Integrating High-Value Cost-Conscious Care into an Existing Medical School Curriculum.

Introduction: High-value cost-conscious care (HVCCC) education has been shown to reduce wasteful health care spending. Incorporating HVCCC into a medical school curriculum can be challenging due to limited curricular time. We explored the feasibility of medical students creating HVCCC peer education within existing platforms at a single urban academic medical school.

Longitudinal Changes in Patient- and Clinical-Reported Outcomes in Early Spinocerebellar Ataxia Types 1, 2, 3, and 6 from the IDEA Study.

Background: Clinical outcomes assessments (COAs) in spinocerebellar ataxia (SCA) need to be standardized, ataxia-specific, sensitive to change, clinically relevant, and meaningful to patients.

Objectives: To evaluate the longitudinal 1- and 2-year performances of different patient reported outcomes, including the Patient Reported Outcome Measure of Ataxia (PROM-Ataxia), and clinician reported outcomes, including FARS and SARA, in those with early manifest symptoms of SCA 1, 2, 3, and 6.

Methods: We studied 53 patients with early stage SCA1-3 and SCA6 from The Instrumented Data Exchange for Ataxia Study and 24 age-matched healthy controls.

Morphological and functional decline of the SNc in a model of progressive parkinsonism.

The motor symptoms of Parkinson's Disease are attributed to the degeneration of dopamine neurons in the substantia nigra pars compacta (SNc). Previous work in the MCI-Park mouse model has suggested that the loss of somatodendritic dopamine transmission predicts the development of motor deficits. In the current study, brain slices from MCI-Park mice were used to investigate dopamine signaling in the SNc prior to and through the onset of movement deficits.

Lipid nanoparticle-mediated intracameral mRNA delivery facilitates gene expression and editing in the anterior chamber of the eye.

Lipid nanoparticles (LNPs) have shown great potential in the field of gene therapy for retinal diseases. To expand on this application, we investigated LNP-mediated mRNA delivery to the anterior chamber of the eye via the intracameral (IC) route of administration. Here, we show that IC injections of LNPs facilitated protein expression and gene editing in the trabecular meshwork (TM).

Leukocytosis in Cushing's syndrome persists post-surgical remission and could predict a lower remission prognosis in patients with Cushing's disease.

Context: Leukocytosis frequently noted in Cushing's syndrome (CS), along with other blood cell changes caused by direct and indirect cortisol effects.

Objective: Assess baseline white blood cell (WBC) profile in CS patients compared to controls and WBC changes pre- and post-remission after surgical treatment for CS.

Design: A comparative nationwide retrospective cohort study.

In vitro evaluation of antimicrobial photodynamic therapy with photosensitizers and calcium hydroxide on bond strength, chemical composition, and sealing of glass-fiber posts to root dentin.

Investigate the impact of antimicrobial photodynamic therapy (aPDT) using different photosensitizers (PSs) such as indocyanine green (IG), curcumin (CC), and methylene blue (MB), with or without intracanal application of calcium hydroxide (CH), on the push-out bond strength of glass-fiber posts (GFPs) to intraradicular dentin, the chemical composition of the root substrate, and the sealing of the adhesive interface across different thirds of intraradicular dentin. A total of 112 bovine teeth underwent biomechanical preparation and were divided into eight experimental groups (n = 14 each): Negative control with deionized water; positive control with deionized water + CH; IG group with indocyanine green and infrared laser; IG + CH group; CC group with curcumin and blue LED; CC + CH group; MB group with methylene blue and red laser; and MB + CH group. The push-out bond strength was measured using a universal testing machine (n = 8), and scanning electron microscopy characterized the fracture patterns.

IGF-1 Assessment During Weekly Somatrogon Treatment in Pediatric Patients With GH Deficiency.

Context: In patients with GH deficiency (GHD) receiving GH treatment, IGF-1 concentrations are used by physicians to monitor treatment safety and efficacy and guide dosing decisions. Somatrogon is a long-acting GH approved as a once-weekly treatment for pediatric GHD. Somatrogon administration results in characteristic changes in the IGF-1 profile, with values measured at 96 hours postdose representing mean IGF-1 concentrations that best reflect overall somatrogon exposure.

Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project.

Background: Racial inequities in pregnancy outcomes persist despite investments in clinical, educational, and behavioral interventions, indicating that a new approach is needed to address the root causes of health disparities. Guaranteed income during pregnancy has the potential to narrow racial health inequities for birthing people and infants by alleviating financial stress.

Objective: We describe community-driven formative research to design the first pregnancy-guaranteed income program in the United States-the Abundant Birth Project (ABP).

Severity and Long-Term Mortality of COVID-19, Influenza, and Respiratory Syncytial Virus.

Importance: SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) contribute to many hospitalizations and deaths each year. Understanding relative disease severity can help to inform vaccination guidance.

Objective: To compare disease severity of COVID-19, influenza, and RSV among US veterans.

Are Randomized Trials Better? Comparison of Baseline Covariate Balance of a Propensity Score-Balanced Lumbar Spine IDE Trial and Comparable RCTs.

Study Design: Prospective Observational Propensity Score.

Objectives: Randomization may lead to bias when the treatment is unblinded and there is a strong patient preference for treatment arms (such as in spinal device trials). This report describes the rationale and methods utilized to develop a propensity score (PS) model for an investigational device exemption (IDE) trial (NCT03115983) to evaluate decompression and stabilization with an investigational dynamic sagittal tether (DST) vs decompression and Transforaminal Lumbar Interbody Fusion (TLIF) for patients with symptomatic grade I lumbar degenerative spondylolisthesis with spinal stenosis.

An introduction to antibacterial materials in composite restorations.

The longevity of direct esthetic restorations is severely compromised because of, among other things, a loss of function that comes from their susceptibility to biofilm-mediated secondary caries, with being the most prevalent associated pathogen. Strategies to combat biofilms range from dental compounds that can disrupt multispecies biofilms in the oral cavity to approaches that specifically target caries-causing bacteria such as . One strategy is to include those antibacterial compounds directly in the material so they can be available long-term in the oral cavity and localized at the margin of the restorations, in which many of the failures initiate.

A Cross-Species Atlas of the Dorsal Vagal Complex Reveals Neural Mediators of Cagrilintide's Effects on Energy Balance.

Amylin analogs, including potential anti-obesity therapies like cagrilintide, act on neurons in the brainstem dorsal vagal complex (DVC) that express calcitonin receptors (CALCR). These receptors, often combined with receptor activity-modifying proteins (RAMPs), mediate the suppression of food intake and body weight. To understand the molecular and neural mechanisms of cagrilintide action, we used single-nucleus RNA sequencing to define 89 cell populations across the rat, mouse, and non-human primate caudal brainstem.

Multimodal Deep Learning for Differentiating Bacterial and Fungal Keratitis Using Prospective Representative Data.

Objective: This study develops and evaluates multimodal machine learning models for differentiating bacterial and fungal keratitis using a prospective representative dataset from South India.

Design: Machine learning classifier training and validation study.

Participants: Five hundred ninety-nine subjects diagnosed with acute infectious keratitis at Aravind Eye Hospital in Madurai, India.

Glutamatergic Input from Arcuate Nucleus Kiss1 Neurons to Preoptic Kiss1 Neurons is Required for LH Surge in Female Mice.

Hypothalamic kisspeptin (Kiss1) neurons are vital for maintaining fertility in the mammal. In the female rodent, Kiss1 neurons populate the anteroventral periventricular/periventricular nuclei (Kiss1AVPV/PeN) and the arcuate nucleus (Kiss1ARH). Kiss1ARH neurons (a.

Early achievement of hemostasis defined by transfusion velocity: A possible mechanism for whole blood survival benefit.

Introduction: Whole blood resuscitation is associated with survival benefits in observational cohort studies. The mechanisms responsible for outcome benefits have not been adequately determined. We sought to characterize the achievement of hemostasis across patients receiving early whole blood versus component resuscitation.

Responsible Use of Population Neuroscience Data in the ABCD: Towards Standards of Accountability and Integrity.

This editorial focuses on the issue of data misuse that is increasingly evidenced in social media as well as some premiere scientific journals. This issue is of critical importance to open science projects in general, and ABCD in particular, given the broad array of biological, behavioural and environmental information collected on this American sample of 12,000 youth and parents. ABCD data are already widely used with over 1,200 publications and twice as many citations per year as expected (relative citation index based on year, field and journal).

Maternal Western Diet Programmes Bile Acid Dysregulation and Hepatic Fibrosis in Fetal and Juvenile Macaques.

Background And Aims: Maternal obesity increases the risk of the paediatric form of metabolic dysfunction-associated steatotic liver disease (MASLD), affecting up to 30% of youth, but the developmental origins remain poorly understood.

Methods: Using a Japanese macaque model, we investigated the impact of maternal Western-style diet (mWSD) or chow diet followed by postweaning WSD (pwWSD) or chow diet focusing on bile acid (BA) homeostasis and hepatic fibrosis in livers from third-trimester fetuses and 3-year-old juvenile offspring.

Results: Juveniles exposed to mWSD had increased hepatic collagen I/III content and stellate cell activation in portal regions.

A mixed-methods observational study of strategies for success in implementation science: overcoming emergency departments hurdles.

Background: Heart failure is a major public health concern, affecting 6.7 million Americans. An estimated 16% of emergency department (ED) patients with acute heart failure (AHF) are discharged home.

The growing complexity of the control of the hypothalamic pituitary thyroid axis and brown adipose tissue by leptin.

The balance between food intake and energy expenditure is precisely regulated to maintain adipose stores. Leptin, which is produced in and released from adipose in direct proportion to its size, is a major contributor to this control and initiates its homeostatic responses largely via binding to leptin receptors (LepR) in the hypothalamus. Decreases in hypothalamic LepR binding signals starvation, leading to hunger and reduced energy expenditure, whereas increases in hypothalamic LepR binding can suppress food intake and increase energy expenditure.

Consensus recommendations for measuring the impact of contraception on the menstrual cycle in contraceptive clinical trials.

Objective: We sought to develop consensus recommendations for measurement and analysis of data on contraceptive-induced menstrual changes (CIMCs) in contraceptive clinical trials. We built upon previous standardization efforts over the last 50 years and prioritized input from a variety of global experts and current regulatory authority guidance on patient-reported outcomes.

Study Design: We completed a formal consensus-building process with an interdisciplinary group of 57 experts from 30 organizations and 14 countries in five global regions who work across academia, nonprofit research organizations, the pharmaceutical industry, and funding agencies.

Evaluating Clinician Experience in Health Care Transition: Results From Six Health Systems.

Purpose: There is a paucity of evidence examining clinician experiences with structured health-care transition (HCT) programs. Among HCT Learning Collaborative participants, this study describes clinician experiences with implementation of a structured HCT process: Got Transition's 6 Core Elements.

Methods: Representative members from 6 health systems designed a survey to collect clinician feedback regarding HCT and demographic and practice information.