Family medicine research: seizing the moment to advance the field.

Despite a growing awareness that primary care is essential to an accessible, equitable, high-quality, cost-effective health care system, family medicine research remains woefully underdeveloped. The increased focus of both state and federal policy makers on primary care payment and care delivery models presents an opportunity for family medicine to redefine itself as an academically rigorous discipline at the forefront of generating evidence that improves patient care and population health while reducing costs. In a critical review of the literature, we identified five themes-leadership, funding, resources, team science, and departmental culture-that are integral to family medicine departments seeking to grow and expand their research capacity.

Autism Spectrum Social Stories in Schools Trial 2 (ASSSIST-2): a pragmatic randomised controlled trial of the Social Stories™ intervention to address the social and emotional health of autistic children in UK primary schools.

Background: Autistic children can experience mental health, social and emotional difficulties. Carol Gray's Social Stories™ are a highly personalised intervention that provide social information in a short individually tailored story.

Methods: A multi-site pragmatic cluster randomised controlled trial to evaluate the clinical and cost-effectiveness of Social Stories™ alongside care as usual in autistic children aged 4-11 years.

Association of Observation Stays with Clinical Outcomes and Costs in Medicare: An Instrumental Variable Analysis.

Background: Observation stays in Medicare have grown over the last 15 years, yet limited research exists on how observation may impact outcomes for older adults.

Objective: To examine the relationship of an observation stay with 30-day hospital returns, total acute care days post-discharge, mortality, and out-of-pocket costs, compared to an inpatient admission.

Design: Retrospective cohort study using instrumental variable analysis.

Molecular Complexity-Inspired Synthetic Strategies toward the Calyciphylline A-Type Alkaloids Himalensine A and Daphenylline.

In this report, we detail two distinct synthetic approaches to calyciphylline A-type alkaloids himalensine A and daphenylline, which are inspired by our analysis of the structural complexity of these compounds. Using MolComplex, a Python-based web application that we have developed, we quantified the structural complexity of all possible precursors resulting from one-bond retrosynthetic disconnections. This led to the identification of transannular bonds as especially simplifying to the molecular graph, and, based on this analysis, we pursued a total synthesis of himalensine A from macrocyclic intermediates with planned late-stage transannular ring formations.

The Importance of Phosphoinositide 3-Kinase in Neuroinflammation.

Neuroinflammation, characterised by the activation of immune cells in the central nervous system (CNS), plays a dual role in both protecting against and contributing to the progression of neurodegenerative diseases, such as Alzheimer's disease (AD) and multiple sclerosis (MS). This review explores the role of phosphoinositide 3-kinase (PI3K), a key enzyme involved in cellular survival, proliferation, and inflammatory responses, within the context of neuroinflammation. Two PI3K isoforms of interest, PI3Kγ and PI3Kδ, are specific to the regulation of CNS cells, such as microglia, astrocytes, neurons, and oligodendrocytes, influencing pathways, such as Akt, mTOR, and NF-κB, that control cytokine production, immune cell activation, and neuroprotection.

Health Center Characteristics Associated With Hospital Care Among Medicare-Medicaid Dual Enrollees.

Using 2012-2018 Medicare claims and health center data, we identified factors associated with variation in rates of hospital care among Medicare-Medicaid dual enrollees receiving primary care at health centers. In our sample ( n = 5961 health center-years), we found no evidence that patient-centered medical home designation or other modifiable health center characteristics were associated with reductions in hospital care use, which depends more on health center patient mix. Thus, policymakers should target efforts to health centers serving the most disadvantaged and marginalized communities.

Accuracy of point-of-care SARS-CoV-2 detection using buccal swabs in pediatric emergency departments.

To optimize the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children, specimen collection and testing method are crucial considerations. Ideally, specimen collection is easy and causes minimal discomfort, and the laboratory approach is simple, accurate, and rapid. In this prospective cohort study we evaluated the accuracy of a point-of care nucleic acid device using caregiver/patient self-collected buccal swabs.

Evaluation of a probiotic blend on psychosocial health and biomarkers of inflammatory, immune and stress response in adults with subthreshold depression: a double-blind, randomised, placebo-controlled trial.

This study examined the efficacy of a probiotic in reducing depressive symptom severity in people with subthreshold depression. In a double-blind, randomised, placebo-controlled trial, a probiotic (1 × 10^9 live cells per strain: LF16 (DSM26956), LR06 (DSM21981), LP01 (LMG P-21021) and 04 (DSM23233)) or placebo was taken daily for 12 weeks. Data were collected at baseline, 6 and 12 weeks including psychological symptom severity (Beck Depression Inventory, BDI; Patient Health Questionnaire, PHQ; Hospital Anxiety Depression Scale, HADS; and Depression Anxiety and Stress Scale, DASS).

SARS-CoV-2 seropositivity among healthcare professionals in a rural state.

Objectives: We evaluated SARS-CoV-2 anti-nucleocapsid (anti-N) seroconversion and seroreversion rates, risk factors associated with SARS-CoV-2 seroconversion, and COVID-19 risk perceptions among academic healthcare center employees in a rural state.

Methods: Among employees aged ≥18 years who completed a screening survey (n = 1,377), we invited all respondents reporting previous COVID-19 (n = 85; 82 accepted) and a random selection of respondents not reporting previous COVID-19 (n = 370; 220 accepted) to participate. Participants completed surveys and provided blood samples at 3-month intervals (T0, T3, T6, T9).

Impact of a Case-Based Sleep Apnoea Education on the Knowledge, Attitudes and Confidence of Dental Hygiene Students-A Multicentre Intervention Study.

Objective: This pilot study aimed to explore knowledge, attitudes and confidence levels of Obstructive Sleep Apnoea (OSA) before and after case-based education among dental hygiene students. Moreover, to give an international perspective, this study included students from the US and Scandinavia.

Methods: A longitudinal multicentre study assessed dental hygiene students' OSA knowledge, attitudes and confidence through a case-based education model.

A transient memory lapse in humans 1-3 h after training.

In many non-human species, learning retention decreases temporarily following training. This has led to the suggestion that these lapses reflect a fundamental component of memory formation. If so, transient memory lapses should also be prevalent in humans, and should occur for all types of learning.

Neuropsychological outcomes following endovascular clot retrieval and intravenous thrombolysis in ischemic stroke.

Objectives: Cognitive impairment, anxiety, depression, fatigue, and dependence in instrumental activities of daily living (ADL) are common after stroke; however, little is known about how these outcomes may differ following treatment with endovascular clot retrieval (ECR), intravenous tissue plasminogen activator (t-PA), or conservative management.

Methods: Patients were recruited after acute treatment and invited to participate in an outcome assessment 90-120 days post-stroke. The assessment included a cognitive test battery and several questionnaires.

Randomized Trial to Evaluate Effects of Peer- and Clinician-Led Interventions for Caregivers of Individuals With Acquired Brain Injury.

Objective: To evaluate the effectiveness of 2 interventions for caregivers of patients with acquired brain injury (ABI) transitioning home after inpatient rehabilitation, to prepare them for the role of caregiving and reduce stress and depression.

Design: Controlled trial with participants randomly assigned to (1) usual care (UC), (2) clinician-delivered Problem-Solving Training (PST), or (3) peer-led Building Better Caregivers (BBC) training; both experimental interventions initiated during the inpatient rehabilitation stay, delivered virtually, of similar intensity (six 60-minute sessions), and focused on managing stress and building skills related to caregiving.

Setting: Nonprofit rehabilitation hospital specializing in care of persons with acquired brain and spinal cord injuries.

Delivery of Enhanced Asthma Care in Pharmacies: Perceptions and Experiences of Australian Service Providers.

Background: Evidence-based asthma management services have been tested in Australian community pharmacies for over two decades and have been well received by patients but are not retained in practice. The positive clinical outcomes of these tested services suggest the potential for wider implementation, for which the providers' perspective is critical.

Objective: This investigation evaluates the implementability of the Pharmacy Asthma Service (PAS) through the experiences and perceptions of the community pharmacists delivering the service.

Diet quality from early pregnancy through 1-y postpartum: a prospective cohort study.

Background: Although diet quality during pregnancy and postpartum is important for multiple parent and child outcomes, within-person changes in diet quality throughout these periods have not been extensively examined.

Objectives: This study investigated diet quality from early pregnancy through 1 y postpartum and examined differences by sociodemographic characteristics in participants receiving obstetric care in Chapel Hill, North Carolina, United States.

Methods: Participants completed 24-h dietary recalls at 6 study visits (each pregnancy trimester and 6 wk, 6 mo, and 1 y postpartum) (n = 383).

Recommendations for Writing a National Institutes of Health Individual Predoctoral Fellowship (F31) Training Grant in Dissemination and Implementation Science.

Early career training is an essential component of building the future of dissemination and implementation (D&I) science. The United States National Institutes of Health Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship (F31) award offers a mechanism for doctoral students to acquire specialized D&I training and mentorship, to pursue independent research in D&I science, and to receive financial support for their graduate studies.