Discovery of robust and highly specific microbiome signatures of non-alcoholic fatty liver disease.

Background: The pathogenesis of non-alcoholic fatty liver disease (NAFLD) with a global prevalence of 30% is multifactorial and the involvement of gut bacteria has been recently proposed. However, finding robust bacterial signatures of NAFLD has been a great challenge, mainly due to its co-occurrence with other metabolic diseases.

Results: Here, we collected public metagenomic data and integrated the taxonomy profiles with in silico generated community metabolic outputs, and detailed clinical data, of 1206 Chinese subjects w/wo metabolic diseases, including NAFLD (obese and lean), obesity, T2D, hypertension, and atherosclerosis.

Impact of worklist selection on point-of-care ultrasound workflow - a quality improvement project.

Background: Research demonstrates that Point-of-care ultrasound (POCUS) improves clinical outcomes for patients. Improving clinician satisfaction with POCUS should promote utilization into everyday practice, leading to improved clinical outcomes. Despite this benefit, there are still barriers to use including POCUS workflow.

'Which treatment do you believe you received?' A randomised blinding feasibility trial of spinal manual therapy.

Background: Blinding is essential for mitigating biases in trials of low back pain (LBP). Our main objectives were to assess the feasibility of blinding: (1) participants randomly allocated to active or placebo spinal manual therapy (SMT), and (2) outcome assessors. We also explored blinding by levels of SMT lifetime experience and recent LBP, and factors contributing to beliefs about the assigned intervention.

Pangenome mining of the Streptomyces genus redefines species' biosynthetic potential.

Background: Streptomyces is a highly diverse genus known for the production of secondary or specialized metabolites with a wide range of applications in the medical and agricultural industries. Several thousand complete or nearly complete Streptomyces genome sequences are now available, affording the opportunity to deeply investigate the biosynthetic potential within these organisms and to advance natural product discovery initiatives.

Results: We perform pangenome analysis on 2371 Streptomyces genomes, including approximately 1200 complete assemblies.

Multiplex genome editing eliminates lactate production without impacting growth rate in mammalian cells.

The Warburg effect, which describes the fermentation of glucose to lactate even in the presence of oxygen, is ubiquitous in proliferative mammalian cells, including cancer cells, but poses challenges for biopharmaceutical production as lactate accumulation inhibits cell growth and protein production. Previous efforts to eliminate lactate production in cells for bioprocessing have failed as lactate dehydrogenase is essential for cell growth. Here, we effectively eliminate lactate production in Chinese hamster ovary and in the human embryonic kidney cell line HEK293 by simultaneous knockout of lactate dehydrogenases and pyruvate dehydrogenase kinases, thereby removing a negative feedback loop that typically inhibits pyruvate conversion to acetyl-CoA.

Telehealth Modality Usage by US Physicians in 2022.

Background: The growth of telehealth care delivery during the COVID-19 pandemic highlighted its potential to enhance access to care and improve patient outcomes. As the healthcare landscape moves toward a new equilibrium in care delivery, few studies have examined physician usage of specific telehealth modalities.

Objective: To understand telehealth usage differences among modalities and across subgroups of physicians.

Multi-omic quantitative trait loci link tandem repeat size variation to gene regulation in human brain.

Tandem repeat (TR) size variation is implicated in ~50 neurological disorders, yet its impact on gene regulation in the human brain remains largely unknown. In the present study, we quantified the impact of TR size variation on brain gene regulation across distinct molecular phenotypes, based on 4,412 multi-omics samples from 1,597 donors, including 1,586 newly sequenced ones. We identified ~2.

Soil erosion susceptibility maps and raster dataset for the hydrological basins of North Africa.

Soil erosion in North Africa modulates agricultural and urban developments as well as the impacts of flash floods. Existing investigations and associated datasets are mainly performed in localized urban areas, often representing a limited part of a watershed. The above compromises the implementation of mitigation measures for this vast area under accentuating extremes and continuous hydroclimatic fluctuations.

Multi-omics architecture of childhood obesity and metabolic dysfunction uncovers biological pathways and prenatal determinants.

Childhood obesity poses a significant public health challenge, yet the molecular intricacies underlying its pathobiology remain elusive. Leveraging extensive multi-omics profiling (methylome, miRNome, transcriptome, proteins and metabolites) and a rich phenotypic characterization across two parts of Europe within the population-based Human Early Life Exposome project, we unravel the molecular landscape of childhood obesity and associated metabolic dysfunction. Our integrative analysis uncovers three clusters of children defined by specific multi-omics profiles, one of which characterized not only by higher adiposity but also by a high degree of metabolic complications.

Genetic predisposition to altered blood cell homeostasis is associated with glioma risk and survival.

Glioma is a highly fatal and heterogeneous brain tumor with few known risk factors. Our study examines genetically predicted variability in blood cell indices in relation to glioma risk and survival in 3418 cases and 8156 controls. We find that increased platelet to lymphocyte ratio (PLR) confers an increased risk of glioma (odds ratio (OR) = 1.

Achieving Language Justice in Pediatric Hematology-Oncology: A Multinational Perspective for Language-Concordant Equitable Patient- and Family-Centered Care and Research Inclusion.

Language-discordant healthcare encounters-when the patient/caregiver and clinician are not able to communicate directly in the patient's/caregiver's preferred language-are associated with worse quality of care, increased adverse events, and research exclusion. Here, we describe the current state of language justice in clinical practice and research in the United States, Canada, and Spain, discuss the role of social determinants of health and language, in patient safety and health outcomes and review an example of culturally and linguistically concordant interventions to increase research participation. We close with practical and global strategies to increase multilingual research participation and to provide equitable patient- and family-centered care in pediatric hematology-oncology.

Factors Associated With Prolonged Venous Transit in Large Vessel Occlusion Acute Ischemic Strokes.

Background And Purpose: Prolonged venous transit (PVT), derived from computed tomography perfusion (CTP) time-to-maximum (T) maps, reflects compromised venous outflow (VO) in acute ischemic stroke due to large vessel occlusion (AIS-LVO). Poor VO is associated with worse clinical outcomes, but pre-treatment markers predictive of PVT are not well described.

Methods: We conducted a retrospective analysis of 189 patients with anterior circulation AIS-LVO who underwent baseline CT evaluation, including non-contrast CT, CT angiography, and CTP.

Chronic Cough and Hyperpnea: Clinical Approach to Equine Asthma.

Exercise intolerance, chronic cough, and hyperpnea are the clinical hallmarks of equine asthma. Diagnosis of severe equine asthma in horses is multistep; determination of the phenotype will help guide future recommendations. Management of equine asthma is largely reduction/elimination of triggering agents/conditions.

Human chorionic gonadotropin-secreting osteosarcoma.

Secretion of beta human chorionic gonadotropin (β-hCG) is a rare, recently recognised paraneoplastic syndrome. Herein, we present a case of a woman in her 30s with right femur conventional high-grade osteosarcoma and a positive screening urine pregnancy test. Subsequent workup failed to reveal an intrauterine or extrauterine pregnancy.

Extended reality in anesthesia: a narrative review.

The application of extended reality (XR) technology is rapidly expanding in the medical field, including anesthesia. This review aims to introduce the current literature on XR utilization to help anesthesiologists adopt this technology in education and clinical practice. XR is useful for both knowledge acquisition and skill training in a wide range of settings, from students to medical professionals.

Out-Of-Network Utilization and Plan Selection Among Medicare Advantage Cost Plan Enrollees.

Objective: To understand how Medicare Advantage (MA) networks impact utilization patterns and plan choices, using the 2019 discontinuation of MA 1876 Cost plans as a natural experiment.

Study Setting And Design: We study 1876 Cost plans, MA plans for which out-of-network care is covered through traditional Medicare (TM) and many of which CMS discontinued in 2019. We characterize the proportion of Cost plan enrollees who utilized out-of-network care in 2018 from different types of medical specialties.

Conditional Generative Models for Synthetic Tabular Data: Applications for Precision Medicine and Diverse Representations.

Tabular medical datasets, like electronic health records (EHRs), biobanks, and structured clinical trial data, are rich sources of information with the potential to advance precision medicine and optimize patient care. However, real-world medical datasets have limited patient diversity and cannot simulate hypothetical outcomes, both of which are necessary for equitable and effective medical research. Fueled by recent advancements in machine learning, generative models offer a promising solution to these data limitations by generating enhanced synthetic data.

Artificial intelligence in gastrointestinal cancers: diagnostic, prognostic, and surgical strategies.

GI (Gastrointestinal) malignancies are one of the most common and lethal cancers globally. The dawn of precision medicine and developing technologies have reduced the mortality rates for GI malignancies, underscoring the main role of early detection methods for survival rate improvement. Artificial intelligence (AI) is a new technology that may improve GI cancer screening, treatment, and therapeutic efficiency for better patient care.

Multi-domain Online Therapeutic Investigation of Neurocognition (MOTION) - A randomized comparative-effectiveness study of two remotely delivered mind-body interventions for older adults with cognitive decline.

Background: Research suggest that mind-body movement programs have beneficial effects on cognitive outcomes for older adults with cognitive decline. However, few studies have directly compared specific approaches to mind-body movement or studied the impact of remote program delivery.

Methods: In a 3-arm randomized controlled trial (RCT) for older adults with cognitive impairment, we are comparing a multidomain mind-body program that emphasizes movement, body awareness, personal meaningfulness, and social connection, and a traditional Chinese mind-body exercise (Tai Chi) to a health and wellness education control condition.

Multilevel intervention for follow-up of abnormal FIT in the safety-net: IMProving Adherence to Colonoscopy through Teams and Technology (IMPACTT).

Background: Fecal immunochemical testing (FIT) is a widely used first step for colorectal cancer (CRC) screening. Abnormal FIT results require a colonoscopy for screening completion and CRC diagnosis, but the rate of timely colonoscopy is low, especially among patients in safety-net settings. Multi-level factors at the clinic- and patient-levels influence colonoscopy completion after an abnormal FIT.

When Leaders Don't Walk the Walk: A National Survey of Academic Nurse Leader Perceptions of Staff Burnout.

Aim: This survey explored nurse leaders' impressions of burnout on college/school of nursing (CON/SON) administrative staff and leadership-facilitated strategies used to promote resilience building/mitigate burnout.

Background: Administrative staff are foundational to the success of a university's CON/SON, yet few studies have explored the impact of burnout in this group.

Method: Cross-sectional survey distributed to associate dean and business officer attendees of the 2022 American Association of Colleges of Nursing, Business Officers of Nursing Schools meeting (summer 2022) (n = 64).

Progressive Loss of Cerebral Structures in ALG11-Related Congenital Disorder Glycosylation.

Background: Congenital disorders of glycosylation (CDG) are a group of metabolic disorders related to dysfunctional glycoprotein and glycolipid biosynthesis. ALG11-related CDG is a rare member of this group, characterized by severe neurodevelopmental impairment, progressive microcephaly, sensorineural hearing loss, and epilepsy. The objective of this report is to provide an update on the phenotype and brain magnetic resonance imaging (MRI) at age seven years for a patient initially described in early infancy with fetal brain disruption sequence.

Black/White disparities in low birth weight across maternal trajectories of social mobility in South Carolina.

Persistent racial disparities in low birth weight (LBW) in the United States may be better understood through the adoption of a life course perspective that considers differential exposure and vulnerability of Black and White women to socioeconomic position across generations. Using a multigenerational dataset of singleton birth certificates from South Carolina from 1989 to 2020 linked along the maternal line, we constructed intergenerational social mobility trajectories of grandmaternal and maternal education and compared unadjusted and adjusted associations between trajectories and LBW among Black and White women. We found that White women were more likely to be upwardly mobile, and Black women to be downwardly mobile.

Innovative prediction and causal analysis of accident vehicle towing probability using advanced gradient boosting techniques on extensive road traffic scene data.

Accurate prediction and causal analysis of road crashes are crucial for improving road safety. One critical indicator of road crash severity is whether the involved vehicles require towing. Despite its importance, limited research has utilized this factor for predicting vehicle towing probability and analyzing its causal factors.