The Pharmacology of Aid in Dying: From Database Analyses to Evidence-Based Best Practices.

Medical aid in dying is legal in 10 states plus Washington DC, covering 22% of the U.S. population.

Thyroid Nodules with Indeterminate Cytology and Negative Molecular Profile: Prevalence of Malignancy and Practice Paradigms for Surveillance.

In the era of molecular testing, thyroid nodules with indeterminate cytology are increasingly being managed nonoperatively. The false-negative rates of these molecular tests, and therefore missed malignancies, are not well defined in real-world clinical practice. This retrospective study of patients undergoing fine needle aspiration (FNA) biopsy at our health system between November 2017 and March 2022 included nodules with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) III and IV cytology and negative, currently negative, or negative but limited ThyroSeq version 3 (TSv3) results.

Convening Hispanic/Latino Caregiving Advisors for Inclusive Research in Dementia Palliative Care.

Dementia clinical trials often fail to include diverse and historically minoritized groups. We sought to adapt the Alzheimer's Disease and Related Dementias-Palliative Care (ADRD-PC) clinical trial to improve enrollment and address the cultural needs of people with late-stage ADRD who identify as Hispanic or Latino and their family caregivers. Bilingual, bicultural research team members adapted study materials and processes using the Cultural Adaptation Process Model.

Phenomenological Description of the Experiences of Teenagers With Critically Ill Parents.

Background: Critical illness not only threatens the life of the patient but also may profoundly impact the lives of their loved ones. For teenagers with a critically ill parent, these impacts may have significant, developmentally impactful effects. A descriptive understanding of these effects may advance scholarly understanding of the challenges these teenagers face.

Negative non-deployment emotions, substance use, and marital satisfaction among never-deployed military couples.

Among military service members, the experience of never-deploying can create a negative affective state (i.e., "non-deployment emotions"; (NDE)) that increases stress and may contribute to higher rates of substance use among Reserve and National Guard soldiers.

Corticosteroids in severe alcohol-associated hepatitis? Not so fast: A systematic review of randomized controlled trials.

Background: Severe alcohol-associated hepatitis (AH) is rising in incidence with a high mortality burden. While corticosteroids are recommended for eligible patients with severe AH, no guidance exists for the timing of steroid initiation, tapering regimens, and surveillance of adverse events.

Objective: We aim to systematically review these variables and provide evidence-based recommendations for the inpatient and outpatient management of severe AH.

Probabilistic Approaches for Risk Assessment and Regulatory Criteria Development: Current Applications, Gaps, and Opportunities.

Traditional ecological and human health risk assessment often relies on deterministic frameworks that preclude the presence of variability or uncertainty among input parameters characterizing exposure, effects, and risk. To promote increased realism and generate more robust risk management decisions, probabilistic risk assessment (PRA) has been introduced as a foundational grouping of techniques that seeks to broadly characterize variability among its components. While multiple methods exist (e.

The Derivation of Acute and Chronic Environmental Quality Standards for Nickel in European Surface Waters: A Demonstrable need to follow scientific evidence.

Environmental Quality Standards (EQS) derived under the European Water Framework Directive are legally binding and enshrined in individual European Member State Country national legislation. These EQS are derived following well-established guidance documents. In 2013, EQS for nickel were derived for freshwaters to be protective against long and short-term exposures, at 4 and 34 µg L-1, respectively.

Beyond the Case Study: Laboratory Activities to Complement Integumentary Education.

Objective: To present a full scope of detailed and engaging laboratory activities recommended by physical therapist clinicians and educators from across the US to assist health professions faculty to develop new or improve current integumentary/wound management (IWM) instruction.

Methods: A three-round Delphi survey was conducted to update IWM curriculum recommendations for entry-level doctor of physical therapy education. First-round participants provided ideas for laboratory activities.

Efficacy of a Community- and Family-Based Intervention on Cardiovascular Fitness and Cardiometabolic Disease Risk Factors Among Primarily Latino Families.

Background: Targeting cardiovascular fitness (CVF), rather than weight loss, may be a more acceptable and feasible outcome among Latinos.

Purpose: The purpose of this study was to test the short-term efficacy of (AFL), a fitness- and lifestyle-focused behavioral intervention to improve CVF and performance among Latino families.

Methods: Latino parent-child dyads (n = 137) were randomized to either AFL program or a waitlist control condition.

Alarmin' lymphoid developments.

The alarmin cytokine IL-33 stimulates the formation of immune hubs within otherwise "cold" tumors.

Mechanism of the Non-Kasha Fluorescence in Pyrene.

The high-energy shoulder in the gas-phase fluorescence emission spectrum of pyrene is a well-known example of non-Kasha emission. We comparatively assess two approaches, vibronic perturbation theory and nonadiabatic dynamics, in their ability to predict and explain the gas-phase fluorescence spectrum of pyrene. While both methods qualitatively capture the non-Kasha emission, they differ in their computational requirements, accuracy, and physical interpretation.

Bacterial vaginosis is associated with transcriptomic changes but not higher concentrations of cervical leukocytes in a study of women at high risk for HIV acquisition.

Background: The association between bacterial vaginosis (BV) and increased HIV acquisition risk may be related to concentrations of HIV-susceptible immune cells in the cervix.

Methods: Participants (31 with BV and 30 with normal microbiota) underwent cervical biopsy at a single visit. Immune cells were quantified and sorted using flow cytometry (N=55), localization assessed by immunofluorescence (N=16), and function determined by bulk RNA sequencing (RNA-seq) of live CD45+ cells (N=21).

Activated SKN-1 alters the aging trajectories of long-lived C. elegans mutants.

In the presence of stressful environments, the SKN-1 cytoprotective transcription factor is activated to induce the expression of gene targets that can restore homeostasis. However, chronic activation of SKN-1 results in diminished health and a reduction of lifespan. Here we demonstrate the necessity of modulating SKN-1 activity to maintain the longevity-promoting effects associated with genetic mutations that impair daf-2/insulin receptor signaling, the eat-2 model of dietary restriction, and glp-1-dependent loss of germ cell proliferation.

Association between Delayed Broad-Spectrum Gram-negative Antibiotics and Clinical Outcomes: How Much Does Getting It Right with Empiric Antibiotics Matter?

Background: Clinicians often start unnecessarily broad-spectrum empiric Gram-negative antibiotics out of the concern that delaying effective therapy could lead to a worse clinical outcome. This study examined the consequences of delayed initiation of broad-spectrum Gram-negative antibiotics.

Methods: In a retrospective cohort of adult inpatients from 928 US hospitals, we compared clinical outcomes after (1) empiric narrow-spectrum antibiotics escalated to broad-spectrum antibiotics (delayed broad-spectrum therapy, DBT) and (2) empiric broad-spectrum antibiotics continued for at least 5 days (early broad-spectrum therapy, EBT) using Win Ratios.

Management of renin-angiotensin system inhibitors prior to major surgery: insights from the STOP-or-NOT trial.

Strong recommendations on how to manage renin-angiotensin system inhibitors, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, before surgery are lacking because of a lack of evidence, which is mostly limited to data from observational studies. The STOP-or-NOT trial was a large multicentre randomised trial designed to determine whether chronic renin-angiotensin system inhibitors should be continued or discontinued before major noncardiac surgery. As principal investigators of the STOP-or-NOT trial, we discuss the trial's results and how they contribute to the existing literature on management of renin-angiotensin system inhibitors before surgery.

Polydipsia Induced Acute Angle-Closure Crisis.

We present a case of Acute Angle-Closure Crisis (AACC) precipitated by primary transient psychogenic polydipsia; we believe that our case is the first of its kind to be reported. A 74-year-old male presented to the emergency department with altered mental status due to acute-onset hyponatremia. Six days after admission, the patient noticed painful loss of vision in his right eye and an ipsilateral headache lasting 10-15 minutes.

Body mass index, regional adipose deposition, and clinical outcomes in non-ischemic dilated cardiomyopathy: a prospective cohort study.

Aim: To assess the relationship between body mass index (BMI), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), epicardial adipose tissue (EAT), pericardial adipose tissue (PAT) and clinical outcomes in dilated cardiomyopathy (DCM) patients.

Methods: Non-ischemic DCM patients were prospectively enrolled. Regional adipose tissue, cardiac function, and myocardial tissue characteristics were measured by cardiac magnetic resonance (CMR).

One-Year Real-World Outcomes of Ab-Externo Gel Stent Placement From the EXPAND Study.

Prcis: In the real-world, retrospective, EXPAND study of consecutive adults with glaucoma, ab-externo gel stent implantation effectively lowered intraocular pressure (34%) and the medication burden (61%), with transient/self-resolving hypotony as the most frequent adverse event (28%).

Purpose: To assess effectiveness and safety of ab-externo gel stent (GS) implantation in glaucoma.

Methods: Multicenter, real-world, retrospective study.

Flight phenology and influence of region and habitat on the abundance of Xylosandrus germanus and Anisandrus maiche (Coleoptera: Curculionidae: Scolytinae) in New York.

The non-native wood-boring and symbiotic fungus-culturing Xylosandrus germanus (Blandford) was first reported in New York apple orchards in 2013. Trapping surveys have been conducted annually since to assist growers in timely applications of preventative control measures. In 2021, a similar-looking introduced species, Anisandrus maiche (Kurentsov), was identified in traps in west central New York.