Plasma Biomarkers of Kidney Health and Mortality in Diabetes and Chronic Kidney Disease in the REGARDS Study.

Key Points: In diabetes and CKD, creatinine- and cystatin C–based eGFR has a strong inverse correlation with plasma TNF receptor 1, TNF receptor 2, and soluble urokinase-type plasminogen activator receptor. Higher plasma soluble TNF receptors 1 and 2 and soluble urokinase-type plasminogen activator receptor were each individually associated with mortality, independent of baseline kidney measures.

Background: Several plasma biomarkers of kidney health have been associated with CKD progression in persons with diabetes, but their associations with mortality risk have been largely unexplored.

Effect of Common Medications on Longitudinal Pectoralis Muscle Area in Smokers.

Background: Cigarette smoke contributes to skeletal muscle wasting. While exercise and nutritional therapies are effective in improving skeletal muscle quantity and quality, the effect of medications on longitudinal muscle loss is unclear. We investigated whether long-term use of common medications affects longitudinal skeletal muscle changes in current and former smokers.

Measuring Stakeholder Engagement in Statewide Primary Care Cardiovascular Health Improvement Cooperatives.

Cardiovascular disease (CVD) remains a major national health challenge with significant disparities linked to socioeconomic status, race, ethnicity, sex, and geography, prompting federal efforts to build statewide primary care quality improvement (QI) cooperatives to improve heart health. To be effective, cooperatives require high levels of member engagement and leaders need ways to assess engagement. The objective of this study was to develop and validate a novel Cooperative Member Survey to assess cooperative member engagement and assess the value of the cooperative to members across three statewide heart health QI cooperatives.

Patient-Reported Pregnancy Outcomes and Survival in Women with Aortic Valve and/or Aortic Root Replacement.

Our objective was to investigate patient-reported maternal and perinatal outcomes and survival among women undergoing aortic valve and/or aortic root replacement (AVR/ARR). This was a single-center observational study of U.S.

Comparison of Strengths of Mandibular Angle Fractures Following Different Plate Designs: A Human Cadaver Study.

Study Design: This institutional cross-sectional study using cadaveric mandibles aimed to measure and compare the strengths of three plating designs utilized in osteosynthesis of mandibular angle fractures.

Objective: There have been prior studies on angle fracture fixation though few biomechanical studies on human cadaveric specimen. This study aims to directly compare the biomechanical strength of different plating designs to the mandibular angle fracture using a human cadaveric specimen substrate.

Tribally led planetary health education in southeast Alaska.

Limited reporting of Indigenous-led planetary health education programmes has constrained efforts to expand planetary health education, in Indigenous communities and beyond, despite urgent need. Although incorporation of Indigenous knowledge and cultures cannot be standardised, showcasing successful programmes could reveal good practices and aid replicability. In this Personal View, we highlight how shellfish toxin education programmes, designed and organised by the Sitka Tribe of Alaska, reduce local environmental health risks and support youth in pathways towards careers in planetary health.

Environmental Exposure Inequities Among Sexual and Gender Minority Populations in the United States: A Scoping Review.

Despite growing attention and guiding frameworks, we still know very little about how environmental exposures may be contributing to the health inequities experienced by sexual and gender minority (SGM) people, especially exposures beyond psycho-behavioral mechanisms that have traditionally been viewed as the pathways between minority stress and negative health outcomes. To address this gap in knowledge, we conducted a scoping review to determine the extent to which disparities in environmental exposures between SGM and non-SGM (ie, heterosexual and cisgender) populations have been measured in the United States. We searched PubMed for studies that were (1) peer-reviewed; (2) written in English; (3) quantitatively measured environmental exposures; (4) included 1 or more groups identifying as a sexual minority, gender minority, or both; (5) compared to the general population; (6) in the United States; and (7) published on or after January 1, 2011.

LGBTQ+ Health Inequities in a Rural, Conservative Context: Alabama Compared with Other Southern States.

Objectives: There are no statewide statistics regarding the health of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) Alabamians. To fill this gap, we used data collected by the Southern Equality Research and Policy Center to compare Alabama with other southern US states regarding the health and well-being of LGBTQ+ people.

Methods: We tested for unadjusted differences between Alabama and other southern states using χ tests for dichotomous outcomes and the Wilcoxon rank-sum test for ordinal outcomes.

Use of e-cigarettes, traditional combustible cigarettes, and high sensitivity C-reactive protein: The Cross Cohort Collaboration.

This cross-sectional study included 18,797 participants from 6 longitudinal cohorts (CARDIA, FHS Gen III, HCHS/SOL, MESA, MiHeart, and REGARDS), and 5,806 of them had high-sensitivity C-reactive protein (hs-CRP) measurements. We found that exclusive electronic cigarette (EC) use was associated with significantly lower hs-CRP levels compared to exclusive combustible cigarette use, suggesting a potentially lower inflammatory burden. hs-CRP levels in dual users and former smokers currently using EC were comparable to those observed in exclusive cigarette smokers.

Contextual Factors Influencing Screening for Diabetic Eye Disease in Alabama: Provider Perspectives.

Comprehensive eye exams are recommended at least every 2 years for people with diabetes for early identification and treatment of diabetic eye disease, but screening rates remain suboptimal. Our objective was to qualitatively assess barriers and facilitators to completing recommended eye exam screening for patients with diabetes among providers and practice staff. As part of a larger initiative, we conducted discussion groups with healthcare providers and practice staff to evaluate factors related to referral and screening for diabetic eye disease at 2 sites, a safety-net healthcare system and a specialty clinic.

Hospital and Patient Factors Associated With Length of Hospitalization in Patients Who Have Osteoarthritis Undergoing Primary Total Knee Arthroplasty: An Analysis of National Data.

Background: By 2040, an estimated 3.5 million primary total knee arthroplasties (TKAs) are expected to be performed annually in the United States. Osteoarthritis (OA) is the most common indication for primary TKA.

Age differences in the change in cognition after stroke.

Objective: To compare changes in cognitive trajectories after stroke between younger (18-64) and older (65+) adults, accounting for pre-stroke cognitive trajectories.

Materials And Methods: Pooled cohort study using individual participant data from 3 US cohorts (1971-2019), the Atherosclerosis Risk In Communities Study (ARIC), Framingham Offspring Study (FOS), and REasons for Geographic And Racial Differences in Stroke Study (REGARDS). Linear mixed effect models evaluated the association between age and the initial change (intercept) and rate of change (slope) in cognition after compared to before stroke.

Bromodomain inhibitor treatment leads to overexpression of multiple kinases in cancer cells.

The bromodomain and extraterminal (BET) family of proteins show altered expression across various cancers. The members of the bromodomain (BRD) family contain epigenetic reader domains that bind to acetylated lysine residues in both histone and non-histone proteins. Since BRD proteins are involved in cancer initiation and progression, therapeutic targeting of these proteins has recently been an area of interest.

Fentanyl-positive urine drug screens in the emergency department: Association with intentional opioid misuse and racial disparities.

Background: An increase in opioid-related overdoses, notably from potent synthetic opioids like fentanyl, prompted this consideration of characteristics of emergency department (ED) patients with evidence for illicit fentanyl use or exposure, the correlation with intentional opioid misuse, and subsequent ED management.

Methods: A retrospective review was performed of patients presenting to an urban academic medical center ED with evidence for illicit fentanyl use, determined by positive urine drug screens (UDS), from 6/2021 through 11/2021. Participant demographics, comorbidities, ED chief complaint and disposition, and evidence of intentional opioid misuse were considered.

Influence of structural racism on cancer health disparities: Tailoring measures relevant to multiple myeloma.

This commentary highlights a need for comprehensive measures of structural racism tailored to cancer health disparities, in particular Black-White disparities in multiple myeloma (MM). Recent political and social calls and advances in the ability to quantitate structural racism have led to rapidly growing research on the health consequences of structural racism. However, to date, most studies have used unidimensional measures of structural racism that do not capture cumulative influences or enable the identification of factors most responsible for driving disparities.

Clonal hematopoiesis of indeterminate potential is associated with reduced risk of cognitive impairment in patients with chronic kidney disease.

Introduction: Clonal hematopoiesis of indeterminate potential (CHIP) and dementia disproportionately burden patients with chronic kidney disease (CKD). The association between CHIP and cognitive impairment in CKD patients is unknown.

Methods: We conducted time-to-event analyses in up to 1452 older adults with CKD from the Chronic Renal Insufficiency Cohort who underwent CHIP gene sequencing.

Path-specific causal decomposition analysis with multiple correlated mediator variables.

A causal decomposition analysis allows researchers to determine whether the difference in a health outcome between two groups can be attributed to a difference in each group's distribution of one or more modifiable mediator variables. With this knowledge, researchers and policymakers can focus on designing interventions that target these mediator variables. Existing methods for causal decomposition analysis either focus on one mediator variable or assume that each mediator variable is conditionally independent given the group label and the mediator-outcome confounders.

Organizational and patient factors associated with positive primary care experiences for veterans with current or recent homelessness.

Objective: To identify organizational service features associated with positive patient ratings of primary care within primary care clinics tailored to accommodate persons with ongoing and recent experiences of homelessness (PEH).

Data Sources And Study Setting: PEH receiving primary care in 29 United States Veterans Health Administration homeless-tailored clinics were surveyed about their primary care experience using the validated Primary Care Quality-Homeless (PCQ-H) survey. Characteristics of the clinics were assessed through surveys of clinic staff using a new organizational survey developed through literature review, site visits, statistical analysis, and consensus deliberation.

Head and neck squamous cell carcinoma (HNSCC) in solid organ transplant recipients - Results from the scientific registry of transplant recipients (SRTR) database.

Background: Solid organ transplant recipients have an elevated risk of cancer following organ transplantation than the age-adjusted general population. We assessed incidence of head and neck squamous cell carcinoma (HNSCC) in heart, lung, and liver recipients.

Basic Procedures/methods: This retrospective cohort study included 124,966 patients from the United States Scientific Registry of Transplant Recipients (SRTR) database who received heart, lung, or liver transplantation between 1991 and 2010.

The forearm elevation-compression test: a novel test for carpal tunnel syndrome.

Background: As the time available to spend with patients decreases, a rapid test for bedside diagnosis of carpal tunnel syndrome (CTS) could be useful.

Design And Methods: We describe the forearm elevation-compression test (FECT) in this context. The FECT was assessed in 40 patients with clinically suspected CTS and compared to Tinel's and Phalen's signs.

Hospital Associated Disability among Older Adults with Plasma Cell Disorders Receiving Autologous Stem Cell Transplant.

Increasing number of older adults with Plasma Cell Disorders (PCDs) are receiving autologous stem cell transplant (ASCT) in the US. Hospital associated disability (HAD) is a common complication associated with acute care hospitalization among older adults. To estimate the prevalence and prognostic significance of HAD among older adults with MM undergoing ASCT.