SPRINT Treatment Among Adults With Chronic Kidney Disease From 2 Large Health Care Systems.

Importance: It is unclear whether the effects of intensive vs standard blood pressure (BP) targets seen in clinical trials generalize to patients with chronic kidney disease (CKD) encountered in everyday practice due to differences in the distribution of cardiovascular risk factors and coexisting conditions.

Objective: To evaluate whether the beneficial and adverse effects of intensive vs standard BP control observed in the Systolic Blood Pressure Intervention Trial (SPRINT) are transportable to a target population of adults with CKD in clinical practice.

Design, Setting, And Participants: This comparative effectiveness study identified 2 populations with CKD who met the eligibility criteria for SPRINT between January 1 and December 31, 2019, in the Veterans Health Administration (VHA) and Kaiser Permanente of Southern California (KPSC).

FlbB forms a distinctive ring essential for periplasmic flagellar assembly and motility in Borrelia burgdorferi.

Spirochetes are a widely existing group of bacteria with a distinct morphology. Some spirochetes are important human pathogens that utilize periplasmic flagella to achieve motility and host infection. The motors that drive the rotation of periplasmic flagella have a unique spirochete-specific feature, termed the collar, crucial for the flat-wave morphology and motility of the Lyme disease spirochete Borrelia burgdorferi.

Perception of Residency Program Diversity Is Associated With Vulnerability to Race and Gender Stereotype Threat Among Minority and Female Orthopaedic Trainees.

Introduction: Stereotype threat (ST) is a psychological phenomenon in which perceived fear of confirming negative stereotypes about one's identity group leads to impaired performance. Gender and racial ST has been described in various academic settings. However, it is prevalence in orthopaedic surgery, where women and minorities are underrepresented, has not been examined.

An overview of intramedullary spinal cord metastases accompanied by a 2D intraoperative video.

Background: Metastatic intramedullary spinal cord metastases (IMSCMs) constitute <2% of spinal cord tumors. IMSCM is a late-stage manifestation of cancer with a highly variable presentation and poor survival rate. Here, we present an operative video involving gross total resection of an IMSCM (i.

Integrating natural product research laboratory with artificial intelligence: Advancements and breakthroughs in traditional medicine.

The Natural Product Research Laboratory (NPRL) of China Medical University Hospital (CMUH) was established in collaboration with CMUH and Professor Kuo-Hsiung Lee from the University of North Carolina at Chapel Hill. The laboratory collection features over 6000 natural products worldwide, including pure compounds and semi-synthetic derivatives. This is the most comprehensive and fully operational natural product database in Taiwan.

Sociodemographic factors associated with trajectories of depression among urban refugee youth in Kampala, Uganda: A longitudinal cohort study.

Background: There is a high prevalence of depression among refugee youth in low- and middle-income countries, yet depression trajectories are understudied. This study examined depression trajectories, and factors associated with trajectories, among urban refugee youth in Kampala, Uganda.

Methods: We conducted a longitudinal cohort study with refugee youth aged 16-24 in Kampala, Uganda.

Non-invasive volumetric ultrasound localization microscopy detects vascular changes in mice with Alzheimer's disease.

Alzheimer's Disease (AD) is the most common form of dementia and one of the leading causes of death. AD is known to be correlated to tortuosity in the microvasculature as well as decreases in blood flow throughout the brain. However, the mechanisms behind these changes and their causal relation to AD are poorly understood.

Millisecond-level transient heating and temperature monitoring technique for ultrasound-induced thermal strain imaging.

Ultrasound-induced thermal strain imaging (US-TSI) is a promising ultrasound imaging modality that has been demonstrated in preclinical studies to identify a lipid-rich necrotic core of an atherosclerotic plaque. However, human physiological motion, e.g.

Disparities in adult women's access to contraception during COVID-19: a multi-country cross-sectional survey.

During the COVID-19 pandemic, family planning services over the world have been disrupted. There are still uncertainties about the impact on access to contraception, particularly among marginalised populations. This study aimed to assess the effect of COVID-19 on women's access to contraception, focusing on those experiencing loss of income and self-isolation.

Role of the tumor board when prescribing mutant isocitrate dehydrogenase inhibitors to patients with isocitrate dehydrogenase-mutant glioma.

Isocitrate dehydrogenase (IDH)-mutant gliomas, comprising both astrocytomas and oligodendrogliomas, represent a distinct group of tumors that pose an interdisciplinary challenge. Addressing the needs of affected patients requires close collaboration among various disciplines, including neuropathology, neuroradiology, neurosurgery, radiation oncology, neurology, medical oncology, and other relevant specialties when necessary. Interdisciplinary tumor boards are central in determining the ideal diagnostic and therapeutic strategies for these patients.

Symptom management in isocitrate dehydrogenase mutant glioma.

According to the 2021 World Health Organization classification of CNS tumors, gliomas harboring a mutation in isocitrate dehydrogenase (mIDH) are considered a distinct disease entity, typically presenting in adult patients before the age of 50 years. Given their multiyear survival, patients with mIDH glioma are affected by tumor and treatment-related symptoms that can have a large impact on the daily life of both patients and their caregivers for an extended period of time. Selective oral inhibitors of mIDH enzymes have recently joined existing anticancer treatments, including resection, radiotherapy, and chemotherapy, as an additional targeted treatment modality.

Cumulative Impact Loading and Cartilage Synthesis Biomarkers May Be Associated With Injury Risk in Female Collegiate Basketball Players.

Purpose: To evaluate whether cumulative impact load and serum biomarkers are related to lower-extremity injury and to determine any impact load and cartilage biomarker relationships in collegiate female basketball athletes.

Methods: This was a prospective longitudinal study evaluating lower-extremity impact load, serum cartilage biomarkers, and injury incidence over the course of a single collegiate women's basketball season. Data were collected from August 2022 to April 2023; no other follow-up after the cessation of the season was conducted in this cohort.

"We Need Gentleness": Isolation, Loneliness, and Implications for Psychosocial Counseling Among People with HIV who are on Methadone Maintenance Treatment and Experience Common Mental Disorders in Vietnam.

The psychological experiences and needs of people with human immunodeficiency virus (HIV) who use methadone maintenance treatment and have common mental disorders in Hanoi, Vietnam remain unknown. Due to limited services for common mental disorders, optimal delivery methods for psychotherapy are also unknown. Accordingly, this qualitive study explored both symptoms of common mental disorders among this population and the preferred qualifications and characteristics of a mental health counselor.

Medicare Part D: Major Shifts With the Inflation Reduction Act and a Way Forward.

The Inflation Reduction Act (IRA) of 2022 introduced major changes in the Part D benefit that aim to improve medication access and correct several of the financial misalignments in the current Part D benefit. The changes address financial obligations of Medicare beneficiaries, the federal government, Part D plan sponsors (i.e.

Gaussian processes for time series with lead-lag effects with applications to biology data.

Investigating the relationship, particularly the lead-lag effect, between time series is a common question across various disciplines, especially when uncovering biological processes. However, analyzing time series presents several challenges. Firstly, due to technical reasons, the time points at which observations are made are not at uniform intervals.

Surgical Deescalation Within Gynecologic Oncology.

Importance: The goal of surgical deescalation is to minimize tissue damage, enhance patient outcomes, and reduce the adverse effects often associated with extensive or traditional surgical procedures. This shift toward less invasive techniques has the potential to revolutionize surgical practices, profoundly impacting the methods and training of future surgeons.

Objective: To evaluate adoption of surgical deescalation within the field of gynecologic oncology using The National Cancer Database.

An emerging fungal disease is spreading across the globe and affecting the blueberry industry.

Powdery mildew is an economically important disease caused by c. 1000 different fungal species. Erysiphe vaccinii is an emerging powdery mildew species that is impacting the blueberry industry.

Ruvbl1 silencing affects reproduction of the corn planthopper, Peregrinus maidis.

Ruvbl1 (also known as TIP49, Pontin) encodes an ATPase of the AAA+ protein superfamily involved in several cellular functions, including chromatin remodeling, control of transcription, and cellular development (motility, growth, and proliferation). While its role has been well established in model organisms including vertebrates and invertebrates (e.g.

Insurance coverage and consistent pricing is needed for over-the-counter naloxone.

With the Food and Drug Administration's approval of the first over-the-counter naloxone nasal spray in 2023, it was expected that access to naloxone nasal spray would increase and that its cost would be reduced. However, the writers of this commentary found varying insurance coverage of naloxone during purchase attempts at local pharmacies. Failure to cover naloxone can reduce access and increase risk of overdose death.

The burden of generational harm due to alcohol use in Tanzania: A mixed method study of pregnant women.

Background: Rates of prenatal alcohol use in Sub-Saharan Africa (SSA) are increasing despite regulatory bodies urging pregnant women to abstain from alcohol. Tanzania has minimal policies, interventions, and educational programs addressing prenatal alcohol exposure. Consequently, a considerable number of mothers and their fetuses are exposed to alcohol, leading to serious health consequences like fetal alcohol spectrum disorder (FASD).

Shared governance increases marine protected area effectiveness.

Marine protected areas (MPAs) are widely used to conserve and manage coastal resources. Protected areas are governed by a variety of institutional arrangements, yet little is known concerning the relative performance of different governance approaches. This research draws upon a unique dataset that combines details on the reported International Union for Conservation of Nature (IUCN) governance categories of 217 global MPAs and their ecological outcomes to compare the performance of alternative governance arrangements.

Molecular mechanisms of inverse agonism via κ-opioid receptor-G protein complexes.

Opioid receptors, a subfamily of G protein-coupled receptors (GPCRs), are key therapeutic targets. In the canonical GPCR activation model, agonist binding is required for receptor-G protein complex formation, while antagonists prevent G protein coupling. However, many GPCRs exhibit basal activity, allowing G protein association without an agonist.