A deep learning analysis for dual healthcare system users and risk of opioid use disorder.

The opioid crisis has disproportionately affected U.S. veterans, leading the Veterans Health Administration to implement opioid prescribing guidelines.

Impact of pulmonary artery catheterization in patients with acute myocardial infarction cardiogenic shock.

Acute myocardial infarction (AMI) remains one of the most common causes for cardiogenic shock (CS), with high inpatient mortality (40-50 %). Studies have reported the use of pulmonary artery catheters (PACs) in decompensated heart failure, but contemporary data on their use to guide management of AMI-CS and in different SCAI stages of CS are lacking. We investigated the association of PACs and clinical outcomes in AMI-CS.

The Mental Health Traumas of Infertility: Impact and Consequences.

Stress is defined as "a state of mental and emotional tension resulting from adverse circumstances." The desire to be a parent is a primordial urge. Many individuals are unable to attain this goal and suffer from guilt, helplessness, and depression.

Epidemiological analysis of reported acute glyphosate poisoning in Malaysia: identifying risk factors and high-risk groups (2006-2023).

Objective: Glyphosate is widely used in Malaysian agriculture but poses a significant under-reported public health concern due to poisoning. This paper aims to study the epidemiology of glyphosate poisoning in Malaysia, assessing severity, identifying risk factors, and high-risk groups.

Setting: All glyphosate-related data of the Malaysia National Poison Centre from 2006 to 2023.

The multifaceted role of the inferior colliculus in sensory prediction, reward processing, and decision-making.

The inferior colliculus (IC) has traditionally been regarded as an important relay in the auditory pathway, primarily involved in relaying auditory information from the brainstem to the thalamus. However, this study uncovers the multifaceted role of the IC in bridging auditory processing, sensory prediction, and reward prediction. Through extracellular recordings in monkeys engaged in a sound duration-based deviation detection task, we observed a 'climbing effect' in neuronal firing rates, indicative of an enhanced response over sound sequences linked to sensory prediction rather than reward anticipation.

Rectovaginal Fistula Repair Following Vaginoplasty in Transgender Females: A Systematic Review of Surgical Techniques.

Rectovaginal fistula (RVF) remains a complex complication following gender-affirming vaginoplasty. This review aims to evaluate RVF repair techniques and outcomes following vaginoplasty. A systematic review was performed per PRISMA guidelines.

Enhancing surveillance for dengue fever in Oyo State, Nigeria - a one health approach.

Background: Dengue fever (DF) poses a growing global threat, necessitating a comprehensive one-health approach to address its complex interplay between human, animal, and environmental factors. In Oyo State, Nigeria, the true burden of DF remains unknown due to underdiagnosis and misdiagnosis as malaria, exacerbated by poor health-seeking behavior, weak surveillance systems, and inadequate health infrastructure. Adopting a one-health approach is crucial to understanding the dynamics of DF transmission.

Structural basis for human NKCC1 inhibition by loop diuretic drugs.

Na-K-Cl cotransporters functions as an anion importers, regulating trans-epithelial chloride secretion, cell volume, and renal salt reabsorption. Loop diuretics, including furosemide, bumetanide, and torsemide, antagonize both NKCC1 and NKCC2, and are first-line medicines for the treatment of edema and hypertension. NKCC1 activation by the molecular crowding sensing WNK kinases is critical if cells are to combat shrinkage during hypertonic stress; however, how phosphorylation accelerates NKCC1 ion transport remains unclear.

The Posterior Ligamentous Complex: Anatomic and Biomechanical Considerations in Injury Classification and Management.

The posterior ligamentous complex (PLC) provides critical structural support in the thoracolumbar spine. Its role in resisting progressive flexion is particularly important at the thoracolumbar junction due to the transition from the rigid thoracic spine to the more mobile lumbar region. Each component of the PLC contains anatomic features that contribute to both the structure and function of the PLC as a whole.

Reflections on the 2024 Final Rule on Public Health Service Policies on Research Misconduct.

Background: The Office of Research Integrity (ORI) of the U.S. Department of Health and Human Services (HHS) recently issued the 2024 Final Rule on Public Health Service Policies on Research Misconduct (42 CFR 93), the first major revision of the regulation in nearly twenty years.

Effects of Isoproterenol Administration in Dobutamine Stress Echocardiography.

Objective: This study evaluated the safety and efficacy of isoproterenol administration as an adjunct for achievement of target heart rate (HR) during dobutamine stress echocardiography (DSE).

Background: In DSE, optimal accuracy is achieved when a target HR of 85% of maximal predicted heart rate (MPHR) is attained. Although rarely studied, intravenous isoproterenol has been used as an adjunct therapy to dobutamine and atropine to increase chronotropic response during pharmacologic stress testing.

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.

Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting.

Introduction: Adults over the age of 65 are at a higher risk for diagnostic errors due to a myriad of reasons. In primary care settings, a large contributor of diagnostic errors are breakdowns in information gathering and synthesis throughout the patient-provider encounter. Diagnostic communication interventions, such as the Agency for Healthcare Research and Quality's "Be the Expert on You" note sheet, may require adaptations to address older adults' unique needs.

Balancing the right to health and commercial speech: the approach of Argentina's Supreme Court.

Noncommunicable diseases (NCDs) cause significant human and economic costs globally. Each year, 17 million people die from an NCD before age 70. The burden of NCDs is associated with socioenvironmental, cultural factors and social behavior, including modifiable risk factors like tobacco use, unhealthy diets, physical inactivity and alcohol consumption.

Assessing online chat-based artificial intelligence models for weight loss recommendation appropriateness and bias in the presence of guideline incongruence.

Background And Aim: Managing obesity requires a comprehensive approach that involves therapeutic lifestyle changes, medications, or metabolic surgery. Many patients seek health information from online sources and artificial intelligence models like ChatGPT, Google Gemini, and Microsoft Copilot before consulting health professionals. This study aims to evaluate the appropriateness of the responses of Google Gemini and Microsoft Copilot to questions on pharmacologic and surgical management of obesity and assess for bias in their responses to either the ADA or AACE guidelines.

Accuracy and Safety of AI-Enabled Scribe Technology: Instrument Validation Study.

Artificial intelligence-enabled ambient digital scribes may have many potential benefits, yet results from our study indicate that there are errors that must be evaluated to mitigate safety risks.

Transient Ischemic Attack in Women: Real-World Hospitalization Incidence, Outcomes, and Risk of Hemorrhage and Stroke.

Background: Sex-specific differences in stroke risk factors, clinical presentation, and outcomes are well documented. However, little is known about real-world differences in transient ischemic attack (TIA) hospitalizations and outcomes between men and women.

Methods: This was a retrospective cohort study of the 2016 to 2021 Nationwide Readmissions Database in the United States.

The WHO Disease Outbreak News during the Covid-19 pandemic.

During the Covid-19 pandemic, the World Health Organization (WHO) was an important public source of information - not only about the pandemic, but also thousands of other potential health emergencies. Here, we examine the 242 reports published in the WHO Disease Outbreak News (DON) during the first four years of the Covid-19 pandemic (2020 to 2023), and document the diseases and regions that were reported. We find that multinational epidemics of diseases like Ebola virus and MERS-CoV continue to dominate the DON.

Prophylactic Irradiation for the Prevention of Heterotopic Ossification After Foot Amputation: A Case Series.

Background: The formation of heterotopic ossification (HO) is a common complication after transosseous partial foot amputation. Development of HO in weightbearing and/or superficial areas can lead to increased pressures, which increases the likelihood of wound formation and pain. Current treatment modalities for HO of the foot include mechanical off-loading and surgical resection; however, prophylactic measures such as nonsteroidal anti-inflammatory drugs, bisphosphonates, and other medical therapies have been attempted previously with mixed efficacy.

Operationalising a Haemophilia Gene Editing Lexicon for Practical Use.

Introduction: Gene editing therapies offer the possibility of substantial improvement in treatment and quality of life for people with haemophilia (PWH) in a landscape of dynamic therapeutic advancement. Developing a common and understandable language to discuss gene editing will be essential to ensure these treatments can be deployed in a safe and effective manner with fully informed and shared decision-making between healthcare professionals (HCPs) and PWH. A lexicon explaining and clarifying key concepts is one potential tool to address these aims.

Mindful self-compassion for lung cancer (MSC-LC): Incorporating perspectives of lung cancer patients, clinicians, and researchers to create an adapted intervention to reduce lung cancer stigma.

Background: Stigma is a pervasive and distressing problem experienced frequently by lung cancer patients, and there is a lack of psychosocial interventions that target the reduction of lung cancer stigma. Mindful self-compassion (MSC) is an empirically supported intervention demonstrated to increase self-compassion and reduce feelings of shame and distress in non-cancer populations. However, there are several anticipated challenges for delivering MSC to lung cancer patients, and modifications may be needed to improve acceptability, appropriateness, and feasibility.