Punctuational evolution is pervasive in distal site metastatic colonization.

The evolution of metastasis, the spread of cancer to distal sites within the body, represents a lethal stage of cancer progression. Yet, the evolutionary dynamics that shape the emergence of metastatic disease remain unresolved. Here, using single-cell lineage tracing data in combination with phylogenetic statistical methods, we show that the evolutionary trajectory of metastatic disease is littered with bursts of rapid molecular change as new cellular subpopulations appear, a pattern known as punctuational evolution.

Utilities Associated with the Treatment of Growth Hormone Deficiency (GHD): A Time Trade-off (TTO) Study in the UK and Canada.

Purpose: Growth hormone deficiency (GHD) causes decreased growth rate in children, resulting in short stature in childhood and adulthood. Daily subcutaneous injections with growth hormone (GH) have been standard treatment. Newer weekly GH formulations now exist.

Complex Cardiovascular Management in an 80-Year-Old Female With Gastrointestinal Bleeds and Klatskin Tumor: A Case of ST-Elevation Myocardial Infarction (MI) Management Complicated by Severe Anemia and Post-MI Ventricular Septal Defect Development.

Managing acute coronary syndrome (ACS) in patients with a recent history of gastrointestinal bleeding presents a unique and challenging clinical dilemma, necessitating a careful balance between minimizing ischemic risk and avoiding potentially life-threatening rebleeding. Standard treatment for ACS typically involves dual antiplatelet therapy (DAPT) to prevent recurrent thrombotic events. However, in patients with recent gastrointestinal hemorrhage or significant anemia, these therapies may substantially increase the risk of life-threatening bleeding, complicating the decision-making process and often leading to conservative management strategies.

Adaptation of a HIV Prevention Mobile App for Transmasculine People: A Pilot Acceptability and Feasibility Study.

Purpose: Using a community-engaged approach, we adapted a human immunodeficiency virus (HIV) prevention smartphone app, Transpire, to meet the HIV and sexually transmitted infection (STI) prevention needs of transgender men and other transmasculine people. We conducted a pilot study to assess the feasibility and acceptability of the app among participants in two cities in the southeastern United States.

Methods: Participants were recruited online and through community partners.

Intrinsic and extrinsic control impact motivation and outcome sensitivity: the role of anhedonia, stress, and anxiety.

Background: Motivated behaviors vary widely across individuals and are controlled by a range of environmental and intrinsic factors. However, due to a lack of objective measures, the role of intrinsic extrinsic control of motivation in psychiatric disorders remains poorly understood.

Methods: We developed a novel multi-factorial behavioral task that separates the distinct contributions of intrinsic extrinsic control, and determines their influence on motivation and outcome sensitivity in a range of contextual environments.