Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.

Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.

Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.

Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.

Diagnostic value of CT scans in pediatric patients with acute non-traumatic altered mental status: a systematic review and meta-analysis.

Background: Computed tomography (CT) scans are widely used for evaluating children with acute atraumatic altered mental status (AMS) despite concerns about radiation exposure and limited diagnostic yield. This study aims to assess the efficacy of CT scans in this population and provide evidence-based recommendations.

Methods: A systematic review was conducted according to PRISMA guidelines.

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Background: Pediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI.

Methods: We analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 U.

Health Care Resource Utilization With Dronedarone Versus Sotalol Following Catheter Ablation in Adults With Atrial Fibrillation.

Background: Clinical trials support dronedarone use for atrial fibrillation (AF) following catheter ablation (CA); however, comparative data on health care resource utilization (HCRU) with other antiarrhythmic drugs are lacking.

Methods: Retrospective analysis of Merative MarketScan databases (January 01, 2012-March 31, 2020) comparatively assessed HCRU in US adults with AF who received dronedarone or sotalol post-CA. Patients with ≥ 12-months' pre-CA data were followed from post-CA index treatment to disenrollment, death, or study end.

Long-Term Impact of Pregnancy on Clinical Outcomes in Individuals With Hypertrophic Cardiomyopathy.

Background: The effect of pregnancy on individuals with hypertrophic cardiomyopathy (HCM) is not well investigated.

Objectives: The purpose of this study was to assess the impact of pregnancy on all-cause mortality and clinical outcomes among individuals with HCM.

Methods: Using the TriNetX research network, we identified individuals within reproductive age (≥18-45 years) with a diagnosis of HCM between 2012 and 2022 (n = 10,936).

Discovery of Rezatapopt (PC14586), a First-in-Class, Small-Molecule Reactivator of p53 Y220C Mutant in Development.

p53 is a potent transcription factor that is crucial in regulating cellular responses to stress. Mutations in the gene are found in >50% of human cancers, predominantly occurring in the DNA-binding domain (amino acids 94-292). The Y220C mutation accounts for 1.

Structure-Based Design of Novel TLR7/8 Agonist Payloads Enabling an Immunomodulatory Conjugate Approach.

Dual activation of the TLR7 and TLR8 pathways leads to the production of type I interferon and proinflammatory cytokines, resulting in efficient antigen presentation by dendritic cells to promote T-cell priming and antitumor immunity. We developed a novel series of TLR7/8 dual agonists with varying ratios of TLR7 and TLR8 activity for use as payloads for an antibody-drug conjugate approach. The agonist-induced production of several cytokines in human whole blood confirmed their functional activity.

A Real-World Prospective Multiple Sclerosis Pregnancy Registry in the United States: PREG-MS.

Background And Objectives: Multiple sclerosis (MS) affects more than 1 million people in the United States, including reproductive-age women. There has been a paucity of prospective, pregnancy registries based on MS disease rather than medication exposures. A prospective MS pregnancy registry (PREG-MS) was established in 2017 as a prospective, single-cohort, real-world MS pregnancy registry in New England States of the United States, with goals to evaluate (1) course of MS and disease-modifying therapies (DMT) use during conception attempts and in the peripartum period, (2) pregnancy outcomes in women with MS (WwMS), and (3) longer-term developmental outcomes in offspring of WwMS.

Controlled ligation and elongation of uniformly truncated amyloid nanofibrils.

This study investigates the production and inter-fibril interactions of uniformly truncated amyloid nanofibrils. By varying extrusion cycles (0, 50, and 100) and using carbonate filters with 100 nm and 200 nm pore sizes, precise fibril length control was achieved. Atomic force microscopy (AFM) confirmed that the mean length of the truncated fibrils corresponded to the respective pore size as extrusion cycles increased.

Gastric Ultrasound in the Management of Emergency Department Patients with Upper Gastrointestinal Bleeding: A Case Series and Sonographic Technique.

Background: Gastrointestinal bleeding (GIB) is a common condition in the emergency department (ED) with high incidence and mortality.

Objectives: Very early risk stratification of GIB patients can sometimes be a challenge. The decision to intubate these patients is multifactorial and requires careful consideration.

Pretrained Deep Neural Network Kin-SiM for Single-Molecule FRET Trace Idealization.

Single-molecule fluorescence resonance energy transfer (smFRET) has emerged as a pivotal technique for probing biomolecular dynamics over time at nanometer scales. Quantitative analyses of smFRET time traces remain challenging due to confounding factors such as low signal-to-noise ratios, photophysical effects such as bleaching and blinking, and the complexity of modeling the underlying biomolecular states and kinetics. The dynamic distance information shaping the smFRET trace powerfully uncovers even transient conformational changes in single biomolecules both at or far from equilibrium, relying on trace idealization to identify specific interconverting states.

Methodological Considerations When Studying Resistance-Trained Populations: Ideas for Using Control Groups.

Hammert, WB, Dankel, SJ, Kataoka, R, Yamada, Y, Kassiano, W, Song, JS, and Loenneke, JP. Methodological considerations when studying resistance-trained populations: Ideas for using control groups. J Strength Cond Res 38(12): 2164-2171, 2024-The applicability of training effects from experimental research depends on the ability to quantify the degree of measurement error accurately over time, which can be accounted for by including a time-matched nonexercise control group.

A Proposed mHealth Intervention to Address Patient Barriers to Colposcopy Attendance: Qualitative Interview Study of Clinic Staff and Patient Perspectives.

Background: Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural and psychosocial barriers to following up with colposcopy are problematic for minoritized women. Evidence-based interventions using patient navigation and tailored telephone counseling, including the Tailored Communication for Cervical Cancer Risk (TC3), have modestly improved colposcopy attendance.

Nonclinical and clinical characterization of the absorption, metabolism, and excretion of islatravir.

The development of new and improved antiretroviral therapies that allow for alternative dosing schedules is needed for people living with HIV-1. Islatravir is a deoxyadenosine analog in development for the treatment of HIV-1 that suppresses HIV-1 replication via multiple mechanisms of action, including reverse transcriptase translocation inhibition and delayed chain termination. Islatravir is differentiated from other HIV-1 antiretrovirals by its high potency, long , broad tissue distribution, and favorable drug resistance profile.

Addressing the Shortage of Academic Nurse Educators: An Opportunity for Collaboration Between Academic and Healthcare Organization Leaders.

Background: The numbers of nursing school admissions and, thus, future nursing graduates are directly affected by the lack of qualified ANEs.

Methods: A consortium of diverse ANEs was formed to research these questions using the nominal group technique.

Results: Two central themes emerged from the consortium: support and collaboration.

Emerging themes in microbial stress response and mechanistic insights: key findings from the fall 2024 ASM Theobald Smith Society meeting.

The annual fall meeting for the Theobald Smith Society was held in November 2024 on the campus of Rutgers University-New Brunswick. Eighty-six branch members from across New Jersey attended the meeting, composed of undergraduate, graduate, and postdoctoral trainees, faculty members, and government and industry professionals. This report highlights the breadth and diversity of research conducted by American Society for Microbiology members in the Theobald Smith Society and celebrates their groundbreaking discoveries.

Surgical Opioid Stewardship: From the Epidemic Through the Pandemic and Beyond.

Background: In response to the opioid epidemic, prescribing guidelines and statewide surgical opioid management programs were initiated in 2018-19. This analysis aims to document the sustainability of a regional opioid stewardship consortium through the pandemic and beyond.

Study Design: From September 2019 through August 2023, 15 NSQIP hospitals in two states gathered opioid-specific variables on patients undergoing 12 procedures.

Environmental Exposures Associated with Enteropathogen Infection in Six-Month-Old Children Enrolled in the ECoMiD Cohort along a Rural-Urban Gradient in Northern Ecuador†.

Enteropathogens are major contributors to mortality and morbidity, particularly in settings with limited access to water, sanitation, and hygiene infrastructure. To assess transmission pathways associated with enteropathogen infection, we measured household environmental conditions and assayed 22 enteropathogens using TaqMan Array Cards in stool samples from 276 six-month-old children living in communities along a rural-urban gradient in Northern Ecuador. We utilized multivariable models, risk factor importance, and distance-based statistical methods to test factors associated with infection.

Enhancing the Travel Experience for People with Visual Impairments through Multimodal Interaction: NaviGPT, A Real-Time AI-Driven Mobile Navigation System.

Assistive technologies for people with visual impairments (PVI) have made significant advancements, particularly with the integration of artificial intelligence (AI) and real-time sensor technologies. However, current solutions often require PVI to switch between multiple apps and tools for tasks like image recognition, navigation, and obstacle detection, which can hinder a seamless and efficient user experience. In this paper, we present NaviGPT, a high-fidelity prototype that integrates LiDAR-based obstacle detection, vibration feedback, and large language model (LLM) responses to provide a comprehensive and real-time navigation aid for PVI.

Strategic Management of Valve Infolding in Evolut TAVR Procedures: Enhancing Outcomes and Ensuring Patient Safety.

Transcatheter aortic valve repair (TAVR) presents a minimally invasive alternative to traditional surgical valve replacement, albeit not without its own set of complications. A rare complication is the infolding of the self-expanding valve, which can precipitate cardiac arrest. The estimated incidence rate of this complication stands at 1.

Macrophage Activation Syndrome/Secondary Hemophagocytic Lymphohistiocytosis in Adult-Onset Still's Disease: An Uncommon Initial Presentation in a Young Nepalese Female: A Case Report.

Hemophagocytic lymphohistiocytosis (HLH), is a fatal systemic hyperinflammatory syndrome. HLH may be due to immunosuppression, infections, cancer, or autoimmune diseases with fever and cytopenia. HLH which occurs in adult-onset Stills disease (AOSD) is called secondary HLH, also known as macrophage activation syndrome (MAS).

Current Applications and Future Directions for Vascular Stents with Stem Cells in the Treatment of Intracranial Aneurysms: A Mini-Review.

Vascular stents and stem cells have been used in high-acuity cases for many decades, particularly in cardiology. Providing the physician with another avenue of treatment, they have had a reasonable amount of success. However, there has been very little research conducted on seeding vascular stents with stem cells when treating intracranial aneurysms.

A Randomized Clinical Study Investigating the Stain Removal Efficacy of Two Experimental Dentifrices.

Objective: This study aims to evaluate extrinsic tooth stain removal and whitening efficacy of two experimental dentifrices containing (i) 5% sodium tripolyphosphate (STP)/1% micronized alumina or (ii) 5% STP/1% micronized alumina with abrasive silica (ED2) compared to a regular fluoride dentifrice (RFD) following 8 weeks of use.

Materials And Methods: This was a single-center, randomized, controlled, blind, three-arm, stratified, parallel-group study. Eligible participants underwent clinical assessment of stain on the facial/lingual surfaces of maxillary and mandibular teeth using the modified Lobene stain index (MLSI), and shade of the facial surfaces of the central and lateral maxillary incisors using the VITA Bleachedguide 3D-Master (VITA) shade guide.

Identifying genetic differences between bipolar disorder and major depression through multiple genome-wide association analyses.

Background: Accurate diagnosis of bipolar disorder (BPD) is difficult in clinical practice, with an average delay between symptom onset and diagnosis of about 7 years. A depressive episode often precedes the first manic episode, making it difficult to distinguish BPD from unipolar major depressive disorder (MDD).

Aims: We use genome-wide association analyses (GWAS) to identify differential genetic factors and to develop predictors based on polygenic risk scores (PRS) that may aid early differential diagnosis.

Determining the intention of receiving the influenza vaccine: a cross-sectional survey among international and domestic college students in the USA.

Objective: Vaccination is the most effective strategy for preventing infectious diseases, yet it is underused in young adults. College students are important targets for the influenza vaccine given this population's low vaccination rates; however, limited research has focused on international college students' vaccination status. This study examined the relationships between the theory of planned behaviour (TPB; attitudes, perceived behavioural control (PBC) and subjective norms) and students' intention of receiving an influenza vaccine.