Primary care providers' perspectives on referrals to the Diabetes Prevention Programme: a qualitative comparative study across varied referral patterns.

Introduction: Despite the effectiveness of Diabetes Prevention Programmes (DPP) in reducing diabetes risk, primary care provider (PCP) referrals remain low, especially among men and racial/ethnic minorities, exacerbating their under-representation in DPPs. Understanding PCPs' perspectives on referrals is crucial for enhancing the intervention's reach and effectiveness.

Research Design And Methods: We conducted a qualitative study to explore PCPs' experiences, perspectives and engagement with DPP referrals, focusing on factors influencing variations in referral rates.

Modern perspective of the Rice Diet for hypertension and other metabolic diseases.

Background: In the early 1940s, before antihypertensive drugs were available, the Rice Diet Programme (RDP) was developed to treat severe hypertension and, later, diabetes and obesity. Despite significant advancements in dietary management for these conditions since then, debates remain regarding the proper guidelines for sodium and macronutrients intakes. The patient care records of RDP offer a unique source of longitudinal examination of a very low sodium (<10 mmol/day), fat, cholesterol and protein diet on blood pressure (BP), other health markers and survival.

Nutrition Users' Guides: RCTs Part 2 - structured guide for interpreting and applying study results from randomised controlled trials on therapy or prevention questions.

This article continues from a prior commentary on evaluating the risk of bias in randomised controlled trials addressing nutritional interventions. Having provided a synopsis of the risk of bias issues, we now address how to understand trial results, including the interpretation of best estimates of effect and the corresponding precision (eg, 95% CIs), as well as the applicability of the evidence to patients based on their unique circumstances (eg, patients' values and preferences when trading off potential desirable and undesirable health outcomes and indicators (eg, cholesterol), and the potential burden and cost of an intervention). Authors can express the estimates of effect for health outcomes and indicators in relative terms (relative risks, relative risk reductions, OR or HRs)-measures that are generally consistent across populations-and absolute terms (risk differences)-measures that are more intuitive to clinicians and patients.

Nutrition users' guides: RCTs part 1 - structured guide for assessing risk of bias in randomised controlled trials that address therapy or prevention questions.

The purpose of this article, part 1 of 2 on randomised controlled trials (RCTs), is to provide readers (eg, clinicians, patients, health service and policy decision-makers) of the nutrition literature structured guidance on interpreting RCTs. Evaluation of a given RCT involves several considerations, including the potential for risk of bias, the assessment of estimates of effect and their corresponding precision, and the applicability of the evidence to one's patient. Risk of bias refers to flaws in the design or conduct of a study that may lead to a deviation from measuring the underlying true effect of an intervention.

Associations of neighbourhood food retail with disability and death in older adults: Cardiovascular Health Study.

Background: A healthier diet is associated with lower chronic disease burden, but the impact of neighbourhood food environments on disability and death in older adults is not known.

Methods: In the Cardiovascular Health Study, a cohort study of adults aged 65+, we calculated study years until death (years of life (YOL)), study years without activities of daily living (ADL) difficulty (years of able life; YoAL) and percent of study years without ADL difficulty (compression of disability). Linear regression quantified associations of food establishments within 5 km of baseline home address (as a z-score) with each outcome, adjusted for sociodemographic characteristics.

Obstacles to Early Diagnosis of Gaucher Disease.

Gaucher disease (GD) is a rare lysosomal storage disorder resulting from a deficiency of the lysosomal enzyme glucocerebrosidase caused by biallelic variants in the gene. Patients may present with a wide spectrum of disease manifestations, including hepatosplenomegaly, thrombocytopenia, bone manifestations, and in the case of GD types 2 and 3, neurodegeneration, cognitive delay, and/or oculomotor abnormalities. While there is no treatment for neuronopathic GD, non-neuronopathic manifestations can be efficiently managed with enzyme replacement therapy or substrate reduction therapy.

Characterization of LTBP2 mutation causing mitral valve prolapse.

Aims: Mitral valve prolapse (MVP) is a common valvular disorder associated with significant morbidity and mortality, with a strong genetic basis. This study aimed to identify a mutation in a family with MVP and to characterize the valve phenotype in LTBP2 knockout (KO) mice.

Methods And Results: Exome sequencing and segregation analysis were performed on a large family with MVP.

Chronic Kidney Disease Is Associated With Increased All-Cause Mortality Risk Among Older Black Adults.

Background And Objectives: Older patients diagnosed with chronic kidney disease (CKD) have a higher risk of all-cause mortality than the general population. However, there is limited information available on how CKD relates to all-cause mortality among Black adults in the United States. We aimed to investigate how CKD relates to all-cause mortality risk among older Black adults.

Microbiome and Colorectal Cancer in Humans: A Review of Recent Studies.

The tumor microenvironment has recently been well-studied in various gastrointestinal cancers, including colorectal cancer (CRC). The gut microbiota, a collection of microorganisms in the human gastrointestinal tract, is one of the microenvironments associated with colon carcinogenesis. It has been challenging to elucidate the mechanisms by which gut microbiota contributes to carcinogenesis and cancer progression due to complex interactions with the host, including its metabolites and immune and inflammatory responses.

Roux-en-Y Intussusception: A Case Report.

Roux-en-Y gastric bypass (RYGB) is a bariatric surgical procedure commonly performed in adults to treat severe obesity. While RYGB is generally safe, it occasionally leads to rare but significant complications, including intussusception, a form of bowel obstruction caused by the invagination of an intestine segment from the proximal to the adjacent distal portion. We report a case of intussusception in a 74-year-old female patient who underwent RYGB 12 years prior.

Study Protocol for 'PsilOCD: A Pharmacological Challenge Study Evaluating the Effects of the 5-HT2A Agonist Psilocybin on the Neurocognitive and Clinical Correlates of Compulsivity'.

Background: Obsessive-compulsive disorder (OCD) is a complex condition marked by persistent distressing thoughts and repetitive behaviours. Despite its prevalence, the mechanisms behind OCD remain elusive, and current treatments are limited. This protocol outlines an investigative study for individuals with OCD, exploring the potential of psilocybin to improve key components of cognition implicated in the disorder.

Ranking Magnetic Colloid Performance for Magnetic Particle Imaging and Magnetic Particle Hyperthermia.

Magnetic particle imaging (MPI) is an emerging modality that can address longstanding technological challenges encountered with magnetic particle hyperthermia (MPH) cancer therapy. MPI is a tracer technology compatible with MPH for which magnetic nanoparticles (MNPs) provide signal for MPI and heat for MPH. Identifying whether a specific MNP formulation is suitable for both modalities is essential for clinical implementation.

Assessing the Benefit of a Digital Pain Alert System in a Community Hospital.

Introduction: In the last decade, clinical alert systems were developed for clinical use, including patient deterioration and other urgent clinical situations. However, investigations focusing on digital pain alert systems to assess and manage pain on time in in-hospital patients are scarce. The objective of the study was to assess the implementation of digital pain alerts in the various departments of a community hospital.

Cardiac magnetic resonance imaging in patients with suspected myocarditis from immune checkpoint inhibitor therapy - A real-world observational study.

Background And Aims: Cardiotoxicity from immune checkpoint inhibitor (ICI) therapy is a challenge in clinical practice, and the assessment of ICI-related myocarditis (ICI-M) is often complicated by a variable phenotype. Cardiac magnetic resonance imaging (CMR) is used frequently, but evidence is poor. Here, we aim to assess the role of CMR in the assessment of suspected ICI-M in a real-world clinical setting.

Clinical Hypnosis and Cognitive Behavioral Therapy for Hot Flashes: A Scoping Review.

Background: Hot flashes can be a prevalent issue for postmenopausal women, but traditional treatments such as hormone therapy can have adverse side effects. Recommended psychotherapies for managing hot flashes include cognitive behavioral therapy (CBT) and clinical hypnosis, but an in-depth review comparing the efficacy of both treatments is warranted.

Objectives: The aim of the present scoping review was to assess the clinical significance and efficacy of symptom reduction of CBT and clinical hypnosis as treatments of hot flashes.

Pandemic Impact on Research Faculty in Academic Medicine: A Mixed Method Study.

Introduction: This mixed-method study sought to elucidate the impact of COVID-19 on the professional environments and career trajectories of midcareer research faculty in U.S. medical schools.

Presenting Your Best Self: How Physician Appearance Influences Patient Perceptions and Impacts Women in Medicine.

Introduction: Trust and rapport between patients and physicians form the cornerstone of effective medical practice. A key factor influencing this trust is the patient's perception of the physician's appearance. Women physicians often face more rigorous expectations concerning their physical appearance compared to men physicians, creating a need to balance traditional professional attire with maintaining femininity and individuality.

A database of nutritional strategies of nanoplankton genera present in North American lake surface waters.

A database of nutritional strategies of nanoplankton genera present in North American lake surface waters is presented. This work represents an integrated and updated database of nutritional strategies for nanoplankton genera commonly found in surface waters of North American lakes. We tabulate the nutritional strategies (autotroph, phago-mixotroph and phago-heterotroph) for nanoplankton genera identified during several pan-continental lake surveys: the EPA-NLA surveys conducted in 2012 and 2017 across the continental USA and the NSERC Canadian Lake Pulse survey campaign conducted from 2017 to 2019.

Mineralized tissue loss at the femoral ACL enthesis in young male ACL-injured patients.

Purpose: Primary anterior cruciate ligament (ACL) reconstruction graft failure remains a significant health concern in young patients. Despite the high incidence of poor graft integration in these patients and the resulting high failure rate, little consideration has been given to the quality of the bone into which the graft is anchored at reconstruction. Therefore, we investigated post ACL injury mineralized tissue changes in the ACL femoral entheses of young males and compared them to changes previously reported for young females.

Biophysics-guided uncertainty-aware deep learning uncovers high-affinity plastic-binding peptides.

Plastic pollution, particularly microplastics (MPs), poses a significant global threat to ecosystems and human health, necessitating innovative remediation strategies. Biocompatible and biodegradable plastic-binding peptides (PBPs) offer a potential solution through targeted adsorption and subsequent MP detection or removal from the environment. A challenge in discovering plastic-binding peptides is the vast combinatorial space of possible peptides (, over 10 for 12-mer peptides), which far exceeds the sample sizes typically reachable by experiments or biophysics-based computational methods.

High-risk electrocardiogram presentations in the acute coronary syndrome patient - Beyond ST-segment elevation myocardial infarction.

This review considers high-risk electrocardiographic patterns in the acute coronary syndrome (ACS) patient; we review 7 electrocardiogram presentations lacking diagnostic criteria for ST-segment elevation myocardial infarction (STEMI) yet likely representing either STEMI equivalent syndromes or ACS presentations with significant short-and long-term risk. The STEMI equivalent presentations include acute posterior wall myocardial infarction, the hyperacute T-wave of early STEMI, de Winter syndrome, first diagonal of the left anterior descending artery occlusion, and left bundle branch block modified Sgarbossa positive findings. High-risk presentation, not felt to be STEMI equivalent entities yet still possessing significant risk of short-and long-term adverse outcome, include lead aVR ST-segment elevation and Wellens syndrome.

'Any male victim?' The legacy of conflating paedophilia and homosexuality and the differential seriousness of sexual abuse by victim gender.

This article presents the findings of a historical, qualitative thematic analysis of archival clinical records of 24 men convicted of child sexual abuse and referred for civil commitment to the Massachusetts Treatment Center between 1959 and 1984. Drawing on the perspective of Cicourel, the study examined the differential ways men convicted of child sexual abuse were constructed by various criminal justice actors based on the gender of their victims. Overall, the study found that men with male victims were constructed as more deviant than men with female victims.

A comprehensive mechanistic investigation of sustainable carbene N-H insertion catalyzed by engineered His-ligated heme proteins.

Engineered heme proteins possess excellent biocatalytic carbene N-H insertion abilities for sustainable synthesis, and most of them have His as the Fe axial ligand. However, information on the basic reaction mechanisms is limited, and ground states of heme carbenes involved in the prior computational mechanistic studies are under debate. A comprehensive quantum chemical reaction pathway study was performed for the heme model with a His analogue as the axial ligand and carbene from the widely used precursor ethyl diazoacetate with aniline as the substrate.