Genomic sequencing in diverse and underserved pediatric populations: parent perspectives on understanding, uncertainty, psychosocial impact, and personal utility of results.

Purpose: Limited evidence evaluates parents' perceptions of their child's clinical genomic sequencing (GS) results, particularly among individuals from medically underserved groups. Five Clinical Sequencing Evidence-Generating Research (CSER) consortium studies performed GS in children with suspected genetic conditions with high proportions of individuals from underserved groups to address this evidence gap.

Methods: Parents completed surveys of perceived understanding, personal utility, and test-related distress after GS result disclosure.

Effect of an Electronic Pill Bottle on Hydroxychloroquine Adherence in Pediatric Lupus: Results of a Novel Direct-to-Family Pilot Trial.

Objective: The objective of this study was to evaluate the preliminary effectiveness of an electronic pill bottle with automated reminders on hydroxychloroquine (HCQ) adherence in children with pediatric systemic lupus erythematosus (pSLE).

Methods: This was a self-controlled, open label, direct-to-family pilot trial. Children with pSLE treated with HCQ were recruited from the Childhood Arthritis and Rheumatology Research Alliance Registry.

Random Survival Forest Machine Learning for the Prediction of Cardiovascular Events Among Patients With a Measured Lipoprotein(a) Level: A Model Development Study.

Background: Established risk models may not be applicable to patients at higher cardiovascular risk with a measured Lp(a) (lipoprotein[a]) level, a causal risk factor for atherosclerotic cardiovascular disease.

Methods: This was a model development study. The data source was the Nashville Biosciences Lp(a) data set, which includes clinical data from the Vanderbilt University Health System.

Stressors contributing to burnout among acute care and trauma surgery care teams: a systems-analysis approach.

Background: Burnout negatively impacts healthcare professionals' well-being, leading to an increased risk of human errors and patient harm. There are limited assessments of burnout and associated stressors among acute care and trauma surgery teams.

Methods: Acute care and trauma surgery team members at a US academic medical center were administered a survey that included a 2-item Maslach Burnout Inventory and 21 workplace stressors based on the National Academy of Medicine's systems model of clinician burnout and professional well-being.

Trauma Survivors Network: history and evolution of a program empowering survivors and families impacted by traumatic injury.

The Trauma Survivors Network (TSN), a program of the American Trauma Society (ATS), has a unique history spanning decades with a vision to continue expanding and strengthening services to support survivors and families impacted by traumatic injury. Since the COVID-19 pandemic, the ATS has adapted TSN services to provide both virtual and in-person services for trauma survivors, increasing equity and inclusion for many survivors to access TSN services for the first time. The recent policy changes in the American College of Surgeons Committee on Trauma provide an impetus for the TSN to grow and expand services in support of a diverse group of trauma survivors and their loved ones.

Impact of mask wearing time on fluid consumption and physical activity during the COVID-19 pandemic.

Purpose: To examine the associations between mask-wearing on fluid consumption and physical activity behaviors during the COVID-19 pandemic.

Methods: 137 college students (female, 72.5%; age, 26 ± 9 y) completed a survey detailing their fluid intake, physical activity behaviors, and time spent wearing a mask throughout the day during the previous month in the Fall 2020 academic semester.

Assessing self-determined motivation for drinking alcohol via the Comprehensive Relative Autonomy Index for Drinking.

Introduction: Self-Determination Theory (SDT) examines human motivation in multiple domains; however, the only existing measure assessing SDT-informed behavioral regulations for drinking focuses on responsible drinker behaviors, rather than drinking , which is important given the alignment between SDT and harm reduction approaches to alcohol use. The aim of this study was to test the structural validity of the SDT-informed Comprehensive Relative Autonomy Index for Drinking (CRAI-Drinking) among college students.

Methods: Participants included two convenience samples with a total of 630 adult drinkers (M = 21.

Co-development of a community pharmacy training regarding fentanyl and xylazine test strips.

Introduction: Fentanyl and xylazine test strips (FTS, XTS) are simple point-of-care tests that determine the presence of fentanyl or xylazine in a substance before use. Access to FTS and XTS is limited. For pharmacists who are willing to sell an FTS, there is little guidance about how to implement FTS sales and counseling as no training for community pharmacists regarding FTS and XTS exists.

Comparison of Glenoid Bone Loss After Unidirectional Versus Combined Shoulder Instability in a Military Population.

Background: While glenoid bone loss (GBL) after anterior shoulder instability correlates with poor functional outcomes, the specific effects of GBL in posterior and combined-type shoulder instability remain poorly characterized, especially in a high-risk military population.

Purpose/hypothesis: The purpose of this study was to compare GBL between unidirectional anterior or posterior instability versus combined-type instability in active-duty servicemembers. It was hypothesized that total GBL and GBL in the direction of instability would be greater in those with combined-type instability compared with unidirectional instability.

The Frequency of Undiagnosed Celiac Disease in Youth with Type 1 Diabetes and Its Association with Diabetic Retinopathy: The SEARCH for Diabetes in Youth Study.

Aims: Celiac disease (CD) in adults with type 1 diabetes has been associated with increased cardiovascular risk and the earlier occurrence of diabetes-associated complications. In the Search for Diabetes in Youth study, we aimed to assess the frequency of CD and the potential for undiagnosed CD among youth with childhood onset type 1 diabetes. In addition, we assessed the burden of cardiovascular risk factors and diabetes-associated complications in youth with type 1 diabetes by CD status and IgA tissue transglutaminase autoantibody (tTGA) levels.

Factor XIa Inhibitor Reversal in Intracranial Hemorrhage: A Case Report.

Background/objectives: There is currently no consensus regarding the optimal strategy for reversal of anticoagulation in life-threatening hemorrhage associated with factor XIa (FXIa) inhibitors.

Methods: For this clinical case report, informed consent was obtained from surrogate.

Results And Discussion: Here, we present the case of an 82-year-old female who sustained a large subdural hematoma after a fall.

A human-centered approach for sharing patient experiences through digital storytelling: a research through design study.

This article outlines a human-centered approach to developing digital patient stories, for sharing their experiences in health care, while preserving patient and others' privacy. Employing a research-through-design approach, the study proposes a design solution using visualization and digital storytelling to document patients' and families' experiences and emotions, as well as their interactions with healthcare professionals in the postnatal unit. By transforming selected observational data into animated stories, this approach has the potential to elicit empathy, stimulate stakeholder engagement, and serve as a practical training tool for clinicians.

Lymph Node Staging and Treatment in Pediatric Patients With Soft Tissue Sarcomas: A Consensus Opinion from the Children's Oncology Group, European paediatric Soft tissue sarcoma Study Group, and the Cooperative Weichteilsarkom Studiengruppe.

Accurate staging of nodal involvement in pediatric sarcoma patients is important to determine correct systemic and local therapy, with the goal to reduce subsequent recurrences. However, differences in lymph node staging strategies, definitions, and treatment protocols between the Children's Oncology Group (COG), European paediatric Soft tissue sarcoma Study Group (EpSSG), and the Cooperative Weichteilsarkom Studiengruppe (CWS) complicate comparisons. In this article, we aim to establish internationally recognized recommendations for lymph node assessment and treatment of children and adolescents diagnosed with rhabdomyosarcoma (RMS) and non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) according to the Consensus Conference Standard Operating Procedure methodology.

Development of a Navigator-Delivered Health Insurance Education Program for Hispanic and Latine Communities.

Background: Equitable access to health care services for Hispanic and Latine populations requires that systems go beyond working to increase enrollment in health insurance but also addressing health insurance literacy-the knowledge, ability, and confidence to find and use health insurance.

Methods: In collaboration with a local health policy organization, individual interviews were conducted with Hispanic and Latine community members. Group engagement sessions were conducted with key professionals.

Development of the Migraine-Related Stigma (MiRS) Questionnaire: Results of the OVERCOME (US) Study.

Background: Stigma is emerging as an important social contributor to migraine-related disability and other outcomes. Currently, there are no published validated measures of migraine-specific measures of stigma.

Objectives: This secondary post hoc analysis of a cross-sectional cohort study aimed to develop a questionnaire to evaluate migraine-related stigma.

First-line cadonilimab plus chemotherapy in HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a randomized, double-blind, phase 3 trial.

Programmed cell death protein-1 (PD-1) inhibitors plus chemotherapy have been the standard of care in the first-line treatment of advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma; however, the survival benefits are modest in patients with low programmed death ligand 1 (PD-L1) expression. Here we investigated the efficacy and safety of cadonilimab (PD-1/cytotoxic T lymphocyte antigen-4 (CTLA-4) bispecific antibody) plus chemotherapy as first-line treatment in G/GEJ adenocarcinoma. The prespecified interim analysis is reported here.

Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.

Patient Perceptions of Provider Race Concordance and Quality of Chronic Illness Care.

Background: Black people are more likely to have hypertension and report lower quality of care than White people. Patient-provider race concordance could improve perceived quality of care, potentially lessening disparities.

Objective: Investigate the association between patient-provider race concordance and patient-perceived quality of chronic disease care, as measured by the Patient Assessment of Chronic Illness Care (PACIC) scale.

Distributed training of foundation models for ophthalmic diagnosis.

Vision impairment affects nearly 2.2 billion people globally, and nearly half of these cases could be prevented with early diagnosis and intervention-underscoring the urgent need for reliable and scalable detection methods for conditions like diabetic retinopathy and age-related macular degeneration. Here we propose a distributed deep learning framework that integrates self-supervised and domain-adaptive federated learning to enhance the detection of eye diseases from optical coherence tomography images.

Klebsiella pneumoniae employs a type VI secretion system to overcome microbiota-mediated colonization resistance.

Microbial species must compete for space and nutrients to persist in the gastrointestinal (GI) tract, and our understanding of the complex pathobiont-microbiota interactions is far from complete. Klebsiella pneumoniae, a problematic, often drug-resistant nosocomial pathogen, can colonize the GI tract asymptomatically, serving as an infection reservoir. To provide insight on how K.

N SABRE-SHEATH and NMR/DFT Characterization of Amino-Metronidazole, a Metabolic Product of the Antibiotic and Prospective Hypoxia Contrast Agent Metronidazole.

The antibiotic metronidazole (MNZ) has gained interest as a potential MRI contrast agent for imaging hypoxia. N-labeled MNZ can be efficiently hyperpolarized via SABRE-SHEATH (Signal Amplification By Reversible Exchange in SHield Enables Alignment Transfer to Heteronuclei), but the envisioned MRI approach requires that MNZ rapidly undergoes structural changes in hypoxic environments with significant N frequency differences manifested in its downstream metabolic products. We have performed NMR studies of the anticipated metabolic product amino-MNZ (despite anticipated stability concerns) accompanied by computational density functional theory (DFT) studies to predict the N chemical shifts of different relevant species.

Grocery intervention and DNA-based assessment to improve diet quality in pediatric obesity: a pilot randomized controlled study.

Objective: We assessed the impact of a food-provisioning intervention on diet quality in children with obesity.

Methods: Participants (n = 33, aged 6-11 years) were randomly assigned to either usual care (intensive health behavior and lifestyle treatment) or intervention (usual care + food provisioning; high-fiber, low-dairy diet) for 4 weeks. The primary outcome was a change in child diet quality at Week 4.

The PRO-AGE Tool and Its Association With Post Discharge Outcomes in Older Adults Admitted From the Emergency Department.

Background: Existing risk scores assessing geriatric vulnerability in the emergency department (ED) have shown limited predictive power, especially in diverse populations. We investigated the relationship of a quick and easy-to-administer geriatric vulnerability scoring system with functional decline and mortality in older patients admitted to multiple hospitals through the ED in the United States (US) and Brazil (BR).

Method: Federated, international, multicenter observational study of hospitalized ED patients aged ≥ 65 from US and BR.

Associations among perceived stress and mindfulness on post-concussion cognitive and mental health outcomes in young adults with a concussion history.

Background: Despite evidence suggesting perceived stress negatively impacts post-concussion outcomes and that mindfulness may improve that relationship, research has not investigated those connections.

Methods: This cross-sectional, observational study included 80 young adults with a concussion history who completed a single study visit including the following measures: 1) demographics and concussion, mental health, and mindfulness histories; 2) perceived stress [Perceived Stress Scale (PSS-10)]; 3) mindfulness [Five Facet Mindfulness Questionnaire (FFMQ)]; and 4) post-concussion cognitive and mental health outcomes - neurocognitive performance (CNS Vital Signs), psychological symptoms [Brief Symptom Inventory-18 (BSI-18)], and QOL [Patient-Reported Outcomes Measurement Information System (PROMIS®)]. First, separate regression models determined the association among perceived stress and post-concussion cognitive and mental health outcomes.