Future Directions in the Management of Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

Context: The traditional management of classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHD) is difficult and often suboptimal.

Objective: To review improvements in the diagnosis and management of 21OHD.

Design: Literature review, synthesis, and authors' experience.

Mental Health Issues Associated With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

Context: The goal of this review is to move beyond summarizing what is known about psychosexual development in females with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency-commonly studied as a natural experiment to understand prenatal androgen effects in 46,XX individuals. Instead, it will explore the various aspects of the condition that significantly impact the daily lives of both male and female patients and their families, with a particular focus on the implications for psychosocial, educational, and vocational adaptation.

Evidence Acquisition: This work represents a selective, yet balanced review of papers highlighting potential threats to positive psychological adaptation in both male and female individuals with CAH.

Managing Calciphylaxis: Insights from Real-World Cases at a Tertiary Academic Center.

Calciphylaxis is a rare and potentially fatal condition involving chronic, nonhealing wounds caused by microvascular calcification. There is currently no approved treatment for calciphylaxis, contributing to its devastating impacts on quality of life. In this case series, the authors highlight instances of potentially misdiagnosed calciphylaxis in a cohort of patients and emphasize the importance of accurate diagnosis through multidisciplinary management approaches.

RAVE checklist: Recommendations for overcoming challenges in retrospective safety studies of automated driving systems.

Objective: The public, regulators, and domain experts alike seek to understand the effect of deployed SAE level 4 automated driving system (ADS) technologies on safety. The recent expansion of ADS technology deployments is paving the way for early stage safety impact evaluations, whereby the observational data from both an ADS and a representative benchmark fleet are compared to quantify safety performance.

Methods: In January 2024; a working group of experts across academia, insurance, and industry came together in Washington, DC to discuss the current and future challenges in performing such evaluations.

Travel Time as an Indicator of Poor Access to Care in Surgical Emergencies.

Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.

Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.

The pregnant moms' empowerment program - Mexico enhances mental health for women exposed to intimate partner violence: a pilot randomized controlled trial.

Purpose: Given the lack of available and effective interventions to address the detrimental consequences of perinatal exposure to intimate partner violence (IPV) on maternal mental health, and reported very low access to IPV-related mental health services in Mexico, we examined the feasibility and efficacy of a culturally adapted, virtual, brief group psychosocial intervention designed to improve maternal mental and physical health and reduce IPV revictimization for pregnant women exposed to IPV. In this pilot randomized controlled trial, we evaluated maternal outcomes after participation in the Pregnant Moms' Empowerment Program (PMEP) in Mexico.

Methods: Women were recruited from social service agencies and health centers in the community, as well as social media advertisements that targeted pregnant women living in Mexico.

Everyday ethnic discrimination and early substance use based on hair samples in high-risk racial/ethnic minority early adolescents.

Objectives: Although racially and ethnically minoritized youth are more likely to experience adverse effects of substance use, and substance use before age 14 is strongly associated with an elevated risk of later substance use disorders, there is limited research identifying risk factors for early substance use. The study examined the role of experiencing ethnic discrimination from teachers, other adults outside of school, and other students in predicting early substance use (measured with hair toxicology reports).

Methods: The study used data from the Adolescent Brain Cognitive Development Study.

The gendered nature of leader behaviors: Navigating stereotype threat from conservation of resources and gender role perspectives.

Previous research has highlighted the benefits followers gain from their leaders' initiating structure and consideration. Adopting a leader-centric perspective, we propose that leaders' gender influences the impact of these behaviors for leaders themselves. Drawing from conservation of resources and gender role theories, we explain why gender-role-inconsistent leader behaviors (behaviors that go against gender stereotypes, such as initiating structure for women and consideration for men) is detrimental, while engaging in gender-role-consistent leader behaviors (such as initiating structure for men and consideration for women) is beneficial.

MRI-assessed Dynamic Hyperinflation Induced by Tachypnea in Chronic Obstructive Pulmonary Disease: The SPIROMICS-HF Study.

Purpose To assess the repeatability of real-time cine pulmonary MRI measures of metronome-paced tachypnea (MPT)-induced dynamic hyperinflation and its relationship with chronic obstructive pulmonary disease (COPD) severity. Materials and Methods SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) (ClinicalTrials.gov identifier no.

Novel Sarcoidosis Epitope Augments MHCII, CD80/CD86 Expression, Promotes B-Cell Differentiation and IgG Production.

Numerous chronic human disorders are associated with immune activation by obscure antigen(s). We identified a novel sarcoidosis-epitope (ChainA) by immunoscreening of a novel T7 phage library and confirmed an abundance of ChainA IgG-antibody in sarcoidosis. We tested whether ChainA epitope elicits immune responses through B-cell activation, plasma cell differentiation and antibody production.

Food availability has direct and delayed effects on structural growth and body reserves in garter snakes.

Phenotypic plasticity in body growth enables organisms to cope with unpredictable paucities in resource availability. Growth traits influence survival and reproductive success, and thereby, population persistence, and early-life resource availability may govern lifetime patterns in growth, reproductive success, and survival. The influence of early-life environment is decidedly consequential for indeterminately growing ectotherms, which rely on available resources and ambient temperatures to maximize fitness throughout life.

Nanoscopic acoustic vibrational dynamics of a single virus captured by ultrafast spectroscopy.

The natural vibrational frequencies of biological particles such as viruses and bacteria encode critical information about their mechanical and biological states as they interact with their local environment and undergo structural evolution. However, detecting and tracking these vibrations within a biological context at the single particle level has remained elusive. In this study, we track the vibrational motions of single, unlabeled virus particles under ambient conditions using ultrafast spectroscopy.

Adenosine diphosphate stimulates VEGF-independent choroidal endothelial cell proliferation: A potential escape from anti-VEGF therapy.

We hypothesized that a strategy employing tissue-specific endothelial cells (EC) might facilitate the identification of tissue- or organ-specific vascular functions of ubiquitous metabolites. An unbiased approach was employed to identify water-soluble small molecules with mitogenic activity on choroidal EC. We identified adenosine diphosphate (ADP) as a candidate, following biochemical purification from mouse EL4 lymphoma extracts.

C-Reactive Protein Changes in Adult and Pediatric People With Cystic Fibrosis During Treatment of Pulmonary Exacerbations.

Objective: Although studies have examined changes in C-reactive protein (CRP) during pulmonary exacerbations (PEX) in people with cystic fibrosis (PwCF), few have evaluated CRP profiles across age groups. Here, we characterize age-related CRP responses to PEX treatment.

Methods: We measured CRP concentrations at the beginning and end of intravenous (IV) antibiotic therapy for PEX in 100 pediatric and 147 adult PwCF at 10 US CF Centers.

Medications for Alcohol Use Disorder Are Increasingly Being Prescribed in American Patients with Advanced Liver Disease.

The number of alcohol use disorder patients with mild (n=101) and severe alcoholic liver disease (n=112) increased between 2013 and 2023 (p=0.06). Naltrexone was prescribed in 65%, acamprosate 26% and disulfiram 9%.

An Unexpected Case of Clear Cell Adenocarcinoma of the Cervix in a Non-Diethylstilbestrol-Exposed Postmenopausal Woman.

Clear cell adenocarcinoma of the cervix (CCAC) is a rare subtype of cervical adenocarcinoma. It has been linked to intrauterine exposure to diethylstilbestrol (DES) but can happen in non-DES-exposed patients, albeit less commonly. Presentation is largely vaginal bleeding, emphasizing the importance of considering CCAC in the differential of abnormal vaginal bleeding despite the tumor's rarity.

Evaluation of Risk Factors for Dupilumab-Associated Ocular Sequelae in the Treatment of Atopic Dermatitis.

Dupilumab is a monoclonal antibody that inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling and is used in the treatment of moderate-to-severe atopic dermatitis (AD) in those six months or older who are uncontrolled on or cannot tolerate topical treatments. Ocular surface disease is a recognized adverse effect of dupilumab, yet few studies describe the risk factors for developing ocular adverse effects. There are no standardized recommendations for monitoring patients on this medication.

Education Research: Use by Neurologists of Microteaching and Microassessment Programs for Teaching, Learning, and Patient Care Needs: A Qualitative Study.

Background And Objectives: Microlearning is the acquisition of knowledge or skills in small units, commonly delivered by digital technology. NeuroBytes (NB) and Question of the Day (QOD) are 2 microinstructional programs in neurology. NB programs are brief, video-based mini-courses on clinical topics (microteaching); QODs are daily multiple-choice questions (microassessment).

Curcumin encapsulated in PAMAM dendrimers for the therapeutic treatment of ischemic stroke in rats.

Introduction: Ischemic stroke is a devastating neurovascular condition that occurs when cerebral tissue fails to receive an adequate supply of oxygen. Despite being a leading cause of death and disability worldwide, therapeutic interventions are currently limited. Polyamidoamine (PAMAM) dendrimers are nanomolecules commonly used in biomedical applications due to their ability to encapsulate small-molecules and improve their pharmacokinetic properties.

The role of autophagy in Graves disease: knowns and unknowns.

Graves disease (GD), an autoimmune disease affects the thyroid gland, results in hyperthyroidisms and goiter. The main cause of GD is not clearly defined; however, stimulating autoantibodies for thyroid stimulating hormone receptor (TSHR) known as thyroid-stimulating immunoglobulins (TSIs) are the primary proposed mechanism. The TSI activation of TSHRs of thyroid gland results in excessive release of thyroid hormones with the subsequent development of hyperthyroidism and goiter.

Variation in compressive mechanical properties between subacute and chronic venous thrombosis in a novel unilateral iliac thrombosis model.

Interventional therapies to relieve chronic deep vein thrombosis (DVT) fail through inability to penetrate, cross, and remove the occlusion. Development of suitable tools requires fundamental understanding of chronic DVT mechanical properties and a reliable model for testing. Female farm swine underwent a novel, endovenous generation of long-segment unilateral iliac vein thrombosis.