Regulation and Compliance in Telemedicine: Viewpoint.

The US COVID-19 Public Health Emergency ended on May 11, 2023. Lawmakers and regulators extended some flexibilities while they deliberate effective long-term telemedicine policy. Here, we discuss critical challenges in telemedicine compliance and regulation grounded in scholarly literature and current events.

Genomic sequencing in diverse and underserved pediatric populations: parent perspectives on understanding, uncertainty, psychosocial impact, and personal utility of results.

Purpose: Limited evidence evaluates parents' perceptions of their child's clinical genomic sequencing (GS) results, particularly among individuals from medically underserved groups. Five Clinical Sequencing Evidence-Generating Research (CSER) consortium studies performed GS in children with suspected genetic conditions with high proportions of individuals from underserved groups to address this evidence gap.

Methods: Parents completed surveys of perceived understanding, personal utility, and test-related distress after GS result disclosure.

Focus Groups With Guatemalan Community Leaders About Barriers to Cervical Cancer Prevention and Control.

Cervical cancer is the leading cause of cancer-related death among Latin American women, including Guatemalans. This is troubling, given we have a vaccine, screening tool, and treatment for this preventable disease. Human papillomavirus (HPV) causes most cervical cancer.

Impact of mask wearing time on fluid consumption and physical activity during the COVID-19 pandemic.

Purpose: To examine the associations between mask-wearing on fluid consumption and physical activity behaviors during the COVID-19 pandemic.

Methods: 137 college students (female, 72.5%; age, 26 ± 9 y) completed a survey detailing their fluid intake, physical activity behaviors, and time spent wearing a mask throughout the day during the previous month in the Fall 2020 academic semester.

Receipt of medications for opioid use disorder among rural and urban veterans health administration patients.

Aim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD.

Methods: Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018-9/30/20.

Development of a Navigator-Delivered Health Insurance Education Program for Hispanic and Latine Communities.

Background: Equitable access to health care services for Hispanic and Latine populations requires that systems go beyond working to increase enrollment in health insurance but also addressing health insurance literacy-the knowledge, ability, and confidence to find and use health insurance.

Methods: In collaboration with a local health policy organization, individual interviews were conducted with Hispanic and Latine community members. Group engagement sessions were conducted with key professionals.

Gemcitabine-induced myositis in a patient with pancreatic cancer.

Gemcitabine, a cytosine analogue, is a cytotoxic agent commonly used in the treatment of patients with a variety of solid tumours, including non-small cell lung cancer, cholangiocarcinoma and breast, pancreatic, testicular and ovarian cancers. Although generally well-tolerated, several reports suggest that it can rarely cause myositis. We present a case of gemcitabine-induced myositis in a patient with pancreatic adenocarcinoma and review the literature on this topic.

Magnetic Resonance Acoustic Radiation Force Imaging (MR-ARFI).

This review covers the theoretical background, pulse sequence considerations, practical implementations, and multitudes of applications of magnetic resonance acoustic radiation force imaging (MR-ARFI) described to date. MR-ARFI is an approach to encode tissue displacement caused by the acoustic radiation force of a focused ultrasound field into the phase of a MR image. The displacement encoding is done with motion encoding gradients (MEG) which have traditionally been added to spin echo-type and gradient recalled echo-type pulse sequences.

Computational predictions of magnetic resonance acoustic radiation force imaging for breast cancer focused ultrasound therapy.

Purpose: In magnetic resonance-guided focused ultrasound (MRgFUS) breast therapies, the focal location must be characterized to guide successful treatment. Focal characterization is difficult because heterogeneous breast tissues introduce phase aberrations that blur and shift the focus and traditional guidance methods do not work in adipose tissues. The purpose of this work is to evaluate numerical simulations of MRgFUS that predict the focal location.

Phenotypic and fitness consequences of plasticity in the rhythmic replication of malaria parasites.

The environments that parasites experience within hosts change dramatically over 24 h. How rhythms shape host-parasite-vector interactions is poorly understood owing to the challenges of disentangling the roles of rhythms of multiple interacting species in the context of the complex lifecycles of parasites. Using canonical circadian clock-disrupted hosts, we probe the limits of flexibility in the rhythmic replication of malaria () parasites and quantify the consequences for fitness proxies of both parasite and host.

General Surgery Residents Competence and Autonomy in Core Vascular Surgery Procedures.

Objective: As vascular surgery has become increasingly sub-specialized, the scope of vascular care that general surgeons can be trained to provide has come into question. Thus, we sought to understand the competence and autonomy of general surgery residents (GSR) in core vascular surgery procedures.

Design: Three core operations in vascular surgery were identified: lower extremity (LE) amputations, arteriovenous fistula (AVF) creation, and LE embolectomy and thrombectomy (thromboembolectomy).

Does Resilience Change in Patients Undergoing Shoulder Surgery? A Retrospective Comparative Study Utilizing the Brief Resilience Scale.

Background: Resilience refers to the ability to adapt or recover from stress. There is increasing appreciation that it plays an important role in wholistic patient-centered care and may affect patient outcomes, including those of orthopaedic surgery. Despite being a focus of the current orthopaedic evidence, there is no strong understanding yet of whether resilience is a stable patient quality or a dynamic one that may be modified perioperatively to improve patient-reported outcome scores.

Pediatric relapsed/refractory ALK+ anaplastic large cell lymphoma treatment and outcomes in the targeted drug era.

Treatment options for patients with relapsed or refractory (R/R) anaplastic large cell lymphoma (ALCL) have increased in the era of targeted therapies such as brentuximab vedotin (BV) and Anaplastic Lymphoma Kinase (ALK) inhibitors. However, there is no standard treatment and limited published data evaluating their use. The goal of this retrospective study is to describe current real-world treatment and outcomes of pediatric, adolescent, and young adult patients with R/R ALK-positive ALCL.

Toxic Anterior Segment Syndrome: A 2012-2022 Update on the Most Common Causes.

Purpose: To identify trends in the reporting of toxic anterior segment syndrome (TASS) to the American Society of Cataract and Refractive Surgery (ASCRS) TASS Force from 2012-2022.

Setting: John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.

Prefrontal 5α-reductase 2 mediates male-specific acute stress response.

A key response to acute stress is the increased brain synthesis of the neurosteroid allopregnanolone (AP). Although the rate-limiting step of this reaction is catalyzed by 5α-reductase (5αR), the role of its two primary isoenzymes, 5αR1 and 5αR2, in stress reactivity remains unclear. Here, we found that acute stress led to increased levels of 5αR2, but not 5αR1, in the medial prefrontal cortex (mPFC) of male, but not female, rats.

High diversity of fungal ecological groups from ice-free pristine and disturbed areas in the Fildes Peninsula, King George Island, Antarctica.

Ice-free areas are habitats for most of Antarctica's terrestrial biodiversity. Although fungal communities are an important element of these habitats, knowledge of their assemblages and ecological functions is still limited. Herein, we investigated the diversity, composition, and ecological functionality of fungal communities inhabiting sediments from ice-free areas across pristine and anthropogenically impacted sites in the Fildes Peninsula on King George Island, Antarctica.

Sex Differences in Long COVID.

Importance: A substantial number of individuals worldwide experience long COVID, or post-COVID condition. Other postviral and autoimmune conditions have a female predominance, but whether the same is true for long COVID, especially within different subgroups, is uncertain.

Objective: To evaluate sex differences in the risk of developing long COVID among adults with SARS-CoV-2 infection.

Efficacy of a novel interstitial lung disease monitoring program in breast cancer patients undergoing treatment with trastuzumab-deruxtecan.

Purpose: Interstitial lung disease (ILD) is a well described and potentially fatal complication of trastuzumab-deruxtecan (T-DXd). It is currently unknown if specific monitoring is beneficial in the early detection of ILD in these patients. We describe the efficacy and feasibility of a novel ILD monitoring protocol in breast cancer patients treated with T-DXd at our institution.

Modular Synthesis of Anti-HER2 Dual-Drug Antibody-Drug Conjugates Demonstrating Improved Toxicity.

Antibodies have gained clinical success in the last two decades for the targeted delivery of highly toxic small molecule chemotherapeutics. Yet antibody-drug conjugates (ADCs) often fail in the clinic due to the development of resistance. The delivery of two mechanistically distinct small molecule drugs on one antibody is of increasing interest to overcome these challenges with single-drug ADCs.

HEalth-Related Quality of Life-Intervention in Survivors of Breast and Other Cancers Experiencing Cancer-Related Fatigue and Associated Cognitive Symptoms Using TraditionAL Chinese Medicine: The 'HERBAL' Trial.

Introduction: As pharmacological strategies remain limited for relieving fatigue and associated cognitive symptoms, integrative modalities such as traditional Chinese medicine (TCM) could be explored as therapeutic strategies in cancer survivors. Here, we evaluate and report the efficacy and safety of a TCM concoction, modified Xiang Bei Yang Rong Tang (XBYRT), on quality of life (QOL), cancer-related fatigue (CRF), and cognitive symptoms, compared to placebo.

Methods: In a single-centered, randomized, double-blinded, placebo-controlled pilot trial conducted from 2019 to 2022, fatigued cancer survivors ≥21 years old were recruited to receive the XBYRT intervention or placebo (5% diluted) once daily for the duration of 8 weeks.

Disentangling Effects of Vegetation Structure and Physiology on Land-Atmosphere Coupling.

Terrestrial vegetation is a key component of the Earth system, regulating the exchange of carbon, water, and energy between land and atmosphere. Vegetation affects soil moisture dynamics by absorbing and transpiring soil water, thus modulating land-atmosphere interactions. Moreover, changes in vegetation structure (e.