Electroencephalogram-Guided General Anesthesia in a Pediatric Patient With Alexander's Disease: A Case Report.

In this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%.

Relationship Between Structural and Functional Network Connectivity Changes for Patients With Traumatic Brain Injury and Chronic Health Symptoms.

Combination of structural and functional brain connectivity methods provides a more complete and effective avenue into the investigation of cortical network responses to traumatic brain injury (TBI) and subtle alterations in brain connectivity associated with TBI. Structural connectivity (SC) can be measured using diffusion tensor imaging to evaluate white matter integrity, whereas functional connectivity (FC) can be studied by examining functional correlations within or between functional networks. In this study, the alterations of SC and FC were assessed for TBI patients, with and without chronic symptoms (TBIcs/TBIncs), compared with a healthy control group (CG).

Decarceration and COVID-19 infections in U.S. Immigration and Customs Enforcement detention facilities: a simulation modeling study.

Background: U.S. Immigration and Customs Enforcement (ICE) facilities had high rates of COVID-19 infections and mortality during the global pandemic.

Mechanisms of aortic dissection: From pathological changes to experimental and models.

Aortic dissection continues to be responsible for significant morbidity and mortality, although recent advances in medical data assimilation and in experimental and models have improved our understanding of the initiation and progression of the accumulation of blood within the aortic wall. Hence, there remains a pressing necessity for innovative and enhanced models to more accurately characterize the associated pathological changes. Early on, experimental models were employed to uncover mechanisms in aortic dissection, such as hemodynamic changes and alterations in wall microstructure, and to assess the efficacy of medical implants.

Assessing the context within academic health institutions toward improving equity-based, community and patient-engaged research.

Introduction: The continued momentum toward equity-based, patient/community-engaged research (P/CenR) is pushing health sciences to embrace principles of community-based participatory research. Much of this progress has hinged on individual patient/community-academic partnered research projects and partnerships with minimal institutional support from their academic health institutions.

Methods: We partnered with three academic health institutions and used mixed methods (i.

Deep Learning-Enabled Integration of Histology and Transcriptomics for Tissue Spatial Profile Analysis.

Spatially resolved transcriptomics enable comprehensive measurement of gene expression at subcellular resolution while preserving the spatial context of the tissue microenvironment. While deep learning has shown promise in analyzing SCST datasets, most efforts have focused on sequence data and spatial localization, with limited emphasis on leveraging rich histopathological insights from staining images. We introduce GIST, a deep learning-enabled gene expression and histology integration for spatial cellular profiling.

Associations Between Delayed Sleep Phase Syndrome and Daytime Napping with the Metabolic Syndrome Among Adults: Results from the Ravansar Non-Communicable Disease (RaNCD) Cohort Study.

Objective: Adverse sleep and wake patterns are associated with physical health complaints, including metabolic disorders. The aim of this study was to evaluate the relationship between delayed sleep phase syndrome (DSPS) and napping during the day with metabolic syndrome (MetS).

Methods: This study was conducted on 10 065 participants aged 35-65 years using baseline data from the Ravansar Non-Communicable Disease (RaNCD) cohort study.

EPISeg: Automated segmentation of the spinal cord on echo planar images using open-access multi-center data.

Functional magnetic resonance imaging (fMRI) of the spinal cord is relevant for studying sensation, movement, and autonomic function. Preprocessing of spinal cord fMRI data involves segmentation of the spinal cord on gradient-echo echo planar imaging (EPI) images. Current automated segmentation methods do not work well on these data, due to the low spatial resolution, susceptibility artifacts causing distortions and signal drop-out, ghosting, and motion-related artifacts.

Bacterial and host enzymes modulate the inflammatory response produced by the peptidoglycan of the Lyme disease agent.

The spirochete causes Lyme disease. In some patients, an excessive, dysregulated proinflammatory immune response can develop in joints leading to persistent arthritis. In such patients, persistence of antigenic peptidoglycan (PG) fragments within joint tissues may contribute to the immunopathogenesis, even after appropriate antibiotic treatment.

From Clinical to Benchside: Lacticaseibacillus and Faecalibacterium Are Positively Associated With Muscle Health and Alleviate Age-Related Muscle Disorder.

Sarcopenia is an age-related muscle disorder that increases risks of adverse clinical outcomes, but its treatments are still limited. Gut microbiota is potentially associated with sarcopenia, and its role is still unclear. To investigate the role of gut microbiota in sarcopenia, we first compared gut microbiota and metabolites composition in old participants with or without sarcopenia.

Prenatal Care of Parents Who Continued Pregnancies With Down Syndrome, 2003-2022.

Parents of children with Down syndrome have historically reported poor experiences receiving a prenatal diagnosis. In a 2003 survey, mothers reported that their physicians pitied them, emphasized negative aspects of Down syndrome, and encouraged them to terminate the pregnancy. This study assesses whether parents' perceptions have since improved.

Predicting doxorubicin-induced cardiotoxicity in breast cancer: leveraging machine learning with synthetic data.

Doxorubicin (DOXO) is a primary treatment for breast cancer but can cause cardiotoxicity in over 25% of patients within the first year post-chemotherapy. Recognizing at-risk patients before DOXO initiation offers pathways for alternative treatments or early protective actions. We analyzed data from 78 Brazilian breast cancer patients, with 34.

Clinical entity augmented retrieval for clinical information extraction.

Large language models (LLMs) with retrieval-augmented generation (RAG) have improved information extraction over previous methods, yet their reliance on embeddings often leads to inefficient retrieval. We introduce CLinical Entity Augmented Retrieval (CLEAR), a RAG pipeline that retrieves information using entities. We compared CLEAR to embedding RAG and full-note approaches for extracting 18 variables using six LLMs across 20,000 clinical notes.

Advancing precision psychiatry and targeted treatments: Insights from immunopsychiatry.

Despite tremendous advancements in neuroscience, there has been limited impact on patient care. Current psychiatric treatments are largely non-specific, and drug development is hindered by outdated, overinclusive diagnostic categories and a "one-size-fits-all" approach. Additionally, mechanisms underlying psychiatric illnesses and their treatments with conventional medications remain poorly understood.

The ACTION VAD Registry: A Collective Five-Year Experience.

Background: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) began in 2018 as a collaborative learning health system committed to improving outcomes in pediatric heart failure, including children and adults with congenital heart disease, supported with ventricular assist devices (VADs). This report describes patient and device characteristics, and outcomes through 1-year post-implant.

Methods: The ACTION VAD registry report was created from data submitted to the ACTION learning network from April 2018-June 2023.

Tuning local matrix compliance accelerates mesenchymal stem cell chondrogenesis in 3D sliding hydrogels.

The mechanical properties of the extracellular matrix critically regulate stem cell differentiation in 3D. Alginate hydrogels with tunable bulk stiffness and viscoelasticity can modulate differentiation in 3D through mechanotransduction. Such enhanced differentiation is correlated with changes in the local matrix compliance- the extent of matrix deformation under applied load.

Comparison of Postoperative Antibiotic Protocols for Pediatric Complicated Appendicitis: A Western Pediatric Surgery Research Consortium Study.

Background: There is no consensus on the appropriate duration of postoperative antibiotics for complicated appendicitis in children. Commonly used antibiotic endpoints include normalization of white blood cell count (WBC) or completion of a minimum number of prespecified treatment days. We compared clinical outcomes resulting from varying postoperative antibiotic protocols for complicated appendicitis in children.

A data-driven latent variable approach to validating the research domain criteria framework.

Despite the widespread use of the Research Domain Criteria (RDoC) framework in psychiatry and neuroscience, recent studies suggest that the RDoC is insufficiently specific or excessively broad relative to the underlying brain circuitry it seeks to elucidate. To address these concerns, we employ a latent variable approach using bifactor analysis. We examine 84 whole-brain task-based fMRI (tfMRI) activation maps from 19 studies with 6192 participants.

Age and Weight Stratified Outcomes of Single Stage Endorectal Pull-through Procedures for Hirschsprung's Disease in Children: Analysis of NSQIP-P Data.

Background: We aimed to analyze the effect of age and weight on 30-day outcomes of single-stage endorectal pull tthrough (ERPT) procedures for Hirschsprung's Disease (HD) using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database to identify an optimal time for surgery.

Methods: We queried NSQIP-P for children <2 years with HD who underwent ERPT between 2016-2021 and did not have a preoperative stoma. Patients were stratified by age (<3 months, 3-6 months and >6 months) and weight (<4 kg, 4-8 kg, and >8 kg) at the time of surgery.

Lipid Management in US Commercial and Medicare Enrollees with Atherosclerotic Cardiovascular Disease: Treatment Patterns and Low-Density Lipoprotein Cholesterol Control.

Lipid-lowering therapy (LLT) is the cornerstone for secondary prevention of atherosclerotic cardiovascular disease (ASCVD), yet many patients exhibit low adherence to therapy and fail to achieve low-density lipoprotein cholesterol (LDL-C) goals. This retrospective cohort study used 2 nationally representative administrative closed claims databases (PharMetrics® Plus and Medicare Fee-for-Service [FFS] Research Identifiable Files) to identify commercial (C) and Medicare (M) enrollees with ASCVD between 2014-2019. Patients were stratified by exposure to statin therapy, ezetimibe and proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9i mAb) regimens.

High-impact trials with genetic and -omics information focus on cancer mutations, are industry-funded and less transparent.

Objective: To assess how genetics and -omics information is used in the most cited recent clinical trials, and to evaluate industry involvement and transparency patterns.

Study Design And Setting: This is a meta-research evaluation using a previously constructed database of the 600 most cited clinical trials published from 2019 to 2022. Trials that utilized genetic or -omics characterization of participants in the trial design, analysis, and results were considered eligible.

Burden and risk factors of stroke in Vietnam from 1990 to 2021 - a systematic analysis from global burden disease 2021.

Background: Stroke is a leading cause of death in Vietnam. However, a comprehensive analysis of stroke burden remains limited. This study aims to investigate the burden of stroke and various risk factors in Vietnam from 1990 to 2021.