An analysis of multilevel factor contributions to breast cancer screening inequities in an academic health system.

Background: Breast cancer screening (BCS) inequities are evident at national and local levels, and many health systems want to address these inequities, but may lack data about contributing factors. The objective of this study was to inform health system interventions through an exploratory analysis of potential multilevel contributors to BCS inequities using health system data.

Methods: The authors conducted a cross-sectional analysis within a large academic health system including 19,774 individuals who identified as Black (n = 1445) or White (n = 18,329) race and were eligible for BCS.

A novel method for expressing and purifying large quantities of functional and stable human voltage-gated proton channel (hH1).

Purifying membrane proteins has been the limiting step for studying their structure and function. The challenges of the process include the low expression levels in heterologous systems and the requirement for their biochemical stabilization in solution. The human voltage-gated proton channel (hH1) is a good example of that: the published protocols to express and purify hH1 produce low protein quantities at high costs, which is an issue for systematically characterizing its structure and function.

CaML: Chemistry-informed machine learning explains mutual changes between protein conformations and calcium ions in calcium-binding proteins using structural and topological features.

Proteins' flexibility is a feature in communicating changes in cell signaling instigated by binding with secondary messengers, such as calcium ions, associated with the coordination of muscle contraction, neurotransmitter release, and gene expression. When binding with the disordered parts of a protein, calcium ions must balance their charge states with the shape of calcium-binding proteins and their versatile pool of partners depending on the circumstances they transmit. Accurately determining the ionic charges of those ions is essential for understanding their role in such processes.

Progressive Approaches in Oncological Diagnosis and Surveillance: Real-Time Impedance-Based Techniques and Advanced Algorithms.

Cancer remains a formidable global health challenge, necessitating the development of innovative diagnostic techniques capable of early detection and differentiation of tumor/cancerous cells from their healthy counterparts. This review focuses on the confluence of advanced computational algorithms with noninvasive, label-free impedance-based biophysical methodologies-techniques that assess biological processes directly without the need for external markers or dyes. This review elucidates a diverse array of state-of-the-art impedance-based technologies, illuminating distinct electrical signatures inherent to cancer vs healthy tissues.

Cardio-renal effect of dapagliflozin and dapagliflozin- saxagliptin combination on CD34 + ve hematopoietic stem cells (HSCs) and podocyte specific markers in type 2 diabetes (T2DM) subjects: a randomized trial.

Introduction: Effects of Dapagliflozin (Dapa) and Dapagliflozin-Saxagliptin combination (Combo) was examined on peripheral blood derived CD34 + Hematopoetic Stem Cells (HSCs) as a cellular CVD biomarker. Both Dapa (a sodium-glucose co-transporter 2 or SGLT2, receptor inhibitor) and Saxagliptin (a Di-peptydl-peptidase-4 or DPP4 enzyme inhibitor) are commonly used type 2 diabetes mellitus or T2DM medications, however the benefit of using the combination has not been evaluated for cardio-renal risk assessment, in a real-life practice setting, compared to a placebo.

Hypothesis: We hypothesized that Dapa will improve the outcomes when compared to placebo and the Combo maybe even more beneficial.

Improved display and detection of small renal stones using photon-counting detector CT compared to conventional energy-integrating detector CT.

Purpose: To compare same-day photon-counting detector CT (PCD-CT) to conventional energy-integrating detector CT (EID-CT) for detection of small renal stones (≤ 3 mm).

Methods: Patients undergoing clinical dual-energy EID-CT for known or suspected stone disease underwent same-day research PCD-CT. Patients with greater than 10 stones and no visible stones under 3 mm were excluded.

Changes in the treatment and outcomes of different severities of neonatal hypoxic ischemic encephalopathy in California: a retrospective cohort study.

Objective: Evaluate the changes in management and outcomes of Californian infants with hypoxic ischemic encephalopathy (HIE).

Study Design: Infants with HIE were identified from a California administrative birth cohort using ICD codes and divided into two epochs, Epoch 1 (2010-2015) and Epoch 2 (2016-2019). Risk ratios (RR) for induced hypothermia (IH) in each epoch and their outcomes were calculated using log-linear regression.

Mucosal integrity and acid sensitivity predict proton pump inhibitor response in patients with heartburn and normal acid exposure.

Background: Patients with typical reflux symptoms and normal acid exposure time (AET) are classified as either reflux hypersensitivity (RH) or functional heartburn (FH), some of whom respond to proton pump inhibitors (PPIs). We determined if esophageal psychophysiological parameters predict PPI response in symptomatic RH and FH patients.

Methods: We prospectively recruited adults with heartburn diagnosed with RH or FH on 24-h impedance-pH monitoring off PPI.

Practice Advisory for Postoperative Pain Management of Thoracic Surgical Patients: Executive Summary: A Report by Society of Cardiovascular Anesthesiologists.

Patients after thoracic surgery experience significant pain that can disrupt normal respiratory mechanics, increase the risk of respiratory complications, and impair recovery. Poorly controlled postoperative pain can develop into persistent postoperative pain. In addition, using opioids for pain control in the thoracic surgical population makes them more susceptible to opioid-related side effects due to their pre-existing comorbidities.

Implications of an Individualized Resuscitation Strategy Using Continuous Rhythm and Physiologic Status Assessment During Ongoing CPR.

Background: Prior studies have proposed defibrillator biosignal algorithms which characterize cardiac arrest rhythm and physiologic status. We evaluated whether a novel, individualized resuscitation strategy that integrates multiple ECG and impedance-based algorithms could reduce CPR interruptions and better align rescuer actions with patient-specific physiology.

Methods: In a retrospective cohort of ventricular fibrillation out-of-hospital cardiac arrests, observed rescuer actions (rhythm analysis, shock delivery, pulse checks, and drug therapy) were compared to hypothetical actions recommended by the proposed individualized strategy.

Sleep variability and time to achieving pregnancy: findings from a pilot cohort study of women desiring pregnancy.

Objective: To determine whether chronodisruption is associated with achieving pregnancy.

Design: Pilot prospective cohort study.

Subjects: One hundred eighty-three women desiring pregnancy were recruited from the local community of an academic medical center located in the Midwest and provided sleep information between February 1, 2015, and November 30, 2017.

The Society of Thoracic Surgeons National Intermacs Database Risk Model for Durable Left Ventricular Assist Device Implantation.

Background: Statistical risk models for durable left ventricular assist device (LVAD) implantation inform candidate selection, quality improvement, and evaluation of provider performance. We developed a 90-day mortality risk model utilizing The Society of Thoracic Surgeons National Intermacs Database (STS Intermacs).

Methods: STS Intermacs was queried for primary durable LVAD implants from 1/ 2019 - 9/2023.

Consensus recommendations for measuring the impact of contraception on the menstrual cycle in contraceptive clinical trials.

Objective: We sought to develop consensus recommendations for measurement and analysis of data on contraceptive-induced menstrual changes (CIMCs) in contraceptive clinical trials. We built upon previous standardization efforts over the last 50 years and prioritized input from a variety of global experts and current regulatory authority guidance on patient-reported outcomes.

Study Design: We completed a formal consensus-building process with an interdisciplinary group of 57 experts from 30 organizations and 14 countries in five global regions who work across academia, nonprofit research organizations, the pharmaceutical industry, and funding agencies.

The International Association for the Study of Lung Cancer Staging Project: The Database and Proposal for the Revision of the Staging of Pulmonary Neuroendocrine Carcinoma in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer.

Introduction: Pulmonary high-grade neuroendocrine carcinoma (NEC) includes small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). The seventh and eighth editions of the TNM classification for lung cancer confirmed the applicability of this staging system for SCLC. With the proposal of N2 and M1c subcategories for the ninth edition classification, we assessed the applicability to NECs.

Pre-induction and post-discharge venous thromboembolism chemoprophylaxis should be considered in patients after major vascular open abdominal procedures.

Background: Venous thromboembolism (VTE) is a significant morbidity following major open abdominal surgery. While there are clear recommendations for perioperative and post-discharge VTE chemoprophylaxis in general surgery, guidance for vascular patients is unclear. We compared the incidence of VTE in vascular versus general surgery cases and then investigated the timing of VTE in vascular patients.

Ethical Challenges in Pediatric Medical Complexity: A Survey of Parents.

Objective: To understand parents' experiences of ethical challenges in the care of children with chronic and serious medical conditions and what resources they access for support.

Study Design: We recruited English-speaking parents of children with complex and serious medical conditions via family advocacy groups to complete an electronic survey from October 2022 through February 2023. We queried respondents' experiences with specific ethical challenges in the care of their child, whether their concerns persisted, and what resources they accessed.

Communication-efficient federated learning of temporal effects on opioid use disorder with data from distributed research networks.

Objective: To develop a distributed algorithm to fit multi-center Cox regression models with time-varying coefficients to facilitate privacy-preserving data integration across multiple health systems.

Materials And Methods: The Cox model with time-varying coefficients relaxes the proportional hazards assumption of the usual Cox model and is particularly useful to model time-to-event outcomes. We proposed a One-shot Distributed Algorithm to fit multi-center Cox regression models with Time varying coefficients (ODACT).

Trajectories and predictors of maternal eating behaviors across the first year postpartum: The role of women's childhood trauma in emotional, external and restraint eating.

The first year postpartum is a sensitive time for maternal eating behaviors including emotional, external and restrained eating, which have all been associated with negative health outcomes. Furthermore, among women with a history of trauma, the stress of the postpartum period and early parenting may replicate feelings of helplessness and overwhelm experienced during childhood trauma, which may further contribute to these eating behaviors. Although evidence has shown how mothers eat during this time has long-term implications for infants' eating and health, limited research has characterized eating trajectories and associations with women's history of childhood trauma exposure during this critical period.

Racial microaggressions in nursing: "We have a long way to go".

Background: Racism in nursing is a significant issue affecting patient safety, nurse well-being, and job performance.

Purpose: Explore racial microaggression experiences of registered nurses working in a children's hospital.

Methods: An exploratory, qualitative research design with in-depth interviews was used to collect data.

Overcoming Shifting Baselines: Paleo-Behaviour Reveals Industrial Revolution as Tipping Point.

Human activities have significantly altered coastal ecosystems worldwide. The phenomenon of shifting baselines syndrome (SBS) complicates our understanding of these changes, masking the true scale of human impacts. This study investigates the long-term ecological effects of anthropogenic activities on New Zealand's coastal ecosystems over 800 years using fish otolith microchemical profiling and dynamic time warping across an entire stock unit.

Faculty Perceptions on the Roles of Mentoring, Advising, and Coaching in an Anesthesiology Residency Program: Mixed Methods Study.

Background: Mentoring, advising, and coaching are essential components of resident education and professional development. Despite their importance, there is limited literature exploring how anesthesiology faculty perceive these practices and their role in supporting residents.

Objective: This study aims to investigate anesthesiology faculty perspectives on the significance, implantation strategies, and challenges associated with mentorship, advising, and coaching in resident education.

Behavior of simple closed ecological systems; lower nutrient concentrations allow longer persistence of grazer populations.

We expect to develop self-sustaining extraterrestrial colonies, and they will approach being closed ecological systems. Using simple closed ecosystems containing Daphnia magna, three species of algae, and microbes, we tested multiple conditions to study long-term organism survival, which is only possible with adequate nutrient recycling. Closed and open systems behaved differently from one another at high nitrate concentrations; in closed systems, the animals were dead by day 14; in open systems, the Daphnia populations persisted beyond 273 days.