Artificial Intelligence in Health Professions Education assessment: AMEE Guide No. 178.

Health Professions Education (HPE) assessment is being increasingly impacted by Artificial Intelligence (AI), and institutions, educators, and learners are grappling with AI's ever-evolving complexities, dangers, and potential. This AMEE Guide aims to assist all HPE stakeholders by helping them navigate the assessment uncertainty before them. Although the impetus is AI, the Guide grounds its path in pedagogical theory, considers the range of human responses, and then deals with assessment types, challenges, AI roles as tutor and learner, and required competencies.

CAGI6 ID panel challenge: assessment of phenotype and variant predictions in 415 children with neurodevelopmental disorders (NDDs).

The Genetics of Neurodevelopmental Disorders Lab in Padua provided a new intellectual disability (ID) Panel challenge for computational methods to predict patient phenotypes and their causal variants in the context of the Critical Assessment of the Genome Interpretation, 6th edition (CAGI6). Eight research teams submitted a total of 30 models to predict phenotypes based on the sequences of 74 genes (VCF format) in 415 pediatric patients affected by Neurodevelopmental Disorders (NDDs). NDDs are clinically and genetically heterogeneous conditions, with onset in infant age.

Outcomes of Older Adults and Frail Patients Receiving Idecabtagene Vicleucel: A CIBMTR Study.

Idecabtagene vicleucel (ide-cel) is an anti-BCMA CAR-T cell therapy approved for patients with relapsed/refractory multiple myeloma (RRMM) after 2 prior lines of therapy. There is limited data on outcomes of CAR T in older adults and frail patients with RRMM. In this study, we utilized data from the Center for International Blood and Marrow Transplantation Registry to describe the safety and efficacy of ide-cel in these clinically important subgroups.

Utilization of Palliative Care in Cardiogenic Shock Patients: A Retrospective Analysis of the National Inpatient Sample Database, 2020.

Cardiogenic shock (CS) is one of the leading causes of death in patients with myocardial infarction, myocarditis, and congestive heart failure. The utilization patterns of specialist palliative care (PC) consultation in these patients are currently unknown. To determine the utilization of PC in patients with CS and the overall comorbidities of that population.

Biomarkers.

Background: Growth/differentiation factor-15 (GDF15) has been associated with dementia risk, yet its predictive value across cohorts and sub-population, as well as its relationship with endophenotypes relevant to dementia, remains unknown.

Methods: Using the Atherosclerosis Risk in Communities (ARIC) study as the discovery cohort, we examined the relationship between plasma GDF15 levels (SomaScan) and risk for incident all-cause dementia (ACD) in late-life (N=4,287, 7-year follow-up, M=75±5) and in midlife (N=11,595, 20-year follow-up, M=57±6). Utilizing the UK Biobank (UKB; replication cohort), we related plasma GDF15 (Olink) to incident ACD (N=35,673, 14-year follow-up, M=61±5), vascular dementia (VaD) and Alzheimer's disease dementia (AD).

Biomarkers.

Background: The identification of novel blood-based biomarkers of small vessel disease of the brain (SVD) may improve pathophysiologic understanding and inform the development of new therapeutic strategies for prevention. We evaluated plasma proteomic associations of white matter fractional anisotropy (WMFA), white matter hyperintensity (WMH) volume, enlarged perivascular space (ePVS) volume, and the presence of microbleeds (MB) on brain magnetic resonance imaging (MRI) in the population-based Multi-Ethnic Study of Atherosclerosis (MESA).

Methods: Eligible MESA participants had 2941 plasma proteins measured from stored blood samples (collected in 2016-2018) using the antibody-based Olink proteomics platform, and completed brain MRI scans in 2018-2019.

Biomarkers.

Background: The gold standard Alzheimer's disease (AD) diagnosis with amyloid PET or CSF sampling is costly and not widely available. There is growing interest in utilizing plasma biomarker tests to provide etiologic clarity in the earliest symptomatic phases. We report the uptake, and biomarker results in relation to clinical diagnosis, of a brain amyloid probability score (APS) with the Precivity AD™ test (C2N Diagnostics) offered to clinician-selected eligible patients during their clinical workup in a memory clinic.

Biomarkers.

Background: Clinical studies in COVID-19 patients have demonstrated evidence of neuroinflammation in patients infected with SARS-CoV-2. In this pre-clinical work, we investigate neuroinflammation in vivo in a mouse model of Alzheimer's disease (AD) that exhibits both amyloid and tau pathology, the 3xTg-AD mice crossed with K18 hAce2 and infected with SARS-CoV-2 using a folate receptor-targeted nanoprobe for molecular MRI (mMRI) followed by ex vivo histopathology.

Method: In vivo studies with SARS-CoV-2 were performed in an animal biosafety level 3 (ABSL3) facility.

Biomarkers.

Background: There is limited information on biomarker-defined Alzheimer's disease (AD) pathology in community-recruited individuals of diverse racial and ethnic groups. Here, we assessed the association of race/ethnicity with baseline biomarkers and cognitive measures and hypothesized a lower impact of AD pathology in non-Hispanic White (nHW) participants in the U.S.

Developing Topics.

Background: Apathy is marked by diminished motivation and goal-directed behavior, prevalent in neurodegenerative diseases like Alzheimer's disease (AD) and Parkinson's disease (PD). Effort-based decision-making paradigms (EBDM), which require choices between tasks of varying effort levels for varying rewards, are effective assessments of goal-directed behavior. Using a transdiagnostic approach, we are examining the neurodegeneration of networks on apathy and EBDM.

Developing Topics.

Background: A decline in memory is a hallmark of Alzheimer's disease (AD). Experiments in rodents and post-mortem studies in humans with AD suggest that serotonin (5-HT) plays a role in memory, but the molecular and neural mechanisms mediating its effects are unknown.

Method: 100,000 individuals in UK Biobank were studied for the role of serotonin 2C receptor (5-HTR) in the regulation of memory.

Drug Development.

Background: Findings regarding the protective effect of Angiotensin II receptor blockers (ARBs) against Alzheimer's disease and related dementias (ADRD) and cognitive decline have been inconclusive.

Method: A total of 6,390,826 hypertensive individuals were included in this study from Optum's de-identified Clinformatics® Data Mart. We identified antihypertensive medication (AHM) drug classes and subclassified ARBs by blood-brain barrier (BBB) permeability.

Dementia Care Research and Psychosocial Factors.

Background: Personality traits are long-standing characteristics of behavior and emotion. Personality might influence cognitive health in later life by affecting responses to stressful events and engagement in cognitively stimulating activities, such as interpersonal interaction. The current study examined associations between personality traits and cognition in late life, and potential mediation by positive and negative emotion, depression, and social connectedness.

Dementia Care Practice.

Current joint practice guidelines (PG) on genetic counseling and testing for Alzheimer's disease (AD), published in 2011 by the National Society of Genetic Counselors (NSGC) and American College of Medical Genetics), recommend against clinical APOE genetic testing. These recommendations were largely followed, as seen in a survey of AD Research Centers in 2019 where only 7% of centers reported disclosure of APOE to research participants. However, because the risk of amyloid related imaging abnormalities (ARIA) associated with anti-amyloid therapy is increased for those with one or two copies of APOE e4, the FDA now endorses APOE testing for those considering this treatment.

Advancing Monogenic Diabetes Research and Clinical Care by Creating a Data Commons: The Precision Diabetes Consortium (PREDICT).

Monogenic diabetes mellitus (MDM) is a group of relatively rare disorders caused by pathogenic variants in key genes that result in hyperglycemia. Lack of identified cases, along with absent data standards, and limited collaboration across institutions have hindered research progress. To address this, the UChicago Monogenic Diabetes Registry (UCMDMR) and UChicago Data for the Common Good (D4CG) created a national consortium of MDM research institutions called the PREcision DIabetes ConsorTium (PREDICT).

Medical students' perceptions of mentorship in cardiothoracic surgery: A Thoracic Surgery Medical Student Association Nationwide Survey.

Objective: The study objective was to explore medical students' perceptions of mentorship in cardiothoracic surgery in the United States.

Methods: A voluntary, anonymous electronic survey was distributed to medical students through the Thoracic Surgery Medical Student Association. The survey included 28 questions across 4 domains: demographic information, current mentorship status, goals and qualities sought in mentorship, and self-reported barriers to mentorship.

Predicting operative mortality in patients who undergo elective open thoracoabdominal aortic aneurysm repair.

Background: We have developed a model aimed at identifying preoperative predictors of operative mortality in patients who undergo elective, open thoracoabdominal aortic aneurysm (TAAA) repair. We converted this model into an intuitive nomogram to aid preoperative counseling.

Methods: We retrospectively analyzed data from 2884 elective, open TAAA repairs performed between 1986 and 2023 in a single practice.

Enhanced Recovery After Surgery (ERAS) cardiac turnkey order set for perioperative pain management in cardiac surgery: Proceedings from the American Association for Thoracic Surgery (AATS) ERAS Conclave 2023.

Objective: Optimal perioperative pain management is an essential component of perioperative care for the cardiac surgical patient. This turnkey order set is part of a series created by the Enhanced Recovery After Surgery Cardiac Society, first presented at the Annual Meeting of The American Association for Thoracic Surgery in 2023. Several guidelines and expert consensus documents have been published to provide guidance on pain management and opioid reduction in cardiac surgery.

Achieving excellence in paediatric cardiac care in resource limited and resource plentiful settings and building successful care networks across different countries.

Background: The delivery of paediatric cardiac care across the world occurs in settings with significant variability in available resources. Irrespective of the resources locally available, we must always strive to improve the quality of care we provide to our patients and simultaneously deliver such care in the most efficient and cost-effective manner. The development of cardiac networks is used widely to achieve these aims.

Exploring Predictors of Treatment Response to GLP-1 Receptor Agonists for Smoking Cessation.

Introduction: Understanding predictors of smoking cessation medication efficacy facilitates the ability to enhance treatment effectiveness. In our pilot trial, exenatide, a glucagon-like peptide-1 receptor agonist, adjunct to nicotine patch improved smoking abstinence compared to nicotine patch alone. This secondary analysis explores potential baseline characteristics associated with differential treatment response to exenatide.

Prevention and Management of Infectious Complications in Pediatric Patients With Cancer: A Survey Assessment of Current Practices Across Children's Oncology Group Institutions.

Introduction: While clinical practice guidelines (CPGs) for pediatric oncology infection prophylaxis and management exist, few data describe actual management occurring at pediatric oncology centers.

Methods: An electronic survey querying infection management practices in nontransplant pediatric oncology patients was iteratively created by the Children's Oncology Group (COG) Cancer Control and Supportive Care Infectious Diseases Subcommittee and sent to leaders at all COG institutions, limiting each site to one response to represent their institution.

Results: The response rate was 57% (129/227 institutions).

Pancreatic organogenesis mapped through space and time.

The spatial organization of cells within a tissue is dictated throughout dynamic developmental processes. We sought to understand whether cells geometrically coordinate with one another throughout development to achieve their organization. The pancreas is a complex cellular organ with a particular spatial organization.