High-Grade Astrocytoma With Piloid Features.

Context.—: High-grade astrocytoma with piloid features (HGAP) is a newly recognized glioma defined by its methylation profile. Understanding of its clinical, histologic, and molecular characteristics continues to evolve.

Outpatient Palliative Care and End-of-Life Care Intensity: Linking Massachusetts Cancer Registry with All-Payer Claims.

Background: Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care intensity and variation across eight provider networks.

Methods: We linked Massachusetts Cancer Registry and the All-Payer Claims Database for individuals with commercial insurance, Medicaid or Medicare Advantage diagnosed with colorectal, lung, prostate, and breast cancers from 2010 through 2013 who died by December 31, 2014.

Neonatal but not Juvenile Gene Therapy Reduces Seizures and Prolongs Lifespan in SCN1B-Dravet Syndrome Mice.

Dravet syndrome (DS) is a developmental and epileptic encephalopathy (DEE) that begins in the first year of life. While most cases of DS are caused by variants in SCN1A, variants in SCN1B, encoding voltage-gated sodium channel β1 subunits, are also linked to DS or to the more severe early infantile DEE. Both disorders fall under the OMIM term DEE52.

Third Proceedings of The North American Airway Collaborative (NoAAC): Consensus Statement on Trial Design for Airway Stenosis.

Importance: Airway stenosis is a rare but debilitating disorder that significantly degrades the quality of life in affected patients. Treatments are primarily surgical, and disease management lacks established medical therapies. The North American Airway Collaborative held its third symposium at The Johns Hopkins Hospital in Baltimore, Maryland, on April 15, 2024, focused on strategies to advance the care of these patients.

Where do "chemical imbalance" beliefs come from? Evaluating the impact of different sources.

Introduction: Although the etiology of depression is incredibly complex, the narrative that it is caused by a simple "chemical imbalance" persists in lay settings. We sought to understand where people are exposed to this explanation (i.e.

The cost-effectiveness of vaccination against COVID-19 illness during the initial year of vaccination.

Background: Substantial investments by government programs and private health plans subsidized the costs of COVID-19 vaccine doses and vaccine administration. The objective of this study was to evaluate the cost-effectiveness of vaccination against COVID-19 illness during the initial year of COVID-19 vaccination (2021).

Methods: Using a simulation model, we projected outcomes for hypothetical cohorts of US adults aged 18 and older, stratified by age and risk status for complications, comparing vaccination and no vaccination in the context of recommended concomitant prevention strategies (e.

Self-acupressure for patients with breast cancer experiencing aromatase inhibitor-associated musculoskeletal symptoms: Protocol for the AcuAIM randomized pilot trial.

Background: Aromatase inhibitors (AI) reduce hormone receptor-positive breast cancer recurrence risk by about 50%. However, half of AI-treated postmenopausal women report new or worsened musculoskeletal symptoms (AIMSS), and 20% discontinue therapy prematurely. Acupuncture is effective for reducing symptoms, but many women are not able to access acupuncture therapy.

Techniques and analytic workflow for spatial transcriptomics and its application to allergy and inflammation.

Spatial profiling, through single-cell gene-level expression data paired with cell localization, offers unprecedented biologic insights within the intact spatial context of cells in healthy and diseased tissue, adding a novel dimension to data interpretation. This review summarizes recent developments in this field, its application to allergy and inflammation, and recent single-cell resolution platforms designed for spatial transcriptomics with a focus on data processing and analyses for efficient biologic interpretation of data. By preserving spatial context, these technologies provide critical insights into tissue architecture and cellular interactions that are unattainable with traditional transcriptomics methods, such as revealing localized inflammatory cell network in atopic dermatitis and T-cell interactions in the lung in chronic obstructive pulmonary disease.

Future Directions in the Management of Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

Context: The traditional management of classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHD) is difficult and often suboptimal.

Objective: To review improvements in the diagnosis and management of 21OHD.

Design: Literature review, synthesis, and authors' experience.

Mental Health Issues Associated With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

Context: The goal of this review is to move beyond summarizing what is known about psychosexual development in females with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency-commonly studied as a natural experiment to understand prenatal androgen effects in 46,XX individuals. Instead, it will explore the various aspects of the condition that significantly impact the daily lives of both male and female patients and their families, with a particular focus on the implications for psychosocial, educational, and vocational adaptation.

Evidence Acquisition: This work represents a selective, yet balanced review of papers highlighting potential threats to positive psychological adaptation in both male and female individuals with CAH.

Managing Calciphylaxis: Insights from Real-World Cases at a Tertiary Academic Center.

Calciphylaxis is a rare and potentially fatal condition involving chronic, nonhealing wounds caused by microvascular calcification. There is currently no approved treatment for calciphylaxis, contributing to its devastating impacts on quality of life. In this case series, the authors highlight instances of potentially misdiagnosed calciphylaxis in a cohort of patients and emphasize the importance of accurate diagnosis through multidisciplinary management approaches.

An Educational Intervention to Promote Central Nervous System-Active Deprescribing in Dementia: A Pilot Study.

Background: Central nervous system (CNS)-active polypharmacy (defined as concurrent exposure to three or more antidepressant, antipsychotic, antiseizure, benzodiazepine, opioid, or nonbenzodiazepine benzodiazepine receptor agonists) is associated with significant potential harms in persons living with dementia (PLWD).We conducted a pilot trial to assess a patient nudge intervention's implementation feasibility and preliminary effectiveness to prompt deprescribing conversations between PLWD experiencing CNS-active polypharmacy and their primary care clinicians ("clinicians").

Methods: We used the electronic health record to identify PLWD prescribed CNS-active polypharmacy in primary care clinics from two health systems.

Iris: A Next Generation Digital Pathology Rendering Engine.

Digital pathology is a tool of rapidly evolving importance within the discipline of pathology. Whole slide imaging promises numerous advantages; however, adoption is limited by challenges in ease of use and speed of high-quality image rendering relative to the simplicity and visual quality of glass slides. Herein, we introduce Iris, a new high-performance digital pathology rendering system.

Moving Beyond the Device: Key Lessons in Creating a Positive Patient Experience for a Remote Foot Health Program.

The burden of diabetic foot ulcers is largely underappreciated, even by the healthcare community. Living with advanced, complex chronic diseases can be challenging for the patient and often requires additional time and resource utilization by the provider. The use of novel technology within medicine should be focused on fostering excellent experiences, thereby promoting satisfaction and ultimately, quality care.

Training for the future of the genetic counseling profession: Exploring the assessment and adaptation of graduate programs' didactic curriculum.

Since the first genetic counseling program (GCP) was established in 1969, there has been a proliferation of growth and demand for genetic counselors. Advances in technology, affordable access to genetic testing, public genomic health initiatives, and diversifying clinical and non-clinical roles comprise a dynamic environment that GCPs must respond to. While there is extensive literature regarding how other health professions adapt their curricula to changing environments, this has yet to be documented and explored for genetic counseling.

Proposed resources required for a comprehensive program for CCT CHD imaging.

Background: Cardiac Computed Tomography (CCT) is increasingly used for evaluation of congenital heart disease (CHD) in patients of all ages. Pediatric and adult congenital heart disease (ACHD) surgical programs require high quality CCT imaging as part of the multimodality imaging support expected of comprehensive care centers. Despite these expectations, there are no benchmarks or defined programmatic elements specific to the performance of CCT in patients with CHD.

Characterization of Clinicopathological Features and Autoantibody Profiles in Patients with Cutaneous Lupus Erythematous: A Single-Center Retrospective Study.

Background: Cutaneous lupus erythematosus (CLE) is an autoimmune condition characterized by a wide range of clinical manifestations and limited treatment options. There is little research on the impact of commonly used diagnostic tests including antinuclear antibodies (ANA) and extractable nuclear antigens (ENA) on disease course or responsiveness to treatment.

Objective: This single-center retrospective cohort study aims to address this gap by characterizing clinicopathological characteristics, patient demographics, and treatment response among patients with CLE.

Patterns of Klebsiella pneumoniae bacteremic dissemination from the lung.

Bacteremia, a leading cause of death, generally arises after bacteria establish infection in a particular tissue and transit to secondary sites. Studying dissemination from primary sites by solely measuring bacterial burdens does not capture the movement of individual clones. By barcoding Klebsiella pneumoniae, a leading cause of bacteremia, we track pathogen dissemination following pneumonia.

Clinical Confidence, Certification, and Connectedness: Impact of a Journal Club for Inpatient Psychiatry Faculty.

Introduction: Inpatient psychiatry faculty manage complex clinical, administrative, and legal issues amid increasing mental health service utilization rates, limiting time for (1) focusing on lifelong learning and (2) connecting. We examined the impact of a monthly journal club on inpatient psychiatry faculty's (1) confidence that their practice is evidence informed, (2) stress related to board recertification, and (3) sense of connectedness with peers.

Methods: We employed a primarily qualitative approach using semi-structured interviews and brief survey questions to elicit input from inpatient psychiatry faculty at an academic medical center on their experience participating in a monthly journal club, including perceived changes in one's practice of evidence-based medicine, recertification stress, and connectedness with peers.

Older US adults' experiences with and views about cognitive screening and blood biomarker testing for Alzheimer's disease.

Introduction: Dementia is underdiagnosed in the United States. Understanding of older adults' experiences with screening is needed to optimize diagnosis.

Methods: US adults ages 65 to 80 ( = 1298) were surveyed on experiences with cognitive screening and blood biomarker (BBM) testing.