Tubal Sterilization And Vasectomy Increased Among US Young Adults After The Supreme Court Decision In 2022.

Young adults' access to contraception is shifting after the June 2022 United States Supreme Court decision. This concurrent mixed-methods study measured young adults' use of and perceptions about tubal sterilization and vasectomy after the leaked opinion in May 2022. Using national-level medical claims data from IQVIA, we conducted difference-in-differences analyses of tubal sterilizations and vasectomies by age and state policy; using open-text survey responses from national MyVoice surveys in 2022 and 2023, we thematically analyzed young adults' perspectives.

Diabetes, Subclinical Myocardial Injury or Stress and Risk of Heart Failure Subtypes: The Jackson Heart Study.

Objective: To assess the extent to which the concomitant presence of subclinical myocardial injury or stress and diabetes affects the risk of heart failure (HF) subtypes.

Research Design And Methods: The Jackson Heart Study included Black adults, categorized based on diabetes status, high-sensitivity cardiac troponin I (hs-cTnI), and brain natriuretic peptide (BNP) levels. Subclinical myocardial injury was defined as hs-cTnI ≥4 ng/L in women and ≥6 ng/L in men, and subclinical myocardial stress as BNP ≥35 pg/mL.

Influenza vaccine effectiveness against medically attended outpatient illness, United States, 2023-24 season.

Background: The 2023-24 U.S. influenza season was characterized by a predominance of A(H1N1)pdm09 virus circulation with co-circulation of A(H3N2) and B/Victoria viruses.

A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett's Esophagus Using the AGREE II Tool.

Background: Several clinical practice guidelines (CPGs) exist for managing Barrett's esophagus (BE). However, the methodological quality of these CPGs is not known. To summarize the methodological quality of CPGs, we performed a critical appraisal of all available CPGs for the management of BE published from January 2018 to February 2023.

Plural molecular and cellular mechanisms of pore domain encephalopathy.

variants in children with neurodevelopmental impairment are difficult to assess due to their heterogeneity and unclear pathogenic mechanisms. We describe a child with neonatal-onset epilepsy, developmental impairment of intermediate severity, and G256W heterozygosity. Analyzing prior KCNQ2 channel cryoelectron microscopy models revealed G256 as a node of an arch-shaped non-covalent bond network linking S5, the pore turret, and the ion path.

Assessing Non-Oral PrEP Alternatives Among Young Black Women in the Southern USA.

Young Black women in the southern US face a high HIV burden. While daily oral HIV pre-exposure prophylaxis (PrEP) can effectively prevent HIV, its use is low among Black women. The acceptability of and perceived intention to use emerging PrEP products among young Black women in the southern US are not well understood.

Posttraumatic stress disorder and its associations with antiretroviral therapy among veterans with HIV.

Objectives: Posttraumatic stress disorder (PTSD) may affect antiretroviral therapy (ART) response and clinical outcomes for veterans with HIV (VWH) receiving care in the Department of Veterans Affairs (VA). Objectives are to estimate the associations between PTSD and ART nonadherence, modifications, and failure; measure effect modification by number of deployments and combat exposure; and examine how these associations vary over time.

Design: In this prospective cohort study of all VWH on ART who deployed to Iraq and Afghanistan and receive care in the VA (n = 3206), patients entered at ART initiation and were censored in December 2022, totaling 22 261 person-years of follow-up.

Mucin5AC promotes breast cancer brain metastasis through cMET/CD44v6.

Purpose: Breast cancer (BC) brain metastasis (BrM) remains a significant clinical problem. Mucins have been implicated in metastasis; however, if they are also involved in BCBrM remains unknown. We queried BrM patient databases and found Mucin 5AC (MUC5AC) to be upregulated and therefore sought to define the role of MUC5AC in BCBrM.

The inability to predict futility in hemorrhaging trauma patients using 4-hour transfusion volumes and rates.

Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.

Racial/ethnic differences in trends of testicular germ cell tumor incidence in the United States, 1992-2021.

Background: Testicular germ cell tumors (TGCTs) are the most common cancers among young men in the United States. Incidence rates among non-Hispanic White (NHW) men historically have been much higher than the rates among other men. To study whether this pattern had changed, the authors examined trends in TGCT incidence for the years 1992-2021.

A Meta-analysis of the Prevalence of Food Insecurity Among People Experiencing Housing Insecurity and Homelessness in the United States.

Objectives: Studies suggest that people experiencing housing insecurity and homelessness (HIH) have varying experiences with food insecurity. We estimated the prevalence of food insecurity and identified the factors associated with it among people experiencing HIH in the United States.

Methods: We conducted a meta-analysis of the prevalence of food insecurity among people experiencing HIH and a systematic review of associated factors through a comprehensive search of 8 academic databases.

Associations Between Vocational Interests and Personality "Beyond" the Big-Five.

This investigation explores the relationships between vocational interests and personality dimensions suggested to be "beyond" the Big Five or Five Factor Model. Participants (653 adults; 125 men and 528 women, with a mean age of 40.57 years, = 16.

Analysis of Orthopaedic Surgery Residency Match Results: 2016 to 2022.

: Objective data examining match trends and applicant characteristics are in high demand given the stakes involved with the orthopaedic surgery match. Our study sought to analyse the trends among matched orthopaedic surgery applicants to clarify how medical students can best prepare for and assess their chances of a successful orthopaedic residency match. : We used the publicly available National Residency Matching Program (NRMP) tool to gather characteristics for matched and unmatched orthopaedic surgery applicants from 2016 to 2022 and compare the probability of matching for all applicants versus each subgroup of reported applicant characteristics using risk difference (RD) and two-tailed p-values.

United States Pooled Cohort Cardiovascular Disease Risk Scores in Adults With Diabetes Mellitus.

Background: There is significant heterogeneity in cardiovascular disease (CVD) risk among patients with diabetes mellitus (DM).

Objectives: The purpose of this study was to develop risk scores for total CVD and its components from a contemporary pooled, observational cohort of U.S.

Propensity Score Analysis of Possible Medication Effects on Outcomes in Patients With Systemic Right Ventricles.

Background: Patients with systemic right ventricle (SRV), either d-transposition of the great arteries following an atrial switch procedure or congenitally corrected transposition of the great arteries, develop severe right ventricular dysfunction, prompting appropriate medical therapy. However, the efficacy of beta-blockers and angiotensin receptor blockers or angiotensin-converting enzyme inhibitors (ACEI) in SRV patients is unproven.

Objectives: The objective of this study was to determine the effects of ACEI/ARB and beta-blockers on outcomes in SRV patients after accounting for likely cofounders affecting their use.

A scoping review of diffuse hemispheric glioma, H3 G34-mutant: Epigenetic and molecular profiles, clinicopathology, and treatment avenues.

Background: Survival of pediatric and young adults with malignant glioma remains poor despite progress in treatment. This is especially true for diffuse hemispheric glioma (DHG), H3 G34-mutant, which is often present in adolescent and young adult patients. This scoping review consolidates existing knowledge of DHG H3 G34-mutant and identifies future targets and therapeutic options.

An Interdisciplinary Perspective on Improving Cancer Care in the State of Mississippi as an Example of Cancer Care Improvements in the Global South.

Cancer disparities, a critical public health issue, particularly in states such as Mississippi, where socioeconomic factors significantly influence health outcomes, require our collective attention. This paper delves into the multifaceted nature of cancer disparities through a macro-level analysis of cancer data, specifically focusing on Mississippi as a microcosm of broader national and global trends. Two key indices, the Socio-Demographic Index (SDI) and the Social Deprivation Index (SDeI), provide valuable insights.

Comparison of the WIDAR application with a manual photogrammetry method of creating 3D models of cadaveric hearts.

Novel methods of bringing gross anatomy laboratory experiences into the lecture setting may offset decreased contact hours. The iOS and Android photogrammetry application WIDAR is a time and cost-effective method for generating 3D digital models of donor specimens for use in medical education.

Alterations in the inflammatory homeostasis of aging-related cardiac dysfunction and Alzheimer's diseases.

Alzheimer's disease (AD) is well known among the elderly and has a profound impact on both patients and their families. Increasing research indicates that AD is a systemic disease, with a strong connection to cardiovascular disease. They share common genetic factors, such as mutations in the presenilin (PS1 and PS2) and the apolipoprotein E (APOE) genes.

Forty-seventh ASPEN Presidential Address: Parenteral nutrition compounding-Advancement or regression, where do we stand?

Parenteral nutrition (PN), a high-alert medication, is an important lifesaving modality. The American Society for Parenteral and Enteral Nutrition (ASPEN) has historically provided guidelines and recommendations for the safe and efficacious use of PN. These recommendations have included detailed guidance regarding the compounding of this highly complex medication.

Extravillous trophoblasts reverse the decidualization induced increase in matrix production by secreting TGFβ antagonists Emilin-1 and Gremlin-1.

The maternal-fetal interface has long been considered as a frontier for an evolutionary arms race due to the close juxtaposition of genetically distinct tissues. In hemochorial species with deep placental invasion, including in humans, maternal stroma prepares its defenses against deep trophoblast invasion by decidualization, a differentiation process characterized by increased stromal cell matrix production, and contractile force generation. Decidualization has evolved from an ancestral wound healing response of fibroblast activation by the endometrial stroma.

Computed tomography scanning in the diagnosis of lower extremity phlebolymphedema.

Objectives: Phlebolymphedema, the most common cause of secondary lymphedema in Western societies, seldom gets the attention it deserves. Diagnosis is often missed and when evaluated is through lymphoscintigraphy (LSG) which is cumbersome. This study aims to assess the role of computed tomography (CT) scanning in the diagnosis of phlebolymphedema of the lower extremities by comparing CT characteristics to the International Society of Lymphology (ISL) grading system and LSG.

Multiple environmental tracers combined with a constrained Bayesian isotope mixing model to elucidate nitrate and sulfate contamination in a coastal groundwater system.

Several groundwater quality investigations have been conducted in coastal regions that are commonly exposed to multiple anthropogenic stressors. Nonetheless, such studies remain challenging because they require focused-diagnostic approaches for a comprehensive understanding of groundwater contamination. Therefore, this study integrates a multi-tracer approach to acquire comprehensive information allowing for an improved understanding of the origins of groundwater contamination, the relative contribution of contaminants, and their biogeochemical cycling within a coastal groundwater system.

Extended reality as a modality to train non-technical skills in healthcare: A scoping review.

The need to train non-technical skills (NTS) has seen a growing emphasis in recent literature, as they have been associated with improved patient outcomes. NTS training often utilizes live simulations where healthcare workers can practice these skills, but simulations like this can be expensive and resource intensive to run. Training technical skills using extended reality tools (e.

Anti-neuraminidase and anti-hemagglutinin stalk responses to different influenza a(H7N9) vaccine regimens.

Introduction: Pandemic influenza vaccine development focuses on the hemagglutinin (HA) antigen for potency and immunogenicity. Antibody responses targeting the neuraminidase (NA) antigen, or the HA stalk domain have been implicated in protection against influenza. Responses to the NA and HA-stalk domain following pandemic inactivated influenza are not well characterized in humans.