Risk and impact of stroke across 38 countries and territories of the Americas from 1990 to 2021: a population-based trends analysis from the Global Burden of Disease Study 2021.

Background: Despite substantial declines in burden over time, stroke remains a public health threat in the Americas. This study aimed to assess the current magnitude, trends, and disparities in the estimates of stroke burden by sex and age in the Americas from 1990 to 2021.

Methods: Estimates from the Global Burden of Disease, Injuries and Risk Factors Study 2021 were used to analyze incidence, prevalence, mortality, years of life lost due to premature death, years lived with disabilities, and disability-adjusted life years (DALYs) caused by stroke and its major subtypes stratified by age, and sex in the Americas from 1990 to 2021.

Evaluation of Women with Peripartum or Dilated Cardiomyopathy and Their First-Degree Relatives: The DCM Precision Medicine Study.

Background: Peripartum cardiomyopathy (PPCM) presents substantial risk of maternal mortality, but underlying cause remains unsettled.

Methods: We compared the prevalence of dilated cardiomyopathy (DCM)-relevant genetic variants in 452 female patients (probands) of African and European ancestry (AA, EA) with PPCM or DCM who had been pregnant at least once. Pathogenic and likely pathogenic (P/LP) variants were identified in DCM-associated genes.

Reason Profiles for not Returning to Preinjury Activity Level Following Anterior Cruciate Ligament Reconstruction- A Latent Class Analysis With Subgroup Comparison of Patient-Reported Outcome Measures.

Background: Given the high proportion of athletes who do not return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR), strategies are needed to identify at-risk patients and optimize rehabilitation for successful RTS after ACLR.

Purpose/hypothesis: This study used latent class analysis (LCA) to characterize a unique clustering of reasons why athletes do not return to their preinjury activity level after ACLR. We hypothesized that patients with high pain scores and high levels of fear would be less likely to return to their preinjury activity level.

TriSwinUNETR lobe segmentation model for computing DIR-free CT-ventilation.

Purpose: Functional radiotherapy avoids the delivery of high-radiation dosages to high-ventilated lung areas. Methods to determine CT-ventilation imaging (CTVI) typically rely on deformable image registration (DIR) to calculate volume changes within inhale/exhale CT image pairs. Since DIR is a non-trivial task that can bias CTVI, we hypothesize that lung volume changes needed to calculate CTVI can be computed from AI-driven lobe segmentations in inhale/exhale phases, without DIR.

Factors influencing the adoption of innovation in spine surgery: An international survey of AO spine network.

Introduction: Knowledge translation from research to clinical practice can often be challenging, and practice modification patterns among surgeons may stem from a variety of sources, including personal experience, peer influence, ongoing education, and evolving research findings.

Research Question: This study aimed to investigate the adoption patterns amongst surgeons for newer innovations and to analyse the factors affecting the implementation of the same in clinical practice. We used the adoption of osteobiologics as a case example.

Community-engaged curriculum development using racial justice and biomedical lenses to address COVID-19 vaccine hesitancy in black individuals with rheumatologic conditions.

Despite the efficacy of the COVID-19 vaccine in reducing mortality and illness severity, racial inequities in vaccination uptake persist. Among individuals with rheumatologic conditions who are often immunocompromised, the impact of disparities in preventive care threatens to widen existing inequities in adverse outcomes related to COVID-19 infection. There exists an urgent need to develop interventions that reduce COVID-19 vaccine hesitancy and promote vaccine uptake.

Interaction between Neighborhood Exposome and Genetic Risk in Child Psychotic-like Experiences.

Persistent distressing psychotic-like experiences (PLE) among children may be driven by genetics and neighborhood environmental exposures. However, the gene-environment interaction to persistent distressing PLE is unknown. The study included 6,449 participants from the Adolescent Brain and Cognitive Development Study.

Artificial Intelligence in Emergency Medicine: A Primer for the Nonexpert.

Artificial intelligence (AI) is increasingly being utilized to augment the practice of emergency medicine due to rapid technological advances and breakthroughs. AI applications have been used to enhance triage systems, predict disease-specific risk, estimate staffing needs, forecast patient decompensation, and interpret imaging findings in the emergency department setting. This article aims to help readers without formal training become informed end-users of AI in emergency medicine.

A Randomized Phase 3 Study Evaluating the Efficacy and Safety of Alogliptin in Pediatric Participants with Type 2 Diabetes Mellitus.

Introduction: There is an unmet need for pharmacological therapies for children with type 2 diabetes mellitus (T2DM). We assessed the efficacy and safety of an oral dipeptidyl peptidase-4 inhibitor, alogliptin, 25 mg once daily (QD), as a potential treatment for pediatric patients with T2DM.

Methods: This phase 3, 52-week, multicenter, randomized, double-blind, placebo-controlled trial was conducted in children and adolescents (10-17 years old) with T2DM.

Accuracy of individual signs and symptoms and case definitions for the diagnosis of influenza in different age groups: a systematic review with meta-analysis.

Objective: The objective of this study is to perform a comprehensive systematic review and meta-analysis of the accuracy of signs, symptoms and case definitions for the diagnosis of influenza.

Design: Systematic review and meta-analysis of diagnostic accuracy.

Setting: Inpatient or outpatient setting.

Recommendations for use of extracorporeal shockwave therapy in sports medicine: an international modified Delphi study.

Objectives: While extracorporeal shockwave therapy (ESWT) may be an efficacious adjunctive treatment option for musculoskeletal injuries, current research is limited by significant heterogeneity within treatment protocols. This study aims to establish international expert consensus recommendations on ESWT terminology, parameters, procedural considerations, contraindications and side effects in the application of ESWT to sports injuries.

Methods: A systematic literature search was performed on the use of ESWT for musculoskeletal and sports medicine injuries to identify potential panellists, followed by the development of a steering committee-led questionnaire.

Substance use and mental health symptoms in adults with prenatal alcohol exposure.

Background: Substance use and mental health problems have been documented in individuals with prenatal alcohol exposure (PAE) in young adulthood, but little is known about how these patterns progress over time into midlife. The current study examined rates of substance use in a sample of adults with PAE in mid-life compared to a demographically similar contrast group.

Methods: Participants (n = 233) were drawn from two longitudinal cohorts of individuals recruited prenatally and followed into adulthood.

The cost-effectiveness of physical therapy versus laminectomy for lumbar spinal stenosis: A Markov decision analysis.

Background Context: Physical therapy is often utilized as a nonoperative modality for the treatment of lumbar stenosis, oftentimes a prerequisite for insurance approval for surgery.

Purpose: The goal of our study was to evaluate the relative cost-effectiveness of physical therapy as compared to a hospital-based or inpatient single-level lumbar laminectomy from the outset for lumbar stenosis.

Study Design/setting: Cost-effectiveness analysis, Markov model simulation PATIENT SAMPLE: We developed a Markov model to analyze the baseline case: a 55-year-old patient with symptomatic lumbar stenosis undergoing physical therapy versus lumbar laminectomy from outset.

Association of Low-Calorie Sweeteners with Selected Circulating Biomarkers of Intestinal Permeability in The Cancer Prevention Study-3 Diet Assessment Substudy.

Background: Low-calorie sweeteners (LCS) are popular sugar substitutes and have been shown to alter the gut microbiota, which raises concerns about potential impacts on intestinal permeability.

Objectives: To examine cross-sectional associations between LCS consumption and circulating biomarkers of intestinal permeability.

Methods: We analyzed data from 572 U.

A randomized controlled trial of a compassion-centered spiritual health intervention to improve hospital inpatient outcomes.

Background: Inpatient medical settings lack evidence-based spiritually integrated interventions to address patient care needs within a pluralistic religious landscape. To address this gap, CCSH™ (Compassion-Centered Spiritual Health) was developed to leverage the skillsets of healthcare chaplains to improve patient outcomes through spiritual consultation. Here, we report the results of a randomized, wait-list controlled, pre-registered (NCT03529812) study that evaluated the impact of CCSH on patient-reported depression and explored putative mediators of CCSH's effects.

Pharmacometabolomics in TB meningitis-Understanding the pharmacokinetic, metabolic, and immune factors associated with anti-TB drug concentrations in cerebrospinal fluid.

Poor penetration of many anti-tuberculosis (TB) antibiotics into the central nervous system (CNS) is thought to be a major driver of morbidity and mortality in TB meningitis (TBM). While the amount of a particular drug that crosses into the cerebrospinal fluid (CSF) varies from person to person, little is known about the host factors associated with interindividual differences in CSF concentrations of anti-TB drugs. In patients diagnosed with TBM from the country of Georgia (n = 17), we investigate the association between CSF concentrations of anti-TB antibiotics and multiple host factors including serum drug concentrations and CSF concentrations of metabolites and cytokines.

Perceptions and Experiences of Refugee Families in the Pediatric Emergency Department: A Qualitative Interview Study.

Objectives: Refugees face significant barriers that make acculturation and utilization of the US health care system challenging. Prior literature regarding health care access for the refugee population has focused on adult refugee patients. However, children and adolescents account for approximately 40% of refugees arriving in the United States annually.

Comparative Review of Seizure and Cognitive Outcomes in Resective, Ablative, and Neuromodulatory Temporal Lobe Epilepsy Surgery.

Resective surgery for drug-resistant temporal lobe epilepsy remains underutilized in the United States. While anteromesial temporal lobectomy consistently achieves the highest rates of long-term seizure freedom, it comes with greater risks for memory and language decline. Magnetic resonance imaging-guided laser interstitial thermal therapy and neuromodulation have gained popularity due to perceived lower surgical risk and faster recovery, although they yield lower rates of sustained seizure freedom.

County-level association between modifiable health behaviors and premature mortality in the United States.

Objective: Unhealthy lifestyle habits are associated with increased morbidity and mortality. This study aims to examine the county-level association of physical inactivity, insufficient sleep, and current smoking, three elements of the American Heart Association's Life's Essential 8, with premature mortality.

Methods: Premature country-level age-adjusted death rate (AADR) in 2018-2020 were obtained from National Center for Health Statistics Mortality Files.

Wrong Way Home: Variant Caval Return to the Left Atrium.

• We report drainage of SVC and IVC to the LA with normal drainage of CS. • A defect in juxtaposed atrial appendages allowed flow from LA to RA. • TTE with agitated saline contrast study confirmed diagnosis.

Indigenous gut microbes modulate neural cell state and neurodegenerative disease susceptibility.

The native microbiome influences a plethora of host processes, including neurological function. However, its impacts on diverse brain cell types remains poorly understood. Here, we performed single nucleus RNA sequencing on hippocampi from wildtype, germ-free mice and reveal the microbiome-dependent transcriptional landscape across all major neural cell types.

A Critical Role for the Fascin Family of Actin Bundling Proteins in Axon Development, Brain Wiring and Function.

Actin-based cell motility drives many neurodevelopmental events including guided axonal growth. Fascin is a major family of F-actin bundling proteins, but its role in axon development and brain wiring is unknown. Here, we report that fascin is required for axon development, brain wiring and function.