Effect of dapagliflozin on blood and breath ketones during supervised insulin withdrawal in adults with type 1 diabetes: A randomized crossover trial.

Aims: Sodium-glucose cotransporter 2 (SGLT2) inhibitors increase ketoacidosis risk, limiting their use in type 1 diabetes. To better understand the pathophysiology of SGLT2 inhibitor-mediated ketoacidosis, we measured blood glucose, capillary blood and plasma β-hydroxybutyrate (BOHB) and breath acetone (BrACE) during supervised insulin withdrawal in adults with type 1 diabetes with and without dapagliflozin treatment.

Materials And Methods: Twenty adults with type 1 diabetes underwent supervised insulin withdrawal twice in a randomized crossover design: during usual care and after treatment with dapagliflozin (10 mg daily for 2 weeks plus the test day).

Breath Acetone Correlates with Capillary β-hydroxybutyrate in Type 1 Diabetes.

Background: Breath acetone (BrACE) is an end product of ketone metabolism that is measurable by noninvasive breath ketone analyzers. We assessed the correlation between capillary blood β-hydroxybutyrate (BOHB) and BrACE in people with type 1 diabetes (T1D) during 14 days of outpatient care with and without dapagliflozin treatment and during supervised insulin withdrawal studies with and without dapagliflozin.

Methods: In this randomized crossover study, participants completed 14-day two outpatient periods with or without dapagliflozin 10 mg daily.

The effect of vitamin D supplementation on mental and functional health outcomes in African Americans with type 2 diabetes.

In patients with type 2 diabetes (T2DM), depression increases the risk of poor glycemic control and decreases adherence to medications, exercise, and diet. Studies have shown an inverse relationship between plasma vitamin D (VD) level and depression risk. However, there are few interventional trials of African Americans (AAs), a demographic with higher prevalence of diabetes, depression, and VD deficiency.

Targeted enamel remineralization with mineral-loaded starch particles.

Background: Noninvasive caries treatments work topically, which may limit efficacy. The authors hypothesized that an alternative approach using mineral-loaded particles designed to target the subsurface of noncavitated caries lesions could be advantageous. This study shows in vitro proof-of-concept.

Convolution Neural Networks and Targeted Fluorescent Nanoparticles to Detect and ICDAS Score Caries.

Previous work has shown targeted fluorescent starch nanoparticles (TFSNs) can label the subsurface of carious lesions and assist dental professionals in the diagnostic process. In this study, we aimed to evaluate the potential of using artificial intelligence (AI) to detect and score carious lesions using ICDAS in combination with fluorescent imaging following application of TFSNs on teeth with a range of lesion severities, using ICDAS-labeled images as the reference standard. A total of 130 extracted human teeth with ICDAS scores from 0 to 6 were selected by a calibrated cariologist.

Development of a cultural competency curriculum.

There has been increased focus on health disparities and how to address them (Baciu et al., 2017; National Institutes of Health, 2021; Williams et al., 2021).

Using natural language processing to compare task-specific verbal cues in coached versus noncoached cardiac arrest teams during simulated pediatrics resuscitation.

Objectives: Coaches improve cardiopulmonary (CPR) outcomes in real-world and simulated settings. To explore verbal feedback that targets CPR quality, we used natural language processing (NLP) methodologies on transcripts from a published pediatric randomized trial (coach vs. no coach in simulated CPR).

Thoracic Trauma, Nonaortic Injuries.

Trauma is one of the leading causes of death worldwide. Approximately two-thirds of trauma patients have thoracic injuries. Nonvascular injury to the chest is most common; however, while vascular injuries to the chest make up a small minority of injuries in thoracic trauma, these injuries are most likely to require intervention by interventional radiology (IR).

Acceptability, safety, and patterns of use of oral tenofovir disoproxil fumarate and emtricitabine for HIV pre-exposure prophylaxis in South African adolescents: an open-label single-arm phase 2 trial.

Background: HIV incidence among adolescents in southern Africa remains unacceptably high. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention but there are few data on its implementation among adolescents. We aimed to investigate the safety, feasibility, and acceptability of PrEP with oral tenofovir disoproxil fumarate and emtricitabine as part of a comprehensive HIV prevention package in an adolescent population in South Africa.

Machine learning to extract communication and history-taking skills in OSCE transcripts.

Objectives: Observed Structured Clinical Exams (OSCEs) allow assessment of, and provide feedback to, medical students. Clinical examiners and standardised patients (SP) typically complete itemised checklists and global scoring scales, which have known shortcomings. In this study, we applied machine learning (ML) to label some communication skills and interview content information in OSCE transcripts and to compare several ML methodologies by performance and transferability.

Cultural Competency Interventions During Medical School: a Scoping Review and Narrative Synthesis.

Many medical accreditation bodies agree that medical students should be trained to care for diverse patient populations. However, the teaching methods that medical schools employ to accomplish this goal vary widely. The purpose of this work is to summarize current cultural competency teaching for medical students and their evaluation methods.

Validation of Three-dimensional Electronic Portal Imaging Device-based PerFRACTION™ Software for Patient-Specific Quality Assurance.

Purpose: PerFRACTION™ is a three-dimensional (3D) electronic portal imaging device-based dosimetry software. To validate the software, three phantoms with different inserts (2D array, ionization chamber, and inhomogeneity materials) were constructed to evaluate point dose and fluence map.

Materials And Methods: Phantoms underwent independent computed tomography simulation for planning and received repetitive fractions of volumetric modulated arc therapy, simulating prostate treatment.

Feasibility and Acceptability in a Community-Partnered Implementation of CenteringParenting for Group Well-Child Care.

Background: In a community-academic partnership, we implemented a group-based model for well-child care (WCC) (CenteringParenting) and conducted a pilot test for feasibility and acceptability among families at a federally qualified health center (FQHC).

Methods: The FQHC implemented CenteringParenting for all WCC visits in the first year of life, starting at the 2-week visit. Over a 14-month time period, parents from each new CenteringParenting group were enrolled into the study.

Prenatal counseling on type 2 diabetes risk, exercise, and nutrition affects the likelihood of postpartum diabetes screening after gestational diabetes.

Objective: Screening rates for type 2 diabetes after a pregnancy with gestational diabetes are inadequate. We aimed to determine how prenatal counseling on exercise, nutrition, and type 2 diabetes risk affects postpartum screening for diabetes.

Methods: Using Pregnancy Risk Assessment Monitoring System data from Colorado (2009-2011) and Massachusetts (2012-2013), we performed multivariable logistic regression to examine the relationship between prenatal counseling and postpartum screening.

The development of an efficient mass balance approach for the purity assignment of organic calibration standards.

The purity determination of organic calibration standards using the traditional mass balance approach is described. Demonstrated examples highlight the potential for bias in each measurement and the need to implement an approach that provides a cross-check for each result, affording fit for purpose purity values in a timely and cost-effective manner. Chromatographic techniques such as gas chromatography with flame ionisation detection (GC-FID) and high-performance liquid chromatography with UV detection (HPLC-UV), combined with mass and NMR spectroscopy, provide a detailed impurity profile allowing an efficient conversion of chromatographic peak areas into relative mass fractions, generally avoiding the need to calibrate each impurity present.

Purity assessment of organic calibration standards using a combination of quantitative NMR and mass balance.

Quantitative NMR spectroscopy (qNMR) has been examined for purity assessment using a range of organic calibration standards of varying structural complexities, certified using the traditional mass balance approach. Demonstrated equivalence between the two independent purity values confirmed the accuracy of qNMR and highlighted the benefit of using both methods in tandem to minimise the potential for hidden bias, thereby conferring greater confidence in the overall purity assessment. A comprehensive approach to purity assessment is detailed, utilising, where appropriate, multiple peaks in the qNMR spectrum, chosen on the basis of scientific reason and statistical analysis.