Causal analysis for multivariate integrated clinical and environmental exposures data.

Electronic health records (EHRs) provide a rich source of observational patient data that can be explored to infer underlying causal relationships. These causal relationships can be applied to augment medical decision-making or suggest hypotheses for healthcare research. In this study, we explored a large-scale EHR dataset on patients with asthma or related conditions (N = 14,937).

Racial and Educational Isolation are Associated with Worse Outcomes in Congenital Heart Disease.

Sociodemographic factors influence outcomes in children with congenital heart disease (CHD). We predict an association between measures of social isolation and outcomes in infants with complex CHD. These measures, racial (RI) and educational (EI) isolation range from 0 to 1, with 0 being no isolation and 1 being fully isolated within a specific population.

Aromatic side-chain crosslinking in RiPP biosynthesis.

Peptide cyclization is a defining feature of many bioactive molecules, particularly in the ribosomally synthesized and post-translationally modified peptide (RiPP) family of natural products. Although enzymes responsible for N- to C-terminal macrocyclization, lanthipeptide formation or heterocycle installation have been well documented, a diverse array of cyclases have been discovered that perform crosslinking of aromatic side chains. These enzymes form either biaryl linkages between two aromatic amino acids or a crosslink between one aliphatic amino acid and one aromatic amino acid.

Revealing excitation-inhibition imbalance in Alzheimer's disease using multiscale neural model inversion of resting-state functional MRI.

Background: Alzheimer's disease (AD) is a serious neurodegenerative disorder without a clear understanding of pathophysiology. Recent experimental data have suggested neuronal excitation-inhibition (E-I) imbalance as an essential element of AD pathology, but E-I imbalance has not been systematically mapped out for either local or large-scale neuronal circuits in AD, precluding precise targeting of E-I imbalance in AD treatment.

Method: In this work, we apply a Multiscale Neural Model Inversion (MNMI) framework to the resting-state functional MRI data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to identify brain regions with disrupted E-I balance in a large network during AD progression.

Malnutrition risk and overall survival at solid tumour diagnosis.

Purpose: Malnutrition severely impacts tolerance to anticancer therapies, but any relationship with overall survival (OS) at the time of solid tumour diagnosis in outpatients in the USA remains unclear.

Methods: This retrospective study evaluated 3562 patients who completed the Malnutrition Screening Tool (MST) at diagnosis, identifying the relationship between MST risk, a validated tool evaluating anorexia and weight loss, and OS. MST score of ≥2 of 5 was classified as high malnutrition risk (H-MST).

Electroacupuncture and Tongbian decoction ameliorate CUMS-induced depression and constipation in mice via TPH2/5-HT pathway of the gut-brain axis.

Depression is commonly associated with gastrointestinal (GI) disorders, such as constipation, which can potentially intensify depressive symptoms. The interplay between these conditions is believed to be facilitated by the gut-brain axis, which suggests a complex bidirectional interaction. Current treatments, such as antidepressants and prokinetics, are often associated with side effects and high recurrence rates, highlighting the need for effective treatments targeting both depression and constipation.

Appropriate Use Criteria for Neoplastic Compression Fractures.

Background Context: Clinical outcomes are directly related to patient selection and treatment indications for improved quality of life. With emphasis on quality and value, it is essential that treatment recommendations are optimized.

Purpose: The purpose of the North American Spine Society (NASS) Appropriate Use Criteria (AUC) is to determine the appropriate (ie, reasonable) multidisciplinary treatment recommendations for patients with metastatic neoplastic vertebral fractures across a spectrum of more common clinical scenarios.

Examining changes in fatal violence against women after bail reform in New Jersey.

Introduction Cash bail reforms that end pretrial detention due to the inability to afford bail have been highly debated across the US. A major concern cited by bail reform opponents is that reducing pretrial detention will increase community violence, particularly violence against women. The objective of this study was to assess if New Jersey's cash bail reform was associated with changes in rates of fatal violence against women.

Heterogeneous entity representation for medicinal synergy prediction.

Motivation: Forecasting the synergistic effects of drug combinations facilitates drug discovery and development, especially regarding cancer therapeutics. While numerous computational methods have emerged, most of them fall short in fully modeling the relationships among clinical entities including drugs, cell lines, and diseases, which hampers their ability to generalize to drug combinations involving unseen drugs. These relationships are complex and multidimensional, requiring sophisticated modeling to capture nuanced interplay that can significantly influence therapeutic efficacy.

Safety and Effectiveness of EUS-Guided Gallbladder Drainage in Patients with Cirrhosis: An International Multicenter Experience.

Introduction EUS-guided gall bladder drainage (EUS-GBD) for management of symptomatic gallbladder disease has been shown to be safe and effective in high surgical risk patients with data lacking in patients with cirrhosis. We sought to study the safety and effectiveness of EUS-GBD in cirrhotic compared to non-cirrhotic patients. Methods Retrospective review of patients who underwent EUS-GBD at four (3 US and 1 Spain) international tertiary care centers.

Mitochondria and NLRP3: To die or inflame.

Mitochondria play critical roles in intrinsic apoptosis and NLRP3 inflammasome activation, but how these processes are interconnected remains unclear. In this issue of Immunity, Saller et al. unveiled the complexity of NLRP3 activators, highlighting mitochondria's roles in switching apoptosis to NLRP3 inflammasome activation.

Research note: Effects of L-carnitine and L-arginine on sperm quality and fertility potential of aged broiler breeder roosters.

This objective of this study was to investigate the effects of L-arginine (L-Arg) and L-carnitine (LC) and their mixture in the diet (at lower levels) on sperm quality in aging broiler breeder roosters. Thirty-two broiler breeder roosters of the Arian breed were kept at 50 wk of age after a 12-wk acclimatization period. The birds were divided into four treatments and eight replicates in a completely randomized design.

The potential of photon-counting CT for the improved precision of lung nodule radiomics.

Lung nodule appearance may provide prognostic information, as the presence of spiculation increases the suspicion of a nodule being cancerous. Spiculations can be quantified using morphological radiomics features extracted from CT images. Radiomics features can be affected by the acquisition parameters and scanner technologies; thus, it is essential to identify imaging conditions that provide reliable measurements, particularly for emerging technologies like photon-counting CT.

Towards linking histological changes to liver viscoelasticity: a hybrid analytical-computational micromechanics approach.

Motivated by elastography that utilizes tissue mechanical properties as biomarkers for liver disease, with the eventual objective of quantitatively linking histopathology and bulk mechanical properties, we develop a micromechanical modeling approach to capture the effects of fat and collagen deposition in the liver. Specifically, we utilize computational homogenization to convert the microstructural changes in hepatic lobule to the effective viscoelastic modulus of the liver tissue, i.e.

Microfluidic and Computational Tools for Neurodegeneration Studies.

Understanding the molecular, cellular, and physiological components of neurodegenerative diseases (NDs) is paramount for developing accurate diagnostics and efficacious therapies. However, the complexity of ND pathology and the limitations associated with conventional analytical methods undermine research. Fortunately, microfluidic technology can facilitate discoveries through improved biomarker quantification, brain organoid culture, and small animal model manipulation.

Improving spatial disaggregation of vehicular emission inventories.

Precise estimates of vehicular emissions at fine spatial scales are essential for effective emission reduction strategies. Achieving high-resolution vehicular emission inventories necessitates detailed data on traffic flow, driving patterns, and vehicle speeds for each road network segment. However, in developing countries, the lack of comprehensive traffic data, limited infrastructure, and insufficient monitoring systems constrains the development of high-resolution inventories.

Cryptic coral diversity is associated with symbioses, physiology, and response to thermal challenge.

Coral persistence in the Anthropocene depends on interactions among holobiont partners (coral animals and microbial symbionts) and their environment. Cryptic coral lineages-genetically distinct yet morphologically similar groups-are critically important as they often exhibit functional diversity relevant to thermal tolerance. In addition, environmental parameters such as thermal variability may promote tolerance, but how variability interacts with holobiont partners to shape responses to thermal challenge remains unclear.

Compressing slippery surface-assembled amphiphiles for tunable haptic energy harvesters.

A recurring challenge in extracting energy from ambient motion is that devices must maintain high harvesting efficiency and a positive user experience when the interface is undergoing dynamic compression. We show that small amphiphiles can be used to tune friction, haptics, and triboelectric properties by assembling into specific conformations on the surfaces of materials. Molecules that form multiple slip planes under pressure, especially through π-π stacking, produce 80 to 90% lower friction than those that form disordered mesostructures.

An Incognito Standardized Patient Approach for Measuring and Reducing Intersectional Healthcare Stigma: A Pilot Cluster Randomized Control Trial.

Background: Consistent evidence shows stigma impedes healthcare access in people living with HIV (PLWH) and men who have sex with men (MSM). We evaluated the impact of a stigma reduction training for providers whose design was informed by direct observation of their clinical behaviors obtained through visits by incognito standardized patient (SP).

Setting: We conducted this study in in sexually transmitted infection clinics in Guangzhou, China.

A Cross-Biomeasure Study to Optimize Antiretroviral Adherence Estimation.

Background: Incomplete adherence to daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) reduces effectiveness. Adherence biomeasures (i.e.

A histochemical approach to activity-based copper sensing reveals cuproplasia-dependent vulnerabilities in cancer.

Copper is an essential nutrient for sustaining vital cellular processes spanning respiration, metabolism, and proliferation. However, loss of copper homeostasis, particularly misregulation of loosely bound copper ions which are defined as the labile copper pool, occurs in major diseases such as cancer, where tumor growth and metastasis have a heightened requirement for this metal. To help decipher the role of copper in the etiology of cancer, we report a histochemical activity-based sensing approach that enables systematic, high-throughput profiling of labile copper status across many cell lines in parallel.

Temporal changes in hospital readmissions for postpartum hypertension in the US, 2010 to 2019; a serial cross-sectional analysis.

Background: Hypertension is the most common primary diagnosis associated with postpartum readmissions within 42 days of delivery hospitalization. In the United States, nearly half of the cases of eclampsia, a severe form of preeclampsia, develop during the postpartum period, and the postpartum onset of hypertensive disorders of pregnancy, like antepartum hypertension poses long-term health risks to pregnant individuals, including an increased likelihood of developing overall cardiovascular disease, coronary heart disease, heart failure, and chronic hypertension. In this paper, we estimate the trends in the incidence of readmissions for postpartum hypertension within 42 days of delivery discharge in the US, disaggregated by median household income.

National survey of financial burden and experience among patients with cancer and autoimmune disease receiving charitable copay assistance.

Background: Little is known about the role that charitable copay assistance (CPA) plays in addressing access to care and financial distress. The study sought to evaluate financial distress and experience with CPA among patients with cancer and autoimmune disease.

Methods: This is a national cross-sectional self-administered anonymous electronic survey conducted among recipients of CPA to cover the costs of a drug for cancer or autoimmune disease.

Artificial Intelligence-Guided Lung Ultrasound by Nonexperts.

Importance: Lung ultrasound (LUS) aids in the diagnosis of patients with dyspnea, including those with cardiogenic pulmonary edema, but requires technical proficiency for image acquisition. Previous research has demonstrated the effectiveness of artificial intelligence (AI) in guiding novice users to acquire high-quality cardiac ultrasound images, suggesting its potential for broader use in LUS.

Objective: To evaluate the ability of AI to guide acquisition of diagnostic-quality LUS images by trained health care professionals (THCPs).

Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.