Critical Care Physicians' Perspectives on Nudging in Communication.

Importance: Research in behavioral economics has demonstrated that people have irrational biases, which make them susceptible to decisional shortcuts, or heuristics. The extent to which physicians consciously might use nudges to exploit these heuristics and thereby influence their patients' decision-making is unclear. In addition, ethical questions about the conscious use of nudges in medicine persist, yet little is known about how physicians experience and perceive their use.

Comparative Safety of JAK Inhibitors vs TNF Antagonists in Immune-Mediated Inflammatory Diseases: A Systematic Review and Meta-Analysis.

Importance: Janus kinase (JAK) inhibitors are highly effective medications for several immune-mediated inflammatory diseases (IMIDs). However, safety concerns have led to regulatory restrictions.

Objective: To compare the risk of adverse events with JAK inhibitors vs tumor necrosis factor (TNF) antagonists in patients with IMIDs in head-to-head comparative effectiveness studies.

Vasculogenic potential of adipose tissue derived stem cells from patients with chronic spinal cord injury and pressure injuries.

Limited vascularization and ischemia are major contributors to the chronicity of wounds, such as ulcers and traumatic injuries, which impose significant medical, social, and economic burdens. These challenges are particularly pronounced in patients with spinal cord injury (SCI), a disabling condition associated with vascular dysfunction, infections, and impaired peripheral circulation, complicating the treatment of pressure injuries (PIs) and the success of reconstructive procedures like grafts and flaps. Regenerative medicine aims to address these issues by identifying effective cellular therapies to restore vascular beds.

Investigating the mechanisms of indocyanine green tumour uptake in sarcoma cell lines and ex vivo human tissue.

Indocyanine green (ICG) is a well-established near-infrared dye which has been used clinically for several decades. Recently, it has been utilised for fluorescence-guided surgery in a range of solid cancer types, including sarcoma, with the aim of reducing the positive margin rate. The increased uptake and retention of ICG within tumours, compared with normal tissue, gives surgeons a visual reference to aid resection when viewed through a near-infrared camera.

Ultrasonographic assessment of bypass capacity after revascularization surgery in moyamoya disease: a systematic review and single-arm meta-analysis.

Purpose: Moyamoya disease (MMD) is a chronic cerebrovascular disorder characterized by progressive arterial stenosis and fragile collateral formation, elevating stroke risk. Revascularization is the standard treatment, yet up to 27% of patients experience ischemic events within a year due to bypass insufficiency. While digital subtraction angiography (DSA) remains the gold standard for assessing bypass function, it is invasive and time-consuming.

The predictive value of the orientation and offset of angle α and angle κ for visual outcomes after trifocal intraocular lens implantation in an Asian cohort.

Purpose: To evaluate the predictive value of the preoperative orientation and offset of angle alpha(chord alpha) and angle kappa(chord mu) for visual outcomes in patients who underwent trifocal intraocular lens (IOL) implantation.

Methods: Patient records of eyes that underwent AT LISA tri 839MP implantation were retrospectively collected and grouped according to the preoperative offset and orientations of chord alpha and chord mu. The two-dimensional location of each angle was described by the interaction of the orientation and offset.

Water hardness and digestive diseases: a large-scale population-based prospective cohort study.

Background: Water hardness, which refers to the level of dissolved calcium and magnesium salts, is of significant public health concern due to its potential impact on health. The association between water hardness and digestive diseases remains underexplored, with limited evidence from small-scale clinical studies. Given the rising prevalence of digestive disorders worldwide, large-scale cohort studies are needed to address this gap in the literature.

Human cytomegalovirus infection coopts chromatin organization to diminish TEAD1 transcription factor activity.

Human cytomegalovirus (HCMV) infects up to 80% of the world's population. Here, we show that HCMV infection leads to widespread changes in human chromatin accessibility and chromatin looping, with hundreds of thousands of genomic regions affected 48 hr after infection. Integrative analyses reveal HCMV-induced perturbation of Hippo signaling through drastic reduction of TEAD1 transcription factor activity.

Composite endpoints in health technology assessment: part 2 - expanding the evidence base with a framework for best modeling practice.

The first paper of this two-part series critically examined the role of composite endpoints in health technology assessments (HTAs) and outlined strategies for determining whether to employ the composite estimate of treatment effect or disaggregate into the component endpoints of the composite and apply separate treatment effects within a modeling framework. In this second paper, we expand the discussion beyond a pivotal trial and consider the way in which additional evidence from the same indication for different drugs in the same class, or the same drug for different indications, could be employed within HTAs. We offer a continuation of the case study of dapagliflozin for the treatment of heart failure with preserved or mildly reduced ejection fraction, where the evidence base was expanded to consider empagliflozin for the same indication, as well as both dapagliflozin and empagliflozin for heart failure with reduced ejection fraction.

Composite endpoints in health technology assessment: Part 1 - an illustration of best modeling practice.

Composite endpoints amalgamate multiple clinical outcomes into a single measure, offering efficiency gains in clinical trials through increased event rates and reduced sample sizes, thus accelerating clinical development and regulatory approval. However, employing composite endpoints introduces complexities into health technology assessments (HTAs), particularly in economic modeling, due to the varying clinical significance and cost implications of the components. In this paper, we explore best modeling practice for HTAs that are based on clinical trials that employ composite endpoints.

Epidemiology, pathophysiology, diagnosis and management of atrial functional mitral regurgitation: An expert opinion paper.

Atrial functional mitral regurgitation (AFMR) is an increasingly recognized subtype of mitral regurgitation, characterized by left atrial remodelling and mitral annular dilation in the absence of primary mitral valve disease or left ventricular dysfunction. Closely linked to chronic atrial fibrillation and heart failure with preserved ejection fraction, AFMR is associated with poor clinical outcomes and represents a growing therapeutic challenge. This expert opinion paper summarizes current evidence on the epidemiology, pathophysiology, diagnosis and management strategies, including medical therapy and emerging data supporting surgical and transcatheter interventions in selected patients.

Genome sequencing reveals the impact of pseudoexons in rare genetic disease.

Purpose: Advancements in sequencing technologies have significantly improved clinical genetic testing, yet the diagnostic yield remains around 30-40%. Emerging technologies are now being deployed to address the remaining diagnostic gap.

Methods: We tested whether short-read genome sequencing could increase the diagnostic yield in individuals enrolled into the UCI-GREGoR research study, who had suspected Mendelian conditions and prior inconclusive testing.

Systematic analyses uncover plasma proteins linked to incident cardiovascular diseases.

Cardiovascular disease (CVD) research is hindered by limited comprehensive analyses of plasma proteome across disease subtypes. Here, we systematically investigated the associations between plasma proteins and cardiovascular outcomes in 53,026 UK Biobank participants over a 14-year follow-up. Association analyses identified 3,089 significant associations involving 892 unique protein analytes across 13 CVD outcomes.

Modeling Musculoskeletal Combat Casualty Care: NATO Trauma System Performance in Large Scale Combat Operations.

Background: It is unclear whether the current North Atlantic Treaty Organization (NATO) trauma system will be effective in the setting of Large-Scale Combat Operations (LSCO). We sought to model the efficacy of the NATO trauma system in the setting of LSCO. We also intended to model novel scenarios that could better adapt the current system to LSCO.

Anterior-posterior and medial-lateral balance metrics are unchanged when two-dimensional pseudorandom motion perturbations are provided in semicircular canal coordinates.

Introduction: External continuous perturbations using a motion platform have been developed by employing either sum-of-sines (SoS) or a pseudorandom ternary sequence (PRTS) of numbers to quantify body sway evoked in the medial-lateral (ML) or anterior-posterior (AP) directions, which ultimately helps understand the human postural control system. These stimuli have been provided via pitch tilts of the motion platform for evaluations of AP balance responses or roll tilts for ML balance responses. However, little is known about whether a healthy postural control system responds to 2-dimensional (2D) perturbations similarly when the perturbation stimuli are provided in semicircular canal coordinates (i.

Call to action: recognize and prevent the effects of extreme heat on early childhood development and health.

The frequency and severity of heat waves are expected to worsen with climate change. Exposure to extreme heat, or prolonged unusually high temperatures, are associated with increased morbidity and mortality. The fetus, infant, and young child are more sensitive to higher temperatures than older children and most adults given that they are rapidly developing.

Prenatal environmental risk for adolescent attention, thought, and substance use problems: A mixtures approach to coexposure and psychiatric comorbidities.

Background: Prospective studies suggest that prenatal exposure to chemical neurotoxicants and maternal stress increase risk for psychiatric problems. However, most studies have focused on childhood outcomes, leaving adolescence-a critical period for the emergence or worsening of psychiatric symptoms-relatively understudied. The complexity of prenatal coexposures and adolescent psychiatric comorbidities, particularly among structurally marginalized populations with high exposure burdens, remains poorly understood.

Don't know much about geography? Decision support for the evaluation of patients with suspected high consequence infectious diseases.

EvalHCID is a clinical decision support system integrating outbreak intelligence, symptom onset, and epidemiologic risk factors to identify high consequence infectious diseases (HCIDs) (eg, Ebola). Tested among 20 emergency department (ED) providers, it significantly reduced assessment time, lowered misclassification, and scored "excellent" usability. EvalHCID may improve institutional preparedness and patient outcomes for emerging infectious disease threats.

Individual, Social and Environmental Influences on Sleep in Latino Pre-Adolescents: A Qualitative Analysis.

A community-based qualitative study identified multilevel influences on sleep duration, quality, and timing in 10 to 12-year-old Latino pre-adolescents via 11 focus groups with 46 children and 15 interviews with parents. An iterative content analysis revealed three themes negatively and positively impacted sleep: (1) Individual-level; (2) Social-level; and (3) Environmental-level influences. At the individual level, use of technology (e.

Ensuring Biosecurity and Research Agility for Outbreak Response: A Researcher's Perspective on the Federal Nucleic Acid Screening Framework.

The Framework for Nucleic Acid Synthesis Screening (FNASS), introduced by the U.S. White House Office of Science and Technology Policy, establishes new biosecurity measures to address emerging concerns about the potential misuse of synthetic nucleic acid sequences.

Fostering Safety, Support, and Hope: A Qualitative Study of Multistakeholder Perspectives on Designing Health Care Services for Women Who Use Drugs in Seattle, Washington, 2023.

Background: Women who use drugs (WWUD) experience increasingly worse outcomes from drug use as compared to men. Additionally, transactional sex, unstable housing, and unmet needs may further complicate their ability to get needed health care. To inform the design of gender-based, mobile health services, we sought perspectives on health care service delivery from WWUD and health care and harm reduction professionals (HHRPs) in Seattle, WA.

Single-Cell and Plasma Proteomics Do Not Differentiate Patients With and Without SARS-CoV-2 Antigenemia in Convalescence in a Cohort of 100 Patients.

Plasma samples obtained approximately 3 ( = 100) and 12 months ( = 78) after acute SARS-CoV-2 infection were tested for S1, spike, and N antigens. There were no significant differences in plasma proteins or single-cell protein expression levels on immune cells between those with and without plasma antigen detected.

Are Sex-Specific Cutoffs Needed With a Next-Generation Urine Tenofovir Lateral Flow Assay for Antiretroviral Adherence Monitoring?

Accurate point-of-care tools are needed to detect early nonadherence to daily HIV regimens and support timely transitions to long-acting options. Emerging evidence suggests that females may require higher adherence than males to achieve equivalent protection. Our next-generation urine tenofovir assay showed high accuracy across sexes but lower urine drug levels among female participants.

How perceptual learning rewires brain connectivity: lessons from the visual system in a top-down perspective.

Neural circuits sculpt their structure and modify the strength of their connections to effectively adapt to the external stimuli throughout life. In response to practice and experience, the brain learns to distinguish previously undetectable stimulus features recurring in the external environment. The unconscious acquisition of improved perceptual abilities falls into a form of implicit learning known as perceptual learning.