Assessing Medicare's Coverage With Evidence Development Program.

The Centers for Medicare and Medicaid Services (CMS) coverage with evidence development (CED) program provides coverage for items and services not meeting Medicare's "reasonable and necessary" standard while requiring participation in clinical studies. As additional evidence is available, CMS may reconsider CED decisions. Of twenty-six items and services in the CED program since its 2005 inception, CMS has reconsidered coverage for ten (38 percent).

Cell-Penetrating Peptide Like Anti-Programmed Cell Death-Ligand 1 Peptide Conjugate-Based Self-Assembled Nanoparticles for Immunogenic Photodynamic Therapy.

The tumor-specific efficacy of the most current anticancer therapeutic agents, including antibody-drug conjugates (ADCs), oligonucleotides, and photosensitizers, is constrained by limitations such as poor cell penetration and low drug delivery. In this study, we addressed these challenges by developing, a positively charged, amphiphilic Chlorin e6 (Ce6)-conjugated, cell-penetrating anti-PD-L1 peptide nanomedicine (CPPD1) with enhanced cell and tissue permeability. The CPPD1 molecule, a bioconjugate of a hydrophobic photosensitizer and strongly positively charged programmed cell death-ligand 1 (PD-L1) binding cell-penetrating peptide (CPP), is capable of self-assembling into nanoparticles with an average size of 199 nm in aqueous solution without the need for any carriers.

High organofluorine concentrations in municipal wastewater affect downstream drinking water supplies for millions of Americans.

Wastewater receives per- and polyfluoroalkyl substances (PFAS) from diverse consumer and industrial sources, and discharges are known to be a concern for drinking water quality. The PFAS family includes thousands of potential chemical structures containing organofluorine moieties. Exposures to a few well-studied PFAS, mainly perfluoroalkyl acids (PFAA), have been associated with increased risk of many adverse health outcomes, prompting federal drinking water regulations for six compounds in 2024.

Correlation of the Sinonasal Outcome Test-22 With the University of Washington Quality of Life in Assessing Quality of Life in Sinonasal Malignancy Utilizing a Multicenter Prospective Observational Cohort Registry.

In this multi-center sinonasal malignancies (SNM) cohort, the Sino-nasal Outcome Test has a correlation with the University of Washington Quality of Life (UWQOL) for assessing QOL. The use of both instruments remains recommended to provide complete and complementary information. Future design of an easy-to-use tool specific to SNM is needed to encompass all aspects of QOL.

Concerns Over Vuse e-Cigarette Digital Marketing and Implications for Public Health Regulation: Content Analysis.

Background: Electronic cigarettes (e-cigarettes) are the most used form of tobacco products among adolescents and young adults, and Vuse is one of the most popular brands of e-cigarettes among US adolescents. In October 2021, Vuse Solo became the first e-cigarette brand to receive marketing granted orders (MGOs) from the US Food and Drug Administration (FDA), authorizing its marketing and their tobacco-flavored pods. Vuse Ciro and Vuse Vibe, and their tobacco-only ("original") e-liquids, were authorized for marketing in May 2022 and Vuse Alto tobacco-flavored devices were authorized in July 2024.

Modeling Hydrogen Markets: Energy System Model Development Status and Decarbonization Scenario Results.

Hydrogen can be used as an energy carrier and chemical feedstock to reduce greenhouse gas emissions, especially in difficult-to-decarbonize markets such as medium- and heavy-duty vehicles, aviation and maritime, iron and steel, and the production of fuels and chemicals. Significant literature has been accumulated on engineering-based assessments of various hydrogen technologies, and real-world projects are validating technology performance at larger scales and for low-carbon supply chains. While energy system models continue to be updated to track this progress, many are currently limited in their representation of hydrogen, and as a group they tend to generate highly variable results under decarbonization constraints.

Propensity Score Analysis of Possible Medication Effects on Outcomes in Patients With Systemic Right Ventricles.

Background: Patients with systemic right ventricle (SRV), either d-transposition of the great arteries following an atrial switch procedure or congenitally corrected transposition of the great arteries, develop severe right ventricular dysfunction, prompting appropriate medical therapy. However, the efficacy of beta-blockers and angiotensin receptor blockers or angiotensin-converting enzyme inhibitors (ACEI) in SRV patients is unproven.

Objectives: The objective of this study was to determine the effects of ACEI/ARB and beta-blockers on outcomes in SRV patients after accounting for likely cofounders affecting their use.

miR-193b-365 microcluster downstream of coordinates neuron-subtype identity and dendritic morphology in cortical projection neurons.

Different neuron types develop characteristic axonal and dendritic arborizations that determine their inputs, outputs, and functions. Expression of fate-determinant transcription factors is essential for specification of their distinct identities. However, the mechanisms downstream of fate-determinant factors coordinating different aspects of neuron identity are not understood.

SpaRG: Sparsely Reconstructed Graphs for Generalizable fMRI Analysis.

Deep learning can help uncover patterns in resting-state functional Magnetic Resonance Imaging (rs-fMRI) associated with psychiatric disorders and personal traits. Yet the problem of interpreting deep learning findings is rarely more evident than in fMRI analyses, as the data is sensitive to scanning effects and inherently difficult to visualize. We propose a simple approach to mitigate these challenges grounded on sparsification and self-supervision.

Brain network correlates of affective symptoms in aMCI.

Affective symptoms (i.e., depression, anxiety, and apathy) are the most prevalent subsyndrome of neuropsychiatric symptoms (NPS) in preclinical dementia, such as amnestic mild cognitive impairment (aMCI), and remain a challenge to understand and treat.

Single-Malt Whisky Versus Cocktail? Approaches to Surgical Lymphedema Management.

Lymphedema is a chronic, dynamic, and multifaceted disease that is effectively treated by surgery. However, there is a lack of consensus in the field about the ideal technique; is it better to perform one surgery type at a time (the "single-malt whisky" approach), or combine different procedures in a single surgery (the "cocktail" approach)? Here, we review advances in these opposing camps, compare outcomes, and discuss potential paradigm shifts in the surgical treatment of lymphedema.

A Fast Nonparametric Sampling Method for Time to Event in Individual-Level Simulation Models.

The nonparametric sampling method is generic and can sample times to an event from any discrete (or discretizable) hazard without requiring any parametric assumption.The method is showcased with 5 commonly used distributions in discrete-event simulation models.The method produced very similar expected times to events, as well as their probability distribution, compared with analytical results.

Light-Controlled Intracellular Synthesis of Poly(luciferin) Polymers Induces Cell Paraptosis.

Accumulation of misfolded proteins challenges cellular proteostasis and is implicated in aging and chronic disorders. Cancer cells, moreover, face an elevated level of basal proteotoxic stress; hence, exacerbating endoplasmic reticulum (ER) stress has been shown to induce programmed cell death while enhancing anticancer immunogenicity. We hypothesize that hydrophobic abiotic macromolecules can trigger a similar stress response.

Alcohol-Related Liver Disease, Followed by Metabolic Dysfunction-Associated Steatotic Liver Disease, Emerges as the Fastest-Growing Aetiologies for Primary Liver Cancer in the United States.

Objective: Primary liver cancer (PLC) is projected to be the third leading cause of cancer mortality in the United States in 2040. We examine the burden of PLC in the United States, stratified by sex, state and aetiological risk factors.

Methods: Data on PLC prevalence, incidence, death and disability-adjusted life years (DALYs) were extracted from the Global Burden of Disease Study 2021.

The St. Jude Global Academy: A Multifaceted Education Program to Expand Pediatric Oncology Workforce Capacity.

There is currently a global shortage of healthcare professionals equipped to handle the rising burden of childhood cancer. St. Jude Global is an initiative to improve survival rates of children with cancer worldwide while improving access to quality care.

Development of a User-Centred Chronic Care Model for Patients With Heart Failure in a Limited-Resource Setting: A Codesign Study.

Background: Health service leaders in Thailand face substantial challenges in addressing the needs of a growing population of patients with moderate to severe Chronic Heart Failure (CHF) who require acute care management and ongoing supportive care in the community. The large number of CHF patients requiring readmission for high-level care places a significant burden on healthcare services.

Methods: The design thinking model proposed by the Hasso-Plattner Institute of Design at Stanford University underpinned an approach to developing a co-designed, tailored, culturally acceptable model of chronic care for people with CHF.

Refining Chronic Pain Phenotypes: A Comparative Analysis of Sociodemographic and Disease-Related Determinants Using Electronic Health Records.

The use of electronic health records (EHR) for chronic pain phenotyping has gained significant attention in recent years, with various algorithms being developed to enhance accuracy. Structured data fields (e.g.

Bromocriptine for Residual Catatonia Following Neuroleptic Malignant Syndrome: Illustrative Case Report and Systematic Review.

Background: Neuroleptic malignant syndrome (NMS) is a rare yet potentially fatal iatrogenic syndrome that can manifest with life-threatening symptoms. Theorized to be caused by the dopamine-blocking effects of certain medications, such as antipsychotics, or the withdrawal of dopaminergic agents, NMS is characterized by hyperthermia, autonomic instability, altered mental status, and muscular rigidity. Most treated cases resolve within weeks; however, in some cases, residual catatonic symptoms can persist for months after the resolution of acute hyperthermic and hypermetabolic symptoms.

A Similar Mutation in the AAUU-Rich Elements of the Mouse TNF Gene Results in a Distinct Ileocolitic Phenotype: A New Strain of TNF-Overexpressing Mice.

Background: Tumor necrosis factor (TNF) is a pleiotropic cytokine that plays a critical role in the pathogenesis of immune-mediated diseases including inflammatory bowel disease (IBD). The stability of its mRNA transcript, determined in part by destabilizing sequences in its AAUU repeats (ARE) gene region, is an important regulator of its tissue and systemic levels. A deletion in the ARE region of the gene resulted in IBD and arthritis in mice and pigs, supporting a critical role for the cytokine in human IBD and several human arthritides.