Global Perspectives on Returning Genetic Research Results in Parkinson Disease.

Background And Objectives: In the era of precision medicine, genetic test results have become increasingly relevant in the care of patients with Parkinson disease (PD). While large research consortia are performing widespread research genetic testing to accelerate discoveries, debate continues about whether, and to what extent, the results should be returned to patients. Ethically, it is imperative to keep participants informed, especially when findings are potentially actionable.

Defining Successful Radiographic Physeal Arrest: A Comparison Between Ulnar Epiphysiodesis With and Without a Sliding Bone Autograft.

Background: Distal radius physeal injuries can result in growth arrest and progressive deformity in children. Ulnar epiphysiodesis may be used to prevent deformity in the skeletally immature child; however, predicting success may be challenging. The purpose of this study was to (1) develop a method to predict successful ulnar epiphysiodesis, and (2) determine the utility of adding a sliding bone autograft as an adjunct to achieving successful epiphysiodesis.

Proton radiotherapy significantly reduces pneumonia in oesophageal cancer patients.

Background: Neoadjuvant chemoradiotherapy (nCRT) followed by surgical resection is the current standard of care for oesophageal cancer (EC) patients. This treatment is associated with a variety of complications, with pneumonia being the most common. We hypothesize that proton radiotherapy (PRT) can significantly reduce the incidence of pneumonia compared to photon radiotherapy (PhRT).

Efficacy and Safety of a Mixture of Microencapsulated Sodium Butyrate, Probiotics, and Short Chain Fructooligosaccharides in Patients with Irritable Bowel Syndrome-A Randomized, Double-Blind, Placebo-Controlled Study.

Biotics are increasingly being used in the treatment of irritable bowel syndrome (IBS). This study aimed to assess the efficacy and safety of a mixture of microencapsulated sodium butyrate, probiotics ( DSM 26357, DSM 32418, DSM 32946, DSM 32403, and DSM 32269), and short-chain fructooligosaccharides (scFOSs) in IBS patients. This was a randomized, double-blind, placebo-controlled trial involving 120 adult participants with IBS.

Primary Mediastinal Ewing's Sarcoma: Post Hoc Analysis from Two International Multicenter Prospective Randomized Trials.

Objective: Ewing sarcoma (EWS) of the mediastinum is extremely rare, with only a few cases reported in the literature. We aimed to gain a better understanding of primary mediastinal EWS, describing patients treated within two international, multicenter, prospective, randomized EWS trials.

Methods: Data from patients with primary mediastinal EWS were retrieved from the database of the EURO-E.

Toward expert-level medical question answering with large language models.

Large language models (LLMs) have shown promise in medical question answering, with Med-PaLM being the first to exceed a 'passing' score in United States Medical Licensing Examination style questions. However, challenges remain in long-form medical question answering and handling real-world workflows. Here, we present Med-PaLM 2, which bridges these gaps with a combination of base LLM improvements, medical domain fine-tuning and new strategies for improving reasoning and grounding through ensemble refinement and chain of retrieval.

Status in Brain Gliomas Can Be Predicted by the Spherical Mean MRI Technique.

Background And Purpose: Diffuse gliomas, a heterogeneous group of primary brain tumors, have traditionally been stratified by histology, but recent insights into their molecular features, especially the mutation status, have fundamentally changed their classification and prognosis. Current diagnostic methods, still predominantly relying on invasive biopsy, necessitate the exploration of noninvasive imaging alternatives for glioma characterization.

Materials And Methods: In this prospective study, we investigated the utility of the spherical mean technique (SMT) in predicting the status and histologic grade of adult-type diffuse gliomas.

Increased Risk of Patellofemoral Instability Events and Surgical Management in Patients With Joint Hypermobility Syndromes: A Matched Cohort Analysis.

Purpose: To compare the odds of patellofemoral instability events requiring subsequent surgery and revision surgical intervention in patients with joint hypermobility syndromes (JHS) to that of a matched cohort.

Methods: This is a retrospective cohort study using the PearlDiver Mariner Database. Records were queried between 2010 and 2021 with a diagnosis of JHS, including Ehlers-Danlos syndrome (EDS) and Marfan syndrome.

Novel Peptidomimetic Cyclo-{E(I)-E(W)}Na (CP-88) with Hematopoietic Activity Sustained in Invasive and Oral Administration: Experimental and Preclinical Evaluation.

Over the last decades, significant progress has been made in studying agonistic and antagonistic hematopoietic peptides. The main disadvantage of this class of peptides is their low stability with noninvasive administration methods, which limits the widespread use of hematopoiesis-regulated peptide drugs in medical practice. The aim of this work is to study novel peptidomimetics with hematopoietic activity sustained in invasive and oral administration.

Utilization, Satisfaction, and Clinical Outcomes of People of Color and White Adults Using an Employer-Sponsored Digital Mental Health Platform.

Evaluating digital mental health services across racial and ethnic identities is crucial to ensuring health equity. We examined how People of Color (POC) and White adults were using and benefiting from an employer-sponsored digital mental health platform. A sample of 947 adults (42% POC) consented to an observational study and completed surveys on their identities and mental health outcomes at baseline and three-month follow-up.

Refinement of a Published Gene-Physical Activity Interaction Impacting HDL-Cholesterol: Role of Sex and Lipoprotein Subfractions.

Large-scale gene-environment interaction (GxE) discovery efforts often involve analytical compromises for the sake of data harmonization and statistical power. Refinement of exposures, covariates, outcomes, and population subsets may be helpful to establish often-elusive replication and evaluate potential clinical utility. Here, we used additional datasets, an expanded set of statistical models, and interrogation of lipoprotein metabolism via nuclear magnetic resonance (NMR)-based lipoprotein subfractions to refine a previously discovered GxE modifying the relationship between physical activity (PA) and HDL-cholesterol (HDL-C).

A Victorian nature cure philosophy as a reconciliation of Romantic Naturalism and laboratory medicine: the case of E.W. Lane's (1823-89) hygienic medicine.

This article primarily concentrates on the theoretical and intellectual dimensions of nature cure, particularly efforts to revive it during the second half of the nineteenth century. Little is known about specific medical professionals or theories concerning the Victorian philosophy of nature cure, although this philosophy is mentioned in general terms in studies on alternative medicine and hygiene. This article illuminates a Victorian nature cure philosophy through the works of Edward W.

Impact of sodium-glucose cotransporter 2 inhibitors on catheter ablation for atrial fibrillation in heart failure patients without type-2 diabetes.

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) reportedly decreased the new-onset atrial arrhythmias in patients with type-2 diabetes (T2DM) or heart failure (HF). This study examined the impact of SGLT2is on catheter ablation for atrial fibrillation (AF) in HF patients without T2DM.

Methods: Persistent AF (PeAF) and HF (N-terminal prohormone of brain natriuretic peptide, NT-proBNP ≥400 pg/ml) patients without T2DM undergoing catheter ablation were prospectively enrolled (n = 102).

Real-world evaluation of an evidence-based telemental health program for PTSD symptoms.

Blended care therapy (BCT), which augments live, video-based psychotherapy sessions with asynchronous digital tools, has the potential to increase access to evidence-based treatments for posttraumatic stress disorder (PTSD). However, its effectiveness in diverse, real-world settings is not well-understood. This evaluation aimed to assess clinical outcomes of a BCT program for PTSD symptoms.

Appreciating Appreciation: Residents' Experience Feeling Valued Differently as Learners, Physicians, and Employees.

Purpose: Cultures of wellness, defined as shared norms, values, attitudes, and behaviors that promote personal and professional growth and well-being, are robust determinants of professional fulfillment and professional performance. A major and largely overlooked aspect of a culture of wellness in medicine is residents' perceived appreciation or experience of feeling valued. Considering the pressing workforce and retention challenges that residency programs face, this study addressed the following research questions: How does appreciation at work manifest in the eyes of residents and how do residents perceive appreciation in relation to their professional fulfillment and performance?

Method: Guided by an interpretative phenomenological approach, this qualitative study purposively sampled 12 residents from different specialties, training years, regions in the Netherlands, and genders.

The ADHD Assessment Quality Assurance Standard for Children and Teenagers (CAAQAS).

Around 5% of the children and teenagers worldwide are affected by Attention-Deficit/Hyperactivity Disorder [ADHD], making it a major public health concern. Recently, demand for assessments has substantially increased, putting strain on healthcare and waiting lists. There is concern that pressure to clear service bottlenecks is leading to variable quality and reliability of ADHD assessments in this population.

Surgical management of costal margin rupture associated with intercostal hernia: Evolution of techniques.

Introduction: Costal margin rupture (CMR) injuries in association with intercostal hernia (IH) are rare and symptomatic and provide a significant surgical challenge. Surgical failure rates up to 60% are reported, and optimal techniques are unclear. We have characterized these injuries and describe the evolution of our surgical management techniques.

Impact of SCN10A Polymorphism on Abdominal Pain Perception and Visceral Hypoalgesia in Crohn's Disease and Ulcerative Colitis.

Introduction: Hypoalgesic inflammatory bowel disease (IBD) may provide critical insights into human abdominal pain. This condition was previously associated with homozygosity for a polymorphism (rs6795970, A1073V; 1073 val/val ) related to Na v 1.8, a voltage-gated sodium channel preferentially expressed on nociceptors.

Clinical Correlates of Efficacy of Pyridostigmine in the Treatment of Orthostatic Hypotension.

Background: The cholinesterase inhibitor pyridostigmine is used to treat orthostatic hypotension by facilitating cholinergic neurotransmission in autonomic ganglia, thereby harnessing residual sympathetic tone to increase blood pressure (BP) preferentially in the upright posture. We hypothesized that less severe autonomic impairment was associated with greater pressor responses to pyridostigmine.

Methods: To identify predictors of pressor response, linear regression analyses between the effect of pyridostigmine on upright BP and markers of autonomic impairment were retrospectively conducted on 38 patients who had a medication trial with pyridostigmine (60 mg single dose).

Chromatin State Maps of Blood Pressure-Relevant Renal Segments Reveal Potential Regulatory Role for SNPs.

Background: Hypertension or elevated blood pressure (BP) is a worldwide clinical challenge and the leading primary risk factor for kidney dysfunctions, heart failure, and cerebrovascular disease. The kidney is a central regulator of BP by maintaining sodium-water balance. Multiple genome-wide association studies revealed that BP is a heritable quantitative trait, modulated by several genetic, epigenetic, and environmental factors.

ST-GMLP: A concise spatial-temporal framework based on gated multi-layer perceptron for traffic flow forecasting.

The field of traffic forecasting has been the subject of considerable attention as a critical component in alleviating traffic congestion and improving urban services. Given the regular patterns of human activities, it is evident that traffic flow is inherently periodic. However, most of existing studies restrict themselves to recent historical observations and typically yield structurally and computationally complex models, which greatly limits the forecasting accuracy and hinders the application of models in realistic situations.

The impact of psoriatic arthritis on quality of life: a systematic review.

Background: Psoriatic arthritis (PsA) is a chronic inflammatory condition that can affect individuals of all ages. Patients may experience a range of physical and psychological issues.

Objective: To examine the impact of PsA on an individual's quality of life (QoL) and physical function.