Efficacy of a Multimodal Digital Behavior Change Intervention on Lifestyle Behavior, Cardiometabolic Biomarkers, and Medical Expenditure: Protocol for a Randomized Controlled Trial.

Background: The US Preventive Services Task Force recommends providers offer individualized healthy behavior interventions for all adults, independent of their risk of cardiovascular disease. While strong evidence exists to support disease-specific programs designed to improve multiple lifestyle behaviors, approaches to adapting these interventions for a broader population are not well established. Digital behavior change interventions (DBCIs) hold promise as a more generalizable and scalable approach to overcome the resource and time limitations that traditional behavioral intervention programs face, especially within an occupational setting.

Spiny mice are primed but fail to regenerate volumetric skeletal muscle loss injuries.

Background: In recent years, the African spiny mouse Acomys cahirinus has been shown to regenerate a remarkable array of severe internal and external injuries in the absence of a fibrotic response, including the ability to regenerate full-thickness skin excisions, ear punches, severe kidney injuries, and complete transection of the spinal cord. While skeletal muscle is highly regenerative in adult mammals, Acomys displays superior muscle regeneration properties compared with standard laboratory mice following several injuries, including serial cardiotoxin injections of skeletal muscle and volumetric muscle loss (VML) of the panniculus carnosus muscle following full-thickness excision injuries. VML is an extreme muscle injury defined as the irrecoverable ablation of muscle mass, most commonly resulting from combat injuries or surgical debridement.

Escalation to Biologics After Methotrexate Among US Veterans With Rheumatoid Arthritis Grouped by Rural Versus Urban Areas.

Objective: Racial and ethnic disparities in rheumatoid arthritis (RA) outcomes are well recognized. However, whether disparities in RA treatment selection and outcomes differ by urban versus rural residence, independent of race, have not been studied. Our objective was to evaluate whether biologic disease-modifying antirheumatic drug (bDMARD) initiation after methotrexate administration differs by rural versus urban residence among veterans with RA.

Galleria mellonella as an Antimicrobial Screening Model.

To combat the rising global issue of antibiotic resistance, the accelerated development of novel antibiotics is essential. Current preclinical antimicrobial development yields a significant number of leads that prove unsuitable either prior to or during clinical trials. To increase the efficiency of preclinical development, relevant, standardized, accessible, and cost-effective models must be developed.

GP Engagement: A Proposed Model to Guide Engagement Activities in Australian Primary Health Networks.

Background: Engagement with general practice is a requirement of Australia's Primary Health Networks (PHNs). We propose a model for engagement that draws on principles of stakeholder and clinician engagement, tailored to meet the needs of PHNs and general practitioners (GPs).

Methods: A comprehensive literature review was undertaken to identify components, challenges, and approaches to optimizing clinician engagement.

Radar-Based Fall Detection: A Survey.

Fall detection, particularly critical for high-risk demographics like the elderly, is a key public health concern where timely detection can greatly minimize harm. With the advancements in radio frequency technology, radar has emerged as a powerful tool for human detection and tracking. Traditional machine learning algorithms, such as Support Vector Machines (SVM) and k-Nearest Neighbors (kNN), have shown promising outcomes.

Efficient epistasis inference via higher-order covariance matrix factorization.

Epistasis can profoundly influence evolutionary dynamics. Temporal genetic data, consisting of sequences sampled repeatedly from a population over time, provides a unique resource to understand how epistasis shapes evolution. However, detecting epistatic interactions from sequence data is technically challenging.

The Dunning‒Kruger effect in resident predicted and actual performance on the American Board of Emergency Medicine in-training examination.

Objectives: The Dunning-Kruger effect (DKE) is a cognitive bias wherein individuals who are unskilled overestimate their abilities, while those who are skilled tend to underestimate their capabilities. The purpose of this investigation is to determine if the DKE exists among American Board of Emergency Medicine (ABEM) in-training examination (ITE) participants.

Methods: This is a prospective, cross-sectional survey of residents in Accreditation Council for Graduate Medical Education (ACGME)-accredited emergency medicine (EM) residency programs.

Antiseizure medication-induced hypersensitivity reactions: Data from a large healthcare system.

Background And Objectives: Data on hypersensitivity reactions (HR) to individual anti-seizure medications (ASMs), and reactions to additional ASMs, is often limited by sample size. This data is vital in helping clinicians identify initial and subsequent ASMs to use in treating persons with epilepsy (PWE). Using a very large dataset, our study attempts to quantify the occurrence of HR across 31 different ASMs.

Assessment of Conjugation Pathways in -Methylporphyrins that Are Fused to Acenaphthylene, Phenanthrene, or Pyrene: Evidence for the Presence of Alternative Aromatic Circuits.

Acenaphtho-, phenanthro-, and pyrenopyrrole esters, readily available from Barton-Zard reactions of ethyl isocyanoacetate with nitroarenes, were reacted with methyl iodide and KOH in DMSO to give -methylpyrroles and subsequent cleavage of the ester moieties was accomplished with KOH in ethylene glycol at 200 °C. Condensation with two equiv of an acetoxymethylpyrrole in refluxing acetic acid-2-propanol afforded a series of annulated tripyrranes. Cleavage of the terminal -butyl ester groups with trifluoroacetic acid, followed by condensation with a diformylpyrrole and oxidation with FeCl, gave -methyl acenaphtho-, phenanthro-, and pyrenoporphyrins.

Health information exchange and 42 CFR part two: Incorporating the voice of people with histories of substance use disorder.

Introduction: We set out to understand patient attitudes and concerns about sharing information about substance use disorder (SUD) history through a Health Information Exchange (HIE), in the context of 42 CFR Part 2.

Methods: The study conducted semi-structured qualitative interviews of people with SUD history, recruited through an association of recovery communities in Rhode Island. Interviews were recorded and transcribed.

A Rare Presentation of Intracerebellar Schwannoma: A Case Report.

Intracerebellar schwannoma is an extremely rare disease entity with only 21 case reports described in the literature. A 68-year-old male presented with chronic headaches, dizziness, gait imbalance, and incoordination. Previous MRI had revealed a cystic lesion in the right cerebellum; however, patient was lost to follow-up.

Gravitropic Gene Expression Divergence Associated With Adaptation to Contrasting Environments in an Australian Wildflower.

Plants adapt to their local environment through complex interactions between genes, gene networks and hormones. Although the impact of gene expression on trait regulation and evolution has been recognised for many decades, its role in the evolution of adaptation is still a subject of intense exploration. We used a Multi-parent Advanced Generation Inter-Cross (MAGIC) population, which we derived from crossing multiple parents from two distinct coastal ecotypes of an Australia wildflower, Senecio lautus.

Physics and vision.

The sun floods our environment with a sea of electromagnetic radiation. The largest proportion of this spectrum that reaches the ground falls within the visible spectrum, which is termed 'light'. The light that reaches the earth is structured by the physical laws that determine how the visible spectrum interacts with surfaces, materials, and objects.

Autism or not? A case series of evaluation decision points in child and adolescent psychological assessment.

Increase in the incidence of autism spectrum disorders (ASD) and increased attention to symptoms of ASD in social media have contributed to a significant rise in referrals for neuropsychological assessment of possible ASD. Many practitioners lack specific training in the assessment of ASD and may avoid addressing these concerns, despite the frequency of those referrals. This paper reviews potential contributors to the rise in referrals and several related conditions which share some overlap with features of ASD.

Computed Tomography of the Head Before Lumbar Puncture in Adults With Suspected Meningitis in High-HIV Prevalence Settings.

Background: The role of computed tomography (CT) before lumbar puncture (LP) is unclear, with limited evidence for a causal link between LP and cerebral herniation or for the ability of CT to identify individuals at risk of herniation. The risks of LP delay or deferral are potentially greater in high-HIV prevalence, resource-limited settings; we analyzed data from such a setting to determine the impact of CT on time to LP and treatment, as well as mortality.

Methods: Adults with suspected central nervous system (CNS) infection were enrolled prospectively into the Botswana National Meningitis Survey between 2016 and 2019.

Subcapsular Splenic Hematoma After Diagnostic Colonoscopy: A Case Report.

Colonoscopy is a widely performed diagnostic and therapeutic procedure essential for the screening, diagnosis, and management of various colorectal conditions. It is a routine and relatively safe procedure. Unfortunately, sometimes complications arise, one of the rarest being splenic injury.

Percutaneous External Fixation of Redistributed Orbital Fat in Transcutaneous Lower Eyelid Blepharoplasty.

Background: Although percutaneous external fixation has gained popularity in transconjunctival blepharoplasty due to its simplicity and minimal incision, internal fixation remains the standard approach in transcutaneous blepharoplasty.

Objectives: The aim of this study was to assess the safety and effectiveness of percutaneous external fixation specifically in transcutaneous fat repositioning blepharoplasty.

Methods: A consecutive cohort of 97 patients underwent this surgical technique between May 2022 and December 2023.

External evaluation of Brain Injury Guideline (BIG) low risk criteria for traumatic brain injury.

Background: Fewer than 20 % of traumatic brain injury (TBI) cases with traumatic intracranial hemorrhage (ICH) result in clinical deterioration. The Brain Injury Guideline (BIG) criteria were published in 2014 and categorize patients with TBI into three risk groups (BIG 1, 2, and 3) based on CT scan findings, neurological examination, anti-coagulant/platelet medications, and intoxication. Early data is promising, suggesting no instances of neurosurgical intervention or death in the low-risk BIG1 category within 30 days.

Lessons learned from the Health Resources and Services Administration health workforce well-being grantees.

Introduction: Burnout and moral injury are among the most pressing issues facing healthcare and public safety today. In 2021, Congress provided $120 million through the American Rescue Plan Act for 44 Health Resources and Services Administration grants to implement evidence-informed strategies to address burnout and improve mental health among the health workforce. This article examines facilitators and barriers to implementation and reported impact of grantees' interventions.