Long term latency of highly mutated cells in normal mouse skin is reversed by exposure to tumor promoters and chronic tissue damage.

Historical studies performed nearly a century ago using mouse skin models identified two key steps in cancer evolution: initiation, a likely mutational event, and promotion, driven by inflammation and cell proliferation. Initiation was proposed to be permanent, with promotion as the critical rate-limiting step for cancer development. Here, we carried out whole genome sequencing to demonstrate that initiated cells with thousands of mutagen-induced mutations can persist for long periods and are not removed by cell competition or by immune intervention, thus mimicking the persistence of cells with cancer driver mutations in normal human tissues.

Exploring the Role of Immersive Virtual Reality Simulation in Health Professions Education: Thematic Analysis.

Background: Although technology is rapidly advancing in immersive virtual reality (VR) simulation, there is a paucity of literature to guide its implementation into health professions education, and there are no described best practices for the development of this evolving technology.

Objective: We conducted a qualitative study using semistructured interviews with early adopters of immersive VR simulation technology to investigate use and motivations behind using this technology in educational practice, and to identify the educational needs that this technology can address.

Methods: We conducted 16 interviews with VR early adopters.

Frequency of Culture-proven Bacterial Infection and Radiographic Pneumonia in Pediatric Heart Transplant Recipients.

Background: Infection is a leading cause of death after pediatric heart transplants (PHTs). Understanding of common pathogens is needed to guide testing strategies and empiric antibiotic use.

Methods: We conducted a 3-center retrospective study of PHT recipients ≤18 years old presenting to cardiology clinics or emergency departments (EDs) from 2010 to 2018 for evaluation of suspected infections within 2 years of transplant.

Navigating Dual-Harm: Integrating Self- and Other-Harm Into Public Health Inquiry.

Dual-harm, the co-occurrence of self- and other-harm, recognizes the overlap between these outcomes of aggressive behavior and their potential shared causes. Little progress has been made in preventing and responding to dual-harm in the broader population, and it remains understudied in public health research. We posit that the scientific investigation of dual-harm would greatly benefit from the application of public health principles and methods.

Depolarization Through Public-Sector Leadership Development: Emerging Leaders and Fellows Programs, United States, 2015‒2024.

Directing depolarization efforts toward those with authority over public health funding and population health policies has great potential to improve health outcomes. Two nonpartisan legislative and executive branch state leadership programs demonstrated personal growth and mutual respect among participants necessary for depolarization that was evidenced by cross-state and cross-party policy implementation. Intentional cohort selection of politically and demographically diverse participants, ground rules based on fundamental values, and curriculum emphasizing collective problem-solving built trust and curiosity despite differing viewpoints.

Association of family history of cardiovascular disease with the prevalence of cardiometabolic risk factors in young adults in the United Arab Emirates: The UAE healthy future study.

Introduction: Family history of cardiovascular disease (CVD) is an independent risk factor for coronary heart disease, and the risk increases with number of family members affected. It offers insights into shared genetic, environmental and lifestyle factors that influence heart disease risk. In this study, we aimed to estimate the association of family history of CVD and its risk factors, as well as the number of affected parents or siblings, with the prevalence of major cardiometabolic risk factors (CRFs) such as hypertension, dysglycemia, dyslipidemia and obesity in a sample of young adults.

Seizures, Driver Licensure, and Medical Reporting Update: An AAN Position Statement.

This consensus position statement of the American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America updates prior 1994 and 2007 position statements on seizures, driver licensure, and medical reporting. Key consensus positions include the following: (1) in the United States, national driving standards promulgated through a system such as the Uniform Law Commission would reduce confusion and improve adherence with state driving standards; (2) state licensing criteria for medical conditions should be promulgated by regulations and guidelines based on enabling legislation rather than in statutes themselves and should be developed by medical advisory boards working in collaboration with departments of motor vehicles; (3) licensing criteria should be equitable, nondiscriminatory, objective, and compatible with comparable risks in other populations; (4) a minimum seizure-free interval of 3 months should ordinarily be required before driving in all cases and should be extended in individual cases based on review of favorable and unfavorable features by medical advisory boards; (5) individuals with exclusively provoked seizures attributable to provoking factors that are unlikely to reoccur in the future may not require a seizure-free interval before resuming driving; (6) individuals with previously well-controlled epilepsy who experience seizures due to short-term interruptions of antiseizure medications in the setting of hospitalization or practitioner-directed medication-titration may not require a seizure-free interval before driving once previously effective levels of antiseizure medications have been resumed; (7) patients and practitioners should pause driving during tapering and following discontinuation of an antiseizure medication if another such medication is not introduced; (8) individuals whose cognition or coordination is impaired due to medications used to prevent seizures should refrain from driving; (9) health care practitioners should be allowed but not mandated to report drivers who pose an elevated risk; but (10) neither a decision to report a patient suspected of being at elevated risk nor a decision declining to report a patient suspected of being at elevated risk should be subject to legal liability; (11) nations, states, and municipalities should provide alternative methods of transportation and accommodations for individuals whose driving privileges are restricted due to medical conditions.

All segments are created equal: locoregional recurrence and survival after single versus multi-segment resection in patients with clinical stage IA ≤ 2 cm non-small cell lung cancer.

Objectives: Compare oncologic outcomes between single-segment and multi-segment resections in patients with clinical stage IA1 and IA2 non-small cell lung cancer.

Methods: A retrospective review (2011-2022) was conducted using a prospectively maintained database. Patients undergoing anatomical segmentectomy for clinical stage IA ≤ 2 cm non-small cell lung cancers were included.

The pentameric complex is not required for congenital CMV transmission in seronegative rhesus macaques.

Congenital cytomegalovirus (cCMV) is the leading infectious cause of neonatal neurological impairment worldwide, but the viral factors enabling vertical spread across the placenta remain undetermined. The pentameric complex (PC), composed of the subunits gH/gL/UL128/UL130/UL131A, has been demonstrated to be important for entry into nonfibroblast cells in vitro. These findings link the PC to broad cell tropism and virus dissemination in vivo, denoting all subunits as potential targets for intervention strategies and vaccine development.

Counterions influence the isothermal self-assembly of DNA nanostructures.

DNA nanostructures are typically assembled by thermal annealing in buffers containing magnesium. We demonstrate the assembly of DNA nanostructures at constant temperatures ranging from 4° to 50°C in solutions containing different counterions. The choice of counterions and the assembly temperature influence the isothermal assembly of several DNA motifs and designed three-dimensional DNA crystals.

On-demand heralded MIR single-photon source using a cascaded quantum system.

We propose a mechanism for generating single photons in the mid-infrared (MIR) using a solid-state or molecular quantum emitter. The scheme uses cavity quantum electrodynamics (QED) effects to selectively enhance a Frank-Condon transition, deterministically preparing a single Fock state of a polar phonon mode. By coupling the phonon mode to an antenna, the resulting excitation is then radiated to the far field as a single photon with a frequency matching the phonon mode.

Intermediate-Term Oncologic Outcomes of Partial Nephrectomy Versus Cryoablation in Renal Tumors >3 cm: A Propensity Score Matched Analysis.

Purpose: Cryoablation (CA) and partial nephrectomy (PN) are effective nephron-sparing treatments for small renal masses. While guidelines list thermal ablation as an option for tumors <3 cm, limited data compare PN and CA in larger tumors. We compared intermediate-term oncologic outcomes between PN and CA in renal masses >3 cm.

Connecting Underrepresented Medical Students to Resources and Role Models in Orthopaedic Surgery: A Virtual Diversity, Equity, Inclusion, and Accessibility Summit.

Introduction: Limited access to resources and stereotypes about orthopaedic surgeons may contribute to the low percentage of women and people of underrepresented in medicine (URiM) backgrounds in orthopaedic surgery. Several organizations have created resources to address these barriers, but medical students are unlikely to be exposed to the initiatives through traditional curricula. The purpose of this study was to (1) evaluate the ability of a 1-day virtual Diversity, Equity, Inclusion, and Accessibility (DEIA) summit to effectively reach URiM medical students, (2) increase medical students' knowledge of DEIA resources, and (3) augment the perception of diverse backgrounds in orthopaedic surgery.

Is There Polyamorphism in Amorphous Indomethacin? Investigating the Physicochemical Properties of Amorphous Indomethacin with Different Thermal History.

Polyamorphism in organic molecules is a poorly understood and controversial phenomenon related to amorphous materials. Although very few studies, including our own, have demonstrated the existence of polyamorphism in drug molecules, this solid-state phenomenon is still very elusive and the investigation of its occurrence in other drugs is fundamental to understand its formation. Indomethacin (IND) has been recently discussed in the literature as a potential drug exhibiting polyamorphism.

Measuring real-time violence exposure and its impact on intimate partner violence perpetration among adolescents.

Background: Intimate partner violence (IPV) has dire health consequences. To intervene, it is critical we first understand why young men perpetrate IPV. One theory is that men who experience violence are more likely to perpetrate violence.

Sustainable visions: unsupervised machine learning insights on global development goals.

The 2030 Agenda for Sustainable Development of the United Nations outlines 17 goals for countries of the world to address global challenges in their development. However, the progress of countries towards these goal has been slower than expected and, consequently, there is a need to investigate the reasons behind this fact. In this study, we have used a novel data-driven methodology to analyze time-series data for over 20 years (2000-2022) from 107 countries using unsupervised machine learning (ML) techniques.

Connecting the dots: Understanding and addressing the metabolic impact of antipsychotic and antidepressant medications.

Serious mental disorders such as schizophrenia and major depression are associated with considerable morbidity and mortality, resulting in much shorter life expectancies in those affected. The discovery of antipsychotic medications ushered in improved health outcomes for people with serious mental disorders but also brought about increased morbidity due to their metabolic side effects, including obesity and diabetes mellitus. Antidepressant medications have a more favorable metabolic side effect profile, but some can still cause weight gain and hyperglycemia.

A survey study of urban retailers selling alkyl nitrites ("poppers") in the New York City area which led to public health interventions.

Introduction: Alkyl nitrites ("poppers") are used recreationally for sexual enhancement, muscle relaxation, and euphoria. However, they can be toxic and cause adverse reactions such as methemoglobinemia. While inhalation is the typical route of usage, the New York City Poison Center has noted an increase in calls related to ingestion.

Optimizing sample size for supervised machine learning with bulk transcriptomic sequencing: a learning curve approach.

Accurate sample classification using transcriptomics data is crucial for advancing personalized medicine. Achieving this goal necessitates determining a suitable sample size that ensures adequate classification accuracy without undue resource allocation. Current sample size calculation methods rely on assumptions and algorithms that may not align with supervised machine learning techniques for sample classification.

Nurses, Chaplains, Clergy and Measurement Scales.

Much of the research in this issue relates to the long-standing profession of nursing and, secondly, the even longer established professions of chaplaincy and the clergy. This issue also provides evidence of the ever-increasing number of religious and spirituality measurement scales, as well as various other forms of religious and/or spiritual evaluations and the associated psychometric properties. Several articles researching religiosity/spirituality, however, identify common research limitations, in particular the error of using contaminated scales and the need to avoid tautological and uninterpretable results.

In memoriam: Carl J. Carrano : July 14, 1950-January 26, 2022.

This article is a celebration of the life and work of Carl J. Carrano who, from a childhood in Long Island, New York, built a career in bioinorganic chemistry, especially in the context of metal uptake and halogen metabolism in microbes and marine organisms.