Economic and equity evaluation of age restrictions on over-the-counter diet pills and muscle-building supplements.

Over-the-counter diet pills and muscle-building supplements are linked to increased eating disorder diagnoses, especially among youth. With limited regulatory oversight, minors may unknowingly consume harmful substances leading to other adverse effects. Massachusetts has proposed restricting sales to individuals under 18 years.

Children betrayed: The unseen victims of domestic violence and how law enforcement can better protect them.

Domestic violence is a commonplace and serious societal problem with vast public health and economic consequences. Childhood exposure to domestic violence can blight children's biological and social development. Often, local police departments are first responders to domestic violence.

Brain mapping during resection of high-grade brain arteriovenous malformation.

Eloquent brain creates a challenge when resecting brain arteriovenous malformations (bAVMs). Here the authors present their technique of using subcortical motor mapping as an adjunct to increase safety during resection of a high-grade bAVM involving somatosensory cortex as well as cortical spinal tracts and visual tracts. After a bilateral craniotomy, they use direct cortical stimulation of the left motor cortex and subcortical stimulation using a suction stimulator to dynamically map motor tracts during the resection.

Motor mapping-guided resection of a brainstem recurrent pilocytic astrocytoma.

Brainstem tumors are bounded by a compact topography of eloquent tracts, cranial nerves, and nuclei. Reliable intraoperative neuromonitoring aids microneurosurgical technique to optimize safe resection. The authors present a case of motor mapping-guided resection of a recurrent brainstem pilocytic astrocytoma.

Harnessing the potential of human induced pluripotent stem cells, functional assays and machine learning for neurodevelopmental disorders.

Neurodevelopmental disorders (NDDs) affect 4.7% of the global population and are associated with delays in brain development and a spectrum of impairments that can lead to lifelong disability and even mortality. Identification of biomarkers for accurate diagnosis and medications for effective treatment are lacking, in part due to the historical use of preclinical model systems that do not translate well to the clinic for neurological disorders, such as rodents and heterologous cell lines.

Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials.

Aims: The sodium-glucose cotransporter 2 inhibitor canagliflozin reduces the risk of heart failure (HF) hospitalization or cardiovascular death and chronic kidney disease (CKD) progression among patients with type 2 diabetes at high cardiovascular risk or with CKD. Patients with type 2 diabetes commonly have coexisting HF or CKD that require treatment with loop diuretics; however, the prognostic implications of oral loop diuretic intensification are not well characterized.

Methods And Results: In this participant-level pooled analysis of the CREDENCE and CANVAS trials (not including CANVAS-R), 1454/8731 (16.

Continental Preferences in Reconstruction of Pharyngolaryngectomy Defects: A Multi-National Survey.

Objectives: Reconstruction of total pharyngolaryngectomy defects may restore pharyngeal function and enable tracheoesophageal speech after resection of locoregionally advanced malignancy. Little remains known about variations in the practices and preferences of surgeons across differing global regions.

Methods: A survey was sent to reconstructive head and neck surgeons across three continents with responses analyzed to evaluate trends.

Changes in Recovery Assessment Scale Scores During a Treatment Episode Among Patients in a Large Behavioral Health Care System.

Objective: The authors utilized patient-reported outcomes from a large U.S. behavioral health care system to evaluate the strength of improvements in patients' self-perceived recovery during mental health treatment.

Development of the Migraine-Related Stigma (MiRS) Questionnaire: Results of the OVERCOME (US) Study.

Background: Stigma is emerging as an important social contributor to migraine-related disability and other outcomes. Currently, there are no published validated measures of migraine-specific measures of stigma.

Objectives: This secondary post hoc analysis of a cross-sectional cohort study aimed to develop a questionnaire to evaluate migraine-related stigma.

High-dimensional multiple imputation (HDMI) for partially observed confounders including natural language processing-derived auxiliary covariates.

Multiple imputation (MI) models can be improved with auxiliary covariates (AC), but their performance in high-dimensional data remains unclear. We aimed to develop and compare high-dimensional MI (HDMI) methods using structured and natural language processing (NLP)-derived AC in studies with partially observed confounders. We conducted a plasmode simulation with acute kidney injury as outcome and simulated 100 cohorts with a null treatment effect, incorporating creatinine labs, atrial fibrillation (AFib), and other investigator-derived confounders in the outcome generation.

Efficacy and Safety Results With Rilzabrutinib, an Oral Bruton Tyrosine Kinase Inhibitor, in Patients With Immune Thrombocytopenia: Phase 2 Part B Study.

Current treatments for persistent or chronic immune thrombocytopenia (ITP) are limited by inadequate response, toxicity, and impaired quality of life. The Bruton tyrosine kinase inhibitor rilzabrutinib was evaluated to further characterize safety and durability of platelet response. LUNA2 Part B is a multicenter, phase 1/2 study in adults with ITP (≥ 3 months duration, platelet count < 30 × 10/L) who failed ≥ 1 ITP therapy (NCT03395210, EudraCT 2017-004012-19).

Three-dimensional complementary breast ultrasound (3D CBUS): Improving 3D spatial resolution uniformity with orthogonal images.

Background: With increasing evidence supporting three-dimensional (3D) automated breast (AB) ultrasound (US) for supplemental screening of breast cancer in increased-risk populations, including those with dense breasts and in limited-resource settings, there is an interest in developing more robust, cost-effective, and high-resolution 3DUS imaging techniques. Compared with specialized ABUS systems, our previously developed point-of-care 3D ABUS system addresses these needs and is compatible with any conventional US transducer, which offers a cost-effective solution and improved availability in clinical practice. While conventional US transducers have high in-plane resolution (axial and lateral), their out-of-plane resolution is constrained by the poor intrinsic elevational US resolution.

Robust Automated Harmonization of Heterogeneous Data Through Ensemble Machine Learning: Algorithm Development and Validation Study.

Background: Cohort studies contain rich clinical data across large and diverse patient populations and are a common source of observational data for clinical research. Because large scale cohort studies are both time and resource intensive, one alternative is to harmonize data from existing cohorts through multicohort studies. However, given differences in variable encoding, accurate variable harmonization is difficult.

The impact of the Lesotho health reform in the re-structuring of the village health workers program.

Background: Community Health Workers locally known as Village Health Workers (VHW) in Lesotho are key members of the primary health workforce, and has been playing a significant role in building primary health systems in many countries and they can fill significant gaps in human resources as low and middle income countries work towards universal health coverage in the era of Sustainable Development Goals (SDGs). The 2014 Lesotho health reform restructured the VHW program to compensate, professionalize, and integrate VHWs into primary care services. We sought to document the ways in which the VHW program changed as a result of the health reform and the perceived impact of those changes.

Use of extracorporeal shockwave therapy combined with standard rehabilitation following anterior cruciate ligament reconstruction: a systematic review with meta-analysis.

Background: Anterior cruciate ligament (ACL) injuries are one of the most common sports injuries, accounting for approximately 50% of knee-related injuries. Extracorporeal shockwave therapy (ESWT), in the form of the radial (R-SWT) or focused shockwave (F-SWT), has been shown effective in treating various orthopaedic conditions. Recently, studies have investigated whether ESWT combined with standard rehabilitation may improve outcomes following anterior cruciate ligament reconstruction (ACLR).

Navigating DR-TB Treatment care: a qualitative exploration of barriers and facilitators to retention in care among people with history of early disengagement from drug-resistant tuberculosis treatment in Johannesburg, South Africa.

Background: Despite advances in drug-resistant tuberculosis (DR-TB) diagnosis, treatment, and service delivery, individuals with DR-TB often face significant socioeconomic and psychosocial challenges due to limited resources. These challenges can hinder retention in care, undermining the progress made in DR-TB management. As a consequence, advances in DR-TB diagnostics and treatment have not resulted in DR-TB programs meeting the 75% treatment success targets set by the World Health Organization (WHO).

The risks of adverse events with mirtazapine for adults with major depressive disorder: a systematic review with meta-analysis and trial sequential analysis.

Background: Mirtazapine is used to treat depression worldwide, and the effects of mirtazapine on depression rating scales are well-known. Our primary objective was to assess the risks of adverse events with mirtazapine for major depressive disorder.

Methods: We searched relevant sources from inception to 7 March 2024 for randomised clinical trials comparing mirtazapine versus placebo in adults with major depressive disorder.

Mortality risk among individuals who smoke opioids compared with those who inject: A propensity score-matched cohort analysis of United States national treatment data.

Background And Aims: Opioid smoking is becoming more common in the United States. The aim of this analysis was to estimate relative mortality risk among those who primarily smoke opioids compared with those who inject.

Design: Retrospective propensity score-matched cohort analysis.

Prescribing rate, healthcare utilization, and expenditure of older adults using potentially inappropriate medications in China: A nationwide cross-sectional study.

Background: The use of potentially inappropriate medications (PIMs) is a major concern for medication safety as it may entail more harm than potential benefits for older adults. This study aimed to explore the prescribing rate, healthcare utilization, and expenditure of older adults using PIMs in China.

Methods: A cross-sectional analysis was conducted using a national representative database of all medical insurance beneficiaries across China, extracting ambulatory visit records of adults aged 65 years and above between 2015 and 2017.

Microglia modulate the cerebrovascular reactivity through ectonucleotidase CD39.

Microglia and the border-associated macrophages contribute to the modulation of cerebral blood flow, but the mechanisms have remained uncertain. Here, we show that microglia regulate the cerebral blood flow baseline and the responses to whisker stimulation or intra-cisternal magna injection of adenosine triphosphate, but not intra-cisternal magna injection of adenosine in mice model. Notably, microglia repopulation corrects these cerebral blood flow anomalies.

Persistent exclusion of non-English speakers in Pediatric research: a national analysis using ClinicalTrials.gov.

Over one-fifth of US households speak a language other than English. While some studies have documented language-based disparities in pediatric clinical research, they are limited in scope and not representative of all US pediatric trials. Because language-based exclusion, if extensive, would limit the generalizability of the results of the research, we performed a systematic analysis of language-based eligibility criteria across all 4982 US pediatric interventional clinical trials registered on ClinicalTrials.

Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.

CD45-PET is a robust, non-invasive tool for imaging inflammation.

Imaging inflammation holds immense potential for advancing the diagnosis, treatment and prognosis of many conditions. The lack of a specific and sensitive positron emission tomography (PET) probe to detect inflammation is a critical challenge. To bridge this gap, we present CD45-PET imaging, which detects inflammation with exceptional sensitivity and clarity in several preclinical models.