California Wellness Foundation

To evaluate the outcomes of a street medicine intervention offering syphilis testing and treatment to people experiencing homelessness in South Los Angeles, California-a population disproportionately affected by syphilis and underserved by traditional healthcare systems. From September 2024 to January 2025, a multidisciplinary street medicine team provided testing and treatment for syphilis during outreach visits to patients experiencing homelessness. A total of 99 patients were tested using the reverse syphilis testing algorithm. Demographic data included gender, race/ethnicity, substance use disorder, mental illness and HIV status. χ2 tests were used to evaluate associations between syphilis diagnosis and each demographic characteristic. Thirty-six (36.4%) of the 99 patients had reactive syphilis test results, with 94.4% (n=34) classified as late-stage infections. Of those diagnosed, 72.2% (n=26) were treated during follow-up visits. Statistically significant associations were found between syphilis diagnosis and gender (p=0.002), substance use disorder (p=0.008) and HIV status (p=0.020). Patients identifying as female or transgender female, and those with cooccurring substance use disorder or HIV, were more likely to be diagnosed with syphilis. This study demonstrates the feasibility and outcomes of delivering sexually transmitted infection care through street medicine. The high prevalence of late-stage syphilis and its syndemic overlap with substance use disorder and HIV underscores the need for low-barrier, community-based services. Street medicine interventions should be recognised and resourced as essential tools in public health responses to rising syphilis rates, particularly among unhoused populations.

OBJECTIVES: To characterize telomere length (TL) and determine biological and clinical factors associated with telomere shortening among individuals leukocyte telomere length (LTL) receiving an advanced wellness program at a clinical wellness institution in Thailand. MATERIALS AND METHODS: This retrospective study included adults aged ≥18 years who underwent TL assessment as part of advanced wellness programs at two clinical wellness institutions in Thailand. Demographic, hormonal, micronutrient, metabolic, and clinical laboratory data were extracted from electronic medical records and laboratory databases within two weeks before or after TL measurement. Associations between TL and related demographic, hormonal, micronutrient, metabolic, and clinical variables were assessed using Pearson’s correlation coefficient. A two-sided p-value < 0.05 was considered statistically significant. RESULTS: Among 1,684 records, TL –derived biological aging was significantly associated with multiple biological domains. Higher levels of insulin-like growth factor 1 (IGF-1) and dehydroepiandrosterone sulfate (DHEA-S) were positively correlated with slower aging, while cortisol showed no significant association. Markers of glucose metabolism, including fasting glucose, HbA1c, and insulin, demonstrated consistent inverse correlations with TL, indicating accelerated aging with poorer glycemic control. Lipid parameters showed modest associations: total cholesterol and low-density lipoprotein cholesterol (LDL-C) were positively associated with slower aging, whereas triglycerides were inversely associated with faster aging. Ferritin levels were negatively correlated with telomere-related aging, while C-reactive protein (CRP) showed no consistent relationship. Several micronutrients and antioxidants, particularly magnesium, selenium, folate, vitamin D, and coenzyme Q10, exhibited significant inverse associations with accelerated aging, most prominently in the fast-aging group. CONCLUSION: Telomere shortening was associated with specific biological domains, particularly metabolic regulation and endocrine function, followed by micronutrient status, whereas associations with acute inflammatory markers were limited. These findings support the role of TL as a contextual biomarker for investigating biological aging within clinical wellness institutions in Thailand settings.

A lack of access to timely and appropriate support is associated with early breastfeeding cessation, and programs that house lactation support in tandem with primary care have improved feeding outcomes. The purpose of this clinical project was the integration of lactation services and primary care within a federally qualified health center, providing insights into implementation challenges and innovations. Utilizing a lactation consultant alongside a clinician during primary care visits required administrative and logistical support, as well as early clinician champions. This program demonstrated a financially stable and efficacious collaboration with a family medicine residency program.

The purpose of this retrospective case series is to describe real-world clinical experience with DermaBind TL or FM, (HealthTech Wound Care, US), a dehydrated full-thickness placental membrane intended for homologous use as a protective wound covering in wounds of various aetiologies that failed to heal with standard of care (SoC). This retrospective observational, uncontrolled case series collected data from healthcare providers in the US. Eligible cases were patients, ≥18 years of age, with hard-to-heal wounds who received DermaBind TL or FM after having completed a minimum of four weeks of SoC without evidence of wound improvement. Data collected included patient demographics, wound characteristics and wound size. The cases of 27 patients encompassing 36 wounds were included. The average age of patients included was 72.4 years (range: 37-101 years). The majority of wounds were pressure ulcers (63.9%), followed by diabetic foot ulcers (19.4%) and venous leg ulcers (8.3%). Wound onset was, on average, 29 weeks prior to the first graft application with the placental membrane, and the average wound size was 34cm2. Graft applications occurred weekly, with an average duration of treatment of 6.7 weeks. The observed average percentage surface area reduction across the 36 wounds was 69.1% (range: -17.6-100%). No adverse events were reported by the provider across all patient cases. These observations describe the clinical use of DermaBind as a wound covering material consistent with its homologous natural protective role. Larger, prospective studies are warranted to further investigate its clinical use. The authors would like to stress that this non-randomised, retrospective uncontrolled case series was used to describe findings, such as number of grafts applied, observed percentage of surface area reduction and graft wasted, and not to demonstrate efficacy.

This study aims to reveal the extent of the negative effects of technology use in children and adolescents, such as cyberbullying, problematic internet use, and difficulties with emotional regulation. It also seeks to determine whether these issues show significant differences based on gender and to test whether emotional regulation difficulties and problematic internet use significantly predict cyberbullying behaviors. The research was designed using a quantitative relational survey model. The study's sample consists of a total of 325 students attending middle and high schools in Mersin and Ankara. The Difficulties in Emotion Regulation Scale – Short Form (DERS-16), Cyberbullying Scale, and Problematic Internet Use Scale – Adolescent Form (PIUS-A) were used as data collection tools. In addition to descriptive statistical analyses, independent samples t-tests and multiple regression analysis were used to test the relationships between variables. The research findings show that emotional regulation difficulties and problematic internet use significantly predict cyberbullying behaviors in children and adolescents. Accordingly, interdisciplinary studies with larger samples, longitudinal designs, and multiple data collection methods are recommended.

ABSTRACT Obesity and mental health disorders are among the greatest public health challenges of the twenty-first century. Interestingly, an altered microbiome profile has been associated with both conditions. The aim of this randomized, double-blind, placebo-controlled clinical trial was to evaluate the effects of dietary supplementation with a specific probiotic strain (Lactiplantibacillus plantarum KABP051) on body composition and gut microbiome balance, together with measures of mood state, in a population of healthy overweight subjects. Sixty healthy, moderately stressed, non-depressed and overweight or obese volunteers were supplemented for 12 weeks with probiotic (L. plantarum KABP051; 1 billion cfu/day) or placebo (microcrystalline cellulose). The KABP051 group experienced significantly greater improvements compared to placebo on body composition measurements, including a reduction in body weight and waist circumference, which decreased in 1.97±0.77 (mean±SE) kg and 2.15±0.81 (mean±SE) cm vs. placebo at the end of the intervention (both p< 0.05, MMRM and post-hoc analysis). Microbiome composition improved in KABP051 group, with significant increase in the relative abundance of Lactiplantibacillus spp. vs. placebo. Body fat percentage, POMS fatigue, and confusion sub-scores showed a global trend toward improvement compared to placebo, with the change at 12 weeks being significant in the three measurements in post-hoc analysis (p=0.015, p=0.014 and p=0.016, respectively). No serious adverse events were registered during the intervention period. These results suggest that a specific strain of probiotic bacteria (L. plantarum KABP051) may have both metabolic and psychobiotic effects and may be beneficial for enhancing weight loss and body composition, improving energy and mood levels while embarking on a healthy lifestyle regimen.

Thyroid hormone replacement remains the cornerstone of hypothyroidism management, yet a substantial subset of patients continue to experience persistent symptoms despite achieving biochemical euthyroidism with standard levothyroxine therapy. This clinical reality highlights the need for a more individualized approach to thyroid hormone replacement that accounts for interindividual variability in thyroid hormone metabolism, tissue sensitivity, and systemic physiologic context. This review proposes a clinician-focused framework for personalized thyroid hormone replacement, integrating current evidence with real-world clinical experience. This review will examine the physiologic determinants of variability in thyroid hormone action, including deiodinase activity, hormone transport, inflammatory and metabolic influences, and the impact of age, sex hormones, and comorbid conditions. Distinct clinical phenotypes of hypothyroid patients are described to guide patient stratification and therapeutic decision-making. Therapeutic strategies are reviewed, including levothyroxine monotherapy, combination T4/T3 therapy, and alternative formulations, with emphasis on patient selection, dosing principles, and safety considerations. A practical clinical algorithm is presented to support individualized treatment adjustments based on both biochemical markers and symptom patterns. In addition, the importance of integrating lifestyle and systemic factors-such as metabolic health, inflammation, nutrient status, and stress physiology-into comprehensive thyroid care will be discussed. Case-based examples illustrate the application of a personalized approach in common clinical scenarios. By moving beyond a one-size-fits-all model and embracing a precision framework, clinicians can better tailor thyroid hormone replacement to optimize patient outcomes. Future research priorities include phenotype-driven clinical trials and the development of biomarkers that more accurately reflect tissue-level thyroid hormone activity.

Electrical impedance tomography (EIT) is an emerging imaging modality that assesses the bioelectrical impedance of the chest wall. It enables the generation of immediate topographical images non-invasively and without the use of radiation. However, current commercial systems are limited to single-plane measurements. Recently, we developed a prototype of a multi-slice EIT system that can reconstruct data into three-dimensional (3D) EIT images. Here, we report the first case of using 3D-EIT measurements in a patient diagnosed with severe pneumonia. A 62-year-old female presented with fever, cough, and difficulty in breathing. The patient was diagnosed with bacterial pneumonia in her bilateral lower lobes based on chest radiography, CT, and laboratory data. The patient's profile was as follows: height, 160 cm; weight, 52 kg; and chest height, 84 cm. The 3D-EIT system comprised eight electrodes per slice surface, with four fault lines positioned on a single belt. We successfully obtained four EIT slices simultaneously, which were converted to 3D-EIT representations. These four slices were almost identical to those in the CT scans. Notably, in this patient with lower-lobe pneumonia, the 3D-EIT system revealed that the air entered the upper area first, whereas the healthy volunteer breathed in the lower lobe first. We successfully performed 3D-EIT in patients with pneumonia. Specifically, in lower-lobe pneumonia cases, our findings showed a reversed airflow pattern, with air initially entering the upper area. This underscores the potential of our developed technology to offer novel insights into the vertical sequence of air inflow.