Smoking Cessation Smartphone App for Nondaily Smoking With Telephone Onboarding: Proof-of-Concept Randomized Controlled Trial.

Background: Nondaily smoking is a widespread and increasingly prevalent pattern of use. To date, no effective treatment approach for nondaily smoking has been identified.

Objective: This study aimed to conduct an unblinded randomized controlled trial to evaluate proof-of-concept markers of the Smiling instead of Smoking (SiS) app, a smartphone app for smoking cessation, designed specifically for people who smoke less than daily, within the framework of positive psychology.

Disrupted target binding with acryloyl group as potential Bcr-Abl/C-Src dual kinase inhibitor optimization strategies with maintained antitumor activity.

Current CML treatments often suffer from undesired side effects. Herein we report the computation-assisted optimization of Bcr-Abl/C-Src dual kinase inhibitor. We surmised the improved toxicity profile was achieved via disrupted ligand-target binding.

Adaptive Cost-Benefit Control Fueled by Striatal Dopamine.

The twenty-first century has brought forth a deluge of theories and data shedding light on the neural mechanisms of motivated behavior. Much of this progress has focused on dopaminergic dynamics, including their signaling properties (how do they vary with expectations and outcomes?) and their downstream impacts in target regions (how do they affect learning and behavior?). In parallel, the basal ganglia have been elevated from their original implication in motoric function to a canonical circuit facilitating the initiation, invigoration, and selection of actions across levels of abstraction, from motor to cognitive operations.

Orthopaedic Surgery in the Jehovah's Witness Patient: Clinical, Ethical, and Legal Considerations.

➢ Jehovah's Witnesses refuse allogeneic blood products based on religious beliefs that create clinical, ethical, and legal challenges in orthopaedic surgery, requiring detailed perioperative planning and specific graft selection.➢ Detailed perioperative planning is particularly important for procedures with high intraoperative blood loss.➢ Graft selection must align with Jehovah's Witnesses patients' religious beliefs, with options including autografts, allografts, and synthetic materials; this requires shared decision-making between the patient and surgeon.

Survival with Trastuzumab Emtansine in Residual HER2-Positive Breast Cancer.

Background: Patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer with residual invasive disease after neoadjuvant systemic therapy have a high risk of recurrence and death. The primary analysis of KATHERINE, a phase 3, open-label trial, showed that the risk of invasive breast cancer or death was 50% lower with adjuvant trastuzumab emtansine (T-DM1) than with trastuzumab alone.

Methods: We randomly assigned patients with HER2-positive early breast cancer with residual invasive disease in the breast or axilla after neoadjuvant systemic treatment with taxane-based chemotherapy and trastuzumab to receive T-DM1 or trastuzumab for 14 cycles.

Iliopsoas Injections: A Systematic Review of Patient Outcomes and Progression to Surgery.

Background: Iliopsoas injuries are a common cause of anterior hip and groin pain and can be successfully managed with conservative treatment. Corticosteroid and local anesthetic injections can also be offered in conjunction with nonoperative management. Given the variability in reported injection guidelines, composition, and techniques, the purpose of this study was to systematically review the literature to assess progression to surgery and patient outcomes following iliopsoas injections.

Revealing the reaction path of UVC bond rupture in cyclic disulfides with ultrafast x-ray scattering.

Disulfide bonds are ubiquitous molecular motifs that influence the tertiary structure and biological functions of many proteins. Yet, it is well known that the disulfide bond is photolabile when exposed to ultraviolet C (UVC) radiation. The deep-UV-induced S─S bond fragmentation kinetics on very fast timescales are especially pivotal to fully understand the photostability and photodamage repair mechanisms in proteins.

HIV pre-exposure prophylaxis prescription initiation and maintenance among homeless-experienced people who use drugs.

Background: HIV pre-exposure prophylaxis (PrEP) remains particularly underutilized among homeless-experienced people who use drugs (PWUD).

Setting: Boston Health Care for the Homeless Program, a Federally Qualified Health Center serving homeless-experienced individuals in Boston, Massachusetts.

Methods: To identify determinants of PrEP prescription initiation and continuation, we analyzed electronic medical records and pharmacy data between April 2018-March 2022.

Acrobatics at the insect scale: A durable, precise, and agile micro-aerial robot.

Aerial insects are exceptionally agile and precise owing to their small size and fast neuromotor control. They perform impressive acrobatic maneuvers when evading predators, recovering from wind gust, or landing on moving objects. Flapping-wing propulsion is advantageous for flight agility because it can generate large changes in instantaneous forces and torques.

Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.

Sociodemographic Variables Associated with Self-reported Access to Mental Healthcare Among Brazilian Immigrant Women in the U.S.

Brazilians are a rapidly growing immigrant population in the United States (U.S.), yet little is known about their mental health and access to mental healthcare.

Advanced Care Planning for the Orthopaedic Patient.

➢ Advanced care planning most commonly refers to the act of planning and preparing for decisions with regard to end-of-life care and/or serious illness based on a patient's personal values, life goals, and preferences.➢ Over time, advanced care planning and its formalization through advanced directives have demonstrated substantial benefits to patients, their families and caregivers, and the larger health-care system.➢ Despite these benefits, advanced care planning and advanced directives remain underutilized.

Sexual minority stressors and disordered eating behaviors in daily life: a daily diary study of sexual minority cisgender female couples.

Young cisgender sexual minority women (e.g. lesbian, queer) in the U.

Current landscape and future prospects of interleukin-2 receptor (IL-2R) agonists in cancer immunotherapy.

Immune checkpoint blockade (ICB) has significantly improved the survival for many patients with advanced malignancy. However, fewer than 50% of patients benefit from ICB, highlighting the need for more effective immunotherapy options. High-dose interleukin-2 (HD IL-2) immunotherapy, which is approved for patients with metastatic melanoma and renal cell carcinoma, stimulates CD8 T cells and NK cells and can generate durable responses in a subset of patients.

Preventive Lipid-Lowering Therapy and Interactions With Health Care in Patients Who Develop Premature Coronary Artery Disease.

Background: Rates of premature coronary artery disease (CAD) are stagnant, and the prevalence of cardiovascular risk factors in young and middle-aged adults is increasing. Lipid-lowering therapy (LLT) is effective in preventing CAD but is underutilized in younger patients. The reasons for and consequences of this underutilization are not fully understood.

The promise and limits of inclusive public policy: federal safety net clinics and immigrant access to health care in the U.S.

In the United States, exclusionary public policies generate inequalities within and across labor, financial, and legal status hierarchies, which together undermine immigrant well-being. But can inclusive public policies improve immigrant health? We examine whether and how an immigrant-inclusive federal program, Federally Qualified Health Centers (FQHCs), shaped health care access and use among farmworkers over nearly three decades, paying particular attention to disparities at the intersection of nativity and legal status. Linking historical administrative data on the location and funding of FQHCs with the National Agricultural Workers Survey from 1989-2017, we first document trends in farmworkers' county-level proximity to FQHCs and identify a steady increase in FQHC access among undocumented farmworkers following the Affordable Care Act.

Identifying Predictors of Extended Intensive Care Unit Stay Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: An Analysis of 101 ACS NSQIP Pediatric Participating Centers.

Background: While prolonged operative time and increased levels fused have been shown to increase the risk of prolonged intensive care unit (ICU) length-of-stay (LOS), studies are limited in guiding decision-making regarding the need for intensive care postoperatively. This is especially the case among the cohort of adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF); associations between comorbidities and ICU LOS are not well-delineated.

Methods: AIS patients who underwent PSF from January 1st, 2016 to December 1st, 2016 at 101 participating centers were identified using the American College of Surgeons (ACS) National Surgical Quality Im-provement Project (NSQIP) Pediatric database.

Post-COVID Hypertension With Hyperreninemic Hyperaldosteronism in a Pediatric Patient.

COVID-19 infection may predispose patients to long-term renovascular complications. Early recognition and management are crucial for optimal outcomes. This case report underscores the importance of thorough follow-up care for children recovering from COVID-19, with a focus on monitoring blood pressure and renal function to mitigate long-term renovascular disease.

Recommendations for Specialty Palliative APRN Graduate Education.

Background: Advanced practice registered nurses (APRNs) are essential to care for the growing number of individuals with advanced illness given the shortage of palliative care clinicians.

Problem: Graduate education for specialty practice palliative APRNs lacks consistency in structure, content, and standardization of specialty palliative APRN education.

Approach: A workgroup of expert palliative APRNs and graduate faculty conducted focused discussions and a literature review to develop consensus recommendations based on national palliative APRN competencies and aligned with the 8 core concepts of the AACN Essentials.

Staffing Up: The Nursing Home Minimum Staffing Rule.

On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) announced new staffing mandates for long-term care (LTC) facilities in an effort to improve care quality in nursing homes (NHs). The guidelines require a minimum of 3.48 h of daily care per resident, including 0.

Potential plant extinctions with the loss of the Pleistocene mammoth steppe.

During the Pleistocene-Holocene transition, the dominant mammoth steppe ecosystem across northern Eurasia vanished, in parallel with megafauna extinctions. However, plant extinction patterns are rarely detected due to lack of identifiable fossil records. Here, we introduce a method for detection of plant taxa loss at regional (extirpation) to potentially global scale (extinction) and their causes, as determined from ancient plant DNA metabarcoding in sediment cores (sedaDNA) from lakes in Siberia and Alaska over the past 28,000 years.

XIS-Temperature: A daily spatiotemporal machine-learning model for air temperature in the contiguous United States.

The challenge of reconstructing air temperature for environmental applications is to accurately estimate past exposures even where monitoring is sparse. We present XGBoost-IDW Synthesis for air temperature (XIS-Temperature), a high-resolution machine-learning model for daily minimum, mean, and maximum air temperature, covering the contiguous US from 2003 through 2023. XIS uses remote sensing (land surface temperature and vegetation) along with a parsimonious set of additional predictors to make predictions at arbitrary points, allowing the estimation of address-level exposures.

Accelerating the Future of Oncology Drug Development: The Role of Consortia in the Delivery of Precision Oncology Early Phase Clinical Trials.

Purpose: Over the past 15 years, the landscape of early phase clinical trials (EPCTs) has undergone a remarkable expansion in both quantity and intricacy. The proliferation of sites, trials, sponsors, and contract research organizations has surged exponentially, marking a significant shift in research conduct. However, EPCT operations suffer from numerous inefficiencies, such as cumbersome start-up processes, which are particularly critical when drug safety and the recommended phase II dose need to be established in a timely manner.