Recent ucsf_postprints items

Cannabis as a Nicotine Cessation Aid: Prevalence of Use and Potential Consequences in a Survey of US Adults

Thu, 15 Oct 2026 00:00:00 +0000

Cannabis as a Nicotine Cessation Aid: Prevalence of Use and Potential Consequences in a Survey of US Adults

Gene-Environment Interaction in Nonfamilial Corticobasal Syndrome in Monozygotic Twins With Differential Occupational Exposure

Tue, 13 Oct 2026 00:00:00 +0000

Gene-Environment Interaction in Nonfamilial Corticobasal Syndrome in Monozygotic Twins With Differential Occupational Exposure

Student Navigators Help UCSF Primary Care Patients Access Behavioral Health Care in the Context of Insurance and Other Barriers

Tue, 13 Oct 2026 00:00:00 +0000

Background: At the University of California, San Francisco (UCSF), college students in the Patient Support Corps learn by helping patients navigate their care. This report focuses on how Patient Support Corps students help patients whose primary care physicians referred them to UCSF’s Integrated Behavioral Health program. We summarize the disposition of these primary care physician referrals. We also describe programmatic efforts to assure that UCSF connects all referrals to behavioral health care, whether at UCSF or externally. Methods: We counted the referrals to UCSF’s Integrated Behavioral Health program between August 2025 and May 2026. Then we determined the number of patients scheduled for care at UCSF, along with the barriers to successful scheduling. We ascertained what support the program’s staff and student navigators were able to provide patients not scheduled for care at UCSF. Student navigators also reflected on their efforts to promote equitable access to behavioral...

Right Care at the Right Time: Student Healthcare Navigators Reduce Patient Wait Times for Behavioral Healthcare

Tue, 13 Oct 2026 00:00:00 +0000

Right Care at the Right Time: Student Healthcare Navigators Reduce Patient Wait Times for Behavioral Healthcare

Cross-molecular active learning for the discovery of antimicrobial polyacrylamides

Mon, 12 Oct 2026 00:00:00 +0000

Antimicrobial resistance poses an urgent threat to global health. The development of new antimicrobials is crucial. Synthetic copolymers are attractive as a potential tool because they can be produced at scale and designed to mimic antimicrobial peptides and act as broad-spectrum antimicrobials capable of evading resistance mechanisms. This work leverages a cross-molecular machine learning pipeline, trained on antimicrobial peptides, to develop potent antimicrobial polymers—which were then synthesized and validated experimentally—to combat Escherichia coli. Crucially, all polymers predicted by the active learning pipeline during exploitation sampling exhibited impressive antimicrobial activity. One candidate copolymer was further characterized and shown to permeabilize the bacterial membrane, which is associated with decreased resistance. Furthermore, this copolymer demonstrated remarkable synergy in eradicating biofilm-associated E. coli when combined with a clinical drug regimen....

Collaborative Care Goes Global

Fri, 9 Oct 2026 00:00:00 +0000

Collaborative Care Goes Global

Therapeutic Efficacy of NSI-189 against Diabetic Neuropathy and Encephalopathy in Mice

Fri, 9 Oct 2026 00:00:00 +0000

Therapeutic Efficacy of NSI-189 against Diabetic Neuropathy and Encephalopathy in Mice

The Greatest Generation

Thu, 8 Oct 2026 00:00:00 +0000

In this narrative medicine essay, the author discusses the inaccuracies of generational stereotypes and unfounded criticisms about trainees, and the problems that faculty members who voice these criticisms can cause among physicians.

Strategies to recruit and retain Black and Latina/x women and birthing people in a biospecimen research study

Thu, 8 Oct 2026 00:00:00 +0000

The Supporting Our Ladies And Reducing Stress to prevent preterm birth (SOLARS) Feasibility Study utilized three strategies to recruit Black and Latina/x women in a biospecimen study: individual (warm hand-off from community partner); group (attend group sessions to discuss study), and tabling (setting up a table at a clinic or community event). Additionally, we combined individual + group and individual + group + tabling strategies. Using these strategies, 35 women were recruited, where 32 completed survey and biospecimen at two timepoints across their pregnancies. Findings from our study support that using a reproductive justice framework is an effective strategy to build trust and increase participation in biospecimen studies among communities of color.

Teaching to the Test: Threading the Needle on Sepsis Quality Metrics

Thu, 8 Oct 2026 00:00:00 +0000

As quality metrics become more tightly linked to reimbursement and reputation, medical educators face the growing challenge of teaching clinical medicine in the context of policy-driven mandates. The Centers for Medicare and Medicaid Services sepsis bundle (SEP-1) requires physicians to execute time-bound interventions with little flexibility, while clinicians’ professional duty compels them to individualize care based on evidence, comorbidities, and evolving best practices. This perspective explores how educators can prepare trainees to recognize when clinical actions are grounded in evidence-based practice, professional judgment, or the demands of a protocol. Teachers should become skilled at narrating the moments when clinical care and compliance overlap, diverge, or conflict. Post hoc reflection plays a critical role in consolidating these lessons, allowing trainees to explore trade-offs and question assumptions. Medical educators must guide learners through today’s system...

Deadenylation and decapping factors cooperatively stimulate biochemical activities of DEAD-box ATPase Dhh1

Thu, 8 Oct 2026 00:00:00 +0000

The DEAD-box ATPase Dhh1 (DDX6 in humans) is a general activator of 5'-3' mRNA decay that acts between the deadenylation and decapping steps of the pathway, although the exact mechanism of its action remains unclear. Dhh1 has been shown to interact with the MIF4G domain of the central scaffold protein of the Ccr4-Not deadenylase complex, Not1, as well as the decapping activator Edc3. Although structures have been published of Dhh1 in complex with Not1MIF4G or an Edc3 peptide, the impact of these interactions on the catalytic cycle of Dhh1 are unknown. Here, we show that cEdc3 enhances ATP and RNA binding by Dhh1, whereas Not1MIF4G promotes the catalytic step of ATP hydrolysis. Additionally, the modulation of Dhh1 activity by Edc3 requires a more extensive set of interaction motifs and interfaces than was previously recognized. While the effect of either Not1MIF4G or Edc3 on the ATPase activity of Dhh1 is modest, together both proteins increase Dhh1 activity over 200-fold. The...

Community Midwifery Postpartum Care: National Data From Community Practice

Thu, 8 Oct 2026 00:00:00 +0000

INTRODUCTION: The United States is a global anomaly in its lack of postpartum care. Community midwives' scope of practice generally includes maternal and infant care until 6 weeks after birth, although research on community midwifery postpartum care in the United States has been limited. The purpose of this analysis was to further describe community midwifery postpartum care using a national quantitative data set. METHODS: This analysis uses data from the Midwives Alliance of North America Statistics Project, birth years 2004 to 2009. The data include 20,720 pregnancies, with home or birth center as the planned place of birth at the onset of labor. We used standard descriptive statistics. The main variables of interest to characterize postpartum care were the number of postpartum care visits and the number of weeks of postpartum care. We used Kruskal-Wallis tests to assess whether number of visits or number of weeks of postpartum care varied by subgroup. RESULTS: Breastfeeding...

SARS-CoV-2 vaccination protects against infection-induced autoantibody formation 2302309

Thu, 8 Oct 2026 00:00:00 +0000

Abstract Introduction SARS-CoV-2-CoV-2 infection is known to induce autoantibodies across a wide range of targets, including immune modulatory proteins and pro-thrombotic factors. It is not known if vaccination with SARS-CoV-2 mRNA vaccines would induce a similar autoantibody profile, or whether prior vaccination would protect recipients from autoantibody production upon SARS-CoV-2 infection. Methods Our group followed a cohort of over 65,000 blood donors across repeat donations in the COVID-19 era. We identified SARS-CoV-2 naïve donors who were infected without prior vaccination (n = 150) or were vaccinated then became infected (n = 100). We tested samples from the naïve time point and 6-10 weeks after infection (2 paired samples) or naïve then vaccination then infection (three samples) using a T7 bacteriophage array displaying 731,724 peptides (49 amino acids each) spanning the human proteome. Data were partitioned into five random groups and peptide comparisons between groups...

SEGUID v2: Extending SEGUID checksums for circular, linear, single- and double-stranded biological sequences

Thu, 8 Oct 2026 00:00:00 +0000

BACKGROUND: Synthetic biology involves combining different DNA fragments, each containing functional biological parts, to address specific problems. Fundamental gene-function research often requires cloning and propagating DNA fragments, such as those from the iGEM Parts Registry or Addgene, typically distributed as circular plasmids. Addgene's repository alone offers around 150,000 plasmids. To ensure data integrity, cryptographic checksums can be calculated for the sequences. Each sequence has a unique checksum, making checksums useful for validation and quick lookups of associated annotations. For example, the SEGUID checksum uniquely identifies protein sequences with a 27-character string. OBJECTIVES: The original SEGUID, while effective for protein sequences and single-stranded DNA (ssDNA), is not suitable for circular DNA since there is no natural starting position nor for double-stranded DNA (dsDNA) since two separate sequences are present. Challenges include how to uniquely...

Old disease, new twist

Thu, 8 Oct 2026 00:00:00 +0000

An 81-year-old man with a history of high-grade urothelial carcinoma of the bladder and ureter on treatment with atezolizumab and tiragolumab presented to the emergency department with 5 months of malaise, generalized weakness, and fatigue and 2 weeks of subjective fevers. One month prior to presentation, he received an empiric 9-day course of levofloxacin for possible epididymitis based on scrotal pain and an ultrasound showing mild bilateral epididymal prominence. Blood and urine cultures were negative. His constitutional symptoms persisted, and he developed a subjective fever 2 weeks prior to presentation. He was admitted for further evaluation.

Parental feeding practices and child weight status in Mexican American families: A longitudinal analysis

Tue, 6 Oct 2026 00:00:00 +0000

Background: Parental feeding practices are thought to influence children's weight status, through children's eating behavior and nutritional intake. However, because most studies have been cross-sectional, the direction of influence is unclear. Moreover, although obesity rates are high among Latino children, few studies of parental feeding practices have focused on this population. Methods: This 2-year longitudinal study examined mutual influences over time between parental feeding practices and children's weight status, in Mexican American families with children 18 years old at baseline. Mothers (n = 322) and fathers (n = 182) reported on their feeding practices at baseline, 1-year follow-up, and 2-year follow-up. Weight status, defined by waist-height ratio (WHtR) and body mass index (BMI), was ascertained at all assessments. Cross-lagged panel models were used to examine the mutual influences of parental feeding practices and child weight status over time, controlling for covariates....

Prostate-Specific Membrane Antigen Radioligand Therapy in Patients with Aggressive-Variant Prostate Cancer.

Mon, 5 Oct 2026 00:00:00 +0000

Aggressive-variant prostate cancer (AVPC) is characterized by several high-risk features and is typically treated with chemotherapy. In this study, we evaluated the outcomes of patients with AVPC who received prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT). Methods: This retrospective study included patients with AVPC with metastatic castration-resistant prostate cancer who received PSMA RLT at 3 academic centers. Patients with AVPC were further stratified into 2 subcategories: AVPC-C (clinicopathologic), referring to patients who met AVPC on the basis of clinical or pathologic features, and AVPC-MS (molecular signature), referring to patients who met AVPC criteria on the basis of genomic alterations. Prostate-specific antigen (PSA) response was calculated in the overall cohort, and PSA progression-free survival and overall survival (OS) were calculated in the paired cohort. In the segmentation cohort, SUV_mean and total tumor volume...

Pre-Health Students Help Patients in their Search for Living Kidney Donors

Thu, 1 Oct 2026 00:00:00 +0000

Pre-Health Students Help Patients in their Search for Living Kidney Donors

De-implementation of inequitable methadone policy and treatment: lessons learned from COVID-19 to support a more just methadone treatment system in the United States

Wed, 30 Sep 2026 00:00:00 +0000

Despite decades of evidence supporting methadone as a life-saving treatment for opioid use disorder, its delivery in the US has been stymied by stigmatizing dispensation policies that are neither evidence-based nor person-centered. Implementation failures and regulatory challenges have resulted in a significant treatment gap in the US and less than 30% of people with OUD enter and remain in treatment. In this article, we provide a historical overview of the methadone treatment (MT) system in the US and outline why it requires de-implementation. We present the COVID-19 public health emergency as a naturalistic experiment in de-implementation, outline evidence from this period on how COVID-19 related flexibilities influenced treatment outcomes and patient experiences and present a de-implementation framework to contextualize these changes while imagining further expansion of de-implementation efforts to support sustained change. We highlight how patient advocacy can shape further...

Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms

Tue, 29 Sep 2026 00:00:00 +0000

BACKGROUND: The impact of depressive symptoms and anxiety on rural patients' decisions to seek care for worsening heart failure (HF) symptoms remains unknown. The purposes of this study were (1) to describe rural patients' reasons for delay in seeking care for HF, and (2) to determine whether depressive symptoms or anxiety was associated with patients' reasons for delay in seeking medical care for worsening symptoms. METHODS: A total of 611 rural HF patients were included. Data on reasons for patient delay in seeking medical care (The Reasons for Delay Questionnaire), depressive symptoms (PHQ-9), and anxiety (BSI-ANX) were collected. Statistical analyses included chi-square and multiple regression. RESULTS: A total of 85.4% of patients reported at least 1 reason for delay. Patients with higher levels of depressive symptoms were more likely to cite embarrassment, problems with transportation, and financial concerns as a reason for delay. Patients with anxiety not only cited nonsymptom-related...

Feasibility and acceptability of remote smartphone cognitive testing in frontotemporal dementia research

Tue, 29 Sep 2026 00:00:00 +0000

Introduction: Remote smartphone assessments of cognition, speech/language, and motor functioning in frontotemporal dementia (FTD) could enable decentralized clinical trials and improve access to research. We studied the feasibility and acceptability of remote smartphone data collection in FTD research using the ALLFTD Mobile App (ALLFTD-mApp). Methods: A diagnostically mixed sample of 214 participants with FTD or from familial FTD kindreds (asymptomatic: CDR®+NACC-FTLD = 0 [N = 101]; prodromal: 0.5 [N = 49]; symptomatic ≥1 [N = 51]; not measured [N = 13]) were asked to complete ALLFTD-mApp tests on their smartphone three times within 12 days. They completed smartphone familiarity and participation experience surveys. Results: It was feasible for participants to complete the ALLFTD-mApp on their own smartphones. Participants reported high smartphone familiarity, completed ∼ 70% of tasks, and considered...

The ENIGMA Consortium: large-scale collaborative analyses of neuroimaging and genetic data

Tue, 29 Sep 2026 00:00:00 +0000

The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium is a collaborative network of researchers working together on a range of large-scale studies that integrate data from 70 institutions worldwide. Organized into Working Groups that tackle questions in neuroscience, genetics, and medicine, ENIGMA studies have analyzed neuroimaging data from over 12,826 subjects. In addition, data from 12,171 individuals were provided by the CHARGE consortium for replication of findings, in a total of 24,997 subjects. By meta-analyzing results from many sites, ENIGMA has detected factors that affect the brain that no individual site could detect on its own, and that require larger numbers of subjects than any individual neuroimaging study has currently collected. ENIGMA’s first project was a genome-wide association study identifying common variants in the genome associated with hippocampal volume or intracranial volume. Continuing work is exploring genetic associations...

A snapshot of how U.S. funding cuts impacted HIV care in one county of Kenya: a qualitative case study

Fri, 25 Sep 2026 00:00:00 +0000

Introduction: In January 2025, the United States government froze most foreign assistance and issued a 90-day stop-work order affecting many global health, education, and nutrition programs. Methods: Using a qualitative case study approach, we examined perceptions about experiences around how this abrupt funding disruption affected HIV care in one county in Kenya through in-depth interviews with women and men living with HIV and with healthcare providers. Results: Participants described immediate and severe antiretroviral therapy (ART) rationing and broader, cascading effects across the HIV care continuum, including missed visits, interrupted monitoring, and heightened anxiety about treatment continuity. Respondents also reported that rapid integration of HIV and primary care services-implemented amid the funding shock-undermined confidentiality in clinical settings, intensifying stigma concerns and discouraging care seeking among people living with HIV. Discussion: These findings...

Elevated Serum Renin Before Liver Transplantation Is Associated With Increased Intraoperative Vasopressor Requirements and Posttransplant Acute Kidney Injury.

Thu, 24 Sep 2026 00:00:00 +0000

BACKGROUND: Derangements of the renin-angiotensin-aldosterone system may contribute to circulatory dysfunction in cirrhosis. We hypothesized that renin is elevated in patients undergoing liver transplantation (LT) and is associated with vasopressor requirements and postoperative organ dysfunction. METHODS: We collected serum from 138 patients before LT and measured renin by enzyme-linked immunosorbent assay. Eligible patients were adults with cirrhosis undergoing LT from a deceased or living donor. Detailed clinical data were obtained from a perioperative data warehouse. The primary outcome was vasopressor dosage during the dissection phase of LT. The secondary outcomes were postoperative acute kidney injury (AKI) and early allograft dysfunction. RESULTS: Renin was elevated up to 100-fold above normal and strongly correlated with Model for End-Stage Liver Disease sodium. A 10-fold increase in renin was associated with a 0.03 µg/kg/min (95% confidence interval [CI], 0.01-0.05)...

A randomized crossover trial comparing the acute physiological and psychological effects of botanical formulations of oral psilocybin, oral psilocin, and sublingual psilocin.

Thu, 24 Sep 2026 00:00:00 +0000

BACKGROUND: Psilocybin, a serotonergic psychedelic found in hallucinogenic mushrooms, is metabolized to psilocin, the compound responsible for its psychoactive effects. Psilocybin has demonstrated therapeutic potential for neuropsychiatric conditions. While recent trials have primarily used orally administered synthetic psilocybin, alternative formulations and delivery methods may offer therapeutic advantages, yet the effects of these approaches remain poorly characterized. AIMS: To compare the pharmacodynamic profiles and tolerability of oral psilocybin, oral psilocin, and sublingual psilocin derived from whole-mushroom extracts in healthy adults. METHODS: In this randomized, within-subject, crossover trial, 20 healthy adults (10 men, 10 women; mean age 40.1 ± 5.9 years) completed up to four drug administration sessions involving botanical oral psilocybin (25 mg), oral psilocin (17.5 mg), or sublingual psilocin (2.18, 4.36, or 8 mg). All sessions included therapeutic support...

How Severe is Severe Enough? Organ Failure Rather Than Anemia Severity as a Potential Threshold for Complement Inhibition in Pediatric Paroxysmal Cold Hemoglobinuria: A Case Report

Thu, 24 Sep 2026 00:00:00 +0000

Paroxysmal cold hemoglobinuria (PCH) is an acquired intravascular hemolytic anemia of young children that is usually self-limited. Two patients with PCH have previously been described in the medical literature to have received complement inhibition with eculizumab, an inhibitor of complement C5, and in both cases, the drug was given in the setting of organ failure. No criterion defines when the use of complement inhibition is warranted. We report a previously healthy 23-month-old boy with postviral PCH whose hemoglobin nadir of 2.7 g/dL, undetectable total hemolytic complement (CH50), and elevated soluble C5b-9 represent the most severe anemia among the three reported patients. Despite this laboratory severity, he remained hemodynamically stable with preserved renal function, never requiring vasoactive support or dialysis, and recovered with warmed transfusion and thermal protection after eculizumab was deferred. Our experience suggests that organ failure, rather than anemia or...

Finding Diastole: Palliative Care Fellows, Transformative Learning Theory, and a Narrative Medicine Curriculum

Thu, 24 Sep 2026 00:00:00 +0000

Finding Diastole: Palliative Care Fellows, Transformative Learning Theory, and a Narrative Medicine Curriculum

Priorities for Advancing Palliative Care for Amyotrophic Lateral Sclerosis: A Consensus Report From a Palliative Care for ALS Working Group in the United States

Thu, 24 Sep 2026 00:00:00 +0000

Until there is a cure for amyotrophic lateral sclerosis (ALS), it is imperative that everyone facing this devastating illness receives care to alleviate symptoms and suffering and improve quality of life. Emerging evidence has demonstrated benefits of palliative care for people with ALS, but palliative care is not yet widely available or accessed by people with ALS throughout the disease course. The Palliative Care for ALS Working Group was formed within the International Neuropalliative Care Society, consisting of interprofessional ALS and palliative care clinicians, researchers, advocates, and patients and care partner representatives who are committed to improving palliative care for people living with ALS. The group engaged in a strategic planning process to determine what is needed to advance palliative care for people with ALS over the next 3-5 years. This report outlines the core recommendations from that strategic planning process. Recommendations are divided into five...

Umbilical artery bypass for surgical treatment of femoral artery stenosis in a newborn: A case report

Thu, 24 Sep 2026 00:00:00 +0000

Femoral artery stenosis is a rare but serious complication of arterial puncture in neonates, and surgical revascularization is challenging due to small vessel size. We report the case of a premature newborn with limb-threatening ischemia from femoral artery stenosis treated using the native umbilical artery as an autologous bypass graft. The umbilical artery was mobilized, tunneled, and anastomosed distal to the stenosis, restoring perfusion. Postoperative Doppler confirmed graft patency and resolution of ischemia. The patient later died from unrelated respiratory complications. This case highlights the technical feasibility of umbilical artery bypass for neonatal limb salvage and underscores the vulnerability of premature infants.

Referrals for Food Assistance at Health Resources and Services Administration Health Centers.

Thu, 24 Sep 2026 00:00:00 +0000

Importance: Approximately 47 million individuals in the US experience food insecurity. Food insecurity adversely impacts treatment and prevention of diet-related health conditions (DRHCs). Health systems are increasingly screening for food insecurity and referring individuals with food insecurity to food assistance. Many people experiencing food insecurity seek care in Health Resources and Services Administration (HRSA) health centers. Objectives: To evaluate the frequency of referrals to food assistance from HRSA health centers and to examine the demographic, socioeconomic, and clinical characteristics of patients who received them. Design, Setting, and Participants: This cross-sectional survey study used data from the 2022 HRSA Healthcare Patient Survey, which included 3616 English- or Spanish-speaking adult patients with at least 1 visit to a HRSA health center from 2021 to 2022; this weighted sample represented 19.6 million patients. Analyses were conducted from August to...

Navigating the Emotional Landscape of Kidney Allograft Failure: Patient and Provider Perspectives.

Thu, 24 Sep 2026 00:00:00 +0000

Navigating the Emotional Landscape of Kidney Allograft Failure: Patient and Provider Perspectives.

Exploring the nature and impact of coaches’ application of coaching skills across contexts

Thu, 24 Sep 2026 00:00:00 +0000

PURPOSE: Coaching is an emerging pedagogical strategy in health professions education, aimed at enhancing learners' growth and competency through self-reflection, self-regulated learning, and lifelong learning skills. Coaching programs are resource-intensive due to the training and support required for clinician educators. Through the lens of actor-oriented transfer theory, this study seeks to understand the broader value of coaching programs beyond benefits for learners by investigating how medical student coaches apply coaching skills beyond their direct coaching relationships and the impacts of this skill transfer. METHOD: Using a qualitative interpretivist approach, individual semi-structured interviews were conducted with 11 medical student coaches at UCSF School of Medicine in 2024-2025. The interviews, guided by literature on coaching and actor-oriented transfer, were analyzed inductively using template analysis. RESULTS: Participants described applying coaching skills...

2026 HRS/PACES scientific statement on the use of antiarrhythmic drugs in understudied clinical scenarios

Thu, 24 Sep 2026 00:00:00 +0000

Antiarrhythmic drugs can be an important treatment option for patients with heart rhythm disorders, but not all patients and scenarios are represented in trials related to antiarrhythmic drug use. This Heart Rhythm Society scientific statement identifies common clinical scenarios for which little guidance exists, at least partly because they are understudied. It also provides as much practical advice as possible, sourcing available evidence and the clinical proficiency of a diverse group of experienced clinicians, and provides the rationale for each recommendation.

3D epigenome of glial cell types in developing human cortex

Thu, 24 Sep 2026 00:00:00 +0000

The human cortex is complex and heterogeneous, undergoing extensive expansion during development1,2. Our prior study of neurogenesis, including radial glia (RG), intermediate progenitor cells, excitatory neurons and interneurons demonstrated that chromatin looping underlies transcriptional regulation for lineage-specific genes, shedding light on how non-coding genetic variants contribute to neuropsychiatric disorders by means of cell-type-specific gene regulation3. RG have a crucial role in generating cellular diversity through both neurogenesis and gliogenesis and can be further classified into ventricular RG (vRG) and outer RG (oRG)4,5. Given their significance in cortical development, we conducted a comprehensive three-dimensional (3D) epigenomic analysis of four main glial populations, including vRG, oRG, oligodendrocyte precursor cells and microglia, from the mid-gestational human neocortex. By integrating gene expression, chromatin accessibility, DNA methylation and...

Using Serum Lactate Concentration to Correct for the Anion Gap.

Thu, 24 Sep 2026 00:00:00 +0000

Using Serum Lactate Concentration to Correct for the Anion Gap.

Newly Diagnosed Breast Cancer Patient Informational Needs Across Visits: Using AI to Mine Question Lists

Tue, 22 Sep 2026 00:00:00 +0000

Newly Diagnosed Breast Cancer Patient Informational Needs Across Visits: Using AI to Mine Question Lists

Oncology Distress Screening with Students Linking Patients to Resources

Tue, 22 Sep 2026 00:00:00 +0000

Introduction In 2016, UCSF implemented an electronic health record (EHR) based tool, the Supportive Care Needs Survey (SCNS), to systematically identify psychosocial concerns and connect patients with appropriate resources. The American College of Surgeons Commission on Cancer Standard 5.2 mandates direct outreach to patients endorsing moderate distress, substantially increasing social work workload. UCSF partnered with Patient Support Corps (PSC) students to conduct outreach and streamline referrals to social work. PSC is a four-year co-op internship in which pre-health college students earn academic credit while working as healthcare navigators. For this evaluation, we reviewed data collected in 2025 to report on program reach. Design At the start of each of their weekly half-day shifts, students review an EHR report showing all patients who have upcoming appointments in 14 participating cancer clinics. Each student messages up to 40 of these patients per shift via the patient...

Must Care Be Earned? The Normalization of Sacrifice in Post-Disenhancement Ethics

Tue, 22 Sep 2026 00:00:00 +0000

Must Care Be Earned? The Normalization of Sacrifice in Post-Disenhancement Ethics

An adenoviral-vectored vaccine confers seroprotection against capsular group B meningococcal disease

Tue, 22 Sep 2026 00:00:00 +0000

Adenoviral-vectored vaccines are licensed for prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Ebola virus, but, for bacterial proteins, expression in a eukaryotic cell may affect the antigen's localization and conformation or lead to unwanted glycosylation. Here, we investigated the potential use of an adenoviral-vectored vaccine platform for capsular group B meningococcus (MenB). Vector-based candidate vaccines expressing MenB antigen factor H binding protein (fHbp) were generated, and immunogenicity was assessed in mouse models, including the functional antibody response by serum bactericidal assay (SBA) using human complement. All adenovirus-based vaccine candidates induced high antigen-specific antibody and T cell responses. A single dose induced functional serum bactericidal responses with titers superior or equal to those induced by two doses of protein-based comparators, as well as longer persistence and a similar breadth. The fHbp transgene...

Structure of a MenB de-N-acetyl polysialic acid antibody and mechanism of immune cell inhibition

Tue, 22 Sep 2026 00:00:00 +0000

The Neisseria meningitidis serogroup B (MenB) polysaccharide, α(2-8) polysialic acid (polySia), is essential for resistance to complement-mediated bacteriolysis and inhibition of opsonophagocytosis. The monoclonal antibody SEAM 3 binds de-N-acetyl polySia (dPSA) but not polySia, yet still recognizes encapsulated MenB, indicating the capsule contains dPSA derivatives. Since SEAM 3 also recognizes other pathogens as well as human cancers, we have explored its biological role and mapped the SEAM 3 epitope. We compared binding of N-acetylated and de-N-acetylated polySia and ganglioside GD3 derivatives to sialic-acid-binding immunoglobulin-like lectins (Siglecs) on leukocytes. Siglec-9 showed higher affinity for dPSA and de-N-acetyl GD3 (K_D ∼2.6-3.1 nM) than for their acetylated counterparts, while Siglec-5 bound polySia and GD3 derivatives with similar and moderate (K_D∼40-60 nM and 7.9 nM, respectively) affinity. Siglecs-2, -3, -7, -10, and -11 showed negligible...

Secondhand smoke exposure at home and school absenteeism among children in the United States: national estimates of attributable missed school days

Fri, 18 Sep 2026 00:00:00 +0000

Objective: The number of missed school days attributable to secondhand smoke (SHS) exposure at home among U.S. children has not been quantified. We estimated the association between SHS exposure at home and school absenteeism and derived national estimates of SHS-attributable missed school days. Methods: We analyzed data from the 2016-2024 National Survey of Children's Health for U.S. children aged 6-11 years. Propensity score weighting and two-part models were used to estimate the association between SHS exposure at home and school absenteeism. National estimates of SHS-attributable missed school days were derived by combining model-based attributable fractions with national public school enrollment data. Results: SHS exposure at home was associated with both a higher likelihood of missing school and a greater number of missed school days among children with any absence. In 2024, an estimated 266,008 (95% CI: 139,627, 392,390) missed school days were attributable to SHS...

HIV Testing and Care Among Publicly Insured Enrollees With Schizophrenia: Is There a Benefit to Dual Eligibility?

Thu, 17 Sep 2026 00:00:00 +0000

Background: Patients with schizophrenia experience gaps in the human immunodeficiency virus (HIV) care continuum. We examined the impact of dual enrollment in Medicare upon HIV testing and retention among Medicaid-enrolled patients with schizophrenia. Methods: Using Medicaid Analytic eXtract and Medicare files from 2008 to 2012, we examined adult participants with schizophrenia enrolled in Medicaid or dually enrolled in Medicare and Medicaid. Our outcomes were (a) HIV testing probability among participants without HIV and (b) retention in HIV care among people living with HIV (PLWH) (two HIV viral loads or CD4+ counts >90 days apart and within 1 year). Results: The average annual HIV testing probability was 4.9% among dually enrolled and 7.4% among Medicaid-enrolled patients (p < 0.001). Compared to Medicaid-only, HIV testing for dually enrolled patients were highest among those with opioid use disorder or sexually transmitted infection (STI);...

The Experience of General Internal Medicine Research Fellows and Program Directors: Results from a National Survey

Tue, 15 Sep 2026 00:00:00 +0000

BackgroundGeneral medicine (GM) research fellowships facilitate health care professionals to obtain the skills and mentored research experience needed for a research career. Yet, little is known about the experience and outcomes of recent graduates of GM fellowships.ObjectiveTo survey (1) GM research fellows and recent graduates and (2) program directors to learn about the opportunities and challenges facing GM research fellowships.DesignCross-sectional retrospective survey study.ParticipantsIndividuals who were enrolled in or completed a GM research fellowship (identified through prior fellow lists, advertising from the Society of General Internal Medicine, and fellowship program directors) between 2012 and 2022 in which ≥ 50% of effort was devoted to training and conducting research; 2022 program directors were recruited separately.Main MeasuresRespondents were asked to rate factors motivating them to pursue a research fellowship and their experiences during fellowship and to...

Detection of Common Thoracic Abnormalities with 0.55-T Lung MRI Compared with Chest CT: A Reader Performance Study.

Tue, 15 Sep 2026 00:00:00 +0000

Purpose To assess image quality and detection performance of 0.55-T MRI for common lung pathologies in a multireader study. Materials and Methods Twenty-eight participants were prospectively enrolled at a tertiary academic medical center between January 1, 2023, and August 31, 2023, and underwent same-day chest CT and 0.55-T MRI with respiratory-triggered T2-weighted axial BLADE and T1-weighted ultrashort echo time sequences. Six radiologists evaluated the quality of the MRI using a Likert-type scale and assessed common lung abnormalities. Sensitivity was calculated as the proportion of CT-confirmed lesions detected on MRI and was compared between readers by training status using the Kruskal-Wallis test. Fleiss κ values were calculated for interreader agreement. Nodule measurements were compared between modalities using the Pearson correlation coefficient. Results Twenty-eight participants (mean age ± SD, 59 years ± 19; 17 female) were included. The overall quality of 80% (134...

Combined Laparoscopic Radiofrequency Ablation and Laparoscopic Myomectomy: An Analysis of the ULTRA-Registry.

Tue, 15 Sep 2026 00:00:00 +0000

Background and Objectives: Uterine fibroids are common in women and can lead to symptoms of abnormal uterine bleeding, pelvic pain and bulk symptoms. Treatment can be medical or surgical. This study aims to describe characteristics and outcomes of women undergoing combined laparoscopic radiofrequency ablation (lap-RFA) and laparoscopic myomectomy (lap-MYO) to treat symptomatic uterine fibroids. Methods: This is a multicenter prospective cohort study including both academic centers and private practices. Women in the Uterine Leiomyoma Treatment by Radiofrequency Ablation (ULTRA) Study who were scheduled to undergo surgical management of fibroids underwent a combined lap-RFA and lap-MYO. We assessed quality of life and sexual function changes from before to 12 months after surgery using validated questionnaires. Results: Of the 480 participants in ULTRA, 49 underwent a combined lap-RFA and lap-MYO procedure between 2014 and 2022. The mean number of fibroids treated was 3.6 (standard...

Knowledge of and Perceived Access to Long-Acting Reversible Contraceptives Among Individuals Considering Tubal Sterilization in the United States.

Tue, 15 Sep 2026 00:00:00 +0000

INTRODUCTION: The authors' objective was to assess knowledge of and perceived access to long-acting reversible contraceptives (LARC) among individuals in the United States considering tubal sterilization. METHODS: Using online convenience sampling through social media advertisements, the authors recruited 442 US-born individuals considering tubal sterilization for this cross-sectional study. Eligibility criteria included age 21-45 years, female sex, premenopausal, desire to avoid future pregnancy, and no history of tubal sterilization, hysterectomy, or infertility treatment. After confirming eligibility, participants completed a 45-item online survey assessing sociodemographic characteristics, contraceptive and pregnancy history, and awareness of LARC. Chi-square tests and multivariate linear regression were used to identify sociodemographic variables associated with knowledge of and perceived access to LARC. RESULTS: Among these diverse (39% Black, 36% White, 10% Hispanic and...

Social Determinants of Health in Early to Mid-Adulthood and Risk of Early-Onset Stroke.

Mon, 14 Sep 2026 00:00:00 +0000

BACKGROUND: Despite increasing incidence of stroke among younger adults, the associations of social determinants of health (SDOH) and stroke among younger adults are not well known. This study investigates the associations between SDOH from early adulthood and stroke in a prospective longitudinal cohort. METHODS: We studied participants enrolled in the CARDIA study (Coronary Artery Risk Development in Young Adults). Participants aged 18 to 30 years were enrolled in 1985 and followed through 2022. We investigated longitudinal, time-varying measures of SDOH classified into 5 distinct domains: economic (6 measures), education (1 measure), healthcare (4 measures), neighborhood (2 measures), and social/community (5 measures). The outcome was incident stroke or transient ischemic attack. We evaluated associations between individual SDOH and stroke using unadjusted Cox models. We then evaluated whether a greater cumulative number of adverse SDOH domains (each represented by 1 exposure...

Unlocking Value: A Cost-Effectiveness Analysis of Hip PJI Diagnostic Pathways Employing the European Bone and Joint Infection Society/Musculoskeletal Infection Society Definition

Sat, 12 Sep 2026 00:00:00 +0000

Background: The European Bone and Joint Infection Society (EBJIS)/Musculoskeletal Infection Society (MSIS) criteria provide a framework for diagnosing hip periprosthetic joint infection, yet daily clinical application lacks a standardized algorithm. Since these criteria rely heavily on synovial fluid markers, surgeons encounter 2 primary dilemmas: the reliability of aspiration techniques (ultrasound vs fluoroscopy) and the economic trade-off between higher-cost proprietary assays and standard institutional laboratories. This cost-effectiveness analysis was conducted to identify the diagnostic pathway that maximizes clinical benefit while minimizing expenditure within the EBJIS/MSIS framework. Methods: A decision tree model simulated the diagnostic workup of a 67-year-old patient with suspected hip periprosthetic joint infection. Ten strategies were evaluated, comparing aspiration modality and laboratory method (institutional, point-of-care, and third-party analysis). The model...

Early Clinico-Radiographic Outcomes of Cementless Collared Triple Taper Stems in Osteoporotic Patients Undergoing Elective Total Hip Arthroplasty: A Descriptive Analysis

Sat, 12 Sep 2026 00:00:00 +0000

Background Osteoporosis is a well-established risk factor for early femoral failure following cementless total hip arthroplasty (THA). The performance of cementless collared triple-taper stems (CTTSs) in patients with a confirmed diagnosis of osteoporosis remains poorly defined. This study aimed to evaluate early clinico-radiographic outcomes of CTTS in osteoporotic patients undergoing elective THA. Methods We retrospectively reviewed 96 patients (87.5% women; mean age 69.5 ± 7.4 years) who underwent elective THA with a CTTS between 2018 and 2025. Osteoporosis was confirmed by either dual-energy x-ray absorptiometry T-score ≤ −2.5 or history of fragility fracture. Preoperative morphology and postoperative canal fill ratios, alignment, and subsidence (>3 mm) were assessed. Femoral failure was defined as periprosthetic fracture or aseptic loosening. Results Preoperative morphology demonstrated a predominance of wide canals (Dorr B: 67.5%, Dorr C: 26%) and a mean morphological...

“Have the writers actually read abortion law?”: using YouTube comments to explore audience responses to entertainment TV abortion plotlines

Fri, 11 Sep 2026 00:00:00 +0000

Comment sections on social media websites such as YouTube provide a unique venue to observe contemporaneous audience interpretation and discussion of entertainment television content. While entertainment-education research has largely examined whether and how exposure to television content influences viewer knowledge, attitudes, and beliefs, analyzing comment sections provides an opportunity to observe how audiences interpret and discuss these plotlines in an organic setting. We examined comments posted to YouTube clips of entertainment television abortion plotlines to document how these comments explicitly discussed the plotlines depicted and what themes emerged in these discussions. We identified 15 YouTube clips of abortion plotlines posted between 2018 and 2023 on official network accounts. We used thematic analysis techniques to qualitatively assess the top 20 comments and replies for each video (n = 162). Twenty-six percent of all comments referenced the content of the clip....

Health and Health Care Access Among Afghan Refugee Women in the United States

Fri, 11 Sep 2026 00:00:00 +0000

Importance: Afghans are one of the world's largest refugee populations. Afghan women face compounded health risks due to sociocultural restrictions, low literacy, forced displacement, and limited health care access, yet little is known about their experiences with health care after resettlement in the US. Objective: To explore health and health care access issues of Afghan refugee women in the US. Design, Setting, and Participants: This qualitative study was part of an ongoing community-based participatory research project started in July 2020. Bilingual investigators conducted semistructured interviews with Afghan refugee women in Dari or English. Dari interviews were interpreted to English by a fluent bilingual investigator, validated by a separate bilingual investigator, and then reviewed with an Afghan immigrant community member for accuracy. Transcribed interviews were analyzed using grounded theory from July 2023 to July 2024. Participants who self-identified as Afghan,...

Coronavirus Disease 2019 is an Occupational Disease for Teachers: How to Support the Teacher Workforce.

Fri, 11 Sep 2026 00:00:00 +0000

Analyzing a growing body of epidemiological research that considers coronavirus disease 2019 (COVID-19) as an occupational disease situates teaching (eg, pre-kindergarten, elementary, secondary) among the more vulnerable occupations. Teachers have experienced a higher risk of COVID-19 infection, hospitalization, death, and Long COVID than people from many other occupations. More research attending to occupational patterns and risk mitigation is needed. Taking an occupational epidemiology approach for teachers can inform a wide array of policy solutions, including school environment improvements that can support infection control, like air cleaning and ventilation, as well as supporting teachers experiencing disproportionate burdens of COVID-19, including those living with Long COVID.

Mitochondrial activity tunes nociceptor resilience to excitotoxicity

Fri, 11 Sep 2026 00:00:00 +0000

The capsaicin receptor, TRPV1, mediates the detection of noxious chemical and thermal stimuli by nociceptors, primary sensory neurons of the pain pathway. Overactivation of TRPV1 leads to cellular damage or death through calcium entry and excitotoxicity. We have exploited this phenomenon to conduct a systematic analysis of excitotoxicity through a genome-wide CRISPRi screen, thereby revealing a comprehensive network of regulatory pathways. We show that decreased expression of mitochondrial electron transport chain (ETC) components protects against capsaicin-induced toxicity and other challenges by mitigating both calcium imbalance and the generation of mitochondrial reactive oxygen species via distinct pathways. Moreover, we confirm the regulatory roles of the ETC in sensory neurons through gain-of-function and loss-of-function experiments. Interestingly, TRPV1⁺ sensory neurons maintain lower expression of ETC components and can better tolerate excitotoxicity and oxidative...

Challenges in Communicating and Understanding Predictive Biomarker Imaging for Alzheimer Disease

Fri, 11 Sep 2026 00:00:00 +0000

Challenges in Communicating and Understanding Predictive Biomarker Imaging for Alzheimer Disease

Chapter 21 Neurodegenerative disorders of the human frontal lobes

Fri, 11 Sep 2026 00:00:00 +0000

The frontal lobes play an integral role in human socioemotional and cognitive function. Sense of self, moral decisions, empathy, and behavioral monitoring of goal-states all depend on key nodes within frontal cortex. While several neurodegenerative diseases can affect frontal function, frontotemporal dementia (FTD) has particularly serious and specific effects, which thus provide insights into the role of frontal circuits in homeostasis and adaptive behavior. FTD represents a collection of disorders with specific clinical-pathologic correlates, imaging, and genetics. Patients with FTD and initial prefrontal degeneration often present with neuropsychiatric symptoms such as loss of social decorum, new obsessions, or lack of empathy. In those patients with early anterior temporal degeneration, language (particularly in patients with left-predominant disease) and socioemotional changes (particularly in patients with right-predominant disease) precede eventual frontal dysregulation....

Gender similarities and differences in dishonesty