Dissection of type 2 diabetes: a genetic perspective.

Diabetes is a leading cause of global mortality and disability, and its economic burden is substantial. This Review focuses on type 2 diabetes, which makes up 90-95% of all diabetes cases. Type 2 diabetes involves a progressive loss of insulin secretion often alongside insulin resistance and metabolic syndrome.

Flusion: Integrating multiple data sources for accurate influenza predictions.

Over the last ten years, the US Centers for Disease Control and Prevention (CDC) has organized an annual influenza forecasting challenge with the motivation that accurate probabilistic forecasts could improve situational awareness and yield more effective public health actions. Starting with the 2021/22 influenza season, the forecasting targets for this challenge have been based on hospital admissions reported in the CDC's National Healthcare Safety Network (NHSN) surveillance system. Reporting of influenza hospital admissions through NHSN began within the last few years, and as such only a limited amount of historical data are available for this target signal.

Diversifying the Surgical Workforce: Understanding Barriers to Inform Solutions.

Objectives: Race and gender concordance between physicians and patients is associated with reductions in healthcare disparities. However, the diversity of the medical workforce does not mirror the population; some of the greatest deficiencies exist in the surgical workforce. We conducted a pilot study focused on early recruitment of diverse college students in our region, with a concurrent needs assessment of their specific barriers to entering the field of surgery.

Correlating autonomic physiology with symptoms of autonomic dysreflexia after spinal cord injury.

Background: Individuals with spinal cord injury (SCI) commonly have autonomic dysreflexia (AD) with increased sympathetic activity. After SCI, individuals have decreased baroreflex sensitivity and increased vascular responsiveness.

Objective: To evaluate the relationship between baroreflex and blood vessel sensitivity with AD symptoms.

Extended Post-Operative Antibiotic Usage Does Not Reduce Surgical Site Infections after Spinal Surgery.

Currently there is not a clear basis of evidence for post-operative antibiotic duration in spine surgery. A better understanding of risk factors and proper dosing for antibiotics will help improve outcomes and further define appropriate antibiotic use. A single-center retrospective cohort study of all patients undergoing spinal fusions and/or decompressions between January 1, 2018, and July 1, 2023 was performed.

Recent clinical and mechanistic insights into vitiligo offer new treatment options for cell-specific autoimmunity.

Vitiligo is an autoimmune disease that has been recognized, stigmatized, and treated for millennia. Recent translational research has revealed key mechanisms of disease, including cellular stress, innate immune activation, T cell-mediated elimination of melanocytes from the skin resulting in clinically apparent white spots, as well as stem cell regeneration that reverses established lesions. Many of these pathways have been targeted therapeutically, leading to the first FDA-approved medication to reverse the disease, with many more in clinical trials.

No bones about it: regulatory T cells promote fracture healing.

Regulatory T cells (Tregs) are increasingly being recognized for their role in promoting tissue repair. In this issue of the JCI, Chen et al. found that Tregs at the site of bone injury contribute to bone repair.

Seizure outcomes after resection of temporal encephalocele in patients with drug-resistant epilepsy: A systematic review and meta-analysis.

Objective: Temporal encephaloceles (TEs) are seen in patients with drug-resistant epilepsy (DRE); yet they are also common incidental findings. Variability in institutional pre-surgical epilepsy practices and interpretation of epileptogenic network localization contributes to bias in existing epilepsy cohorts with TE, and therefore the relevance of TE in DRE remains controversial. We sought to estimate effect sizes and sample sizes necessary to demonstrate clinically relevant improvements in seizure outcome with different surgical approaches.

Downscaling of Non-Van der Waals Semimetallic WN with Resistivity Preservation.

The bulk phase of transition metal nitrides (TMNs) has long been a subject of extensive investigation due to their utility as coating materials, electrocatalysts, and diffusion barriers, attributed to their high conductivity and refractory properties. Downscaling TMNs into two-dimensional (2D) forms would provide valuable members to the existing 2D materials repertoire, with potential enhancements across various applications. Moreover, calculations have anticipated the emergence of uncommon physical phenomena in TMNs at the 2D limit.

Lessons Learned From the Liver About the Undergraduate to Graduate Medical Education Transition.

The burden of cirrhosis and chronic liver disease is growing, yet there is a projected worsening deficit in hepatology providers. As such, cirrhosis and liver disease have been important inclusions within the core curricula of Internal Medicine. Formal assessments of provider preparedness resulting from the curriculum are lacking though.

Cognitive and Alzheimer's disease biomarker effects of oral nicotinamide riboside (NR) supplementation in older adults with subjective cognitive decline and mild cognitive impairment.

Introduction: Age-associated depletion in nicotinamide adenine dinucleotide (NAD+) concentrations has been implicated in metabolic, cardiovascular, and neurodegenerative disorders. Supplementation with NAD+ precursors, such as nicotinamide riboside (NR), offers a potential therapeutic avenue against neurodegenerative pathologies in aging, Alzheimer's disease, and related dementias. A crossover, double-blind, randomized placebo (PBO) controlled trial was conducted to test the safety and efficacy of 8 weeks' active treatment with NR (1 g/day) on cognition and plasma AD biomarkers in older adults with subjective cognitive decline and mild cognitive impairment.

Cardio-Obstetrics Practice in Latin America: A Regional Survey of General Cardiologists.

Background: Cardiovascular (CV) disease is a leading cause of death in pregnant women globally, especially in low- and middle-income countries including Latin America (LATAM), where there is lack of data on how cardiologists are trained in cardio-obstetrics (CO) and the practice patterns in the care of pregnant patients.

Objectives: The authors aimed to identify CO competency and practice patterns among LATAM general cardiologists.

Methods: An anonymous cross-sectional Google-based electronic survey was sent via email to clinical cardiologists through local American College of Cardiology chapters and CV societies.

Association of Epicardial Adipose Tissue and Ventricular Arrhythmias in Patients With Nonischemic Cardiomyopathy.

Background: Risk stratification for sudden cardiac death (SCD) in patients with nonischemic cardiomyopathy (NICM) remains challenging.

Objectives: This study aimed to investigate the impact of epicardial adipose tissue (EAT) on SCD in NICM patients.

Methods: Our study cohort included 173 consecutive patients (age 53 ± 14 years, 73% men) scheduled for primary prevention implantable cardioverter-defibrillators (ICDs) implantation who underwent preimplant cardiovascular magnetic resonance.

Rheumatic Heart Disease Burden in Africa and the Need to Build Robust Infrastructure.

Rheumatic heart disease (RHD) is an important public health problem in Africa. Mapping the epidemiology of RHD involves elucidating its geographic distribution, temporal trends, and demographic characteristics. The prevalence of RHD in Africa varies widely, with estimates ranging from 2.

PREVENT and Pooled Cohort Equations in Mortality Risk Prediction: National Health and Nutrition Examination Survey.

Background: The Predicting Risk of CVD Events (PREVENT) equations were developed to address limitations of the Pooled Cohort Equations (PCEs) in predicting atherosclerotic cardiovascular disease (ASCVD) risk. The comparative effectiveness of the PREVENT equations versus the PCEs in predicting mortality risk remains unknown.

Objectives: The purpose of this study was to compare the risk discrimination value of the PREVENT equations with the PCEs for predicting mortality.

Associations With Adverse Postoperative Outcomes in Children Undergoing Atrial Septal Defect Closure in Lower-Resource Settings.

Background: Atrial septal defects (ASDs) are a common cause of congenital heart disease worldwide.

Objectives: The purpose of the study was to assess change over time in surgical outcomes for ASD repair and identify patient-level risk factors for adverse postoperative outcomes.

Methods: We analyzed cases of isolated ASD in patients <18 years from 2010 to 2020 from 71 sites participating in the International Quality Improvement Collaborative for Congenital Heart Disease.

Implementation of a Virtual Cardiology Curriculum to Address the Deficit of Cardiovascular Education in Haiti.

Background: Cardiovascular disease (CVD) is the leading cause of death in low- and middle-income countries such as Haiti. Our team has demonstrated in a pilot study the implementation of a virtual cardiology curriculum to address the deficit of cardiology education in Haiti among medicine residents.

Objectives: The objective of this study was to determine if cardiology education can be delivered nationwide in Haiti via a virtual platform with quantifiable improvement.

Vaccination Against Influenza and Pneumococcus During Pretravel Health Consultations in the United States: Interventions and Missed Opportunities.

Background: Infections by and influenza viruses are vaccine-preventable diseases causing great morbidity and mortality. We evaluated pneumococcal and influenza vaccination practices during pre-international travel health consultations.

Methods: We evaluated data on pretravel visits over a 10-year period (1 July 2012 through 31 June 2022) from 31 sites in Global TravEpiNet (GTEN), a consortium of US healthcare facilities providing pretravel health consultations.

Malnutrition and risks of atrial fibrillation recurrence after catheter ablation.

Background: Recent data showed an association between malnutrition and increased all-cause mortality and thromboembolic risk in patients with atrial fibrillation (AF). However, the impact of malnutrition on the clinical outcomes for patients undergoing catheter ablation for AF is still debated. Our study aimed to examine this relationship using all existing available data.