Trends in Respiratory Pathogen Testing at US Children's Hospitals.

Importance: Respiratory pathogen testing has been a common deimplementation focus. The COVID-19 pandemic brought new considerations for respiratory testing; recent trends in testing rates are not well understood.

Objective: To measure trends in respiratory testing among encounters for acute respiratory infections among children and adolescents (aged <18 years) from 2016 to 2023, assess the association of COVID-19 with these trends, and describe associated cost trends.

Wealth Disparities in End-of-Life Symptom Burden Among Older Adults.

Importance: Understanding how wealth influences the end-of-life experience is crucial for improving patient care and policy, particularly with regard to symptom burden.

Objective: To examine the prevalence of 12 end-of-life symptoms by wealth categories; the association between wealth and a composite measure of high symptom burden; and whether this association is mediated by multimorbidity, functional impairment, or dementia.

Design, Setting, And Participants: This cohort study used data from the Health and Retirement Study (HRS), a nationally representative survey of older adults in the US, on decedents who died between January 1, 2000, and February 28, 2021, from proxy-reported exit interviews through February 28, 2021.

Multicancer Detection (MCD) Testing in Gastrointestinal Cancers: An Evolving Tool for Early Diagnosis.

Purpose Of Review: The current review aims to summarize the benefits and limitations of the novel multicancer detection tests (MCD) for diagnosing gastrointestinal (GI) malignancies.

Recent Findings: Traditional cancer screening methods can reduce deaths in malignancies involving the GI tract. For GI cancers, screening options vary by type and often involve invasive techniques with limited sensitivity.

Phenotypic heterogeneity in familial epilepsies is influenced by polygenic risk for generalized and focal epilepsies.

Objective: Although previous research shows that generalized and focal epilepsies have at least some distinct genetic influences, it remains uncertain why some families manifest both types of epilepsy. We tested two hypotheses: (1) families with both generalized and focal epilepsy carry separate risk alleles for both types; and (2) within mixed families, the type of epilepsy each individual manifests is influenced by the relative burden of separate risk alleles for generalized epilepsies and focal epilepsies.

Methods: The Epi4K cohort included 711 individuals with epilepsy from 257 families (113 generalized families, 66 focal families, 78 mixed families).

Results From a Long-Term Observational Follow-Up Study of a Single Dose of Psilocybin for a Treatment-Resistant Episode of Major Depressive Disorder.

The largest randomized study of psilocybin to date demonstrated the efficacy of COMP360 25 mg (Compass Pathways' investigational proprietary pharmaceutical-grade synthesized psilocybin formulation) in participants with treatment-resistant depression (COMP 001), compared with 10 mg and 1 mg doses. Here, we report findings from COMP 004, a 52-week observational follow-up of patients from COMP 001 and COMP 003, a small open-label study of the coadministration of 25 mg COMP360 with continuing antidepressant treatment. Adverse events (AEs) were collected over the full 52-week period.

Development and Validation of an Electronic Health Record-Based, Pediatric Acute Respiratory Distress Syndrome Subphenotype Classifier Model.

Objective: To determine if hyperinflammatory and hypoinflammatory pediatric acute respiratory distress syndrome (PARDS) subphenotypes defined using serum biomarkers can be determined solely from electronic health record (EHR) data using machine learning.

Design: Retrospective, exploratory analysis using data from 2014 to 2022.

Setting: Single-center quaternary care PICU.

Effect of Monetary Incentives on Peer Review Acceptance and Completion: A Quasi-Randomized Interventional Trial.

Objectives: Peer review typically relies on experts volunteering their time to review research. This process presents challenges for journals that may face a shortage of qualified referees, resulting in either delay in handling papers or less thorough review than is optimal. We experimentally tested the impact of providing cash incentives to complete peer review assignments at Critical Care Medicine.

Future Directions of Chronic Total Occlusion Management: Identifying the Right Patient for Intervention With a Focus on Biomarkers.

The management of a chronic total occlusion (CTO) of a coronary artery has been a conundrum in interventional cardiology, as revascularization has not been proven to provide a mortality benefit. However, there are subgroups of patients with a CTO that have high levels of ischemia on myocardial perfusion imaging and high circulating levels of high sensitivity troponin-I (hsTn-I) and N terminal pro-brain natriuretic peptide (NT pro-BNP) that are at a particularly high-risk for adverse cardiovascular events. These high-risk subgroups of patients with a CTO may have not been well represented in prior clinical trials, and may gain a mortality benefit from revascularization of the CTO.

HIV-related Differences in Placental Immunology: Data From the PRACHITi Cohort in Pune, India.

Background: Maternal HIV infection can affect placental immunology and expression of the neonatal crystallizable fragment receptor (FcRn), which allows transplacental antibody transfer. This study delineated differences in placental FcRn and T-cell expression by HIV status, with or without viral suppression.

Methods: This observational cohort study in Pune, India, followed pregnant women with and without HIV through 1 year postpartum; 42 had placenta collected, stratified by HIV status.

Enhancing Hepatitis B Virus Vaccine Uptake and Immunity Through Long-Acting Antiretroviral Therapy Programmatic Synergy in the US South.

We leveraged a long-acting antiretroviral therapy program infrastructure in the US South to vaccinate 32 of 39 (82%) eligible persons with HIV against hepatitis B virus. Novel interprofessional programmatic synergy may facilitate hepatitis B virus vaccine uptake in a population uniquely at risk in the era of 2-drug and injectable antiretroviral therapy.

Breast Hemangioma Diagnosed in a Male Patient: A Case Report.

Vascular tumors rarely occur in the breast, with hemangiomas being the most common benign form. The vast majority of these lesions occur in women and are clinically asymptomatic and non-palpable on exam, often detected as incidental findings during routine mammography. This report describes and discusses the case of a symptomatic breast hemangioma diagnosed in a 69-year-old male patient with no pertinent medical history, who presented to his primary care provider with complaints of vague left-sided chest wall pain to palpation.

Design considerations for optogenetic applications of soft micro-LED-based device systems across diverse nervous systems.

Optogenetics enables precise, cell-specific control of neural activity, surpassing traditional electrical stimulation methods that indiscriminately activate nearby cells, making it crucial for rehabilitation, neurological disorder treatment, and understanding neural circuits. Among light sources for delivering light to genetically modified cells, bio-implants integrated with Light Emitting Diodes (LEDs) have recently been the focus of extensive research due to their advantage of enabling local photogeneration. Unlike laser-based systems, which require tethered setups that hinder behavioral experiments, μ-LED-based devices allow for wireless operation, facilitating more natural movement in subjects.

Built differently or defective: can RNA exosomopathies cause ribosome heterogeneity?

The RNA exosome is an essential, evolutionarily conserved ribonuclease required for processing and degradation of key cellular RNAs. The complex maintains RNA homeostasis within every cell by ensuring the proper maturation, quality control and turnover of various RNA species including rRNAs. A growing list of diseases, collectively termed RNA exosomopathies, are caused by mutations in genes encoding structural subunits of the RNA exosome complex.

Building Capacity: A Systematic Review of Training in the Diagnosis of Autism for Community-Based Clinicians.

In an effort to reduce the "waitlist crisis," researchers have developed training programs to educate community-based clinicians in best-practice autism diagnostic assessments. This systematic review aims to synthesize the effectiveness and implementation outcomes of such trainings. The following databases were searched from inception until August 2023: PubMed, Web of Science, APA PsycINFO, CINAHL, ERIC, and a select number from Google Scholar.

BRAF-PROTAC versus inhibitors in melanoma cells: Deep transcriptomic characterisation.

Aims: This study compares the suppression of Mitogen-activated protein kinase (MAPK) signalling and early resistance potential between a proteolysis-targeting chimera (PROTAC) and inhibitors targeting BRAF.

Methods: We performed a detailed in silico analysis of the transcriptomic landscape of the A375 melanoma cell line treated with a PROTAC and BRAF inhibitors from RNA sequencing data. The study assessed gene dysregulation, MAPK and Phosphoinositide-3-kinase (PI3K/AKT) pathway inhibition, and cell survival.

Prediction of mental health risk in adolescents.

Prospective prediction of mental health risk in adolescence can facilitate early preventive interventions. Here, using psychosocial questionnaires and neuroimaging measures from over 11,000 children in the Adolescent Brain and Cognitive Development Study, we trained neural network models to stratify general psychopathology risk. The model trained on current symptoms accurately predicted which participants would convert into the highest psychiatric illness risk group in the following year (area under the receiver operating characteristic curve = 0.

Cross-species and mammal-to-mammal transmission of clade 2.3.4.4b highly pathogenic avian influenza A/H5N1 with PB2 adaptations.

Highly pathogenic H5N1 avian influenza viruses (HPAIV) belonging to lineage 2.3.4.

Patient-Reported Barriers and Preferred Interventions to Improve Lung Cancer Screening Uptake.

Objective: Lung cancer screening (LCS) utilization remains low. We aimed at assessing LCS patient-reported barriers and preferred interventions to improve uptake.

Methods: Between July and November 2023, an electronic 60-item survey was completed by consented patients aged 50 to 80 years who were due to receive LCS, and their eligibility for LCS was confirmed.

Etiologies underlying pediatric papilledema at a tertiary care children's hospital.

Background: Pediatric papilledema is a common reason for ophthalmology evaluation in high acuity emergency department and inpatient settings. This study describes the frequency of consultation, causative diagnoses, and presenting characteristics of papilledema at a tertiary care children's hospital.

Methods: All consecutive patients seen in pediatric ophthalmology consultation or diagnosed with papilledema at a large children's hospital between January 1, 2021, and August 18, 2023, were retrospectively reviewed.

Less is more: selection from a small set of options improves BCI velocity control.

Decoding algorithms used in invasive brain-computer interfaces (iBCIs) typically convert neural activity into continuously varying velocity commands. We hypothesized that putting constraints on which decoded velocity commands are permissible could improve user performance. To test this hypothesis, we designed the discrete direction selection (DDS) decoder, which uses neural activity to select among a small menu of preset cursor velocities.

Pedicled Pectoralis Major Transfer for Axillary Nerve Palsy and Greater Tuberosity Nonunion: A Case Report.

Case: A 46-year-old male patient presented with shoulder pain, limited range of motion, and loss of sensation for a year after undergoing hemiarthroplasty for a proximal humerus fracture. Workup demonstrated a greater tuberosity nonunion and deltoid paralysis secondary to upper trunk brachial plexopathy. The pectoralis major (PM) for deltoid transfer successfully restored shoulder function and resolved pain without requiring any subsequent intervention.

Perceived Confidence Levels of Cultural Humility Skills and Knowledge of Physician Assistant Students Who Have or Have Not Participated in Program-Sponsored Community Service Events.

Introduction: While reducing health disparities is widely acknowledged as a crucial component in medical education, there is not a standard curriculum for teaching physician assistant (PA) students how to deliver patient care with cultural humility. Instead, PA programs use various methods. This study took place at a PA program that sponsored several community service events that targeted underserved populations.