Comparative analysis of sleep physiology using qualitative and quantitative criteria for insomnia symptoms.

Despite decades of research, defining insomnia remains challenging due to its complex and variable nature. Various diagnostic systems emphasize the chronic nature of insomnia and its impact on daily functioning, relying heavily on patient self-reporting due to limitations in objective measures like polysomnography (PSG). Discrepancies between subjective experiences and objective PSG results highlight the need for more nuanced approaches, such as electroencephalogram (EEG) spectral analysis, which reveals distinct patterns of high-frequency activity in individuals with insomnia.

Longitudinal cognitive performance of participants with sporadic early onset Alzheimer's disease from LEADS.

Introduction: Early-onset Alzheimer's disease (EOAD) manifests prior to the age of 65, and affects 4%-8% of patients with Alzheimer's disease (AD). The current analyses sought to examine longitudinal cognitive trajectories of participants with early-onset dementia.

Methods: Data from 307 cognitively normal (CN) volunteer participants and those with amyloid-positive EOAD or amyloid-negative cognitive impairment (EOnonAD) were compared.

Cross-sectional and longitudinal changes in category-selectivity in visual cortex following pediatric cortical resection.

The topographic organization of category-selective responses in human ventral occipitotemporal cortex (VOTC) and its relationship to regions subserving language functions is remarkably uniform across individuals. This arrangement is thought to result from the clustering of neurons responding to similar inputs, constrained by intrinsic architecture and tuned by experience. We examined the malleability of this organization in individuals with unilateral resection of VOTC during childhood for the management of drug-resistant epilepsy.

Differences in baseline cognitive performance between participants with early-onset and late-onset Alzheimer's disease: Comparison of LEADS and ADNI.

Introduction: Early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD) share similar amyloid etiology, but evidence from smaller-scale studies suggests that they manifest differently clinically. Current analyses sought to contrast the cognitive profiles of EOAD and LOAD.

Methods: Z-score cognitive-domain composites for 311 amyloid-positive sporadic EOAD and 314 amyloid-positive LOAD participants were calculated from baseline data from age-appropriate control cohorts.

Trainee Autonomy and Supervision in the Inpatient Clinical Learning Environment.

Background: Balancing autonomy and supervision during medical residency is important for trainee development while ensuring patient safety. In the increasingly complex inpatient clinical learning environment, tension exists when this balance is skewed. In this study, we aimed to understand current and ideal states of autonomy and supervision and then describe factors that contribute to imbalance from both trainee and attending perspectives.

Glepaglutide, a Long-acting Glucagon-like Peptide-2 Analog, Reduces Parenteral Support in Patients with Short Bowel Syndrome: a Phase 3, Randomized, Controlled Trial.

Background And Aims: Glepaglutide is a long-acting GLP-2 analog developed to improve intestinal absorption in short bowel syndrome (SBS) patients. We conducted a trial to establish efficacy and safety of glepaglutide in reducing parenteral support (PS) needs in SBS patients with intestinal failure (IF).

Methods: In an international, placebo-controlled, randomized, parallel-group, double-blind, phase 3 trial, SBS-IF patients requiring PS ≥3 days/week were randomized 1:1:1 to 24 weeks of glepaglutide 10 mg twice-weekly (TW) or once-weekly (OW), or placebo.

Left Ventricular Dimensions and Clinical Outcomes With a Fully Magnetically Levitated Left Ventricular Assist Device.

Background: Prior analyses have suggested that a smaller left ventricular end-diastolic diameter (LVEDD) is associated with reduced survival following HeartMate 3 left ventricular assist device implantation.

Objectives: In this trial-based comprehensive analysis, the authors sought to examine clinical characteristics and association with the outcome of this specific relationship.

Methods: The authors analyzed the presence of LVEDD <55 mm among 1,921 analyzable HeartMate 3 patients within the MOMENTUM 3 (Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3) trial portfolio, on endpoints of overall survival and adverse events at 2 years.

Prognostic value of residual disease (RD) biology and gene expression changes during the neoadjuvant treatment in patients with HER2+ early breast cancer (EBC).

Background: In HER2+ early breast cancer (EBC), we investigated tumor and immune changes during neoadjuvant treatment and their impact on residual disease (RD) biology and prognostic implications across 4 neoadjuvant studies of trastuzumab with or without lapatinib, and with or without chemotherapy: CALGB 40601, PAMELA, NeoALTTO and NSABP B-41.

Patients And Methods: We compared tumor and immune gene expression changes during neoadjuvant treatment and their association with with event-free survival (EFS) by uni- and multivariable Cox regression models in different cohorts and timepoints: 452 RD samples at baseline including 169 with a paired RD, and biomarker changes during neoadjuvant therapy, evaluating model performance via the c-index.

Results: Analysis of 169 paired tumor samples revealed a shift in intrinsic subtype proportions from HER2-Enriched at baseline (50.

Avelumab + axitinib vs sunitinib as first-line treatment for patients with advanced renal cell carcinoma: final analysis of the phase 3 JAVELIN Renal 101 trial.

Background: In the phase 3 JAVELIN Renal 101 trial (NCT02684006), first-line treatment with avelumab + axitinib resulted in significantly longer progression-free survival (PFS) and a higher objective response rate (ORR) vs sunitinib in patients with advanced renal cell carcinoma (aRCC). We report the final analysis, including the primary analysis of overall survival (OS).

Patients And Methods: Patients with untreated aRCC (any prognostic risk score) were enrolled.

Regulation of presynaptic homeostatic plasticity by glial signalling in Alzheimer's disease.

Alzheimer's disease (AD), the most common form of dementia among the elderly, affects numerous individuals worldwide. Despite advances in understanding the molecular underpinnings of AD pathology, effective treatments to prevent or cure the disease remain elusive. AD is characterized not only by pathological hallmarks such as amyloid plaques and neurofibrillary tangles but also by impairments in synaptic physiology, circuit activity and cognitive function.

US Tobacco 21 Policies and Potential Mortality Reductions by State.

Importance: Research shows that Tobacco 21 (T21) policies with a minimum legal access age for tobacco products of 21 years reduce smoking, yet their impact varies across US states due to differences in smoking behaviors, mortality rates, and policy coverage.

Objective: To quantify potential reductions in smoking-attributable mortality associated with Tobacco 21 policies for each of the 50 states and Washington, DC.

Design, Setting, And Participants: The Cancer Intervention Surveillance and Modeling Network (CISNET) Tobacco Control Policy Model of smoking was used with detailed state-specific data on smoking initiation, smoking cessation and mortality rates as they vary by age, gender, and birth cohort for 50 US states and the District of Columbia.

Point-of-care Ultrasound Used in the Diagnosis of Reverse Takotsubo Cardiomyopathy.

Case Presentation: We present a case of a 50-year-old patient who presented to the emergency department with palpitations, nausea, vomiting, and chest discomfort. She was found to have a reduced ejection fraction and basal wall hypokinesis on point-of-care ultrasound concerning for reverse takotsubo cardiomyopathy.

Discussion: Reverse takotsubo cardiomyopathy is a rare variant of takotsubo cardiomyopathy and involves basal ballooning instead of apical ballooning.

Concurrent processing of the prosodic hierarchy is supported by cortical entrainment and phase-amplitude coupling.

Models of phonology posit a hierarchy of prosodic units that is relatively independent from syntactic structure, requiring its own parsing. It remains unexplored how this prosodic hierarchy is represented in the brain. We investigated this foundational question by means of an electroencephalography (EEG) study.

A randomized, double-blind, placebo-controlled study of a GHSR blocker in people with alcohol use disorder.

BACKGROUNDStudies have demonstrated the role of ghrelin in alcohol-related behaviors and consumption. Blockade of the growth hormone secretagogue receptor (GHSR), which is the ghrelin receptor, has been shown to decrease alcohol drinking and reward-related behaviors across several animal models. We previously conducted a human study testing a GHSR inverse agonist/competitive antagonist, PF-5190457, in individuals who are heavy drinkers and showed its safety when coadministered with alcohol.

An update of a systematic review and meta-analyses exploring flavours in intervention studies of e-cigarettes for smoking cessation.

Aims: To determine patterns of e-cigarette flavour use (sweet, tobacco, menthol/mint) in interventional studies of e-cigarettes for stopping smoking, and to estimate associations between flavours and smoking/vaping outcomes.

Methods: Update of secondary data analyses, including meta-analyses subgrouped by flavour provision and narrative syntheses, incorporating data from January 2004 to February 2024. Eligible studies were identified from a Cochrane review.

Error monitoring and response inhibition in adolescents with bipolar disorders: An ERP study.

Cognitive control develops throughout adolescence, a high-risk period for bipolar disorders (BD) onset. Despite neurobehavioral abnormalities in adults with BD, there is minimal research investigating deviations in cognitive control in adolescents with BD. Cognitive control involves numerous processes.

DOT1L mediates stem cell maintenance and represents a therapeutic vulnerability in cancer.

Tumor-initiating cancer stem cells (CSC) pose a challenge in human malignancies since they are largely treatment resistant and can seed local recurrence and metastasis. Epigenetic mechanisms governing cell fate decisions in embryonic and adult stem cells are deregulated in CSCs. This review focuses on the methyltransferase DOT1L, which methylates H3K79 and is a key epigenetic regulator governing embryonic organogenesis and adult tissue stem cell maintenance.

Telehealth in emergency medicine residency training: A model curriculum.

Emergency physicians are well-positioned to take a leadership role in telehealth, particularly in emerging categories such as triage, direct acute unscheduled care, and virtual observation. However, the growth of telehealth has outpaced curricular development in emergency medicine (EM) residency programs. This manuscript presents a model longitudinal telehealth curriculum, developed by the consensus of education experts, including representatives from the telehealth interest groups from EM's two primary specialty societies: the American College of Emergency Physicians and the Society for Academic Emergency Medicine.

Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients.

Social media provides platforms for transplant infectious diseases (TIDs) clinicians to network, exchange ideas, and educate each other and the broader public. A #TxIDChat on the social media platform X was conducted on the perceptions of social media in TID by the account @TxID_Fellows. This article examines the current usage of social media by TID clinicians, and its role in education, patient outreach, and networking.

Biased Language in Simulated Handoffs and Clinician Recall and Attitudes.

Importance: Poor-quality handoffs can lead to medical errors when transitioning patient care. Biased language within handoffs may contribute to errors and lead to disparities in health care delivery.

Objective: To compare clinical information recall accuracy and attitudes toward patients among trainees in paired cases of biased vs neutral language in simulated handoffs.

Simulated Galactic Cosmic Radiation Exposure-Induced Mammary Tumorigenesis in Mice Coincides with Activation of ERα-ERRα-SPP1 Signaling Axis.

Background: Exposure to galactic cosmic radiation (GCR) is a breast cancer risk factor for female astronauts on deep-space missions. However, the specific signaling mechanisms driving GCR-induced breast cancer have not yet been determined.

Methods: This study aimed to investigate the role of the estrogen-induced ERα-ERRα-SPP1 signaling axis in relation to mammary tumorigenesis in female mice exposed to simulated GCR (GCRsim) at 100-110 days post-exposure.

Characterization of the Ocular Phenotype in a Col4a3 Knockout Mouse Model of Alport Syndrome.

Purpose: Alport syndrome (AS) is a genetic condition caused by a dysfunctional collagen (IV) α3α4α5 heterotrimer, leading to basement membrane instability and, ultimately, abnormalities in the kidney, inner ear, and eyes. This study aimed to characterize ocular pathology of AS by focusing on inflammatory and fibrotic markers.

Methods: Col4a3tm1Dec knockout (KO) mice eyes were evaluated for the localization of collagen (IV) α3 and collagen (IV) α4, then stained for transforming growth factor-β1 (TGF-β1), TGF-β2, connective tissue growth factor (CTGF), and β-catenin.

Effects of expressive helping writing during stem cell transplant: Randomized controlled trial.

Objective: Most cancer patients undergoing hematopoietic stem cell transplant report elevated symptoms and reduced health-related quality of life during peritransplant. These concerns can become persistent. A prior randomized controlled trial showed that expressive helping-a low-burden, brief intervention combining expressive writing with a novel peer support writing exercise-reduced psychological distress and physical symptoms in long-term transplant survivors with moderate/high persistent symptoms.