Exclusion of people from oncology clinical trials based on functional status.

Background/aims: People with disability have higher rates of cancer, excluding skin cancer, compared with people without disability. Food and Drug Administration draft guidelines from 2024 address use of performance status criteria to determine eligibility for clinical trials, advocating for less restrictive thresholds. We examined the exclusion of people with disability from clinical trials based on performance status and other criteria.

Evaluation of Long-Term Lymphedema Rate in Patients With Subclinical Lymphedema Diagnosed in the Preoperative Period via Bioimpedance.

Objective: The aim of this study was to evaluate the relationship between subclinical lymphedema identified prior to surgical intervention and clinical lymphedema observed in the late period, the incidence of lymphedema in our cohort, and the associated risk factors.

Materials And Methods: This prospective study was conducted with early-stage breast cancer patients who had been enrolled in a previous study. For diagnosing lymphedema, physical examination, L-Dex® score, and circumferential measurement was used.

Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence.

Background: Predicting treated language improvement (TLI) and transfer to the untreated language (cross-language generalization, CLG) after speech-language therapy in bilingual individuals with poststroke aphasia is crucial for personalized treatment planning. This study evaluated machine learning models to predict TLI and CLG and identified the key predictive features (eg, patient severity, demographics, and treatment variables) aligning with clinical evidence.

Methods: Forty-eight Spanish-English bilingual individuals with poststroke aphasia received 20 sessions of semantic feature-based naming treatment in either their first or second language.

Sex-Based Differences in Endovascular Thrombectomy Outcomes for Large Ischemic Stroke: A SELECT2 Subanalysis.

Background: Several social and biological factors are shown to differentially affect stroke outcomes between men and women. We evaluated whether clinical outcomes and endovascular thrombectomy (EVT) treatment effects differed between the sexes in patients presenting with large ischemic stroke.

Methods: The SELECT2 trial (A Randomized Controlled Trial to Optimize Patient's Selection for Endovascular Treatment in Acute Ischemic Stroke) was a randomized controlled trial assessing the efficacy and safety of EVT in patients with large strokes across the United States, Canada, Europe, Australia, and New Zealand between October 2019 and September 2022.

Utilization of artificial intelligence in the diagnosis of pes planus and pes cavus with a smartphone camera.

Background: Pes planus (flatfoot) and pes cavus (high arch foot) are common foot deformities, often requiring clinical and radiographic assessment for diagnosis and potential subsequent management. Traditional diagnostic methods, while effective, pose limitations such as cost, radiation exposure, and accessibility, particularly in underserved areas.

Aim: To develop deep learning algorithms that detect and classify such deformities using smartphone cameras.

A molecularly distinct cell type in the midbrain regulates intermale aggression behaviors in mice.

: The periaqueductal gray (PAG) is a central hub for the regulation of aggression, whereas the circuitry and molecular mechanisms underlying this regulation remain uncharacterized. In this study, we investigate the role of a distinct cell type, -expressing (Tac2) neurons, located in the dorsomedial PAG (dmPAG) and their modulation of aggressive behavior in mice. : We combined activity mapping, Ca recording, chemogenetic and pharmacological manipulation, and a viral-based translating ribosome affinity purification (TRAP) profiling using a mouse resident-intruder model.

Conceptual Frameworks in Neurology Education Research.

This article discusses conceptual frameworks in neurology education research. We provide practical case examples highlighting the conceptual framework development process for different research scenarios in neurology education. We explore the steps that shape the conceptual framework process, including defining the educational problem, exploring the scholarly conversation on the topic of study through understanding the literature and outlining its gaps, constructing research questions, selecting the theoretical frameworks that underpin the study, and choosing the appropriate methodology and methods for the research questions.

Neuroinflammation at the Gray-White Matter Interface in Active-Duty U.S. Special Operations Forces.

Emerging evidence from autopsy studies indicates that interface astroglial scarring (IAS) at the gray-white matter junction is a pathological signature of repeated blast brain injury in military personnel. However, there is currently no neuroimaging test that detects IAS, which is a major barrier to diagnosis, prevention, and treatment. In 27 active-duty U.

Melanoma toolkit for early detection for primary care clinicians: a 1-year follow-up on outcomes.

Introduction: Primary care providers or clinicians (PCPs) have the potential to assist dermatologists in screening patients at risk for skin cancer, but require training to appropriately identify higher-risk patients, perform skin checks, recognize and biopsy concerning lesions, interpret pathology results, document the exam, and bill for the service. Very few validated dermatology training programs exist for PCPs and those that are available focus primarily on one emphasis area, which results in variable efficacy and single-topic limited scope.

Methods: We have created a free, online, continuing education program (Melanoma Toolkit for Early Detection, MTED) that allows learners to choose from a variety of multimedia tools (image recognition, videos, written material, in-person seminars, self-tests, etc.

Long-term impact of Diabetes Prevention Program interventions on walking endurance.

Objectives: Type 2 diabetes (T2D) and prediabetes are associated with poor walking endurance, a marker of physical function. We aimed to examine the long-term effects of metformin or intensive lifestyle intervention in adults at high risk of T2D on their 6-min walk test (6MWT) performance.

Methods: Participants were randomized in the 3-year Diabetes Prevention Program (DPP) to one of the three groups: lifestyle intervention, metformin, or placebo, and were subsequently followed in the DPP Outcomes Study.

Evaluation of the Ki-67 labeling index on immediate pre-ablation biopsies as a predictive biomarker of local recurrence of colorectal cancer liver metastases.

The aim of this study was to evaluate if the Ki-67 labeling index (LI) on immediate pre-ablation biopsies of colorectal liver metastases (CLM) is associated with the presence of viable tumor cells in subsequent ablation zone biopsies and/or local tumor progression-free survival (LTPFS). Biopsies of CLM were performed before and after microwave ablation (MWA), as part of a prospective clinical trial between October 2013 and May 2019. Pre-ablation biopsy slides were examined for the Ki-67 LI using light microscopy.

First clinical utility of sensing Ultrasound Localization Microscopy (sULM): identifying renal pseudotumors.

Renal pseudotumors, which mimic tumors on imaging, pose diagnostic challenges that can lead to unnecessary interventions. Sensing ultrasound localization microscopy (sULM) is an advanced imaging technique that uses ultrasound imaging and microbubbles as sensors to visualize kidney functional units. This study aims to investigate whether sULM could differentiate between renal pseudotumors and tumors based on the presence of glomeruli.

External validation of EncephalApp Stroop test to screen minimal hepatic encephalopathy patients with nonalcoholic cirrhosis.

Background: Neurocognitive impairment, including minimal hepatic encephalopathy (MHE) and overt hepatic encephalopathy, is one of the most common complications of all types of primary liver diseases, such as hepatitis B, biliary cholangitis, and autoimmune hepatitis. The EncephalApp Stroop test is a smartphone application-based test that is time-saving for MHE screening. However, neurocognitive impairment is different between alcoholic cirrhosis patients and nonalcoholic cirrhosis patients, so the cutoff value for MHE diagnosis might be inflated.

Analysis of User-Generated Posts on Social Media of Adjuvant Analgesics: A Machine Learning Study.

Antiepileptics and antidepressants are frequently prescribed for chronic pain, but their efficacy and potential adverse effects raise concerns, including dependency issues. Increased prescriptions, sometimes fraudulent, prompted reclassification of antiepileptics in some countries. Our aim is to comprehend opinions, perceptions, beliefs, and attitudes towards co-analgesics from online discussions on X (formerly known as Twitter), offering insights closer to reality than conventional surveys.

Clinical utility of synuclein skin biopsy in the diagnosis and evaluation of synucleinopathies.

Introduction: The diagnosis of diseases known as synucleinopathies, Parkinson's disease (PD), multiple system atrophy (MSA) and Lewy body dementia (DLB), is predominantly based on clinical criteria. However, diagnostic uncertainty may persist until late in the disease process leading to delays in diagnosis and medical mismanagement. Skin biopsy detection of phosphorylated alpha-synuclein (P-SYN) is a sensitive and specific technique that increases diagnostic sensitivity of synucleinopathies, although the clinical utility of this test has not been fully explored.

Genotype-microbiome-metabolome associations in early childhood and their link to BMI.

Through the analysis of data from children aged 6 months to 8 years enrolled in the Vitamin D Antenatal Asthma Reduction Trial (VDAART), significant simultaneous associations were identified between variants in the fragile histidine triad () gene, children's body mass index, microbiome features related to obesity, and key lipids and amino acids. These patterns represent evidence of the genotype influence in shaping the host microbiome in developing stages and new potential biomarkers for childhood obesity, insulin resistance, and type 2 diabetes.

Assessing the Current State of USA-Based Disaster Medicine Fellowships.

Objectives: This study aimed to understand the current landscape of USA-based disaster medicine (DM) programs through the lens of alumni and program directors (PDs). The data obtained from this study will provide valuable information to future learners as they ponder careers in disaster medicine and allow PDs to refine curricular offerings.

Methods: Two separate surveys were sent to USA-based DM program directors and alumni.

Neighborhood resources and stressors associated with parenting inputs for children's learning and development.

Prior research has assessed the ways in which neighborhoods promote or inhibit children's development but has paid less attention to delineating the particular processes through which neighborhoods are linked to child outcomes. This study combines geospatial data with survey data from the Early Childhood Longitudinal Study Kindergarten Cohort of 2010-2011, a nationally representative sample of kindergarteners followed through 5th grade (N ~ 12,300), to explore how differences in neighborhood resources (parks and services) and stressors (crime and neighborhood disadvantage) are associated with variations in parental inputs-school involvement and provision of out-of-home enrichment activities. Using multilevel models assessing within- and between-family associations, we found mixed evidence concerning how neighborhood features are linked to parental inputs.

TB or not TB? Development and validation of a clinical decision support system to inform airborne isolation requirements in the evaluation of suspected tuberculosis.

Background: The study objective was to develop and validate a clinical decision support system (CDSS) to guide clinicians through the diagnostic evaluation of hospitalized individuals with suspected pulmonary tuberculosis (TB) in low-prevalence settings.

Methods: The "TBorNotTB" CDSS was developed using a modified Delphi method. The CDSS assigns points based on epidemiologic risk factors, TB history, symptoms, chest imaging, and sputum/bronchoscopy results.

Group myths can create shared understanding even if they don't act as superstimuli.

Sijilmassi et al. argue that myths around shared ancestry and history exploit an evolved psychology of interdependence. In contrast, we argue that psychological exploitation is not required.

"We are one people": Group myths also draw cues from self-concept formation.

Sijilmassi et al. suggest that group myths explaining the shared history of a people succeed and propagate by leveraging cognitive cues from fitness interdependence. We offer an alternative and mutually compatible account rooting the success of group myths in cues from a different cognitive domain: The development of self-concepts.

Surgical Treatment of Transgender and Gender-Diverse Individuals and Health Outcomes.

Gender affirming surgeries are procedures that are used by transgender and gender diverse individuals to align their bodies to their gender identities. These have been shown to improve the mental health and wellbeing of those individuals who choose to access them. Rates of regret associated with gender affirming surgeries are low, and in addition to improving mental health and quality of life, these procedures have the potential to make it safer for transgender and gender diverse people to move through the world.

Reducing functionally defective old HSCs alleviates aging-related phenotypes in old recipient mice.

Aging is a process accompanied by functional decline in tissues and organs with great social and medical consequences. Developing effective anti-aging strategies is of great significance. In this study, we demonstrated that transplantation of young hematopoietic stem cells (HSCs) into old mice can mitigate aging phenotypes, underscoring the crucial role of HSCs in the aging process.

Dysregulation of mTOR signalling is a converging mechanism in lissencephaly.

Cerebral cortex development in humans is a highly complex and orchestrated process that is under tight genetic regulation. Rare mutations that alter gene expression or function can disrupt the structure of the cerebral cortex, resulting in a range of neurological conditions. Lissencephaly ('smooth brain') spectrum disorders comprise a group of rare, genetically heterogeneous congenital brain malformations commonly associated with epilepsy and intellectual disability.