Elevated Levels of Serum Alpha-2-Macroglobulin Associate with Diabetes Status and Incident Cardiovascular Disease in Type 1 Diabetes.

Background: Atherosclerotic cardiovascular disease (CVD) is a major cause of death in individuals with type 1 diabetes mellitus (T1DM). However, conventional risk factors do not fully account for the increased risk. This study aimed to investigate whether serum proteins associate with diabetes status and the occurrence of CVD in T1DM.

Proton Beam Therapy for Pancreatic Tumors: A Consensus Statement from the Particle Therapy Cooperative Group Gastrointestinal Subcommittee.

Objectives: Radiotherapy manages pancreatic cancer in various settings; however, the proximity of gastrointestinal (GI) luminal organs-at-risk (OAR) poses challenges to conventional radiotherapy. Proton beam therapy (PBT) may reduce toxicities compared to photon therapy. This consensus statement summarizes PBT's safe and optimal delivery for pancreatic tumors.

Trends in use of tobacco and cannabis across different alcohol consumption levels in the United States, 2010-19.

Aims: People often drink alcohol and use other substances concurrently, increasing the risk of adverse health outcomes. Our aims were to: (i) assess temporal trends in tobacco and/or cannabis use by varying alcohol consumption levels and (ii) identify associated factors of polysubstance use in high-risk alcohol users.

Methods: We conducted a repeated cross-sectional study combining 2010-19 U.

Target product profile for cell-based and gene-based therapies to achieve a cure for HIV.

This target product profile (TPP) highlights the minimal and optimal characteristics for ex-vivo and in-vivo cell and gene therapy-based products aimed at achieving an HIV cure (ie, durable antiretroviral-free viral control). The need for an effective, safe, scalable, affordable, accessible, and acceptable cure for HIV infection remains a major global priority. The possibilities for cell and gene therapy-based products for an HIV cure are rapidly expanding.

Assessing the Impact of Multidisciplinary Cancer Consultations on Cancer Quality Metrics.

Objective: Multidisciplinary cancer consultations play a critical role in the delivery of quality cancer care by promoting treatment planning and collaborative decision-making. The objective of this study was to evaluate associations between multidisciplinary cancer consultations and receipt of guideline-recommended adjuvant treatments among breast, colorectal, or non-small cell lung cancer patients and assess these associations between and within racial and ethnic groups.

Methods: This is a population-based retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER), Medicare-linked data (2006-2016) to identify Medicare beneficiaries diagnosed with nonmetastatic breast, colorectal, or non-small cell lung cancer.

A Survey of Forensic Pathologists Regarding Medicolegal Investigation of Perinatal and Stillborn Deaths.

Stillborn and perinatal deaths may be referred to medical examiners and coroners for investigation and determination of cause and/or manner of death. One of the key questions is determining a live birth from a stillbirth. We surveyed 147 forensic pathologists to assess their investigative practices for these deaths and for their ability to diagnose a live birth and a stillbirth.

Executive Summary of the American Radium Society Appropriate Use Criteria: Regional Nodal Irradiation for Breast Cancer.

Objectives: Recent literature has provided additional data to further individualize treatment recommendations on regional nodal irradiation (RNI) patient selection and delivery techniques, but controversies surrounding optimal RNI utilization remain, including radiation technique, modality selection, and internal mammary lymph node (IMN) inclusion. The American Radium Society (ARS) Breast Appropriate Use Criteria (AUC) Committee performed a systematic review and developed a consensus guideline to summarize recent data and provide evidence-based recommendations.

Methods: A multidisciplinary panel comprised of 15 members representing radiation oncologists, medical oncologists, and surgical oncologists specializing in the treatment of breast cancer conducted an analysis of the medical literature from January 1, 2011 to April 1, 2024.

Detecting Xe in an atmospheric tracer experiment.

The Xcounts algorithm for calculating air concentrations of radioactive xenon isotopes (Eslinger et al., 2023) has been extended to estimate Xe in addition to Xe, Xe, Xe, and Xe. The algorithm was applied to 119 samples collected with a SAUNA Q system (Ringbom et al.

Examining the Emotional and Physical Health Impact in Users of Open-Source Automated Insulin Delivery and Sources of Support: Qualitative Analysis of Patient Narratives.

Background: Although commercially developed automated insulin delivery (AID) systems have recently been approved and become available in a limited number of countries, they are not universally available, accessible, or affordable. Therefore, open-source AID systems, cocreated by an online community of people with diabetes and their families behind the hashtag #WeAreNotWaiting, have become increasingly popular.

Objective: This study focused on examining the lived experiences, physical and emotional health implications of people with diabetes following the initiation of open-source AID systems, their perceived challenges, and their sources of support, which have not been explored in the existing literature.

Trastuzumab Plus Pertuzumab Versus Cetuximab Plus Irinotecan in Patients With Wild-Type, HER2-Positive, Metastatic Colorectal Cancer (S1613): A Randomized Phase II Trial.

Purpose: overexpression/amplification in wild-type (WT) metastatic colorectal cancer (mCRC; human epidermal growth factor receptor 2 [HER2]-positive mCRC) appears to be associated with limited benefit from anti-EGFR antibodies and promising responses to dual-HER2 inhibition; however, comparative efficacy has not been investigated. We conducted a randomized phase II trial to evaluate efficacy and safety of dual-HER2 inhibition against standard-of-care anti-EGFR antibody-based therapy as second/third-line treatment in HER2-positive mCRC.

Methods: Patients with -WT mCRC after central confirmation of HER2 positivity (immunohistochemistry 3+ or 2+ and in situ hybridization amplified [HER2/CEP17 ratio >2.

A Core Outcome Set for Adult General ICU Patients.

Objectives: Randomized clinical trials informing clinical practice (e.g., like large, pragmatic, and late-phase trials) should ideally mostly use harmonized outcomes that are important to patients, family members, clinicians, and researchers.

Reconciling Archean organic-rich mudrocks with low primary productivity before the Great Oxygenation Event.

The organic carbon content of ancient rocks provides a fundamental record of the biosphere on early Earth. For over 50 y, the high organic content of Archean (>2.5 Ga) mudrocks has puzzled geologists and evolutionary biologists, because high biological primary productivity was unexpected for the nascent biosphere before the rise of O.

Nurse Experiences in an Electronic Health Record Transition: A Mixed Methods Analysis.

Transitions from one EHR to another can be enormously disruptive to care. Nurses are the largest group of EHR users, but nurse experiences with EHR transitions have not been well documented. We sought to understand nurse experiences with an EHR transition at the US Department of Veterans Affairs.

Influenza vaccine effectiveness against medically attended outpatient illness, United States, 2023-24 season.

Background: The 2023-24 U.S. influenza season was characterized by a predominance of A(H1N1)pdm09 virus circulation with co-circulation of A(H3N2) and B/Victoria viruses.

EUS-Guided Gastroenterostomy for Benign Gastric Outlet Obstruction: A Systematic Review and Meta-analysis.

Background And Aims: Gastric outlet obstruction (GOO) is a clinical manifestation of mechanical obstruction at the antropyloric region or proximal small bowel. The goal of endoscopic management is to relieve the obstruction so patients can resume per oral intake. Most studies have focused on malignant causes of GOO; yet only a handful have explored outcomes related to benign etiologies.

Reliability of consumer applied wearable sensor for kinematic and kinetic analysis of overhand pitching.

The PULSE workload monitor (PULSE) is a commercially available, wearable device that assesses upper extremity kinematics and kinetics during overhand pitching with three metrics to improve pitching performance. The purpose of this study was to determine the inter-tester and intra-tester reliability of the PULSE metrics when applied by a lay consumer versus trained researcher. A total of 14 healthy, adult male (age: 44.

Comparing predictive risk to actual presence of coronary atherosclerosis on coronary computed tomography angiography.

Background: There is limited data showing the predictive accuracy of traditional cardiovascular risk scores (CVRS) to predict asymptomatic coronary artery disease (CAD) determined by coronary computed tomography angiography (CCTA).

Methods: Asymptomatic individuals without known CAD undergoing a screening CCTA and sufficient data to calculate their CVRS, were extracted retrospectively. Atherosclerosis was extracted using natural language processing of the CCTA report, including the coronary artery calcium score (CACS) and the extent and severity of CAD.

Inter-city movement pattern of notifiable infectious diseases in China: a social network analysis.

Background: Co-existence of efficient transportation networks and geographic imbalance of medical resources greatly facilitated inter-city migration of patients of infectious diseases in China.

Methods: To characterize the migration patterns of major notifiable infectious diseases (NIDs) during 2016-2020 in China, we collected migratory cases, who had illness onset in one city but were diagnosed and reported in another, from the National Notifiable Infectious Disease Reporting System, and conducted a nationwide network analysis of migratory cases of major NIDs at the city (prefecture) level.

Findings: In total, 2,674,892 migratory cases of NIDs were reported in China during 2016-2020.

Diffusion weighted imaging for improving the diagnostic performance of screening breast MRI: impact of apparent diffusion coefficient quantitation methods and cutoffs.

Introduction: Diffusion weighted MRI (DWI) has emerged as a promising adjunct to reduce unnecessary biopsies prompted by breast MRI through use of apparent diffusion coefficient (ADC) measures. The purpose of this study was to investigate the effects of different lesion ADC measurement approaches and ADC cutoffs on the diagnostic performance of breast DWI in a high-risk MRI screening cohort to identify the optimal approach for clinical incorporation.

Methods: Consecutive screening breast MRI examinations (August 2014-Dec 2018) that prompted a biopsy for a suspicious breast lesion (BI-RADS 4 or 5) were retrospectively evaluated.

Modeling lake conductivity in the contiguous United States using spatial indexing for big spatial data.

Conductivity is an important indicator of the health of aquatic ecosystems. We model large amounts of lake conductivity data collected as part of the United States Environmental Protection Agency's National Lakes Assessment using spatial indexing, a flexible and efficient approach to fitting spatial statistical models to big data sets. Spatial indexing is capable of accommodating various spatial covariance structures as well as features like random effects, geometric anisotropy, partition factors, and non-Euclidean topologies.

Integrating Disability Education into the Preclinical Neurology Curriculum.

Medical school curricula often lack specific disability educational content. This project, driven by medical students, identified specific disability-centered educational learning points that could be integrated into existing preclinical neurology content as part of an integrated disability curriculum.

Beyond continuous positive airway pressure for cardiovascular risk reduction in patients with obstructive sleep apnea.

An accumulating body of evidence suggests a bidirectional relationship between sleep and cardiovascular (CV) health. A high level of evidence has linked obstructive sleep apnea (OSA) with cardiovascular disease (CVD). Accordingly, clinical sleep medicine emphasizes the diagnosis and treatment of OSA in the context of promoting CV health.

Feasibility and psychometric quality of smartphone administered cognitive ecological momentary assessments in women with metastatic breast cancer.

Objective: Metastatic breast cancer (MBC) is associated with burdensome side effects, including cognitive changes that require ongoing monitoring. Cognitive ecological momentary assessments (EMAs) allow for assessment of individual cognitive functioning in natural environments and can be administered via smartphones. Accordingly, we sought to establish the feasibility, reliability, and validity of a commercially available cognitive EMA platform.

"Equity" in genomic health policies: a review of policies in the international arena.

Introduction: The field of genomics is rapidly evolving and has made significant impact on the diagnosis and understanding of rare and genetic diseases, in guiding precision medicine in cancer treatment, and in providing personalized risk assessment for disease development and treatment responses. However, according to the literature, there is widespread socio economic and racial inequities in the diagnosis, treatment, and in the use of genomic medicine services. This policy review sets out to explore the concept of equity in access to genomic care, the level of inclusion of equity and how it is addressed and what mechanisms are in place to achieve equity in genomic care in the international health policy.

Validation and Utility of Drug-Nutrient Interaction and Dietary Supplement Mechanistic Activity in the Natural Medicines Database.

Purpose: The increasing use of dietary supplements by patients with cancer and other chronic diseases requires the systematized review of potential interactions between prescription drugs and nutrients from supplements by health care and clinical research teams. Dietary supplement interaction databases are positioned to fill a gap in quantifying potential risks for patients, although none have been assessed for reliability in data interpretation. The NatMed database, a source for comprehensive reports on mechanistic and safety data for dietary supplement ingredients, was evaluated for use in future investigations.