The Role of the Microbiome in Cancer Therapies: Current Evidence and Future Directions.

The microbiome is essential for maintaining human health and is also a key factor in the development and progression of various diseases, including cancer. Growing evidence has highlighted the microbiome's significant impact on cancer development, progression, and treatment outcomes. As research continues to unfold, the microbiome and its modulation stand out as a promising frontier in cancer research and therapy.

Directed protein engineering identifies a human TIM-4 blocking antibody that enhances anti-tumor response to checkpoint inhibition in murine colon carcinoma.

Background: T-cell immunoglobulin and mucin domain containing molecule-4 (TIM-4) is a scavenger receptor best known for its role in recognizing dying cells. TIM-4 orchestrates phagocytosis allowing for cellular clearance of apoptotic cells, termed efferocytosis. It was previously shown that TIM-4 directly interacts with AMPKα1, activating the autophagy pathway, leading to degradation of ingested tumors, and effectively reducing antigen presentation.

Original Research: Is Your Outpatient Office Prepared to Manage an Opioid Overdose?

Background: Outpatient facilities, such as family and adult practice offices, psychiatric offices, and substance use treatment centers, should be equipped to manage medical emergencies and facilitate hospital transfers. Clinics that treat patients with opioid use disorder must be especially prepared to address respiratory arrest due to opioid overdose.

Purpose: The objective of this integrative review was to identify emergency response initiatives already investigated or developed that could be adapted to address opioid-related medical emergencies in the outpatient adult treatment setting.

Correction: A pragmatic parallel arm randomized-controlled trial of a multi-pronged electronic health record-based clinical decision support tool protocol to reduce low-value antipsychotic prescriptions among older adults with Alzheimer's and related dementias.

[This corrects the article DOI: 10.1371/journal.pone.

Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America.

Heart failure (HF) is characterized by significant symptoms, compromised quality of life, frequent hospital admissions, and high mortality rates; palliative care (PC) is, therefore, highly relevant for patients with HF and their clinicians. Multiple guidelines and consensus statements recommend the provision of PC alongside HF management. However, few resources exist to guide the integration of PC into HF care, for both primary PC (provided by HF clinicians in the course of HF care) and specialty PC (provided by PC specialists).

Are Direct Primary Care Practices Located in Health Professional Shortage Areas?

Direct primary care (DPC) is a model of health care delivery that relies on membership fees for service; however, it has been criticized as potentially worsening the shortage of primary care physicians. We sought to compare the distribution of DPC practices in the United States to that of non-DPC primary care and assess the overlap with Health Resources and Services Administration designated health professional shortage areas (HPSAs). We mined data from publicly available sources on DPC practices, HPSAs, and other primary care physicians.

Symptom prevalence in patients with advanced heart failure and its association with quality of life and activities of daily living.

Background: Quality of life (QOL) and functional status are two key outcomes for patients with advanced heart failure (HF). We examined the association of eleven symptoms with QOL and functional status impairment in patients with advanced HF.

Methods And Results: This was a retrospective analysis of baseline data from a multi-center, cluster-randomized controlled trial (NCT01459744) which enrolled patients with an implanted cardioverter-defibrillator and advanced HF at high-risk for mortality.

The Positive School Safety Program (PSSP) for School Officers: Implementation Processes and Outcomes.

Approximately 50% of U.S. students attend a school with a school officer.

Reverse-engineering placebo analgesia.

Placebo analgesia is a widely observed clinical phenomenon. Establishing a robust mouse model of placebo analgesia is needed for careful dissection of the underpinning circuit mechanisms. However, previous studies failed to observe consistent placebo effects in rodent models of chronic pain.

Contrasting methods to operationalize antibiotic exposure in clinical research: a real-world application on healthcare-associated Clostridioides difficile infection.

The goal of this article is to summarize common methods of antibiotic operationalization used in clinical research and demonstrate methods for exposure variable selection. We demonstrate three methods for modeling exposure, using data from a case-control study on Clostridioides difficile infection in hospitalized patients: 1) factor analysis, 2) logistic regression models, and 3) Least Absolute Shrinkage and Selection Operator (LASSO) regression. The factor analysis identified 8 variables contributing the most variation in the dataset: any antibiotic exposure; number of antibiotic classes; number of antibiotic courses; dose; and specific classes monobactam, 𝛽-lactam 𝛽-lactamase inhibitors, rifamycin, and cephalosporin.

Self-Reported PrEP Use and Risk of Bacterial STIs Among Ontarian Men Who Are Gay or Bisexual or Have Sex With Men.

Purpose: HIV pre-exposure prophylaxis (PrEP) may increase rates of bacterial sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (GBM) through risk compensation (eg, an increase in condomless sex or number of partners); however, longitudinal studies exploring the time-dependent nature of PrEP uptake and bacterial STIs are limited. We used marginal structural models to estimate the effect of PrEP uptake on STI incidence.

Methods: We analyzed data from the iCruise study, an online longitudinal study of 535 Ontarian GBM from July 2017 to April 2018, to estimate the effects of PrEP uptake on incidence of self-reported bacterial STIs (chlamydia, gonorrhea, and syphilis) collected with 12 weekly diaries.

Phosphodiesterase-4 Inhibitors Increase Pigment Cell Proliferation and Melanization in Cultured Melanocytes and within a 3-Dimensional Skin Equivalent Model.

Vitiligo is a common chronic autoimmune disease characterized by white macules and patches of the skin, having a negative impact on patients' life and without any definitive cure at present. Identification of new compounds to reverse depigmentation is therefore a pressing need for this disease. The pharmacologic compounds phosphodiesterase-4 inhibitors (PDE4is) are small molecules with immunomodulatory properties used for treatment of inflammatory dermatoses.

Gender Differences Regarding Palliative Care Consultation Among Persons Hospitalized With Heart Failure.

Context: Palliative care is increasingly recognized as an important aspect of heart failure (HF) management, but data on gender differences regarding palliative care needs are scarce.

Objective: We retrospectively studied patients hospitalized with a primary diagnosis of HF who received an initial palliative care consultation in the Mount Sinai Health System to examine gender differences.

Methods: From electronic health records, we extracted patient information, diagnostic codes, and the palliative care consult assessment which included the Karnofsky performance status (KPS) and the Edmonton symptom assessment scale (ESAS).

Donald N. Bersoff (1939-2024).

This article memorializes Donald N. Bersoff (1939-2024), who provided a foundational influence on the development of American law-psychology and served as the 2013 president of the American Psychological Association (APA). Don had a long and meaningful career as a psychologist and a lawyer.

Clinician Insights into Effective Components, Delivery Characteristics and Implementation Strategies of Ambulatory Palliative Care for People with Heart Failure: A Qualitative Analysis.

Objectives: To elicit perspectives from specialist palliative care (SPC) and cardiology clinicians concerning the necessary components, delivery characteristics and implementation strategies of successful ambulatory SPC for people with heart failure (HF).

Background: Palliative care is a recommended component of guideline-directed care for people with HF. However, optimal strategies to implement SPC within ambulatory settings are unknown.

Clinician perspectives on integrating neuro-oncology and palliative care for patients with high-grade glioma.

Background: Patients with high-grade glioma have high palliative care needs, yet few receive palliative care consultation. This study aims to explore themes on (1) benefits of primary (delivered by neuro-oncologists) and specialty palliative care (SPC) and (2) barriers to SPC referral, according to a diverse sample of clinicians.

Methods: From September 2021 to May 2023, 10 palliative physicians and 10 neuro-oncologists were recruited via purposive sampling for diversity in geographic setting, seniority, and practice structure.

Inferring Population HIV Viral Load From a Single HIV Clinic's Electronic Health Record: Simulation Study With a Real-World Example.

Background: Population viral load (VL), the most comprehensive measure of the HIV transmission potential, cannot be directly measured due to lack of complete sampling of all people with HIV.

Objective: A given HIV clinic's electronic health record (EHR), a biased sample of this population, may be used to attempt to impute this measure.

Methods: We simulated a population of 10,000 individuals with VL calibrated to surveillance data with a geometric mean of 4449 copies/mL.

Associations of PM exposure with emergency department visits and readmissions among preterm infants with bronchopulmonary dysplasia.

Objectives: To quantify the association of ambient air pollution (particulate matter, PM) exposure with medically attended acute respiratory illness among infants with bronchopulmonary dysplasia (BPD).

Study Design: Single center, retrospective cohort study of preterm infants with BPD in Metropolitan Philadelphia. Multivariable logistic regression quantified associations of annual mean PM exposure (per μg/m) at the census block group level with medically attended acute respiratory illness, defined as emergency department (ED) visits or hospital readmissions within a year after first hospital discharge adjusting for age at neonatal intensive care unit (NICU) discharge, year, sex, race, insurance, BPD severity, and census tract deprivation.

Continuous Monitoring of Advanced Hemodynamic Parameters during Hemodialysis Demonstrated Early Variations in Patients Experiencing Intradialytic Hypotension.

Intradialytic hypotension (IDH) is a severe complication of hemodialysis (HD) with a significant impact on morbidity and mortality. In this study, we used a wearable device for the continuous monitoring of hemodynamic vitals to detect hemodynamic changes during HD and attempted to identify IDH. End-stage kidney disease patients were continuously monitored 15 min before starting the session and until 15 min after completion of the session, measuring heart rate (HR), noninvasive cuffless systolic and diastolic blood pressure (SBP and DBP), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR).

"Life…Gets Turned Upside-Down…" Opportunities to Improve Palliative Care for High-Grade Glioma.

Context: Early palliative care referral is recommended broadly in oncology. Yet, few patients with high-grade gliomas (HGG) - highly aggressive brain tumors - receive specialty palliative care consultation.

Objectives: To delineate unique needs of HGG patients relative to other oncology patients according to perceptions of a diverse sample of US palliative medicine physicians and neuro-oncologists in each of the eight domains of palliative care; and to describe contrasts between physician specialties on indications for and timing of specialty palliative care referrals in HGG.

SASH1 S519N Variant Links Skin Hyperpigmentation and Premature Hair Graying to Dysfunction of Melanocyte Lineage.

A better understanding of human melanocyte (MC) and MC stem cell biology is essential for treating MC-related diseases. This study employed an inherited pigmentation disorder carrying the SASH1 variant in a Hispanic family to investigate SASH1 function in the MC lineage and the underlying mechanism for this disorder. We used a multidisciplinary approach, including clinical examinations, human cell assays, yeast 2-hybrid screening, and biochemical techniques.

A Qualitative Study of Physicians' Views on the Reuse of Electronic Health Record Data for Secondary Analysis.

Electronic health records (EHRs) have become ubiquitous in clinical practice. Given the rich biomedical data captured for a large panel of patients, secondary analysis of these data for health research is also commonplace. Yet, there are many caveats to EHR data that the researchers must be aware of, such as the accuracy of and motive for documentation, and the reason for patients' visits to the clinic.

Testing the Reliability of Optical Coherence Tomography to Measure Epidermal Thickness and Distinguish Volar and Nonvolar Skin.

In persons with limb loss, prosthetic devices cause skin breakdown, largely because residual limb skin (nonvolar) is not intended to bear weight such as palmoplantar (volar) skin. Before evaluation of treatment efficacy to improve skin resiliency, efforts are needed to establish normative data and assess outcome metric reliability. The purpose of this study was to use optical coherence tomography to (i) characterize volar and nonvolar skin epidermal thickness and (ii) examine the reliability of optical coherence tomography.