Coronary atherosclerosis in athletes: emerging concepts and preventive strategies.

There should be no assumption that an athlete is immune to coronary artery disease (CAD), even when traditional cardiovascular (CV) risk factors appear well-managed. Excelling in certain aspects of health does not equate to total CV protection. Recent data from cardiac imaging studies have raised the possibility that long-term, high-volume, high-intensity endurance exercise is associated with coronary atherosclerosis.

Preservation of the azygos vein versus ligation of the azygos vein during primary surgical repair of congenital esophageal atresia.

Background: Esophageal atresia is one of the most common life-threatening congenital malformations and is defined as an interruption in the continuity of the esophagus with or without fistula to the trachea or bronchi. Definitive treatment is surgical ligation of the fistula if present and esophageal end-to-end anastomosis of the two pouches, thereby reconstructing the continuity of the esophagus. During this procedure, the surgeon may choose to either ligate or preserve the azygos vein, a major draining vein for the esophagus and surrounding structures, but no definitive consensus on the matter exists.

Variation in Hypertension Control by Race and Ethnicity, and Geography in US Veterans.

Background: Hypertension control and related cardiovascular outcomes among Americans remain suboptimal, and differ by race, ethnicity, and geography. Healthcare access is one of multiple critical factors in hypertension control. Understanding the degree to which healthcare access, versus other factors, produce these outcomes can inform policies and interventions to improve cardiovascular outcomes and reduce disparities.

A Malleable Collagen-Mimic that Undergoes Moisture-Induced Hardening for Gluing Hydrophilic Surfaces.

A collagen-inspired helical protein-mimic has been synthesized via topochemical polymerization of a designed tripeptide monomer. In the monomer crystal, molecules arrange in a head-to-tail manner, forming supramolecular helices. The azide and alkyne of adjacent molecules in the supramolecular helix are proximally preorganized in a ready-to-react arrangement.

Testing the mediating mechanism of alcohol use on the association between retirement and depressive symptoms in the United States using generalized mixed effect models.

Objectives: Both alcohol use and the prevalence of depression-depressive disorders, among older adults have increased over the past several decades and have been associated with increased morbidity and mortality. To our knowledge, the interactions between retirement, depression, and alcohol use have not yet been examined. This study aims to longitudinally explore the mediating role of alcohol use on the association between retirement and depressive symptoms in the United States, comparing individuals who are retired and not retired, while also exploring individuals who transitioned into and out of retirement at different times.

Anti-bacterial Efficacy of Zirconium Oxide Nanoparticles on Streptococcus mutans and Enterococcus faecalis: An In Vitro Study.

Introduction Complex interactions between cariogenic bacteria and host factors modulate dental caries. , a gram-positive facultative anaerobe plays a prominent role in the initiation of caries. The ability of to adhere to salivary enamel pellicle results in an acidic local habitat for the organism.

Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey-Based Study.

Objective: We investigated use of hearing care among US veterans and explore motivations, barriers, and adherence to hearing healthcare.

Study Design: Cross-sectional online survey.

Setting: US Veterans.

Making Deception Fun: Teaching Autistic Individuals How to Play Friendly Tricks.

Perspective taking is a critical repertoire for navigating social relationships and consists of a variety of complex verbal skills, including socially adaptive forms of deception. Detecting and being able to use socially adaptive deception likely has many practical uses, including defending oneself against bullying, telling white lies to avoid hurting others' feelings, keeping secrets and bluffing during games, and playing friendly tricks on others. Previous research has documented that some Autistic children have challenges identifying deception and playfully deceiving others (Reinecke et al.

Association of Kidney Function With Inpatient Mortality and Morbidity After Cardiac Surgery.

Background: Contemporary population-based data examining the rates of cardiac surgery and the relationship between non-dialysis-requiring chronic kidney disease (CKD) and postoperative outcomes in cardiac surgery are limited.

Methods: We identified hospital admissions for cardiac surgical procedures in adults from 2010-2019 in the United States. The primary exposure was kidney disease, categorized as CKD stage G3, CKD stages G4 or G5, and end-stage kidney disease (ESKD).

"In the spectrum of people who are healthy": Views of individuals at risk of dementia on using neurotechnology for cognitive enhancement.

Neurotechnological cognitive enhancement has become an area of intense scientific, policy, and ethical interest. However, while work has increasingly focused on ethical views of the general public, less studied are those with personal connections to cognitive impairment. Using a mixed-methods design, we surveyed attitudes regarding implantable neurotechnological cognitive enhancement in individuals who self-identified as having increased likelihood of developing dementia (n=25; 'Our Study'), compared to a nationally representative sample of Americans (n=4726; 'Pew Study').

The Scenic Route: Lingular Metastasectomy Through the Right Chest.

Metastasectomy for isolated pulmonary metastasis can improve disease-free and overall-survival in well-selected patients. When feasible, a minimally invasive wedge resection is the preferred approach. However, a hostile ipsilateral chest can hinder surgical resection.

Impact of Surreptitious Glucocorticoids in Over-the-Counter Arthritis Supplements.

Adrenal dysfunction due to over-the-counter (OTC) health supplements containing unlabeled glucocorticoids has been previously reported. Here, we present a case series of 12 patients at an urban safety net medical center evaluated by endocrinology for iatrogenic adrenal dysfunction, Cushing syndrome (CS) and/or adrenal insufficiency (AI), associated with use of OTC arthritis supplements surreptitiously containing glucocorticoids. There were 12 patients using OTC arthritis supplements (Artri King [n = 8], Ardosons [n = 3], Ajo Rey [n = 1]) included.

Recurrent Bacteremia and Cholangitis From Eroded Hepatic Artery Pseudoaneurysm Coil Into the Common Hepatic Duct: A Rare Indication for Liver Transplantation.

Liver transplant may be necessary to manage infectious complications from severe structural biliary disease. In this report, we describe a 71-year-old woman with history of coil-embolized hepatic artery pseudoaneurysm who subsequently developed biliary obstruction resulting from coil erosion into the common hepatic duct. Resultant complications included recurrent cholangitis, bacteremia, and numerous hepatic abscesses.

The Role of Empiric Antifungal Therapy in Patients With Perforated Peptic Ulcer: An Updated Systematic Review and Meta-Analysis.

Fungal growth is common in intraoperative cultures of patients with perforated peptic ulcer (PPU) leading to the common use of empiric antifungal therapy, with current evidence not clearly supporting this practice. The goal of this updated systematic review and meta-analysis was to synthesize the effect of empiric antifungals in patients with PPU. Eligible studies were identified through a comprehensive literature search in the MEDLINE (PubMed) and EMBASE databases, following the PRISMA 2020 statement.

Demographic and Clinical Characteristics of Mental Health Crisis Line Callers Who Were Transferred to 911.

Objective: This study aimed to describe the characteristics of callers to a statewide mental health crisis line who were transferred to 911 (active rescue).

Methods: This retrospective cohort study examined mental health crisis line calls transferred to active rescue (N=3,538 calls; N=3,132 unique callers) from the Georgia Crisis and Access Line (2016-2018). Chi-square analyses and t tests were used to examine descriptive differences between caller characteristics and call features.

Voxel-Based Morphometry and Subfield Volumetry Analysis Reveal Limbic System Involvement in Tinnitus.

Background And Purpose: Tinnitus is a condition in which individuals perceive sounds, such as ringing or buzzing, without any external source. Although the exact cause is not fully understood, recent studies have indicated the involvement of nonauditory brain structures, including the limbic system. We aimed to compare the volumes of specific brain structures between patients with tinnitus and controls.

Impulsivity behaviors and white matter mediate the relationship between genetic risk for cannabis use disorder and early cannabis use in adolescents.

Background And Aim: Cannabis use disorder (CUD) is strongly influenced by genetic factors; however the mechanisms underpinning this association are not well understood. This study investigated whether a polygenic risk score (PRS) based on a genome-wide association study for CUD in adults predicts cannabis use in adolescents and whether the association can be explained by inter-individual variation in structural properties of brain white matter or risk-taking behaviors.

Design And Setting: Longitudinal and cross-sectional analyses using data from the IMAGEN cohort, a European longitudinal study integrating genetic, neuroimaging and behavioral measures.

Objective study validity diagnostics: a framework requiring pre-specified, empirical verification to increase trust in the reliability of real-world evidence.

Objective: Propose a framework to empirically evaluate and report validity of findings from observational studies using pre-specified objective diagnostics, increasing trust in real-world evidence (RWE).

Materials And Methods: The framework employs objective diagnostic measures to assess the appropriateness of study designs, analytic assumptions, and threats to validity in generating reliable evidence addressing causal questions. Diagnostic evaluations should be interpreted before the unblinding of study results or, alternatively, only unblind results from analyses that pass pre-specified thresholds.

Study protocol for a hybrid type 3 effectiveness-implementation trial of a team-based implementation strategy to support educators' use of a social engagement intervention.

Background: Remaking Recess (RR) is a school-based evidence-based peer social engagement intervention for autistic students. RR involves direct training and coaching with educators; however, educators face several barriers to implementation at both the individual- and organizational-levels. This protocol paper describes a multi-site study that will test whether an educator-level implementation strategy, coaching, with or without a school-level implementation strategy, school-based teams, will maximize educators' use (fidelity and sustainment) of RR for autistic students and their peers who are socially-isolated, rejected, or peripheral and may need additional support during recess.

Standardized patient profile review using large language models for case adjudication in observational research.

Using administrative claims and electronic health records for observational studies is common but challenging due to data limitations. Researchers rely on phenotype algorithms, requiring labor-intensive chart reviews for validation. This study investigates whether case adjudication using the previously introduced Knowledge-Enhanced Electronic Profile Review (KEEPER) system with large language models (LLMs) is feasible and could serve as a viable alternative to manual chart review.

Transcription factor networks in cellular quiescence.

Many of the cells in mammalian tissues are in a reversible quiescent state; they are not dividing, but retain the ability to proliferate in response to extracellular signals. Quiescence relies on the activities of transcription factors (TFs) that orchestrate the repression of genes that promote proliferation and establish a quiescence-specific gene expression program. Here we discuss how the coordinated activities of TFs in different quiescent stem cells and differentiated cells maintain reversible cell cycle arrest and establish cell-protective signalling pathways.

A response time-based mixture item response theory model for dynamic item-response strategies.

Educational researchers have a long-lasting interest in the strategies examinees employ when responding to items in an assessment. Mixture item response theory (IRT) modeling is a popular class of approaches to studying examinees' item-response strategies. In the present study, we introduce a response time (RT)-based mixture IRT model for flexible modeling of examinee-and-item-specific item-response strategies.

Associations between per-and polyfluoroalkyl substances (PFAS) and county-level cancer incidence between 2016 and 2021 and incident cancer burden attributable to PFAS in drinking water in the United States.

Background: Exposure to per- and polyfluoroalkyl substances (PFAS) has been linked with various cancers. Assessment of PFAS in drinking water and cancers can help inform biomonitoring and prevention efforts.

Objective: To screen for incident cancer (2016-2021) and assess associations with PFAS contamination in drinking water in the US.

Deep learning model to identify and validate hypotension endotypes in surgical and critically ill patients.

Background: Hypotension is associated with organ injury and death in surgical and critically ill patients. In clinical practice, treating hypotension remains challenging because it can be caused by various underlying haemodynamic alterations. We aimed to identify and independently validate endotypes of hypotension in big datasets of surgical and critically ill patients using unsupervised deep learning.

Impact of diabetes mellitus on coronary artery plaque characteristics and outcomes in the SCOT-HEART trial.

Background: Diabetes mellitus is an established cardiovascular risk factor. We assessed the impact of diabetes mellitus on quantitative plaque and long-term outcomes in patients with and without diabetes mellitus in the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

Methods: Coronary artery calcium (CAC) was assessed on non-contrast computed tomography (CT).