Disease-State Dependent Associations Between Intrinsic Brain Function and Symptoms of Fatigue, Depression, and Anxiety in Crohn's Disease.

Background: Extraintestinal symptoms (EIS) in inflammatory bowel diseases, including fatigue, depression and anxiety, are highly prevalent, but poorly understood. Alterations of brain function may contribute to EIS, but their association with disease activity is unclear. This study analyzed intrinsic neural activity (INA) of individuals with Crohn's disease (CD) in different disease states and examined the relationship between INA and EIS.

Digestive cancers: mechanisms, therapeutics and management.

Cancers of the digestive system are major contributors to global cancer-associated morbidity and mortality, accounting for 35% of annual cases of cancer deaths. The etiologies, molecular features, and therapeutic management of these cancer entities are highly heterogeneous and complex. Over the last decade, genomic and functional studies have provided unprecedented insights into the biology of digestive cancers, identifying genetic drivers of tumor progression and key interaction points of tumor cells with the immune system.

Symptom Reporting in Patients with Primary Biliary Cholangitis: Higher Burden of Symptoms detection using an interactive App.

Introduction: Primary Biliary Cholangitis (PBC) is a chronic autoimmune liver disease causing bile duct destruction and inflammation, impacting patient quality of life (QoL) due to variable symptoms. Digital symptom-tracker apps may improve patient care through enhanced monitoring. This feasibility study reassessed symptom burden in PBC patients using a tailored symptom-tracker app, focusing on its usability, effectiveness, and impact on management and QoL.

Guidance on selecting and evaluating AI auto-segmentation systems in clinical radiotherapy: insights from a six-vendor analysis.

Artificial Intelligence (AI) based auto-segmentation has demonstrated numerous benefits to clinical radiotherapy workflows. However, the rapidly changing regulatory, research, and market environment presents challenges around selecting and evaluating the most suitable solution. To support the clinical adoption of AI auto-segmentation systems, Selection Criteria recommendations were developed to enable a holistic evaluation of vendors, considering not only raw performance but associated risks uniquely related to the clinical deployment of AI.

Evaluating the prognostic value of radiomics and clinical features in metastatic prostate cancer using [Ga]Ga-PSMA-11 PET/CT.

Prostate cancer is a significant global health issue due to its high incidence and poor outcomes in metastatic disease. This study aims to develop models predicting overall survival for patients with metastatic biochemically recurrent prostate cancer, potentially helping to identify high-risk patients and enabling more tailored treatment options. A multi-centre cohort of 180 such patients underwent [Ga]Ga-PSMA-11 PET/CT scans, with lesions semi-automatically segmented and radiomic features extracted from lesions.

Fractionated low-dose radiotherapy primes the tumor microenvironment for immunotherapy in a murine mesothelioma model.

Combination immune checkpoint inhibitors (nivolumab and ipilimumab) are currently a first-line treatment for mesothelioma; however, not all patients respond. The efficacy of treatment is influenced by the tumor microenvironment. Murine mesothelioma tumors were irritated with various radiotherapy doses.

Monte Carlo in the mechanistic modelling of the FLASH effect: a review.

FLASH radiotherapy employs ultra-high dose rates of >40 Gy/s, which may reduce normal tissue complication as compared to conventional dose rate treatments, while still ensuring the same level of tumour control. The potential benefit this can offer to patients has been the cause of great interest within the radiation oncology community, but this has not translated to a direct understanding of the FLASH effect. The oxygen depletion and inter-track interaction hypotheses are currently the leading explanations as to the mechanisms behind FLASH, but these are still not well understood, with many questions remaining about the exact underpinnings of FLASH and the treatment parameters required to optimally induce it.

Correlation of Preclinical Imaging Modalities and Immunohistochemistry for Tumor Hypoxia and Vasculature.

Background/aim: Tumors exhibit impaired blood flow and hypoxic areas, which can reduce the effectiveness of treatments. Characterizing these tumor features can inform treatment decisions, including the use of vasculature modulation therapies. Imaging provides insight into these characteristics, with techniques varying between clinical and preclinical settings.

Identification of novel candidate genes for Ascochyta blight resistance in chickpea.

Ascochyta blight, caused by the necrotrophic fungus Ascochyta rabiei, is a major threat to chickpea production worldwide. Resistance genes with broad-spectrum protection against virulent A. rabiei strains are required to secure chickpea yield in the US Northern Great Plains.

Process-based therapy vs. routine-CBT for difficult-to-treat mood and anxiety disorders: study protocol for a randomized controlled trial.

Background: Process-based therapy (PBT) is a new framework to intervention planning, based on the use of ecological momentary assessment (EMA) data and dynamic and idiographic network analyses. Support for its applicability has been reported from a single-case studies. Here, we examine the feasibility and effectiveness of PBT in a larger clinical sample.

[Left bundle branch (area) pacing: lead positioning and implant criteria-step for step].

Left bundle branch area pacing is currently the most common form of physiological pacing prior to His bundle pacing. It is intended to prevent or correct the development of pacemaker-induced cardiomyopathy and is being used more and more frequently. In order to be able to perform this successfully, knowledge regarding the specific anatomy and radiological anatomy as well as the ECG criteria for left bundle branch pacing is required in addition to knowledge of the tools.

Family planning impact on medical students' surgery interest and current policies in the United States: A scoping review.

Introduction: Previous reviews have examined female residents' experiences while ante- and postpartum. However, to our knowledge, no review exists that synthesizes medical students' perception of family planning during surgical residencies. We wanted to synthesize current literature on the perceptions of family planning of medical students interested in surgical fields and current medical school policies or resources related to family planning.

Predictive value of renal shear wave elastography in liver cirrhosis.

Background: In liver cirrhosis, prognosis is profoundly affected by renal function. This study evaluates the usefulness of renal stiffness measurement by point-shear wave elastography and renal perfusion by duplex.

Methods: In this case-control study, organ stiffness was quantified using point-shear wave elastography and duplex sonography to calculate the arterial resistive (RI) and pulsatility indices (PI) in 123 patients, including patients with liver cirrhosis with (LC+A) and without ascites (LC-A) and patients without liver cirrhosis (NLC).

ECM1 attenuates hepatic fibrosis by interfering with mediators of latent TGF-β1 activation.

Objective: Extracellular matrix protein 1 (ECM1) serves as a gatekeeper of hepatic fibrosis by maintaining transforming growth factor-β1 (TGF-β1) in its latent form. ECM1 knockout (KO) causes latent (L) TGF-β1 activation, resulting in hepatic fibrosis with rapid mortality. In chronic liver disease (CLD), ECM1 decreases with increasing CLD severity.

Improving quantitative neuromuscular monitoring: an education initiative on stimulating electrode placement.

Quantitative neuromuscular monitoring reduces the incidence of residual neuromuscular block, but broad acceptance of monitoring has been elusive despite recommendations for quantitative monitoring for decades. Acceptance of quantitative monitoring may, in part, be related to the quality of the data from monitoring systems. This evaluation explored proper stimulating electrode positioning for electromyographic (EMG) monitoring, the impact of an educational intervention on electrode positioning and anesthesia provider (anesthesiologist, resident, anesthetist) confidence in the monitoring data from the device.

Delayed Gut Colonization Changes Future Insulin Resistance and Hepatic Gene Expression but Not Adiposity in Obese Mice.

Objective: The importance of early microbial dysbiosis in later development of obesity and metabolic disorders has been a subject of debate. Here we tested cause and effect in mice.

Methods: Germ-free male Swiss Webster mice were colonized in a specific-pathogen-free (SPF) facility at 1 week (1W) and 3 weeks (3W) of age.

Hepatic bile acid accretion correlates with cholestatic liver injury and therapeutic response in knockout mice with a humanized bile acid composition.

knockout (KO) mice lack the liver enzyme responsible for synthesis of 6-hydroxylated muricholate bile acid species and possess a more hydrophobic human-like bile acid composition. KO mice develop cholestatic liver injury that can be prevented by the administration of an ileal bile acid transporter (IBAT) inhibitor. In this study, we investigated the potential of an ileal bile acid transporter (IBAT) inhibitor (SC-435) and steroidal farnesoid X receptor (FXR) agonist (cilofexor) to modulate established hepatobiliary injury and the consequent relationship of intrahepatic bile acid content and hydrophobicity to the cholestatic liver injury phenotype.

Privacy-preserving large language models for structured medical information retrieval.

Most clinical information is encoded as free text, not accessible for quantitative analysis. This study presents an open-source pipeline using the local large language model (LLM) "Llama 2" to extract quantitative information from clinical text and evaluates its performance in identifying features of decompensated liver cirrhosis. The LLM identified five key clinical features in a zero- and one-shot manner from 500 patient medical histories in the MIMIC IV dataset.

LLM-AIx: An open source pipeline for Information Extraction from unstructured medical text based on privacy preserving Large Language Models.

In clinical science and practice, text data, such as clinical letters or procedure reports, is stored in an unstructured way. This type of data is not a quantifiable resource for any kind of quantitative investigations and any manual review or structured information retrieval is time-consuming and costly. The capabilities of Large Language Models (LLMs) mark a paradigm shift in natural language processing and offer new possibilities for structured Information Extraction (IE) from medical free text.

mFOLFOX6 versus mFOLFOX6 + aflibercept as neoadjuvant treatment in MRI-defined T3-rectal cancer: a randomized phase-II-trial of the German Rectal Cancer Study Group (CAO/ARO/AIO 0214).

Background: Neoadjuvant chemotherapy is an option for patients with locally advanced rectal cancer at low risk for local recurrence. This randomized phase II trial investigated whether the addition of aflibercept to modified FOLFOX6 (mFOLFOX6) could improve the rates of centrally confirmed pathological complete remissions (pCR) and (disease-free) survival in magnetic resonance imaging (MRI)-staged cT3 rectal cancer.

Patients And Methods: Patients with rectal cancer fulfilling the following criteria were included: lower border of tumor >5 cm and <16 cm from anal verge; circumferential resection margin >2 mm and T3-tumor with a maximum infiltration of 10 mm, as determined by MRI.

Molecular identification of Mymarothecium viatorum and Anacanthorus penilabiatus in extensive native fish farming systems of the Peruvian Amazon.

Piaractus brachypomus (Pacú) is the main native fish species cultivated in Peru and holds great potential for growth in aquaculture from the Peruvian Amazon. Between October 2021 and January 2022 in two fish producing farms in the Amazon region of San Martín in Peru, P. brachypomus individuals were examined for parasite evaluation.

ChatGPT and large language models (LLMs) awareness and use. A prospective cross-sectional survey of U.S. medical students.

Generative-AI (GAI) models like ChatGPT are becoming widely discussed and utilized tools in medical education. For example, it can be used to assist with studying for exams, shown capable of passing the USMLE board exams. However, there have been concerns expressed regarding its fair and ethical use.