Exercise Therapy Rescues Skeletal Muscle Dysfunction and Exercise Intolerance in Cardiometabolic HFpEF.

Exercise intolerance, a hallmark of heart failure with preserved ejection fraction (HFpEF) exacerbated by obesity, involves unclear mechanisms related to skeletal muscle metabolism. In a "2-hit" model of HFpEF, we investigated the ability of exercise therapy (voluntary wheel running) to reverse skeletal muscle dysfunction and exercise intolerance. Using state-of-the-art metabolic cages and a multiomic approach, we demonstrate exercise can rescue dysfunctional skeletal muscle lipid and branched-chain amino acid oxidation and restore exercise capacity in mice with cardiometabolic HFpEF.

Seizure network characterization by functional connectivity mapping and manipulation.

Significance: Despite the availability of various anti-seizure medications, nearly 1/3 of epilepsy patients experience drug-resistant seizures. These patients are left with invasive surgical options that do not guarantee seizure remission. The development of novel treatment options depends on elucidating the complex biology of seizures and brain networks.

Renal Physiology Education via Podcast: Channel Your Enthusiasm.

Renal physiology is considered one of the most challenging medical disciplines to understand and to teach. Eight academic nephrologists have come together to produce a podcast devoted to helping learners at any level improve their understanding of this difficult topic. Using Dr Burton D.

Neighborhood Socioeconomic Status and Cardiovascular Events in Adults With CKD: The CRIC Study.

Rationale & Objective: In the general population, neighborhood socioeconomic status (SES) has been found to be associated with cardiovascular risk, but this relationship has not been well studied among patients with chronic kidney disease (CKD). This study seeked to evaluate the association between neighborhood SES and cardiovascular outcomes in a CKD cohort.

Study Design: Multicenter prospective cohort.

Telehealth for Goals of Care Conversations in Advanced CKD: A Mixed-Methods Pilot Study of US Veterans and Their Clinicians.

Rationale & Objective: Engaging patients with advanced chronic kidney disease (CKD) in goals of care (GOC) conversations is essential to align life-sustaining treatments with patient preferences. This pilot study described the feasibility of engaging older Veterans with advanced CKD in GOC conversations via telehealth by (1) comparing patient characteristics, including life-sustaining treatment note completion rates and preferences by visit modality, and (2) exploring Veteran and clinician perspectives surrounding telehealth GOC conversations.

Study Design: Mixed-method convergent design including a prospective, quantitative observational cohort analysis (n = 40) and qualitative, semi-structured interviews with 4 clinicians and 11 Veterans.

Applications of genome sequencing as a single platform for clinical constitutional genetic testing.

The number of human disease genes has dramatically increased over the past decade, largely fueled by ongoing advances in sequencing technologies. In parallel, the number of available clinical genetic tests has also increased, including the utilization of exome sequencing for undiagnosed diseases. Although most clinical sequencing tests have been centered on enrichment-based multigene panels and exome sequencing, the continued improvements in performance and throughput of genome sequencing suggest that this technology is emerging as a potential platform for routine clinical genetic testing.

The March to Health Equity and Justice in Pulmonary and Critical Care Medicine.

Training programs in pulmonary and critical care medicine have greatly expanded in the past decade, yet they do not reflect the racial/ethnic and economic diversity of the United States, which has significant implications for health equity. The lack of representation across medical education is likely to worsen with the recent Supreme Court decision banning affirmative action. The authors review health disparities in pulmonary and critical care medicine, the relationship of the workforce to health equity, and 10 tactics for addressing this urgent public health issue.

Lessons Learned from Integrating Educational Technology into the Preclerkship Teaching of Pulmonary Medicine.

The structure and delivery of preclerkship undergraduate medical education has changed significantly over the past decade. Asynchronous didactic lectures are now routinely paired with in-person sessions that emphasize active and small-group learning. In this environment, educators tasked with teaching pulmonary medicine should be familiar with the growing number of educational technologies that can transform how and where content is delivered to students.

Craniectomy and Cranioplasty Effects on Balance and Gait in Rehabilitation: A Retrospective Study.

Objective: To analyze changes in balance and gait in patients undergoing rehabilitation postcraniectomy and postcranioplasty, including comparison of outcomes across time periods, rate of change, and among diagnoses.

Design: Retrospective cohort study.

Setting: Inpatient rehabilitation.

Association of Step Count with Cardiorespiratory Fitness: Results from the Virtual 2-Minute Step Test.

Objective: To test the hypothesis that step count based on a virtual 2-minute step test (2MST) predicts cardiorespiratory fitness (CRF).

Design: Cross-sectional study.

Setting: Veteran Affairs Medical Centers participating in a randomized trial of functional exercise training delivered by videoconferencing.

Nonresponse Bias on Inpatient Rehabilitation Hospitals' Experience of Care Quality Measure Scores.

Objective: To describe the magnitude of nonresponse bias on inpatient rehabilitation facility (IRF) experience of care survey data in patients with neurologic disorders.

Design: Cohort study of patients at 2 IRFs. Patients reported experience of care via an IRF-administered survey as part of routine operations approximately 2 weeks after discharge.

DAA-PASS: A Prospective Evaluation of HCC Recurrence After Direct Acting Antiviral Therapy.

Direct-acting antiviral (DAA) therapy is associated with a significant reduction in hepatocellular carcinoma (HCC) incidence among patients with cirrhosis, but data are conflicting about the risk of recurrence following DAA therapy. DAA-PASS was a prospective, pragmatic, observational study designed to estimate the risk of HCC recurrence associated with DAA therapy exposure during routine clinical care. Eligible patients were DAA treatment naive with Barcelona Clinic Liver Cancer (BCLC) stage A.

Emergency department utilization by youth before and after firearm injury.

Background: Emergency department (ED) visits may serve as opportunities for firearm injury prevention and intervention efforts. Our objective was to determine ED utilization by youth before and after firearm injury.

Methods: We performed a retrospective cohort study of ED encounters by youth (0-18 years old) with firearm injury from eight states using the 2019 State ED and Inpatient Databases.

Medicaid and the Children's Health Insurance Program: Understanding These Programs to Promote Advancements.

Medicaid and the Children's Health Insurance Program together represent the largest healthcare coverage programs in the United States, providing benefits for approximately one in four residents and more than half of all children. Both programs are funded by a combination of federal and state dollars with more than 70% of beneficiaries enrolled in managed care plans. The size and scope of these programs underpin the importance of a working knowledge to understand healthcare delivery in the United States.

New Index Demonstrates Association between Social Vulnerability, Environmental Burden, and Kidney Failure Risk among Individuals with Glomerular Disease.

Background: The Centers for Disease Control and Prevention (CDC) Environmental Justice Index Social-Environmental Ranking (EJI-SER) combines a Social Vulnerability Module (SV) with an Environmental Burden Module (EB) to characterize cumulative environmental and social burden at the census tract level. This analysis evaluates the association between EJI-SER and kidney outcomes in glomerular disease (GD) patients.

Methods: Cure Glomerulopathy (CureGN) is an observational cohort study of adults and children with biopsy-proven GD.

Highly Efficient Compositional and Compound Specific Isotopic Analysis of Volatile Primary Amines and Ammonia in the Murchison Meteorite Using SPME On-Fiber Derivatization: Optimization for Bennu Sample Analyses.

Rationale: Extraterrestrial amines and ammonia are critical ingredients for the formation of astrobiologically important compounds such as amino acids and nucleobases. However, conventional methods for analyzing the composition and isotopic ratios of volatile amines suffer from lengthy derivatization and purification procedures, high sample mass consumption, and chromatographic interferences from derivatization reagents and non-target compounds.

Methods: Here we demonstrate a highly efficient method to analyze the composition and compound specific isotopic ratios of C to C amines as well as ammonia based on solid phase micro-extraction (SPME) on-fiber derivatization.

Effects of defined voluntary running distances coupled with high-fat diet consumption on the skeletal muscle transcriptome of male mice.

Exercise counters many adverse health effects of consuming a high-fat diet (HFD). However, complex molecular changes that occur in skeletal muscle in response to exercising while consuming a HFD are not yet known. We investigated the interplay between diverse exercise regimes and HFD consumption on the adaptation of skeletal muscle transcriptome.

The role of statins in breast cancer survivors.

Purpose: As breast cancer survival rates improve, cardiovascular disease (CVD) has become a critical concern among survivors due to co-morbidities and the cardiotoxic effects of cancer treatments. The risk of developing CVD in this population may surpass the risk of cancer recurrence. This review aims to analyze existing research on the use of statins in breast cancer survivors, focusing on their potential role in mitigating cardiovascular risk and cancer recurrence.

Delivering Guideline-Concordant Care for Patients With High-Risk HPV and Normal Cytologic Findings.

Importance: As US health care systems shift to human papillomavirus (HPV)-based cervical cancer screening, more patients are receiving positive high-risk non-16/18 genotype HPV results and negative for intraepithelial lesion or malignancy (NILM) cytological findings. Risk-based management guidelines recommend 2 consecutive negative annual results to return to routine screening.

Objective: To quantify patterns of surveillance testing and associated outcomes for patients after an HPV-positive results and NILM cytologic findings.

Hospitalization for carbon monoxide poisoning is associated with substance use and mood disorders.

Carbon monoxide (CO) poisoning continues to result in hospitalization and mortality. We sought to analyze risk factors associated with inpatient admission for CO poisoning. Retrospective study of the US National Inpatient Sample (NIS) database.

Pediatric erythromelalgia from multidisciplinary perspectives: a scoping review.

Erythromelalgia is a rare, chronic pain disorder characterized by the triad of intense burning sensation, warmth, and redness, primarily involving the hands and feet, and usually alleviated by cold and worsened by heat. The objective of this scoping review was to: 1) map the existing literature on erythromelalgia in youth, 2) identify knowledge gaps, and 3) inform directions for future research in pediatric erythromelalgia. One hundred and sixty-seven studies reporting 411 cases of childhood-onset erythromelalgia were identified.