Approach to the Patient: From Endocrinopathy to the Diagnosis of a Histiocytic Disorder.

Endocrinopathies are frequently the initial presentation of histiocytic neoplasms, which are rare hematologic disorders affecting multiple organ systems. Langerhans cell histiocytosis and Erdheim-Chester disease are 2 such disorders known to infiltrate the hypothalamus and/or pituitary gland, leading to arginine vasopressin deficiency (AVP-D) and anterior pituitary dysfunction (APD) in 20% to 30% of cases, often as the first manifestation. Conversely, histiocytic disorders account for a notable proportion (10-15%) of all pituitary stalk lesions.

Commissioning a clinical proton pencil beam scanning beamline for pre-clinical ultra-high dose rate irradiations on a cyclotron-based system.

Background: This manuscript describes modifications to a pencil beam scanning (PBS) proton gantry that enables ultra-high dose rates (UHDR) irradiation, including treatment planning and validation.

Methods: Beamline modifications consisted of opening the energy slits and setting the degrader to pass-through mode to maximize the dose rate. A range shifter was inserted upstream from the isocenter to enlarge the spot size and make it rotationally symmetric.

Cannabis and alcohol enforcement strategies across the U.S.

Objective: As the legalization of adult-use cannabis has expanded to include almost half of the states in the U.S., substance use-related enforcement responsibilities for state and local law enforcement agencies may have changed.

Effect of Delaying High School Start Time on Teen Physical Activity, Screen Use, and Sports and Extracurricular Activity Participation: Results From START.

Background: We aimed to characterize relationships between delayed high school start time policy, which is known to lengthen school night sleep duration, and patterns in activity outcomes: physical activity, non-school electronic screen time (non-schoolwork), and sports and extracurricular activity among adolescents.

Methods: We used data from the START study, a multi-site evaluation of a natural experiment, assessing the effects of a school start time policy change in high schools in the Minneapolis, Minnesota metropolitan area. The study follows students in 2 schools that shifted to a later start time (8:20 or 8:50 am) after baseline year and 3 schools that maintained a consistent, early start time (7:30 am) over the 3-year study period.