Consensus Preconception Educational Domains for People With Mobility Disabilities: A Delphi Study.

Background: Preconception health education is critical to improve pregnancy and neonatal outcomes, but people with mobility disabilities have specific, often unique issues related to preparing for pregnancy. This study sought to develop consensus-based domains for a preconception education curriculum for people with mobility disabilities.

Methods: We used a mixed methods approach, including a literature review and a Delphi method to develop consensus.

Increases in Donor/Recipient Predicted Heart Mass Ratios Do Not Result in Large Donor Right Ventricles.

Pulmonary hypertension puts strain on the right ventricle (RV), leading to the widespread practice of oversizing donor hearts to mitigate complications. However, contemporary evidence for this practice is neutral. We studied the relationship between donor-recipient predicted heart mass (D/R PHM) ratios and increases in donor left ventricle (LV) and right ventricle (RV) mass.

A Modified Delphi Process to Achieve Consensus on Social/Administrative Science Topics in Pharmacy Curricula.

Objective: To identify a consensus among pharmacy educators regarding relevant social/administrative science (SAS) topic areas and their priorities within pharmacy curricula.

Methods: A modified Delphi process was conducted with members of selected American Association of Colleges of Pharmacy (AACP) affinity groups as the expert panel. Eighty-three potential topic areas across 12 domains were gathered via an informal literature review.

Executive function in young children with and without global developmental delays: Association with mastery motivation and developmental abilities.

Executive functions (EF) affect child competencies across domains in early childhood. Thus, this study examined: 1) the EF differences between young children with global developmental delays (GDD) and those with typical development (TD); 2) the relationship between mastery motivation (MM) and EF; 3) the association between developmental abilities and EF in both groups. Participants included 26 mother-child dyads of preschoolers with GDD (age 24-55 months) and 26 sex- and mental-age-matched dyads of TD preschoolers (age 15-29 months).

The International Bathymetric Chart of the Arctic Ocean Version 5.0.

Knowledge about seafloor depth, or bathymetry, is crucial for various marine activities, including scientific research, offshore industry, safety of navigation, and ocean exploration. Mapping the central Arctic Ocean is challenging due to the presence of perennial sea ice, which limits data collection to icebreakers, submarines, and drifting ice stations. The International Bathymetric Chart of the Arctic Ocean (IBCAO) was initiated in 1997 with the goal of updating the Arctic Ocean bathymetric portrayal.

Non-viral predators of marine picocyanobacteria.

The Earth's most abundant photosynthetic cells, the picocyanobacteria - Prochlorococcus and Synechococcus - play a fundamental global role in aquatic ecosystems. The success of these picocyanobacteria is interpreted through a cross-scale systems framework that integrates bottom-up controls on growth (e.g.

Stimulation of dorsal root ganglion with low-intensity focused ultrasound ameliorates pain responses through the GABA inhibitory pathway.

Aims: Chronic pain is a critical public health issue that severely impacts quality of life and poses significant treatment challenges, particularly due to the risk of adverse effects associated with pharmacological therapies. The search for effective non-invasive treatment alternatives has become increasingly relevant. Low-intensity focused ultrasound (LIFU) has been identified as an effective non-invasive strategy for pain management, although the underlying mechanism remains unclear.

AAHPM Assessment Workgroup: Hospice and Palliative Medicine Fellowship Assessment Needs & Directions.

Context: Medical education is moving towards competency based medical education (CBME). This provides opportunities and challenges for the field of Hospice and Palliative Medicine (HPM). The American Academy of Hospice and Palliative Medicine (AAHPM) created the Assessment Workgroup to spearhead a shared vision and process to implement high-quality assessment of fellow performance.

Alterations in functional connectivity of interoceptive and Cortico-Subcortical areas in Multiple Sclerosis-Related fatigue.

Fatigue in people with Multiple Sclerosis (PwMS) is a poorly understood, complex, and disabling symptom. We hypothesized that the perception of fatigue in PwMS results from increased information processing in cortical areas responsible for the perception of bodily states and decreased information processing in the cortico-basal ganglia network involved in the perception of motor performance. We investigated whether PwMS who perceive excessive fatigue would have increased resting-state functional connectivity (rsFC) between interoceptive brain areas (amygdala, anterior cingulate cortex [ACC], and insula) and decreased rsFC between cortico-basal ganglia premotor network compared to PwMS not reporting fatigue.

Daily life mobility detects frailty, falls, and functioning in older prostate cancer survivors treated with androgen deprivation therapy.

Introduction: Androgen deprivation therapy (ADT) increases the risk of frailty, falls, and poor physical functioning in older adults with prostate cancer. Detection of frailty is limited to self-report instruments and performance measures, so unbiased tools are needed. We investigated relationships between an unbiased measure - daily life mobility - and ADT history, frailty, fall history, and functioning in older prostate cancer survivors treated with ADT.

Structure of subcortico-cortical tracts in middle-aged and older adults with autism spectrum disorder.

Middle-aged and older adults with autism spectrum disorder may be susceptible to accelerated neurobiological changes in striato- and thalamo-cortical tracts due to combined effects of typical aging and existing disparities present from early neurodevelopment. Using magnetic resonance imaging, we employed diffusion-weighted imaging and automated tract-segmentation to explore striato- and thalamo-cortical tract microstructure and volume differences between autistic (n = 29) and typical comparison (n = 33) adults (40 to 70 years old). Fractional anisotropy, mean diffusivity, and tract volumes were measured for 14 striato-cortical and 12 thalamo-cortical tract bundles.

What is the role of parenteral nutrition in the management of the patient with severe acute pancreatitis?

Severe acute pancreatitis often presents as a complex critical illness associated with a high rate of infectious morbidity, multiple organ failure, and in-hospital mortality. Breakdown of gut barrier defenses, dysbiosis of intestinal microbiota, and exaggerated immune responses dictate that early enteral nutrition (EN) is preferred over parenteral nutrition (PN) as the primary route of nutrition therapy. EN, however, is not feasible in all cases because of intolerance, risk of complications, or a direct contraindication to enteral feeding.

Association between serum urate levels and all-cause mortality, cardiovascular and renal outcomes among gout patients in Singapore.

Objectives: We investigated the longitudinal association between Serum Urate (SU) level and Acute Myocardial Infarction (AMI), Stroke, End Stage Renal Failure (ESRF) and all-cause mortality.

Design: We conducted a retrospective hospital-based cohort study of individuals with gout managed in specialist outpatient clinics. Cox proportional hazards regression was used to estimate HR and 95% CI, with adjustments for potential confounders.

Family medicine research: seizing the moment to advance the field.

Despite a growing awareness that primary care is essential to an accessible, equitable, high-quality, cost-effective health care system, family medicine research remains woefully underdeveloped. The increased focus of both state and federal policy makers on primary care payment and care delivery models presents an opportunity for family medicine to redefine itself as an academically rigorous discipline at the forefront of generating evidence that improves patient care and population health while reducing costs. In a critical review of the literature, we identified five themes-leadership, funding, resources, team science, and departmental culture-that are integral to family medicine departments seeking to grow and expand their research capacity.

Cost-Effectiveness Analysis of a Novel Fetal Vesicoamniotic Shunt-The Vortex Shunt.

Objective: We estimated the potential outcomes, costs, and cost-effectiveness of the Vortex shunt, a novel fetal vesicoamniotic shunt (VAS), compared to standard shunts for treating fetal lower urinary tract obstruction (LUTO).

Method: We designed a decision-analytic model comparing the Vortex shunt to current shunts using a theoretical cohort of 1000 pregnancies equivalent to the annual U.S.

The challenge of integrating a diagnosis of malnutrition in the practical application of nutrition care in the intensive care unit.

Evidence of poor nutrition status in a patient present on admission to the intensive care unit is associated with worse clinical outcomes than that for a well-nourished patient who becomes critically ill. Diagnosing malnutrition in this setting is fraught with difficulty, though, because elements of nutrition history are hard to obtain, the interpretation of anthropometric parameters is influenced by the disease process and interventions of critical care and the subjectivity of traditional assessment tools lacks precision. Determining the severity of disease drives the initial management and sets priorities in the derivation of the nutrition plan, focusing on strategies that promote survival.

The Society of Thoracic Surgeons Expert Consensus Statements on a Framework for a Standardized National Robotic Curriculum for Thoracic Surgery Trainees.

Objective: With robotic technology's rapid growth and integration, an urgent need to bridge the educational gap in thoracic surgical training has emerged. This document, a result of consensus among a group of experts in the practice and training of robotic surgery from the Society of Thoracic Surgeons (STS), aims to provide a framework for a standardized national robotic curriculum for thoracic surgery trainees.

Methods: The STS Task Force on Robotic Thoracic Surgery and Workforce on E-learning and Educational Innovation assembled an expert group with the input of the Thoracic Surgery Director's Association (TSDA).

A PDZ-kinase allosteric relay mediates Par complex regulator exchange.

The Par complex polarizes the plasma membrane of diverse animal cells using the catalytic activity of atypical Protein Kinase C (aPKC) to pattern substrates. Two upstream regulators of the Par complex, Cdc42 and Par-3, bind separately to the complex to influence its activity in different ways. Each regulator binds a distinct member of the complex, Cdc42 to Par-6 and Par-3 to aPKC, making it unclear how they influence one another's binding.

The physicochemical properties of lipopolysaccharide chemotypes regulate activation of the contact pathway of blood coagulation.

Lipopolysaccharide (LPS) is the primary pathogenic factor in Gram-negative sepsis. While the presence of LPS in the bloodstream during infection is associated with disseminated intravascular coagulation, the mechanistic link between LPS and blood coagulation activation remains ill-defined. The contact pathway of coagulation-a series of biochemical reactions that initiates blood clotting when plasma factors XII (FXII) and XI (FXI), prekallikrein (PK) and high molecular weight kininogen (HK) interact with anionic surfaces-has been shown to be activated in Gram-negative septic patients.

Outliers of Total Shoulder Arthroplasty in the Bundled Payment Era.

Background: The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement Advanced (BPCIA) Model that covers 90-day care episodes after select orthopedic procedures including anatomic or reverse ball-and-socket total shoulder arthroplasty (TSA/rTSA). This study investigated whether patients undergoing TSA/rTSA for non-degenerative processes incur higher costs than patients undergoing arthroplasty for degenerative processes.

Methods: A retrospective review was conducted of all patients at a single academic medical center enrolled in the BPCIA model for TSA/rTSA from October 1, 2018, through December 31, 2022.

Short-term cognitive practice effects in Parkinson's disease: More than meets the eye.

Introduction: Although practice effects (PE) on repeated cognitive testing have received growing interest in Alzheimer's disease, they have been understudied in Parkinson's disease (PD). The current paper examined PE across one week in a sample of patients with PD via traditional methods and regression-based change scores, as well as if these change scores relate to clinical variables in PD.

Methods: Thirty-five patients with PD were administered a brief cognitive battery twice across approximately one week.