ALSUntangled #77: Psilocybin.

ALSUntangled reviews alternate and off-label treatments prompted by patient interest. Here, we review psilocybin, a chemical derived from mushrooms and belonging in the category of drugs known as psychedelics. Psilocybin has plausible mechanisms for slowing ALS progression because of its ability to cross the blood brain barrier and effect neurogenesis and inflammation.

Implementation of trauma and disaster mental health awareness training in Puerto Rico.

Climate change is disproportionately impacting youth mental health around the world. Using a Community-Based Participatory approach, three universities (one in South Carolina and two in Puerto Rico) partnered after the devastation of Hurricane Maria in 2017. We offered culturally and linguistically tailored trauma and disaster-informed mental health awareness training (e.

Bedside mental health risk screening of traumatic injury patients is enhanced by measurement of injury mechanism and social support.

Background: The American College of Surgeons now requires mental health screening and follow up for hospitalized patients in trauma centers. National estimates indicate that 20-40 % of these patients will develop posttraumatic stress disorder (PTSD) and/or depression within one year post-injury. Research has identified brief bedside screens that predict PTSD and depression post-discharge, such as the Injured Trauma Survivor Screen and Peritraumatic Distress Inventory.

Qualitative and quantitative relationships between comorbid seizures and dementia among hospitalized stroke patients.

This study examines the relationship between comorbid seizures and dementia among stroke patients using the 2017 Nationwide Inpatient Sample (NIS), the largest publicly available inpatient healthcare database in the United States. We analyzed data from 128,341 stroke patients, including those with ischemic and hemorrhagic strokes, to determine the prevalence of seizures and dementia, and the association between these conditions. Our findings reveal that 7.

Ranking of Health Problems and Prioritization of Cancer Education Topics by African American Communities in South Carolina.

Despite landmark breakthroughs in cancer research, African American adults (AA) bear the highest cancer burden compared to other racial groups in the United States (US). AA adults have twice the likelihood of dying from prostate and uterine cancers compared to White adults, suggesting that there are fundamental issues yet to be addressed when developing and implementing cancer-preventative programs for AA communities. Community-based participatory research (CBPR) empowers community members to identify and prioritize their health problems and preferred strategies to tackle these issues.

High-Throughput Microarray Approaches for Predicting the Stability of Drug-Polymer Solid Dispersions.

Amorphous solid dispersions (ASDs) offer a well-recognized strategy to improve the effective solubility and, hence, bioavailability of poorly soluble drugs. In this study, we developed an extensive library of a significant number of solid dispersion formulations using a library of chemically diverse drugs combined with a water-soluble polymer (polyvinylpyrrolidone vinyl acetate, PVPVA) at different loadings. These formulations were printed as microarrays of solid dispersion formulations, utilizing minimal material amounts (nanograms).

Multiple DNA repair pathways prevent acetaldehyde-induced mutagenesis in yeast.

Acetaldehyde is the primary metabolite of alcohol and is present in many environmental sources including tobacco smoke. Acetaldehyde is genotoxic, whereby it can form DNA adducts and lead to mutagenesis. Individuals with defects in acetaldehyde clearance pathways have increased susceptibility to alcohol-associated cancers.

The Individuals With Disabilities Education Act: Clarifying the Relationship Between Free Appropriate Public Education and Least Restrictive Environment.

In 2025, the Individuals with Disabilities Education (IDEA) will have been the primary law driving the field of special education for 50 years. A contentious area of disagreement has been the relationship between two primary mandates of the law: the obligation of schools to provide a free appropriate public education (FAPE) to eligible students with disabilities and the obligation to place these students in the least restrictive environment (LRE) appropriate to each student's individual needs. The conflict over LRE can be traced throughout the history of IDEA, in debates referenced as "mainstreaming," "regular education initiative," "inclusion," and "full inclusion.

Family medicine research: seizing the moment to advance the field.

Despite a growing awareness that primary care is essential to an accessible, equitable, high-quality, cost-effective health care system, family medicine research remains woefully underdeveloped. The increased focus of both state and federal policy makers on primary care payment and care delivery models presents an opportunity for family medicine to redefine itself as an academically rigorous discipline at the forefront of generating evidence that improves patient care and population health while reducing costs. In a critical review of the literature, we identified five themes-leadership, funding, resources, team science, and departmental culture-that are integral to family medicine departments seeking to grow and expand their research capacity.

Vagus nerve stimulation in treatment-resistant depression: A one-year, randomized, sham-controlled trial.

Background: Few treatments are available for individuals with marked treatment-resistant depression (TRD).

Objective: Evaluate the safety and effectiveness of FDA-approved adjunctive vagus nerve stimulation (VNS) in patients with marked TRD.

Methods: This 12-month, multicenter, double-blind, sham-controlled trial included 493 adults with marked treatment-resistant major depression who were randomized to active or no-stimulation sham VNS for 12 months.

Pharmacotherapy adjuncts for traumatic brain injury: A narrative review of evidence and considerations in the emergency department.

Traumatic Brain Injury (TBI) remains a significant global health concern with significant impact on morbidity and mortality. This narrative review explores adjunctive pharmacologic agents to be employed by emergency medicine clinicians during Advanced Trauma Life Support (ATLS) in patients presenting with a TBI. Pharmacologic agents are commonly employed for the management of rapid sequence intubation and post-intubation analgosedation, hemodynamics, intracranial pressure, coagulopathy, seizure prophylaxis, and infection.

Adaptive Platform Trials in Stroke.

Clinical trials of treatments for stroke have generally utilized 2-arm, randomized designs to evaluate a single intervention against a control. Running separate clinical trials, with each addressing a single therapeutic question, is resource intensive and slows evidence generation, especially in a field with rapidly expanding treatment options and evolving practices. Platform trials-randomized clinical trials designed to evaluate multiple interventions that may enter and exit the ongoing platform based on a master protocol-accelerate the investigation of multiple therapeutic options within a single infrastructure.

Draft genome sequences of six high pH adapted strains isolated from Mariana forearc serpentinite mud volcanoes.

Six marine bacterial isolates were obtained from fluid and sediments collected at alkaline serpentinite mud volcanoes of the Mariana forearc to examine life at high pH in a marine environment. Here, we present the draft genome sequences of these six isolates, classified as strains of the species .

Full-field, frequency-domain comparison of simulated and measured human brain deformation.

We propose a robust framework for quantitatively comparing model-predicted and experimentally measured strain fields in the human brain during harmonic skull motion. Traumatic brain injuries (TBIs) are typically caused by skull impact or acceleration, but how skull motion leads to brain deformation and consequent neural injury remains unclear and comparison of model predictions to experimental data remains limited. Magnetic resonance elastography (MRE) provides high-resolution, full-field measurements of dynamic brain deformation induced by harmonic skull motion.

Neurophysiological Effects of Latent Trigger Point Dry Needling on Spinal Reflexes.

Deep dry needling (DDN) is a method to treat muscle trigger points (TrPs) often found in persons with neuromuscular pain and spasticity. Currently, its neurophysiological actions are not well established. Thus, to understand how DDN affects spinal cord physiology, we investigated the effects of TrP DDN on spinal reflexes.

Transcription as a double-edged sword in genome maintenance.

Genome maintenance is essential for the integrity of the genetic blueprint, of which only a small fraction is transcribed in higher eukaryotes. DNA lesions occurring in the transcribed genome trigger transcription pausing and transcription-coupled DNA repair. There are two major transcription-coupled DNA repair pathways.

Management of recurrent intussusception after Roux-en-Y gastric bypass.

While intussusception is a well described complication of Roux-en-Y gastric bypass (RYGB), cases of recurrent intussusception after lead point resection and reconstruction are described much less frequently. We present a case of a 28-year-old female with triple recurrent intussusception all of which were treated with surgical resection and reconstruction of her RYGB anastomoses. There is currently limited evidence to direct management in the setting of recurrent intussusception.

Burnout in Practicing Neurologists: A Systematic Review and Meta-Analysis.

Purpose Of Review: Burnout is a context-dependent, global issue among physicians in the medical field who often face job-related stressors, high workloads, and limited or lack of social support or autonomy. Within medicine, neurology is a specialty with high levels of burnout and low levels of work-life satisfaction. We, therefore, conducted this study to evaluate burnout rates among neurologists globally and identify the tools used to evaluate it.

Do the Effects of Head Start Vary Across Time Based on Children's Exposure to Different Patterns of Childhood Adversity? Differential Intervention Effects Using Latent Profile Analysis and Time-varying Effect Modeling.

This study examined whether exposure to different patterns of poverty-related adversity (i.e., risk profiles) was associated with longitudinal child outcomes and children's response to Head Start.

A practical framework for the design of resistance exercise interventions in oncology research settings-a narrative review.

Resistance exercise (RE) has been demonstrated to result in a myriad of benefits for individuals treated for cancer, including improvements in muscle mass, strength, physical function, and quality of life. Though this has resulted in the development of recommendations for RE in cancer management from various international governing bodies, there is also increasing recognition of the need to improve the design of RE interventions in oncology. The design and execution of RE trials are notoriously complex, attempting to account for numerous cancer/treatment related symptoms/side effects.

Cirrhosis associated with increased complications and healthcare utilization following total shoulder arthroplasty.

Introduction: Cirrhosis is a known risk factor for morbidity and mortality following surgical procedures and has been associated with increased complications, hospital length of stay (LOS), and cost of admission following total joint arthroplasty. However, a paucity of literature exists evaluating the effect of cirrhosis on postoperative outcomes following total shoulder arthroplasty (TSA). The purpose of this study is to evaluate the short-term outcomes following elective primary TSA in patients with cirrhosis compared to matched controls.

Association Between Emotional Intimate Partner Violence Around the Time of Pregnancy and Postpartum Contraceptive Use: Results from the Pregnancy Risk Assessment Monitoring System 2016-2021.

This study assessed the relationships between emotional intimate partner violence (IPV) before, during, and after pregnancy and postpartum contraceptive use. We used 2016-2021 Pregnancy Risk Assessment Monitoring System data from seven sites ( = 30,125). We used multivariable logistic regression to assess indicators of emotional IPV and provider counseling associated with postpartum contraceptive use.