A systematic review of evidence comparing spinal cord stimulation to sham or conservative medical management in the treatment of persistent spinal pain syndrome - Type 2.

Objective: To assess the effectiveness of dorsal column spinal cord stimulation (SCS) in treating persistent spinal pain syndrome - Type 2 (PSPS-T2).

Design: Systematic review.

Methods: PICOS (Population, Intervention, Comparison, Outcomes, and Studies) criteria were developed to include randomized controlled trials (RCTs) examining dorsal column stimulation for PSPS-T2 compared to conventional medical management or sham.

A Retrospective Comparative Study of Sex-Based Risk Variations in Heart Failure With Preserved Ejection Fraction (HFpEF) Versus Heart Failure With Reduced Ejection Fraction (HFrEF).

Introduction/objectives: The prevalence of heart failure (HF) in the United States is currently at an all-time high and is predicted to rise to 8.5 million by 2030. Development of HF differs between men and women.

State E-Cigarette Flavor Restrictions and Tobacco Product Use in Youths and Adults.

Importance: Seven states have policies restricting the sale of flavored e-cigarettes. Limited evidence exists regarding these policies' association with the use of tobacco products across age groups.

Objective: To evaluate associations of e-cigarette flavor restriction policies with e-cigarette and cigarette use by age group over multiple years.

Profound anaemia and thrombocytosis due to hidradenitis suppurativa.

This case presents a woman in her late 50s with hidradenitis suppurativa (HS) who presented for weight loss, syncope and dyspnoea. Labs revealed severe microcytic anaemia, thrombocytosis and leucocytosis. Despite initial uncertainties, further investigation pointed towards multifactorial anaemia suspected from iron deficiency and chronic inflammation associated with HS.

Analyzing the relationship between the social vulnerability index and 90-day elective lumbar fusion outcomes.

Background Context: The social vulnerability index (SVI) is a centers for disease control and prevention (CDC) census data tool to identify populations that are susceptible to hazards and health emergencies. Higher scores indicate more socioeconomic vulnerability. There is a scarcity of studies investigating the relationship of SVI on spine surgery outcomes.

Qualified Medicare Beneficiary Program: Enrollment Trends And Characteristics Of Low-Income Beneficiaries.

To address low take-up of Medicare Savings Programs for low-income Medicare beneficiaries, the Centers for Medicare and Medicaid Services issued regulations in 2023 aimed at streamlining the enrollment process. We analyzed 2016-22 data from the Medicare Current Beneficiary Survey to examine recent take-up of the largest and most generous Medicare Savings Program, the Qualified Medicare Beneficiary (QMB) program. We compared beneficiary characteristics and cost-related barriers to care among QMB enrollees and beneficiaries who were eligible but not enrolled.

Structural basis for target DNA cleavage and guide RNA processing by CRISPR-Casλ2.

RNA-guided CRISPR-Cas nucleases are widely used as versatile genome-engineering tools. Among the diverse CRISPR-Cas effectors, CRISPR-Casλ-also referred to as Cas12n-is a recently identified miniature type V nuclease encoded in phage genomes. Given its demonstrated nuclease activity in both mammalian and plant cells, Casλ has emerged as a promising candidate for genome-editing applications.

Initial Characterization of 12 New Subtypes and Variants of Type V CRISPR Systems.

Type V CRISPR systems are highly diverse in sequence, mechanism, and function. Although recent efforts have greatly expanded our understanding of their evolution, the diversity of type V systems remains to be completely explored, and many clades have not been experimentally characterized. In this work, we mined metagenomic databases to identify three new subtypes and nine new variants of Cas12, the effector of Type V systems, and provide experimental and computational characterization of their Protospacer-Adjacent Motif (PAM), interference activity, loci architecture, and tracrRNA dependence.

Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adults with neoplastic vertebral fractures.

Background Context: The North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Adults with Neoplastic Vertebral Fractures features evidence-based recommendations for diagnosing and treating adult patients with neoplastic vertebral fractures. The guideline is intended to reflect contemporary treatment concepts for neoplastic vertebral fractures as reflected in the highest quality clinical literature available on this subject as of October 2020.

Purpose: The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with neoplastic vertebral fractures.

Biomarker states and risk of death among individuals hospitalized with SARS-CoV-2 infection.

Background: Identifying individuals hospitalized for SARS-CoV-2 infection at increased risk of death is crucial for clinical decision making. Analyses must consider simultaneously the multitude of biomarkers across several domains and how these biomarker profiles change over time.

Methods: This electronic health records-based study included individuals hospitalized at a Massachusetts General Brigham hospital for at least 24 h within 5 days prior and 30 days after diagnosis of COVID-19.

Functional disability after clinically significant extracranial bleeding: a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) Trial.

Background: Clinically significant extracranial bleeding, defined as bleeding at any site other than the brain or spinal cord requiring either a hospital admission >24 hours, red blood cell transfusion, surgery for hemostasis, or resulting in death, is a common side effect of antithrombotic agents. Compared to intracranial bleeding, the impact of clinically significant extracranial bleeding on long-term outcomes, including functional independence, has been poorly studied.

Objectives: To determine if clinically significant extracranial bleeding impacts the development of functional disability in healthy older adults.

Application of an Electronic Frailty Index to Identify High-Risk Older Adults Using Electronic Health Record Data.

Background: Measurement of frailty is limited in clinical practice. Existing electronic frailty indices (eFIs) are derived from routine primary care encounters, with near-complete health condition capture. We aimed to develop an eFI from routinely collected clinical data and evaluate its performance in older adults without complete health condition capture.

Evaluating the Effectiveness of Epidural Steroid Injections in Relieving Pain in a Single-Center Retrospective Cohort.

Background Epidural steroid injections (ESIs) are a common conservative treatment for mitigating radicular pain and are often used to relieve pain, increase function, and improve mobility. However, their efficacy and duration of pain relief are relatively unclear because of the variability in clinical indications, injection techniques, injection mixtures, the number of allowable injections, and the lack of standard and objective outcome measures in the literature. Objectives This study aimed to characterize the effectiveness of ESIs in improving pain, measured with numerical rating scale (NRS) scores, and their relationship with subsequent lumbar spine surgery within a one-year period.

Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adults with osteoporotic vertebral compression fractures.

Background Context: The North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Adults with Osteoporotic Vertebral Compression Fractures features evidence-based recommendations for diagnosing and treating adult patients with osteoporotic vertebral compression fractures. The guideline is intended to reflect contemporary treatment concepts for osteoporotic vertebral compression fractures as reflected in the highest quality clinical literature available on this subject as of September 2020.

Purpose: The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with osteoporotic vertebral compression fractures.

County-Level Enrollment in Medicare Advantage Plans Offering Expanded Supplemental Benefits.

Importance: Since 2019 and 2020, Medicare Advantage (MA) plans have been able to offer supplemental benefits that address long-term services and supports (LTSS) and social determinants of health (SDOH).

Objective: To examine the temporal trends and geographic variation in enrollment in MA plans offering LTSS and SDOH benefits.

Design, Setting, And Participants: This cross-sectional study used publicly available data to examine changes in beneficiary enrollment and plan offerings of LTSS and SDOH benefits from the benefits data from the second quarter of each year and other data from April of each year except 2024, for which the first quarter was the latest for benefits data and January the latest for other data at the time of analysis.

Viral Vector Eluting Lenses for Single-Step Targeted Expression of Genetically-Encoded Activity Sensors for in Vivo Microendoscopic Calcium Imaging.

Optical methods for studying the brain offer powerful approaches for understanding how neural activity underlies complex behavior. These methods typically rely on genetically encoded sensors and actuators to monitor and control neural activity. For microendoscopic calcium imaging, injection of a virus followed by implantation of a lens probe is required to express a calcium sensor and enable optical access to the target brain region.

Tailored vs. General COVID-19 prevention for adults with mental disabilities residing in group homes: a randomized controlled effectiveness-implementation trial.

Background: People with serious mental illness (SMI) and people with intellectual disabilities/developmental disabilities (ID/DD) are at higher risk for COVID-19 and more severe outcomes. We compare a tailored versus general best practice COVID-19 prevention program in group homes (GHs) for people with SMI or ID/DD in Massachusetts (MA).

Methods: A hybrid effectiveness-implementation cluster randomized control trial compared a four-component implementation strategy (Tailored Best Practices: TBP) to dissemination of standard prevention guidelines (General Best-Practices: GBP) in GHs across six MA behavioral health agencies.

Predictors of COVID-19 infection and hospitalization in group homes for individuals with intellectual and/or developmental disabilities.

Background: More than seven million people with intellectual and/or developmental disabilities (ID/DD) live in the US and may face an elevated risk for COVID-19.

Objective: To identify correlates of COVID-19 and related hospitalizations among people with ID/DD in group homes in Massachusetts.

Methods: We collected data during March 1, 2020-June 30, 2020 (wave 1) and July 1, 2020-March 31, 2021 (wave 2) from the Massachusetts Department of Public Health and six organizations administering 206 group homes for 1035 residents with ID/DD.

Cardiovascular Risk Estimation Is Suboptimal in People With HIV.

Background: Established cardiovascular disease (CVD) risk prediction functions may not accurately predict CVD risk in people with HIV. We assessed the performance of 3 CVD risk prediction functions in 2 HIV cohorts.

Methods And Results: CVD risk scores were calculated in the Mass General Brigham and Kaiser Permanente Northern California HIV cohorts, using the American College of Cardiology/American Heart Association atherosclerotic CVD function, the FHS (Framingham Heart Study) hard coronary heart disease function and the Framingham Heart Study hard CVD function.

Assessing Management of Abnormal Cervical Cancer Screening Results and Concordance with Guideline Recommendations in Three US Healthcare Settings.

Background: Follow-up of abnormal results is essential to cervical cancer screening, but data on adherence to follow-up are limited. We describe patterns of follow-up after screening abnormalities and identify predictors of guideline-concordant follow-up.

Methods: We identified the index screening abnormality (positive human papillomavirus test or atypical squamous cells of undetermined significance or more severe cytology) among women of ages 25 to 65 years at three US healthcare systems during 2010 to 2019.

Brain MRI microbleeds and risk of intracranial hemorrhage in atrial fibrillation patients: A Swedish case-control study.

Objectives: Our goal was to quantify the independent association of brain microbleeds with future intracranial hemorrhage (ICrH). Microbleed findings on brain magnetic resonance imaging (MRI) may identify distinctive risk factors for ICrH which could inform the anticoagulant therapy decision for atrial fibrillation (AF) patients. Our study design includes patients with MRIs for numerous reasons, not limited to evaluation of stroke.

Associations Between Annual Medicare Part D Low-Income Subsidy Loss and Prescription Drug Spending and Use.

Importance: The Medicare Part D Low Income Subsidy (LIS) program provides millions of beneficiaries with drug plan premium and cost-sharing assistance. The extent to which LIS recipients experience subsidy losses with annual redetermination cycles and the resulting associations with prescription drug affordability and use are unknown.

Objective: To examine how frequently annual LIS benefits are lost among Medicare Part D beneficiaries and how this is associated with prescription drug use and out-of-pocket costs.

Leaders laughing in the line of fire: An emotional aperture perspective on leader laughter in response to critical questions.

Leaders are frequently put in the difficult position of repudiating critical questions in front of their followers. To help manage this situation, leaders sometimes express laughter in the hopes that it will "lubricate" their interaction and reduce perceptions that they are aggressive or confrontational with the critical questioner. Ironically, leaders' laughter may backfire by diminishing their apparent friendliness and approachability in the eyes of the witnessing followers.

Daily positive and negative affect during the COVID-19 pandemic.

The COVID-19 pandemic influenced emotional experiences globally. We examined daily positive and negative affect between May/June 2020 and February 2021 (N = 151,049; 3,509,982 observations) using a convenience sample from a national mobile application-based survey that asked for daily affect reports. Four questions were examined: (1) How did people in the United States feel from May/June 2020 to February 2021?; (2) What demographic variables are related to positive and negative affect?; (3) What is the relationship between experienced stressors and daily affect?; and (4) What is the relationship between daily affect and preventive behavior? Positive affect increased, and negative decreased over time.