Citations

Abstract Background and Objectives Implementation of screening, brief intervention, and referral to treatment (SBIRT) for substance use in primary care remains challenging. Care coordination (CC) may strengthen SBIRT by supporting brief interventions, improving referral follow‐through, and enhancing continuity. CC models and outcomes vary, however, and no prior scoping review has synthesized these. Methods A comprehensive search of 10 resources, including Embase, MEDLINE, and PsycINFO, was conducted on 4/15/2025. Eligible studies described outpatient SBIRT models adding CC for any age group. Articles were excluded if they lacked CC, presented no original data, or were not in English. Relevant implementation and patient‐level outcomes were extracted to describe CC models and their impact. Results Of 737 abstracts and 50 full texts reviewed, 15 met the inclusion criteria. Studies spanned primary care, specialty care, and age ranges. CC models included embedded behavioral health providers, centralized linkage managers, and remote coordinators using phone or digital platforms. CC was associated with higher screening completion, brief intervention delivery, referral initiation, and treatment engagement. Successful integration incorporated structured communication, follow‐up protocols, and accessible technology. Barriers included limited billing infrastructure, weak electronic record integration, and unclear roles. Discussion and Conclusions CC appears to enhance SBIRT implementation and treatment engagement across outpatient settings. Embedded approaches offer relational benefits, while remote and digital strategies show promise for scalability. Comparative studies are needed to assess effectiveness, cost, and contextual fit. Scientific Significance Provides the first review of CC models within SBIRT, highlighting their implementation impact and guiding future optimization.

Objective We examined the weight management practices of successful high school wrestlers to contribute meaningful data to the conversations that weight-certifying clinicians and athletic trainers have with athletes at the start of the wrestling season. Understanding how elite athletes navigate weight management can inform safer and more individualized guidance during preseason assessments. Specifically, we sought to determine the proportion of state-qualifying wrestlers who competed at or above their certified minimum weight class. We also quantified the magnitude of weight change from certification to state competition and analyzed seasonal trends in both body weight and body fat percentage over a 20-year period. Design Longitudinal retrospective review. Setting Four Minnesota high schools. Patients or Other Participants State-qualifying wrestlers from 2003 to 2023. Independent Variable State-qualifying weight class. Main Outcome Measure(s) Dependent variables are certification weight, measured body fat percent, and calculated minimum weight class. Results Only 48 wrestlers (52.7%; CI = 42.5%, 63.0%) competed at state in their minimum weight class, while the other 43 competed 1 to 2 weight classes above. Thirty-six wrestlers (39.6%) gained weight over the season. Conclusions Nearly half the successful wrestlers competed in weight classes above their minimum weight, while 5% lost 9% to 18% of their body mass over the wrestling season. This suggests factors other than maximizing individual athletic potential, such as team needs to fill a weight class, influence weight management decisions. Over the 20-year span of the study, trends toward lower measured body fat percentage and lower weight fluctuations suggest influences from sports specialization and year-round training and less emphasis on extreme leanness for competitive advantage. Athletes, in consultation with their coaches and clinicians, should select a competition weight class where they can adequately fuel, train, and recover. This may not be their minimum certified weight class.

Key Points Contemporary aspirin exacerbated respiratory disorder (AERD) therapy commonly includes aspirin desensitization (55%) and biologics (48%). Aspirin desensitization therapy has higher discontinuation rates than biologics. Patients receiving biologics are younger, and ∼25% of the patients switch to other agents.

Abstract Description RNA- and DNA-binding proteins are crucial for regulating gene expression by affecting DNA accessibility, transcription, and repair, as well as RNA splicing, transport, and stability. Dysfunction, mislocalization, aggregation, and liquid-liquid phase separation of these proteins are common in neurodegenerative and neuroinflammatory diseases. TDP43 mislocalization is notably implicated in neurodegenerative diseases like amyotrophic lateral sclerosis (ALS) and frontotemporal dementia. In 97% of ALS cases, the loss of nuclear TDP43 and the formation of cytoplasmic aggregates (TDP43 proteinopathy) in motor neurons are observed. This loss or mislocalization of TDP43 disrupts nucleic acid sequestration and may activate cytosolic DNA and RNA sensors such as RIG1 and cGas-STING pathways, leading to the expression of interferon-stimulated genes (ISGs). Evidence suggests that the ubiquitin-like protein ISG15 contributes to neuron loss. Using primary murine cortical neurons, human IPSC-derived motor neurons, and mixed neural cultures, we report the impact of TDP43 knockdown and mislocalization on neuronal interferon signaling and ISG15 expression. We also use ISG15-deficient neurons to measure ISG15-dependent impacts on neuron viability. Our findings show ISG15-dependent effects on cGas-STING signaling, astrogliosis, and neuron loss in an AAV-C9orf72 mouse model of ALS using global and conditional ISG15 KO mice. Funding Sources Supported by Dominium Foundation Career Development Award (Clarkson). Topic Categories Neuroimmunology (NEUR)

Abstract Description Coccidiomycosis is an endemic fungal infection caused by Coccidioides spp., and diagnosis is often made with serology. Coccidiomycosis is especially problematic for immunocompromised patients, with greater risk for disseminated infection and mortality. This study evaluated current strategies for detecting antibodies to Coccidioides, including enzyme immunoassay (EIA), immunodiffusion (ID) and complement fixation (CF) and applied a new ID assay for improved sensitivity and specificity. Clinical sensitivity and specificity studies were done using 1544 unique serum specimens for which Coccidioides EIA testing was clinically requested. A full panel of EIA IgG, EIA IgM, ID and CF was performed on each, comparing our in-house immunodiffusion assay using reagents from Cactus Bio, LLC to our current reference laboratory. Full method validation was completed, as prescribed by CLIA. Using existing reference lab testing as the standard, a sensitivity of 96.9%, specificity 85.9%, PPV 54.9%, NPV 99.4% was achieved. Additional chart review demonstrated the in-house ID improved to 98.0% sensitivity, 94.6 specificity, 84.2% PPV, 99.4% NPV. Such high NPV supports using reflex testing, which allowed our lab to eliminate hundreds of unnecessary CF referrals each month, saving diagnostic time, financial waste and lab resources. A reflexive testing algorithm paired with this enhanced ID assay is especially useful for the immunosuppressed, for which Coccidioides infections carry a greater risk. Topic Categories Translational and Interventional Immunology (TI)

Background: Qualification of non-invasive tests (NITs) and blood biomarkers for fibrosis severity and risk assessment is an unmet need in clinical care for cirrhosis. The paucity of reproducibility data for imaging and blood biomarkers in cirrhosis hinders their application for longitudinal monitoring. The aim of this study was to evaluate the reproducibility of imaging and blood biomarkers in a prospective cohort of adults with cirrhosis. Methods: We prospectively enrolled adults with cirrhosis in an observational, longitudinal cohort study. Participants completed a research visit with vibration-controlled transient elastography (VCTE) with liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) and blood testing, including AST, ALT, platelets, alpha-fetoprotein (AFP), and the Fibrosis-4 Index (FIB-4). Biomarkers were repeated a median of 3 months apart without any interim intervention. The primary outcome was the reproducibility of each biomarker as assessed by the reproducibility coefficient (RDC%), within-participant coefficient of variation (wCV), intraclass correlation coefficient (ICC), and Bland–Altman analysis. Results: In total, 40 participants (mean age 62, 60% female, mean BMI 28.6 kg/m 2 ) had VCTE/CAP, 38 AST/ALT, and 26 had AFP at both time points. The RDC% for VCTE-LSM was 54.4, wCV 0.19, and ICC 0.91. VCTE CAP had an RDC% of 56, a wCV of 0.30, and ICC 0.47. AFP had an RDC% of 58, a wCV of 0.21, and an ICC of 0.95. RDC% for AST, ALT, and FIB-4 ranged from 70% to 79%. On Bland–Altman analyses, VCTE-LSM demonstrated the lowest relative bias (0.4%). Conclusions: Prospective assessment of repeat biomarkers in adults with cirrhosis found that VCTE-LSM and CAP provide consistent assessments across individuals but may yield substantial within-individual variation. Blood-based biomarkers had poor reproducibility within individuals but were consistent in detecting between-patient variability. These data can inform ultrasound-based non-invasive testing qualification by defining thresholds that may reflect measurement variability rather than true biologic change over time.