Exploring diagnostic stewardship in the emergency department evaluation of pediatric abdominal pain in a statewide quality collaborative.

Background: Diagnostic stewardship is the effort to optimize diagnostic testing to reduce errors while avoiding overtesting and overtreatment. Abdominal pain and appendicitis in children are essential use cases. Delayed diagnosis of appendicitis can be dangerous and even life-threatening, but overtesting is harmful.

Phosphate starvation signaling increases mitochondrial membrane potential through respiration-independent mechanisms.

Mitochondrial membrane potential directly powers many critical functions of mitochondria, including ATP production, mitochondrial protein import, and metabolite transport. Its loss is a cardinal feature of aging and mitochondrial diseases, and cells closely monitor membrane potential as an indicator of mitochondrial health. Given its central importance, it is logical that cells would modulate mitochondrial membrane potential in response to demand and environmental cues, but there has been little exploration of this question.

Association of a coronavirus disease 2019 (COVID-19) vaccine booster with control of a COVID-19 outbreak in a long-term care facility in Switzerland, November to December 2021.

Coronavirus disease 2019 (COVID-19) outbreaks in long-term care facilities are often correlated with high case fatality rates. We describe the association of administration of an mRNA booster with the control of an outbreak. Our findings highlight the possibility of vaccine booster early in an outbreak as a promising method to mitigate the spread of infection.

Conceptualizing lifer versus destination patients for optimized care delivery.

Background: Patients presenting to academic medical centers (AMC) typically receive primary care, specialty care, or both. Resources needed for each type of care vary, requiring different levels of care coordination. We propose a novel method to determine whether a patient primarily receives primary or specialty care to allow for optimization of care coordination.

Isoform-specific, Semi-quantitative Determination of Highly Homologous Protein Levels via CRISPR-Cas9-mediated HiBiT Tagging.

Many protein families consist of multiple highly homologous proteins, whether they are encoded by different genes or originating from the same genomic location. Predominance of certain isoforms has been linked to various pathological conditions, such as cancer. Detection and relative quantification of protein isoforms in research are commonly done via immunoblotting, immunohistochemistry, or immunofluorescence, where antibodies against an isoform-specific epitope of particular family members are used.

Evaluating the pediatric mental health care continuum at an American health system.

Objective: To describe trends in the pediatric mental health care continuum and identify potential gaps in care coordination.

Methods: We used electronic medical record data from October 2016 to September 2019 to characterize the prevalence of mental health issues in the pediatric population at a large American health system. This was a single institution case study.

Can You Tell Who Scores? An Assessment of the Recognition of Affective States Based on the Nonverbal Behavior of Amateur Tennis Players in Competitive Matches.

The purpose of the present study was to assess whether the recognition of tennis players' affective state associated with their nonverbal behavior would be influenced by (a) the importance of the situation, (b) the point outcome, and (c) the tennis expertise of the observer. Two hundred sixty-nine participants (Mage = 30.51 years; 116 female; 79 tennis club members) watched video excerpts showing the nonverbal behavior of amateur tennis players during competitive matches immediately after the end of a rally and were asked to estimate whether the player had just won or lost the point.

Risk of type 2 diabetes mellitus among adults aging with vision impairment: The role of the neighborhood environment.

Background: Vision impairment (VI) affects approximately 1 in 28 Americans over the age of 40 and the prevalence increases sharply with age. However, experiencing vision loss with aging can be very different from aging with VI acquired earlier in life. People aging with VI may be at increased risk for diabetes due to environmental barriers in accessing health care, healthy food, and recreational resources that can facilitate positive health behaviors.

Psychometric Properties of the Mindfulness Inventory for Sport (German Version).

Mindfulness-based training programs are highly established in competitive and recreational sports. One of the best-known approaches is the Mindfulness-Acceptance-Commitment Approach (MAC) by Gardner and Moore), which integrates mindfulness aspects of awareness, non-judgmental attitude, and focus. Based on these aspects, Thienot and colleagues developed and validated an English language sport-specific questionnaire, the so-called Mindfulness Inventory for Sport (MIS), for the assessment of mindfulness skills in athletes.

Hexokinase 3 enhances myeloid cell survival via non-glycolytic functions.

The family of hexokinases (HKs) catalyzes the first step of glycolysis, the ATP-dependent phosphorylation of glucose to glucose-6-phosphate. While HK1 and HK2 are ubiquitously expressed, the less well-studied HK3 is primarily expressed in hematopoietic cells and tissues and is highly upregulated during terminal differentiation of some acute myeloid leukemia (AML) cell line models. Here we show that expression of HK3 is predominantly originating from myeloid cells and that the upregulation of this glycolytic enzyme is not restricted to differentiation of leukemic cells but also occurs during ex vivo myeloid differentiation of healthy CD34 hematopoietic stem and progenitor cells.

Longitudinal Associations Between Vision Impairment and the Incidence of Neuropsychiatric, Musculoskeletal, and Cardiometabolic Chronic Diseases.

Purpose: To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI).

Design: Retrospective cohort study.

Methods: The sample comprised enrollees in a large private health insurance provider in the United States, including 24 657 adults aged ≥18 years with VI and age- and sex-matched controls.

Reducing FASN expression sensitizes acute myeloid leukemia cells to differentiation therapy.

Fatty acid synthase (FASN) is the only human lipogenic enzyme available for de novo fatty acid synthesis and is often highly expressed in cancer cells. We found that FASN mRNA levels were significantly higher in acute myeloid leukemia (AML) patients than in healthy granulocytes or CD34 hematopoietic progenitors. Accordingly, FASN levels decreased during all-trans retinoic acid (ATRA)-mediated granulocytic differentiation of acute promyelocytic leukemia (APL) cells, partially via autophagic degradation.

Adverse outcomes associated with inappropriate direct oral anticoagulant starter pack prescription among patients with atrial fibrillation: a retrospective claims-based study.

Direct oral anticoagulant (DOAC) starter packs are designed for unique treatment dosing for acute venous thromboembolism (VTE). Inappropriate use of 30-day DOAC starter packs in patients with atrial fibrillation (AF) may increase the risk for bleeding events given higher dosing in the first 1-3 weeks of treatment. A retrospective analysis of medical and outpatient pharmacy claims data from 2015 to 2018 in Optum's De-identified Clinformatics® Data Mart was performed.

Small Bowel Resection Increases Paracellular Gut Barrier Permeability via Alterations of Tight Junction Complexes Mediated by Intestinal TLR4.

Background: Short bowel syndrome resulting from small bowel resection (SBR) is associated with significant morbidity and mortality. Many adverse sequelae including steatohepatitis and bacterial overgrowth are thought to be related to increased bacterial translocation, suggesting alterations in gut permeability. We hypothesized that after intestinal resection, the intestinal barrier is altered via toll-like receptor 4 (TLR4) signaling at the intestinal level.

EGFR in enterocytes & endothelium and HIF1α in enterocytes are dispensable for massive small bowel resection induced angiogenesis.

Background: Short bowel syndrome (SBS) results from significant loss of small intestinal length. In response to this loss, adaptation occurs, with Epidermal Growth Factor Receptor (EGFR) being a key driver. Besides enhanced enterocyte proliferation, we have revealed that adaptation is associated with angiogenesis.

Inappropriate Prescription of Direct Oral Anticoagulant Starter Packs.

Background: The 30-day direct oral anticoagulant starter pack has simplified the treatment of acute venous thromboembolisms, but it is not appropriate for use in patients with other indications for anticoagulation.

Methods: A retrospective analysis of national outpatient pharmacy claims data between January 1, 2015 and December 31, 2018, was performed. Adult patients (ages >18 years) with continuous insurance enrollment at least 12 months prior to and 1 month following a direct oral anticoagulant starter pack prescription during the study period were included.

Rational discovery of molecular glue degraders via scalable chemical profiling.

Targeted protein degradation is a new therapeutic modality based on drugs that destabilize proteins by inducing their proximity to E3 ubiquitin ligases. Of particular interest are molecular glues that can degrade otherwise unligandable proteins by orchestrating direct interactions between target and ligase. However, their discovery has so far been serendipitous, thus hampering broad translational efforts.

Increased Intraoperative Faculty Entrustment and Resident Entrustability Does Not Compromise Patient Outcomes After General Surgery Procedures.

Background: Intraoperative resident autonomy has been compromised secondary to expectations for increased supervision without defined parameters for safe progressive independence, diffusion of training experience, and more to learn with less time. Surgical residents who are insufficiently entrusted during training attain less autonomy, confidence, and even clinical competency, potentially affecting future patient outcomes.

Objective: To determine if OpTrust, an educational intervention for increasing intraoperative faculty entrustment and resident entrustability, negatively impacts patient outcomes after general surgery procedures.

Adaptation of extracellular matrix to massive small bowel resection in mice.

Background: Extracellular matrix (ECM) affects cell behavior, and vice versa. How ECM changes after small bowel resection (SBR) to support adaptive cellular processes has not been described. Here we characterize changes in ECM following SBR and integrate this with concomitant transcriptional perturbations.

Patient-derived small intestinal myofibroblasts direct perfused, physiologically responsive capillary development in a microfluidic Gut-on-a-Chip Model.

The development and physiologic role of small intestine (SI) vasculature is poorly studied. This is partly due to a lack of targetable, organ-specific markers for in vivo studies of two critical tissue components: endothelium and stroma. This challenge is exacerbated by limitations of traditional cell culture techniques, which fail to recapitulate mechanobiologic stimuli known to affect vessel development.

Are surgeons behind the scientific eight ball: Delayed acquisition of the NIH K08 mentored career development award.

Background: Surgery residents complete their research training early in residency. Non-surgical trainees typically have research incorporated toward the last two years of their fellowship, conferring an advantage to apply for grants with recent research experience and preliminary data.

Methods: The NIH RePORTER database was queried for K08 awardees trained in medicine, pediatrics, and surgery from 2013 to 2017.

Nation-Wide Use of Periprocedural Bridging Anticoagulation in Patients With Atrial Fibrillation.

The randomized, controlled BRIDGE trial established a lack of efficacy for use of bridging anticoagulation in warfarin-treated patients who underwent surgical procedures. A large nation-wide insurance claims database was used to perform a retrospective interrupted time series cohort study of adult patients with atrial fibrillation treated with warfarin who underwent surgical procedures. Patients were assessed for the use of low-molecular-weight heparin (LMWH) use as a periprocedural bridging anticoagulant between July 2015 and November 2017.