The need to include intellectual/developmental disability in medical school curriculum: The perspective of a student advocate.

Medical students receive very little instruction related to caring for people with intellectual/developmental disabilities. As a result, medical students and physicians alike report low levels of confidence in their ability to provide care to this population. In this piece, I provide a medical student's perspective on how to implement changes in the medical school curriculum such that our future physicians are more prepared to provide care to people with intellectual/developmental disabilities.

Interview skills associated with employment recommendations for individuals with intellectual and developmental disabilities.

Background: Mock or practice interviews have become a typical tool for transition programs for individuals with intellectual and developmental disabilities.

Method: We examined what interview skills were most associated with subsequent employment for individuals intellectual and developmental disabilities via practice interviews. The likelihood of employment was measured as a function of whether the interviewer responded that they would hire the individual.

Experiences in outdoor recreation among individuals with developmental disabilities: Benefits, constraints, and facilitators.

Background: Individuals with developmental disabilities have specific physical and psychosocial needs that can require extra support to participate fully in and enjoy many benefits of recreation activities. Unfortunately, little is known about individuals with developmental disabilities' experiences in outdoor recreation. The purpose of this study was to explore adults with developmental disabilities' perceived benefits of outdoor recreation, and the constraints or facilitators that affected their participation.

Patient-Specific Rods vs Traditional Rods in Surgical Correction of Adult Spinal Deformities: A Case-Matched Study.

Aim: Patient specific pre-contoured rods (PSRs) represent a relatively new technological development aimed at improving surgical outcomes and reducing complications in adult spinal deformity surgery. To date, only a limited number of studies have been published comparing PSRs with traditional spinal rods. In this paper, we compare the surgical, imaging, and clinical outcomes of PSRs and traditional spinal rods in a single-center case-matched study.

Comparison of Multi-Drug Resistant Organisms Causing Early Ventilator-Associated Pneumonia in Three Geographically Distinct Trauma Intensive Care Units.

It is unclear why differences in patient location change organisms causing ventilator-associated pneumonia (VAP). We investigated VAP organisms in three geographically separate trauma intensive care units (TICUs). A retrospective review of organisms causing VAP (bronchoalveolar lavage [BAL] performed ≤7 d after admission and growing ≥10 cfu/mL) in three geographically separate TICUs was conducted.

Alcohol withdrawal syndrome presentations to emergency departments in the United States from 2015 to 2023.

Introduction: Alcohol withdrawal syndrome (AWS) is a common condition prompting emergency department (ED) presentation. However, there are limited recent, large-scale, robust data available on the incidence, admission, and medical treatment of AWS in the ED.

Methods: This was a retrospective cohort study of ED presentations for AWS from January 1, 2016, to December 31, 2023, using Epic Cosmos.

Fine particulate matter from burning oil and gas and associated neurological symptoms among Deepwater Horizon oil spill cleanup workers.

Burning and flaring of oil and gas following the 2010 Deepwater Horizon (DWH) oil spill generated high airborne concentrations of fine particulate matter (PM). Neurological effects of PM have been previously reported, but this relationship has received limited attention in the context of oil spills. We evaluated associations between burning-related PM and prevalence of self-reported neurological symptoms during, and 1-3 years after, the DWH disaster cleanup.

Biocomposites of 2D layered materials.

Molecular composites, such as bone and nacre, are everywhere in nature and play crucial roles, ranging from self-defense to carbon sequestration. Extensive research has been conducted on constructing inorganic layered materials at an atomic level inspired by natural composites. These layered materials exfoliated to 2D crystals are an emerging family of nanomaterials with extraordinary properties.

A first-born twin has a higher risk of acute leukemia in a population-based assessment of cancer in twins in California, and a lower than anticipated rate of twin concordance.

Not available.

Results from patient-derived xenograft models support co-administration of allopurinol and 6-mercaptopurine to reduce hepatotoxicity and improve event-free survival in pediatric acute lymphoblastic leukemia.

Not available.

Best Interests and Decisions to Withdraw Life-Sustaining Treatment from a Conscious, Incapacitated Patient.

Conscious but incapacitated patients need protection from both undertreatment and overtreatment, for they are exceptionally vulnerable, and dependent on others to act in their interests. In the United States, the law prioritizes autonomy over best interests in decision making. Yet U.

Targeting the membrane-proximal domain of CD33 to maximize the efficacy of natural killer cell-based immunotherapies.

Not available.

Mind the gap in kidney care: translating what we know into what we do.

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do.

Iowa emergency departments lack board-certified emergency physicians: A comprehensive statewide emergency department workforce study.

Introduction: The emergency physician (EP) workforce has been a recent focus after a workforce projection predicted a surplus of EPs by 2030. A previous study of Iowa emergency departments (EDs) demonstrated wide variability in ED staffing patterns and attributed it to the lack of EP job candidates. With the recent increase in emergency medicine (EM) residency positions, the objectives of this study were to understand how Iowa ED physician staffing has changed in regard to presence of board-certified EPs and what operational differences in Iowa EDs may be associated with staffing to provide insight into what may be occurring in other predominantly rural states.

Chimpanzee Activity and Behavioral Diversity Extends Across 24 Hours in Both Captive and Wild Settings.

Studying nocturnal behavior is crucial for understanding the full scope of a species' behavioral flexibility so as to inform the conservation of wild populations and the care of captive individuals. However, this aspect of primate behavior is understudied, especially in great apes, which exhibit some of the widest documented behavioral diversity and flexibility. Our investigation is among the first to systematically compare the 24 h activity patterns and behavioral activities of captive chimpanzees (Saint Louis Zoo, USA) with those of wild chimpanzees (three sites across the Nouabalé-Ndoki National Park in the Republic of Congo) and a published data set of the nocturnal behavior of all chimpanzee subspecies.

Emergency department early mortality model for patients admitted after presenting to a tertiary medical center emergency department.

Objectives: Identifying patients in the emergency department (ED) at higher risk for in-hospital mortality can inform shared decision making and goals-of-care discussions. Electronic health record systems allow for integrated multivariable logistic regression (LR) modeling, which can provide early predictions of mortality risk in time for crucial decision making during a patient's initial care. Many commonly used LR models require blood gas analysis values, which are not frequently obtained in the ED.

Extracellular RNA communication: A decade of NIH common fund support illuminates exRNA biology.

The discovery that extracellular RNAs (exRNA) can act as endocrine signalling molecules established a novel paradigm in intercellular communication. ExRNAs can be transported, both locally and systemically in virtually all body fluids. In association with an array of carrier vehicles of varying complexity, exRNA can alter target cell phenotype.

New Horizons in Menopause, Menopausal Hormone Therapy, and Alzheimer's Disease: Current Insights and Future Directions.

Accumulating evidence suggests that the effects of menopausal hormone therapy (MHT) on risk of Alzheimer's disease (AD) and all-cause dementia are influenced by timing of initiation relative to age and time-since-menopause and the type of formulation. Randomized clinical trials (RCTs) of MHT conducted in older postmenopausal women indicate an increased risk of dementia. While RCTs conducted in midlife are lacking, observational research has provided evidence for associations between midlife estrogen-only therapy (ET) use and a reduced risk of AD dementia, whereas estrogen-progestogen therapy (EPT) is associated with more variable outcomes.

Malnutrition in Spine Oncology: Where Are We and What Are We Measuring?

Study Design: Scoping review.

Objective: To identify which markers are used as surrogates for malnutrition in metastatic spine disease and which are the most studied outcomes associated with it.

Methods: A scoping review was performed by searching the PubMed/Medline, EMBASE, and Web of Science databases up to July 2022.

Genetic Variants Associated with the Biochemical Response to Vitamin D3 in the Multi-Ethnic Study of Atherosclerosis.

Context: The response to treatment with vitamin D varies between patients.

Objective: To identify genetic variants associated with the biochemical response to vitamin D3 supplementation.

Design: Randomized placebo-controlled trial conducted between 2017 and 2019.

Epidemiology of diagnostic errors in pediatric emergency departments using electronic triggers.

Objectives: We applied three electronic triggers to study frequency and contributory factors of missed opportunities for improving diagnosis (MOIDs) in pediatric emergency departments (EDs): return visits within 10 days resulting in admission (Trigger 1), care escalation within 24 h of ED presentation (Trigger 2), and death within 24 h of ED visit (Trigger 3).

Methods: We created an electronic query and reporting template for the triggers and applied them to electronic health record systems of five pediatric EDs for visits from 2019. Clinician reviewers manually screened identified charts and initially categorized them as "unlikely for MOIDs" or "unable to rule out MOIDs" without a detailed chart review.

Management of Pediatric Rhegmatogenous Retinal Detachment.

Introduction And Primary Objective: Pediatric rhegmatogenous retinal detachment (RRD) presents unique challenges in diagnosis and management. A thorough evaluation of family, medical, and ocular history is helpful, as systemic and genetic conditions can predispose children to RRD. Trauma, high myopia, and history of prematurity are also common risk factors.