Criminal legal penalties, substance use, and overdose: a concept mapping study examining Colorado's criminal legal penalties.

Background: In the USA, many states, including Colorado, have increased criminal penalties for illicit opioid possession, which may alter overdose risk. We aimed to evaluate the relationship between Colorado's increased drug-related criminal legal penalties, risk of overdose, and substance use patterns.

Methods: We used concept mapping - a mixed-methods approach used to develop a conceptual understanding of an issue from a community lens - to engage with people with living and/or lived experience with the criminal legal system, substance use, and/or overdose, their loved ones, and service providers.

Antigen experience history directs distinct functional states of CD8 CAR T cells during the antileukemia response.

Although chimeric antigen receptor (CAR) T cells are effective against B-lineage malignancies, post-CAR relapse is common, and efficacy in other tumors is limited. These challenges may be addressed through rational manipulations to control CAR T cell function. Here we examine the impact of cognate T cell antigen experience on subsequent CD8 CAR T cell activity.

Cytosolic phospholipase A2 in infiltrating monocyte derived macrophages does not impair recovery after spinal cord injury in female mice.

Spinal cord injury (SCI) leads to permanent motor and sensory loss that is exacerbated by intraspinal inflammation and persists months to years after injury. After SCI, monocyte-derived macrophages (MDMs) infiltrate the lesion to aid in myelin-rich debris clearance. During debris clearance, MDMs adopt a proinflammatory phenotype that exacerbates neurodegeneration and hinders recovery.

Next Steps in Efforts to Address the Obesity Epidemic.

Obesity prevalence continues to rise globally at alarming rates, with adverse health and economic implications. In this state-of-the-art review, we provide an analysis of selected evidence about the current knowledge in the obesity literature, including a synthesis of current challenges in obesity and its determinants. In addition, we review past and current efforts to combat the obesity epidemic, highlighting both successful efforts and areas for further development.

Comparison of WatchPAT to polysomnography measurement of apnea-hypopnea index and obstructive sleep apnea severity in adolescents with overweight and obesity.

Study Objectives: The prevalence of obstructive sleep apnea (OSA) increases dramatically in adolescents with overweight or obesity. The gold standard for diagnosis of OSA is in-laboratory polysomnography (PSG). However, access to PSG can be challenging, necessitating development of alternative devices.

Effects of hypoxia on uteroplacental and fetoplacental vascular function during pregnancy.

During pregnancy, marked changes in vasculature occur. The placenta is developed, and uteroplacental and fetoplacental circulations are established. These processes may be negatively affected by genetic anomalies, maternal environment (i.

Global perspectives on transplant disparities.

Purpose Of Review: Our goal was to review and summarize the current state of global disease burden from organ failure and the efforts to improve outcomes with organ transplantation. We also reviewed intra- and inter-country disparities in organ failure and organ transplantation along with potential mechanisms to improve access to organ transplantation globally.

Recent Findings: Many disparities and inequities observed globally can be characterized by the country's income category.

Maternal Plasma Choline Levels Are Positively Correlated with Maternal and Placental Phospholipid-DHA Content in Females with Obesity Who Receive DHA Supplementation.

Background: Pregnancies complicated by maternal obesity are characterized by metabolic differences affecting placental nutrient transport and fetal development. Docosahexaenoic acid (DHA) is critical for fetal brain development and is primarily incorporated into phosphatidylcholine (PC). Recent evidence suggests that choline may enhance PC-DHA synthesis; however, data on the impact of maternal plasma choline on placental phospholipid DHA content in females with obesity are limited.

Beyond the Exam Room: Teaching Intervisit Care to Internal Medicine Residents.

Introduction: Intervisit care, asynchronous care provided between patient visits, represents an essential part of patient care. Despite the importance of intervisit care, residency programs have not traditionally taught residents how to effectively manage intervisit care within the formal curriculum. We aimed to improve resident preparedness in providing intervisit care with an intervisit workshop.

Safety and Efficacy of STREAMLINE Canaloplasty with Phacoemulsification in Hispanic Adults with Open-Angle Glaucoma: 12-Month Outcomes.

Purpose: To report the 12-month clinical outcomes in eyes with mild to moderate open-angle glaucoma (OAG) in Hispanic adults undergoing STREAMLINE Surgical System (STREAMLINE) canaloplasty combined with phacoemulsification.

Patients And Methods: This was a prospective, multi-center, interventional clinical trial involving 45 eyes of 45 Hispanic adult patients receiving topical medical therapy for mild to moderate OAG and undergoing phacoemulsification surgery for visually significant cataracts at three sites. All eyes underwent a Screening visit, followed by medication washout and a subsequent Baseline visit to determine eligibility for STREAMLINE canaloplasty.

Social support and self-efficacy during early adolescence: Dual impact of protective and promotive links to mental health and wellbeing.

This study aimed to assess the impact of sources of social support and dimensions of self-efficacy on psychological symptoms and mental wellbeing among early adolescents. A total of 274 adolescents aged 10-14 from Darjeeling, India, participated in the study. The Multidimensional Scale of Perceived Social Support (MSPSS) and Self-Efficacy Questionnaire for Children (SEQ-C) were utilized to assess dimensions of protective/promotive factors.

Learned phenotypes emerge during social stress modifying hippocampal orexin receptor gene expression.

Psychological distress, including anxiety or mood disorders, emanates from the onset of chronic/unpredictable stressful events. Symptoms in the form of maladaptive behaviors are learned and difficult to treat. While the origin of stress-induced disorders seems to be where learning and stress intersect, this relationship and molecular pathways involved remain largely unresolved.

A single mutation in dairy cow-associated H5N1 viruses increases receptor binding breadth.

Clade 2.3.4.

JAK inhibition decreases the autoimmune burden in Down syndrome.

Background: Individuals with Down syndrome (DS), the genetic condition caused by trisomy 21 (T21), display clear signs of immune dysregulation, including high rates of autoimmunity and severe complications from infections. Although it is well established that T21 causes increased interferon responses and JAK/STAT signaling, elevated autoantibodies, global immune remodeling, and hypercytokinemia, the interplay between these processes, the clinical manifestations of DS, and potential therapeutic interventions remain ill defined.

Methods: We report a comprehensive analysis of immune dysregulation at the clinical, cellular, and molecular level in hundreds of individuals with DS, including autoantibody profiling, cytokine analysis, and deep immune mapping.

Revisiting Injectable Estrogen Dosing Recommendations for Gender-Affirming Hormone Therapy.

Injectable estrogens are options for gender-affirming hormone therapy per guidelines, which suggest intramuscular dosages of 5-30 mg every 2 weeks or 2-10 mg weekly with estradiol cypionate or valerate interchangeably. Data among transgender and gender-diverse patients are limited due to local unavailability and concerns around laboratory assay variability and estradiol (E2) level fluctuation. We note a concerning trend where patients are prescribed high-dose injections based on the guidelines leading to serum E2 levels well above the range recommended in the same guidelines.

Updates on the MR safety guidelines - Essentials for radiologists.

Magnetic Resonance Imaging (MRI) is a sophisticated diagnostic tool that utilizes the magnetic properties of biological tissue to generate detailed images of internal structures without the use of ionizing radiation. Despite its benefits in providing high-contrast images of soft tissues, the strong magnetic fields used in MRI present a unique safety challenge. Increasing MRI-related accidents and the prevalence of patients with metallic implants in recent years underscore the critical need for stringent MR safety protocols.

Bone Health ECHO Case Report: Significant Elevation in Bone Turnover Markers and Progression of Vertebral Fractures After Denosumab Discontinuation Followed by a PTH-Analog.

Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual community of practice, where healthcare professionals have met via videoconferencing weekly since 2015. This model of learning is focused on short didactics and the presentation of real but de-identified patient cases followed by highly interactive discussions. These are often clinical situations with diagnostic and therapeutic dilemmas that are not readily addressed by randomized placebo-controlled clinical trials and clinical practice guidelines.

A descriptive examination of rurality in the Environmental influences on Child Health Outcomes Cohort: Implications, illustrations, and future directions.

Purpose: The Environmental influences on Child Health Outcomes (ECHO) Cohort has enrolled over 60,000 children to examine how early environmental factors (broadly defined) are associated with key child health outcomes. The ECHO Cohort may be well-positioned to contribute to our understanding of rural environments and contexts, which has implications for rural health disparities research. The present study examined the outcome of child obesity to not only illustrate the suitability of ECHO Cohort data for these purposes but also determine how various definitions of rural and urban populations impact the presentation of findings and their interpretation.

Rare variants in cardiomyopathy genes predispose to cardiac injury in severe COVID-19 patients of African or Hispanic ancestry.

In one of the earliest reports from China during COVID-19, it was noted that over 20% of patients hospitalized with the disease had significant elevations of troponin, a marker of myocardial tissue damage, that put them at a higher risk. In a hypothesis-independent whole exome sequencing (WES) study in hospitalized COVID-19 patients of diverse ancestry, we observed putative enrichment in pathogenic variants in genes known to be involved in the pathogenesis of cardiomyopathy. This observation led us to hypothesize that the observed high morbidity and mortality in these patients might be due to the presence of rare genetic factors that had previously been silent but became relevant as a consequence of the severe stress inflicted by an infection with SARS-CoV-2.