Medicaid Policy and Hepatitis C Treatment Among Rural People Who Use Drugs.

Background: Restrictive Medicaid policies regarding hepatitis C virus (HCV) treatment may exacerbate rural health care disparities for people who use drugs (PWUD). We assessed associations between Medicaid restrictions and HCV treatment among rural PWUD.

Methods: We compiled state-specific Medicaid treatment policies across 8 US rural sites in 10 states and merged these with participant survey data.

DNTT-mediated DNA Damage Response Drives Inotuzumab Ozogamicin Resistance in B-cell Acute Lymphoblastic Leukemia.

Inotuzumab Ozogamicin (InO) is an antibody-calicheamicin conjugate with striking efficacy in B-cell acute lymphoblastic leukemia (B-ALL). However, there is wide inter-patient variability in treatment response, and the genetic basis of this variation remains largely unknown. Using a genome-wide CRISPR screen, we discovered the loss of DNTT as a primary driver of InO resistance.

The Comparative Sufficiency of ChatGPT, Google Bard, and Bing AI in Answering Diagnosis, Treatment, and Prognosis Questions About Common Dermatological Diagnoses.

Our team explored the utility of unpaid versions of 3 artificial intelligence chatbots in offering patient-facing responses to questions about 5 common dermatological diagnoses, and highlighted the strengths and limitations of different artificial intelligence chatbots, while demonstrating how chatbots presented the most potential in tandem with dermatologists' diagnosis.

Cancer-related health behaviors during the COVID 19 pandemic in geographically diverse samples across the US.

Background: The COVID-19 pandemic involved business closures (e.g., gyms), social distancing policies, and prolonged stressful situations that may have impacted engagement in health behaviors.

Differences in anxiety, depression and pain experience among adults with chronic low back pain as a function of nicotine product use.

The landscape of nicotine use in the United States (US) has continued to evolve, with electronic cigarette use (hereafter e-cigarette) becoming more evident in recent years. Patterns of dual nicotine use, or using combustible nicotine in conjunction with e-cigarettes, may increase dependence on nicotine, continued exposure to toxins, and corresponding health risks. One of the most prevalent health problems related to nicotine use is the experience of chronic pain.

Impact of COVID-19 Public Health Measures on Antiretroviral Therapy Use Among Ugandans Living with HIV in Sero-Different Couples.

Antiretroviral therapy (ART) use and HIV suppression among people living with HIV (PLHIV) are critical for HIV control and prevention. Extreme restrictions on movement early during the COVID-19 pandemic in Uganda may have impeded the ability to initiate and sustain access to and use of ART. From our stepped-wedge cluster-randomized trial of an integrated PrEP and ART intervention for HIV-serodifferent couples at 12 ART clinics in Uganda, we identified participants who enrolled and had a 6-month post-ART initiation viral load measured before the beginning of the first COVID-19 lockdown (Period 1), participants whose enrollment and 6-month viral load measurement straddled pre-COVID and COVID lockdown times (Period 2), and participants whose enrollment and 6-month viral load were quantified entirely during COVID-19 (Period 3).

Commutability assessment of new standard reference materials (SRMs) for determining serum total 25-hydroxyvitamin D using ligand binding and liquid chromatography-tandem mass spectrometry (LC-MS/MS) assays.

Commutability is where the measurement response for a reference material (RM) is the same as for an individual patient sample with the same concentration of analyte measured using two or more measurement systems. Assessment of commutability is essential when the RM is used in a calibration hierarchy or to ensure that clinical measurements are comparable across different measurement procedures and at different times. The commutability of three new Standard Reference Materials (SRMs) for determining serum total 25-hydroxyvitamin D [25(OH)D], defined as the sum of 25-hydroxyvitamin D [25(OH)D] and 25-hydroxyvitamin D [25(OH)D], was assessed through an interlaboratory study.

Balancing Data Quality and Bias: Investigating Functional Connectivity Exclusions in the Adolescent Brain Cognitive Development℠ (ABCD Study) Across Quality Control Pathways.

Analysis of resting state fMRI (rs-fMRI) typically excludes images substantially degraded by subject motion. However, data quality, including degree of motion, relates to a broad set of participant characteristics, particularly in pediatric neuroimaging. Consequently, when planning quality control (QC) procedures researchers must balance data quality concerns against the possibility of biasing results by eliminating data.

Validation and performance of microvue sC5b-9 plus ELISA on the Dynex DS2 platform.

Background: The complement membrane attack complex involves C5b-mediated assembly of C6-C9 polymers to form pores in cell membranes during complement activation. Inactive complexes can become soluble C5b-9 (sC5b-9) when they bind to Protein S. Elevated sC5b-9 levels are associated with increased risk of hematopoietic stem cell transplant-associated thrombotic microangiopathy (TA-TMA), a serious condition which can be improved with eculizumab therapy.

Collaboration encourages innovation: setting new standards in wound care with the Wound Care Collaborative Community expert panel consensus Recommendations.

Background: The Wound Care Collaborative Community (WCCC) assesses shortcomings and unmet needs in wound care by partnering with key stakeholders, such as the National Institutes of Health, the US Food and Drug Administration (FDA), industry leaders, and expert health care providers and researchers, to advance the study of wound healing. Through this work, the WCCC has identified a few key barriers to innovation in wound care. The WCCC aims to accelerate the development of science-based, patient-centered solutions and address public policy challenges related to ensuring patients receive early access to innovative treatment options.

NXP800 activates the unfolded protein response, altering AR and E2F function to impact castration-resistant prostate cancer growth.

Purpose: Advanced prostate cancer (PCa) is invariably fatal with the androgen receptor (AR) being a major therapeutic target. AR signaling inhibitors have improved overall survival for men with advanced PCa, but treatment resistance is inevitable and includes reactivation of AR signaling. Novel therapeutic approaches targeting these mechanisms to block tumor growth is an urgent unmet clinical need.

Utility of word embeddings from large language models in medical diagnosis.

Objective: This study evaluates the utility of word embeddings, generated by large language models (LLMs), for medical diagnosis by comparing the semantic proximity of symptoms to their eponymic disease embedding ("eponymic condition") and the mean of all symptom embeddings associated with a disease ("ensemble mean").

Materials And Methods: Symptom data for 5 diagnostically challenging pediatric diseases-CHARGE syndrome, Cowden disease, POEMS syndrome, Rheumatic fever, and Tuberous sclerosis-were collected from PubMed. Using the Ada-002 embedding model, disease names and symptoms were translated into vector representations in a high-dimensional space.

Registry versus claims-based index dates for studies of cancer diagnosis in administrative data.

Purpose: Studies of healthcare encounters leading to cancer diagnosis have increased over recent years. While some studies examine healthcare utilization before the cancer registry date of diagnosis, relevant pre-diagnosis interactions are not always immediately prior to this date due to date abstraction guidelines. We evaluated agreement of a registry date with a claims-based index and examined Emergency Department (ED) involvement in cancer diagnosis as an example of possible pre-diagnostic healthcare misclassification that could arise from improper date choice.

CAGI6 ID panel challenge: assessment of phenotype and variant predictions in 415 children with neurodevelopmental disorders (NDDs).

The Genetics of Neurodevelopmental Disorders Lab in Padua provided a new intellectual disability (ID) Panel challenge for computational methods to predict patient phenotypes and their causal variants in the context of the Critical Assessment of the Genome Interpretation, 6th edition (CAGI6). Eight research teams submitted a total of 30 models to predict phenotypes based on the sequences of 74 genes (VCF format) in 415 pediatric patients affected by Neurodevelopmental Disorders (NDDs). NDDs are clinically and genetically heterogeneous conditions, with onset in infant age.

A dataset and benchmark for hospital course summarization with adapted large language models.

Objective: Brief hospital course (BHC) summaries are clinical documents that summarize a patient's hospital stay. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as synthesizing BHCs from clinical notes have not been shown. We introduce a novel preprocessed dataset, the MIMIC-IV-BHC, encapsulating clinical note and BHC pairs to adapt LLMs for BHC synthesis.

Phase 2 Open-Label Trial of Brentuximab Vedotin with Pembrolizumab in PD-1 Pretreated Metastatic Non-Small Cell Lung Cancer and Metastatic Cutaneous Melanoma.

Purpose: Brentuximab vedotin (BV) is hypothesized to selectively deplete T regulatory cells (Tregs) that express CD30 and re-sensitize tumors to anti-(PD-1) therapy. This study evaluated responses to BV+pembrolizumab post PD-1 and explored corresponding biomarkers.

Methods: 55 patients with metastatic non-small cell lung cancer (NSCLC) and 58 with metastatic cutaneous melanoma received ≥1 dose of BV+pembrolizumab.

Biomarkers.

Background: APOE genotype is the most important genetic risk factor for Alzheimer's disease (AD), but whether it affects the proteins associated with AD risk is unclear. Circulating proteins may reveal biology underlying pathologic processes.

Methods: We evaluated log2 standardized levels of 4979 proteins quantified using modified aptamer technology [SomaScan] in plasma from 2725 participants in the Cardiovascular Health Study who were free of dementia and stroke.

Biomarkers.

Background: CADASIL, linked to NOTCH3 variants, is a primary monogenic cause of vascular dementia, leading to vascular cognitive impairment and dementia (VCID) observable in early stages. The NIH-funded USA CADASIL Consortium aims to explore CADASIL's onset and progression in the USA, crucial due to varying phenotype-genotype associations globally. The consortium will identify biological and clinical markers across the disease spectrum, contributing to clinical trial preparations.

Public Health.

Background: The Adult Changes in Thought (ACT) study is an ongoing population-based prospective cohort study that began in 1994 and aims to identify risk and preventive factors for dementia. ACT randomly selects and enrolls Kaiser Permanente Washington (KPWA) health plan members age ≥ 65 years. Historically, the cohort make up has been 88% non-Hispanic White participants.

Public Health.

Background: There are 6.7 million people living with dementia in the United States, and this number is projected to increase as the population ages. The cost of informal care makes up a large proportion of the societal costs of dementia due to the significant care needs associated with the condition.

Public Health.

Background: Anticholinergic medication use has been found to be associated with higher dementia risk and cognitive decline in older adults. The presence of a biologic pathway through changes to white matter hyperintensities (WMH) remains unclear.

Method: We used the first clinically indicated magnetic resonance imaging (MRI) scan from each participant in the Adult Changes in Thought (ACT) Study-a prospective cohort study within Kaiser Permanente Washington (KPWA)-collected between January 2003 and March 2020 from participants ≥65 years old and with ≥10 years of continuous KPWA enrollment prior to the scan.

Public Health.

Background: Cancer diagnosis is related to poor short-term cognition, reflecting the condition, stress, and management. Less is known about long-term relationships between time since cancer diagnosis and cognition. We evaluated the association between recency of cancer diagnosis and cognition.

Public Health.

Background: Long-term exposure to ambient air pollution-including fine particulate matter <2.5µm in diameter (PM)-has previously been associated with incident dementia. As climate change drives longer and more intense wildfire seasons, exposure to PM produced by wildfires may be a unique and increasingly important risk factor for dementia.

Public Health.

Background: Asian Americans and Asian Canadians (ASACs) are the fastest growing minority group in the US and Canada. However, ASACs are under-sampled in Alzheimer's disease (AD) research. To address the need of culturally appropriate clinical protocols and community-based recruitment approaches for ASACs, the Asian Cohort for Alzheimer's Disease (ACAD), the first large dementia genetics cohort focusing on Chinese, Korean, and Vietnamese, launched in 2021 to examine genetic and non-genetic risk factors for AD among ASACs.

Public Health.

Background: The increasing incidence of cognitive impairment in older adults poses significant, complex challenges for patients and their families. While specialists have traditionally addressed this care, there is an urgent need to shift diagnosis and management of mild cognitive impairment (MCI) and dementia to primary care. The annual wellness visit for Medicare recipients provides an excellent opportunity for primary care providers (PCPs) to assess patients who may need a cognitive evaluation.