Kratom: A Narrative Review of the Possible Clinical Uses and Dangers of This Opioid-Like Plant.

The term "kratom" refers to a plant species formally known as  Kratom is composed of over 40 alkaloids, a type of organic compound that contains nitrogen. These compounds work primarily via binding to opioid receptors expressed on neurons, where they stimulate signal transduction mechanisms involving the activation of G proteins. Kratom has been shown to cause both a stimulant-like effect and a sedative effect in humans.

Ultrasound measurement of traumatic scar and skin thickness: a scoping review of evidence across the translational pipeline of research-to-practice.

Objectives: To identify the ultrasound methods used in the literature to measure traumatic scar thickness, and map gaps in the translation of these methods using evidence across the research-to-practice pipeline.

Design: Scoping review.

Data Sources: Electronic database searches of Ovid MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature and Web of Science.

Comparison of Sub-Scalp EEG and Endovascular Stent-Electrode Array for Visual Evoked Potential Brain-Computer Interface.

Brain-computer interfaces (BCI) have the potential to improve the quality of life for persons with paralysis. Sub-scalp EEG provides an alternative BCI signal acquisition method that compromises between the limitations of traditional EEG systems and the risks associated with intracranial electrodes, and has shown promise in long-term seizure monitoring. However, sub-scalp EEG has not yet been assessed for suitability in BCI applications.

Economic Costs of Diabetes in the U.S. in 2022.

Objective: This study updates previous estimates of the economic burden of diagnosed diabetes, with calculation of the health resource use and indirect costs attributable to diabetes in 2022.

Research Design And Methods: We combine the demographics of the U.S.

Predicting wastewater treatment plant influent in mixed, separate, and combined sewers using nearby surface water discharge for better wastewater-based epidemiology sampling design.

For wastewater sample collection approaches supporting public health applications, few high hydrologic activity normalizing guidelines currently consider readily available environmental flow data that may earlier capture information regarding periods of influent mixing and dilution of wastewater with groundwater and runoff. This study aimed to identify wastewater sampling rules for high hydrological activity events, allowing for an earlier decision point in the control of dilution before sample collection. We defined the sampling rules via data-driven models (Random Forest and linear regression) using environmental data (i.

Urbanization as a limiter and catalyst of watershed-scale sediment transport: Insights from probabilistic connectivity modeling.

The conversion of rural lands to urban areas exerts considerable influence on the hydrologic processes governing sediment transport at the watershed scale. While the effects of urbanization on hydrology have been well-studied, the corresponding impact to the spatial and temporal variability of sediment detachment, transport, and connectivity is less certain. To address this knowledge gap, we apply process-based hydrologic simulation, probabilistic connectivity modeling, and in situ turbidity sensing to five watersheds positioned along a steep land use gradient in Kansas, USA.

Pediatric septorhinoplasty: Current attitudes and practices by facial plastic and reconstructive surgeons.

Objective: There is hesitation to offer pediatric patients rhinoplasty due to concerns about postoperative effect on midface growth. A cross-sectional survey of members of the American Academy of Facial Plastic and Reconstructive Surgery was conducted regarding practice information and attitudes towards pediatric septorhinoplasty. The goal of the study is to describe the current attitudes on pediatric septorhinoplasty.

Standardized measurement of abdominal muscle by computed tomography: association with cardiometabolic risk in the Framingham Heart Study.

Objectives: To provide a standard for total abdominal muscle mass (TAM) quantification on computed tomography (CT) and investigate its association with cardiovascular risk in a primary prevention setting.

Methods: We included 3016 Framingham Heart Study participants free of cardiovascular disease (CVD) who underwent abdominal CT between 2002 and 2005. On a single CT slice at the level of L3/L4, we segmented (1) TAM-Area, (2) TAM-Index (= TAM-Area/height) and, (3) TAM-Fraction (= TAM-Area/total cross-sectional CT-area).

Correlates of Homonegativity Towards Men Who Have Sex With Men Among Black Individuals in the United States.

This study aims to identify the factors that are associated with homonegativity toward men who have sex with men (MSM) within Black communities since the expansion of LGBTQ rights. A survey was completed in 2016 by a nationally representative sample of 868 Black respondents, 18-50 years old, via e-mail. Demographics, perception of same-gender sexual behaviors, religiosity, experienced racism, and contact with the carceral system (CS) were assessed.

Primary Care Behavioral Health Integration and Care Utilization: Implications for Patient Outcome and Healthcare Resource Use.

Background: Behavioral health (BH) integration in primary care (PC) can potentially improve outcomes and reduce cost of care. While different models of integration exist, evidence from real-world examples is needed to demonstrate the effectiveness and value of integration. This study aimed to evaluate the outcomes of six PC practice sites located in Western New York that implemented a primary care behavioral health (PCBH) integration model.

Social determinants of health and treatment decisions in head and neck cancer.

Background: This study compares select social determinants of health (SDOH) with treatment modality selection and treatment completion in head and neck cancer (HNC) patients, to better understand disparities in health outcomes.

Methods: A retrospective cohort study of HNC (n = 1428) patients was conducted. Demographic and disease-specific variables were recorded, including treatment modality selection and completion.

Geographic Barriers Affect Follow-Up Care in Head and Neck Cancer.

Objectives/hypothesis: Follow-up care in head and neck cancers (HNC) is critical in managing patient health. However, social determinants of health (SDOH) can create difficulties in maintaining follow-up care. The study goal is to explore how SDOH impacts maintenance of HNC follow-up care appointments.

Frontal Bone Cranioplasty for Facial Feminization: Long-Term Follow-Up of Postoperative Sinonasal Symptoms.

Forehead feminization cranioplasty (FFC) risks entering the frontal sinus to achieve the desired contour. To date, no study has investigated long-term FFC complications. Determine if long-term sinus and headache symptoms worsen secondary to frontal sinus mucosal violation, measured by patient-reported outcomes.

Admission Lymphocytopenia is Associated with Urinary Tract Infection and Nosocomial Infections in Hemorrhagic Stroke.

Objective: Growing evidence suggests that lymphocytopenia on admission (LOA) is associated with infectious complications and poor outcomes in intracerebral hemorrhage (ICH). Whether LOA preferentially increases the risk for community acquired infections or nosocomial infections is unknown. This study investigates the relationship between LOA and nosocomial infections in a cohort of patients with ICH in a safety-net hospital.

Association Between HIV Testing and HIV-Related Risk Behaviors Among US and Non-US Born Black Individuals Living in the US: Results From the National Survey on HIV in the Black Community (NSHBC).

Despite improvements in HIV prevention and treatment, Black individuals continue to be disproportionately affected by the HIV epidemic in the US. Using data from the National Survey on HIV in the Black Community, we examined the differences in demographic characteristics, risk behaviors, and HIV testing between US and non-US born Black adults. 868 individuals completed the survey and provided baseline data on sexual risk.

Validation of a Crisis Standards of Care Model for Prioritization of Limited Resources During the Coronavirus Disease 2019 Crisis in an Urban, Safety-Net, Academic Medical Center.

Objectives: The coronavirus disease 2019 pandemic has overwhelmed healthcare resources even in wealthy nations, necessitating rationing of limited resources without previously established crisis standards of care protocols. In Massachusetts, triage guidelines were designed based on acute illness and chronic life-limiting conditions. In this study, we sought to retrospectively validate this protocol to cohorts of critically ill patients from our hospital.

Sex Differences in the Associations of Visceral Adipose Tissue and Cardiometabolic and Cardiovascular Disease Risk: The Framingham Heart Study.

Background Men and women are labeled as obese on the basis of a body mass index (BMI) using the same criterion despite known differences in their fat distributions. Subcutaneous adipose tissue and visceral adipose tissue (VAT), as measured by computed tomography, are advanced measures of obesity that closely correlate with cardiometabolic risk independent of BMI. However, it remains unknown whether prognostic significance of anthropometric measures of adiposity versus VAT varies in men versus women.

HIV Risk-Related Behaviors and Willingness to Use Pre-Exposure Prophylaxis Among Black Americans with an Arrest History.

Objective: Black individuals in the USA are arrested and incarcerated at a significantly higher rate than White individuals, and incarceration is associated with increased HIV vulnerability. Pre-exposure prophylaxis (PrEP) reduces the risk for HIV transmission, but little is known about the relationship between HIV risk behavior and willingness to use PrEP among Black individuals with an arrest history.

Method: A total of 868 individuals completed a nationally representative survey and provided baseline data on sexual risk.

Deep convolutional neural networks to predict cardiovascular risk from computed tomography.

Coronary artery calcium is an accurate predictor of cardiovascular events. While it is visible on all computed tomography (CT) scans of the chest, this information is not routinely quantified as it requires expertise, time, and specialized equipment. Here, we show a robust and time-efficient deep learning system to automatically quantify coronary calcium on routine cardiac-gated and non-gated CT.

Utilization of absolute monocyte counts to predict cardiovascular events in people living with HIV.

Objectives: Cardiovascular risk is increased in people living with HIV (PLWH). In HIV-uninfected populations, total absolute monocyte count (AMC) has been shown to be predictive of future cardiovascular events (CVEs). We sought to determine whether AMC predicts CVEs in PLWH independent of established and HIV-related cardiovascular risk factors.

HIV-Related Mistrust (or HIV Conspiracy Theories) and Willingness to Use PrEP Among Black Women in the United States.

Uptake of pre-exposure prophylaxis (PrEP) among Black women living in the US is suboptimal. We sought to determine the association between HIV-related medical mistrust (or belief in HIV conspiracy theories) and willingness to use PrEP among Black women. We analyzed data from the 2016 National Survey on HIV in the Black Community (NSHBC), a nationally representative cross-sectional survey.

Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury.

Objective: Equine-assisted activities and therapies (EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury (TBI).

Baseline 10-Year Cardiovascular Risk Scores Predict Cognitive Function in Older Persons, and Particularly Women, Living With Human Immunodeficiency Virus Infection.

Background: Cardiovascular disease (CVD) and associated comorbidities increase the risk of cognitive impairment in persons living with human immunodeficiency virus (PLWH). Given the potential composite effect of multiple cardiovascular risk factors on cognition, we examined the ability of the Atherosclerotic Cardiovascular Disease (ASCVD) risk score and the Framingham Heart Study Global CVD risk score (FRS) to predict future cognitive function in older PLWH.

Methods: We constructed linear regression models evaluating the association between baseline 10-year cardiovascular risk scores and cognitive function (measured by a summary z-score, the NPZ-4) at a year 4 follow-up visit.