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Introduction: Patients use the internet to search for health-related information. We sought to characterize the information that patients find when searching for dermatologists on Google. Methods: The Centers for Medicare and Medicaid Services (CMS) Physician Comparable Downloadable File was utilized to identify all Medicare-participating dermatologists practicing in Pennsylvania (PA). A custom Google-based search engine was used to search each dermatologist. Up to the top 10 results for each physician were then sorted into: (1) physician, hospital, or healthcare system, (2) third-party, (3) social media, (4) academic journal articles, or (5) other. Results: Within the CMS, 519 health care providers (53.9% male, 46.1% female) self-identified as dermatologists practicing in PA. At least one search result was obtained for each physician (4,963 total search results). About 30.6% (1,519) search results were hospital, health system, or physician-controlled websites, and 26.6% (1,318) were third-party websites (1,318; 26.6%). Social media websites accounted for 601 (12.1%) hits whereas peer-reviewed academic journal websites generated 135 (2.7%) results. One-way chi-square analysis showed domains were not randomly distributed across the five categories (P

Objective: Glial fibrillary acidic protein (GFAP) is expressed in astrocytes and may be a useful marker of non‐active progressive multiple sclerosis (MS). We evaluate serum GFAP (sGFAP) in a large cohort of MS patients to determine if it predicts progression independent of relapse activity (PIRA), future gait aid, and conversion to secondary progressive disease (SPMS). Methods: Adults with clinically isolated syndrome or any subtype of MS who were listed in the Brigham MS Center Research Database and had at least one sGFAP result were included. All clinic visits following first sample were analyzed for PIRA, future gait aid, and conversion to SPMS. Future cognitive dysfunction and fatigue were evaluated as secondary outcomes. Results: In total, 741 patients were included (average age: 42.3, average disease duration: 3.7 years, median EDSS: 2, and median follow‐up duration: 10.0 years). Of 643 patients (86.8%) without progressive disease at baseline, 15.9% developed SPMS. Among all 741, 50.5% had PIRA and 18.6% developed a gait aid requirement. sGFAP level predicted PIRA, future gait aid, and conversion to SPMS in univariable models (p < 0.001, <0.001, and 0.002). sGFAP remained predictive for PIRA and future gait aid in multivariable models in those younger than 50 (p = 0.048, 0.003). Change in sGFAP level over time was not predictive. There was no association between sGFAP and future fatigue or cognitive dysfunction. Interpretation: sGFAP helps to predict PIRA, future gait aid, and conversion to SPMS in a large cohort of MS patients. Our data suggest that baseline levels may be more useful than the change over time. [ABSTRACT FROM AUTHOR]

Chitosan was chemically functionalized with poly(diethylaminoethyl methacrylate) (PDEAEMA) using a grafting to approach to produce a CO2-responsive material for adsorbing metals from wastewater streams. A need for improved economical and greener approaches to recover heavy metals from wastewater streams exists due to increasing resource scarcity. Chitosan is currently used as an adsorbent for heavy metals but suffers from some properties that can be disadvantageous to its effectiveness; it is difficult to effectively disperse in water (which limits available surface area) and to regenerate. We set out to improve its effectiveness by grafting CO2-responsive tertiary amine containing polymers onto the chitosan backbone, with the goals of preparing and assessing a new type of adsorbent based on a novel concept; using carbon dioxide switchable polymers to enhance the performance of chitosan. PDEAEMA chains prepared by nitroxide-mediated polymerization were grafted onto chitosan functionalized with glycidyl methacrylate. In carbonated water, the grafted chitosan displayed improved dispersibility and exhibited a Ni(II) adsorption capacity higher than several other chemically functionalized chitosan variants reported in the literature with the regenerated material having a higher capacity than all physical and chemical derivatives reported in the literature. The results of this study validate the continued development of this material for applications in heavy metal removal and recovery from wastewater streams. [ABSTRACT FROM AUTHOR]

We describe a case of spontaneous intracranial hypotension secondary to a CSF-venous fistula that was treated with transvenous embolization. We present the imaging findings from a brain MRI before and after embolization demonstrating changes in the patient's mamillopontine distance. Decreased mamillopontine distance is a marker of spontaneous intracranial hypotension and a minor criterion in the Bern Score., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)