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Draft a comprehensive differential diagnosis for acute substernal chest pain in a 45-year-old male with hypertension and hyperlipidemia, diaphoresis, exertional onset, and normal initial ECG/troponin; include life-threatening causes first, key distinguishing features, and immediate diagnostic next steps.

Draft a detailed differential diagnosis for new-onset unilateral throbbing headache with visual aura and brief monocular vision loss in a 32-year-old female on oral contraceptives; include red-flag symptoms, stroke/TIA considerations, and recommended initial workup.

Draft an assessment and plan for stage-2 hypertension (BP 162/98) in an obese 52-year-old with suspected obstructive sleep apnea; include ASCVD risk estimate, lifestyle prescriptions, first-line pharmacotherapy with drug/dose/targets, baseline labs/monitoring, and 4–6 week follow-up.

Draft an assessment and plan for type 2 diabetes follow-up with A1c 9.2% on metformin 1,000 mg BID and eGFR 65; compare adding a GLP-1 receptor agonist vs an SGLT2 inhibitor, address weight loss goals, hypoglycemia education, vaccinations, and micro/macrovascular screening.

Draft a history and physical for a patient presenting with chest pain, including HPI using OLDCARTS, pertinent ROS, PMH/meds/allergies, FH/SH, focused cardiac/pulmonary exam, initial labs and imaging orders, prioritized differential, HEART score risk stratification, and early management.

Draft a history and physical for a new patient with progressive exertional dyspnea, orthopnea, and bilateral leg edema; include differential (heart failure, COPD, PE, anemia, renal disease), targeted exam maneuvers, and first-line diagnostics and management.

Draft a progress note for COPD follow-up two weeks after an acute exacerbation treated with prednisone and antibiotics; include symptom trajectory, CAT score (if available), inhaler technique/adherence, oxygen needs, spirometry plan, smoking cessation counseling, and return precautions.

Draft a progress note for post-operative day 2 after total knee arthroplasty; include pain control strategy, DVT prophylaxis, PT/OT milestones, wound status, bowel/urinary function, labs/vitals review, complications screening, and discharge readiness.

Draft a discharge summary for community-acquired pneumonia admission; include admission/discharge dates, presenting symptoms, radiology/labs, pathogen if identified, inpatient therapies and response, discharge medications with durations, pending tests, follow-up appointments, and return precautions.

Draft a discharge summary for myocardial infarction managed with PCI and drug-eluting stent placement; include cath findings, complications, inpatient course, discharge medications (DAPT, statin, beta-blocker, ACEi/ARB), cardiac rehab referral, and follow-up plan.

Draft discharge instructions for a patient hospitalized with acute decompensated heart failure; include daily weights, sodium and fluid restriction amounts, medication list with dosing, signs of worsening heart failure, follow-up appointments, and lab monitoring plan.

Draft discharge instructions for an asthma exacerbation; include controller and reliever regimen, steroid taper schedule, spacer technique, trigger avoidance, a written asthma action plan, return precautions, and follow-up timing.

Draft a patient handout on managing high blood pressure in plain language; explain what BP numbers mean, key lifestyle steps (DASH diet, sodium limits, alcohol moderation), home BP monitoring instructions, medication adherence tips, and when to call the doctor.

Draft a patient handout for type 2 diabetes education in plain language; cover A1c goals, the plate method, physical activity targets, self-monitoring of blood glucose, hypoglycemia signs and the 15-15 rule, foot care basics, and a vaccination checklist.

Draft a summary of the latest CDC and WHO guidelines for managing community-acquired pneumonia in adults, including empiric antibiotic choices, duration of therapy, and follow-up recommendations.

Draft a plain-language overview of the ADA and AACE guidelines for diabetes management, focusing on A1c goals, weight management, and the use of GLP-1 receptor agonists and SGLT2 inhibitors.

Draft a summary of the 2024 USPSTF breast cancer screening recommendations, including updated screening intervals, risk-based approaches, and the role of MRI for high-risk patients.

Draft a concise summary of NCCN guidelines for melanoma management, including staging, surgical margins, adjuvant therapy, and checkpoint inhibitor recommendations.

Draft treatment alternatives for community-acquired MRSA skin infections in patients allergic to sulfa drugs; include oral and IV options, dosing, and duration.

Draft treatment alternatives for patients with type 2 diabetes who are unable to tolerate GLP-1 receptor agonists due to nausea; include medication substitutions and lifestyle recommendations.

Draft a summary of options for treating refractory depression, comparing ketamine infusions, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT).

Draft treatment options for advanced prostate cancer, including hormonal therapy, radiopharmaceuticals, and novel androgen receptor pathway inhibitors.

Draft a summary of recent research on mRNA vaccine technology beyond COVID-19, including applications in oncology and autoimmune disease prevention.

Draft an easy-to-understand overview of long COVID research, summarizing major symptoms, hypothesized mechanisms, and emerging treatment approaches.

Draft a summary of current research on Alzheimer’s disease biomarkers, including amyloid and tau imaging, and discuss how they influence diagnosis and trial design.

Draft an explanation of the interaction between warfarin and antibiotics such as ciprofloxacin or TMP-SMX, including INR effects and management recommendations.

Draft a summary evaluating drug interactions for patients taking Paxlovid and common cardiovascular drugs; include mechanism and recommended dose adjustments.

Draft a summary of the common and serious side effects of semaglutide, including GI intolerance, gallbladder disease, and thyroid-related warnings.

Draft an overview of potential side effects associated with long-term corticosteroid use, including osteoporosis, glucose intolerance, and adrenal suppression.

Draft a summary of essential lab tests to order in suspected acute pancreatitis, including amylase, lipase, liver enzymes, and metabolic panels, with interpretation guidance.

Draft laboratory workup recommendations for suspected hypothyroidism, including TSH, free T4, thyroid antibodies, and when to consider secondary causes.

Draft an explanation of which labs should be monitored in patients receiving methotrexate therapy, including CBC, LFTs, renal function, and frequency of monitoring.

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Research Article: Family functioning and dysfunctional attitudes mediate the link between childhood maltreatment and nonsuicidal self-injury in depressed college students: a moderated mediation model of anhedonia

Date Published: 2025-10-01

Abstract:
Childhood maltreatment is a well-established risk factor for nonsuicidal self-injury (NSSI), particularly in individuals with major depressive disorder (MDD). The psychological mechanisms are complex and not completely understood. Based on the Cognitive?Behavioral Vulnerability Model, this study aimed to investigate whether family functioning and dysfunctional attitudes act as parallel mediators of the relationship between childhood maltreatment and NSSI and anhedonia moderates the association between dysfunctional attitudes and NSSI in depressed college students. 525 college students diagnosed with MDD were recruited from the ESCID project. They completed Childhood Trauma Questionnaire (CTQ), Family Assessment Device (FAD), Dysfunctional Attitude Scale (DAS), Snaith-Hamilton Pleasure Scale (SHAPS), and a measure of NSSI. Data were analyzed using SPSS 26.0 for descriptive statistics and correlations, and Mplus 8.3 for mediation and moderated mediation analyses, employing maximum-likelihood estimation with Monte Carlo integration. Childhood maltreatment showed a positive correlation with dysfunctional attitudes, anhedonia, and NSSI, while family functioning demonstrated no significant association. Mediation analyses revealed that childhood maltreatment had both a direct effect on NSSI (? = 0.125, p < 0.05, 95% CI [0.010, 0.240]) and an indirect effect through dysfunctional attitudes (? = 0.035, p < 0.05, 95% CI [0.008, 0.063]). In contrast, the mediating role of family functioning was not significant (? = ?0.060, p > 0.05), as was the total indirect effect. Moderated mediation analyses showed that anhedonia significantly moderated the association between dysfunctional attitudes and NSSI (? = 0.190, p < 0.001, 95% CI [0.092, 0.288]). Simple slope tests indicated that dysfunctional attitudes exhibited a stronger correlation with NSSI in individuals with high levels of anhedonia, while this correlation became nonsignificant at lower levels. Our findings reveal that dysfunctional attitudes significantly mediate the link between childhood maltreatment and NSSI, while family functioning showed no mediating effect. Anhedonia amplified the impact of dysfunctional attitudes on NSSI, suggesting that cognitive and affective vulnerabilities enhance the risk of self-injury. Interventions that target dysfunctional attitudes and enhance hedonic capacity may improve prevention and treatment among maltreated youth with depression.

Introduction:
Major depressive disorder (MDD) is a prevalent mental health condition worldwide, recognized as a primary contributor to disability and disease burden. Global estimates indicate that around 290 million individuals were affected by depression in 2019, demonstrating a consistent rise in its prevalence ( 1 , 2 ). Notably, the prevalence of depressive symptoms or diagnosed MDD is much higher among college students than in the general adult population. A large-scale survey conducted in the post-pandemic era reported…

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