Application of Artificial Intelligence to Analyze Data from Randomized Controlled Trials: An Example from DECAAF-II.

Background: Causal machine learning (ML) provides an efficient way of identifying heterogeneous treatment effect groups from hundreds of possible combinations, especially for randomized trial data.

Objective: The aim of this paper is to illustrate the potential of applying causal ML on the DECAAF II trial data. We proposed a causal ML model to predict the treatment response heterogeneity.

The Impact of Antibiotics on Latency When Given at the Time of Membrane Rupture Prior to Viability.

Background: It is well established that antibiotics administered in preterm prelabor rupture of membranes increases latency to delivery. While data is limited for membrane rupture prior to viability, antibiotics may also increase latency in this population.

Objective: To assesses the effect of prophylactic antibiotics on the duration of latency in individuals with previable prelabor rupture of membranes.

Real-time control of radiofrequency ablation using three-dimensional ultrasound echo decorrelation imaging in normal and diseasedhuman liver.

Ultrasound echo decorrelation imaging can successfully monitor and control thermal ablation of animal liver and tumor tissue ex vivo and in vivo. However, normal and diseased human liver has substantially different physical properties that affect echo decorrelation. Here, effects of human liver tissue condition on ablation guidance by three-dimensional echo decorrelation imaging are elucidated in experiments testing closed-loop control of radiofrequency ablation (RFA) in normal and diseased human liver tissue ex vivo.

Using the Key Characteristics Framework to Unlock the Mysteries of Aryl Hydrocarbon Receptor-Mediated Effects on the Immune System.

Initially discovered for its role mediating the deleterious effects of environmental contaminants, the aryl hydrocarbon receptor (AHR) is now known to be a crucial regulator of the immune system. The expanding list of AHR ligands includes synthetic and naturally derived molecules spanning pollutants, phytochemicals, pharmaceuticals, and substances derived from amino acids and microorganisms. The consequences of engaging AHR vary, depending on factors such as the AHR ligand, cell type, immune challenge, developmental state, dose, and timing of exposure relative to the immune stimulus.

Effectiveness of a program director for osteopathic medical education to support osteopathic recognition at a training site with multiple programs.

Context: With the advent of the Single Accreditation System (SAS) within the Accreditation Council for Graduate Medical Education (ACGME), few programs have achieved Osteopathic Recognition (OR) status to date. OR is an accreditation that graduate medical education (GME) programs can achieve to distinctly acknowledge the additional focus on osteopathic training. There is an effort by national osteopathic organizations to determine barriers for programs to achieve OR and what innovative methods might help overcome them.

Constructing tridimensional modeling and radiographic evaluation of diaphyseal fractures in a canine femur for veterinary education.

Purpose: To create tridimensional (3D) anatomical models of diaphyseal fractures in dogs (3D AMDFD) and to evaluate the models from their radiographs.

Methods: The study consisted of six stages: preparation of femur from a healthy dog cadaver; digitalization of the bone through a 3D scanner and creation of the base model; creation of a 3D AMDFD based on the image of the base model, 3D modeling carried out to reproduce five different types of diaphyseal fractures; printing the models produced on a 3D printer with a thermoplastic material; insertion of neodymium magnets in the fracture line to allow the assembly and disassembly of the parts; and radiography of 3D AMDFD in lateromedial and craniocaudal positions.

Results: The base model and 3D AMDFD had high precision in the replication of bone structures, like the bone in natura.

From "isolation" to "me-time": linguistic shifts enhance solitary experiences.

Spending time alone is a virtually inevitable part of daily life that can promote or undermine well-being. Here, we explore how the language used to describe time alone - such as "me-time", "solitude", or "isolation" - influences how it is perceived and experienced. In Study 1 ( = 500 U.

Spine-Abductor Syndrome: Novel Associations Between Lumbar Spine Disease and Hip Gluteal Muscle Pathology.

Background: Risk factors for gluteal tears include age-related deterioration, female sex, and increased body mass index. As the literature that supports the sagittal relationship between the lumbar spine and the hip is increasing, there may be a parallel relationship between the perturbations in spinopelvic alignment caused by lumbar spine disease and gluteal muscle tears. Because no prior studies other than single-institution series have reported on this phenomenon, we investigated spine-abductor syndrome at the population level.

A descriptive study of fatal drownings among children and adolescents in the United States, with a focus on retention pond deaths, 2004-2020.

The objective of this study was to characterize fatal drownings among children and adolescents, with a focus on retention pond drownings, and identify risk factors for these fatalities using child death review data. We acquired 2004-2020 National Fatality Review-Case Reporting System data for drowning deaths among youth 0-19 years. Retention pond drownings were identified through case narratives.

Evolutionary lineage-specific genomic imprinting at the ZNF791 locus.

Genomic imprinting is an epigenetic process that results in parent-of-origin effects on mammalian development and growth. Research on genomic imprinting in domesticated animals has lagged due to a primary focus on orthologs of mouse and human imprinted genes. This emphasis has limited the discovery of imprinted genes specific to livestock.

A Controversial Clinical Case of a Child With Hypoplastic Left Heart Syndrome.

We present the case of a child born with hypoplastic left heart syndrome. After developing multiple complications following the first surgical stage (Norwood procedure), her parents decide not to proceed with the second stage (Glenn operation). Cardiac surgeons, pediatric intensivists, a psychologist, and a bioethicist analyze whether further surgical intervention is ethically obligatory.

Fission yeast GPI inositol deacylase Bst1 regulates ER-Golgi transport and functions in late stages of cytokinesis.

The Munc13/UNC-13 family protein Ync13 is essential for septum integrity and cytokinesis in fission yeast. To further explore the mechanism of Ync13 functions, spontaneous suppressors of mutants, which can suppress the colony-formation defects and lysis phenotype of mutant cells, are isolated and characterized. One of the suppressor mutants, -, shows defects in the cytokinetic contractile ring constriction, septation, and daughter-cell separation, similar to mutant.

Impact of Frailty on Surgical Outcomes of Patients With Cushing Disease Using the Multicenter Registry of Adenomas of the Pituitary and Related Disorders Registry.

Background And Objectives: Despite growing interest in how patient frailty affects outcomes (eg, in neuro-oncology), its role after transsphenoidal surgery for Cushing disease (CD) remains unclear. We evaluated the effect of frailty on CD outcomes using the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) data set from a collaboration of US academic pituitary centers.

Methods: Data on consecutive surgically treated patients with CD (2011-2023) were compiled using the 11-factor modified frailty index.

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).

Safety and Efficacy of Tranexamic Acid in General Surgery.

Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery.

Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery.

Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.

Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.

Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.

Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.

Technical considerations of cardiac computed tomography in children.

Cardiac computed tomography angiography (CTA) is a valuable tool in the assessment of congenital and acquired cardiac disease in children. The goal of cardiac CTA is to produce images that are free of motion and provide sufficient characterization of the anatomy in question. Given the complexity of pediatric patient characteristics, including patient size, heart rate, breath-holding capability, and variant anatomy, cardiac CTA technique must be individualized to the patient as well as the indication to answer the clinical question while also minimizing radiation exposure.

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Background: Pediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI.

Methods: We analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 U.

Event-level differences in quantity, frequency, and consequences of cannabis use by modes of use: Moderation by differences in how often individuals use each mode among sexual minority women and gender diverse individuals.

Background: A handful of studies have examined differences in the subjective effects and consequences of utilizing different modes of cannabis (e.g., smoking vs.

Challenges in determining the global burden of non-malignant central nervous system tumors: an analysis of international incidence and mortality data sources.

Background: Non-malignant tumors of the CNS contribute substantially to the morbidity and mortality from CNS tumors. It is critical to understand the epidemiology of non-malignant CNS tumors separately from CNS malignancies to inform resource allocation and policy since treatment and prognosis can differ. High quality international data on non-malignant CNS tumor burden are needed to accomplish this goal.

The role of multi-modality imaging for the assessment of left atrium and left atrial appendage. A clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC).

Structural, architectural, contractile or electrophysiological alterations may occur in the left atrium (LA). The concept of LA cardiopathy is supported by accumulating scientific evidence demonstrating that LA remodeling has become a cornerstone diagnostic and prognostic marker. The structure and the function of LA and left atrial appendage (LAA) which is an integral part of the LA, are key elements for a better understanding of multiple clinical conditions, most notably atrial fibrillation (AF), cardioembolism, heart failure and mitral valve diseases.

Youth participatory action research (YPAR) to promote educational equity.

The article uses theory and qualitative evidence to show how youth participatory action research (YPAR) can advance educational equity. YPAR engages young people and adult allies in research and action on issues in their schools and communities. Interviews with over two dozen YPAR researchers-students and partner teachers-elaborate the mechanisms through which school-based YPAR can affect equity, including through direct changes to policy and practice as a result of YPAR actions, a school culture that values student experiences, transformative teacher-student relationships, and improved individual outcomes for participants.

Metabolic Characterization of Sarin, Cyclosarin, and Novichoks (A-230, A-232) in Human Liver Microsomes.

We have assessed the human liver microsomal (HLM) metabolism of the chemical warfare nerve agents' sarin (GB), cyclosarin (GF), and the Novichok agents A-230 and A-232. In HLM, GB showed drastically decreased stability ( = 1.4 h).

Olfactory Cleft Opacification Improves With Intranasal Steroid Treatment and Is Correlated With Objective and Patient-Reported Olfactory Outcomes.

In patients with severe olfactory and gustatory dysfunction, olfactory cleft opacification improves with expanded intranasal steroid treatment (EDS-FLU) relative to placebo. This is directly associated with objective and patient-reported taste/smell improvement.