Carnitine palmitoyltransferase 1 facilitates fatty acid oxidation in a non-cell-autonomous manner.

Mitochondrial fatty acid oxidation is facilitated by the combined activities of carnitine palmitoyltransferase 1 (Cpt1) and Cpt2, which generate and utilize acylcarnitines, respectively. We compare the response of mice with liver-specific deficiencies in the liver-enriched Cpt1a or the ubiquitously expressed Cpt2 and discover that they display unique metabolic, physiological, and molecular phenotypes. The loss of Cpt1a or Cpt2 results in the induction of the muscle-enriched isoenzyme Cpt1b in hepatocytes in a Pparα-dependent manner.

The Effects of Weight Loss and Aerobic Exercise on Cortisol and Cortisol Suppression in Postmenopausal Women with Overweight and Obesity.

Purpose: The goal of this study was to explore the complex relationship between obesity, dietary content, weight loss, and cortisol concentrations in postmenopausal women with overweight and obesity.

Methods: Women completed basal cortisol testing, a dexamethasone suppression test (DST), DXA scan, 3-hour oral glucose tolerance test (OGTT), and food records before ( = 60) and a subset after 6-months of weight loss (WL;  = 15) or aerobic exercise training+weight loss (AEX+WL,  = 34).

Results: At baseline, plasma cortisol concentrations decreased significantly after DST in the entire group, a 54% suppression which was associated with basal glucose.

Machine Learning-based Prognostic Subgrouping of Glioblastoma: A Multi-center Study.

Background: Glioblastoma is the most aggressive adult primary brain cancer, characterized by significant heterogeneity, posing challenges for patient management, treatment planning, and clinical trial stratification.

Methods: We developed a highly reproducible, personalized prognostication and clinical subgrouping system using machine learning (ML) on routine clinical data, MRI, and molecular measures from 2,838 demographically diverse patients across 22 institutions and 3 continents. Patients were stratified into favorable, intermediate, and poor prognostic subgroups (I, II, III) using Kaplan-Meier analysis (Cox proportional model and hazard ratios [HR]).

Mast cells proliferate in the peri-hippocampal space during early development and modulate local and peripheral immune cells.

Brain development is a non-linear process of regionally specific epochs occurring during windows of sensitivity to endogenous and exogenous stimuli. We have identified an epoch in the neonatal rat brain defined by a transient population of peri-hippocampal mast cells (phMCs) that are abundant from birth through 2-weeks post-natal but absent thereafter. The phMCs are maintained by proliferation and harbor a unique transcriptome compared with mast cells residing in the skin, bone marrow, or other brain regions.

Cholangiocarcinoma (CCA) mortality in Vietnam war era veterans.

Background: There is concern about the risk of cholangiocarcinoma mortality (CCA) among U.S. veterans who deployed to the Vietnam War theater.

Evaluating adoption and reach in a pragmatic randomized trial of community paramedicine for intermediate acuity patient care.

Introduction: Pragmatic trials aim to speed translation to practice by integrating study procedures in routine care settings. This study evaluated implementation outcomes related to clinician and patient recruitment and participation in a trial of community paramedicine (CP) and presents successes and challenges of maintaining pragmatic study features.

Methods: Adults in the pre-hospital setting, emergency department (ED), or hospital being considered for referral to the ED/hospital or continued hospitalization for intermediate-level care were randomized 1:1 to CP care or usual care.

Higher preoperative patient expectations predict better patient-reported psychosocial health outcomes after hip arthroscopy.

Introduction: Preoperative expectations are a determinant of patient-reported outcomes (PROs) within several orthopaedic subspecialties. However, the impact on outcomes after hip arthroscopy is unclear. The aim of this study was to explore the relationship between preoperative patient expectations and PROs after hip arthroscopy.

Leptomeningeal metastatic disease: new frontiers and future directions.

Leptomeningeal metastatic disease (LMD), encompassing entities of 'meningeal carcinomatosis', neoplastic meningitis' and 'leukaemic/lymphomatous meningitis', arises secondary to the metastatic dissemination of cancer cells from extracranial and certain intracranial malignancies into the leptomeninges and cerebrospinal fluid. The clinical burden of LMD has been increasing secondary to more sensitive diagnostics, aggressive local therapies for discrete brain metastases, and improved management of extracranial disease with targeted and immunotherapeutic agents, resulting in improved survival. However, owing to drug delivery challenges and the unique microenvironment of LMD, novel therapies against systemic disease have not yet translated into improved outcomes for these patients.

What Clinicians Think About When They Think About Sepsis: Results From a Survey Across the University of Maryland Medical System.

Importance: Sepsis, a leading cause of death in the hospital, is a heterogeneous syndrome without a defined or specific set of symptoms.

Objectives: We conducted a survey of clinicians in practice to understand which clinical findings they tend to associate with sepsis.

Design, Setting, And Participants: A survey was distributed to physicians and advanced practice providers across a multihospital health system during April 2022 and May 2022 querying likelihood of suspecting sepsis and initiating sepsis care in response to various normal and abnormal clinical findings.

Microfluidics-generated PLA nanoparticles: impact of purification method on macrophage interactions, anti-inflammatory effects, biodistribution, and protein corona formation.

Polymeric nanoparticles (NPs) are traditionally formulated using batch methodologies that are poorly scalable and require time consuming, hands-on purification procedures. Here, we prepared poly(lactic acid) (PLA)-based polymeric NPs using a scalable microfluidics-based method and systematically investigated the impact of purification method (centrifugation tangential flow filtration (TFF)) to remove poly(vinyl alcohol) (PVA) on macrophage uptake, anti-inflammatory effects, biodistribution, and protein corona formation. TFF purification demonstrated significantly higher recovery of NPs compared to the centrifugation method, with little-to-no aggregation observed.

Overview of the Head and Neck Tumor Segmentation for Magnetic Resonance Guided Applications (HNTS-MRG) 2024 Challenge.

Magnetic resonance (MR)-guided radiation therapy (RT) is enhancing head and neck cancer (HNC) treatment through superior soft tissue contrast and longitudinal imaging capabilities. However, manual tumor segmentation remains a significant challenge, spurring interest in artificial intelligence (AI)-driven automation. To accelerate innovation in this field, we present the Head and Neck Tumor Segmentation for MR-Guided Applications (HNTS-MRG) 2024 Challenge, a satellite event of the 27th International Conference on Medical Image Computing and Computer Assisted Intervention.

Implementing Precision Medicine for Dilated Cardiomyopathy: Insights from The DCM Consortium.

Background: Clinical genetic evaluation of dilated cardiomyopathy (DCM) is implemented variably or not at all. Identifying needs and barriers to genetic evaluations will enable strategies to enhance precision medicine care.

Methods: An online survey was conducted in June 2024 among cardiologist investigators of the DCM Consortium from US advanced heart failure/transplant (HF/TX) programs to collect demographics, training, program characteristics, genetic evaluation practices for DCM, and implementation needs.

Clinical Insights and Outcomes in Community-Acquired Acute Bacterial Meningitis versus Postoperative Bacterial Meningitis.

Objective: To compare the demographics, clinical characteristics, and in-hospital mortality rates between community-acquired bacterial meningitis cases and postoperative bacterial meningitis.

Study Design: Analytical study. Place and Duration of the Study: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from 2016 to 2022.

Drugs stimulating insulin secretion in early clinical development for the treatment of type 1 diabetes: what's new?

Introduction: Type 1 diabetes is a chronic autoimmune condition characterized by the selective destruction of insulin-producing beta cells in the pancreas. The etiology of T1D is multifactorial, with a combination of genetic susceptibility and environmental triggers believed to underlie beta-cell destruction. Preserving and prolonging beta-cell function in T1D is a pivotal therapeutic objective that can mitigate disease progression and improve glycemic control.

Elevated C-reactive protein levels and cardiovascular risk in prurigo nodularis patients with sleep disturbance: a multi-center cohort study.

Patients with prurigo nodularis (PN) present with pruritus which may lead to sleep disturbances and systemic comorbidities. The objective of our study was to determine the risk of sleep disorders in PN and its association with systemic inflammation and adverse cardiovascular outcomes. We conducted a retrospective population-level cohort using a global health records database to analyze the development of sleep disorders, C-reactive protein (CRP) levels, and risk of cardiovascular disease and mortality in PN compared to controls.

Association of T-Cell Phenotypes With Peri-Coronary Inflammation in People With and Without HIV and Without Cardiovascular Disease.

Background: Persistent immune activation is linked to elevated cardiovascular diseases in people with HIV on antiretroviral therapy. The fat attenuation index (FAI) is a measure of peri-coronary inflammation that independently predicts cardiovascular disease risk in people without HIV. Whether FAI is associated with immune activation is unknown.

Endovascular management of central venous catheter induced superior vena cava syndrome.

This case series describes the endovascular management of three patients with catheter-associated superior vena cava (SVC) syndrome. SVC syndrome can result from malignant (60%) or benign (40%) etiologies. The most common causes of benign SVC syndrome are indwelling central venous catheters (CVCs) with 1%-3% and 0.

How Reliable is the Assessment of Fusion Status Following ACDF Using Dynamic Flexion-Extension Radiographs?

Study Design: Reliability study.

Objectives: The radiographic diagnosis of non-union is not standardized. Prior authors have suggested using a cutoff of <1 mm interspinous process motion (ISPM) on flexion-extension radiographs, but the ability of practicing surgeons to make these measurements reliably is not clear.

Vector coding and place coding in hippocampus share a common directional signal.

Vector coding is a major mechanism by which neural systems represent an animal's location in both global and local, item-based reference frames. Landmark vector cells (LVCs) in the hippocampus complement classic place cells by encoding vector relationships between the organism and specific landmarks. How these place- and vector-coding properties interact is not known.