Supporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN): Study protocol for a type 2 hybrid effectiveness-implementation trial.

Background: Unhealthy substance use (USU) is common and ranges from use above guideline-recommended levels to severe substance use disorder. USU results in substantial morbidity and mortality yet primary care practices rarely systematically screen, diagnose, and treat USU. Supporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN) tests whether the implementation of a co-designed change package for USU improves patient function.

Long-Term Cognitive Outcomes in Adult Patients Receiving Chimeric Antigen Receptor T-Cell Therapies.

Background: CAR T-cell therapy (CAR-T) is leading to durable responses in patients with cancer but there is concern that cytokine release syndrome (CRS) and neurotoxicity may impact survivors' cognitive function. We assessed long-term cognitive function in CAR-T recipients and examine factors associated with change in cognition over time.

Methods: We assessed perceived cognition (Functional Assessment of Cancer Therapy - Cognition) and neurocognitive performance (standardized neuropsychological battery) in adult patients prior to receiving CAR-T and at 6 month follow-up.

A Comparison of Endoscopic and Surgical Gastrojejunostomy in Patients with Malignant Gastric Outlet Obstruction: A National Cohort Analysis (2016-2020).

Background And Aims: Malignant gastric outlet obstruction (MGOO) is an unfortunate complication of advanced upper gastrointestinal malignancies. Historically, surgical gastrojejunostomy has been the procedure of choice to achieve enteral bypass. Recently, endoscopic techniques have gained popularity in the management of MGOO.

First-in-human experience performing high-resolution cortical mapping using a novel microelectrode array containing 1,024 electrodes.

Localization of function within the brain and central nervous system is an essential aspect of clinical neuroscience. Classical descriptions of functional neuroanatomy provide a foundation for understanding the functional significance of identifiable anatomic structures. However, individuals exhibit substantial variation, particularly in the presence of disorders that alter tissue structure or impact function.

Vulnerability to natural disasters and sustainable consumption: Unraveling political and regional differences.

The urgent calls for action on climate change underscore the importance of increasing sustainable behavior among individuals who have traditionally veered away from it, such as those on the political right. Utilizing data from four geopolitical regions across 24 countries, we explore whether vulnerability to natural disasters, brought on by either experiencing or anticipating a natural disaster, is a crucial factor. We find that as vulnerability to natural disasters increases, sustainable consumption intentions significantly increase among rightists in Western Europe, Israel, and the United States.

Machine perfusion strategies in Liver Transplantation: A systematic review, pairwise, and network meta-analysis of randomized controlled trials.

Background: Machine perfusion (MP), including hypothermic oxygenated machine perfusion (HOPE), dual HOPE, normothermic machine perfusion (NMP), NMP ischemia-free liver transplantation (NMP-ILT), and controlled oxygenated rewarming (COR), is increasingly being investigated to improve liver graft quality from extended criteria donors and donors after circulatory death and expand the donor pool. This network meta-analysis investigates the comparative efficacy and safety of various liver MP strategies versus traditional static cold storage (SCS).

Methods: We searched PubMed, Scopus, Web of Science, and Cochrane Controlled Register of Trials for randomized controlled trials (RCTs) comparing liver transplantation (LT) outcomes between SCS and MP techniques.

"It's Like You're Feeding Your Child Twice": Barriers and Facilitators to Human Milk Feeding Children With Cystic Fibrosis.

Background: Cystic Fibrosis Foundation guidelines recommend human milk (HM) as the ideal source of nutrition for children with CF (cwCF). Despite known pulmonary and nutritional benefits, fewer cwCF ever receive HM compared to the general population. Early nutrition choices are preference-sensitive, yet little is known about the factors that impede or sustain HM feeding among parents of cwCF.

Functional independence trajectories over 5 years in older veterans with traumatic brain injury: A model systems study.

Background: Research on older adults who sustain a traumatic brain injury (TBI) has predominantly been on civilian, nonveteran populations. Military populations experience higher rates of TBI and often experience the additive effects of TBI and other comorbid disorders, including posttraumatic stress disorder and/or substance use that may increase disability over time.

Objective: To investigate predictors of functional independence trajectories over the 5 years after TBI in veterans 55 years or older at injury.

Recovery and Degradation Drive Changes in the Dispersal Capacity of Stream Macroinvertebrate Communities.

Freshwater ecosystems face significant threats, including pollution, habitat loss, invasive species, and climate change. To address these challenges, management strategies and restoration efforts have been broadly implemented. Across Europe, such efforts have resulted in overall improvements in freshwater biodiversity, but recovery has stalled or failed to occur in many localities, which may be partly caused by the limited dispersal capacity of many species.

Genetic Services in Appalachia Conference Series.

This study examined the data generated as part of a seven-session webinar series that focused on genetics care provision in the medically underserved, rural Appalachian region and examined how these services have adapted to challenging practice environments. Barriers and facilitators to care in our region were considered. Data included a baseline survey of registrants, transcripts of sessions, and feedback about sessions.

"No Matter the Age or Medical Complexity, People Benefit From That Intensity of Exercise": A Mixed-Methods Study Describing Rehabilitation Provider Perceptions of High-Intensity Resistance Training Among Veterans Receiving Post-Acute Care.

Background: In skilled nursing facilities (SNFs), i-STRONGER is a novel, high-intensity resistance training approach that incorporates progressive resistance training to promote greater improvements in patient function compared to usual care. To inform large-scale expansion of i-STRONGER as standard-of-care in SNFs, this mixed-methods study assessed rehabilitation providers' perceptions of i-STRONGER and purported needs for its adoption.

Methods: Forty-three rehabilitation providers participated in an 18-week, interactive i-STRONGER training program.

Predicting the impact of targeted fence removal on connectivity in a migratory ecosystem.

Fencing is one of the most widely utilized tools for reducing human-wildlife conflict in agricultural landscapes. However, the increasing global footprint of fencing exceeds millions of kilometers and has unintended consequences for wildlife, including habitat fragmentation, movement restriction, entanglement, and mortality. Here, we present a novel and quantitative approach to prioritize fence removal within historic migratory pathways of white-bearded wildebeest (Connochaetes taurinus) across Kenya's Greater Masai Mara Ecosystem.

Genomic clustering tendency of transcription factors reflects phase-separated transcriptional condensates at super-enhancers.

Many transcription factors (TFs) have been shown to bind to super-enhancers, forming transcriptional condensates to activate transcription in various cellular systems. However, the genomic and epigenomic determinants of phase-separated transcriptional condensate formation remain poorly understood. Questions regarding which TFs tend to associate with transcriptional condensates and what factors influence their association are largely unanswered.

Frailty in kidney transplant candidates: new therapeutic strategies to intervene.

Purpose Of Review: Patients that present with a physical frail phenotype have a higher risk of poor kidney transplant outcomes and are therefore less likely to be wait listed for a transplant. The physical frailty phonotype is more prevalent in older adults >65years with chronic and end stage kidney disease, thus partly contributing to inequitable access to transplant. Frailty can potentially be reversed by prehabilitation.

Initiation of primary T cell-B cell interactions and extrafollicular antibody responses in an organized microphysiological model of the human lymph node.

Antibody production is central to protection against new pathogens and cancers, as well as to certain forms of autoimmunity. Antibodies often originate in the lymph node (LN), specifically at the extrafollicular border of B cell follicles, where T and B lymphocytes physically interact to drive B cell maturation into antibody-secreting plasmablasts. In vitro models of this process are sorely needed to predict aspects of the human immune response.

From macro to micro: De novo genomes of Aedes mosquitoes enable comparative genomics among close and distant relatives.

The yellow fever mosquito () is an organism of high medical importance because it is the primary vector for diseases such as yellow fever, Zika, dengue, and chikungunya. Its medical importance has made it a subject of numerous efforts to understand their biology. One such effort, was the development of a high-quality reference genome (AaegL5).

Switch from eculizumab to satralizumab in aquaporin 4 immunoglobulin G-seropositive neuromyelitis optica spectrum disorder: a case series report.

Objectives: This case series describes adults with aquaporin 4 immunoglobulin G-seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorder (NMOSD) who switched treatment from eculizumab to satralizumab.

Methods: Case information for patients with AQP4-IgG+ NMOSD who received satralizumab for ≥6 months was obtained from US healthcare providers from April 2022 to January 2024. Patient characteristics, examination findings, diagnostic test results, treatment response, and adverse events were recorded.

Structure Characterization of a Disordered Peptide Using In-Droplet Hydrogen/Deuterium Exchange Mass Spectrometry and Molecular Dynamics.

In-droplet hydrogen/deuterium exchange (HDX)-mass spectrometry (MS) experiments have been conducted for peptides of highly varied conformational type. A new model is presented that combines the use of protection factors (PF) from molecular dynamics (MD) simulations with intrinsic HDX rates ( ) to obtain a structure-to-reactivity calibration curve. Using the model, the relationship of peptide structural flexibility and HDX reactivity for different peptides is elucidated.

Oral Contraceptive Use Is Associated with Significant Differences in MicroRNA Cargo of L1CAM-Associated Extracellular Vesicles.

Oral contraceptives (OCs) are approved for use after onset of menarche, which is well before brain maturation is complete. OC use may induce biochemical changes in the brain, especially during the neurobiologically dynamic adolescent/young adult years. MicroRNA cargo in L1CAM-associated extracellular vesicles was measured from serum samples collected from young women using the miRCURY LNA miRNA Focus PCR Panel (Qiagen) and validated using quantitative PCR.