Depression is Associated with Treatment Response Trajectories in Adults with Prolonged Grief Disorder: A Machine Learning Analysis.

Unlabelled: Although evidence-based treatments for Prolonged Grief Disorder (PGD) exist, pretreatment characteristics associated with differential improvement trajectories have not been identified. To identify clinical factors relevant to optimizing PGD treatment outcomes, we used unsupervised and supervised machine learning to study treatment effects from a double-blinded, placebo-controlled, randomized clinical trial. Participants were randomized into four treatment groups for 20 weeks: citalopram with grief-informed clinical management, citalopram with prolonged grief disorder therapy (PGDT), pill placebo with PGDT, or pill placebo with clinical management.

Change in Grip and Pinch Strength Over the Course of a Game in Professional Baseball Pitchers.

Background: Baseball pitching injuries can be related to fatigue. Changes in grip and pinch strength over the course of professional baseball games are unknown.

Hypothesis: Grip and pinch strength will decrease as the number of innings pitched increases; injured pitchers will have a lower grip strength than uninjured pitchers.

Optimized MR pulse sequence for high-resolution brain 3D-T1ρ mapping with weighted spin-lock acquisitions.

Purpose: To implement and evaluate the feasibility of brain spin-lattice relaxation in the rotating frame (T1ρ) mapping using a novel optimized pulse sequence that incorporates weighted spin-lock acquisitions, enabling high-resolution three-dimensional (3D) mapping.

Methods: The optimized variable flip-angle framework, previously proposed for knee T1ρ mapping, was enhanced by integrating weighted spin-lock acquisitions. This strategic combination significantly boosts signal-to-noise ratio (SNR) while reducing data acquisition time, facilitating high-resolution 3D-T1ρ mapping of the brain.

State-of-the-Art Narrative Review: Mounier-Kuhn Syndrome and Tracheobronchomegaly.

Mounier-Kuhn syndrome (MKS) or tracheobronchomegaly is an uncommon disease of the central airways. It is characterized by pathological dilatation of the trachea and main bronchi and inevitably leads to recurrent respiratory infections, bronchiectasis, hospitalizations, and results in considerable morbidity and mortality. Despite numerous case reports, there is a shortage of evidence on clinical outcomes and limited data on interventions, thus presenting a significant gap in the literature.

Emerging Role of Genetics in Kidney Transplantation.

The advent of more affordable genomic analytical pipelines has facilitated the expansion of genetic studies in kidney transplantation. Advances in genetic sequencing have allowed for a greater understanding of the genetic basis of chronic kidney disease, which has helped to guide transplant management and address issues related to living donation in specific disease settings. Recent efforts have shown significant effects of genetic ancestry and donor APOL1 risk genotypes in determining worse allograft outcomes and increased donation risks.

External Validation of the Neiman Imaging Comorbidity Index in Medicare, Medicaid, and Private Payer Claims Data.

Objective: The Neiman Imaging Comorbidity Index (NICI) was developed and validated in a claims dataset encompassing >10 million privately insured beneficiaries, in which it outperformed the commonly used Charlson Comorbidity Index (CCI) in predicting advanced imaging use. This external validation assessed the broader generalizability of NICI for predicting receipt of advanced imaging in nationally representative populations, including patients insured by Medicare, Medicaid, and private payers.

Methods: All 2018 to 2019 patient-level claims from the CMS Medicare 5% Research Identifiable File, CMS Medicaid 100% Research Identifiable File, and private insurance (commercial and Medicare Advantage) claims from Inovalon Insights, LLC, were included.

Factors associated with placebo response rate in randomized controlled trials of antiseizure medications for focal epilepsy.

Objective: Randomized controlled trials (RCTs) are necessary to evaluate the efficacy of novel treatments for epilepsy. However, there have been concerning increases in the placebo responder rate over time. To understand these trends, we evaluated features associated with increased placebo responder rate.

Partial-linear single-index Cox regression models with multiple time-dependent covariates.

Background: In cohort studies with time-to-event outcomes, covariates of interest often have values that change over time. The classical Cox regression model can handle time-dependent covariates but assumes linear effects on the log hazard function, which can be limiting in practice. Furthermore, when multiple correlated covariates are studied, it is of great interest to model their joint effects by allowing a flexible functional form and to delineate their relative contributions to survival risk.

Guidelines for Seizure Prophylaxis in Patients Hospitalized with Nontraumatic Intracerebral Hemorrhage: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society.

Background: There is practice heterogeneity in the use, type, and duration of prophylactic antiseizure medications (ASM) in patients hospitalized with acute nontraumatic intracerebral hemorrhage (ICH).

Methods: We conducted a systematic review and meta-analysis assessing ASM primary prophylaxis in adults hospitalized with acute nontraumatic ICH. The following population, intervention, comparison, and outcome (PICO) questions were assessed: (1) Should ASM versus no ASM be used in patients with acute ICH with no history of clinical or electrographic seizures? (2) If an ASM is used, should levetiracetam (LEV) or phenytoin/fosphenytoin (PHT/fPHT) be preferentially used? and (3) If an ASM is used, should a long (> 7 days) versus short (≤ 7 days) duration of prophylaxis be used? The main outcomes assessed were early seizure (≤ 14 days), late seizures (> 14 days), adverse events, mortality, and functional and cognitive outcomes.

Scholars in Health Equity: A Program of Structured Physician Faculty Development.

Background: Structured faculty development programs focused on integrating health equity into medical education curricula remain limited.

Aim: To describe an interdisciplinary faculty development program grounded in adult learning theory and to assess its impact on participants' professional growth.

Setting And Participants: Twenty-one faculty members across six academic-affiliated health systems.

Cost-Effectiveness Analysis of a Novel Fetal Vesicoamniotic Shunt-The Vortex Shunt.

Objective: We estimated the potential outcomes, costs, and cost-effectiveness of the Vortex shunt, a novel fetal vesicoamniotic shunt (VAS), compared to standard shunts for treating fetal lower urinary tract obstruction (LUTO).

Method: We designed a decision-analytic model comparing the Vortex shunt to current shunts using a theoretical cohort of 1000 pregnancies equivalent to the annual U.S.

Household Income Moderates Longitudinal Relations Between Neighborhood Child Opportunity Index and BMI Growth.

To examine longitudinal associations of early neighborhood Child Opportunity Index 2.0 (COI) with children's BMI trajectories and identify whether household economic resources moderate relations of COI in infancy/toddlerhood and the preschool years to longitudinal BMI growth between 2 and 12 years. Family data ( = 1091) were drawn from the Family Life Project, a longitudinal study of families residing in rural high-poverty areas.

Integrating Generative Artificial Intelligence Into Medical Education: Curriculum, Policy, and Governance Strategies.

The rapid advancement of generative artificial intelligence (GAI) is poised to revolutionize medical education, clinical decision-making, and health care workflow. Despite considerable interest and a surfeit of newly available tools, medical educators largely lack both competencies and guidance on how to incorporate the new and rapidly evolving world of GAI into the core medical school curriculum and experiences of undergraduate medical education. This Scholarly Perspective highlights the need for medical schools to adapt to this new paradigm by implementing policies, governance, and curricula that address the ethical, technical, and pedagogical implications of GAI.

The differential interactomes of the KRAS splice variants identify BIRC6 as a ubiquitin ligase for KRAS4A.

Transcripts of the KRAS locus are alternatively spliced to generate two proteins, KRAS4A and KRAS4B, which differ in their membrane-targeting sequences. These splice variants have been conserved for more than 450 million years, suggesting non-overlapping functions driven by differential membrane association. Here, we use proximity labeling to map the differential interactomes of the KRAS splice variants.

Glucose Abnormalities Detected by Continuous Glucose Monitoring in Very Old Adults With and Without Diabetes.

Objective: To characterize the prevalence of continuous glucose monitoring (CGM)-defined glucose abnormalities in a large, community-based population of very old adults (>75 years).

Research Design And Methods: A cross-sectional analysis of 1,150 older adults with and without diabetes who attended the Atherosclerosis Risk in Communities Study (2021-2022). Diabetes was based on a self-reported diagnosis of diabetes by a health care provider, use of diabetes medication, or a hemoglobin A1c (HbA1c) ≥6.

Neighborhood Factors as Correlates of Alcohol Use in the N2 Cohort Study of Black Sexually Minoritized Men and Transgender Women.

Sexually minoritized men (SMM), transgender women (TW), and particularly Black SMM and Black TW may be disproportionately impacted by alcohol-related problems. Few studies have empirically examined neighborhood factors that may contribute to alcohol use, specifically among these populations. Using data from the N2 longitudinal cohort study in Chicago, IL, survey data from the second wave of longitudinal assessment (n = 126) and GPS mobility data from enrollment were used to evaluate neighborhood alcohol outlet availability, neighborhood disorder, and neighborhood poverty as correlates of individual alcohol use.

E-cigarette (EC) and heated tobacco product (HTP) use in the United Arab Emirates, an emerging EC and HTP market: A cross-sectional analysis of the International Tobacco Control (ITC) UAE Survey.

Introduction: E-cigarettes (ECs) and heated tobacco products (HTPs) are recent arrivals to the nicotine product market in the Middle East, which are rapidly growing in popularity in the region. There is a lack of surveillance data at the country-level on use of these products and factors associated with their use.

Methods: This study analyzed a subset of data from the UAE Healthy Future Study, a population-based cohort study of the Emirati population, to determine the factors associated with EC and HTP use among a sample of Emirati adults (≥ 18 years).

Efficacy of CTLA-4 checkpoint therapy is dependent on IL-21 signaling to mediate cytotoxic reprogramming of PD-1CD8 T cells.

The mechanisms underlying the efficacy of anti-programmed cell death protein 1 (PD-1) and anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4) therapy are incompletely understood. Here, by immune profiling responding PD-1CD8 T (T) cell populations from patients with advanced melanoma, we identified differential programming of T cells in response to combination therapy, from an exhausted toward a more cytotoxic effector program. This effect does not occur with anti-PD-1 monotherapy.

Catheter ablation in rate-controlled atrial fibrillation with severely reduced ejection fraction: intervention for irregularity-mediated cardiomyopathy.

Background: Recent evidence suggests atrial fibrillation (AF) causes cardiomyopathy due to remodeling driven by both irregular rate and rhythm. Atrial fibrillation (AF) ablation in patients with reduced ejection fraction (EF) ≤ 35% has been shown to improve EF and mortality. It is unknown whether the benefits of AF ablation among patients with reduced EF are affected by the degree of pre-ablation rate control.

Demographic and clinical risk factors of developing clinically-recognized varicose veins in older adults.

Introduction: Varicose veins are common in older adults and are associated with adverse clinical outcomes such as deep venous thrombosis. Established risk factors for varicose veins include female sex, height, and obesity, but other risk factors are relatively uncharacterized.

Methods: This was a prospective cohort analysis of 6241 participants aged 66-70 years from the Atherosclerosis Risk in Communities (ARIC) Study.

Readmission outcomes after acute coronary syndrome among patients with myeloproliferative neoplasms.

Background And Aims: Myeloproliferative neoplasms (MPNs) are associated with arterial thrombosis, including acute coronary syndrome (ACS). Prior studies have suggested similar in-hospital mortality among patients with MPN compared to those without. However, post-ACS outcomes have not been thoroughly evaluated.

Therapeutic Potential of MDMA- and Psychedelic-Assisted Psychotherapy for Adolescent Depression and Trauma.

Purpose Of Review: There is a mental health crisis affecting youth, and the utility of existing treatments is often limited by lack of effectiveness and tolerability. The aim of this review is to report on outcomes of clinical trials for psilocybin-assisted psychotherapy for adults with depression and MDMA-assisted psychotherapy for adults with post-traumatic stress disorder (PTSD) and discuss recommendations for exploring these treatments in adolescent populations.

Recent Findings: There have been encouraging data supporting the use of psilocybin-assisted psychotherapy for depression, including previously treatment-resistant symptoms.