Net Promoter Score as a Reflection of Patients' Opinions About Telemedical Visits: A Mixed Methods Analysis.

In order to assess patient experiences of telemedicine, researchers and administrators use the net promoter score (NPS), based on a likelihood to recommend (LTR) question. However, there is reason to doubt validity of this metric for this purpose. We assessed the degree to which the LTR question reflects actual patient preferences about telemedicine.

Medicaid‑Insured Children with Medical Complexity in a Rural State.

Objectives: To describe children with medical complexity (CMC) in Montana according to their clinical characteristics, rurality and distance from specialty care, and to assess for disparities in geographic access to specialty care for American Indian children.

Methods: In this cross-sectional study we categorized children in 2016-2021 Montana Medicaid claims data using the Pediatric Medical Complexity Algorithm and compared the associations of medical complexity and demographic traits using Chi-squared tests. Using a database of providers we calculated drive times from children's residences to the nearest pediatric subspecialist and calculated bootstrap confidence intervals for the difference in median driving distances by complexity and race.

Pharmacogenetic and microRNA mechanisms of beta blocker use on bone.

Motivated by studies showing an association between beta blocker (BB) use and positive bone outcomes, a pilot randomized control trial (RCT) was performed at the Mayo Clinic which randomized postmenopausal women to placebo, propranolol (40 or 80 mg twice daily), atenolol (50 mg/day), or nebivolol (5 mg/day) to determine changes in bone turnover markers (BTMs) and in bone mineral density (BMD) over 20 weeks. Pharmacogenetic effects and microRNA-mediated mechanisms involving beta adrenergic receptor and related genes have previously been found. We sought to validate these effects and discover new candidates in an ancillary study to the pilot clinical trial.

Associations of PFAS concentrations during pregnancy and midlife with bone health in midlife: Cross-sectional and prospective findings from Project Viva.

Background: PFAS may impair bone health, but effects of PFAS exposure assessed during pregnancy and the perimenopause-life stages marked by rapidly changing bone metabolism-on later life bone health are unknown.

Methods: We studied 531 women in the Boston-area Project Viva cohort. We used multivariable linear, generalized additive, and mixture models to examine associations of plasma PFAS concentrations during early pregnancy [median (IQR) maternal age 32.

NOISe: Nuclei-Aware Osteoclast Instance Segmentation for Mouse-to-Human Domain Transfer.

Osteoclast cell image analysis plays a key role in osteoporosis research, but it typically involves extensive manual image processing and hand annotations by a trained expert. In the last few years, a handful of machine learning approaches for osteoclast image analysis have been developed, but none have addressed the full instance segmentation task required to produce the same output as that of the human expert led process. Furthermore, none of the prior, fully automated algorithms have publicly available code, pretrained models, or annotated datasets, inhibiting reproduction and extension of their work.

Predictors of frequency of CF care in the US Cystic Fibrosis Foundation Patient Registry.

Introduction: Prolonged gaps in care of >12-months are frequent among people with cystic fibrosis (pwCF) and are associated with reduced lung function. Comprehensive analysis of patient-level predictors of visit frequency is needed to optimize protocols for stable pwCF and identify subgroups at high risk of gaps and poor outcomes, promoting equitable treatment for all pwCF.

Objective: To determine sociodemographic and disease-related factors predictive of visit frequency in pwCF and to assess how these effects vary across the lifespan.

A Call for Pediatric Clinicians to Address Environmental Health Concerns in Rural Settings.

Children in rural communities encounter unique environmental exposures, many of which can result in negative long-term health consequences. Children are particularly at risk from these exposures due to their close interaction with the environment and developing physiology. The authors describe 3 rural environmental hazards: wood stove smoke, well water contaminants, and agricultural pollutants.

Cellular Characteristics and Protein Signatures of Human Adipose Tissues from Donors With or Without Advanced Coronary Artery Disease.

: Perivascular adipose tissue (PVAT) exerts a paracrine effect on blood vessels and our objective was to understand PVAT molecular signatures related to cardiovascular disease. : We studied two groups: those undergoing mitral valve repair/replacement (VR, n = 16) and coronary artery bypass graft (CABG, n = 38). VR donors did not have coronary artery disease, whereas CABG donors had advanced coronary artery disease.

The relationship between adverse childhood experiences and disorders of the gut-brain interaction.

Objectives: Disorders of the gut-brain interaction (DGBI) arise from a complex interplay of psychosocial factors, altered physiology, and early life factors. In adults, adverse childhood experiences (ACEs) have been associated with DGBI. While both ACEs and DGBI are prevalent among children, the relationship between ACEs and DGBI in childhood is not well understood.

Spatial and temporal distribution of Ixodes scapularis and tick-borne pathogens across the northeastern United States.

Background: The incidence of tick-borne diseases is increasing across the USA, with cases concentrated in the northeastern and midwestern regions of the country. Ixodes scapularis is one of the most important tick-borne disease vectors and has spread throughout the northeastern USA over the past four decades, with established populations in all states of the region.

Methods: To better understand the rapid expansion of I.

Calorie restriction induces mandible bone loss by regulating mitochondrial function.

Caloric restriction (CR), commonly used as both a lifestyle choice and medical strategy, has been shown to adversely impact appendicular bone mass. However, its influence on alveolar bone health and the underlying mechanisms remain poorly understood. In this study, 8-week-old C57BL/6 J mice were fed with 30 % CR for 8 weeks.

In nondiabetic C57BL/6J mice, canagliflozin affects the skeleton in a sex- and age-dependent manner.

Canagliflozin (CANA) is a sodium glucose cotransporter-2 inhibitor that reduces blood glucose levels. Sodium glucose cotransporter-2 is primarily expressed in the kidney, but not in any bone cells, therefore effects on the skeleton are likely to be non-cell autonomous. Originally developed to treat type II diabetes, CANA use has expanded to treat cardiovascular and renovascular disease.

Aging alters the effect of adiponectin receptor signaling on bone marrow-derived mesenchymal stem cells.

Adiponectin receptor signaling represents a promising therapeutic target for age-related conditions such as osteoporosis and diabetes. However, the literature presents conflicting evidence regarding the role of adiponectin signaling in bone homeostasis and fracture repair across different health states, ages, and disease conditions. These inconsistencies may arise from the complex endocrine and paracrine feedback mechanisms regulating adiponectin, as well as the variability in adiponectin isoforms and receptor expressions.

Diabetes Control Status and Severity of Depression: Insights from NHANES 2005-2020.

Examining the risk of depression among patients with diabetes is crucial for understanding the mental health burden of this chronic condition. This study examined the likelihood of depression severity among participants in the National Health And Nutrition Examination Survey (NHANES) from 2005 to 2020, based on glycemic control status. Depression severity was categorized into three levels using the Patient Health Questionnaire-9 (PHQ-9), and glycemic control status was categorized into five groups based on prior diabetes diagnoses and hemoglobin A1c (HbA1c) levels.

Latest on Anabolic Agents for Osteoporosis Treatment.

In the last decades, novel therapeutics with anabolic bone properties have been developed and are currently used in the management of osteoporosis particularly in patients with high-risk of fragility fractures. These drugs include PTH-Related Analogues, teriparatide and abaloparatide, and the anti-sclerostin agent romosozumab, this latter drug currently approved only in female patients. Their efficacies in preventing fragility fractures are widely demonstrated and their potential serious side effects were progressively downgraded, including risk of malignancies in teriparatide- and cardiovascular events in romosozumab-users, respectively.

Assessing variations in care delivered to rural out of hospital cardiac arrest patients in the interfacility transfer setting.

Objective: There is significant variation in out-of-hospital cardiac arrest (OHCA) outcomes between different regions. We sought to evaluate outcomes of OHCA patients in the interfacility transfer (IFT) setting, between critical care transport (LifeFlight) and community Emergency Medical Services (EMS), in the state of Maine.

Methods: This was a retrospective analysis of our institution's electronic medical record and the Maine EMS database.

ALK1 Signaling in Human Cardiac Progenitor Cells Promotes a Pro-angiogenic Secretome.

Pro-angiogenic paracrine/autocrine signaling impacts myocardial repair in cell-based therapies. Activin A receptor-like type 1 (, ALK1) signaling plays a pivotal role in cardiovascular development and maintenance, but its importance in human-derived therapeutic cardiac cells is not well understood. Here, we isolated a subpopulation of human highly proliferative cells (hHiPCs) from adult epicardial tissue and found that they express ALK1, a high affinity receptor for bone morphogenetic protein-9 (BMP9), which signals via SMAD1/5 to regulate paracrine/autocrine signaling and angiogenesis.

Associations of ethnicity, skin tone, and genome-wide sequencing with bone mineral density in adolescents.

Background: Dual-energy x-ray absorptiometry reference data designate Black and non-Black categories, as higher BMD has been documented among Black youth. We examined associations of race, skin tone, and genetic factors with bone mineral density (BMD).

Methods: 557 adolescents were followed longitudinally.