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This data article describes a two-wave longitudinal panel dataset that supports research on the public acceptance of Precision Livestock Farming (PLF) technology in swine production among adult residents of three U.S. pork-producing states. The dataset comprises two structured comma-separated-value files - panel_long_analysis.csv (n = 2565 person-wave observations; 37 variables) and panel_wide_analysis.csv (n = 345 balanced-panel respondents; 64 variables) - alongside four fully documented R analysis scripts. Data were collected via a two-wave online and mail survey administered by the Michigan State University Office for Survey Research (MSU-OSR) to adult residents of Iowa, Michigan, and North Carolina: Wave 1 in Fall 2022 (n = 1287) and Wave 2 in Fall 2023 through Spring 2024 (n = 1278). These three states together account for the majority of U.S. pork production but their residents constitute approximately 7% of the U.S. population; the deposit is therefore best characterized as a regional U.S. dataset on publics most proximate to active swine production, not as a nationally representative sample. Sampling used a 50/50 urban-rural address stratification within each state. The survey instrument measured PLF acceptance via an eight-item belief index (plf_index) and general attitudes toward agriculture and technology via a ten-item index (att_index), together with binary livestock familiarity indicators, social proximity to farmers, and standard sociodemographic covariates. A balanced sub-panel of 345 respondents who completed both waves enables within-person analysis of attitude dynamics. To recover the theoretical n = 690 person-wave panel, the deposited analysis pipeline applies multiple imputation by chained equations (MICE; m = 50, predictive mean matching for continuous and Likert items, logistic regression for binary covariates) and pools regression estimates via Rubin's rules; a listwise-deletion sample of n = 414 person-wave observations is preserved as a sensitivity benchmark. The deposited data support pooled ordinary least squares, individual fixed-effects, state × wave fixed-effects, random-effects, and first-difference panel model estimation, as well as principal components analysis, reliability assessment, distribution diagnostics, cross-sectional sub-group comparisons, and geographic analyses. All files are structured in UTF-8 CSV format with a detailed variable codebook documented herein. To the best of our knowledge, this is the first publicly available longitudinal panel dataset on U.S. general public acceptance of PLF technology in swine production. All files are deposited on Zenodo under a CC BY 4.0 license.

Perforator flaps play a vital role in soft tissue repair; however, they face challenges due to anatomical variability. Although computed tomography angiography (CTA)-based three-dimensional visualization can assist in surgical planning, it is limited by image quality and vessel extraction accuracy. This study presents advanced 3D techniques designed to enhance accuracy and evaluates their clinical outcomes. This case series investigated the clinical applications and outcomes of enhanced three-dimensional visualization for anterolateral thigh perforator (ALTP) flaps in 12 patients (13 flaps) treated between January 2021 and December 2024. Technical enhancements included: 1) optimized CTA protocols (adjusted voltage based on body mass index, high-contrast injection, and nitroglycerin administration); 2) an "Indirect Extraction Method" with a reduced threshold (105-115 HU) for small vessel reconstruction; 3) manual tracing of perforators; 4) "Digital Reverse Flap Design" (an expanded wound model projected onto the donor site); and 5) 3D-printed surgical guides for enhanced precision. The outcomes assessed were perforator accuracy, flap fit, survival, and complications. All flaps were successfully transplanted in the present study. Perforator localization was excellent (<1 cm) (81.3%, n = 13/16) and moderate (1-2 cm) (18.8%, n = 3/16). Surgical findings were consistent with 3D planning in 100% of cases regarding perforator type, source artery, and pedicle route. The flap fit was excellent (84.6%, n = 11/13) and moderate (15.4%, n = 2/13). The survival rate was 100% (n = 13/13). Foot function, assessed by the American Orthopaedic Foot & Ankle Society (AOFAS) score, was good in both cases. Hand function, measured by the Michigan Hand Outcomes Questionnaire (MHQ), was rated as excellent or good in 60% (n = 6/10) of cases. Complications occurred in two cases (12.5%), including infection (n = 1) and delayed fracture healing (n = 1). The advanced 3D technique enhances perforator localization, flap design, and surgical precision, resulting in high success rates. Limitations of the present study include a small sample size and its retrospective design.

Diabetic peripheral neuropathy is a frequent and disabling complication of type 2 diabetes mellitus (T2DM). Early identification of subclinical neuropathy is crucial to prevent progression. F-wave parameters, by assessing proximal and distal motor pathways, may serve as sensitive indicators of early nerve dysfunction. To evaluate F-wave parameters in patients with T2DM and analyse their relationship with clinical neuropathy severity (Michigan Neuropathy Screening Instrument-MNSI and Vibration Perception Threshold-VPT) and metabolic control indices. This hospital-based cross-sectional study included 226 participants (184 diabetics and 42 non-diabetic controls). All subjects underwent detailed clinical evaluation, biochemical profiling, neuropathy assessment using MNSI and VPT, and electrophysiological testing including F-wave analysis of the tibial nerve. Parameters studied were F-min latency, F-max latency, chronodispersion, F-estimate, F-wave/M-wave (F/M) amplitude ratio and persistence. Comparisons were made among three groups-non-diabetic controls, diabetics without neuropathy and diabetics with neuropathy. Correlation and receiver operating characteristic (ROC) analyses were performed to assess diagnostic and predictive utility. F-min, F-max and F-estimate latencies were significantly prolonged in diabetic subjects compared with controls (p<0.001), with stepwise worsening from non-diabetic to neuropathic groups. Chronodispersion showed minor, non-significant change, and F/M amplitude ratio exhibited mild elevation in diabetics (p<0.05). F-wave persistence remained comparable across groups. Significant positive correlations were observed between F-min latency and VPT (r=0.424, p<0.001), MNSI score (r=0.198, p=0.012) and glycated haemoglobin (HbA1c) (r=0.366, p=0.031). ROC analysis identified F-min latency (area under the curve, AUC=0.729) and F-max latency (AUC=0.710) as the most accurate discriminators for neuropathy. Prolonged F-wave latencies, particularly minimum latency and F-estimate, are sensitive markers of early motor nerve involvement in T2DM. These parameters correlate with clinical and metabolic indices of neuropathy and can enhance detection of subclinical diabetic neuropathy when routine nerve conduction studies are normal.

Despite its known effectiveness, pre-exposure prophylaxis (PrEP) remains underutilized, particularly among Black women who experience disproportionately high rates of human immunodeficiency virus (HIV). This quality improvement (QI) project evaluated the impact of a provider education intervention, combined with a culturally tailored patient educational video, on PrEP prescribing, uptake, and documentation at an urban sexually transmitted infections (STI) clinic in Detroit, Michigan. Using a pre-post design, data were collected for 3 months before and after implementation of the intervention. Among 549 eligible Black women, PrEP prescribing increased from 3.6% pre-intervention to 11.4% post-intervention (p = 0.001). Among a small sample, nearly one-third of post-intervention patients who were prescribed PrEP received the medication within 30 days, compared with zero pre-intervention. This difference did not reach statistical significance (p = 0.08), likely due to limited sample size, but may be clinically meaningful. Documentation using the recommended International Classification of Diseases, 10th Revision (ICD-10) code Z29.81 for PrEP-related encounters improved from 21.5% to 88.3% (p < 0.001). Multivariable logistic regression analyses showed that post-intervention encounters were independently associated with higher odds of PrEP prescribing within 7 days of the clinical encounter and higher odds of the recommended ICD-10 code Z29.81 being utilized for PrEP-related services. Findings suggest that combining culturally responsive strategies with patient and provider education may improve PrEP prescribing, uptake, and documentation practices. The intervention was successful in addressing persistent disparities while offering a scalable model for similar clinical settings.

Carbon stocks and stock changes in harvested wood products (HWPs) are an important part of land sector greenhouse gas (GHG) estimation and reporting. HWPs broadly categorized as products in-use (e.g., solid wood and paper products) and in solid waste disposal sites (SWDS; e.g., landfills), store carbon transferred from harvested trees. In the United States (US), estimates of carbon in HWPs have historically been reported in the US GHG Inventory and included in submissions to the United Nations Framework Convention on Climate Change. These data have been obtained from national and international statistics on production and consumption of forest products and incorporated into a compilation system to estimate carbon in products in-use and in SWDS. In contrast, estimates of carbon in forest ecosystems have been obtained from nationwide forest inventory (NFI) data collected and maintained by the US Forest Service, Forest Inventory and Analysis (FIA) program. Here we describe a case study for the northern Lake States region of the US (Michigan, Minnesota, Wisconsin) where harvest data from the FIA program were integrated into HWP compilation systems. This advance improves consistency and continuity with forest ecosystem from NFI plots with estimates of HWPs. Over the 1900-2024 time period, total estimated net accumulation (i.e., balance of additions from transfers of harvested wood from forest ecosystems and losses from decay of wood harvested in the past) of carbon stored in products in-use was 277.0&#x2009;&#xb1;&#x2009;17.5 Million Metric Tons (MMT) Carbon (C) and in SWDS was 155.2&#x2009;&#xb1;&#x2009;9.8 MMT C. We estimate that HWPs from the region represent a carbon sink of 4.9&#x2009;&#xb1;&#x2009;0.1 MMT C in 2024. These estimates include HWPs produced in the region and exported domestically or internationally, as well as any HWPs produced and retained in the region, but not imports. The proposed methodology enables disaggregation with coarse national and state-level FIA data, and allows for integration of more specific, entity-level data to improve precision and reduce uncertainty in HWPs estimates in the US and improves consistency and continuity with forest ecosystem estimates across spatial and temporal scales.

The relationship between gingival biotype (GB) and bone thickness is paramount for optimal maxillary implant outcomes. This study aimed to determine the correlation between GB and buccal bone thickness (BBT) and buccal bone height (BBH) in candidates for immediate maxillary implant placement using cone-beam computed tomography (CBCT). This cross-sectional study assessed 54 patients from the Periodontology Department at Ilam University of Medical Sciences Dental School. Gingival thickness (GT), buccal bone measurements (BBT and BBH), and clinical parameters, including keratinized gingival width (KGW) and papillary height (PH), were recorded using Michigan probes and CBCT scans. Statistical analyses (Mann-Whitney and Kruskal-Wallis tests) were conducted to evaluate associations between variables, with P<0.05 considered significant. Of the participants, 62.96% had a thick GB and 37.04% had a thin GB. Thin biotypes were significantly more prevalent among females (P<0.05). The thick GB group exhibited significantly greater KGW and overall mean BBT compared to the thin GB group (P<0.05). Conversely, no statistically significant differences were observed between thick and thin biotypes regarding overall mean BBH or PH (P>0.05). A thick gingival biotype is anatomically associated with greater buccal bone thickness and keratinized gingival width. However, there were no statistically significant differences in buccal or papillary bone height between the different gingival biotypes. Thin gingival biotypes are more prevalent among females.

The integration of artificial intelligence (AI) tools in healthcare offers significant opportunities to improve patient care. However, underrepresented groups such as the Arab/Middle Eastern North African (MENA) community in the United States have historically been excluded in health data and conversations regarding AI tool implementation and development. We present our experience with the Arab/MENA community exploring attitudes about the use of AI in healthcare, focusing on our engagement and recruitment efforts as well as relevance for learning health systems science. We conducted a virtual democratic deliberation session (n&#x2009;=&#x2009;33) in partnership with the Arab Community Center for Economic and Social Services (ACCESS) in Michigan, as part of a larger study involving five sessions (n&#x2009;=&#x2009;159). In partnership with ACCESS staff, we collaboratively developed study materials and recruited Arab/MENA community members to share their perspectives on AI in healthcare. Qualitative thematic analysis was used to identify the community's perspectives, priorities, and barriers to the use of AI in healthcare. The deliberation session highlighted four key themes related to the use of AI tools: (1) transparency in AI development was viewed as essential to building community trust, (2) human connection, with concerns that increased reliance on AI could replace empathy and weaken patient-provider interactions, (3) the role of healthcare providers, with preference on providers using AI as a supportive tool rather than replacing direct care, and (4) representation due to concerns over whether AI systems would reflect the experiences and needs of the Arab/MENA community in healthcare. Community-based partnerships are essential for advancing responsible AI implementation in healthcare and building a learning health system. Our experiences highlight the importance of transparency, cultural sensitivity, and meaningful community involvement to build trust and address the needs of underrepresented groups as AI evolves.

A 4-year-old, female spayed domestic shorthair cat was presented to the Michigan State University emergency service for evaluation of vomiting 4 days after exposure to vitamin D supplements. On intake, the patient was found to have ionized hypercalcemia and azotemia. The patient was hospitalized for calciuresis therapy including fluid diuresis, diuretics, steroids, bisphosphonates and a nasogastric feeding tube. She was discharged and presented for a recheck evaluation and was then hospitalized a second time for the same therapy as her first hospitalization. Eventually the patient was discharged for at-home care with subcutaneous fluids and oral medications because of financial constraints. Approximately 52 days after exposure, the cat was noted to have persistently normal ionized calcium and all medications were discontinued. This case provides a unique example of acute vitamin D toxicosis in a cat and a financially conservative approach in treating a toxicity with a significant half-life.

G-protein-coupled receptors (GPCRs) transduce the effects of many neurotransmitters such as epinephrine, norepinephrine, and acetylcholine. However, understanding neurotransmitter release via GPCRs at high resolution across large brain volumes remains a significant challenge. Here, we report a modular platform called single-chain expressing neurotransmitter sensing integrator tool (SENSIT) featuring the design of bifunctional chimeric nanobodies. We applied the SENSIT platform by designing reporters for epinephrine and norepinephrine that exhibit 20-fold and 5-fold selectivity over another catecholamine, respectively. To further demonstrate the modularity of the platform, we also developed a muscarinic acetylcholine receptor 2 (CHRM2)-based sensor and chimeric miniG proteins. The SENSIT platform reports the first single-chain integrator sensor capable of distinguishing epinephrine and norepinephrine as well as enabling the generalized design of integrator sensors for diverse neurotransmitters with the potential for whole-brain mapping.

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Three BODIPY-based fluorescent probes, AH+, BH+, and CH+, were synthesized for ratiometric pH sensing in living cells and fruit fly larvae. These probes were designed to target mitochondrial environments by functionalizing the BODIPY core with various substituent groups that tune their pH sensitivity. The probes exhibited strong ratiometric fluorescence changes with pKa values (AH+, 7.3; BH+, 7.5; CH+, 7.2) suitable for mitochondrial pH detection. Theoretical calculations supported these findings by establishing the geometries and electronic transitions and also resulted in the derivation of their pKa values. Confocal imaging confirmed mitochondrial accumulation of these probes in HeLa cells, facilitating a broad-range pH monitoring across a wide pH spectrum (3.5 to 9.1). These ratiometric pH sensors display good reversibility and response time under varying pH conditions. In application, the probe AH+ was utilized to monitor pH fluctuations under conditions of oxidative stress and starvation conditions. Dual-channel cell imaging revealed a pH-dependent fluorescence shift with precise transitions, demonstrating the feasibility of real-time monitoring of mitochondrial pH changes in living cells. Furthermore, the probe AH+ effectively visualized pH changes in Drosophila melanogaster larvae, further supporting its applicability across diverse biological systems. We demonstrate that a fluorescence ratiometric intensity graph for probe AH+ can be effectively employed to determine pH values within the mitochondria of HeLa cells.

Patients with Turner syndrome often have ear abnormalities which predispose them to chronic otitis media. They are also predisposed to develop intracranial hypertension. Both of these conditions can contribute to the development of skull base defects, which should be considered in patients with Turner syndrome presenting with them.

Emergency medicine (EM) residency programs must strive to teach adaptive expertise (AE) so that graduates can apply existing knowledge to innovatively address novel problems. The Master Adaptive Learner (MAL) framework describes a structured approach for the development of AE, yet its practical application in medical education, and specifically in EM training, is limited. This study aimed to explore how first-year EM residents approach identifying, prioritizing, and filling knowledge gaps during the planning phase of the MAL framework. We conducted a prospective qualitative study using a simulation-based learning exercise at two U.S. academic medical centers across two consecutive years. The simulation placed EM interns in a realistic emergency department scenario where they had to independently address knowledge gaps before engaging in guided discussions. Data were collected through surveys and focus groups, transcribed, and thematically analyzed. Knowledge gaps were categorized by type (factual, conceptual, procedural, metacognitive), and success in filling selected gaps was recorded. Intern rationales for gap prioritization and resource selection were examined. Fifty-seven EM interns participated, identifying 305 knowledge gaps, with factual gaps being most common. Participants successfully filled 90% of their top-priority knowledge gaps using resources such as UpToDate and WikEM. Rationales for gap prioritization emphasized clinical urgency (e.g., airway management) and readiness to engage in decision-making and communication. Resource selection was driven by familiarity and perceived efficiency. Interns often explored multiple resources, highlighting intellectual curiosity and desire for conceptual application of knowledge. This study demonstrates that EM interns possess developing skills aligned with the MAL planning phase and can effectively address knowledge gaps through structured learning simulations. Simulation-based exercises offer an impactful method for contextualizing medical education theory and preparing residents for future clinical challenges. These findings support the integration of MAL principles into early residency curricula to promote adaptive expertise development.

Core-shell electrospun scaffolds may help coordinate antibacterial and immunomodulatory effects during periodontal healing. Their unique architecture may enable a more spatiotemporal control over the delivery of therapeutic agents. This study fabricated coaxial poly(&#x3b5;-caprolactone)/gelatin (PCL/Gel) fibers loaded with dexamethasone (DEX) and metronidazole (MET) and evaluated their physicochemical and biological performance. PCL/Gel core-shell fibers were electrospun with DEX (5% w/w in the PCL core) and MET (30% w/w in the gelatin shell), producing four groups: PCL/Gel (control), MET, DEX, and DEX/MET. Core-shell structure and morphology were assessed by SEM, TEM, and fluorescence imaging; mass loss in PBS and tensile properties were measured. Antibiofilm activity against Porphyromonas gingivalis (Pg), alveolar bone-derived mesenchymal stem cells (aBMSCs) viability/spreading and mineralization, and IL-1&#x3b1;/TNF-&#x3b1; production by LPS-stimulated RAW 264.7 macrophages exposed to scaffold extracts were evaluated. Data were analyzed based on normality and variance; group comparisons used one- or two-way ANOVA with appropriate post hoc tests (&#x3b1; = 0.05). All groups formed uniform core-shell fibers with comparable degradation and mechanical behavior. MET-containing scaffolds reduced Pg biofilm recovery (p &#x2264; 0.032). After LPS stimulation, IL-1&#x3b1; levels returned to baseline only in DEX-containing groups (DEX and DEX/MET), whereas IL-1&#x3b1; remained elevated in groups without DEX (p &#x2264; 0.0119); TNF-&#x3b1; was also significantly reduced in DEX-containing groups versus control and MET (p < 0.0001). All scaffolds supported increasing aBMSCs viability and spreading; mineralization increased from day 14-21 in all groups (p < 0.0001), with the highest deposition in the DEX-only group at day 21 (p &#x2264; 0.0032). Coaxial PCL/Gel core-shell fibers provided antibiofilm and anti-inflammatory functionality while maintaining cytocompatibility and osteogenic compatibility, supporting their potential as a multifunctional scaffold for periodontal regenerative applications.

A 77-year-old man with chronic iron-deficiency anemia and prior small bowel resection presented with terminal ileal ulcerations suggestive of Crohn's disease, along with elevated C-reactive protein and markedly increased fecal calprotectin. Medication review revealed chronic meloxicam use. Following discontinuation, his inflammatory markers and anemia normalized, and repeat colonoscopy demonstrated complete resolution of ileal ulcers. This case highlights nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy as an important mimic of Crohn's disease and emphasizes the importance of thorough medication review and clinical correlation to prevent misdiagnosis and unnecessary immunosuppressive therapy.

Research on community health effects of Animal Feeding Operations (AFOs) frequently relies on prevalence-based effect measures, particularly for chronic respiratory outcomes. Interpreting these measures as indicators of comparative disease occurrence requires specific structural population assumptions, yet it remains unclear whether such assumptions are reported in this literature. We conducted a Mini Review of observational studies identified through a previously published systematic review and an ongoing living systematic review to assess whether prevalence studies of AFO exposures and community health explicitly reported the assumptions required to interpret prevalence ratios or prevalence odds ratios as approximations of comparative incidence. Eligible studies used prevalent disease status and reported comparative prevalence-based effect measures. We assessed whether authors discussed assumptions related to population stability, outcome duration, temporal ordering, reverse causality, and disease rarity. Across 15 included studies, none explicitly reported or discussed these structural population assumptions, despite routinely presenting covariate-controlled effect estimates. Greater transparency in reporting population-level assumptions is needed to support valid causal interpretation of prevalence-based effect measures in AFO research and to better inform public health decision-making.

Vocational interests predict relevant outcomes in individuals' lives, but most evidence comes from youth. It remains unexplored whether interests continue to predict outcomes across mid and late adulthood, and whether their predictive power varies with age. Drawing on life course and motivational lifespan theories, we hypothesized that the relations of interests with life outcomes depend on structural opportunities and constraints that vary across age. We used large-scale, population-representative data (N = 3,596-8,904) to examine whether vocational interests predict work (e.g., income, unemployment, leadership), relationship (e.g., marriage, divorce), and communal (e.g., civic engagement, cultural participation) outcomes assessed 11 years later. Across adulthood (ages 25-67 at interest assessment), interests significantly contributed to all 12 outcomes, demonstrating that interests are predictive of life outcomes after adolescence and young adulthood. Age-moderation analyses using local structural equation modeling and age-group-specific analyses indicated that many interest-outcome links remained stable throughout adulthood but revealed some differentiated patterns consistent with age-graded opportunities and constraints. Specifically, links between interests and work outcomes were often strongest in mid-career and largely remained stable thereafter. For relationship outcomes, the predictive strength of interests peaked in early adulthood and weakened over midlife. For communal outcomes, most age variation in the predictive strength of interests occurred in later adulthood. Overall, results add a lifespan perspective to interest theory and suggest that age can provide a relevant context to realize interests through life choices, which should be considered in theory and practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Increasing numbers of children are conceived using infertility treatment; concerns remain about potential effects on child neurodevelopment. To evaluate whether infertility treatment is associated with child neurodevelopment and whether such an association may be attributable to underlying subfecundity. This cohort study was conducted among mother-child dyads in the National Institutes of Health Environmental Influences on Child Health Outcomes Cohort, with infants conceived between 1998 and 2022. Associations of subfecundity and infertility treatment with neurodevelopmental outcomes were assessed among children ages 2 to 10 years. Data were analyzed from May 14, 2025, to March 31, 2026. Subfecundity was defined as prior consultation for, treatment of, or diagnosis of infertility for either partner; at least 2 prior miscarriages; or ever having had unprotected heterosexual intercourse for 12 months without conceiving. Infertility treatment was categorized as in vitro fertilization (IVF) or non-IVF treatment. Harmonized caregiver responses to the Strengths and Difficulties Questionnaire and the Child Behavior Checklist yielded continuous raw scores for externalizing and internalizing problems. The total raw Social Responsiveness Scale (SRS) score quantified autism-like symptoms. Caregivers reported physician diagnosis of autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). Among 15&#x202f;382 mother-infant dyads, there were 14&#x202f;191 unique maternal participants (mean [SD] age at delivery, 30.9 [5.33] years; 8780 parous participants [57.1%]). ASD and ADHD were diagnosed in 876 offspring (7.6%) and 819 offspring (7.1%), respectively. In generalized linear models, subfecundity was associated with higher externalizing problem and SRS scores among all pregnancies (externalizing problems: b&#x2009;=&#x2009;0.47 [95% CI, 0.14-0.81]; SRS score: b&#x2009;=&#x2009;1.08 [95% CI, 0.01-2.14]) and when restricted to natural conceptions (externalizing problems: b&#x2009;=&#x2009;0.45 [95% CI, 0.07-0.83]; SRS score: b&#x2009;=&#x2009;1.12 [95% CI, -0.09 to 2.34]). Offspring of parents with subfecundity had higher odds of ASD (overall: odds ratio [OR], 1.27 [95% CI, 1.03-1.57]; natural conceptions: OR, 1.31 [95% CI, 1.04-1.64]). Children conceived via non-IVF treatment had higher odds of ADHD compared with those conceived via natural conception with subfecundity (OR, 1.77 [95% CI, 1.16-2.68]) or without subfecundity (OR, 1.54 [95% CI, 1.05-2.25]). There were no significant associations for IVF treatment. In this large US cohort study, subfecundity was associated with elevated scores for caregiver-reported symptoms of behavioral problems and higher odds of ASD diagnosis, independent of infertility treatment. Non-IVF treatment was associated with ADHD, warranting further research into specific indications for treatment that may increase risk of offspring neurodevelopmental problems.

To ensure Alzheimer's disease-modifying treatments can be initiated in diverse populations, efficient pathways to obtain timely diagnoses are required. This interim sub-analysis of a multicenter US study included cross-sectional surveys and interviews with neurologists at 12 diverse sites to assess real-world lecanemab use. At survey completion, &#x223c;1342 patients had received lecanemab. Most referrals originated from primary care. Amyloid pathology was confirmed primarily by positron emission tomography (58%) or cerebrospinal fluid (35%), with blood-based biomarkers (BBMs) increasingly used to reduce diagnostic delays. All sites performed apolipoprotein E4 (APOE &#x3b5;4) testing to inform risk/benefit decisions. Infusions usually started within 6 months of diagnosis. Delayed/incomplete referrals were identified as the most significant barrier in the current patient pathway. These findings demonstrate the feasibility of lecanemab integration in diverse clinical settings and highlight the importance of primary care physician engagement, optimization of referral pathways, and expanding BBM use in improving timely diagnosis, equitable access, and early treatment initiation.