High-Value Care Education in the USA: Lessons from a National Value Curriculum for Resident and Fellow Physicians.

Purpose: Physicians are estimated to be responsible for more than 50% of national healthcare costs and hold the greatest potential to improve value by orchestrating quality-driven programs to reduce unnecessary practices and variability. A physician's ability to practice cost-conscious care has been linked to their training, underscoring the importance of integrating cost-conscious practice into training.

Methods: The High Value Practice Academic Alliance was formed to help advance the value-improvement work of individual institutions through a national organization.

Understanding fish assemblage structure using enviro assessment techniques in a Northwestern Himalayan reservoir of Beas River basin in Himachal Pradesh (H.P.), India.

Environmental factors play a fundamental role in shaping fish assemblage in aquatic ecosystems. The present study describes the fish assemblage structure on the spatial scale in Pong Reservoir, which lies in foothills of the Northwestern Himalaya within the river Beas basin. Through sophisticated enviro assessment techniques, using ArcGIS mapping, this study provides valuable insight into how physicochemical factors shape the fish assemblage in the reservoir.

In silico analysis of mitochondrial DNA genes: implication for conservation of Tor putitora (Hamilton, 1822).

Tor putitora is an endangered cyprinid fish constrained to cold water and is also considered an indicator of a healthy aquatic ecosystem. The present study aimed to examine the haplotypic diversity, genetic variation and population structure of T. putitora isolates using COI and Cyt b gene sequences submitted in GenBank.

Designing, Validation, and Feasibility of Integrated Approach of Heartfulness Meditation and Yoga Protocol (IAHFNM & YP) for Hypertensive Participants.

The module was designed and developed at Heartfulness Institute, Kanha Shanti Vanam, Hyderabad. The Department of Medicine, MGM Medical College & Hospital, MGMIHS, Navi Mumbai, carried out the validation and subsequently pilot-tested on volunteers. Forty experts were selected to validate the contents of IAHFNM & YP which was designed after a thorough review of meditation and yoga literature.

Spatiotemporal patterns of mortality events in farmed Atlantic salmon in British Columbia, Canada, using publicly available data.

Monitoring mortality is an essential strategy for fish health management. Commercial marine finfish sites in British Columbia, Canada, are required to report mortality events (MEs) to Fisheries and Oceans Canada (DFO), which makes these data publicly available. This study aimed to analyze the spatial and temporal patterns of ME composition and total MEs.

Effect of biopolymers on morphology and functionality of low-sodium condiments containing Maillard reaction products.

The impact of various biopolymers on low-sodium condiments composed of salt, potassium chloride, sodium glutamate and Maillard reaction products with chicken flavor were evaluated in order to generate uniformly distributed low-sodium condiments. The addition of biopolymers reduced the sodium and potassium content of low sodium condiments, as well as improved the particle size, changed the particle morphology. The addition of different biopolymers had different effects on the color, flow characteristics, solubility, hygroscopicity and thermal stability of low sodium condiments.

A review on comparative analysis of marine and freshwater fish gut microbiomes: insights into environmental impact on gut microbiota.

The gut microbiota, which includes prokaryotes, archaea, and eukaryotes such as yeasts, some protozoa, and fungi, significantly impacts fish by affecting digestion, metabolism, and the immune system. In this research, we combine various tasks carried out by various bacteria in the gut of fish. This study also examines the gut microbiome composition of marine and freshwater fish, identifying important bacterial species linked to different biological functions.

A systematic review of pesticide exposure, associated risks, and long-term human health impacts.

Pesticides are widely used to control pests, but their widespread use raises concerns regarding potential health risks for humans. There are several routes through which pesticides can be ingested, inhaled, and absorbed, resulting in acute and long-term health consequences. This systematic review synthesizes the available evidence regarding the health risks and long-term effects of pesticide exposure, with a particular focus on epidemiological and toxicological studies.

Metabolite differences and molecular mechanism between dehiscent and indehiscent capsule of mature sesame.

The loss of sesame capsule seed prior to harvest poses a significant economical challenge in mechanized production. The metabolites involved in capsule closure are still unclear. Using comparative metabolome and transcriptome analysis, this work investigated the molecular regulation and enrichment pathways in two sesame types of indehiscent capsule WanZhi28 (ND) and dehiscent capsule WanZhi2 (WZ2).

Infrapatellar Fat Pad Calcification: A Case Series and a Narrative Review.

Introduction: Infrapatellar fat pad (IFP) calcification is a rarely reported entity in the literature. Only a few cases have been reported so far and that too as case reports. The authors in the present study present two cases of IFP calcification.

Effect of neuromuscular taping and transcutaneous electrical stimulation on neuromusculoskeletal impairments in patients with diabetic peripheral neuropathy: A case-series.

Introduction: Approximately 60-70% of individuals with diabetes experience varying degrees of damage to their nervous system, resulting in a condition known as diabetic peripheral neuropathy (DPN). DPN usually involves distal body parts and is characterised as distal symmetrical sensorimotor neuropathy which is progressive in nature and follows a "glove and stocking pattern". It has significantly contributed to neuropathic pain, decreased nerve conduction velocity (NCV), impaired proprioception, compromised balance, and postural instability.

Identifying CNS infections in transplantation and immunomodulatory therapy.

Opportunistic central nervous system (CNS) infections are a significant cause of morbidity and mortality in immunocompromized patients, including those undergoing transplantation and receiving immunomodulatory therapy. Particularly in these individuals, the clinical presentation of these infections may have atypical patterns, emphasizing the need to consider various diagnostic possibilities, including noninfectious conditions. Quick and accurate identification, along with prompt treatment, is crucial for improving patient outcomes.

Clinical Characteristics and Risk Factors for Cryptococcal Meningitis in Diverse Patient Populations in New York City.

Background: Cryptococcal meningitis (CM) is responsible for 15%-20% of human immunodeficiency virus (HIV)-associated mortalities. CM prevalence has also increased in other immunocompromised populations of transplant recipients, patients with cancer, and individuals on immunomodulatory medication.

Methods: This retrospective review included 51 definitive patients with CM hospitalized at a tertiary academic medical center in New York City between 2010 and 2023.

Incidental detection of purely cystic pheochromocytoma in a young adult presenting with lower urinary tract infection.

Pheochromocytoma is a rare neuroendocrine tumor arising from adrenal medulla. Patients usually show classic triad of headache, palpitations and diaphoresis along with persistent or paroxysmal hypertension. Majority of the tumors are solid or mixed solid and cystic.

Bioactivity and application potential of O/W emulsions derived from carboxylic acid-based NADES-extracted total saponins from Polygonatum cyrtonema Hua.

This study focuses on evaluating new methods for the green extraction of saponin compounds from Polygonatum cyrtonema Hua (PCH). This study utilized a combination of carboxylic acid-based natural deep eutectic solvents (NADES) and various extraction techniques including conventional heat reflux-, ultrasound-, and microwave-assisted extraction. The primary objectives were to assess total saponin yield, antioxidant capacity, and enzyme inhibition efficiency.

Therapeutic advances in neuroinfectious diseases.

There have been several major advances in therapeutic options for the treatment of neurological infections over the past two decades. These advances encompass both the development of new antimicrobial therapies and the repurposing of existing agents for new indications. In addition, advances in our understanding of the host immune response have allowed for the development of new immunomodulatory strategies in the treatment of neurological infections.

Sociodemographic and Clinical Factors Associated With Clinical Outcome in Neuroinfectious Diseases: A Multicenter Retrospective Cohort Study.

Objective: To evaluate sociodemographic and clinical factors associated with clinical outcomes in patients hospitalized with neuroinfectious diseases at three tertiary care centers in New York City.

Methods: This retrospective cohort study was conducted at three large urban tertiary care centers between January 1, 2010 and December 31, 2017. Poor clinical outcome was defined as length of hospital stay (LOS) ≥2 weeks and/or discharge to a location other than home.

Public health trends in neurologically relevant infections: a global perspective.

Neuroinfectious diseases represent a growing threat to public health globally. Infections of the central nervous system remain challenging to diagnose and treat, partially driven by the fact that a high proportion of emerging pathogens are capable of causing neurological disease. Many of the trends driving the emergence of novel pathogens, including climate change, ecological degradation, urbanization, and global travel, have accelerated in recent years.

Clinical and diagnostic features of central nervous system tuberculosis in Indian children - a descriptive study.

Background: Children with tuberculous meningitis (TBM) present with diagnostic challenges as they often have atypical clinical features.

Objective: To describe the baseline characteristic features of children diagnosed with central nervous system (CNS) TB (TBM and tuberculoma).

Design: Retrospective descriptive study.

Utilization of publicly available data to summarize spatio-temporal patterns of fish health events of Atlantic salmon (Salmo salar) reported by marine finfish industries in British Columbia (BC), Canada.

Atlantic salmon aquaculture companies in British Columbia (BC) must report fish health events to Fisheries and Oceans Canada (DFO) as part of their licensing conditions. Our study aimed to summarize these fish health events reported by Atlantic salmon sites in BC to identify spatial and spatio-temporal clusters. We conducted descriptive, retrospective global, and local cluster analyses using Moran's I and scan statistics.

Endophyte-based fungal elicitors for enhanced production of valepotriates and sesquiterpenoids in leaf cell suspension cultures of Valeriana jatamansi Jones.

Aims: The immense therapeutic value of Valeriana jatamansi is attributed to the presence of bioactive secondary metabolites (valepotriates and sesquiterpenoids). Its over-exploitation in wild habitats resulted in extensive depletion, necessitating alternative approaches to produce its therapeutic metabolites. This study sought to assess the ability of endophytes of V.

pulp addition improves the dough properties and gluten protein structure.

This study investigated the effects of pulp (LBP) on the properties of mixed dough and gluten protein. The results showed that appropriate addition of LBP (5 %) significantly improved the performance of the dough, promoted the aggregation of gluten protein, enhanced the water binding ability, and delayed the gelatinization of starch during cooking. Compared with the control group, the peak temperature (T) of the LBP sample gradually increased from 63.