A Review of the Prospera Spinal Cord Stimulation System with Multiphase Stimulation and Proactive Care.

Purpose Of Review: The purpose of this review is to describe the development and key features of the Prospera™ Spinal Cord Stimulation (SCS) System, as well as the clinical evidence supporting its use. Prospera delivers therapy using a proprietary multiphase stimulation paradigm and is the first SCS system to offer proactive care through automatic, objective, daily, remote device monitoring and remote programming capabilities.

Recent Findings: Results from the recently published BENEFIT-02 trial support the short-term safety and efficacy of multiphase stimulation in patients with chronic pain.

Associations of personality trait level and change with mortality risk in 11 longitudinal studies.

People who are higher in conscientiousness, extraversion, and agreeableness and lower in neuroticism tend to live longer. The present research tested the hypothesis that personality trait change in middle and older adulthood would also be associated with mortality risk, above and beyond personality trait level. Personality trait change may causally influence mortality risk through corresponding changes in health behaviors, social processes, and stress experience.

Preliminary Development and Validation of Automated Nociception Recognition Using Computer Vision in Perioperative Patients.

Background: Effective pain recognition and treatment in perioperative environments reduce length of stay and decrease risk of delirium and chronic pain. We sought to develop and validate preliminary computer vision-based approaches for nociception detection in hospitalized patients.

Methods: Prospective observational cohort study using red-green-blue camera detection of perioperative patients.

Electrocardiogram-based machine learning for risk stratification of patients with suspected acute coronary syndrome.

Background And Aims: The importance of risk stratification in patients with chest pain extends beyond diagnosis and immediate treatment. This study sought to evaluate the prognostic value of electrocardiogram feature-based machine learning models to risk-stratify all-cause mortality in those with chest pain.

Methods: This was a prospective observational cohort study of consecutive, non-traumatic patients with chest pain.

Electroconvulsive therapy in autism spectrum disorders: an update to the literature.

Purpose Of Review: Over the last quarter century, the clinical evidence surrounding the use of electroconvulsive therapy (ECT) in individuals with autism spectrum disorder (ASD) has expanded. This review provides the most up-to-date findings on the usage of ECT in ASD and discusses these results within the historical context and direct patient care experience.

Recent Findings: ECT is typically implemented for psychotropic-refractory catatonic, affective, psychotic, and combined pathology for individuals across the lifespan.

ZNFX1 functions as a master regulator of epigenetically induced pathogen mimicry and inflammasome signaling in cancer.

DNA methyltransferase and poly (ADP-ribose) polymerase inhibitors (DNMTis, PARPis) induce a stimulator of interferon genes (STING)-dependent pathogen mimicry response (PMR) in ovarian and other cancers. Here, we showed that combining DNMTis and PARPis upregulates expression of the nucleic-acid sensor NFX1-type zinc finger-containing 1 protein (ZNFX1). ZNFX1 mediated induction of PMR in mitochondria, serving as a gateway for STING-dependent interferon/inflammasome signaling.

Anticoagulation during extracorporeal membrane oxygenation.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the efficacy and safety of anticoagulation for maintaining extracorporeal membrane oxygenation in people of all ages with cardiac or respiratory failure, or both.

A plant-based diet index and all-cause and cause-specific mortality: a prospective study.

: A plant-based dietary pattern has been recently suggested to have health benefits. However, its relationship with mortality is not completely consistent in prior studies. We aimed to investigate whether a plant-based diet was associated with a lower death risk in a Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening study.

Spreading the Word: Communicating Evidence-Based Guidelines About Turner Syndrome to Patients, Parents, Providers, and Payors.

Given the overwhelming volume of medical information, medical guidelines play a key role in informing clinicians and payors and guidelines directly affect how patients, and their families will be treated. In this review, we describe the production cycle of international guidelines for Turner syndrome (TS) and promote the timely and proactive dissemination of these guidelines. We encourage deliberate adoption of an updated standard of care by providers, payors, patients and their families, and professional organizations.

Bilingual Perspectives of Functional Dyspepsia Management in People from Underserved Areas.

Introduction: Disorders of gut-brain interaction (DGBIs), like functional dyspepsia (FD), are prevalent and challenging conditions. In other gastrointestinal (GI) disorders, individuals from underserved areas (UAs) have difficulty accessing care. Little is known about UA FD patient perspectives of their care, especially in those with limited English proficiency (LEP).

Treatment of focal anaplastic Wilms tumor: A report from the Children's Oncology Group AREN0321 and AREN03B2 studies.

Background: In the fifth National Wilms Tumor Study, patients received vincristine and dactinomycin (VA) without radiation for stage I focal anaplastic Wilms tumor (FAWT) and VA plus doxorubicin (DD4A) and radiation for stage II-IV FAWT. Four-year event-free survival (EFS) and overall survival (OS) for stage I FAWT were 67.5% and 88.

Disparities in Triple Negative Breast Cancer Among Hispanic Population Living in Latin America Versus the United States.

Introduction: Triple-negative breast cancer (TNBC) has a prevalence of 12%-24% in the Hispanic population. Previous research has demonstrated that disparities in healthcare access significantly influence patient outcomes. We aimed to compare the clinicopathological characteristics and outcomes of Hispanic females with TNBC living in Latin America (HPLA) to the Hispanic population in the United States (HPUS).

Evaluation of Intestinal Permeability Using Serum Biomarkers in Learning Early About Peanut Allergy Trial.

Background: Intestinal barrier dysfunction may lead to a break in tolerance and development of food allergy (FA). There is contradictory evidence on whether intestinal permeability (IP) is altered in IgE-mediated FA. Thus, we sought to determine whether IP differed between children with eczema who did (FA group) or did not (atopic controls, ACs) develop FA and whether peanut sensitization, allergy, and early introduction impacted IP using serum biomarkers zonulin, soluble CD14, and Intestinal Fatty Acid Binding Protein among randomly selected participants enrolled in the Learning Early About Peanut allergy trial.

Use of continuous cardiac monitoring to assess the influence of atrial fibrillation burden and patterns on patient symptoms and healthcare utilization: The DEFINE AFib study.

Background: Atrial fibrillation (AF) has a significant impact on health and quality of life. The relationship of AF burden and temporal patterns of AF on patient symptoms, outcomes, and healthcare utilization is unknown. Insertable cardiac monitors (ICMs) are a strategic and as yet untapped, tool to investigate these relationships.

Percutaneous left atrial appendage closure using a modified single-operator-technician approach under deep sedation: A single-center experience.

Background: Historically, percutaneous transcatheter left atrial appendage closure (LAAC) has been performed under general anesthesia (GA) with transesophageal echocardiographic images obtained by a noninvasive cardiologist and usually requires an overnight hospital stay. Alternatively, we present our single-center experience performing LAACs under deep sedation (DS), employing an echocardiographic technician instead of a noninvasive cardiologist, and expediting same-day discharge. Mid- to long-term outcomes were also evaluated with follow-up imaging at a 45-day visit.

2024 HRS perspective on advancing workflows for CIED remote monitoring.

Cardiac implantable electronic devices (CIEDs) generate substantial data, often stored in image or PDF formats. Remote monitoring, now an integral component of patient care, places considerable administrative burdens on clinicians and staff, in large part due to the challenge of integrating these data seamlessly into electronic health records. Since 2006, the Heart Rhythm Society, in collaboration with the CIED industry, has led an initiative to establish a unified standard nomenclature.

Prevalence and characteristics of group standardized letters of evaluation in emergency medicine: A cross-sectional observational study.

Background: The standardized letter of evaluation (SLOE) for emergency medicine (EM) is a well-established tool for residency selection. While previous work characterizes the utility and outcomes related to SLOE use, less is known about SLOE authorship patterns and trends.

Objective: The objective was to measure the prevalence of group SLOEs in EM over time, characterize the role groups represented in group SLOEs, and compare the rating practices of groups of authors versus single authors.

Selective diet induced nutritional optic neuropathy in developmentally normal children.

Purpose: Nutritional deficiencies in developed countries are a rare but potentially intervenable cause of optic neuropathy in pediatric populations. To date, much of the literature on nutritional optic neuropathy has focused on children with developmental delay, however, a growing body of evidence supports other underreported risk factors.

Observations: We describe three pediatric patients with normal neurodevelopment, who presented with decreased vision and were subsequently found to have optic neuropathy attributed to vitamin deficiencies, predominantly vitamin B12.

A widespread family of viral sponge proteins reveals specific inhibition of nucleotide signals in anti-phage defense.

Cyclic oligonucleotide-based antiviral signaling systems (CBASS) are bacterial anti-phage defense operons that use nucleotide signals to control immune activation. Here we biochemically screen 57 diverse and phages for the ability to disrupt CBASS immunity and discover anti-CBASS 4 (Acb4) from the phage SPO1 as the founding member of a large family of >1,300 immune evasion proteins. A 2.

Clair3-RNA: A deep learning-based small variant caller for long-read RNA sequencing data.

Variant calling using long-read RNA sequencing (lrRNA-seq) can be applied to diverse tasks, such as capturing full-length isoforms and gene expression profiling. It poses challenges, however, due to higher error rates than DNA data, the complexities of transcript diversity, RNA editing events, etc. In this paper, we propose Clair3-RNA, the first deep learning-based variant caller tailored for lrRNA-seq data.

Langerhans Cells Directly Interact with Resident T Cells in the Human Epidermis.

Adult human skin contains nearly twice as many T cells as the peripheral blood, which include tissue-resident memory T cells. However, the precise mechanisms maintaining tissue-resident memory T cells in the healthy skin remain unclear. Using normal human skin samples, we find that Langerhans cells (LCs) contact T cells in the epidermis of the elderly.

The Role of Ombuds in Graduate Medical Education: Fostering Wellness and Psychological Safety.

The authors propose an educational innovation in graduate medical education, the creation of an Education Ombudsperson. Although this role has been implemented for faculty and students within the medical field, it has not been described in residency programs. The Ombudsperson for house staff is distinct from institutional or programmatic leadership.

Recurrent negative autobiographical memories and mental health.

Background: Recurrent symptom-relevant negative autobiographical memories are common in patients with emotional disorders such as anxiety and depression, even among those without a trauma-related diagnosis. Recurrent negative autobiographical memories may also contribute to distress in non-clinical populations.

Methods: To examine the prevalence of recurrent negative autobiographical memories and associated psychological features, we recruited a student sample ( = 101) and a treatment-seeking sample of patients with emotional disorders ( = 123).