Long-Term Impact of an Online Physician Group-Coaching Program to Improve Burnout and Self-Compassion in Trainees.

Goal: To evaluate long-term outcomes of Better Together Physician Coaching, a digital life-coaching program to improve resident well-being.

Methods: We performed a secondary analysis of survey data from the pilot program implementation between January 2021 and June 2022. An intention-to-treat analysis was completed for baseline versus post-6 months and baseline versus post-12 months for all outcome measures.

Quantifying spectral information about source separation in multisource odour plumes.

Odours released by objects in natural environments can contain information about their spatial locations. In particular, the correlation of odour concentration timeseries produced by two spatially separated sources contains information about the distance between the sources. For example, mice are able to distinguish correlated and anti-correlated odour fluctuations at frequencies up to 40 Hz, while insect olfactory receptor neurons can resolve fluctuations exceeding 100 Hz.

Necrosis of pleomorphic adenoma of the lacrimal gland with acute and chronic arteriolar occlusion.

Pleomorphic adenoma of the lacrimal gland (PALG) is a benign neoplasm typically presenting with gradual, painless globe displacement and/or lid swelling. We report an atypical case of PALG in a 53-year old male presenting acutely, mimicking orbital cellulitis. Imaging demonstrated an extraconal rim-enhancing soft-tissue lesion medial to the left lacrimal gland, involving superior rectus and levator palpebrae superioris.

Multiomics dissection of human RAG deficiency reveals distinctive patterns of immune dysregulation but a common inflammatory signature.

Human recombination-activating gene (RAG) deficiency can manifest with distinct clinical and immunological phenotypes. By applying a multiomics approach to a large group of -mutated patients, we aimed at characterizing the immunopathology associated with each phenotype. Although defective T and B cell development is common to all phenotypes, patients with hypomorphic variants can generate T and B cells with signatures of immune dysregulation and produce autoantibodies to a broad range of self-antigens, including type I interferons.

Amplicon Sequencing Reveals Diversity in Spatially Separated Microbial Communities in the Icelandic Mars Analog Environment Mælifellssandur.

Exploration missions to Mars rely on landers or rovers to perform multiple analyses over geographically small sampling regions, while landing site selection is done using large-scale but low-resolution remote-sensing data. Utilizing Earth analog environments to estimate small-scale spatial and temporal variation in key geochemical signatures and biosignatures will help mission designers ensure future sampling strategies meet mission science goals. Icelandic lava fields can serve as Mars analog sites due to conditions that include low nutrient availability, temperature extremes, desiccation, and isolation from anthropogenic contamination.

High-Cost Cancer Drug Use in Medicare Advantage and Traditional Medicare.

Importance: Medicare Advantage (MA) plans are designed to incentivize the use of less expensive drugs through capitated payments, formulary control, and preauthorizations for certain drugs. These conditions may reduce spending on high-cost therapies for conditions such as cancer, a condition that is among the most expensive to treat.

Objective: To determine whether patients insured by MA plans receive less high-cost drugs than those insured by traditional Medicare (TM).

Social Determinants of Uncorrected Distance and Near Visual Impairment in an Older Adult Population.

Purpose: Uncorrected visual impairment (VI) significantly impacts life quality and exacerbates age-related health issues. Social determinants of health (SDOH) are associated with uncorrected VI, but quantitative evidence is limited. This study investigated the link between SDOH and uncorrected VI among aging adults to identify disparities and improve vision care.

Temporal Trends of Subsequent CNS Malignancies Among Survivors of Childhood Cancer.

Purpose: It is not known whether temporal changes in childhood cancer therapy have reduced risk of subsequent malignant neoplasms (SMNs) of the central nervous system (CNS), a frequently fatal late effect of cancer therapy.

Methods: Five-year survivors of primary childhood cancers diagnosed between 1970-1999 in the Childhood Cancer Survivor Study with a subsequent CNS SMN were identified. Cumulative incidence rates and standardized incidence ratios (SIR) were compared among survivors diagnosed between 1970-1979 (N = 6223), 1980-1989 (N = 9680), and 1990-1999 (N = 8999).

Appearance of green tea compounds in plasma following acute green tea consumption is modulated by the gut microbiome in mice.

Unlabelled: Studies have suggested that phytochemicals in green tea have systemic anti-inflammatory and neuroprotective effects. However, the mechanisms behind these effects are poorly understood, possibly due to the differential metabolism of phytochemicals resulting from variations in gut microbiome composition. To unravel this complex relationship, our team utilized a novel combined microbiome analysis and metabolomics approach applied to low complexity microbiome (LCM) and human colonized (HU) gnotobiotic mice treated with an acute dose of powdered matcha green tea.

Association Between a Family Caregiver's Relationship to Persons With Dementia and Cardiovascular Disease by Race and Ethnicity: A Secondary Analysis of the Behavioral Risk Factor Surveillance System Data.

Background: Caregiver stress is linked to key mechanisms for developing cardiovascular disease and the burden differs by caregiving relationship (eg, spouse). Furthermore, cardiovascular disease risk in family caregivers (FCGs) has been shown to differ by race and ethnicity. However, little is known about whether the association between caregiving relationship and FCGs' cardiovascular health differs by race and ethnicity.

Neuropsychological test performance in mild cognitive impairment with Lewy bodies: A systematic review and meta-analysis.

Background: We sought to characterize the cognitive profile among individuals with mild cognitive impairment with Lewy bodies (MCI-LB) to help guide future clinical criteria.

Methods: Systematic review and meta-analysis included MCI-LB studies with cognitive data from PubMed, Embase, Web of Science, and PsycINFO (January 1990 to March 2023). MCI-LB scores were compared to controls, MCI due to Alzheimer's disease (MCI-AD), and dementia with Lewy bodies (DLB) groups with random-effects models.

The P200 ERP Response in Mild Cognitive Impairment and the Aging Population.

Evoked potential metrics extracted from an EEG exam can provide novel sources of information regarding brain function. While the P300 occurring around 300 ms post-stimulus has been extensively investigated in relation to mild cognitive impairment (MCI), with decreased amplitude and increased latency, the P200 response has not, particularly in an oddball-stimulus paradigm. This study compares the auditory P200 amplitudes between MCI (28 patients aged 74(8)) and non-MCI, (35 aged 72(4)).

Longitudinal monitoring of class-switched memory-B cell proportions identifies plausible germinal center failure in patients with suspected immune disorders.

A reduced proportion of peripheral class-switched memory B cells (CSM-B cells) is presumed to indicate ineffective germinal activity. The extent that this finding corresponds to a plausible germinal center failure pathophysiology in patients not diagnosed with CVID or hyper IgM syndrome is not known. We asked if patients with low CSM-B cells are more likely to demonstrate failure to produce serum IgA and IgG than counterparts with nonreduced class-switched memory B cell levels, regardless of diagnosis.

How Are You Doing… Really? A Review of Whole Person Health Assessments.

Unlabelled: Policy Points A redirection of measurement in health care from a narrow focus on diseases and care processes towards assessing whole person health, as perceived by the person themself, may provide a galvanizing view of how health care can best meet the needs of people and help patients feel heard, seen, and understood by their care team. This review identifies key tensions to navigate as well as four overarching categories of whole person health for consideration in developing an instrument optimized for clinical practice. The categories (body and mind, relationships, living environment and finances, and engagement in daily life) include nine constituent domains.

A systemic evaluation of COVID-19 vaccination drives in LICs, LMICs, UMICs, and HICs: Preparedness for future pandemics.

Introduction: The COVID-19 pandemic has significantly impacted global healthcare systems. Vaccination is an effective strategy to battle the disease. Policies and distribution frameworks have varied widely across countries.

Uncovering Diversity within the Glomeromycota: Novel Clades, Family Distributions, and Land Use Sensitivity.

Arbuscular mycorrhizal fungi (AMF, phylum Glomeromycota) are essential to plant community diversity and ecosystem functioning. However, increasing human land use represents a major threat to native AMF globally. Characterizing the loss of AMF diversity remains challenging because many taxa are undescribed, resulting in poor documentation of their biogeography and family-level disturbance sensitivity.

Congenital Pulmonary Airway Malformation Associated With Papillary Adenocarcinoma.

Congenital pulmonary airway malformations (CPAMs) are cystic lung lesions often detected prenatally. Resection is often recommended for potential recurrent infections and malignancy. This report describes a case of a 14-year-old female patient who presented with abdominal pain.

Provider Adherence to the 2020 US Multi-Society Task Force Guidelines for Surveillance After Colonoscopy With Polypectomy.

Background And Aims: The 2020 United States Multi-Society Task Force on Colorectal Cancer guidelines for surveillance after colonoscopy with polypectomy introduced significant changes in surveillance intervals. We sought to identify rates of adherence to these new guidelines at an academic medical center.

Methods: Average-risk screening colonoscopies where 1 to 4 polyps <10 mm were removed between January 1, 2020, and June 30, 2021 were included.

Functional genotype classification groups distinguish disease severity in recessive dystrophic epidermolysis bullosa.

Recessive dystrophic epidermolysis bullosa (RDEB) is a genetic disorder due to pathogenic variants in the COL7A1 gene. In this study we determined the association between different categories of COL7A1 variants and clinical disease severity in 236 RDEB patients in North America. Published reports or in-silico predictions were used to assess the impact of pathogenic variants in COL7A1 on type VII collagen (C7) protein function.

Examining the Relation Between Prenatal Emotion Dysregulation and Toddler Vocabulary Development: A Biobehavioral Approach.

Early language is shaped by parent-child interactions and has been examined in relation to maternal psychopathology and parenting stress. Minimal work has examined the relation between maternal emotion dysregulation and toddler vocabulary development. This longitudinal study examined associations between maternal emotion dysregulation prenatally, maternal everyday stress at 7 months postpartum, and toddler vocabulary at 18 months.

Third trimester fetal 4D flow MRI with motion correction.

Purpose: To correct maternal breathing and fetal bulk motion during fetal 4D flow MRI.

Methods: A Doppler-ultrasound fetal cardiac-gated free-running 4D flow acquisition was corrected post hoc for maternal respiratory and fetal bulk motion in separate automated steps, with optional manual intervention to assess and limit fetal motion artifacts. Compressed-sensing reconstruction with a data outlier rejection algorithm was adapted from previous work.

Cancer-related health behaviors during the COVID 19 pandemic in geographically diverse samples across the US.

Background: The COVID-19 pandemic involved business closures (e.g., gyms), social distancing policies, and prolonged stressful situations that may have impacted engagement in health behaviors.

The Experience of Undocumented Individuals Denied Stem Cell Transplant for Hematologic Malignancies.

Background: Undocumented individuals with hematologic malignancies in the United States face barriers to receiving often-curative stem cell transplant (SCT), instead receiving inferior treatment with higher mortality. Federal and state policies' impact on undocumented individuals' lived experiences goes unnoticed.

Objective: To understand the experiences of this rare population of undocumented individuals with hematologic malignancies who cannot receive medically indicated SCT.