety of by-products, such as peanut press cake (PPC). Groundnuts are sensitive to infection by aflatoxigenic fungi.

Challenges in the Development and Evaluation of Pediatric Heart Valve Technologies.

Background: In October 2022, the Heart Valve Collaboratory and United States Food and Drug Administration convened a global multidisciplinary workshop to address the unmet clinical need to promote and accelerate the development of pediatric-specific heart valve technologies.

Methods: The Pediatric Heart Valve Global Multidisciplinary Workshop was convened in October 2022. Key stakeholders, including expert clinicians in pediatric cardiology and cardiac surgery, valve manufacturers, engineers, and scientists were assembled to review the current state of the art, discuss unique challenges in the premarket and postmarket evaluation of pediatric valve therapies, and highlight emerging technologies that show potential to address some of the key unmet needs of children with valve disease.

Nucleophilic Amination of Aryl Halides with an Azanide Surrogate.

We report the development of an azanide (NH) surrogate which enables the facile conversion of electron-deficient (hetero)aryl halides into primary N-aryl amines under transition-metal-free conditions. The designed amidine reagent is easy to prepare, bench stable, and undergoes facile N-arylation under basic conditions at 40 °C. Intermediate N-aryl amidines are readily cleaved to form N-aryl amines in situ through hydrolysis or base-promoted elimination.

Ferroptosis Inhibition Combats Metabolic Derangements and Improves Cardiac Function in Pulmonary Artery Banded Pigs.

Right heart failure (RHF) is a leading cause of mortality in multiple cardiovascular diseases and preclinical and human data suggest impaired metabolism is a significant contributor to right-sided cardiac dysfunction. Ferroptosis is a nonapopotic form of cell death driven by impaired metabolism. Rodent data suggests ferroptosis inhibition can restore mitochondrial electron transport chain function and enhance cardiac contractility in left heart failure models, but the effects of ferroptosis inhibition in translational large animal models of RHF are unknown.

Evaluation of an engineered vascular graft exhibiting somatic growth in lambs to model repair of absent pulmonary artery branch.

Background: Growth is the holy grail of tissue implants in pediatrics. No vascular graft currently in use for surgical repairs of congenital heart defects has somatic growth capacity.

Methods: Biologically-engineered grafts (6 mm) grown from donor ovine fibroblasts in a sacrificial fibrin gel were implanted into the left pulmonary branch of 3-month old lambs for 3, 6, and 18 months.

"My Cross to Bear": Mothering in the Context of Intimate Partner Violence Among Pregnant Women in Mexico.

Intimate partner violence (IPV) during pregnancy negatively affects both maternal and infant health, yet gaps remain in understanding factors that maintain violence and/or promote resilience within the context of mothering. Nine focus groups were conducted with pregnant and/or IPV-exposed women ( 17) and service providers ( =  26) working with these women in Nuevo León, Mexico. Thematic analysis of the focus group data revealed the detrimental impact of cultural norms that prioritize the relationship with women's partners, marriage, and family above women's dignity.

Ethics-testing an eating disorder recovery memoir: a pre-publication experiment.

Background: Narratives (including memoirs and novels) about eating disorders (EDs) are typically published with the intention to benefit readers, but survey evidence suggests that reading such narratives with an active ED may more often be harmful than helpful. To reduce the probability of inadvertent harm and learn more about how narrative reading and EDs interact, a pre-publication study was designed to determine whether or not a recovery memoir should be published.

Methods: 64 participants with a self-reported ED read either the experimental text (The Hungry Anorexic [HA]) or a control text (Ten Zen Questions [TZ]) over a roughly two-week period.

Non-immune factors cause prolonged myofibroblast phenotype in implanted synthetic heart valve scaffolds.

The clinical application of heart valve scaffolds is hindered by complications associated with the activation of valvular interstitial cell-like (VIC-like) cells and their transdifferentiation into myofibroblasts. This study aimed to examine several molecular pathway(s) that may trigger the overactive myofibroblast phenotypes in the implanted scaffolds. So, we investigated the influence of three molecular pathways - macrophage-induced inflammation, the TGF-β1-SMAD2, and WNT/β-catenin β on VIC-like cells during tissue engineering of heart valve scaffolds.

Ethics and Academic Discourse, Scientific Integrity, Uncertainty, and Disinformation in Medicine: An American College of Physicians Position Paper.

Respect for the scientific process and a diversity of views; open discourse and debate based on principles of ethics, best available evidence, and scientific inquiry and integrity; and an understanding of evidence gaps and uncertainty and how to communicate about them are important values in the advancement of science and the practice of medicine. Physicians often must make decisions about their recommendations to patients in the face of scarce or conflicting data. Are these characteristics of medicine and science widely understood and effectively communicated among members of the profession and to patients and the public? Issues of scientific integrity are longstanding, but COVID-19 brought them to the forefront, in an environment that was sometimes characterized by communication missteps as guidance came and went-or changed-quickly.

BONE Break: A Hot Debrief Tool to Reduce Second Victim Syndrome for Nurses.

The pandemic has intensified clinicians' workloads, leading to an increased incidence of adverse events and subsequent second victim syndrome, with almost half of health care clinicians experiencing its symptoms. However, following a literature review, no tools were found that addressed second victim syndrome in nurses. To address these issues and the gap in the literature, the authors developed the BONE Break hot debriefing tool.

Multimodal preoperative imaging for transcatheter mitral valve replacement in the domestic sheep model.

Preclinical in vivo evaluation is an essential step in the progression of new cardiac devices into patient use, with studies predominantly performed in the domestic sheep model. A growing area of interest in cardiac device development is transcatheter mitral valve replacement (TMVR). Clinically, multimodal imaging, or computed tomography (CT) and echocardiography (echo) are used extensively to preoperatively determine mitral valve morphology prior to an intervention, but there is no description on how these modalities can be implemented to support preclinical studies.