Atomic-Scale Mechanistic Insights into the Ring-Opening Polymerization of Elemental Sulfur.

A detailed understanding of the composition and polymerization mechanism of elemental sulfur remains a decades long unresolved question for modern chemistry. However, the dynamic nature of molten sulfur significantly complicates its accurate characterization. To overcome this challenge, we performed the first comprehensive molecular dynamics (MD) simulations using a ReaxFF reactive force field specifically parameterized to capture the complex ring-opening polymerization dynamics of elemental sulfur.

Building A Pharmacy Preceptor Development Framework for Nurturing Learner Professional Identity Formation.

Objectives: To explore experiential education (EE) and preceptor development experts' perceptions of priorities for preceptor development aimed at supporting learner professional identity formation (PIF) and create a framework for preceptor development to inform future preceptor training programs.

Methods: This multi-component study involved: 1) conducting virtual focus groups of EE and preceptor development experts to explore perceived preceptor development needs, including content and learning outcomes, 2) utilizing a modified nominal group technique (NGT) to identify priorities for preceptor development and 3) creating a preceptor development framework for supporting learner PIF. Transcripts were analyzed to identify specific content areas of focus and practical program insights.

Incidence of long COVID among U.S. children and adults during the omicron era - Tracking Post-COVID Conditions (Track-PCC) network, 2022-2023.

Background: Long COVID, or Post-COVID Conditions (PCC), refers to new and persisting sequelae occurring in the months following an acute SARS-CoV-2 infection. Although previous studies have reported estimates of PCC incidence, few have examined trends during the Omicron variant period or have included geographically distinct regions for the same time periods.

Methods: Track PCC is a surveillance network, leveraging electronic health records and public health data to monitor incidence over time across five diverse geographic sites in the U.

MRI versus radiography as eligibility screening tool for knee osteoarthritis clinical trials: Data from the osteoarthritis initiative.

Objective: To estimate the prevalence of knee structural pathologies that may warrant exclusion from disease-modifying osteoarthritis drug (DMOAD) trials, based on MRI versus radiography, among participants who would otherwise be considered eligible for enrollment based on commonly used radiographic inclusionary criteria.

Methods: We selected participants from the baseline visit of the Osteoarthritis Initiative that met radiographic structural and clinical eligibility criteria for a DMOAD clinical trial: Radiographic OA (Kellgren-Lawrence grade 2 or 3 with medial minimum joint space width ≥ 1.5 mm); and WOMAC knee pain score between 8 and 18 (0-20 scale).

VO Max in Clinical Cardiology: Clinical Applications, Evidence Gaps, and Future Directions.

Purpose Of Review: VO₂ max is a fundamental marker of cardiorespiratory fitness with substantial prognostic and diagnostic value within the field of cardiology. This review analyzes current and emerging evidence regarding its clinical uses, highlights key evidence gaps, and explores emerging developments poised to broaden its clinical application.

Recent Findings: Evidence supports VO2 max as a powerful independent predictor for heart failure, coronary artery disease, hypertrophic cardiomyopathy, and cardiac amyloidosis, supporting it use in identifying high-risk patients for advanced interventions.

Extracoronary Arterial Pathologies in Patients With Spontaneous Coronary Artery Dissection (SCAD).

Background/objective: Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of acute coronary syndrome and has been associated with extracoronary arteriopathies, such as fibromuscular dysplasia (FMD), aneurysms, and dissections across other vascular beds. However, these associations remain understudied in the literature. This study aims to characterize the prevalence and distribution of extracoronary arteriopathies in a large cohort of SCAD patients.

Diverse social environments and 10-year all-cause mortality in a cohort of historically excluded racial/ethnic older adults: A latent class analysis of social integration.

Purpose: The association between social integration and mortality in older adults from historically excluded groups may not align with the patterns observed in predominately white samples. We modeled latent groups of social integration and their association with 10-year all-cause mortality in a cohort of older adults from historically excluded racial/ethnic groups.

Methods: In a sub-sample of a national cohort study of older adults, we used latent class analysis to model social integration using ten item indicators spanning couple status, network characteristics, and neighborhood and community connections.

DeepGAM: An interpretable deep neural network using generalized additive model for depression diagnosis: Data from the heart and soul study.

Deep neural networks have achieved significant performance breakthroughs across a range of tasks. For diagnosing depression, there has been increasing attention on estimating depression status from personal medical data. However, the neural networks often act as black boxes, making it difficult to discern the individual effects of each input component.

Genetically diverse mice exhibit divergent domain-specific, sex-dependent behavioral outcomes following exposure to early life stress.

Understanding how genetic variability shapes responses to environmental and developmental factors is critical for advancing translational neuroscience. However, most preclinical studies rely on inbred mouse strains that do not capture the genetic complexity of human populations. One key area of translational research focuses on identifying the neural and behavioral consequences of early life trauma.

(Re)conceptualizing structural stigma: Insights from a qualitative study of sexual minority men in a longitudinal, population-based cohort.

A growing body of evidence has documented the adverse health consequences of structural stigma across multiple marginalized groups, including sexual minorities. In light of these advancements, scholars have urged the field to refine conceptualizations of structural stigma to guide future empirical work. We heed this charge by analyzing two sets of qualitative data among gay and bisexual men obtained from a probability-based panel: 1) responses to an open-ended survey question about structural stigma (=385) and 2) in-depth interviews about their subjective experiences of structural stigma (=60).

Recent extinctions of plant and animal genera are rare, localized, and decelerated.

An important aspect of the current extinction crisis is the loss of distinct clades (e.g., genera).

Greater HIV Viral Load Suppression in Patients Using an Integrated Health System Specialty Pharmacy.

PurposeThis study assessed the impact of an integrated health system specialty pharmacy (HSSP) on viral load (VL) suppression in HIV patients, compared to patients utilizing non-health system specialty pharmacies (non-HSSPs).MethodsThis was a single-center, retrospective observational cohort study of patients ≥18 years with a HIV diagnosis and an encounter in the outpatient HIV clinic at an academic medical center associated with a HSSP, at least one order for an antiretroviral (ARV) medication, and at least one HIV-1 RNA VL result between January 2018 and May 2022. Outcomes included average rate of VL suppression and socio-demographic factors associated with VL suppression.

Preexisting Psychiatric Risk Factors and Any and Long-Term Opioid Use in Head and Neck Cancer.

Introduction: Head and neck cancer (HNC), one of the most emotionally distressing cancers, carries a significant burden of psychiatric comorbidities. While opioids are commonly prescribed in cancer care, the association between preexisting psychiatric risk factors and prescription opioid use in HNC remains unclear.

Objective: To test the hypothesis that preexisting psychiatric risk factors are associated with any opioid prescription and long-term opioid therapy in patients with HNC.

Implementation of opioid stewardship programs (OSPs) in hospitals: A narrative literature review.

Pain and addiction are persistent public health issues that can lead to serious and fatal consequences on individuals, families, and communities. With the continued development of the opioid epidemic and the subsequent rise in opioid use and misuse, it is important to recognize the need for intervention at a public health level. Opioid stewardship programs (OSPs) are promising public health interventions that aim to coordinate safe and effective pain management through evidence-based intervention strategies.

Cardiopulmonary changes and its association with clinical features in noncirrhotic portal hypertension.

Background: Cardiopulmonary changes in noncirrhotic portal hypertension (NCPH) are poorly understood.

Aim: To investigate cardiopulmonary changes using transthoracic echocardiography (TTE) in NCPH and their correlation with clinical features.

Methods: Prospective cohort including 10 preclinical NCPH [without portal hypertension (PH)] and 32 NCPH subjects who underwent TTE with agitated saline injection and comprehensive clinical evaluation were assessed.

Despite dense amnesia, patients with hippocampal lesions show partially intact navigation for recent and remotely learned environments.

The extent to which medial temporal lobe amnesia affects recently compared to remotely formed memories remains debated. Some studies have investigated this issue by employing either verbal recall of routes or map drawing, suggesting profound loss of recent yet largely intact remote spatial memory. Here, we studied navigation in two patients with amnesia and their matched controls by recreating virtual versions of their recent and remote neighborhoods.

A Family With X-Linked Charcot-Marie-Tooth Disease Type 1: A Case for Reclassifying a Variant of Uncertain Significance in GJB1and Review of the Literature.

Objectives: X-linked Charcot-Marie-Tooth disease Type 1 (CMTX1), caused by gap junction beta-1 (GJB1) mutations, is the second most common form of CMT. Patients present with length-dependent sensorimotor polyneuropathy and split hand syndrome. Males are more severely affected; females show variable symptoms because of skewed X-inactivation.

An adaptive simulation intervention decreases emergency physician physiologic stress while caring for patients during COVID-19: A randomized clinical trial.

Background: Stressful work environments and burnout in emergency medicine (EM) physicians adversely impact patient care quality. The future EM workforce will need to prioritize clinician well-being to ensure optimal patient care.

Methods: This prospective, randomized, controlled study aimed to determine whether an adaptive simulation intervention, COVID-19 Responsive Intervention: Systems Improvement Simulations (CRI:SIS), decreased physiologic stress as measured by heart rate variability (HRV) in front-line EM physicians during the COVID-19 pandemic.

Incorporating preprints in systematic reviews: a preliminary study of a novel method for rapid evidence synthesis.

Objectives: By October 1, 2024, over 450,000 COVID-19 manuscripts were published, with 10% posted as unreviewed preprints. While they accelerate knowledge sharing, their inconsistent quality complicates systematic studies.

Materials And Methods: We propose a 2-stage method to include preprints in meta-analyses.

A Pluripotent Progression of the Gate Control System Theory of Pain - Modeling Ascending & Descending Pain Pathways as a Lotka-Volterra Coupled Control & Feedback Loop.

Introduction: Pain is a subjective experience, the perception of stimulus input transmitted by neurons that respond to real or perceived tissue injury and propagate the information to the brain. Under normal conditions, the perception is a reliable indicator of the magnitude and duration of the sensory input (viz. threat), so that appropriate action can be taken (eg, fight-or-flight).