Structure of subcortico-cortical tracts in middle-aged and older adults with autism spectrum disorder.

Middle-aged and older adults with autism spectrum disorder may be susceptible to accelerated neurobiological changes in striato- and thalamo-cortical tracts due to combined effects of typical aging and existing disparities present from early neurodevelopment. Using magnetic resonance imaging, we employed diffusion-weighted imaging and automated tract-segmentation to explore striato- and thalamo-cortical tract microstructure and volume differences between autistic (n = 29) and typical comparison (n = 33) adults (40 to 70 years old). Fractional anisotropy, mean diffusivity, and tract volumes were measured for 14 striato-cortical and 12 thalamo-cortical tract bundles.

What is the role of parenteral nutrition in the management of the patient with severe acute pancreatitis?

Severe acute pancreatitis often presents as a complex critical illness associated with a high rate of infectious morbidity, multiple organ failure, and in-hospital mortality. Breakdown of gut barrier defenses, dysbiosis of intestinal microbiota, and exaggerated immune responses dictate that early enteral nutrition (EN) is preferred over parenteral nutrition (PN) as the primary route of nutrition therapy. EN, however, is not feasible in all cases because of intolerance, risk of complications, or a direct contraindication to enteral feeding.

Association between serum urate levels and all-cause mortality, cardiovascular and renal outcomes among gout patients in Singapore.

Objectives: We investigated the longitudinal association between Serum Urate (SU) level and Acute Myocardial Infarction (AMI), Stroke, End Stage Renal Failure (ESRF) and all-cause mortality.

Design: We conducted a retrospective hospital-based cohort study of individuals with gout managed in specialist outpatient clinics. Cox proportional hazards regression was used to estimate HR and 95% CI, with adjustments for potential confounders.

Family medicine research: seizing the moment to advance the field.

Despite a growing awareness that primary care is essential to an accessible, equitable, high-quality, cost-effective health care system, family medicine research remains woefully underdeveloped. The increased focus of both state and federal policy makers on primary care payment and care delivery models presents an opportunity for family medicine to redefine itself as an academically rigorous discipline at the forefront of generating evidence that improves patient care and population health while reducing costs. In a critical review of the literature, we identified five themes-leadership, funding, resources, team science, and departmental culture-that are integral to family medicine departments seeking to grow and expand their research capacity.

Cost-Effectiveness Analysis of a Novel Fetal Vesicoamniotic Shunt-The Vortex Shunt.

Objective: We estimated the potential outcomes, costs, and cost-effectiveness of the Vortex shunt, a novel fetal vesicoamniotic shunt (VAS), compared to standard shunts for treating fetal lower urinary tract obstruction (LUTO).

Method: We designed a decision-analytic model comparing the Vortex shunt to current shunts using a theoretical cohort of 1000 pregnancies equivalent to the annual U.S.

The challenge of integrating a diagnosis of malnutrition in the practical application of nutrition care in the intensive care unit.

Evidence of poor nutrition status in a patient present on admission to the intensive care unit is associated with worse clinical outcomes than that for a well-nourished patient who becomes critically ill. Diagnosing malnutrition in this setting is fraught with difficulty, though, because elements of nutrition history are hard to obtain, the interpretation of anthropometric parameters is influenced by the disease process and interventions of critical care and the subjectivity of traditional assessment tools lacks precision. Determining the severity of disease drives the initial management and sets priorities in the derivation of the nutrition plan, focusing on strategies that promote survival.

The Society of Thoracic Surgeons Expert Consensus Statements on a Framework for a Standardized National Robotic Curriculum for Thoracic Surgery Trainees.

Objective: With robotic technology's rapid growth and integration, an urgent need to bridge the educational gap in thoracic surgical training has emerged. This document, a result of consensus among a group of experts in the practice and training of robotic surgery from the Society of Thoracic Surgeons (STS), aims to provide a framework for a standardized national robotic curriculum for thoracic surgery trainees.

Methods: The STS Task Force on Robotic Thoracic Surgery and Workforce on E-learning and Educational Innovation assembled an expert group with the input of the Thoracic Surgery Director's Association (TSDA).

A PDZ-kinase allosteric relay mediates Par complex regulator exchange.

The Par complex polarizes the plasma membrane of diverse animal cells using the catalytic activity of atypical Protein Kinase C (aPKC) to pattern substrates. Two upstream regulators of the Par complex, Cdc42 and Par-3, bind separately to the complex to influence its activity in different ways. Each regulator binds a distinct member of the complex, Cdc42 to Par-6 and Par-3 to aPKC, making it unclear how they influence one another's binding.

The physicochemical properties of lipopolysaccharide chemotypes regulate activation of the contact pathway of blood coagulation.

Lipopolysaccharide (LPS) is the primary pathogenic factor in Gram-negative sepsis. While the presence of LPS in the bloodstream during infection is associated with disseminated intravascular coagulation, the mechanistic link between LPS and blood coagulation activation remains ill-defined. The contact pathway of coagulation-a series of biochemical reactions that initiates blood clotting when plasma factors XII (FXII) and XI (FXI), prekallikrein (PK) and high molecular weight kininogen (HK) interact with anionic surfaces-has been shown to be activated in Gram-negative septic patients.

Outliers of Total Shoulder Arthroplasty in the Bundled Payment Era.

Background: The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement Advanced (BPCIA) Model that covers 90-day care episodes after select orthopedic procedures including anatomic or reverse ball-and-socket total shoulder arthroplasty (TSA/rTSA). This study investigated whether patients undergoing TSA/rTSA for non-degenerative processes incur higher costs than patients undergoing arthroplasty for degenerative processes.

Methods: A retrospective review was conducted of all patients at a single academic medical center enrolled in the BPCIA model for TSA/rTSA from October 1, 2018, through December 31, 2022.

Short-term cognitive practice effects in Parkinson's disease: More than meets the eye.

Introduction: Although practice effects (PE) on repeated cognitive testing have received growing interest in Alzheimer's disease, they have been understudied in Parkinson's disease (PD). The current paper examined PE across one week in a sample of patients with PD via traditional methods and regression-based change scores, as well as if these change scores relate to clinical variables in PD.

Methods: Thirty-five patients with PD were administered a brief cognitive battery twice across approximately one week.

A phase 1 study of the CDK9 inhibitor voruciclib in relapsed/refractory acute myeloid leukemia and B-cell malignancies.

The anti-apoptotic protein myeloid cell leukemia-1 (Mcl-1) contributes to the pathophysiology of acute myeloid leukemia (AML) and certain B-cell malignancies. Tumor dependence on Mcl-1 is associated with resistance to venetoclax. Voruciclib, an oral cyclin-dependent kinase (CDK) inhibitor targeting CDK9, indirectly decreases Mcl-1 protein expression and synergizes with venetoclax in preclinical models.

Bovine milk consumption affects the transcriptome of porcine adipose stem cells: Do exosomes play any role?

The potential association of milk with childhood obesity has been widely debated and researched. Milk is known to contain many bioactive compounds as well as bovine exosomes rich in micro-RNA (miR) that can have effects on various cells, including stem cells. Among them, adipose stem cells (ASC) are particularly interesting due to their role in adipose tissue growth and, thus, obesity.

Effects of Supranutritional Selenium Supplementation During Different Trimesters of Pregnancy on Humoral Immunity in Beef Cattle at Parturition.

Supranutritional Se supplementation may improve immune responses in beef cattle. Immunity is compromised in beef cattle during the periparturient period. This study aims to determine the best time during pregnancy to supplement beef cows with Se-yeast to optimize humoral immunity at parturition.

Exploring the Impact of a Targeted Positive Psychological Intervention on Healthcare Workers' Subjective Happiness.

Objective: The aim of this study was to generate new knowledge to improve healthcare worker (HCW) happiness.

Background: Already trending upward, HCW burnout spiked during the pandemic reaching rates of 49% to 69%.

Methods: This unblinded randomized controlled trial studied a positive psychological intervention's (PPI) impact on subjective happiness among 183 HCWs in a 644-bed community healthcare organization.

Relationship Between Coronary Artery Calcium Score and Vulnerability of Culprit Plaque Assessed by OCT in Patients With Established Coronary Artery Disease.

Background: Coronary artery calcium score (CACS) is widely used for risk stratification. However, in patients with established coronary artery disease, its clinical implication and relationship with plaque vulnerability are unclear. We sought to correlate the CACS and plaque vulnerability assessed by optical coherence tomography.

Annual Research Review: Micronutrients and their role in the treatment of paediatric mental illness.

The aim of this narrative review is to summarize evidence relating the importance of nutrient intake from diet and supplementation for paediatric mental health. We begin by reviewing several mechanisms by which nutrients maximize brain health, including enabling metabolic reactions to occur, supporting mitochondrial function, reducing inflammation and assisting with detoxification. Circumstances that may contribute to an individual requiring additional nutrients beyond what are available in the diet, such as consumption of nutritionally depleted food, individual differences in biological need, long-term medication use and gut-brain health needs are then reviewed.

Exacerbation of neuropsychiatric symptoms in an adult male with influenza A virus treated with oseltamivir.

Oseltamivir (Tamiflu) package labeling has a warning for neuropsychiatric adverse events (NPAE), most commonly in children and adolescents, especially males. There are several case reports of NPAE in adults treated with oseltamivir, but few document patients with preexisting neuropsychiatric conditions without additional contributing factors. This case report describes a 22-year-old male with a history of bipolar disorder, depression, and attention-deficit/hyperactivity disorder who had been stable on his medication regimen before experiencing sudden worsening of symptoms after the initiation of oseltamivir.

Early Diagnosis and Treatment of Cardiac Amyloidosis by Screening Biopsy During Trigger Finger Release.

Patients undergoing trigger release surgery are known to be at increased risk of amyloidosis and heart failure, and therefore, amyloidosis screening during trigger release surgery may facilitate early diagnosis and treatment of cardiac amyloidosis. However, the reported prevalence of amyloid on biopsies taken during trigger release surgery has varied widely, and no biopsy-positive patients in prior studies have been diagnosed with occult cardiac amyloidosis or started on disease-modifying therapy. We review the existing literature on this topic and present a case of a patient with cardiac amyloidosis diagnosed from a biopsy taken during trigger release surgery and subsequently started on disease-modifying therapy.

Oxylipin Receptors and Their Role in Inter-Partner Signalling in a Model Cnidarian-Dinoflagellate Symbiosis.

Oxylipin signalling is central in biology, mediating processes such as cellular homeostasis, inflammation and molecular signalling. It may also facilitate inter-partner communication in the cnidarian-dinoflagellate symbiosis, though this aspect remains understudied. In this study, four oxylipin receptors were characterised using immunohistochemistry and immunoblotting in the sea anemone Exaiptasia diaphana ('Aiptasia'): Prostaglandin E2 receptor 2 (EP2) and 4 (EP4), Transient Receptor Potential cation channel A1 (TRPA1) and Glutamate Receptor Ionotropic, Kainate 2 (GRIK2).

Subcellular NAD pools are interconnected and buffered by mitochondrial NAD.

The coenzyme NAD is consumed by signalling enzymes, including poly-ADP-ribosyltransferases (PARPs) and sirtuins. Ageing is associated with a decrease in cellular NAD levels, but how cells cope with persistently decreased NAD concentrations is unclear. Here, we show that subcellular NAD pools are interconnected, with mitochondria acting as a rheostat to maintain NAD levels upon excessive consumption.

Taxonomic variability and functional stability across Oregon coastal subsurface microbiomes.

The factors shaping microbial communities in marine subsurface sediments remain poorly understood. Here, we analyzed the microbiome of subsurface sediments within a depth range of 1.6-1.