Improving Postpartum Depression Screening Rates Using a Quality Improvement Framework in a Community-based Academic Primary Care Clinic.

Introduction: Maternal postpartum depression (PPD) is the most common diagnosis during the postpartum period, with a higher incidence in underserved populations. Though PPD often goes undiagnosed, prompt diagnosis has a positive impact on several measures of children's health and development, as well as maternal health. To increase routine screening per American Academy of Pediatrics recommendations, we implemented a multipronged quality improvement (QI) initiative centered around a newborn coordinator embedded in our primary care clinic.

Buprenorphine adherence among a prospective cohort of homeless-experienced adults with opioid use disorder.

Introduction: People experiencing homelessness face high rates of opioid-related mortality. Buprenorphine is a medication that reduces opioid-related mortality, but adherence to this medication among people experiencing homelessness is not well-documented. This study assessed buprenorphine adherence and identified factors associated with it in this high-risk population.

Neighborhood-level adversity and inflammation among sexual minority men living with HIV.

Objective: This cross-sectional study investigated the associations of neighborhood-level factors with immune activation, systemic inflammation, and leukocyte telomere length in 110 sexual minority men with human immunodeficiency virus.

Method: From 2013 to 2017, sexual minority men with human immunodeficiency virus who used stimulants were recruited in San Francisco, California and provided blood samples to measure the markers of immune activation, systemic inflammation, and leukocyte telomere length. To measure neighborhood-level indices, the home address for each participant was geocoded and linked to data from the Centers for Disease Control and Prevention.

Pharmacokinetics of SARS-CoV-2 RNA Polymerase Inhibitor Remdesivir in Participants With Moderate and Severe Hepatic Impairment.

Remdesivir is an RNA polymerase inhibitor of severe acute respiratory syndrome coronavirus 2 administered intravenously (IV) that is approved for the treatment of coronavirus disease 2019 in hospitalized and nonhospitalized patients. The clinical dosing regimen is a single loading dose of 200 mg on Day 1 followed by once-daily maintenance doses of 100 mg from Day 2, for a total duration of up to 10 days. The prodrug, remdesivir, undergoes metabolic activation inside the cell to form the intracellular active metabolite (GS-443902) along with two plasma metabolites (GS-704277 and GS-441524).

Clinical Reasoning: A 68-Year-Old Man With Progressive Numbness, Vertigo, and Cognitive Decline.

A 68-year-old man presented with subacute progressive numbness in his lower extremities and vertigo. Concurrently, he developed behavioral and cognitive changes. Initial examination demonstrated mild distal symmetric weakness in the lower extremities, allodynia in the feet, decreased proprioception at the ankles, and absent reflexes in the lower extremities.

Intricacies of human-AI interaction in dynamic decision-making for precision oncology.

AI decision support systems can assist clinicians in planning adaptive treatment strategies that can dynamically react to individuals' cancer progression for effective personalized care. However, AI's imperfections can lead to suboptimal therapeutics if clinicians over or under rely on AI. To investigate such collaborative decision-making process, we conducted a Human-AI interaction study on response-adaptive radiotherapy for non-small cell lung cancer and hepatocellular carcinoma.

Phasic dopamine release in two different rat models of attention-deficit/hyperactivity disorder: Spontaneously hypertensive rats (SHR) versus Lphn3 knockout rats.

We examined DA activity in the medial prefrontal cortex (mPFC) and nucleus accumbens core (NAcc) in two Different Rat Models of Attention-Deficit/Hyperactivity Disorder: Spontaneously Hypertensive Rats (SHR) Versus Lphn3 Knockout Rats. We examined baseline stimulation-evoked phasic DA release, half-life, and DA autoreceptor (DAR) functioning in the mPFC and NAcc, as well as the response to nomifensine (10 mg/kg, IP), a DA transporter (DAT) blocker, on these measures in the NAcc. Both rat models were hypodopaminergic, with notable regional and mechanistic differences.

The Impact of Addiction Consultation and Medication for Opioid or Alcohol Use Disorder on Hospital Readmission.

Background: Patients with substance use disorder (SUD) are frequently hospitalized and readmitted. Hospitalization is an opportunity for treatment initiation, including medications for alcohol (MAUD) and opioid use disorder (MOUD). Addiction consult teams are one model for increasing hospital-based SUD treatment.

Neighborhood Factors as Correlates of Alcohol Use in the N2 Cohort Study of Black Sexually Minoritized Men and Transgender Women.

Sexually minoritized men (SMM), transgender women (TW), and particularly Black SMM and Black TW may be disproportionately impacted by alcohol-related problems. Few studies have empirically examined neighborhood factors that may contribute to alcohol use, specifically among these populations. Using data from the N2 longitudinal cohort study in Chicago, IL, survey data from the second wave of longitudinal assessment (n = 126) and GPS mobility data from enrollment were used to evaluate neighborhood alcohol outlet availability, neighborhood disorder, and neighborhood poverty as correlates of individual alcohol use.

Microboost in Localized Prostate Cancer: Analysis of a Statewide Quality Consortium.

Purpose: Prospective trials have reported isotoxicity and improved oncologic outcomes with external beam radiation therapy (EBRT) microboost to a dominant intraprostatic lesion. There is often variability in the rate of adoption of new treatments, and current microboost practice patterns are unknown. We leveraged prospectively collected data from the multicenter Michigan Radiation Oncology Quality Consortium to understand the current state of microboost usage for localized prostate cancer.

Applications of a Rayleigh-Taylor model to direct-drive laser fusion.

This paper presents a simple physics-based model for the interpretation of key metrics in laser direct drive. The only input parameters required are target scale, in-flight aspect ratio, and beam-to-target radius, and the importance of each has been quantified with a tailored set of cryogenic implosion experiments. These analyses lead to compact and accurate predictions of the fusion yield and areal density as a function of hydrodynamic stability, and they suggest new ways to take advantage of direct drive.

Clinical Pharmacokinetics and Safety of Remdesivir in Phase I Participants with Varying Degrees of Renal Impairment.

Background And Objective: Remdesivir is a nucleotide analog prodrug approved for the treatment of COVID-19. This study evaluated the pharmacokinetics and safety of remdesivir and its metabolites (GS-704277 and GS-441524) in participants with varying degrees of renal impairment. Results of this phase I study, along with those of a phase III study, contributed to an extension of indication for remdesivir in the USA and Europe for use in patients with COVID-19 with all stages of renal impairment, including those on dialysis, with no dose adjustment.

Three-dimensional reconstruction of laser-direct-drive inertial confinement fusion hot-spot plasma from x-ray diagnostics on the OMEGA laser facility (invited).

A deep-learning convolutional neural network (CNN) is used to infer, from x-ray images along multiple lines of sight, the low-mode shape of the hot-spot emission of deuterium-tritium (DT) laser-direct-drive cryogenic implosions on OMEGA. The motivation of this approach is to develop a physics-informed 3-D reconstruction technique that can be performed within minutes to facilitate the use of the results to inform changes to the initial target and laser conditions for the subsequent implosion. The CNN is trained on a 3D radiation-hydrodynamic simulation database to relate 2D x-ray images to 3D emissivity at stagnation.

Nonlinear light-output calibration of the oxygenated xylene scintillators used in OMEGA neutron time-of-flight spectrometers.

Neutron time-of-flight (nTOF) spectrometers are essential instruments for measuring and evaluating the performance of inertial confinement fusion implosions. The neutron spectrometers utilized for the OMEGA laser include two liquid-based scintillators, each consisting of a large volume filled with xylene that is coupled to four photomultiplier tubes. Analysis of the signal from these detectors requires detailed knowledge of the scintillator's light output, which is needed to fit the nTOF spectrum, from which the neutron energy spectrum is informed.

Ex situ calibration of the scattered-light time-history diagnostic on the National Ignition Facility.

The scattered-light time-history diagnostic (SLTD) suite measures time-resolved scattered light in three wavelength bands: stimulated Brillouin scattering (350-352 nm), stimulated Raman scattering (430-760 nm), and plasma emission at half the laser frequency (695-735 nm), at 15 locations around the National Ignition Facility (NIF) target chamber. The SLTD, along with the full-aperture backscatter station (FABS), collects scattered light from direct- and indirect-drive inertial confinement fusion experiments. The SLTD calibration was revisited after a discrepancy between FABS and SLTD measurements was observed on NIF polar direct-drive [Skupsky et al.

Persistent Hot-Spot Mix in Cryogenic Direct-Drive Fusion Experiments.

We show that an x-ray emission signature associated with acceleration phase mass injection [R. C. Shah et al.

RING1 missense variants reveal sensitivity of DNA damage repair to H2A monoubiquitination dosage during neurogenesis.

Polycomb repressive complex 1 (PRC1) modifies chromatin through catalysis of histone H2A lysine 119 monoubiquitination (H2AK119ub1). RING1 and RNF2 interchangeably serve as the catalytic subunit within PRC1. Pathogenic missense variants in PRC1 core components reveal functions of these proteins that are obscured in knockout models.

The next-generation magnetic recoil spectrometer (MRSnext) on OMEGA and NIF for diagnosing ion temperature, yield, areal density, and alpha heating.

The next-generation magnetic recoil spectrometer (MRSnext) is being designed to replace the current MRS at the National Ignition Facility and OMEGA for measurements of the neutron spectrum from an inertial confinement fusion implosion. The MRSnext will provide a far-superior performance and faster data turnaround than the current MRS systems, i.e.

Characterization of the upgraded single-line-of-sight time-resolved x-ray imager using short-pulse visible and UV lasers.

The single-line-of-sight time-resolved x-ray imager (SLOS-TRXI), a fast-gated x-ray imager used for capturing x-ray self-emission in inertial confinement fusion experiments on OMEGA, has been upgraded and characterized. SLOS-TRXI combines an electron-dilation imager and a hybrid complementary metal-oxide-semiconductor (hCMOS) sensor to capture multiple gated frames on a single line of sight with a temporal resolution of ∼40 ps and a spatial resolution of 10 µm. The original hCMOS sensor with four frames was replaced with a newer-generation hCMOS sensor having eight frames.

Community Collaboration to Advance Racial/Ethnic Equity in Colorectal Cancer Screening: Protocol for a Multilevel Intervention to Improve Screening and Follow-up in Community Health Centers.

Introduction: Colorectal cancer (CRC) screening utilization is low among low-income, uninsured, and minority populations that receive care in community health centers (CHCs). There is a need for evidence-based interventions to increase screening and follow-up care in these settings.

Methods: A multilevel, multi-component pragmatic cluster randomized controlled trial is being conducted at 8 CHCs in two metropolitan areas (Boston and Los Angeles), with two arms: (1) Mailed FIT outreach with text reminders, and (2) Mailed FIT-DNA with patient support.

The Effects of Cathepsin B Inhibition in the Face of Diffuse Traumatic Brain Injury and Secondary Intracranial Pressure Elevation.

Traumatic brain injury (TBI) affects millions of people each year. Previous studies using the central fluid percussion injury (CFPI) model in adult male rats indicated that elevated intracranial pressure (ICP) was associated with long-term effects, including neuronal cell loss and increased sensory sensitivity post-injury and secondary ICP elevation, which were not seen following injury alone. Investigations also indicated that cathepsin B (Cath B), a lysosomal cysteine protease, may play a role in the pathological progression of neuronal membrane disruption; however, the specific impact of Cath B inhibition following CFPI remained unknown.

Treatment of Locally Recurrent Rectal Cancer: A Review.

Up to 10% of patients with locally advanced rectal cancer will experience locoregional recurrence. In the setting of prior surgery and often radiation and chemotherapy, these represent uniquely challenging cases. When feasible, surgical resection offers the best chance for oncologic control yet risks significant morbidity.

Outpatient-Based Opioid Treatment Engagement and Attendance: A Prospective Cohort Study of Homeless-Experienced Adults.

Background: The opioid overdose epidemic disproportionately impacts people experiencing homelessness. Outpatient-based opioid treatment (OBOT) programs have been established in homeless health care settings across the USA, but little is known about the success of these programs in engaging and retaining this highly marginalized patient population in addiction care.

Objective: To evaluate predictors of initial engagement and subsequent attendance in a homeless-tailored OBOT program.