Use of Ex Situ Machine Perfusion for Liver Transplantation: The National Experience.

Background: Machine perfusion (MP) for liver transplantation has become more widespread in the United States, but national studies on this growing practice are lacking. We investigated national use and outcomes of MP for liver transplantation.

Methods: Adult (≥18 y) liver recipients transplanted between January 1, 2016 and September 30, 2023 in the United Network for Organ Sharing database were included.

Personal career decisions during medical training are not complicated, they are complex.

Background: For medical training to be deemed successful, in addition to gaining the skills required to make appropriate clinical decisions, trainees must learn how to make good personal decisions. These decisions may affect satisfaction with career choice, work-life balance, and their ability to maintain/improve clinical performance over time-outcomes that can impact future wellness. Here, the authors introduce a decision-making framework with the goal of improving our understanding of personal decisions.

Dignity-related distress and recall among alert, non-delirious critically ill patients.

Objectives: Critical illness is associated with multiple undesired impacts, including residual psychological distress, frequently associated with recollections of critical illness. Dignity-related distress is highly prevalent among the one-fifth of critically ill patients who are alert. The distress may be associated with unpleasant recollections of care.

Birth Prevalence of Sickle Cell Disease and County-Level Social Vulnerability - Sickle Cell Data Collection Program, 11 States, 2016-2020.

Sickle cell disease (SCD) remains a public health priority in the United States because of its association with complex health needs, reduced life expectancy, lifelong disabilities, and high cost of care. A cross-sectional analysis was conducted to calculate the crude and race-specific birth prevalence for SCD using state newborn screening program records during 2016-2020 from 11 Sickle Cell Data Collection program states. The percentage distribution of birth mother residence within Social Vulnerability Index quartiles was derived.

ILT2 and ILT4 Drive Myeloid Suppression via Both Overlapping and Distinct Mechanisms.

Solid tumors are dense three-dimensional (3D) multicellular structures that enable efficient receptor-ligand trans interactions via close cell-cell contact. Immunoglobulin-like transcript (ILT)2 and ILT4 are related immune-suppressive receptors that play a role in the inhibition of myeloid cells within the tumor microenvironment. The relative contribution of ILT2 and ILT4 to immune inhibition in the context of solid tumor tissue has not been fully explored.

Top Ten Tips Palliative Care Clinicians Should Know About Dignity-Conserving Practice.

The acknowledgment and promotion of dignity is commonly viewed as the cornerstone of person-centered care. Although the preservation of dignity is often highlighted as a key tenet of palliative care provision, the concept of dignity and its implications for practice remain nebulous to many clinicians. Dignity in care encompasses a series of theories describing different forms of dignity, the factors that impact them, and strategies to encourage dignity-conserving care.

The N-terminus of Stag1 is required to repress the 2C program by maintaining rRNA expression and nucleolar integrity.

Our understanding of how STAG proteins contribute to cell identity and disease have largely been studied from the perspective of chromosome topology and protein-coding gene expression. Here, we show that STAG1 is the dominant paralog in mouse embryonic stem cells (mESCs) and is required for pluripotency. mESCs express a wide diversity of naturally occurring Stag1 isoforms, resulting in complex regulation of both the levels of STAG paralogs and the proportion of their unique terminal ends.

Why we should view the decision of medical trainees to cheat as the product of a person-by-situation interaction.

Background: Cheating during medical training is a delicate subject matter with varying opinions on the prevalence, causes and gravity of cheating during training.

Proposed Framework: In this article, the authors suggest that the decision to cheat is best viewed as the product of a person-by-situation interaction rather than indicating inherent dishonesty and/or extrinsic motivation in those who participate in cheating. This framework can explain why individuals who would typically default to honesty may participate in cheating if there is perceived justification for cheating and where situational variables, such as ease of cheating, rewards for cheating and perceived risk associated with cheating, make the decision to cheat appear rational.

Ear and hearing outcomes in Aboriginal infants living in an urban Australian area: the birth cohort study.

Objective: Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area.

Design: Aboriginal infants enrolled in the prospective cohort study had ear health screenings at ages 2-4, 6-8 and 12-18 months and audiological assessment at ∼12 months of age. Sociodemographic, environmental characteristics, otoscopy, otoacoustic emissions, tympanometry and visual reinforcement audiometry data were collected.

Mitigating diagnostic performance bias in a skin-tone balanced dermatology curriculum.

Introduction: Individuals with skin of colour (SoC) have delayed diagnosis and poorer outcomes when presenting with some dermatologic conditions when compared to individuals with light skin (LS). The objective of this study was to determine if diagnostic performance bias can be mitigated by a skin-tone balanced dermatology curriculum.

Methodology: A prospective randomised intervention study occurred over 2 weeks in 2020 at a Canadian medical school.

Successful liver transplantation from deceased donors with active COVID-19 infections with undetectable SARS-CoV-2 in donor liver and aorta.

Background: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had unprecedented effects on society and modern healthcare. In liver transplantation, uncertainty regarding the safety of performing transplants during the early stage of the pandemic resulted in increased waitlist mortality. Additionally, concerns about disease transmission led to avoidance of deceased donors with COVID-19 infections.

Development and validation of echocardiography-based machine-learning models to predict mortality.

Background: Echocardiography (echo) based machine learning (ML) models may be useful in identifying patients at high-risk of all-cause mortality.

Methods: We developed ML models (ResNet deep learning using echo videos and CatBoost gradient boosting using echo measurements) to predict 1-year, 3-year, and 5-year mortality. Models were trained on the Mackay dataset, Taiwan (6083 echos, 3626 patients) and validated in the Alberta HEART dataset, Canada (997 echos, 595 patients).

Early onset of otitis media is a strong predictor of subsequent disease in urban Aboriginal infants: Djaalinj Waakinj cohort study.

Aim: Australian Aboriginal and/or Torres Strait Islander children in rural/remote areas suffer high rates of persistent otitis media (OM) from early infancy. We aimed to determine the proportion of Aboriginal infants living in an urban area who have OM and investigate associated risk factors.

Methods: Between 2017 and 2020, the Djaalinj Waakinj cohort study enrolled 125 Aboriginal infants at 0-12 weeks of age in the Perth South Metropolitan region, Western Australia.

Structural Basis of Cysteine Ligase MshC Inhibition by Cysteinyl-Sulfonamides.

Mycothiol (MSH), the major cellular thiol in (Mtb), plays an essential role in the resistance of Mtb to various antibiotics and oxidative stresses. MshC catalyzes the ATP-dependent ligation of 1--(2-amino-2-deoxy-α-d-glucopyranosyl)-d--inositol (GlcN-Ins) with l-cysteine (l-Cys) to form l-Cys-GlcN-Ins, the penultimate step in MSH biosynthesis. The inhibition of MshC is lethal to Mtb.

A robust COVID-19 mortality prediction calculator based on Lymphocyte count, Urea, C-Reactive Protein, Age and Sex (LUCAS) with chest X-rays.

There have been numerous risk tools developed to enable triaging of SARS-CoV-2 positive patients with diverse levels of complexity. Here we presented a simplified risk-tool based on minimal parameters and chest X-ray (CXR) image data that predicts the survival of adult SARS-CoV-2 positive patients at hospital admission. We analysed the NCCID database of patient blood variables and CXR images from 19 hospitals across the UK using multivariable logistic regression.

Partitioning of the initial catalytic steps of leucyl-tRNA synthetase is driven by an active site peptide-plane flip.

To correctly aminoacylate tRNA, leucyl-tRNA synthetase (LeuRS) catalyzes three reactions: activation of leucine by ATP to form leucyl-adenylate (Leu-AMP), transfer of this amino acid to tRNA and post-transfer editing of any mischarged product. Although LeuRS has been well characterized biochemically, detailed structural information is currently only available for the latter two stages of catalysis. We have solved crystal structures for all enzymatic states of Neisseria gonorrhoeae LeuRS during Leu-AMP formation.

Discovery of novel druggable pockets on polyomavirus VP1 through crystallographic fragment-based screening to develop capsid assembly inhibitors.

Polyomaviruses are a family of ubiquitous double-stranded DNA viruses many of which are human pathogens. These include BK polyomavirus which causes severe urinary tract infection in immunocompromised patients and Merkel cell polyomavirus associated with aggressive cancers. The small genome of polyomaviruses lacks conventional drug targets, and no specific drugs are available at present.

Development of a Mortality Prediction Model in Hospitalised SARS-CoV-2 Positive Patients Based on Routine Kidney Biomarkers.

Acute kidney injury (AKI) is a prevalent complication in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive inpatients, which is linked to an increased mortality rate compared to patients without AKI. Here we analysed the difference in kidney blood biomarkers in SARS-CoV-2 positive patients with non-fatal or fatal outcome, in order to develop a mortality prediction model for hospitalised SARS-CoV-2 positive patients. A retrospective cohort study including data from suspected SARS-CoV-2 positive patients admitted to a large National Health Service (NHS) Foundation Trust hospital in the Yorkshire and Humber regions, United Kingdom, between 1 March 2020 and 30 August 2020.

Lack of Equity in the Cardiology Physician Workforce: A Narrative Review and Analysis of the Literature.

The gender and racial diversity in the cardiology workforce in Canada does not reflect that of the population we serve. As social awareness of the principles of equity, diversity, and inclusion rises, our profession must rise to meet the challenges they present. We detail contemporary examples of publication bias in the cardiac sciences literature and describe the factors that led to oversight in the peer-review process.