Environmental impact of large language models in medicine.

The environmental impact of large language models (LLMs) in medicine spans carbon emission, water consumption and rare mineral usage. Prior-generation LLMs, such as GPT-3, already have concerning environmental impacts. Next-generation LLMs, such as GPT-4, are more energy intensive and used frequently, posing potentially significant environmental harms.

Association of internship with performance on American Board of Physical Medicine and Rehabilitation certification examinations.

Physical Medicine and Rehabilitation (PM&R) residents must complete twelve months of fundamental skills training prior to beginning PM&R residency. The objective of this study is to determine if characteristics of the first post-graduate year (PGY-1) impact performance on American Board of PM&R (ABPMR) initial certification examinations. A retrospective review was conducted on a deidentified ABPMR database of physicians who completed PM&R residency and took the Part I Examination between 2008 and 2022.

Splicing is dynamically regulated during limb development.

Modifications to highly conserved developmental gene regulatory networks are thought to underlie morphological diversification in evolution and contribute to human congenital malformations. Relationships between gene expression and morphology have been extensively investigated in the limb, where most of the evidence for alterations to gene regulation in development consists of pre-transcriptional mechanisms that affect expression levels, such as epigenetic alterations to regulatory sequences and changes to cis-regulatory elements. Here we report evidence that alternative splicing (AS), a post-transcriptional process that modifies and diversifies mRNA transcripts, is dynamic during limb development in two mammalian species.

The international prevalence of prenatal alcohol use obtained via meconium biomarkers: A systematic literature review.

Fetal alcohol exposure is a growing public health concern. However, ascertaining its true extent remains challenging as maternal self-reports may lack validity. Increasingly, interest has turned to more objective measures of prenatal alcohol use (PAU) of which one, meconium, is recognized as a valuable tool.

Incidence of Nonsynostotic Plagiocephaly and Developmental Disorders.

Importance: This is the first population-based study quantifying the incidence of nonsynostotic positional plagiocephaly and/or brachycephaly (PPB) in infancy and its association with developmental disorders.

Objective: To report the incidence of PPB before age 1 year, the incidence of craniosynostosis, and the percentage of children with PPB diagnosed with a developmental disorder by age 7 years.

Design, Setting, And Participants: This was a retrospective, population-based cohort study of children in the Rochester Epidemiology Project (REP) born in Olmsted County, Minnesota, from January 1, 2008, through December 31, 2012, with follow-up through age 7 years.

Mitf is a Schwann cell sensor of axonal integrity that drives nerve repair.

Schwann cells respond to acute axon damage by transiently transdifferentiating into specialized repair cells that restore sensorimotor function. However, the molecular systems controlling repair cell formation and function are not well defined, and consequently, it is unclear whether this form of cellular plasticity has a role in peripheral neuropathies. Here, we identify Mitf as a transcriptional sensor of axon damage under the control of Nrg-ErbB-PI3K-PI5K-mTorc2 signaling.

Training the public health emergency response workforce: a mixed-methods approach to evaluating the virtual reality modality.

Objectives: To produce and evaluate a novel virtual reality (VR) training for public health emergency responders.

Design: Following a VR training designed to test key public health emergency responder competencies, a prospective cohort of participants completed surveys rating self-assessed skill levels and perceptions of training methods.

Setting: The VR training sessions were administered in a quiet room at the US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.

Spasticity Interventions: Decision-Making and Management.

Spasticity results from an abnormality of the central nervous system and is characterized by a velocity-dependent increase in muscle tone or stiffness. In children, it can cause functional impairments, delays in achieving developmental or motor milestones, participation restrictions, discomfort, and musculoskeletal differences. Unique to children is the ongoing process of a maturing central nervous system and body, which can create the appearance of worsening or changing spasticity.

Expandable Sendai-Virus-Reprogrammed Human iPSC-Neuronal Precursors: Post-Grafting Safety Characterization in Rats and Adult Pig.

One of the challenges in clinical translation of cell-replacement therapies is the definition of optimal cell generation and storage/recovery protocols which would permit a rapid preparation of cell-treatment products for patient administration. Besides, the availability of injection devices that are simple to use is critical for potential future dissemination of any spinally targeted cell-replacement therapy into general medical practice. Here, we compared the engraftment properties of established human-induced pluripotent stem cells (hiPSCs)-derived neural precursor cell (NPCs) line once cells were harvested fresh from the cell culture or previously frozen and then grafted into striata or spinal cord of the immunodeficient rat.

The Beginning of the AI-Enabled Preventative PAP Therapy Era: A First-in-Human Proof of Concept Interventional Study.

Positive Airway Pressure (PAP) therapy is the most common and efficacious treatment for Obstructive Sleep Apnea (OSA). However, it suffers from poor patient adherence due to discomfort and may not fully alleviate all adverse consequences of OSA. Identifying abnormal respiratory events before they have occurred may allow for improved management of PAP levels, leading to improved adherence and better patient outcomes.

Associations of the skin, oral and gut microbiome with aging, frailty and infection risk reservoirs in older adults.

Older adults represent a vulnerable population with elevated risk for numerous morbidities. To explore the association of the microbiome with aging and age-related susceptibilities including frailty and infectious disease risk, we conducted a longitudinal study of the skin, oral, and gut microbiota in 47 community- or skilled nursing facility-dwelling older adults vs. younger adults.

Exposure methodologies for dissolved individual hydrocarbons, dissolved oil, water oil dispersions, water accommodated fraction and chemically enhanced water accommodated fraction of fresh and weathered oil.

Characterizing the nature and effects of oil released into the marine environment is very challenging. It is generally recognized that "environmentally relevant" conditions for exposure involve a range of temporal and spatial conditions, a range of exposure pathways (e.g.

Key Findings From Peer-Reviewed Published Research by the American Board of Physical Medicine and Rehabilitation in Review.

Recognizing the dearth of published research on board certification in physical medicine and rehabilitation and its subspecialties, the American Board of Physical Medicine and Rehabilitation has increased efforts to conduct and disseminate research in this area. This report summarizes key findings of peer-reviewed studies published by American Board of Physical Medicine and Rehabilitation staff and leadership in the past 6 yrs, including those conducted in partnership with other entities. The reported studies are organized in three main categories: initial certification, continuing certification, and subspecialty certification in physical medicine and rehabilitation.

Taking Leave During Residency: Types of Absences and Subsequent Delays and Variations in Physical Medicine and Rehabilitation Medical Board Pass Rates.

There is limited literature examining the reasons physical medicine and rehabilitation residents take an extended leave of absence during residency and the impact of leave on board examination performance. Such information could better inform leave policies, help guide residency program directors, and potentially destigmatize taking leave. Study objectives were to describe the characteristics of physical medicine and rehabilitation residents who take leave during residency, compare differences in part I (written) and part II (oral) certification examination performance, and determine the prevalence of delays in taking board examinations.

American Board of Physical Medicine and Rehabilitation Diplomate Customization Choices on the Longitudinal Assessment for Physical Medicine and Rehabilitation: A First-Year Experience.

The American Board of Physical Medicine and Rehabilitation began administering the longitudinal assessment for physical medicine and rehabilitation for continuing certification in 2020. The longitudinal assessment for physical medicine and rehabilitation digitally delivers quarterly short assessments of content and repeats missed items to facilitate learning as well as serve as a summative certification assessment. With a goal of offering content relevant to an individual's practice and learning needs, diplomates choose how to customize the domains or topic areas of their question content on an annual basis.

Why Do Physical Medicine and Rehabilitation Physicians Lose American Board of Physical Medicine and Rehabilitation Board Certification?

Objective: Physicians can lose board certification through revocation related to professionalism violations or expiration due to failure to complete continuing certification requirements. The purpose of this study was to analyze the causes of board certification loss for physicians with board certification through the American Board of Physical Medicine and Rehabilitation.

Design: This retrospective cohort study analyzed the certification status of 5541 American Board of Physical Medicine and Rehabilitation diplomates between 1993 and 2019 to determine reasons for certification loss.

Improving Patient Safety and Quality in Physical Medicine and Rehabilitation Through Participation in the American Board of Physical Medicine and Rehabilitation Continuing Certification Program.

The American Board of Medical Specialties Continuing Certification Program's Improvement in Medical Practice Standard requires physicians to participate in practice improvement activities. Despite this universal requirement, there has been no assessment of this requirement or its potential impact on patient care. Because of its continuing certification oversight structure, the American Board of Physical Medicine and Rehabilitation is in a unique position to provide this assessment.

Precision spinal gene delivery-induced functional switch in nociceptive neurons reverses neuropathic pain.

Second-order spinal cord excitatory neurons play a key role in spinal processing and transmission of pain signals to the brain. Exogenously induced change in developmentally imprinted excitatory neurotransmitter phenotypes of these neurons to inhibitory has not yet been achieved. Here, we use a subpial dorsal horn-targeted delivery of AAV (adeno-associated virus) vector(s) encoding GABA (gamma-aminobutyric acid) synthesizing-releasing inhibitory machinery in mice with neuropathic pain.

Sexually transmitted infections in suspected child sexual abuse.

Making associations between sexually transmitted infections (STIs) and child sexual abuse can be controversial. To contribute to the paucity of research in this field, this service evaluation aims to (1) define the prevalence of STIs in children aged 0-13 years seen at a regional Children's Sexual Assault Referral Centre, (2) determine whether sexual transmission is the most likely mode of transmission for diagnosed STIs, (3) identify factors affecting application of STI screening and (4) assess follow-up. Methods consisted of retrospective analysis of an anonymous database for all patients seen between 1 July 2016 and 1 July 2019.

Detecting microRNA-mediated gene regulatory effects in murine neuronal subpopulations.

microRNAs (miRNAs) have unique gene regulatory effects in different neuronal subpopulations. Here, we describe a protocol to identify neuronal subtype-specific effects of a miRNA in murine motor neuron subpopulations. We detail the preparation of primary mouse spinal tissue for single cell RNA sequencing and bioinformatics analyses of pseudobulk expression data.