A Unified Approach to Health Data Exchange: A Report From the US DHHS.

Importance: Health information technology, such as electronic health records (EHRs), has been widely adopted, yet accessing and exchanging data in the fragmented US health care system remains challenging. To unlock the potential of EHR data to improve patient health, public health, and health care, it is essential to streamline the exchange of health data. As leaders across the US Department of Health and Human Services (DHHS), we describe how DHHS has implemented fundamental building blocks to achieve this vision.

Self-Management Practices Among Adults With Diabetes in the United States: An Analysis of the 2017-2020 National Health and Nutrition Examination Survey (NHANES).

Purpose: The purpose of the study was to examine the extent to which adults with diabetes engage in self-management practices to lower their blood glucose levels and determine factors associated with these engagements.

Methods: The study analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). The sample included 1171 adults ages 20 and older with a laboratory A1C level of 6.

Substitution and Complementarity in the Consumption of Alcohol, Cannabis, and Opium.

Understanding the behavior of populations of drug consumers has been and remains a topic of keen interest. Using a unique dataset on 25 districts from Bengal, India, from 1911 to 1925, we analyze whether populations of consumers treat alcohol, cannabis, and opium as economic substitutes or complements in a legal regime. Additionally, we examine responsiveness to prices and income.

Estimation of factorial expressions and its improvement through calibration: A replication and extension of Tversky and Kahneman (1973).

Fifty years ago, Tversky and Kahneman (Cognitive Psychology, 5[2], 207-232, 1973) reported that people's speeded estimations of 8 × 7 × 6 × 5 × 4 × 3 × 2 × 1 were notably higher than their estimations for the equivalent expression in the opposite order, 1 × 2 × 3 × 4 × 5 × 6 × 7 × 8 (Median = 2,250 vs. 512, respectively). On top of this order effect, both groups grossly underestimated the correct value (40,320).

Mechanosensation of the heart and gut elicits hypometabolism and vigilance in mice.

Interoception broadly refers to awareness of one's internal milieu. Although the importance of the body-to-brain communication that underlies interoception is implicit, the vagal afferent signalling and corresponding brain circuits that shape perception of the viscera are not entirely clear. Here, we use mice to parse neural circuits subserving interoception of the heart and gut.

Analyzing the relationship between gene expression and phenotype in space-flown mice using a causal inference machine learning ensemble.

Spaceflight has several detrimental effects on human and rodent health. For example, liver dysfunction is a common phenotype observed in space-flown rodents, and this dysfunction is partially reflected in transcriptomic changes. Studies linking transcriptomics with liver dysfunction rely on tools which exploit correlation, but these tools make no attempt to disambiguate true correlations from spurious ones.

The effect of a general practitioner's perception of a patient request for antibiotics on antibiotic prescribing for respiratory tract infections: secondary analysis of a point prevalence audit survey in 18 European countries.

Background: Illness severity, comorbidity, fever, age and symptom duration influence antibiotic prescribing for respiratory tract infections (RTI). Non-medical determinants, such as patient expectations, also impact prescribing.

Aim: To quantify the effect of general practitioners' (GPs') perception of a patient request for antibiotics on antibiotic prescribing for RTI and investigate effect modification by medical determinants and country.

Association of Residential Segregation with Mortality in the U.S., 2018-2022.

Introduction: This study aimed to examine the association of county-level racial and economic residential segregation with mortality rates in the U.S. between 2018 and 2022.

ECLS-SHOCK and DanGer Shock: Implications for optimal temporary mechanical circulatory support use for cardiogenic shock due to acute myocardial infarction.

Despite concerted efforts to rapidly identify patients with cardiogenic shock complicating acute myocardial infarction (AMI-CS) and provide timely revascularization, early mortality remains stubbornly high. While artificially augmenting systemic flow through the use of temporary mechanical circulatory support (tMCS) devices would be expected to reduce the rate of progression to multi-organ dysfunction and thereby enhance survival, reliable evidence for benefit has remained elusive with lingering questions regarding the appropriate selection of both patients and devices, as well as the timing of device implantation relative to other critical interventions. Further complicating matters are the resource-intensive multidisciplinary systems of care that must be brought to bear in this complex patient population.

Vanillin and IGF1-loaded dual-layer multifunctional wound dressing with micro-nanofibrous structure for full-thickness wound healing acceleration.

Multifunctional dual-layer wound dressings hold significant promise for comprehensive full-thickness wound management by closely mimicking the native skin structure and features. Herein, we employed an innovative approach utilizing electrospinning techniques to develop a dual-layer dressing comprising a microfibrous Ecoflex®-Vanillin (Ex-Vnil) top layer (TL) and a nanofibrous Soluplus®-Insulin-like growth factor-1 (Sol-IGF1) bottom layer (BL). The tensile properties of dual-layer wound dressings were within the standard range for use in skin tissue regeneration.

First-in-human trial of atrial fibrillation ablation using real time tissue optical assessment to predict pulsed field lesion durability.

Background: Loss of bipolar electrograms immediately after pulsed field ablation (PFA) makes lesion durability assessment challenging.

Objective: The aim of this trial (NCT06700226) was to evaluate a novel ablation system that can optically predict lesion durability by detecting structural changes in the tissue during ablation.

Methods: Patients with paroxysmal atrial fibrillation underwent pulmonary vein isolation (PVI) using PFA (AblaView®, MedLumics).

Development and Evaluation of a Presenter Coaching Program at an Academic Surgical Conference.

Objective: Presenting at academic conferences is an important means of disseminating research, networking, and building a professional reputation, but the quality of presentations at conferences is often suboptimal. This project describes the design, implementation, and evaluation of a presentation coaching program offered by an academic surgical society to presenters at its annual meeting.

Design: Oral presenters were paired with a coach and encouraged to meet independently, yet coaching was unstructured.

Enhancing prediction of major depressive disorder onset in adolescents: A machine learning approach.

Major Depressive Disorder (MDD) is a prevalent mental health condition that often begins in adolescence, with significant long-term implications. Indicated prevention programs targeting adolescents with mild symptoms have shown efficacy, yet the methods for identifying at-risk individuals need improvement. This study aims to evaluate the utility of Partial Least Squares Regression (PLSR) in predicting the onset of MDD among non-depressed adolescents, compared to traditional screening methods.

Cognitive and behavioral effects of perampanel 4 mg daily dose.

Objective: The neuropsychological adverse effects of antiseizure medications (ASMs) influence the tolerability, and in turn effectiveness of these medications, which can occur in a dose-dependent fashion. In this study, we examine the neuropsychological effects of perampanel (PER) at 4 mg daily as this dose has not been previously assessed with objective cognitive tests.

Methods: The study was originally designed to assess (1) effects of perampanel at 4 mg using different titration rates, and (2) habituation over time.

Individual on Death Row Receiving Electroconvulsive Therapy (ECT) for Catatonia: A Case Report.

Electroconvulsive therapy (ECT) is underused, logistically challenging for those who are justice-involved, and laced with ethical problems for those on death row. Herein we describe a case of a man without history of long-standing psychiatric illness who, after more than 15 years on death row, was hospitalized for altered mental status. After medical stabilization, the altered mental status persisted.

Dysuria: Evaluation and Differential Diagnosis in Adults.

Dysuria, a feeling of pain or discomfort during urination, is often caused by urinary tract infection but can also be due to sexually transmitted infection, bladder irritants, skin lesions, and some chronic pain conditions. History is most often useful for finding signs of sexually transmitted infection, complicated infections, lower urinary symptoms in males, and noninfectious causes. Most patients presenting with dysuria should have a urinalysis performed.

Effect of nirmatrelvir/ritonavir (Paxlovid) on hospitalization among adults with COVID-19: An electronic health record-based target trial emulation from N3C.

Background: Nirmatrelvir with ritonavir (Paxlovid) is indicated for patients with Coronavirus Disease 2019 (COVID-19) who are at risk for progression to severe disease due to the presence of one or more risk factors. Millions of treatment courses have been prescribed in the United States alone. Paxlovid was highly effective at preventing hospitalization and death in clinical trials.

Enhancement of Transdermal Drug Delivery: Integrating Microneedles with Biodegradable Microparticles.

This investigation aimed to enhance transdermal methotrexate delivery through human skin by employing Dr. Pen microneedles and poly(d,l-lactide--glycolide) acid microparticles formulated from eight polymer grades (Expansorb DLG 95-4A, DLG 75-5A, DLG 50-2A, DLG 50-5A, DLG 50-8A, DLG 50-6P, DLG 50-7P, and DLL 10-15A). A comprehensive characterization of the microparticles was performed, encompassing various parameters such as size, charge, morphology, microencapsulation efficiency, yield, release kinetics, and chemical composition.

Mucin Colocalizes with Influenza Virus and Preserves Infectivity in Deposited Model Respiratory Droplets.

The stability of influenza virus in respiratory particles varies with relative humidity (RH) and protein content. This study investigated the decay, or loss of infectivity, of influenza A virus (IAV) in 1-μL respiratory droplets deposited on a surface with varying concentrations of mucin, one of the most abundant proteins in respiratory mucus, and examined the localization of virions within droplets. IAV remained stable at 0.

Assessing the impact of messages about reduced nicotine cigar products among people who use little cigar and cigarillo: Insights from a discrete choice experiment.

Introduction: The U.S. Food and Drug Administration's (FDA) pursuit of a low nicotine standard for cigarettes raises concerns that a focus on cigarettes may encourage people to use other combusted tobacco products, undermining the policy's effectiveness.

Dispensing practices of amoxicillin suspension by community pharmacists.

Background: Amoxicillin suspension is frequently prescribed to children; we hypothesized that prescribing convention system constraints lead to unusual dosing regimens and unnecessary waste of the drug.

Objective: Identify antibiotic dispensing practices by community pharmacists and/or technicians to understand opportunities to decrease wasted amoxicillin liquid and optimize prescribing convention of liquid amoxicillin to children.

Methods: Pilot online survey of Atlanta area and National Community Pharmacists Association pharmacists or pharmacy technicians that self-reported dispensing amoxicillin suspension.