Palliative Care Program for Community-Dwelling Individuals With Dementia and Caregivers: The IN-PEACE Randomized Clinical Trial.

Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.

Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.

Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).

Short-term costs of alcohol-associated hepatitis care in different clinical settings.

Background: Alcohol-associated hepatitis (AH) leads to high rates of mortality and health care costs. Understanding the immediate costs after an AH diagnosis and identifying key cost factors is crucial for health care policies and clinical decisions.

Objectives: This study quantifies medical costs within 30 days of an AH diagnosis across outpatient (OP), emergency department (ED), and inpatient (IP) settings.

Sodium valproate enhances efficacy of NKG2D CAR-T cells against glioblastoma.

Chimeric antigen receptor T-cell (CAR-T) therapies have shown promise in glioblastoma clinical studies, but responses remain inconsistent due to heterogeneous tumor antigen expression and immune evasion post-treatment. NKG2D CAR-T cells have demonstrated a favorable safety profile in patients with hematologic tumors, and showed robust antitumor efficacy in various xenograft models, including glioblastoma. However, malignant glioma cells evade immunological surveillance by reducing NKG2D ligands expression or cleavage.

Effect of Ibuprofen on Markers of Acute Kidney Injury, Intestinal Injury, and Endotoxemia after Running in the Heat.

Purpose: To test the hypothesis that ibuprofen ingestion exacerbates markers of acute kidney injury (AKI), gastrointestinal (GI) injury, and endotoxemia after running in the heat.

Methods: Using a randomized double-blind crossover design, eleven physically active individuals (six women) ingested 600 mg of ibuprofen or placebo 12- and one-hour prior to running one-hour in a heated chamber (35 °C, 20%-60% R.H.

Cell-specific transcriptional signatures of vascular cells in Alzheimer's disease: perspectives, pathways, and therapeutic directions.

Alzheimer's disease (AD) is a debilitating neurodegenerative disease that is marked by profound neurovascular dysfunction and significant cell-specific alterations in the brain vasculature. Recent advances in high throughput single-cell transcriptomics technology have enabled the study of the human brain vasculature at an unprecedented depth. Additionally, the understudied niche of cerebrovascular cells, such as endothelial and mural cells, and their subtypes have been scrutinized for understanding cellular and transcriptional heterogeneity in AD.

Positive feedback regulation between RpoS and BosR in the Lyme disease pathogen.

In , the causative agent of Lyme disease, differential gene expression is primarily governed by the alternative sigma factor RpoS (σ). Understanding the regulation of RpoS is crucial for elucidating how is maintained throughout its enzootic cycle. Our recent studies have shown that the homolog of Fur/PerR repressor/activator BosR functions as an RNA-binding protein that controls the mRNA stability.

Impact of liver cirrhosis on morbidity and mortality of patients admitted to the hospital with necrotizing fasciitis.

Background: Necrotizing fasciitis (NF) is a potentially fatal bacterial infection of the soft tissues. Liver cirrhosis appears to be a contributing factor to higher morbidity and mortality in patients with NF. This research article explores the relationship between these two conditions.

Role of the Veterans Health Administration's LGBTQ+ Veteran Care Coordinators in Facilitating Care for Transgender and Gender-Diverse Veterans.

Introduction: Transgender and gender-diverse (TGD) individuals frequently encounter discrimination in health care settings. The Veterans Health Administration (VA) is committed to addressing the health disparities experienced by TGD veterans. The purpose of this study was to explore the experiences of TGD veterans with LGBTQ+ veteran care coordinators.

Parent-Adult Child Relationships and Repartnering After Gray Divorce.

Objectives: The rise in gray divorce has catalyzed repartnering in later life. However, the antecedents of older adult repartnering remain poorly understood, particularly the potential role of adult children. A form of ambiguous loss, marital disruption often leads to family boundary ambiguity, thereby weakening family ties.

Forensic Assessment of Kinship, Genomic Ancestry, and Natural History of an Iconic Tiger of Harlem-New York City.

In the fall of 2003, a two-year-old tiger named Ming, weighing some four hundred pounds, was discovered living in an apartment in Harlem, New York. Ming's rescue by NYPD was witnessed, recalled, and venerated by scores of neighbors. The tiger's history and ancestry stimulated considerable media interest, investigative sleuthing, and forensic genomic analyses.

Direct factor Xa inhibitors versus low molecular weight heparins or vitamin K antagonists for prevention of venous thromboembolism in elective primary hip or knee replacement or hip fracture repair.

Background: People undergoing major orthopaedic surgery are at increased risk of postoperative thromboembolic events. Low molecular weight heparins (LMWHs) are recommended for thromboprophylaxis in this population. New oral anticoagulants, including direct factor Xa inhibitors, are recommended as alternatives.

Variational Autoencoder-based Model Improves Polygenic Prediction in Blood Cell Traits.

Genetic prediction of complex traits, enabled by large-scale genomic studies, has created new measures to understand individual genetic predisposition. Polygenic Risk Scores (PRS) offer a way to aggregate information across the genome, enabling personalized risk prediction for complex traits and diseases. However, conventional PRS calculation methods that rely on linear models are limited in their ability to capture complex patterns and interaction effects in high-dimensional genomic data.

Engaging Patients with Headache in the Veterans Health Administration (VHA): ACTIvated Veterans Engagement Group (ACTIVE) to Improve Delivery of Patient-Centered Headache Services.

In 2018, the Veterans Health Administration (VHA) established the original 19 Headache Centers of Excellence (HCoE) program, and an evaluation center. This study utilized a Veteran engagement group method to elicit input from Veteran patients living with chronic headache on daily needs, social determinants of health, and preferences and suggestions for headache programs, services, and research priorities. Four engagement groups were conducted between July 13 and August 22 of 2022 with Veterans who experience headache and received care at a VHA HCoE.

Synthetic studies of the mutant proinsulin syndrome demonstrate correlation between folding efficiency and age of diabetes onset.

Purpose: Heterozygous mutations in the insulin gene can give rise to a monogenic diabetes syndrome due to toxic misfolding of the variant proinsulin in the endoplasmic reticulum (ER) of pancreatic β-cells. Clinical mutations are widely distributed in the sequence (86 amino acids). Misfolding induces chronic ER stress and interferes in with wildtype biosynthesis and secretion.

Determining the minimal amount of DMSO necessary to stabilize the Angiomotin lipid binding domain.

Angiomotins (Amots) are a family of adaptor proteins with important roles in cell growth, migration, and proliferation. The Amot coiled-coil homology (ACCH) domain has a high affinity for non-phosphorylated and mono-phosphorylated phosphatidylinositol which provides specificity in the membrane association. The membrane specificity is linked with targeting and recycling of the membrane protein to maintain normal cell phenotypes and function.

Association of a Liver Allocation Policy Change With Domestic Travel for Liver Transplantation.

Background: In 2020, liver allocation policy in the United States was changed to allow for broader organ sharing, which was hypothesized to reduce patient incentives to travel for transplant. Our objective was to describe patterns of travel for domestic liver transplant pre- and post-acuity circle (AC) implementation.

Methods: Incident adult liver transplant listings between August 16, 2016, and February 3, 2020 (pre-AC) or June 13, 2020, and December 3, 2023 (post-AC) were obtained from the Scientific Registry of Transplant Recipients.

Integrating deep learning and machine learning for improved CKD-related cortical bone assessment in HRpQCT images: A pilot study.

High resolution peripheral quantitative computed tomography (HRpQCT) offers detailed bone geometry and microarchitecture assessment, including cortical porosity, but assessing chronic kidney disease (CKD) bone images remains challenging. This proof-of-concept study merges deep learning and machine learning to 1) improve automatic segmentation, particularly in cases with severe cortical porosity and trabeculated endosteal surfaces, and 2) maximize image information using machine learning feature extraction to classify CKD-related skeletal abnormalities, surpassing conventional DXA and CT measures. We included 30 individuals (20 non-CKD, 10 stage 3 to 5D CKD) who underwent HRpQCT of the distal and diaphyseal radius and tibia and contributed data to develop and validate four different AI models for each anatomical site.

Body mass index and sleep disorders after moderate-to-severe traumatic brain injury - a national TBI model systems study.

Objective: To examine the relationship between body mass index (BMI), newly developed sleep disorders and functional outcome after moderate-to-severe traumatic brain injury (msTBI).

Methods: Retrospective data from the TBI Model Systems National Database was analyzed, focusing on the independent association between BMI, sleep disorder diagnosis, and functional outcome as measured by the Extended Glasgow Outcome Scale (GOSE) at 1-year post-injury. Linear and logistic regression were used.

Epigenetic Threads of Neurodegeneration: TFAM's Intricate Role in Mitochondrial Transcription.

There is a myriad of activities that involve mitochondria that are crucial for maintaining cellular equilibrium and genetic stability. In the pathophysiology of neurodegenerative illnesses, mitochondrial transcription influences mitochondrial equilibrium, which in turn affects their biogenesis and integrity. Among the crucial proteins for keeping the genome in optimal repair is mitochondrial transcription factor A, more commonly termed TFAM.

Criminal Offending and Incarceration in United States Adults With Early Phase Psychosis and Comorbid Substance Use Disorder.

Aim: Studies have shown that people experiencing early phase psychosis (EPP) are at increased risk for criminal conviction and incarceration. However, there is limited data looking at overall legal burden. To address these gaps in the literature, the goal of this study was to categorise criminal charges and convictions using the United States Federal Bureau of Investigation (FBI) uniform crime reporting (UCR) program, assess frequency of incarcerations, and describe the frequency of substance use disorder (SUD) diagnoses and its relationship to criminal offending and incarceration in a well categorised EPP population.

Serum Periostin is Able to Stratify Type 2-Dominant Ulcerative Colitis.

Background: Ulcerative colitis (UC) is a heterogeneous disease composed of different endotypes. It is important to develop useful biomarkers for endotyping UC; however, available biomarkers are insufficient. We have already established that periostin is a surrogate biomarker of type 2 inflammation.