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In a speech, Kelly discusses the call to action to expand and maintain the precious pool of physician-scientists. He would like to begin by reminding everyone of two historic eras that spawned a rapid expansion of physician-scientists in the US. First, under the visionary leadership of Dr James Shannon, a series of new programs was launched aimed at formally supporting the scientific training of physicians. The second development was more accidental and involved the civil unrest of the late 1960s, driven in part by the Vietnam War. In partnership with American Physician Scientists Association (APSA), they propose the Association of American Physicians (AAP)-APSA Longitudinal Coaching Program. This approach will match single- and dual-degree medical student APSA members with AAP mentor-coaches who will serve as personalized career advisors for the duration of training, from medical school to independence.

In previous studies, Auriculariaauricula polysaccharides (AAP) has been found to improve type 2 diabetes mellitus, but its mechanism remains unclear. In this study, we sought to demonstrate that AAP achieves remission by altering the gut microbiota in mice with type 2 diabetes. We successfully constructed a type 2 diabetes mellitus (T2DM) model induced by a high-fat diet (HFD) combined with streptozotocin (STZ), following which fasting blood glucose (FBG) levels and oral glucose tolerance test (OTGG) were observed to decrease significantly after 5 weeks of AAP intervention. Furthermore, AAP enhanced the activities of total superoxide dismutase (T-SOD), catalase (CAT), and glutathione peroxidase (GSH-Px), and reduced the content of malondialdehyde (MDA) to alleviate the oxidative stress injury. AAP-M (200 mg/kg/d) displayed the best improvement effect. Moreover, 16S rRNA results showed that AAP decreased the abundance of Firmicutes and increased that of Bacteroidetes. The abundance of beneficial genera such as Faecalibaculum, Dubosiella, Alloprevotella, and those belonging to the family Lachnospiraceae was increased due to the intake of AAP. AAP could reduced the abundance of Desulfovibrio, Enterorhabdus, and Helicobacter. In all, these results suggest that AAP can improve the disorders of glucose and lipid metabolism by regulating the structure of the gut microbiota.

In a speech delivered at the at the 2024 AAP/ASCI/APSA Joint Meeting, Ioannidis discusses the state of scientific research practices and how they impact the quality and reliability of scientific findings, emphasizing the challenges of reproducibility, transparency, and data sharing. He argues that the traditional reward system, which prioritizes quantity over quality, has led to a culture of questionable research practices and a decline in trust in science. He proposes a shift towards a more rigorous and transparent approach, including better study design, data sharing, and replication efforts. He also discusses the importance of addressing fraud and the impact of AI on scientific research. He calls for a reevaluation of scientific practices to ensure the integrity and reliability of research findings.

Purpose High-grade astrocytoma with piloid features (HGAP) is a recently described brain tumor entity defined by a specific DNA methylation profile. HGAP has been proposed to be integrated in the upcoming World Health Organization classification of central nervous system tumors expected in 2021. In this series, we present the first single-center experience with this new entity. Methods During 2017 and 2020, six HGAP were identified. Clinical course, surgical procedure, histopathology, genome-wide DNA methylation analysis, imaging, and adjuvant therapy were collected. Results Tumors were localized in the brain stem (n = 1), cerebellar peduncle (n = 1), diencephalon (n = 1), mesencephalon (n = 1), cerebrum (n = 1) and the thoracic spinal cord (n = 2). The lesions typically presented as T1w hypo- to isointense and T2w hyperintense with inhomogeneous contrast enhancement on MRI. All patients underwent initial surgical intervention. Three patients received adjuvant radiochemotherapy, and one patient adjuvant radiotherapy alone. Four patients died of disease, with an overall survival of 1.8, 9.1, 14.8 and 18.1 months. One patient was alive at the time of last follow-up, 14.6 months after surgery, and one patient was lost to follow-up. Apart from one tumor, the lesions did not present with high grade histology, however patients showed poor clinical outcomes. Conclusions Here, we provide detailed clinical, neuroradiological, histological, and molecular pathological information which might aid in clinical decision making until larger case series are published. With the exception of one case, the tumors did not present with high-grade histology but patients still showed short intervals between diagnosis and tumor progression or death even after extensive multimodal therapy.

Atypical antipsychotics (AAPs) are commonly prescribed medications to treat schizophrenia, bipolar disorders and other psychotic disorders. However, they might cause metabolic syndrome (MetS) in terms of weight gain, dyslipidemia, type 2 diabetes (T2D), and high blood pressure, which are responsible for reduced life expectancy and poor adherence. Importantly, there is clear evidence that early metabolic disturbances can precede weight gain, even if the latter still remains the hallmark of AAPs use. In fact, AAPs interfere profoundly with glucose and lipid homeostasis acting mostly on hypothalamus, liver, pancreatic β-cells, adipose tissue, and skeletal muscle. Their actions on hypothalamic centers via dopamine, serotonin, acetylcholine, and histamine receptors affect neuropeptides and 5′AMP-activated protein kinase (AMPK) activity, thus producing a supraphysiological sympathetic outflow augmenting levels of glucagon and hepatic glucose production. In addition, altered insulin secretion, dyslipidemia, fat deposition in the liver and adipose tissues, and insulin resistance become aggravating factors for MetS. In clinical practice, among AAPs, olanzapine and clozapine are associated with the highest risk of MetS, whereas quetiapine, risperidone, asenapine and amisulpride cause moderate alterations. The new AAPs such as ziprasidone, lurasidone and the partial agonist aripiprazole seem more tolerable on the metabolic profile. However, these aspects must be considered together with the differences among AAPs in terms of their efficacy, where clozapine still remains the most effective. Intriguingly, there seems to be a correlation between AAP’s higher clinical efficacy and increase risk of metabolic alterations. Finally, a multidisciplinary approach combining psychoeducation and therapeutic drug monitoring (TDM) is proposed as a first-line strategy to avoid the MetS. In addition, pharmacological treatments are discussed as well.

Background/Objectives: Periodontitis is an inflammatory disease associated with many systemic disorders such as diabetes and cardiovascular disease. The aim was to evaluate the usefulness of the CDC/AAP and the EFP/AAP criteria to detect subclinical atherosclerosis in subjects with diabetes and severe periodontal disease. Methods: This was a cross-sectional study. Atheroma plaque was evaluated by high-resolution carotid and femoral ultrasonography. A dental examination protocol was implemented by a trained periodontist. A full-mouth periodontal clinical examination was carried out at six sites by automated computerized Florida Probe Periodontal Probing. Periodontal disease was defined by CDC/AAP and EFP/AAP criteria. Results: In total, 98 patients were included (60.2% women), of which 50% had diabetes. Subjects with diabetes showed a high prevalence of severe cases of periodontal disease. Both criteria were useful to detect the presence of atheroma plaque only in the presence of diabetes. However, the CDC/AAP criteria had higher correlation with atheroma plaques than EFP/AAP criteria (r = 0.522 vs. r = 0.369, p < 0.001). Conclusions: The CDC/AAP and the EFP/AAP criteria are a useful tool to identify subclinical atherosclerosis in subjects with severe periodontal disease and diabetes. These results show the potential role of the oral healthcare team in the dental office for the identification of subjects with diabetes at risk of developing cardiovascular disease.

Ginsburg discusses his career path and research on blood clotting and cholesterol regulation. He explores the importance of physician-scientists who can investigate diseases from both the bedside and the bench. He discusses his research on von Willebrand factor and how he used positional cloning to identify genes responsible for rare bleeding disorders. He also talks about his work on ADAMTS13, a protein involved in a blood clotting disorder called thrombotic thrombocytopenic purpura. His work on COPII components led to the identification of SURF4, a cargo receptor for PCSK9.