Addressing Diabetes Distress in Primary Care: Where Are We Now, and Where Do We Need to Go?

Purpose Of Review: Addressing diabetes distress (DD), the emotional demands of living with diabetes, is a crucial component of diabetes care. Most individuals with type 2 diabetes and approximately half of adults with type 1 diabetes receive their care in the primary care setting. This review will provide guidance on addressing DD and implementing targeted techniques that can be tailored to primary care patients.

An Interprofessional Collaboration Between a Community-Based Doula Organization and Clinical Partners: The Champion Dyad Initiative.

As access to doula services expands through state Medicaid coverage and specific initiatives aimed at improving maternal health equity, there is a need to build and improve upon relationships between the doula community, hospital leaders, and clinical staff. Previous research and reports suggest rapport-building, provider education, and forming partnerships between community-based organizations and hospitals can improve such relationships. However, few interventions or programs incorporating such approaches are described in the literature.

Blood biomarker profiles in young-onset neurocognitive disorders: A cohort study.

Introduction: Young-onset neurocognitive symptoms result from a heterogeneous group of neurological and psychiatric disorders which present a diagnostic challenge. To identify such factors, we analysed the Biomarkers in Younger-Onset Neurocognitive Disorders cohort, a study of individuals <65 years old presenting with neurocognitive symptoms for a diagnosis and who have undergone cognitive and biomarker analyses.

Methods: Sixty-five participants (median age at assessment of 56 years, 45% female) were recruited during their index presentation to the Royal Melbourne Hospital Neuropsychiatry Centre, a tertiary specialist service in Melbourne, Australia, and categorized as either early-onset Alzheimer's disease ( = 18), non-Alzheimer's disease neurodegeneration ( = 23) or primary psychiatric disorders ( = 24).

Effectiveness and utilization of a cognitive screening program for primary geriatric care.

Background: Effective detection of cognitive impairment in the primary care setting is limited by lack of time and specialized expertise to conduct detailed objective cognitive testing and few well-validated cognitive screening instruments that can be administered and evaluated quickly without expert supervision. We therefore developed a model cognitive screening program to provide relatively brief, objective assessment of a geriatric patient's memory and other cognitive abilities in cases where the primary care physician suspects but is unsure of the presence of a deficit.

Methods: Referred patients were tested during a 40-min session by a psychometrist or trained nurse in the clinic on a brief battery of neuropsychological tests that assessed multiple cognitive domains.

Mobile health clinics in a rural setting: a cost analysis and time motion study of La Clínica in Oregon, United States.

Background: Mobile Health Clinics (MHCs) are an alternate form of healthcare delivery that may ameliorate current rural-urban health disparities in chronic diseases and have downstream impacts on the health system by reducing costs. Evaluations of providers' time allocation on MHCs are scarce, hindering knowledge transfer related to MHC implementation strategies.

Methods: Retrospective economic cost was assessed using business ledgers and expert assessments in 2023 US Dollar (USD) from 2022 to 2023.

Methods for modeling gestational weight gain: empirical application using electronic health record data from a safety net population.

Background: Understanding the risks and effects of gestational weight gain (GWG) is a prominent area of perinatal research but approaches for quantifying GWG are evolving and remain underdeveloped, especially in clinical settings for underserved demographic subgroups. To fill this gap, we demonstrated and compared six GWG metrics across pre-pregnancy BMI classifications: total GWG, trimester-specific linear rate of GWG, adherence to total and trimester-specific recommendations, area under the curve, and GWG for gestational age z-scores.

Methods: We used clinical data on 44,801 pregnant people from community-based health care organizations with extensive longitudinal measures and substantial representation of understudied subgroups.

Neutralizing antibody immune correlates in COVAIL trial recipients of an mRNA second COVID-19 vaccine boost.

Neutralizing antibody titer has been a surrogate endpoint for guiding COVID-19 vaccine approval and use, although the pandemic's evolution and the introduction of variant-adapted vaccine boosters raise questions as to this surrogate's contemporary performance. For 985 recipients of an mRNA second bivalent or monovalent booster containing various Spike inserts [Prototype (Ancestral), Beta, Delta, and/or Omicron BA.1 or BA.

Nr4a1 and Nr4a3 redundantly control clonal deletion and contribute to an anergy-like transcriptome in auto-reactive thymocytes to impose tolerance in mice.

The Nr4a nuclear hormone receptors are transcriptionally upregulated in response to antigen recognition by the T cell receptor (TCR) in the thymus and are implicated in clonal deletion, but the mechanisms by which they operate are not clear. Moreover, their role in central tolerance is obscured by redundancy among the Nr4a family members and by their reported functions in Treg generation and maintenance. Here we take advantage of competitive bone marrow chimeras and the OT-II/RIPmOVA model to show that Nr4a1 and Nr4a3 are essential for the upregulation of Bcl2l11/BIM and thymic clonal deletion by self-antigen.

Advances in the understanding and therapeutic manipulation of cancer immune responsiveness: a Society for Immunotherapy of Cancer (SITC) review.

Cancer immunotherapy-including immune checkpoint inhibition (ICI) and adoptive cell therapy (ACT)-has become a standard, potentially curative treatment for a subset of advanced solid and liquid tumors. However, most patients with cancer do not benefit from the rapidly evolving improvements in the understanding of principal mechanisms determining cancer immune responsiveness (CIR); including patient-specific genetically determined and acquired factors, as well as intrinsic cancer cell biology. Though CIR is multifactorial, fundamental concepts are emerging that should be considered for the design of novel therapeutic strategies and related clinical studies.

A systematic review of participant diversity in psychedelic-assisted psychotherapy trials.

A lack of diverse and representative participant samples in mental health intervention research perpetuates mental health disparities. This issue has become a salient concern in studies of psychedelic-assisted psychotherapy (PAT), which is emerging as a promising mental health intervention. This systematic review evaluates the reporting, representation, and analysis of participant sociodemographic characteristics in randomized controlled trials (RCTs) of PAT.

Prognostic value of manual versus automatic methods for assessing extents of resection and residual tumor volume in glioblastoma.

Objective: The extent of resection (EOR) and postoperative residual tumor (RT) volume are prognostic factors in glioblastoma. Calculations of EOR and RT rely on accurate tumor segmentations. Raidionics is an open-access software that enables automatic segmentation of preoperative and early postoperative glioblastoma using pretrained deep learning models.

ChatGPT-Assisted Machine Learning for Chronic Disease Classification and Prediction: A Developmental and Validation Study.

Background Chronic diseases such as chronic kidney disease (CKD), chronic liver disease (CLD), tuberculosis (TB), dementia, and heart disease are global health concerns of significant importance, representing major causes of morbidity and mortality worldwide. Early diagnosis and interventions are critical to improve patient outcomes and reduce healthcare costs. Methods This prospective observational study analyzed clinical data from 270 patients (calculated using G*Power 3.

Exploring the Ethical Implications of ChatGPT in Medical Education: Privacy, Accuracy, and Professional Integrity in a Cross-Sectional Survey.

Background: The inclusion of artificial intelligence in medical education, specifically through the use of ChatGPT (OpenAI, San Francisco, CA), has transformed learning and generated many ethical questions. This study aims to analyze the medical students' ethical concerns about using ChatGPT in medical education, focusing on privacy, accuracy, and professional integrity.

Methods: The study format was a cross-sectional survey distributed to 219 medical students at ABWA Medical College, Pakistan.

Prioritizing post-COVID-19 health research in sub-Saharan Africa: A modified Delphi study for future pandemic.

Background: The COVID-19 pandemic exposed weaknesses in healthcare systems and disparities in healthcare access across sub-Saharan Africa (SSA). The insights of frontline healthcare professionals (HCPs), and healthcare researchers involved with the response to COVID in SSA are crucial to ensuring that health systems are optimally prepared for the next pandemic threat. Nonetheless, there is limited consensus as to what are the clinical and public health research priorities necessary to ensure that SSA is optimally prepared and responsive to future pandemics.

Services and payments associated with the medicare new technology add-on payment program.

In 2001, the Centers for Medicare and Medicaid Services established the New Technology Add-On Payment (NTAP) program to incentivize access to costly new technologies for Medicare beneficiaries. These technologies, authorized by the Food and Drug Administration (FDA), must demonstrate "substantial clinical improvement" when compared to existing technologies. However, in FY2021, the FDA introduced two expedited authorization pathways, allowing technologies with either designation to bypass the "substantial clinical improvement" criterion.

Resource availability for CNS tumor diagnostics in the Asian Oceanian region: A survey by the Asian Oceanian Society of Neuropathology committee for Adapting Diagnostic Approaches for Practical Taxonomy in Resource-Restrained Regions (AOSNP-ADAPTR).

The shift toward a histo-molecular approach in World Health Organization classification of central nervous system tumors (WHO CNS5) emphasizes the critical role of molecular testing, such as next-generation sequencing (NGS) and DNA methylation profiling, for accurate diagnosis. However, implementing these advanced techniques is particularly challenging in resource-constrained countries. To address this, the Asian Oceanian Society of Neuropathology committee for Adapting Diagnostic Approaches for Practical Taxonomy in Resource-Restrained Regions (AOSNP-ADAPTR) was initiated to help pathologists in resource-limited regions to implement WHO CNS5 diagnoses using simpler diagnostic tools, mainly immunohistochemistry.

Self-reported experiences and perspectives on using psychedelics to manage opioid use among participants of two Reddit communities.

Background And Aims: The opioid crisis continues to exert a tremendous toll in North America, with existing interventions often falling short of addressing ongoing needs. Psychedelics are emerging as a possible alternative therapy for mental health and substance use disorders. This study aimed to gather insights on how people use or are considering using psychedelics to manage opioid use disorder (OUD), how these experiences are perceived to impact opioid use and what these lessons imply for future research and practice.

A qualitative study to understand the facilitators of and barriers to retention in care to the national PMTCT Option B+ programme in Uganda.

Introduction: Effective prevention of mother to child transmission (PMTCT) programmes require women and their infants to have access to a cascade of HIV care and treatment interventions. Retention in care reduces the risk of vertical transmission and opportunistic infections among mothers living with HIV. Uganda has made great strides in ensuring the success of the prevention of mother to child transmission program.

Recommendations for mitochondria transfer and transplantation nomenclature and characterization.

Intercellular mitochondria transfer is an evolutionarily conserved process in which one cell delivers some of their mitochondria to another cell in the absence of cell division. This process has diverse functions depending on the cell types involved and physiological or disease context. Although mitochondria transfer was first shown to provide metabolic support to acceptor cells, recent studies have revealed diverse functions of mitochondria transfer, including, but not limited to, the maintenance of mitochondria quality of the donor cell and the regulation of tissue homeostasis and remodelling.

Biomarker Panels for Discriminating Risk of CKD Progression in Children.

Background: We have previously studied biomarkers of tubular health (EGF), injury (KIM-1), dysfunction (alpha-1 microglobulin), and inflammation (TNFR-1, TNFR-2, MCP-1, YKL-40, suPAR), and demonstrated that plasma KIM-1, TNFR-1, TNFR-2 and urine KIM-1, EGF, MCP-1, urine alpha-1 microglobulin are each independently associated with CKD progression in children. In this study, we used bootstrapped survival trees to identify a combination of biomarkers to predict CKD progression in children.

Methods: The CKiD Cohort Study prospectively enrolled children 6 months to 16 years old with an eGFR of 30-90 ml/min/1.

Low dose DNA methyltransferase inhibitors potentiate PARP inhibitors in homologous recombination repair deficient tumors.

Background: Poly (ADP-Ribose) polymerase inhibitors are approved for treatment of tumors with BRCA1/2 and other homologous recombination repair (HRR) mutations. However, clinical responses are often not durable and treatment may be detrimental in advanced cancer due to excessive toxicities. Thus we are seeking alternative therapeutics to enhance PARP-directed outcomes.