Readmissions and Mortality After "Before Medically Advised" Hospital Discharges Among Medicare Beneficiaries with Opioid Use Disorder.

Background: "Before medically advised" (BMA) discharges are rising among hospitalized people with opioid use disorder (OUD) and associated with worse outcomes. However, little is known about BMA discharge among the growing share of U.S.

Comparison of definitions of early knee osteoarthritis for likelihood of progression at 2-year and 5-year follow-up: the Multicenter Osteoarthritis Study.

Background: Preventing worsening osteoarthritis (OA) in persons with early OA is a major treatment goal. We evaluated if different early OA definitions yielded enough cases of worsening OA within 2-5 years to make trial testing treatments feasible.

Methods: We assessed different definitions of early OA using data from Multicenter Osteoarthritis (MOST) Study participants who were followed up longitudinally.

Prevalence and Prognostic Impact of ST Segment Elevation in Lead aVR Among Patients with Cardiac Arrest.

Background: In acute coronary syndrome, ST-segment elevation in lead aVR (STE-aVR) indicates global myocardial ischemia, often related to multivessel or severe left main disease, and correlates with increased mortality. The prevalence and prognostic significance of STE-aVR in cardiac arrest (CA) patients is unknown.

Methods: We identified patients (≥18 years) with CA between 2011 to 2022 who achieved return of spontaneous circulation (ROSC).

β-Caryophyllene and Statins in Bone Fracture Healing - A Narrative Review.

Bone fractures are a leading cause of morbidity and healthcare expenditure globally. The complex healing process involves inflammation, cartilage formation, mineralization, and bone remodeling. Current treatments like immobilization, surgery, and bone grafting, though effective, pose significant challenges, such as prolonged recovery and high costs.

Recent Updates in the Diagnosis and Management of Kidney Diseases in Multiple Myeloma.

Multiple myeloma (MM) represents a difficult-to-treat plasma cell malignancy and the second most common hematologic malignancy in adults, significantly impacting kidney function. The spectrum of kidney involvement in MM is broad, encompassing electrolyte imbalances, tubular injury, and even rare glomerular diseases. The evolution of MM treatment modalities has led to notable improvements in the long-term survival of patients experiencing kidney-related complications.

Environment scan of generative AI infrastructure for clinical and translational science.

This study reports a comprehensive environmental scan of the generative AI (GenAI) infrastructure in the national network for clinical and translational science across 36 institutions supported by the CTSA Program led by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) at the United States. Key findings indicate a diverse range of institutional strategies, with most organizations in the experimental phase of GenAI deployment. The results underscore the need for a more coordinated approach to GenAI governance, emphasizing collaboration among senior leaders, clinicians, information technology staff, and researchers.

Rethinking the residual approach: leveraging statistical learning to operationalize cognitive resilience in Alzheimer's disease.

Cognitive resilience (CR) describes the phenomenon of individuals evading cognitive decline despite prominent Alzheimer's disease neuropathology. Operationalization and measurement of this latent construct is non-trivial as it cannot be directly observed. The residual approach has been widely applied to estimate CR, where the degree of resilience is estimated through a linear model's residuals.

Relationship between functional structures and horizontal connections in macaque inferior temporal cortex.

Horizontal connections in anterior inferior temporal cortex (ITC) are thought to play an important role in object recognition by integrating information across spatially separated functional columns, but their functional organization remains unclear. Using a combination of optical imaging, electrophysiological recording, and anatomical tracing, we investigated the relationship between stimulus-response maps and patterns of horizontal axon terminals in the macaque ITC. In contrast to the "like-to-like" connectivity observed in the early visual cortex, we found that horizontal axons in ITC do not preferentially connect sites with similar object selectivity.

AI for all: bridging data gaps in machine learning and health.

Artificial intelligence (AI) and its subset, machine learning, have tremendous potential to transform health care, medicine, and population health through improved diagnoses, treatments, and patient care. However, the effectiveness of these technologies hinges on the quality and diversity of the data used to train them. Many datasets currently used in machine learning are inherently biased and lack diversity, leading to inaccurate predictions that may perpetuate existing health disparities.

Dispersion-based cognitive intra-individual variability in former American football players: Association with traumatic encephalopathy syndrome, repetitive head impacts, and biomarkers.

Exposure to repetitive head impacts (RHI), such as those experienced in American football, is linked to cognitive dysfunction later in life. Traumatic encephalopathy syndrome (TES) is a proposed clinical syndrome thought to be linked to neuropath-ology of chronic traumatic encephalopathy (CTE), a condition associated with RHI from football. Cognitive intra-individual variability (d-CIIV) measures test-score dispersion, indicating cognitive dysfunction.

The growing complexity of the control of the hypothalamic pituitary thyroid axis and brown adipose tissue by leptin.

The balance between food intake and energy expenditure is precisely regulated to maintain adipose stores. Leptin, which is produced in and released from adipose in direct proportion to its size, is a major contributor to this control and initiates its homeostatic responses largely via binding to leptin receptors (LepR) in the hypothalamus. Decreases in hypothalamic LepR binding signals starvation, leading to hunger and reduced energy expenditure, whereas increases in hypothalamic LepR binding can suppress food intake and increase energy expenditure.

Identifying proteomic prognostic markers for Alzheimer's disease with survival machine learning: The Framingham Heart Study.

Background: Protein abundance levels, sensitive to both physiological changes and external interventions, are useful for assessing the Alzheimer's disease (AD) risk and treatment efficacy. However, identifying proteomic prognostic markers for AD is challenging by their high dimensionality and inherent correlations.

Methods: Our study analyzed 1128 plasma proteins, measured by the SOMAscan platform, from 858 participants 55 years and older (mean age 63 years, 52.

Planetary Health Diet Index in relation to mortality in a prospective cohort study of U.S. Black females.

Background: To improve both human health and the health of our planet, the EAT-Lancet Commission proposed the planetary health diet (PHD).

Objective: We aimed to evaluate associations of PHD with all-cause, cardiovascular disease (CVD), and cancer-specific mortality among U.S.

Prolonged length of stay among individuals presenting to the emergency department with psychosis: Associations with sociodemographic and visit-level characteristics.

Introduction: Individuals experiencing psychosis commonly initiate and engage in treatment within an emergency department (ED) setting. Understanding factors contributing to adverse ED experiences is critical for improving psychosis-related treatment. Prolonged ED length of stay (LOS), which can be conversely associated with treatment quality, is not well explored among individuals experiencing psychosis.

Heart rate variability as a digital biomarker for frailty in cardiovascular patients.

Background: Frailty is a syndrome associated with age-related impairments in multiple organ systems, of which the autonomic nervous system plays a fundamental role. Measurement of heart rate variability (HRV) is a non-invasive method to evaluate the autonomic activity and gain insights into cardiovascular health and potentially, frailty. A few small studies have explored the relationship between HRV and frailty, with promising but conflicting results.

Coronavirus Disease 2019 (COVID-19) Real World Data Infrastructure: A Big-Data Resource for Study of the Impact of COVID-19 in Patient Populations With Immunocompromising Conditions.

Background: We developed a United States-based real-world data resource to better understand the continued impact of the coronavirus disease 2019 (COVID-19) pandemic on immunocompromised patients, who are typically underrepresented in prospective studies and clinical trials.

Methods: The COVID-19 Real World Data infrastructure (CRWDi) was created by linking and harmonizing de-identified HealthVerity medical and pharmacy claims data from 1 December 2018 to 31 December 2023, with severe acute respiratory syndrome coronavirus 2 virologic and serologic laboratory data from major commercial laboratories and Northwell Health; COVID-19 vaccination data; and, for patients with cancer, 2010 to 2021 National Cancer Institute Surveillance, Epidemiology, and End Results registry data.

Results: The CRWDi contains 4 cohorts: patients with cancer; patients with rheumatic diseases receiving pharmacotherapy; noncancer solid organ and hematopoietic stem cell transplant recipients; and people from the general population including adults and pediatric patients.

Developing a comprehensive inventory to define harm reduction housing.

Background: The City of Boston has faced unprecedented challenges with substance use amidst changes to the illicit drug supply and increased visibility of homelessness. Among its responses, Boston developed six low threshold harm reduction housing (HRH) sites geared towards supporting the housing needs of people who use drugs (PWUD) and addressing health and safety concerns around geographically concentrated tent encampments. HRH sites are transitional supportive housing that adhere to a "housing first" approach where abstinence is not required and harm reduction services and supports are co-located.

States Do Not Delineate the "Accepted Medical Standards" for Brain Death/Death by Neurologic Criteria Determination.

Background: The Uniform Determination of Death Act requires brain death/death by neurologic criteria (BD/DNC) determination to be in accordance with "accepted medical standards." The medical organizations responsible for delineating these guidelines are only specified statutorily in two states. State health organizations (SHOs) are composed of policy experts and medical professionals who are responsible for addressing medical, ethical, and legislative problems related to health.

Association between adverse perinatal events and postpartum depressive symptoms in a North American prospective preconception cohort study.

Background: Identifying risk factors for postpartum depression (PPD) is critical to inform early intervention efforts. This study investigated the impact of adverse perinatal events on PPD.

Methods: We analyzed data from the Pregnancy Study Online (PRESTO), a North American prospective preconception cohort study.