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Shivon Zilis worked closely with Elon Musk while she was on OpenAI’s board。 Her ties to the world’s richest man were detailed in a landmark trial on Wednesday
Systemic immunomodulatory treatments may affect cardiovascular and renal outcomes in patients with chronic plaque psoriasis. We conducted a network meta-analysis (NMA) to compare these outcomes of systemic treatments for plaque psoriasis. Databases were searched from inception through June 1, 2023. We conducted duplicate study selection, data extraction, bias assessment risk, and NMA evidence certainty assessment and analyses. Outcomes included proportion of participants achieving Psoriasis Area and Severity Index (PASI) 75 and/or 90 and those with (1) total cardiovascular events, (2) major adverse cardiovascular events (MACE), (3) other cardiovascular events, and (4) total renal events. We included 68 randomized clinical trials (n = 34,414 patients). Compared with placebo, bimekizumab (odds ratio [OR] 101.12, 95% confidence interval [CI] 34.26-301.46, surface under the cumulative ranking curve [SUCRA] 27, high certainty) was the top treatment demonstrating better PASI 75 and had reduced total cardiovascular events (OR 0.06, 95% CI 0-0.80, SUCRA 89, moderate certainty). Ixekizumab (OR 86.92, 95% CI 39.06-199.66, SUCRA 15, high certainty) showed better PASI 90 rates but was associated with increased MACE over placebo (OR 3.26, 95% CI 1.26-9.31, SUCRA 26, high certainty) and bimekizumab (OR 31.92, 95% CI 2.01, 1123.25), moderate certainty). Renal outcomes were similar among groups. Bimekizumab showed better therapeutic efficacy scores and safety profile than other agents. Ixekizumab may increase cardiovascular risk and should be used with caution. Reliable long-term safety data of the treatments analyzed here require assessing non-randomized studies and examining postmarketing reports from regulatory agencies. PROSPERO (CRD42022381489).
Nurses working in a variety of settings may encounter transgender-diverse patients. It is important for nurses and all health care providers to understand and know how to care for and provide inclusive care. This article will discuss ways to provide inclusive care as well as the health maintenance for transgender-diverse patients, and gender-affirming treatment options.
Most intensive care patients require substitute decision makers (SDMs) to make decisions. The SDMs may prefer an active, shared, or passive decision-making role. Role incongruence is when preferred and actual roles differ. To evaluate the impact of decision-making role preferences and role incongruence on psychological distress symptoms in SDMs. A multicenter, interviewer-administered survey was conducted among SDMs of critically ill adults. The Control Preferences Scale was used to evaluate role preferences. Psychological distress was defined as anxiety, depression, or posttraumatic stress symptoms with predefined cut points on the Hospital Anxiety and Depression Scale (score > 10 on the anxiety or the depression subscale) and Impact of Events Scale (score > 30). One hundred eighty SDMs were recruited; 64% responded. Most were white (71%) and female (65%); 46% were spouses. Role preferences varied: active, 24%; shared, 44%; and passive, 31%. Almost half (49%) reported incongruence. Symptom prevalence was 50% for posttraumatic stress, 32% for anxiety, and 16% for depression. Most (56%) reported some psychological distress. In multivariable logistic regression, the composite outcome of psychological distress was independently associated with patient death (odds ratio, 2.95; 95% CI, 1.08-8.02; P = .03), female sex of SDM (odds ratio, 2.96; 95% CI, 1.49-5.89; P = .002), and incongruence (odds ratio, 3.26; 95% CI, 1.67-6.36; P < .001). Adverse psychological symptoms are prevalent in SDMs of critically ill patients and are related to role incongruence.
Infants born to women with diabetes or obesity are exposed to excess circulating fuels during fetal heart development and are at higher risk of cardiac diseases. We have previously shown that late-gestation diabetes, especially in conjunction with a maternal high-fat (HF) diet, impairs cardiac functions in rat-offspring. This study investigated changes in genome-wide histone modifications in newborn hearts from rat-pups exposed to maternal diabetes and HF-diet. Chromatin-immunoprecipitation-sequencing revealed a differential peak distribution on gene promoters in exposed pups with respect to acetylation of lysines 9 and 14 and to trimethylation of lysines 4 and 27 in histone H3 (all, false discovery rate, FDR < 0.1). In the HF-diet exposed offspring, 54% of the annotated genes showed the gene-activating mark trimethylated lysine 4. Many of these genes (1) are associated with the "metabolic process" in general and particularly with "positive regulation of cholesterol biosynthesis" (FDR = 0.03); (2) overlap with 455 quantitative trait loci for blood pressure, body weight, serum cholesterol (all, FDR < 0.1); and (3) are linked to cardiac disease susceptibility/progression, based on disease ontology analyses and scientific literature. These results indicate that maternal HF-diet changes the cardiac histone signature in offspring suggesting a fuel-mediated epigenetic reprogramming of cardiac tissue in utero.
In a major breakthrough, scientists have experimentally confirmed a universal growth law in two dimensions using a quantum system of fleeting light–matter particles。 The finding strengthens the idea that wildly different processes—from crystals to living systems—may all follow the same hidden rules
A powerful new electromagnetic thruster has taken a major step forward after a successful high-energy test at NASA’s Jet Propulsion Laboratory。 Fueled by lithium vapor and driven by intense magnetic forces, the experimental engine reached record-breaking power levels—far beyond anything currently used in space。 Glowing hotter than molten lava and f
A bizarre planetary pairing 190 light-years away is challenging everything astronomers thought they knew about how worlds form。 A “lonely” hot Jupiter — typically found without nearby companions — is sharing its system with a smaller mini-Neptune tucked even closer to the star, a setup once thought nearly impossible
Voyager 1 just powered down a nearly 50-year-old instrument to stay alive in deep space。 The spacecraft is running critically low on energy, forcing NASA to make careful sacrifices to keep its mission going。 Despite the shutdown, it continues to send back unique data from beyond our solar system
For decades, relaxor ferroelectrics have powered everything from medical ultrasounds to sonar systems, yet their inner atomic structure remained a mystery—until now。 Researchers have finally mapped their three-dimensional structure in unprecedented detail, uncovering hidden patterns in how electric charges are arranged at the nanoscale。 The breakth
Scientists are using sunlight to turn plastic waste into clean fuels like hydrogen, offering a breakthrough solution to both pollution and energy challenges。 While still in development, the approach could transform trash into a valuable resource for a low-carbon future
Astronomers have unleashed a powerful new AI tool called RAVEN to comb through data from NASA’s TESS mission—and it’s paying off in a big way。 By analyzing millions of stars, the system has confirmed over 100 exoplanets, including 31 brand-new worlds, and identified thousands more promising candidates。 What makes this especially exciting is the dis
NASA’s Psyche spacecraft is about to pull off a dramatic close flyby of Mars, skimming just 2,800 miles above the planet to get a powerful gravitational boost on its journey to the mysterious metal-rich asteroid Psyche。 The maneuver will save propellant while giving mission scientists a rare chance to test and calibrate the spacecraft’s instruments
NASA’s Curiosity rover had an unexpectedly stubborn Mars souvenir after drilling into a rock nicknamed “Atacama” — the entire chunk ripped loose from the ground and stayed stuck to the rover’s drill。 Engineers watched as Curiosity shook, vibrated, tilted, and spun the drill over several days in an effort to free the rock, while cameras captured the
A new quantum physics study reveals that simply changing a magnetic field over time can unlock entirely new forms of matter that don’t exist under normal conditions。 By carefully “driving” materials with timed magnetic shifts, researchers created exotic quantum states that could be far more stable and resistant to errors—one of the biggest challeng
Physicists may have just cracked open a hidden side of the quantum world。 For decades, every known particle was thought to belong to one of two categories — bosons or fermions — but researchers have now shown that bizarre “in-between” particles called anyons could also exist in a one-dimensional system。 Even more exciting, these strange particles m