Mixed-methods reproductive health knowledge, attitudes and practices survey of IDPs, returnees and host communities in Jonglei State, South Sudan.

Objectives: To understand the current state of maternal, newborn and child health (MNCH) among internally displaced persons (IDPs), returnees and host communities in remote counties of Jonglei state.

Design: Cross-sectional, randomly sampled, mixed-methods, population-based household study.

Setting: Ayod, Nyirol, Fangak and Pigi counties of Jonglei, South Sudan.

Proton Beam Therapy for Pancreatic Tumors: A Consensus Statement from the Particle Therapy Cooperative Group Gastrointestinal Subcommittee.

Objectives: Radiotherapy manages pancreatic cancer in various settings; however, the proximity of gastrointestinal (GI) luminal organs-at-risk (OAR) poses challenges to conventional radiotherapy. Proton beam therapy (PBT) may reduce toxicities compared to photon therapy. This consensus statement summarizes PBT's safe and optimal delivery for pancreatic tumors.

Factors and Outcomes Associated With Using Scratch-Cooked, Organic, and Locally Grown Foods in School Meals in California.

Background: Incorporating scratch-cooked, organic, and locally grown foods into school meal programs can enhance meal quality and support local food systems.

Methods: 430 California school food authorities were surveyed to (1) evaluate their use of scratch-cooked, organic, and locally grown foods in their programs; (2) identify demographic and operational characteristics related to this use; and (3) analyze the relationship between serving more of these foods and perceived barriers to student meal participation. Poisson and logistic regression models, adjusted for SFAs' demographic characteristics, were used.

Role of CTRP14/C1QL1 in motor coordination and learning across the lifespan.

C1q/TNF-related protein 14 (CTRP14), also known as C1q-like 1 (C1QL1), is a synaptic protein predominantly expressed in the brain. It plays a critical role in the formation and maintenance of the climbing fiber-Purkinje cell synapses, ensuring that only one single winning climbing fiber from the inferior olivary neuron synapses with the proximal dendrites of Purkinje cells during the early postnatal period. Loss of CTRP14/C1QL1 results in incomplete elimination of supernumerary climbing fibers, leading to multiple persistent climbing fibers synapsing with the Purkinje cells.

Are Fewer Diagnoses Better? Assessing A Proposal To Improve The Medicare Advantage Payment System.

Medicare Advantage (MA) plans report diagnoses more completely than they are reported in traditional Medicare. As a result, payment to MA plans is greater than it would be if coding patterns were identical in the two sectors. The Medicare Payment Advisory Commission estimates that the overpayment to MA attributable to differential coding was $50 billion in 2024.

Current Use And Evaluation Of Artificial Intelligence And Predictive Models In US Hospitals.

Effective evaluation and governance of predictive models used in health care, particularly those driven by artificial intelligence (AI) and machine learning, are needed to ensure that models are fair, appropriate, valid, effective, and safe, or FAVES. We analyzed data from the 2023 American Hospital Association Annual Survey Information Technology Supplement to identify how AI and predictive models are used and evaluated for accuracy and bias in hospitals. Hospitals use AI and predictive models to predict health trajectories or risks for inpatients, identify high-risk outpatients to inform follow-up care, monitor health, recommend treatments, simplify or automate billing procedures, and facilitate scheduling.

Self-Diagnosed Cases of Dissociative Identity Disorder on Social Media: Conceptualization, Assessment, and Treatment.

Recent global popularity of social media content about dissociative identity disorder (DID) has coincided with increased self-diagnosis among children and young people who have formed large online communities and presented in clinical settings seeking to affirm their self-diagnoses. We situate this phenomenon within a broader trend toward self-diagnosis due to the widespread visibility and accessibility of mental health content on social media. Social media propelled self-diagnosis raises particular questions for the study and treatment of DID due to long-standing debates over whether the condition is traumagenic, sociogenic, or iatrogenic.

Structure-Activity Relationship Studies of an Autophagy Inhibitor That Targets the ATG14L-Beclin1 Protein-Protein Interaction Reveal Modifications That Improve Potency and Solubility and Maintain Selectivity.

Autophagy, a recycling process in eukaryotes, contributes to tumor growth and metastasis by alleviating cellular stress and facilitating survival and chemoresistance. The development of small molecules that selectively inhibit this pathway has proven challenging and is required to determine if autophagy inhibition can be harnessed as an effective therapeutic strategy in cancer. Compound 19 was previously identified as a selective autophagy inhibitor that targets the ATG14L-Beclin1 protein-protein interaction, which regulates the formation, localization, and function of VPS34 Complex I to initiate autophagy.

Second Time Around: Increased Rate of Living Donation From Repeat Organ Donors.

Introduction: Some living organ donors will decide to donate again at a later date. Evidence has indicated that this practice may have increased in recent years. We evaluated the incidence and outcomes of this practice to inform counseling of potential repeat donors.

Human mobility and malaria risk in peri-urban and rural communities in the Peruvian Amazon.

Background: While the global burden of malaria cases has decreased over the last two decades, the disease remains a major international threat, even on the rise in many regions. More than 85% of Peruvian malaria cases are in the Amazonian region of Loreto. Internal mobility primarily related to occupation is thought to be primarily responsible for maintaining endemicity and introducing and reintroducing malaria parasites into areas of anophelism, a challenge for malaria eradication.

Leveraging cancer mutation data to inform the pathogenicity classification of germline missense variants.

Innovative and easy-to-implement strategies are needed to improve the pathogenicity assessment of rare germline missense variants. Somatic cancer driver mutations identified through large-scale tumor sequencing studies often impact genes that are also associated with rare Mendelian disorders. The use of cancer mutation data to aid in the interpretation of germline missense variants, regardless of whether the gene is associated with a hereditary cancer predisposition syndrome or a non-cancer-related developmental disorder, has not been systematically assessed.

Quality of care offered by health care retail markets for medication abortion self-management: Findings from states in Nigeria and India.

Dispensing of misoprostol and mifepristone by pharmacies and chemist shops for self-management of medication abortion (MA) fills a crucial gap in settings where abortion care by trained health professionals is not readily available. This promising service delivery pathway, endorsed by the World Health Organization (WHO), is hindered by concerns of poor-quality care. Simulated clients collected data on MA pill dispensing practices from 92 pharmacies and chemist shops in three Nigerian states and 127 pharmacies in an Indian state that we have anonymized.

Evaluating the ingress of total polycyclic aromatic hydrocarbons (PAHs) specifically naphthalene through firefighter hoods and base layers.

Structural firefighters are exposed to an array of polycyclic aromatic hydrocarbons (PAHs) as a result of incomplete combustion of both synthetic and natural materials. PAHs are found in both the particulate and vapor phases in the firefighting environment and are significantly associated with acute and chronic diseases, including cancer. Using a fireground exposure simulator (FES) and standing mannequins dressed in four different firefighter personal protective equipment (PPE) conditions, each with varying levels of protective hood interface and particulate-blocking features, the efficacy of the hoods was assessed against the ingress of PAHs (specifically, naphthalene).

EUS-Guided Gastroenterostomy for Benign Gastric Outlet Obstruction: A Systematic Review and Meta-analysis.

Background And Aims: Gastric outlet obstruction (GOO) is a clinical manifestation of mechanical obstruction at the antropyloric region or proximal small bowel. The goal of endoscopic management is to relieve the obstruction so patients can resume per oral intake. Most studies have focused on malignant causes of GOO; yet only a handful have explored outcomes related to benign etiologies.

Impact of COVID-19 Diagnosis on Weight Trajectories of Children in the US National COVID Cohort Collaborative.

The COVID-19 pandemic has exacerbated the obesity epidemic, with both adults and children demonstrating rapid weight gain during the pandemic. However, the impact of having a COVID-19 diagnosis on this trend is not known. Using longitudinal data from January 2019 to June 2023 collected by the US National Institute for Health's National COVID Cohort Collaborative (N3C), children (age 2-18 years) with positive COVID-19 test results { = 11,474, 53% male, mean [standard deviation (SD)] age 5.

Recent Developments in Women's Health Research at the US National Institutes of Health.

Importance: This article highlights key National Institutes of Health (NIH) programs, policies, and scientific advances that have informed and improved the health of women and describe the promise and potential of harnessing cutting-edge science and integrative approaches to advance women's health research. Policy updates combined with recent scientific and programmatic initiatives are intended to expand understanding of women's health, deliver diagnostics, and develop preventive approaches and novel therapies to meet critical health needs of contemporary women.

Observations: To benefit all people through the work funded and conducted by the NIH biomedical research enterprise, NIH has implemented policies that broadly expanded the knowledge of human health and disease from the laboratory to the clinic.

Priority Clinical Actions for Outpatient Management of Nonhospitalized Traumatic Brain Injury.

Outpatient care following nonhospitalized traumatic brain injury (TBI) is variable, and often sparse. The National Academies of Sciences, Engineering, and Medicine's 2022 report on highlighted the need to improve the consistency and quality of TBI care in the community. In response, the present study aimed to identify existing evidence-based guidance and specific clinical actions over the days to months following nonhospitalized TBI that should be prioritized for implementation in primary care.

Glucarpidase for Treatment of High-Dose Methotrexate Toxicity.

High-dose methotrexate (MTX) results in high rates of acute kidney injury (AKI), neutropenia, and hepatotoxicity. Glucarpidase is a recombinant enzyme that cleaves MTX, but clinical data supporting its use are scarce. We examined the association between glucarpidase administration and outcomes in adults with MTX-AKI from 28 cancer centers across the U.

Incarceration is associated with higher mortality after trauma: An unreported health care disparity.

Background: While the United States has the highest incarceration rate worldwide, at nearly 1% of the adult population (more than 2 million people), insights regarding health disparities in this population remain limited. This retrospective cohort study represents the largest national database analysis of incarcerated trauma patients to date and investigates whether incarceration status is an independent risk factor for poor outcomes after trauma for US adults.

Methods: We analyzed data from the National Trauma Data Bank from 2017 to 2018.