The Relationship Between Perimesenteric Fat and Measures of Central Adiposity in Young Adults.

Visceral fat has been identified as a key contributor to metabolic disorders owing to its association with decreased adipocytokine function. Perivascular adipose tissue (PVAT), a specialized local deposit of adipose tissue surrounding arteries, has been shown to regulate vascular tone through adipocytokine functions but is compromised in obesity, contributing to increased vascular resistance. This study aimed to investigate the correlation between PVAT of the superior mesenteric artery (SMA), visceral adipose tissue (VAT), body mass index (BMI), and waist-to-hip ratio (WHR).

Paradoxes in the coevolution of contagions and institutions.

Epidemic models study the spread of undesired agents through populations, be it infectious diseases through a country, misinformation in social media or pests infesting a region. In combating these epidemics, we rely neither on global top-down interventions, nor solely on individual adaptations. Instead, interventions commonly come from local institutions such as public health departments, moderation teams on social media platforms or other forms of group governance.

A graduate medical education (GME) quality improvement curriculum leads to improved knowledge and participation in high quality improvement projects by trainees.

Background: There is increased awareness about the need for quality improvement (QI) education for trainees within clinical training programs. However, formal integration of a QI curriculum into graduate medical education (GME) remains a work-in-progress. We describe the creation and implementation of a novel, virtual QI curriculum complemented by virtual-based workshops.

Defining the Genetic Landscape of Congenital Mirror Movements in 80 Affected Individuals.

Background: Congenital mirror movements (CMM) is a rare neurodevelopmental disorder characterized by involuntary movements from one side of the body that mirror voluntary movements on the opposite side. To date, five genes have been associated with CMM, namely DCC, RAD51, NTN1, ARHGEF7, and DNAL4.

Objective: The aim of this study is to characterize the genetic landscape of CMM in a large group of 80 affected individuals.

mTOR Pathway Somatic Pathogenic Variants in Focal Malformations of Cortical Development: Novel Variants, Topographic Mapping, and Clinical Outcomes.

Background And Objectives: Somatic and germline pathogenic variants in genes of the mammalian target of rapamycin (mTOR) signaling pathway are a common mechanism underlying a subset of focal malformations of cortical development (FMCDs) referred to as mTORopathies, which include focal cortical dysplasia (FCD) type II, subtypes of polymicrogyria, and hemimegalencephaly. Our objective is to screen resected FMCD specimens with mTORopathy features on histology for causal somatic variants in mTOR pathway genes, describe novel pathogenic variants, and examine the variant distribution in relation to neuroimaging, histopathologic classification, and clinical outcomes.

Methods: We performed ultra-deep sequencing using a custom HaloPlex Target Enrichment kit in DNA from 21 resected fresh-frozen histologically confirmed FCD type II, tuberous sclerosis complex, or hemimegalencephaly specimens.

Integrating Persons With Lived Experience in Opioid Use Disorder Education: A Small Group Exercise and Patient Panel.

Objectives: Based on increasing drug overdose deaths and a shortage of healthcare professionals trained in the management of opioid use disorder (OUD), it is imperative to improve health professional education in addiction medicine. This small group learning exercise and patient panel was designed to provide first year medical students with insights into the lives of people with OUD-through a lens of harm reduction-and to connect biomedical knowledge to the core values and professional themes of their doctoring courses.

Methods: Facilitators were assigned to each small group of 8 students for the harm reduction-centered Long and Winding Road small group case exercise.

Vaccination in pregnancy: Healthcare provider attitudes and practices.

Objective: To assess provider attitudes and practices regarding vaccination in pregnancy to discern strategies to increase vaccination rates in pregnancy, given that in the USA, various healthcare organizations recommend that pregnant individuals be vaccinated against influenza, pertussis, and SARS-CoV-2, but vaccination rates among gravidas remain suboptimal across these vaccines.

Methods: An Institutional Review Board-approved survey was disseminated to obstetric healthcare providers by email from June through October 2021. Questions assessed provider demographics, attitudes, and practices surrounding vaccination in pregnancy.

Opioid Use Disorder Curriculum: Medicine Clerkship Standardized Patient Case, Small-Group Activity, and Patient Panel.

Introduction: The overdose crisis remains a critical public health problem, creating an urgent need to train physicians in the treatment and management of opioid use disorder (OUD). Our medicine clerkship module aimed to close this gap by training and assessing students' motivational interviewing skills, harm reduction knowledge, and use of nonstigmatizing language in the treatment of patients with OUD.

Methods: We evaluated the impact of a small-group, case-based activity and patient panel on the clinical documentation skills of students in a medicine clerkship.

Socio-semantic networks as mutualistic networks.

Several studies have shown that discourse and social relationships are intertwined and co-evolve. However, we lack theoretical models to explain the phenomenon. Inspired by recent work in ecology, we propose to model socio-semantic networks as an interaction between two intermingled data generating processes: a social community process and a document-based process.

Burnout: exploring the differences between U.S. and international medical graduates.

Background: International medical graduates (IMGs) have less burnout than U. S. medical school graduates (USMGs) during residency training.

Online Educational Tools for Caregivers of People with Dementia: A Scoping Literature Review.

Background: Informal caregivers of people with dementia provide the majority of health-based care to people with dementia. Providing this care requires knowledge and access to resources, which caregivers often do not receive. We set out to evaluate the effect of online educational tools on informal caregiver self-efficacy, quality of life, burden/stress, depression, and anxiety, and to identify effective processes for online educational tool development.

Effectiveness of Three-Dimensional Multiple-Object Tracking in Patients with Multiple Sclerosis: A Pilot Trial.

Background: Computerized cognitive training remains an attractive supplemental modality to enhance rehabilitation in multiple sclerosis (MS). The objective of the present study was to assess the usability of three-dimensional multiple-object tracking (3D-MOT) in patients with MS.

Methods: In this pilot study, 16 patients with relapsing-remitting MS and nine age-matched controls participated in four 30-minute training sessions of 3D-MOT.

A missed opportunity: underutilization of inpatient behavioral health services to reduce injection drug use sequelae in Florida.

Background: People who inject drugs (PWID) suffer high morbidity and mortality from injection related infections (IRI). The inpatient setting is an ideal opportunity to treat underlying substance use disorder (SUD), but it is unclear how often this occurs.

Objectives: To quantify the utilization of behavioral health services for PWID during inpatient admissions for IRI.

Paternal distress and child behavior problems in low-SES families: Quality of father-child interactions as mediators.

This study examines, in low-income families, whether fathers' distress is associated with behavioral problems in preschool children and if the quality of father-child interactions mediates this association. Participants were 81 children between the ages of 3 and 5 years and their parents who were receiving social welfare. Quality of father-child interactions was assessed during a free-play situation and a toy cleanup task, fathers' parenting stress and psychological distress were self-reported, and children's behavior problems were assessed by both parents.

How Does Black History Help Doctors? Addressing Cultural Competency through Cinemeducation at a Diverse Medical School.

Abstract: Racial minorities will account for >50% of the United States population by 2045, yet race and ethnicity persist as leading predictors of morbidity. Although minorities achieve better outcomes when treated by racially concordant providers, the number of minority physicians is disproportionately low compared with the rapidly growing minority population. This imbalance creates a cultural gap between many minority patients and their healthcare providers.

Acute generalised exanthematous pustulosis associated with shock.

A 23-year-old man with a history of end-stage renal disease was admitted to the hospital due to fever and shock, which occurred during his dialysis. One week prior, he developed an erythematous rash on his chest, face and back, associated with generalised eruption of pustules. In hospital, his status did not improve with norepinephrine and empirical broad-spectrum antibiotics.

The University of Miami Infectious Disease Elimination Act Syringe Services Program: A Blueprint for Student Advocacy, Education, and Innovation.

After the closure of pill mills and implementation of Florida's Prescription Drug Monitoring Program in 2010, high demand for opioids was met with counterfeit pills, heroin, and fentanyl. In response, medical students at the University of Miami Miller School of Medicine embarked on a journey to bring syringe services programs (SSPs) to Florida through an innovative grassroots approach. Working with the Florida Medical Association, students learned patient advocacy, legislation writing, and negotiation within a complex political climate.

Hospital Costs of Injection Drug Use in Florida.

People who inject drugs (PWID) experience significant injection-related infections (IRIs) at significant healthcare system cost. This study used and validated an algorithm based on the International Classification of Diseases, Tenth Revision, to estimate hospitalized PWID populations, assess the total statewide morbidity for IRIs among PWID, and calculate associated costs of care.

mutations in the X-linked gene cause intellectual disability with pigmentary mosaicism and storage disorder-like features.

Introduction: Pigmentary mosaicism (PM) manifests by pigmentation anomalies along Blaschko's lines and represents a clue toward the molecular diagnosis of syndromic intellectual disability (ID). Together with new insights on the role for lysosomal signalling in embryonic stem cell differentiation, mutations in the X-linked transcription factor 3 () have recently been reported in five patients. Functional analysis suggested these mutations to result in ectopic nuclear gain of functions.

Hospital admissions among people who inject opioids following syringe services program implementation.

Background: Syringe services programs (SSPs) are an evidence-based harm reduction strategy that reduces dangerous sequelae of injection drug use among people who inject drugs (PWID) such as overdose. SSP services include safer injection education and community-based naloxone distribution programs. This study evaluates differences in overdose-associated hospital admissions following the implementation of the first legal SSP in Florida, based in Miami-Dade County.