Clinical utility of synuclein skin biopsy in the diagnosis and evaluation of synucleinopathies.

Introduction: The diagnosis of diseases known as synucleinopathies, Parkinson's disease (PD), multiple system atrophy (MSA) and Lewy body dementia (DLB), is predominantly based on clinical criteria. However, diagnostic uncertainty may persist until late in the disease process leading to delays in diagnosis and medical mismanagement. Skin biopsy detection of phosphorylated alpha-synuclein (P-SYN) is a sensitive and specific technique that increases diagnostic sensitivity of synucleinopathies, although the clinical utility of this test has not been fully explored.

Effect of Tiered Implementation of Clinical Decision Support System for Acute Kidney Injury and Nephrotoxin Exposure in Cardiac Surgery Patients.

Background:  Nephrotoxin exposure may worsen kidney injury and impair kidney recovery if continued in patients with acute kidney injury (AKI).

Objectives:  This study aimed to determine if tiered implementation of a clinical decision support system (CDSS) would reduce nephrotoxin use in cardiac surgery patients with AKI.

Methods:  We assessed patients admitted to the cardiac surgery intensive care unit at a tertiary care center from January 2020 to December 2021, and August 2022 to September 2023.

Night flight facilitates late breeding catch-up in a long-distance migratory seabird.

Long-distance migrants must optimise their timing of breeding to capitalise on resources at both breeding and over-wintering sites. In species with protracted breeding seasons, departing earlier on migration might be advantageous, but is constrained by the ongoing breeding attempt. Here we investigated how breeding timing affects migratory strategies in the Manx shearwater (Puffinus puffinus), a trans-hemispheric migratory seabird with large temporal variation in the onset of breeding.

The impact of transient air pollution exposure on worker performance in Chinese soccer players.

Using a unique dataset on the performance of soccer players in China (retrieved from 632 matches involving 24 teams during the 2014 to 2016 seasons), we investigate the effect of air pollution on different performance indicators that rely on different mixtures of the physical and cognitive inputs of players. To ensure a causal interpretation, we implement an instrumental variable (IV) approach using thermal inversion as the instrument for air pollution. We found that players' performance indicators, especially those more related to cognitive factors, are more strongly influenced by air pollution.

Extracting International Classification of Diseases Codes from Clinical Documentation using Large Language Models.

Background: Large language models (LLMs) have shown promise in various professional fields, including medicine and law. However, their performance in highly specialized tasks, such as extracting ICD-10-CM codes from patient notes, remains underexplored.

Objective: The primary objective was to evaluate and compare the performance of ICD-10-CM code extraction by different LLMs with that of human coder.