Regulation and Compliance in Telemedicine: Viewpoint.

The US COVID-19 Public Health Emergency ended on May 11, 2023. Lawmakers and regulators extended some flexibilities while they deliberate effective long-term telemedicine policy. Here, we discuss critical challenges in telemedicine compliance and regulation grounded in scholarly literature and current events.

Short-term outcomes of low anterior resection with and without ileostomy for low, mid and upper rectal cancers.

Although the addition of an ileostomy to low anterior resection (LAR) may often be considered preventative of anastomotic leakage (AL), evidence that clearly demonstrates such benefit is lacking. This study aimed to identify the impact of adding an ileostomy upon AL and organ-space surgical site infection (SSI) rates in patients with lower, middle, or upper rectal cancer. This case-control study included rectal cancer patients who had undergone elective LAR in the American College of Surgeons-National Surgical Quality Improvement Program dataset between 2016 and 2022.

An In Vivo Biostability Evaluation of ALD and Parylene-ALD Multilayers as Micro-Packaging Solutions for Small Single-Chip Implants.

Miniaturization of next-generation active neural implants requires novel micro-packaging solutions that can maintain their long-term coating performance in the body. This work presents two thin-film coatings and evaluates their biostability and in vivo performance over a 7-month animal study. To evaluate the coatings on representative surfaces, two silicon microchips with different surface microtopography are used.

Genetic Predisposition to Hippocampal Atrophy and Risk of Amnestic Mild Cognitive Impairment and Alzheimer's Dementia.

Background: There is a paucity of evidence on the association between genetic propensity for hippocampal atrophy with cognitive outcomes. Therefore, we examined the relationship of the polygenic risk score for hippocampal atrophy (PRShp) with the incidence of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) as well as the rates of cognitive decline.

Methods: Participants were drawn from the population-based HELIAD cohort.

Genomic sequencing in diverse and underserved pediatric populations: parent perspectives on understanding, uncertainty, psychosocial impact, and personal utility of results.

Purpose: Limited evidence evaluates parents' perceptions of their child's clinical genomic sequencing (GS) results, particularly among individuals from medically underserved groups. Five Clinical Sequencing Evidence-Generating Research (CSER) consortium studies performed GS in children with suspected genetic conditions with high proportions of individuals from underserved groups to address this evidence gap.

Methods: Parents completed surveys of perceived understanding, personal utility, and test-related distress after GS result disclosure.

Focus Groups With Guatemalan Community Leaders About Barriers to Cervical Cancer Prevention and Control.

Cervical cancer is the leading cause of cancer-related death among Latin American women, including Guatemalans. This is troubling, given we have a vaccine, screening tool, and treatment for this preventable disease. Human papillomavirus (HPV) causes most cervical cancer.

Changes in multidisciplinary perceptions of trauma video review following implementation of a novel program: let us go to the tape.

Background: Trauma video review (TVR) is an evolving technology that can be used to measure technical and non-technical aspects of trauma care leading to meaningful improvements. Only 30% of centers currently use TVR, with non-users citing medicolegal concerns, staff discomfort with recording, and resource constraints as barriers to implementation. Multiple studies have shown established TVR programs are well-perceived by staff.

Impact of mask wearing time on fluid consumption and physical activity during the COVID-19 pandemic.

Purpose: To examine the associations between mask-wearing on fluid consumption and physical activity behaviors during the COVID-19 pandemic.

Methods: 137 college students (female, 72.5%; age, 26 ± 9 y) completed a survey detailing their fluid intake, physical activity behaviors, and time spent wearing a mask throughout the day during the previous month in the Fall 2020 academic semester.

Receipt of medications for opioid use disorder among rural and urban veterans health administration patients.

Aim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD.

Methods: Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018-9/30/20.

Development of a Navigator-Delivered Health Insurance Education Program for Hispanic and Latine Communities.

Background: Equitable access to health care services for Hispanic and Latine populations requires that systems go beyond working to increase enrollment in health insurance but also addressing health insurance literacy-the knowledge, ability, and confidence to find and use health insurance.

Methods: In collaboration with a local health policy organization, individual interviews were conducted with Hispanic and Latine community members. Group engagement sessions were conducted with key professionals.

Gradient Design with Low-tortuosity Overcoming Kinetic Limitations in High-Loading Solid-State Cathodes.

The extensive commercialization of practical solid-state batteries (SSBs) necessitates the development of high-loading solid-state cathodes with fast charging capability. However, electrochemical kinetics are severely delayed in thick cathodes due to tortuous ion transport pathways and slow solid-solid ion diffusion, which limit the achievable capacity of SSBs at high current densities. In this work, we propose a conductivity gradient cathode with low-tortuosity to enable facile ion transport and counterbalance ion concentration gradient, thereby overcoming the kinetic limitations and achieving fast charging capabilities in thick cathodes.

Probing the Signal Transduction Mechanism of the Light-Activated Adenylate Cyclase OaPAC Using Unnatural Amino Acid Mutagenesis.

OaPAC, the photoactivated adenylyl cyclase from , is composed of a blue light using FAD (BLUF) domain fused to an adenylate cyclase (AC) domain. Since both the BLUF and AC domains are part of the same protein, OaPAC is a model for understanding how the ultrafast modulation of the chromophore binding pocket caused by photoexcitation results in the activation of the output domain on the μs-s time scale. In the present work, we use unnatural amino acid mutagenesis to identify specific sites in the protein that are involved in transducing the signal from the FAD binding site to the ATP binding site.

Resolving native GABA receptor structures from the human brain.

Type A GABA (γ-aminobutyric acid) receptors (GABA receptors) mediate most fast inhibitory signalling in the brain and are targets for drugs that treat epilepsy, anxiety, depression and insomnia and for anaesthetics. These receptors comprise a complex array of 19 related subunits, which form pentameric ligand-gated ion channels. The composition and structure of native GABA receptors in the human brain have been inferred from subunit localization in tissue, functional measurements and structural analysis from recombinant expression and in mice.

Long-Term Safety of Ixekizumab Treatment in Patients with Psoriasis, Psoriatic Arthritis, or Axial Spondyloarthritis: a Post Hoc Analysis of Cerebro-Cardiovascular Events.

Introduction: Psoriasis (PsO), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) may confer an increased risk for cardiovascular (CV) disease, including major adverse cerebro-cardiovascular events (MACE), deep vein thrombosis (DVT), and pulmonary embolism (PE). Patients with these conditions are often exposed for extended time periods to biologics, such as ixekizumab (IXE). Therefore, understanding the risk of CV events, especially MACE, in patients with PsO, PsA, and axSpA exposed to IXE is important.

The effect of plasticizers on rheological, physical and mechanical properties of low cement high alumina gunning refractories.

In this research, the effect of different plasticizers with different amounts on the properties of monolithic alumina-based refractories has been investigated. All samples were fired at 1100 °C and 1550 °C. In order to evaluate the desired properties, first the rheological properties of the samples were examined, and then for further investigations, loss on ignition (LOI), percentage of permanent linear changes (PLC), apparent porosity (AP), bulk density (BD) and cold crushing strength (CCS) tests were used.

Efficacy and empathy of AI chatbots in answering frequently asked questions on oral oncology.

Objectives: Artificial intelligence chatbots have demonstrated feasibility and efficacy in improving health outcomes. In this study, responses from 5 different publicly available AI chatbots-Bing, GPT-3.5, GPT-4, Google Bard, and Claude-to frequently asked questions related to oral cancer were evaluated.

Computational predictions of magnetic resonance acoustic radiation force imaging for breast cancer focused ultrasound therapy.

Purpose: In magnetic resonance-guided focused ultrasound (MRgFUS) breast therapies, the focal location must be characterized to guide successful treatment. Focal characterization is difficult because heterogeneous breast tissues introduce phase aberrations that blur and shift the focus and traditional guidance methods do not work in adipose tissues. The purpose of this work is to evaluate numerical simulations of MRgFUS that predict the focal location.

Adaptive Just-in-Time Intervention to Reduce Everyday Stress Responses: Protocol for a Randomized Controlled Trial.

Background: Personalized approaches to behavior change to improve mental and physical health outcomes are needed. Reducing the intensity, duration, and frequency of stress responses is a mechanism for interventions to improve health behaviors. We developed an ambulatory, dynamic stress measurement approach that can identify personalized stress responses in the moments and contexts in which they occur; we propose that intervening in these stress responses as they arise (ie, just in time; JIT) will result in positive impacts on health behaviors.

Electrospun nanofiber chitosan/polyvinyl alcohol loaded with metal organic framework nanofiber for efficient adsorption and removal of industrial dyes from waste water: Adsorption isotherm, kinetic, thermodynamic, and optimization via Box-Behnken design.

Dyes can seriously harm human health because they linger or break down in the environment and find their way into drinking water through the water cycle. Examples of the most important interactions between MOFs and dyes are provided, and an effort is made to comprehend how surface charge and size compatibility affect the adsorption process. The methods for incorporating functionalized Ce-MOF into electrospun nanofibers made of polyvinyl alcohol and chitosan to create functionalized cerium metal organic framework nanofiber membranes (FCCP nanofiber membranes) are presented in this paper.

Phenotypic and fitness consequences of plasticity in the rhythmic replication of malaria parasites.

The environments that parasites experience within hosts change dramatically over 24 h. How rhythms shape host-parasite-vector interactions is poorly understood owing to the challenges of disentangling the roles of rhythms of multiple interacting species in the context of the complex lifecycles of parasites. Using canonical circadian clock-disrupted hosts, we probe the limits of flexibility in the rhythmic replication of malaria () parasites and quantify the consequences for fitness proxies of both parasite and host.

Does Resilience Change in Patients Undergoing Shoulder Surgery? A Retrospective Comparative Study Utilizing the Brief Resilience Scale.

Background: Resilience refers to the ability to adapt or recover from stress. There is increasing appreciation that it plays an important role in wholistic patient-centered care and may affect patient outcomes, including those of orthopaedic surgery. Despite being a focus of the current orthopaedic evidence, there is no strong understanding yet of whether resilience is a stable patient quality or a dynamic one that may be modified perioperatively to improve patient-reported outcome scores.

Toxic Anterior Segment Syndrome: A 2012-2022 Update on the Most Common Causes.

Purpose: To identify trends in the reporting of toxic anterior segment syndrome (TASS) to the American Society of Cataract and Refractive Surgery (ASCRS) TASS Force from 2012-2022.

Setting: John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.

Prefrontal 5α-reductase 2 mediates male-specific acute stress response.

A key response to acute stress is the increased brain synthesis of the neurosteroid allopregnanolone (AP). Although the rate-limiting step of this reaction is catalyzed by 5α-reductase (5αR), the role of its two primary isoenzymes, 5αR1 and 5αR2, in stress reactivity remains unclear. Here, we found that acute stress led to increased levels of 5αR2, but not 5αR1, in the medial prefrontal cortex (mPFC) of male, but not female, rats.