The double life of glucose metabolism: brain health, glycemic homeostasis, and your patients with type 2 diabetes.

The maintenance of cognitive function is essential for quality of life and health outcomes in later years. Cognitive impairment, however, remains an undervalued long-term complication of type 2 diabetes by patients and providers alike. The burden of sustained hyperglycemia includes not only cognitive deficits but also the onset and progression of dementia-related conditions, including Alzheimer's disease (AD).

Building a Time-Series Model to Predict Hospitalization Risks in Home Health Care: Insights Into Development, Accuracy, and Fairness.

Objectives: Home health care (HHC) serves more than 5 million older adults annually in the United States, aiming to prevent unnecessary hospitalizations and emergency department (ED) visits. Despite efforts, up to 25% of patients in HHC experience these adverse events. The underutilization of clinical notes, aggregated data approaches, and potential demographic biases have limited previous HHC risk prediction models.

MRI findings in six dogs with ependymoma of the brain and spinal cord.

There are few published descriptions of the MRI appearance of canine intracranial or spinal cord ependymoma. In this multicenter, retrospective, secondary analysis, case series study, three veterinary radiologists independently reviewed and recorded imaging characteristics of MRI studies in six dogs with histopathologically confirmed ependymoma (three intracranial and three spinal cord cases). A consensus was reached when there was disagreement on specific features.

A Decision-Making Grid for Coenrollment in Multiple Clinical Trials.

Background: While subject coenrollment into multiple trials is desirable, thoughtful consideration is required to avoid compromising each trial's scientific integrity.

Objective: We developed a Decision-Making Grid (GRID) to help investigators determine whether a clinical trial is compatible with a second clinical trial, thus allowing coenrollment, or if it should be considered competing, prohibiting coenrollment.

Methods: The GRID evaluates 21 elements across 4 domains: Scientific Integrity, Data Interpretation, Feasibility/Burden, and Additional Considerations.

Impaired Awareness and Symptomatology of Hypoglycemia in Adults with Type 1 Diabetes using Continuous Glucose Monitoring.

Context & Objective: Sparse large-scale studies have characterized hypoglycemia symptomatology in adults with type 1 diabetes (T1D) who use continuous glucose monitoring (CGM). This research aimed to evaluate the relationship of impaired awareness of hypoglycemia (IAH) with hypoglycemia symptomatology and frequency in this population.

Design: A cross-sectional survey was conducted in 2023.

Antibiotic Management and Imaging Practices of Sinusitis-Related Epidural Empyema Among Pediatric Centers.

A survey of pediatric infectious diseases clinicians from 49 children's hospitals demonstrated variability across institutions in the treatment of epidural empyema from sinus extension, including antibiotic route, selection, and impact of neuroimaging on determining duration of therapy.

Opioid prescribing guidelines for spine surgery patients: a multisite analysis of guideline implementation and monitoring with an automated text messaging platform.

Objective: The aim of this study was to describe the effect of opioid prescribing guideline implementation for elective spine surgery cases on prescribing and consumption behaviors in a multisite academic hospital system. The effectiveness of an automated text messaging system as a tool to monitor postoperative opioid use and pain outcomes and inform guideline development and deployment is also evaluated.

Methods: The authors conducted a prospective study of postoperative opioid use behaviors and patient-reported outcomes for 2101 elective spine surgery cases between December 2018 and March 2022, prior to and following the implementation of opioid-prescribing guidelines in February 2021 at three urban hospital sites within a large academic health system.

The impact of fellowship training on current practice patterns and the job market: a survey of Fellowship Council graduates.

Background: General surgery has changed significantly over the last decades, with the need for advanced training and expertise. The Fellowship Council (FC) accredits fellowships that train approximately 200 fellows annually. This study aimed to analyze FC graduates' perceptions of training, current practices, and the job market.

Associations between subclinical thyroid dysfunction and cardiovascular risk factors according to age and sex.

Context: Subclinical thyroid dysfunction (ScTD) comprising subclinical hypothyroidism (SHypo) and subclinical hyperthyroidism (SHyper) has been associated with increased risk for cardiovascular events.

Objective: To assess associations between ScTD and cardiovascular risk factors (cvRFs) according to age and sex.

Design And Setting: Pooled individual participant data analysis of large prospective cohort studies from the Thyroid Studies Collaboration.

Generating Real-World Evidence From the Excellence Network in Rheumatology.

Purpose: The Excellence Network in RheumatoloGY (ENRGY) was founded in 2021 and encompasses data from more than 700 private practice rheumatology providers throughout the United States, forming a practice-based research network (PBRN).

Methods: Electronic health record (EHR) data from participating practices are aggregated, including structured data (e.g.

Patient and provider experiences with opioid use disorder care delivered via telehealth: A systematic mixed-studies review.

Introduction: Since the onset of the COVID-19 pandemic and loosening of some opioid use disorder (OUD) treatment regulations in the U.S. and Canada, there has been a rapid rise in the use of telehealth for buprenorphine induction, maintenance, and counseling (tele-bupe).

Afraid of the dentist? There's an app for that: Development and usability testing of a cognitive behavior therapy-based mobile app.

Objectives: Although several brief cognitive behavior therapy (CBT)-based treatments for dental fear have proven efficacious, these interventions remain largely unavailable outside of the specialty clinics in which they were developed. Leveraging technology, we sought to increase access to treatment for individuals with dental fear through the development of a mobile application (Dental FearLess).

Materials And Methods: To assess the resonance of our app as an avenue for dental fear treatment, we conducted a study assessing the usability, feasibility, and acceptability of the beta app.

HIV Clinical Providers' Awareness, Attitudes, and Willingness to Support Patient Outreach Efforts for HIV Cure-Directed Research in Philadelphia, United States.

Background: Ethical patient outreach is critical for engaging patients with HIV in HIV cure-directed research. We sought to examine HIV clinical providers' awareness of current HIV cure-directed research strategies investigated through the Martin Delaney Collaboratories (MDC) and providers' attitudes toward patient outreach for HIV cure-directed research and to identify opportunities for clinical provider education on MDC research strategies.

Methods: We conducted a 1-time, cross-sectional, web-based survey with 64 HIV clinical providers (physicians, physician assistants, and nurses) in Philadelphia.

Decoding disparities: evaluating automatic speech recognition system performance in transcribing Black and White patient verbal communication with nurses in home healthcare.

Objectives: As artificial intelligence evolves, integrating speech processing into home healthcare (HHC) workflows is increasingly feasible. Audio-recorded communications enhance risk identification models, with automatic speech recognition (ASR) systems as a key component. This study evaluates the transcription accuracy and equity of 4 ASR systems-Amazon Web Services (AWS) General, AWS Medical, Whisper, and Wave2Vec-in transcribing patient-nurse communication in US HHC, focusing on their ability in accurate transcription of speech from Black and White English-speaking patients.

Glycemia and Insulin Secretion in Cystic Fibrosis Two Years After Elexacaftor/Tezacaftor/Ivacaftor: PROMISE-ENDO.

Background: Elexacaftor/tezacaftor/ivacaftor (ETI) is a highly effective therapy that improves lung disease in people with cystic fibrosis (pwCF), but its effect on glucose tolerance and insulin secretion is unclear.

Methods: PROMISE is a multicenter prospective, observational study of ETI in pwCF ≥12 years and at least one F508del allele. The PROMISE Endocrine sub-study (PROMISE-ENDO) enrolled participants at 10 CF Centers where hemoglobin A1c (HbA1c) was collected and 3-hour oral glucose tolerance tests (OGTT) conducted to examine glucose tolerance, glucose excursions, insulin secretory rates (deconvolution of C-peptide) and sensitivity (oral minimal model) prior to ETI and 12-18 months (mos) and 24-30 mos following ETI initiation.

The State of Medical Education on Criminal Justice Health: A Systematic Review.

Background: The justice-involved population faces significant health disparities yet is often overlooked in medical education, resulting in medical providers having limited preparation to serve this community. The objective of this study is to understand the scope and context of medical education in correctional healthcare.

Methods: Literature was systematically reviewed for curriculum on correctional healthcare aimed at undergraduate or graduate medical learners in U.

An erythroid-specific lentiviral vector improves anemia and iron metabolism in a new model of XLSA.

X-linked sideroblastic anemia (XLSA) is a congenital anemia caused by mutations in ALAS2, a gene responsible for heme synthesis. Treatments are limited to pyridoxine supplements and blood transfusions, offering no definitive cure except for allogeneic hematopoietic stem cell transplantation, only accessible to a subset of patients. The absence of a suitable animal model has hindered the development of gene therapy research for this disease.

The dynamics of hematopoiesis over the human lifespan.

Over a lifetime, hematopoietic stem cells (HSCs) adjust their lineage output to support age-aligned physiology. In model organisms, stereotypic waves of hematopoiesis have been observed corresponding to defined age-biased HSC hallmarks. However, how the properties of hematopoietic stem and progenitor cells change over the human lifespan remains unclear.

Challenges of Motherhood for Anesthesiologists: A Scoping Review.

Despite advancements in gender representation, female anesthesiologists continue to encounter challenges in career advancement that may be further impacted by motherhood. This scoping review examines personal and systemic barriers and facilitators to career advancement for anesthesiologists facing infertility, pregnancy, and childcare. The review identified 22 relevant studies across five themes: the timing of pregnancy and parental leave, breastfeeding and lactation needs, childcare and gender norms, job reentry and career advancement opportunities, and work-life balance and physician well-being.