Using Large Language Models to Detect and Understand Drug Discontinuation Events in Web-Based Forums: Development and Validation Study.

Background: The implementation of large language models (LLMs), such as BART (Bidirectional and Auto-Regressive Transformers) and GPT-4, has revolutionized the extraction of insights from unstructured text. These advancements have expanded into health care, allowing analysis of social media for public health insights. However, the detection of drug discontinuation events (DDEs) remains underexplored.

Revised Process for ACNS Guidelines Development.

The development of clinical practice guidelines is an evolving field. In response to the need for consistent, evidence-based medical practice, the American Clinical Neurophysiology Society identified the need to update the Society's guideline development process. The American Clinical Neurophysiology Society Guidelines Committee created an action plan with the goal of improving transparency and rigor for future guidelines and bringing existing guidelines to current standards.

The involuntary experience of digital exclusion among older adults: A taxonomy and theoretical framework.

The emerging phenomenon of digital exclusion raises an important issue that not everyone is equally engaged in and can benefit from the digital world. Older adults are particularly susceptible to digital exclusion, but a comprehensive conceptual treatment of digital exclusion in older adults is lacking in the psychology literature. In this article, we provide a taxonomy to advance the literature on digital exclusion in older adults, identifying key conceptual attributes of older adults' digital exclusion experiences by articulating both structural (i.

Medications That May be Contributing to Your Patient's Weight Gain.

Nearly 42% of adults in the United States are considered obese. Although there are a number of contributing factors to obesity, one sometimes overlooked contributor to weight gain is medications. Within many classes of medications that may affect weight, the degree of weight gain varies.

Increasing Communication about Fall Risk and Prevention between Internal Medicine Residents and Older Adults.

Objectives: More than one in four older adults fall yearly, but fewer than half inform their doctors. As such, medical trainees must gain experience assessing fall risk in older adults. Studies exploring how often residents initiate these assessments and which interventions effectively increase this frequency are needed.

METTL7A improves bovine IVF embryo competence by attenuating oxidative stress.

In vitro fertilization (IVF) is a widely used assisted reproductive technology to achieve a successful pregnancy. However, the acquisition of oxidative stress in embryo in vitro culture impairs its competence. Here, we demonstrated that a nuclear coding gene, methyltransferase-like protein 7A (METTL7A), improves the developmental potential of bovine embryos.

Berlin Heart EXCOR sVAD implantation technique for neonates and infants with functionally univentricular ductal-dependent systemic circulation.

The Berlin Heart EXCOR is a pulsatile paracorporeal ventricular assist device (VAD) for neonates, infants, children and adults with congenital or acquired severe ventricular dysfunction. Berlin Heart EXCOR VADs are routinely used as either a bridge to a cardiac transplantation, or occasionally as a bridge to ventricular recovery. Our programmatic philosophy is to bridge neonates and infants with functionally univentricular ductal-dependent systemic circulation or functionally univentricular ductal-dependent pulmonary circulation who are at high risk for staged palliation because of important cardiac risk factors with a single-ventricle VAD (sVAD) as a bridge to a cardiac transplant.

A high-resolution view of the immune and stromal cell response to infection in human volunteers.

causes the genital ulcer disease chancroid and cutaneous ulcers in children. To study its pathogenesis, we developed a human challenge model in which we infect the skin on the upper arm of human volunteers with to the pustular stage of disease. The model has been used to define lesional architecture, describe the immune infiltrate into the infected sites using flow cytometry, and explore the molecular basis of the immune response using bulk RNA-seq.

Control of virulence and physiology by the flagellin homeostasis checkpoint FliC-FliW-CsrA in the absence of motility.

Unlabelled: Mutations affecting flagellin (FliC) have been shown to be hypervirulent in animal models and display increased toxin production and alterations in central metabolism. The regulation of flagellin levels in bacteria is governed by a tripartite regulatory network involving , , and , which creates a feedback system to regulate flagella production. Through genomic analysis of clade 5 strains (non-motile), we identified they have jettisoned many of the genes required for flagellum biosynthesis yet retain the major flagellin gene and regulatory gene .

Transforming Early Stroke Care Through Mobile Stroke Treatment Unit Rendezvous With Rural Emergency Medical Services.

Background: Mobile stroke units, also sometimes called Mobile Stroke Treatment Units (MSTUs) are changing the paradigm of acute stroke care and are considered to be an extension of the time is brain concept. Of the <20 active Mobile Stroke Programs in the United States, most are rooted in urban settings. In July 2023, the first MSTU in Florida was launched in Alachua County, implementing a unique and innovative rendezvous process with rural emergency medical services (EMS).

Fixed start method for repetitive project scheduling with simulated annealing.

This research deals with the high project completion variability by presenting a new method to decrease such variability in repetitive construction projects. To achieve this, a Fixed Start Method (FSM) -where the starts of each activity with a high level of probabilistic confidence for the planned project duration are fixed- was applied, where the high level of probabilistic confidence obtained was optimized with the use of the metaheuristic algorithm called Simulated Annealing (SA). This procedure evaluated the project completion in a case study based on the coefficient of variance (COV) of the resulting standard deviation, mean, and temperature selected for the SA.

Quality of undifferentiated chest pain evaluation and diagnosis guidelines: a systematic review and critical appraisal.

Chest pain is a symptom that is potentially life-threatening and requires quick and accurate evaluations. This article describes the quality of guidelines related to the evaluation and diagnosis of acute, undifferentiated chest pain. After systematically evaluating existing guidelines, we found that there exists a wide variety of quality in these documents.

Roux-en-Y Intussusception: A Case Report.

Roux-en-Y gastric bypass (RYGB) is a bariatric surgical procedure commonly performed in adults to treat severe obesity. While RYGB is generally safe, it occasionally leads to rare but significant complications, including intussusception, a form of bowel obstruction caused by the invagination of an intestine segment from the proximal to the adjacent distal portion. We report a case of intussusception in a 74-year-old female patient who underwent RYGB 12 years prior.

Endophytic strategies decoded by genome and transcriptome analysis of strain NQ8GII4.

Introduction: strain NQ8GII4 is an endophytic fungus with significant potential for improving growth and disease resistance of alfalfa. However, the molecular mechanisms underlying the symbiotic relationship between NQ8GII4 and alfalfa roots remain poorly understood.

Methods: In this study, we conducted (1) a comparative genomic analysis of selected saprophytic, pathogenic, and endophytic fungi, including molecular phylogeny analysis, whole-genome alignment, and divergence date estimation positioning, and (2) transcriptomic profiling of alfalfa roots infected with NQ8GII4.

Not getting better but not getting worse: A cluster randomized controlled pilot trial of a leadership implementation strategy.

Background: Implementation of evidence-based practices (EBPs) in schools is fraught with challenges. Even when EBPs are initiated, deterioration of implementation efforts often hinders their long-term success. School leadership behaviors can influence teachers' EBP implementation.

Effects of an Organizational Implementation Strategy on Sustainment of Measurement-Based Care in Community Mental Health.

Objective: Little is known about how to sustain evidence-based interventions with fidelity in community mental health settings. Phase 1 of the Working to Implement and Sustain Digital Outcome Measures (WISDOM) trial showed that an organizational strategy improved the implementation of measurement-based care (MBC) in mental health services for youths 1-12 months after clinician MBC training. The authors report results from phase 2 of the trial, in which the strategy's effects on MBC sustainment 13-26 months after clinician MBC training were examined.

Implementation Determinants of PrEP and Behavioral Health Treatment Referral among HIV Test Counselors.

Pre-exposure prophylaxis (PrEP), an effective biomedical prevention intervention, is not sufficiently reaching populations experiencing high HIV incidence. Behavioral health (BH) treatment addressing mental health and substance use similarly requires increased reach to HIV-affected populations. HIV testing is an opportunity to refer individuals to PrEP and BH treatment.

Adaptation of the Florida Cognitive Activities Scale for Latinx adults with chronic diseases.

Background: Latinx adults experience disparately high rates of chronic diseases and cognitive dysfunction. Participating in cognitive-stimulating activities, such as reading, is thought to improve and preserve cognitive function. However, little is known about cognitively stimulating activities preferred by Latinx adults.

Biocatalytic diversification of abietic acid in Streptomyces.

Biocatalysis provides access to synthetically challenging molecules and commercially and pharmaceutically relevant natural product analogs while adhering to principles of green chemistry. Cytochromes P450 (P450s) are amongst the most superlative and versatile oxidative enzymes found in nature and are desired regio- and stereoselective biocatalysts, particularly for structurally complex hydrocarbon skeletons. We used 10 genome-sequenced Streptomyces strains, selected based on their preponderance of P450s, to biotransform the bioactive diterpenoid abietic acid.

Timing and Outcomes of PCI in Conjunction With TAVR With Balloon-Expandable Valves.

Background: The optimal timing for percutaneous coronary intervention (PCI) in patients undergoing transcatheter aortic valve replacement (TAVR) is debatable.

Objectives: The aim of this study was to compare outcomes based on the timing of PCI in stable coronary artery disease patients undergoing TAVR.

Methods: Leveraging the STS/ACC TVT Registry and Medicare Linkage, we analyzed patients with stable coronary artery disease undergoing PCI and TAVR between 2015 and 2023 using the SAPIEN 3 balloon-expandable valve platform.

Post-traumatic Stress Disorder and the Mental Burden Resulting from the Dobbs Decision.

The obstetrics and mental health care fields have significant crossover. Women with unintended, undesired, or medically complex pregnancies are at greater risk of adverse mental health outcomes, which have the capacity to create long-lasting and intergenerational ripple effects within their larger family unit. Given the frequency with which women seek pregnancy terminations, the numerous factors that influence care accessibility, and the serious repercussions that stem from insufficient use of evidence-based care surrounding pregnancy termination, women are at risk of experiencing a range of mental health outcomes based on their experiences around pregnancy termination.