Blunted Reward Prediction Error Encoding Drives Diminished Motivation to Explore in Apathy Associated With Traumatic Brain Injury.

Clinical apathy might result from either a diminished willingness to exert effort for known rewards or from reduced motivation to explore potentially beneficial future opportunities. To identify the underlying cognitive and neural bases of apathy, we used task-based fMRI to examine motivated choice computations in patients with chronic traumatic brain injury (TBI)-a condition frequently associated with apathy-and compared their behavior and neural activity to that of healthy controls (CTRLs). Participants performed two choice tasks involving distinct types of motivational tradeoffs: i) An effort-value tradeoff task (the 'Apples Task') requiring them to decide how much physical effort they were willing to exert for varying reward magnitudes, and ii) An explore-exploit tradeoff task (the 'Novelty-Bandit Task') requiring them to choose between exploiting options with a known history of reward or exploring novel options with uncertain but potentially higher future value.

Genetically proxied blood pressure, vascular brain injury, and Alzheimer's disease pathology.

Introduction: Lower blood pressure (BP) is linked to reduced dementia risk, though it is uncertain whether this benefit stems solely from mitigating vascular brain injury (VBI) or also extends to directly influencing Alzheimer's disease (AD) pathology. We leveraged Mendelian randomization (MR) to assess whether lifelong lower BP is causally associated with neuropathological correlates of VBI and AD.

Methods: We identified genetic proxies for systolic and diastolic BP (n = 1,028,980) and applied them in MR analyses of post mortem neuropathological measures of VBI and AD (n = 6363-7786).

Long-term mortality rates in patients with proximal humerus fracture managed acutely with reverse shoulder arthroplasty and hemiarthroplasty.

Background: Proximal humerus fractures (PHFs) are common in the elderly, often requiring acute arthroplasty, such as reverse shoulder arthroplasty (RSA) or hemiarthroplasty (HA). Understanding long-term mortality trends in these patients is crucial for improving care and informing health economic analyses.

Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry (2004-2022) were analysed.

Molecular and clinical spectrum of epilepsy-dyskinesia syndromes: a cross-sectional study of 609 patients.

Epilepsy-dyskinesia syndromes (EDS) are a complex group of neurogenetic disorders characterized by the co-occurrence of epilepsy and movement disorders. Despite their increasing clinical recognition, the molecular and clinical spectrum of EDS remain poorly understood. While numerous genetic etiologies have been implicated, systematic characterization across diverse populations is lacking.

Hepatitis C Treatment Outcomes for Patients With Infective Endocarditis Treated by an Interdisciplinary Team.

Background: Patients with endocarditis often have comorbid injection substance use and are at risk for hepatitis C virus (HCV) infection. This population may encounter several significant barriers to treatment. To improve access to treatment, we developed an interdisciplinary collaboration between specialty pharmacy and the University of Kentucky endocarditis team and conducted a retrospective study evaluating treatment outcomes.