Governance Considerations for Point-of-Care Ultrasound: a HIMSS-SIIM Enterprise Imaging Community Whitepaper in Collaboration with AIUM.

Point-of-care ultrasound (POCUS) has emerged as a standard of care across a variety of healthcare settings due to its ability to provide critical clinical information and as well as procedural guidance to clinicians directly at the bedside. Implementation of enterprise imaging (EI) strategies is needed such that POCUS images can be appropriately captured, indexed, managed, stored, distributed, viewed, and analyzed. Because of its unique workflow and educational requirements, reliance on traditional order-based workflow solutions may be insufficient.

Cerebellar Ataxia, Neuropathy, and Vestibular Areflexia as a Presentation of a Novel DNMT1 Mutation.

A 50-year-old woman with a 20-year history of gait instability presented with new-onset vertigo and oscillopsia. Examination revealed bilateral vestibular loss, cerebellar ataxia, sensory neuropathy, a "yes-yes" head tremor, nystagmus and a family history of a similar syndrome. Genetic testing for cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (RFC1) was negative, but whole exome sequencing identified a novel mutation in the DNA methyltransferase 1 (DNMT1) gene, broadening the differential diagnosis for this phenotype.

Refining breast cancer genetic risk and biology through multi-ancestry fine-mapping analyses of 192 risk regions.

Genome-wide association studies have identified approximately 200 genetic risk loci for breast cancer, but the causal variants and target genes are mostly unknown. We sought to fine-map all known breast cancer risk loci using genome-wide association study data from 172,737 female breast cancer cases and 242,009 controls of African, Asian and European ancestry. We identified 332 independent association signals for breast cancer risk, including 131 signals not reported previously, and for 50 of them, we narrowed the credible causal variants down to a single variant.

The Moreton Lecture Series: The Renin-Angiotensin-Aldosterone System-Physiology, Pathophysiology, and Pharmacological Inhibition.

The renin-angiotensin-aldosterone system (RAAS) is a complex regulator comprising hormones, proteins, and enzymes. The discovery of the RAAS and its pharmacological manipulation has been essential in the management of cardiovascular diseases, including hypertension. Beyond the benefits of hypertension, RAAS inhibition has implications for heart failure, atherosclerotic disease, and kidney disease.

Disentangling Sources of Momentum Fluctuations in Xe+Xe and Pb+Pb Collisions with the ATLAS Detector.

High-energy nuclear collisions create a quark-gluon plasma, whose initial condition and subsequent expansion vary from event to event, impacting the distribution of the eventwise average transverse momentum [P([p_{T}])]. Disentangling the contributions from fluctuations in the nuclear overlap size (geometrical component) and other sources at a fixed size (intrinsic component) remains a challenge. This problem is addressed by measuring the mean, variance, and skewness of P([p_{T}]) in ^{208}Pb+^{208}Pb and ^{129}Xe+^{129}Xe collisions at sqrt[s_{NN}]=5.

Impact of 24-hour pharmacy call response on time to antibiotics in open fractures.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Single-nucleus and spatial landscape of the sub-ventricular zone in human glioblastoma.

The sub-ventricular zone (SVZ) is the most well-characterized neurogenic area in the mammalian brain. We previously showed that in 65% of patients with glioblastoma (GBM), the SVZ is a reservoir of cancer stem-like cells that contribute to treatment resistance and the emergence of recurrence. Here, we build a single-nucleus RNA-sequencing-based microenvironment landscape of the tumor mass and the SVZ of 15 patients and two histologically normal SVZ samples as controls.

Basic Science and Pathogenesis.

Background: Non-coding RNA species, such as microRNA (miRNA), regulate multiple biological and pathological processes by binding to target mRNAs and facilitating alteration of translation levels via complexes such as RNA-induced silencing complex (RISC). Disrupting this process could contribute to AD pathogenesis by fostering aggregation of hyperphosphorylated microtubule-associated protein tau and amyloid-β (Aβ) peptides, and neuroinflammation. Understanding how these pathological changes are regulated remains our research focus.

Basic Science and Pathogenesis.

Background: Specialized pro-resolving mediators (SPMs) promote inflammatory resolution and homeostasis and are thought to have specific reprogramming effects on hman microglia. Decreased SPM levels have been correlated with chronic neuroinflammation, late-stage Alzheimer's disease (AD) and neuropathology in humans, yet few studies have explored the cellular signatures of resolution. Amyloid is though to bind one target resolution receptor, ChemR23, leading to internalization.

Basic Science and Pathogenesis.

Background: Heparan sulfate (HS) interacts with many important proteins. These interactions are primarily driven by electrostatics, with specificity determined by sulfation patterns. Although 3-O-sulfation is a rare modification in HS, several genome-wide association studies (GWAS) revealed that the Hs3st1 gene, encoding HS-3-O-sulfotransferase-1, is significantly linked to late onset AD risk.

Basic Science and Pathogenesis.

Background: Alzheimer's disease (AD) is associated with cognitive impairment and neuro-inflammation. Dysregulated activation of microglia and astrocytes induces neuro-inflammation, and reactive astrocytes have been classified into A1 neurotoxic and A2 neuroprotective phenotypes. A1 astrocytes are induced by activated neuro-inflammatory microglia via secreting IL-1α, TNFα and C1q, and contributing to inflammation and neuronal cell death.

Basic Science and Pathogenesis.

Background: Alzheimer's disease disproportionately affects women in the U.S., with two-thirds of individuals diagnosed being female.

Basic Science and Pathogenesis.

Background: Alzheimer's disease (AD) has traditionally been recognized as progressive dementia with brain deposits of amyloid (Aβ) and Tau (MAPT) proteins starting 20 and 10 years before the onset of clinical symptoms. Aggregation and deposition of Aβ and Tau proteins have been successfully studied in vitro, cell cultures, and animal models, but clinical deficits have been more difficult to assess. Behavior in mice is a complex phenomenon and subject to variation based on mouse interest, moods, stress-induced distraction, and other undefined parameters.

Basic Science and Pathogenesis.

Background: The orexin/hypocretin neuropeptide system, primarily found in the lateral hypothalamus and perifornical region, modulates sleep, wakefulness, appetite, and cognitive function. One region with dense orexinergic projections is the basal forebrain (BF), which is the major source of acetylcholine in the neocortex and limbic structures such as the hippocampus. The basal forebrain cholinergic system mediates cognition and dysfunction is one of the key hallmarks of Alzheimer's disease.

Clinical Manifestations.

Background: Prior longitudinal studies among older adults have documented associations between hearing loss and changes in brain morphology. Whether interventions involving hearing aids can reduce age-related atrophy is unknown. A substudy within the Aging and Cognitive Health Evaluation in Elders (ACHIEVE, Clinicaltrials.

Basic Science and Pathogenesis.

Background: Alzheimer's disease (AD) pathology can start accumulating 20-30 years before cognitive symptoms occur, with increases in inflammation, amyloid-β (Aβ), and hyperphosphorylated Tau during this time. Previous studies have shown that the post-translational modification of a single N-acetylglucosamine moiety to serine or threonine residues to cytosolic or nuclear proteins, known as O-GlcNAcylation, can modify a plethora of cellular processes, including the processing of the amyloid precursor protein, competing with phosphorylation on tau, as well as having anti-inflammatory effects. This study is designed to evaluate how increasing O-GlcNAcylation is impacting AD pathology in the most comprehensive AD rat model to date, the TgF344-AD rat model.

Superdiffusive Thermal Transport in Polymer-Grafted Nanoparticle Melts.

In contrast to normal diffusion processes, thermal conduction in one-dimensional systems is anomalous. The thermal conductivity is found to vary with the length as κ∼L^{α}(α>0), but there is a long-standing debate on the value α. Here, we present a canonical example of this behavior in polymer-grafted spherical nanoparticle (GNP) melts at fixed grafting density and nanoparticle radius.

Search for Fractionally Charged Particles with CUORE.

The Cryogenic Underground Observatory for Rare Events (CUORE) is a detector array comprised by 988 5  cm×5  cm×5  cm TeO_{2} crystals held below 20 mK, primarily searching for neutrinoless double-beta decay in ^{130}Te. Unprecedented in size among cryogenic calorimetric experiments, CUORE provides a promising setting for the study of exotic throughgoing particles. Using the first tonne year of CUORE's exposure, we perform a search for hypothesized fractionally charged particles (FCPs), which are well-motivated by various standard model extensions and would have suppressed interactions with matter.

Clinical Manifestations.

Background: Prodromal dementia with Lewy bodies (DLB) research criteria were recently published and further work is needed to characterize the neuropsychological profile and refine clinical criteria. We performed a meta-analysis to compare the cognitive performance of mild cognitive impairment with Lewy bodies (MCI-LB) groups to controls, MCI due to Alzheimer's disease (MCI-AD), and DLB.

Method: Following PRISMA guidelines, we searched the literature for 1) English-language studies on MCI-LB; 2) published January 1990-March 2023, 3) with ≥1 standardized cognitive measure; and 4) comparison data from controls, MCI-AD, and/or DLB.

Geographic Variation in Inpatient Rehabilitation Outcomes After Traumatic Brain Injury.

Objective: To determine whether regional variations exist in functional outcomes of patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation facilities (IRFs) across the United States, while controlling for demographic and clinical variables.

Setting: Inpatient rehabilitation facilities (IRFs) across 4 U.S.

Clinical Manifestations.

Background: Apathy in Alzheimer's disease (AD) is associated with cognitive impairment, particularly executive functions such as selective attention, making it unclear whether apathy should be a separate treatment target. Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) is the largest and most recent trial assessing apathy and cognition. This analysis assessed whether changes in apathy correlated to changes in various cognitive domains in ADMET 2.

Clinical Manifestations.

Background: Language impairment is common in progressive supranuclear palsy (PSP) and is often overlooked due to the severity of the motor symptoms. We investigated whether language can be used to predict PSP prognosis.

Methods: One hundred-forty-six patients with a diagnosis of possible or probable PSP from the Tilavonemab (ABBV-8E12) clinical trial were evaluated at baseline and week 32 using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the PSP rating scale (PSPRS) and the Schwab and England Activities of Daily Living Scale (SEADL).

TXSELECT: a web-based decision support system for regional assessment of potential loads using a spatially explicit approach.

Bacterial source characterization and allocation are imperative to watershed planning and identifying best management practices. The Spatially Explicit Load Enrichment Calculation Tool (SELECT) has been extensively utilized in watershed protection plans to evaluate the potential bacteria loads and sources in impaired watersheds. However, collecting data, compiling inputs, and spatially mapping sources can be arduous, time-intensive, expensive, and iterative until potential bacteria loads are appropriately allocated to sources based on stakeholder recommendations.