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.

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).

Associations of neighbourhood food retail with disability and death in older adults: Cardiovascular Health Study.

Background: A healthier diet is associated with lower chronic disease burden, but the impact of neighbourhood food environments on disability and death in older adults is not known.

Methods: In the Cardiovascular Health Study, a cohort study of adults aged 65+, we calculated study years until death (years of life (YOL)), study years without activities of daily living (ADL) difficulty (years of able life; YoAL) and percent of study years without ADL difficulty (compression of disability). Linear regression quantified associations of food establishments within 5 km of baseline home address (as a z-score) with each outcome, adjusted for sociodemographic characteristics.

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.

'Any male victim?' The legacy of conflating paedophilia and homosexuality and the differential seriousness of sexual abuse by victim gender.

This article presents the findings of a historical, qualitative thematic analysis of archival clinical records of 24 men convicted of child sexual abuse and referred for civil commitment to the Massachusetts Treatment Center between 1959 and 1984. Drawing on the perspective of Cicourel, the study examined the differential ways men convicted of child sexual abuse were constructed by various criminal justice actors based on the gender of their victims. Overall, the study found that men with male victims were constructed as more deviant than men with female victims.

Optimizing Clinical Postgraduate Training: Perspectives of Postgraduate Alumni Regarding Their Residency Training at Mbarara University of Science and Technology, Uganda.

Background: Understanding alumni satisfaction and the competencies gained during university training can guide improvements in education quality, particularly in higher education institutions. This study at Mbarara University of Science and Technology (MUST) explored the factors influencing alumni decisions, their residency experiences, and their levels of satisfaction. Additionally, it provided recommendations for improving graduate training programs.

Developing a Novel Integrative Health Equity and Anti-racism Tool (IHEART) for Pilot Application in a Multicenter Integrative Health Elective for Medical Students and Resident Physicians: A Study Protocol.

Background: This study protocol introduces the Integrative Health Equity and Anti-Racism Tool (IHEART), an innovative instrument designed to infuse equity, diversity, and inclusion (EDI) into Integrative Health (IH) education. Recognizing the gaps in current IH training that fail to address social and systemic inequities adequately, the IHEART is intended to respond to the growing need for inclusivity in IH practices and educational materials. The tool is mainly focused on addressing issues such as accessibility of complementary and integrative health (CIH) therapies, cultural misappropriation, anti-racism, gender diversity, disability justice, trauma-informed care, weight inclusivity, and planetary health, which are currently inconsistently covered in IH training.

Adult onset wilms tumor.

Wilms tumor (WT) is the most common primary renal malignancy in the pediatric population and has very good overall survival with contemporary treatment protocols. In contrast, WT in adults is extremely rare and is associated with a poorer prognosis. The clinical presentation and imaging features of WT in adults are nonspecific and overlap with other more common forms of renal cancer, often leading to a delay in diagnosis.

Enhancing transcranial ultrasound stimulation planning with MRI-derived skull masks: a comparative analysis with CT-based processing.

Transcranial ultrasound stimulation (TUS) presents challenges in ultrasound wave transmission through the skull, affecting study outcomes due to aberration and attenuation. While planning strategies incorporating 3D computed tomography (CT) scans help mitigate these issues, they expose participants to radiation, which can raise ethical concerns. A solution involves generating skull masks from participants' anatomical magnetic resonance imaging (MRI).

Systematic empirical evaluation of individual base editing targets: validating therapeutic targets in USH2A and comparison of methods.

Base editing shows promise for the correction of human mutations at a higher efficiency than other repair methods and is especially attractive for mutations in large genes that are not amenable to gene augmentation therapy. Here, we demonstrate a comprehensive workflow for in vitro screening of potential therapeutic base editing targets for the USH2A gene and empirically validate the efficiency of adenine and cytosine base editor/guide combinations for correcting 35 USH2A mutations. Editing efficiency and bystander edits are compared between different target templates (plasmids versus transgenes) and assays (Next generation sequencing versus Sanger), as well as comparisons between unbiased empirical results and computational predictions.

The role of renal dual-energy computed tomography in exploring the gouty kidney: the RENODECT study.

Objective: The objective of this study was to explore the ability of dual-energy computed tomography (DECT) to detect monosodium urate (MSU) crystal deposits in the kidneys and renal artery walls, and uric acid urolithiasis, in patients with gout and chronic kidney disease (CKD).

Methods: Patients with gout and with stage 2-4 CKD were prospectively included in this cross-sectional study. Patients underwent renal, knee and feet DECT scans.

Subtypes A1 and D, and recombinant HIV-1 natural polymorphisms associated with lenacapavir drug resistance in Uganda.

Background: Lenacapavir, a novel HIV-1 capsid inhibitor, shows promise for treating MDR HIV-1, as well as for pre-exposure prophylaxis (PrEP) in prevention of HIV infection. Its unique mechanism and lack of cross-resistance with other antiretroviral classes make lenacapavir a significant addition to HIV therapy. The clinical trials CALIBRATE and CAPELLA have demonstrated high viral suppression rates in both ART-naive individuals and individuals with MDR HIV-1.

Health-Related Social Needs Intervention for Adolescents and Young Adults With Type 2 Diabetes and Their Caregivers: An Exploratory Study Using Human-Centered Design.

Youth-onset type 2 diabetes (T2D) is increasingly common and projected to impact over 200,000 adolescents and young adults by 2060. Youth with T2D frequently experience health-related social needs (HRSN) that increase their risk for poor outcomes. Using human-centered design methodology, we explored how best to address HRSN in pediatric endocrinology clinics.

Scientific and Regulatory Policy Committee Points to Consider: Proposal and Recommendations to Reduce Euthanasia of Control Nonhuman Primates in Nonclinical Toxicity Studies.

Nonhuman primates (NHPs) have been and remain a highly valuable animal model with an essential role in translational research and pharmaceutical drug development. Based on current regulatory guidelines, the nonclinical safety of novel therapeutics should be evaluated in relevant nonclinical species, which commonly includes NHPs for biotherapeutics. Given the practical and ethical limitations on availability and/or use of NHPs and in line with the widely accepted guiding "3Rs" (replace, reduce, and refine) principles, many approaches have been considered to optimize toxicity study designs to meaningfully reduce the number of NHPs used.

Midterm to Long-term Follow-up After Limited Saucerization of a Discoid Lateral Meniscus: Radiological and Functional Outcomes With Age-Dependent Variations.

Background: A discoid lateral meniscus (DLM) is the most common meniscus variant and is commonly treated with arthroscopic saucerization. There are mixed data regarding long-term results after surgery, especially in terms of radiological parameters.

Purpose/hypothesis: The aim was to evaluate the functional and radiological results of patients who underwent arthroscopic saucerization for a symptomatic DLM.

Ultrasound-guided intraoperative liver ablation - retrospective review of indications and outcomes.

Aim: To define the indications and outcomes of intraoperative ablation of hepatic malignancies.

Materials And Methods: This retrospective study comprises 27 patients (male/female: 19/8; mean age: 56 ± 13) undergoing intraoperative ablation (IOA) of liver tumours between July 2001 and August 2021 for 42 tumours, including colorectal liver metastasis (CRLM) (n = 27), hepatocellular carcinoma (HCC)(n = 14), and ovarian cancer metastasis (n = 1). The mean tumour diameter was 2.

Positive STEPS: Enhancing Medication Adherence and Achieving Viral Load Suppression in Youth Living with HIV in the United States - Results from a Stepped-Care Randomized Controlled Efficacy Trial.

Background: In the U.S. and worldwide, there is a significant number of young people acquiring and living with HIV.

Racial and Ethnic Disparities in Hospital Breastfeeding Care in the US.

Objectives: This study examines the associations between race and ethnicity and receipt of Baby Friendly Hospital Initiative (BFHI) key clinical practices that support breastfeeding in US hospitals.

Methods: National data from 2016 to 2019 CDC PRAMS were analyzed. Our sample included 60,395 mothers who initiated breastfeeding with healthy, term newborns.

Medical management pathways for Cushing's disease in pituitary tumors centers of excellence (PTCOEs).

Purpose: A recent update of consensus guidelines for the management of Cushing's disease (CD) included indications for medical therapy. However, there is limited evidence regarding their implementation in clinical practice. This study aimed to evaluate current medical therapy approaches by expert pituitary centers through an audit conducted to validate the criteria of Pituitary Tumors Centers of Excellence (PTCOEs) and provide an initial standard of medical care for CD.

Generative AI as a tool to accelerate the field of ecology.

The emergence of generative artificial intelligence (AI) models specializing in the generation of new data with the statistical patterns and properties of the data upon which the models were trained has profoundly influenced a range of academic disciplines, industry and public discourse. Combined with the vast amounts of diverse data now available to ecologists, from genetic sequences to remotely sensed animal tracks, generative AI presents enormous potential applications within ecology. Here we draw upon a range of fields to discuss unique potential applications in which generative AI could accelerate the field of ecology, including augmenting data-scarce datasets, extending observations of ecological patterns and increasing the accessibility of ecological data.

APOE4 and sedentary lifestyle synergistically impair neurovascular function in the visual cortex of awake mice.

Reduced cerebral blood flow occurs early in the development of Alzheimer's disease (AD), but the factors producing this reduction are unknown. Here, we ask whether genetic and lifestyle risk factors for AD-the ε4 allele of the Apolipoprotein (APOE) gene, and physical activity-can together produce this reduction in cerebral blood flow which leads eventually to AD. Using in vivo two-photon microscopy and haemodynamic measures, we record neurovascular function from the visual cortex of physically active or sedentary mice expressing APOE3 and APOE4 in place of murine APOE.

Examining the physical and psychological effects of combining multimodal feedback with continuous control in prosthetic hands.

Myoelectric prosthetic hands are typically controlled to move between discrete positions and do not provide sensory feedback to the user. In this work, we present and evaluate a closed-loop, continuous myoelectric prosthetic hand controller, that can continuously control the position of multiple degrees of freedom of a prosthesis while rendering proprioceptive feedback to the user via a haptic feedback armband. Twenty-eight participants without and ten participants with upper limb difference (ULD) were recruited to holistically evaluate the physical and psychological effects of the controller via isolated control and sensory tasks, dexterity assessments, embodiment and task load questionnaires, and post-study interviews.

Three-dimensional diffractive acoustic tomography.

Acoustically probing biological tissues with light or sound, photoacoustic and ultrasound imaging can provide anatomical, functional, and/or molecular information at depths far beyond the optical diffusion limit. However, most photoacoustic and ultrasound imaging systems rely on linear-array transducers with elevational focusing and are limited to two-dimensional imaging with anisotropic resolutions. Here, we present three-dimensional diffractive acoustic tomography (3D-DAT), which uses an off-the-shelf linear-array transducer with single-slit acoustic diffraction.