Reflections on the Inclusion of Direct-Care Physicians as Educators in Community Hospitals.

This paper discusses the increasing trend of direct-care physicians taking on teaching roles in community hospitals, both in the United States and Brazil. It highlights the challenges faced by these physicians, who often lack formal pedagogical training and dedicated time for teaching. The text emphasizes the need for structured support, faculty development programs, and collaboration with academic centers to ensure the quality of education in these settings.

Defining the Cost of Arthroscopic Rotator Cuff Repair: A Multicenter, Time-Driven Activity-Based Costing and Cost Optimization Investigation.

Background: Rotator cuff repair (RCR) is a frequently performed outpatient orthopaedic surgery, with substantial financial implications for health-care systems. Time-driven activity-based costing (TDABC) is a method for nuanced cost analysis and is a valuable tool for strategic health-care decision-making. The aim of this study was to apply the TDABC methodology to RCR procedures to identify specific avenues to optimize cost-efficiency within the health-care system in 2 critical areas: (1) the reduction of variability in the episode duration, and (2) the standardization of suture anchor acquisition costs.

Clinically Advancing BDK Inhibitors.

The physiopathology of cardiac and related disorders is strongly associated with BCAA metabolic imbalance. BDK, a negative regulator of the BCKDH complex, is significant in BCAA catabolic dysfunction. A Clinically potential BDK inhibitor, PF-07328948, with excellent drug-like properties, is under phase-1 clinical trials for CVD metabolic disorders.

Spine-Abductor Syndrome: Novel Associations Between Lumbar Spine Disease and Hip Gluteal Muscle Pathology.

Background: Risk factors for gluteal tears include age-related deterioration, female sex, and increased body mass index. As the literature that supports the sagittal relationship between the lumbar spine and the hip is increasing, there may be a parallel relationship between the perturbations in spinopelvic alignment caused by lumbar spine disease and gluteal muscle tears. Because no prior studies other than single-institution series have reported on this phenomenon, we investigated spine-abductor syndrome at the population level.

ThCTi@(6)-C: Th═C Double Bond in a Mixed Actinide-Transition Metal Cluster.

A thorium-carbon double bond that corresponds to the sum of theoretical covalent double bond radii has long been sought after in the study of actinide-ligand multiple bonding as a synthetic target. However, the stabilization of this chemical bond remains a great challenge to date, in part because of a relatively poor energetic matching between 5f-/6d- orbitals of thorium and the 2s-/2p- frontier orbitals of carbon. Herein, we report the successful synthesis of a thorium-carbon double bond in a carbon-bridged actinide-transition metal cluster, i.

Rural Culture and Diabetes Self-Management Beliefs, Behaviors and Health Outcomes.

Background: Rural populations in the United States face a diabetes mortality penalty. Self-management is a core component of treatment for type 2 diabetes, but there is low uptake of self-management education and support interventions in rural areas. Rural structural barriers to diabetes self-management have been described, yet the role of rural culture has not been extensively explored.

Molecular Structures of Surfaces and Interfaces of Poly(dimethylsiloxane) Incorporated with Silicone Oils Containing Phenyl Functionality.

Poly(dimethylsiloxane) (PDMS) materials have been widely researched and applied as fouling-release coatings. Incorporation of silicone oils into PDMS has been shown to improve the antifouling properties of PDMS materials. In this research, we applied sum frequency generation (SFG) vibrational spectroscopy to study PDMS materials incorporated with various silicone oils containing phenyl groups in air, water, and protein solutions.

Proton-Induced Switching of Paramagnetism: Reversible Conversion between a Low and High Spin Co Center within a Heterobimetallic Core.

The development of molecular species with switchable magnetic properties has been a long-standing challenge in chemistry. One approach involves binding an analyte, such as protons, to a compound to trigger a change in magnetism. Transition metal complexes have been targeted for this type of magnetic modulation because they can undergo changes in their spin states.

Evaluation of Cereblon-Directing Warheads for the Development of Orally Bioavailable PROTACs.

PROTACs usually occupy physicochemical space outside the one defined by classical drug-like molecules, which often presents considerable challenges in their optimization and development for oral administration. We have previously reported phenyl glutarimide (PG)-based BET PROTAC SJ995973, with improved overall degradation and antiproliferative activities compared to its direct thalidomide-based analogue dBET1, but similarly poor pharmacokinetic profile. To further demonstrate the PG utility, we describe here optimization efforts that led to the discovery of an orally bioavailable BET-PROTAC SJ44236 (), and results of a comprehensive comparative study with analogues containing alternative CRBN-directing warheads.

Sex differences in the maximal metabolic steady state of fitness matched women and men.

We tested the hypothesis that power at maximal metabolic steady state is similar between fitness matched men and women. Eighteen participants (9 men, 9 women) performed a cycling graded exercise test for maximal oxygen consumption (V̇O). Men and women were matched for V̇O normalized to fat free mass (FFM), which was 50.

A Dynamic Active Site for OER Catalysis at Nickel-Vanadium-Phosphide Depends on V Surface Position and Fe in Alkaline.

Enhancing the rate of the oxygen evolution reaction (OER) by doping Ni-based electrocatalysts with guest metals other than Fe (V in this work) and the stability of the metal site should be assessed independent of Fe traces and in relation to the guest metal activity in solution. We examined OER catalysis and its sustainability at vanadium-doped nickel phosphide (NiP-V) independent of the role of Fe traces in alkaline. V was included in NiP by codeposition at cathodic bias (termed V) or postdeposition during the phosphide-to-hydroxide surface transformation at anodic bias in alkaline spiked with VCl (termed V).

The partisanship of mayors has no detectable effect on police spending, police employment, crime, or arrests.

In this paper, we examine whether mayors' partisan affiliations lead to differences in crime and policing. We use a large new dataset on mayoral elections and three different modern causal inference research designs (a regression discontinuity design centered around close elections and two robust difference-in-differences methods) to determine the causal effect of mayoral partisanship on crime, arrests, and racial differences in arrest patterns in medium and large US cities. We find no evidence that mayoral partisanship affects police employment or expenditures, police force or leadership demographics, overall crime rates, or numbers of arrests.

Hybrid coral reef restoration can be a cost-effective nature-based solution to provide protection to vulnerable coastal populations.

Coral reefs can mitigate flood damages by providing protection to tropical coastal communities whose populations are dense, growing fast, and have predominantly lower-middle income. This study provides the first fine-scale, regionally modeled valuations of how flood risk reductions associated with hybrid coral reef restoration could benefit people, property, and economic activity along Florida and Puerto Rico's 1005 kilometers of reef-lined coasts. Restoration of up to 20% of the regions' coral reefs could provide flood reduction benefits greater than costs.

Effect of Improved Provider Communication and Adherence to Guidelines on PrEP Initiation in Kisumu Kenya.

Introduction: Adolescent girls and young women (AGYW) in Kenya have low pre-exposure prophylaxis (PrEP) initiation rates in part due to stigmatizing interactions with health care providers. Our recent randomized clinical trial of a standardized patient actor (SP) training intervention for providers found higher quality PrEP delivery at intervention sites, however it was unclear whether improved service quality improved PrEP initiation.

Methods: This analysis used routine records from facilities participating in the randomized trial which aimed to improve provider communication and adherence to Kenyan guidelines when offering PrEP to AGYW.

A descriptive study of fatal drownings among children and adolescents in the United States, with a focus on retention pond deaths, 2004-2020.

The objective of this study was to characterize fatal drownings among children and adolescents, with a focus on retention pond drownings, and identify risk factors for these fatalities using child death review data. We acquired 2004-2020 National Fatality Review-Case Reporting System data for drowning deaths among youth 0-19 years. Retention pond drownings were identified through case narratives.

Dynamics of SARS-CoV-2 infection over two epidemic waves in Manaus, Brazil: A serological study of seven thousand blood donors.

Background: Most longitudinal studies of COVID-19 incidence have used unlinked samples. The city of Manaus, Brazil, has a blood donation program which allows sample linkage, and was struck by two large COVID-19 epidemic waves between mid-2020 and early 2021.

Methods: We estimated the changing force of infection, i.

MmuPV1 infection of Tmc6/Ever1 or Tmc8/Ever2 deficient FVB mice as a model of βHPV in typical epidermodysplasia verruciformis.

Typical epidermodysplasia verruciformis (EV) is a rare, autosomal recessive disorder characterized by an unusual susceptibility to infection with specific skin-trophic types of human papillomavirus, principally betapapillomaviruses, and a propensity for developing malignant skin tumors in sun exposed regions. Its etiology reflects biallelic loss-of-function mutations in TMC6 (EVER1), TMC8 (EVER2) or CIB1. A TMC6-TMC8-CIB1 protein complex in the endoplasmic reticulum is hypothesized to be a restriction factor in keratinocytes for βHPV infection.

3D genomic features across >50 diverse cell types reveal insights into the genomic architecture of childhood obesity.

The prevalence of childhood obesity is increasing worldwide, along with the associated common comorbidities of type 2 diabetes and cardiovascular disease in later life. Motivated by evidence for a strong genetic component, our prior genome-wide association study (GWAS) efforts for childhood obesity revealed 19 independent signals for the trait; however, the mechanism of action of these loci remains to be elucidated. To molecularly characterize these childhood obesity loci, we sought to determine the underlying causal variants and the corresponding effector genes within diverse cellular contexts.

Nucleosome repositioning in cardiac reprogramming.

Early events in the reprogramming of fibroblasts to cardiac muscle cells are unclear. While various histone undergo modification and re-positioning, and these correlate with the activity of certain genes, it is unknown if these events are causal or happen in response to reprogramming. Histone modification and re-positioning would be expected to open up chromatin on lineage-specific genes and this can be ascertained by studying nucleosome architecture.

Prevalence and features of allergic bronchopulmonary aspergillosis, United States, 2016-2022.

The epidemiology of allergic bronchopulmonary aspergillosis (ABPA) in the United States is not well-described. To estimate national ABPA prevalence among patients with asthma or cystic fibrosis, characterize ABPA testing practices, and describe ABPA clinical features, treatment, and 6-month outcomes. We used the 2016-2022 Merative™ MarketScan® Commercial/Medicare and Multi-State Medicaid Databases to identify cohorts of patients with 1) asthma, 2) cystic fibrosis (CF), and 3) ABPA.

The role of psychosocial factors in mediating the treatment response of epidural steroid injections for low back pain with or without lumbosacral radiculopathy: A scoping review.

Epidural steroid injections (ESIs) are often used to treat low back pain (LBP) due to lumbosacral radiculopathy as well as LBP without a clear component of radiculopathy, in some cases. While it is increasingly recognized that psychosocial factors are associated with pain outcomes, few studies have assessed the contribution of these factors to common pain interventions like ESIs. This study aimed to summarize the scope and nature of how psychosocial factors are accounted for in research on ESIs for the treatment of LBP with or without lumbosacral radiculopathy and to identify gaps and recommendations for future research.

Binaural speech intelligibility for combinations of noise, reverberation, and hearing-aid signal processing.

Binaural speech intelligibility in rooms is a complex process that is affected by many factors including room acoustics, hearing loss, and hearing aid (HA) signal processing. Intelligibility is evaluated in this paper for a simulated room combined with a simulated hearing aid. The test conditions comprise three spatial configurations of the speech and noise sources, simulated anechoic and concert hall acoustics, three amounts of multitalker babble interference, the hearing status of the listeners, and three degrees of simulated HA processing provided to compensate for the noise and/or hearing loss.

Evaluating the Effectiveness of a Mobile Health Intervention on Enhancing HIV Knowledge in Sexual and Gender Minority Men.

Background: In the United States, young men who have sex with men (YMSM) and young transgender women (YTGW) are disproportionately affected by HIV infection. Adequate HIV knowledge is critical for protecting adolescents and young adults at risk for HIV. This study aimed to evaluate the effectiveness of the mLab App intervention in enhancing HIV knowledge among YMSM and YTGW.

3D fluorescence staining and confocal imaging of low amount of intestinal organoids (enteroids): Protocol accessible to all.

The emerging field of 3D organ modeling encounters several imaging issues in particular related to antigen retrieval and sample loss during staining processes. Due to their compact shape, several antibodies fail to penetrate intact organoids or spheroids. Histology of organoids can be approached by paraffin inclusion and sectioning at 5 μm as performed for biopsies.

Temporal changes in hospital readmissions for postpartum hypertension in the US, 2010 to 2019; a serial cross-sectional analysis.

Background: Hypertension is the most common primary diagnosis associated with postpartum readmissions within 42 days of delivery hospitalization. In the United States, nearly half of the cases of eclampsia, a severe form of preeclampsia, develop during the postpartum period, and the postpartum onset of hypertensive disorders of pregnancy, like antepartum hypertension poses long-term health risks to pregnant individuals, including an increased likelihood of developing overall cardiovascular disease, coronary heart disease, heart failure, and chronic hypertension. In this paper, we estimate the trends in the incidence of readmissions for postpartum hypertension within 42 days of delivery discharge in the US, disaggregated by median household income.