Evolutionary insights into gut acidification: Invertebrate-like mechanisms in the basal vertebrate hagfish.

Acidification is a key component of digestion throughout metazoans. The gut digestive fluid of many invertebrates is acidified by the vesicular-type H+-ATPase (VHA). In contrast, vertebrates generate acidic gut fluids using the gastric H+/K+-ATPase (HKA); an evolutionary innovation linked with the appearance of a true stomach that greatly improves digestion, absorption, and immune function.

Impaired Exercise Capacity in High-Risk Diabetic Cardiomyopathy: The ARISE-HF Cardiopulmonary Exercise Testing Subanalysis.

Background: Objective indices of functional capacity in patients with diabetic cardiomyopathy and stage B heart failure (HF) have not been comprehensively defined. We sought to characterize the cardiopulmonary exercise characteristics of individuals with diabetic cardiomyopathy at high risk for overt HF.

Methods: The relationships from cardiopulmonary exercise testing with clinical and laboratory characteristics of participants with diabetic cardiomyopathy were evaluated using baseline data from the ARISE-HF trial (Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure).

Ultra-Early Hematoma Expansion Is Associated With Ongoing Hematoma Growth and Poor Functional Outcome.

There is limited data on ultra-early hematoma growth dynamics and its clinical relevance in primary intracerebral hemorrhage (ICH). We aimed to estimate the incidence of hematoma expansion (HE) within the hyperacute period of ICH, describe hematoma dynamics over time, investigate the associations between ultra-early HE and clinical outcomes after ICH, and assess the effect of tranexamic acid on ultra-early HE. We performed a planned secondary analysis of the STOP-MSU international multicenter randomized controlled trial.

US general population food allergy treatment preferences: a discrete choice experiment.

Objective: To quantify treatment preferences for food allergy management options (oral immunotherapy, biologic therapy, and allergen avoidance), overall and by sociodemographic strata.

Methods: A US general population (≥13 years) discrete choice experiment (DCE) conducted comprised of 12 treatment-feature focused DCE choice sets; the Intolerance of Uncertainty─12 Scale (IUS-12); and clinical/demographic questions. Conditional logistic regression analyses were conducted overall and by age, income, urbanization, educational attainment, food and other sociodemographic factors, and presented as odds ratios (ORs) with 95% confidence intervals (CIs).

From flat to twisted - multifunctional phosphacyclic nanocarbons based on Vat Orange 3.

The field of π-conjugated organic materials has seen significant advances in recent years. However, enhancing the functionality of well-established, mass-produced compounds remains a considerable challenge, despite being an intriguing strategy for designing high-value organic materials with low production costs. In this context, vat dyes, known for their wide range of colors and extensive use in the textile industry are particularly attractive.

Plastic Surgeon Well-being, Mindfulness, and the Art of Letting Go.

As plastic surgeons, we strive to achieve the best possible outcomes for our patients. However, despite being a good surgeon with a sound plan that was thoughtfully crafted and well executed, complications still happen. As a result, surgeons involved in the care of patients who have complications can experience mental and emotional suffering, including feelings of guilt, sadness, anxiety, and stress.

Assessment of home environment for autistic individuals: a literature review of the existing tools.

Background: Autism Spectrum Disorder is a neurodevelopmental disorder, and its prevalence is estimated at 1% worldwide. The home environment can influence activities and roles for autistic individuals, however there are limited assessments that focus on the home environment for this population.

Purpose: To identify existing assessment tools of home environment for autistic individuals in the literature.

Dynamic Coupling of MAPK Signaling to the Guanine Nucleotide Exchange Factor GEF-H1.

The gene is nearly ubiquitously subjected to activating mutation in pancreatic adenocarcinomas (PDAC), occurring at a frequency of over 90% in tumors. Mutant KRAS drives sustained signaling through the MAPK pathway to affect frequently disrupted cancer phenotypes including transcription, proliferation and cell survival. Recent research has shown that PDAC tumor growth and survival required a guanine nucleotide exchange factor for RAS homolog family member A (RhoA) called GEF-H1.

Raising aluminum foil fists: how to speak about anger in transplant medicine.

Dominant narratives of solid-organ transplantation foreground vocabularies of gratitude. Solid-organ transplantation is often celebrated in biomedicine for its high-tech innovation and specialization. But transplantation also includes the organizations that oversee the distribution of donated organs to potential recipients who disproportionately outnumber available organs.

A novel small RNA regulates Locus of Enterocyte Effacement and site-specific colonization of enterohemorrhagic O157:H7 in gut.

Enterohemorrhagic (EHEC) is a contagious foodborne pathogen that specifically colonizes the human large intestine, which is regulated by different environmental stimuli within the gut. Transcriptional regulation of EHEC virulence and infection has been extensively studied, while the posttranscriptional regulation of these processes by small RNAs (sRNAs) remains not fully understood. Here we present a virulence-regulating pathway in EHEC O157:H7, in which the sRNA EvrS binds to and destabilizes the mRNA of Z2269, a novel transcriptional regulator.

Quality of undifferentiated chest pain evaluation and diagnosis guidelines: a systematic review and critical appraisal.

Chest pain is a symptom that is potentially life-threatening and requires quick and accurate evaluations. This article describes the quality of guidelines related to the evaluation and diagnosis of acute, undifferentiated chest pain. After systematically evaluating existing guidelines, we found that there exists a wide variety of quality in these documents.

Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs.

Introduction: In high-altitude cities located above 2,500 m, hospitals face a concerning mortality rate of over 50% among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS). This elevated mortality rate is largely due to the absence of altitude-specific medical protocols that consider the unique physiological adaptations of high-altitude residents to hypoxic conditions. This study addresses this critical gap by analyzing demographic, clinical, sex-specific, and preclinical data from ICUs in Bogotá, Colombia (2,650 m) and El Alto, Bolivia (4,150 m).

Early life adverse environmental, nutrition and infection factors are associated with lower developmental scores in Pakistani children at 5 years: a cohort study.

Background: The effects of multiple early adverse psychosocial and biological factors on child development at preschool age in deprived settings are not fully understood.

Methods: The 'Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development' (MAL-ED) project followed children from eight countries, recording sociodemographic, nutritional, illness, enteroinfection biomarkers and scores for quality of home environment (Home Observation for Measurement of the Environment (HOME)), development (Bayley) and maternal depression during the first year of life. In the Pakistan cohort, we investigated associations of these early factors with Z-scores (derived from the eight participating countries) of three developmental outcomes at 5 years: Executive Functions (Z-EF), the Wechsler Preschool and Primary Scale for Intelligence (Z-WPPSI) and the externalising behaviours component of the Strength and Difficulties test (Z-externalising behaviours).

Health policy to address disease-related malnutrition: a scoping review.

Background: Health policies promote optimal care, yet policies that address disease-related malnutrition (DRM) are lacking. The purpose of this study was to conduct a scoping review to identify literature on existing and planned policy to address DRM in children or adults and explore the settings, contexts and actors of DRM policy.

Methods: A search strategy comprising DRM and policy keywords was applied to eight databases on 24 February 2023.

Exploring gaps, opportunities, barriers and enablers in malnutrition policy through key informant interviews: a qualitative inquiry from the CANDReaM initiative.

Objectives: Disease-related malnutrition (DRM) presents in up to half of adults and one-third of children admitted to Canadian hospitals and significantly impacts health outcomes. Strategies to screen, diagnose and treat DRM exist but policy to facilitate implementation and sustainability are lacking. The purpose of this study was to explore gaps, opportunities, barriers and enablers for DRM policy in Canada.

Nutrition users' guides: systematic reviews part 1 -structured guide for methodological assessment, interpretation and application of systematic reviews and meta-analyses of non-randomised nutritional epidemiology studies.

Due to the challenges of conducting randomised controlled trials (randomised trials) of dietary interventions, evidence in nutrition often comes from non-randomised (observational) studies of nutritional exposures-called nutritional epidemiology studies. When using systematic reviews of such studies to advise patients or populations on optimal dietary habits, users of the evidence (eg, healthcare professionals such as clinicians, health service and policy workers) should first evaluate the rigour (validity) and utility (applicability) of the systematic review. Issues in making this judgement include whether the review addressed a sensible question; included an exhaustive literature search; was scrupulous in the selection of studies and the collection of data; and presented results in a useful manner.

Nutrition Users' Guides: RCTs Part 2 - structured guide for interpreting and applying study results from randomised controlled trials on therapy or prevention questions.

This article continues from a prior commentary on evaluating the risk of bias in randomised controlled trials addressing nutritional interventions. Having provided a synopsis of the risk of bias issues, we now address how to understand trial results, including the interpretation of best estimates of effect and the corresponding precision (eg, 95% CIs), as well as the applicability of the evidence to patients based on their unique circumstances (eg, patients' values and preferences when trading off potential desirable and undesirable health outcomes and indicators (eg, cholesterol), and the potential burden and cost of an intervention). Authors can express the estimates of effect for health outcomes and indicators in relative terms (relative risks, relative risk reductions, OR or HRs)-measures that are generally consistent across populations-and absolute terms (risk differences)-measures that are more intuitive to clinicians and patients.

Nutrition users' guides: RCTs part 1 - structured guide for assessing risk of bias in randomised controlled trials that address therapy or prevention questions.

The purpose of this article, part 1 of 2 on randomised controlled trials (RCTs), is to provide readers (eg, clinicians, patients, health service and policy decision-makers) of the nutrition literature structured guidance on interpreting RCTs. Evaluation of a given RCT involves several considerations, including the potential for risk of bias, the assessment of estimates of effect and their corresponding precision, and the applicability of the evidence to one's patient. Risk of bias refers to flaws in the design or conduct of a study that may lead to a deviation from measuring the underlying true effect of an intervention.

Characterization of LTBP2 mutation causing mitral valve prolapse.

Aims: Mitral valve prolapse (MVP) is a common valvular disorder associated with significant morbidity and mortality, with a strong genetic basis. This study aimed to identify a mutation in a family with MVP and to characterize the valve phenotype in LTBP2 knockout (KO) mice.

Methods And Results: Exome sequencing and segregation analysis were performed on a large family with MVP.

Assessing the Benefit of a Digital Pain Alert System in a Community Hospital.

Introduction: In the last decade, clinical alert systems were developed for clinical use, including patient deterioration and other urgent clinical situations. However, investigations focusing on digital pain alert systems to assess and manage pain on time in in-hospital patients are scarce. The objective of the study was to assess the implementation of digital pain alerts in the various departments of a community hospital.