Niche comparisons reveal significant divergence despite narrow endemism in Leavenworthia, a genus of rare plants.

Background And Aims: Quantifying niche similarity among closely related species offers myriad insights into evolutionary history and ecology. In this study, our aim was to explore the interplay of geographic and niche space for rare, endemic plant species and determine if endemic habitats were environmentally similar or unique.

Methods: We characterized the niche of all Leavenworthia species, a genus of rare plants endemic to rocky glades in the eastern United States, using WorldClim data, surface geology, elevation, and slope.

Treatment of a Radiation-Associated Femur Fracture with an Intercalary Endoprosthesis: A Case Report.

Case: A 72-year-old woman with undifferentiated pleomorphic sarcoma of the thigh received neoadjuvant chemotherapy and radiotherapy. She underwent wide resection and was scheduled for prophylactic fixation of the femur. However, prophylactic fixation was deferred secondary to COVID-19 pandemic.

Critical Care Therapy After Cytoreductive Nephrectomy for Metastatic Kidney Cancer.

Objectives: To examine critical care therapy rates after cytoreductive nephrectomy in metastatic kidney cancer patients.

Design, Setting, And Patients: Relying on the National Inpatient Sample (2000-2019), we addressed critical care therapy use (total parenteral nutrition, invasive mechanical ventilation, renal replacement therapy, percutaneous endoscopic gastrostomy tube insertion, and tracheostomy) and in-hospital mortality in surgically treated metastatic kidney cancer patients. Estimated annual percentage changes and multivariable logistic regression models were fitted.

Diabetes Mellitus Is Not a Risk Factor for Difficult Intubation Among Critically Ill Adults: A Secondary Analysis of Multicenter Trials.

Objectives: Diabetes mellitus has been associated with greater difficulty of tracheal intubation in the operating room. This relationship has not been examined for tracheal intubation of critically ill adults. We examined whether diabetes mellitus was independently associated with the time from induction of anesthesia to intubation of the trachea among critically ill adults.

Perseverance of Optimal Realignment is Associated With Improved Cost-utility in Adult Cervical Deformity Surgery.

Background: Early-term complications may not predict long-term success after adult cervical deformity (ACD) correction.

Objective: Evaluate whether optimal realignment results in similar rates of perioperative complications but achieves longer-term cost-utility.

Study Design: Retrospective cohort study.

DNA targeting by compact Cas9d and its resurrected ancestor.

Type II CRISPR endonucleases are widely used programmable genome editing tools. Recently, CRISPR-Cas systems with highly compact nucleases have been discovered, including Cas9d (a type II-D nuclease). Here, we report the cryo-EM structures of a Cas9d nuclease (747 amino acids in length) in multiple functional states, revealing a stepwise process of DNA targeting involving a conformational switch in a REC2 domain insertion.

Local and systemic biodistribution of a small-molecule radiopharmaceutical probe after transcatheter embolization and intra-arterial delivery in a porcine orthotopic renal tumor model.

Background: Small-molecule biomacromolecules target tumor-specific antigens. They are employed as theranostic agents for imaging and treatment. Intravenous small-molecule radioligands exhibit rapid tumor uptake and excretion.

The evolving role of liver biopsy: Current applications and future prospects.

Histopathologic evaluation of liver biopsy has played a longstanding role in the diagnosis and management of liver disease. However, the utility of liver biopsy has been questioned by some, given the improved imaging modalities, increased availability of noninvasive serologic tests, and development of artificial intelligence over the past several years. In this review, we discuss the current and future role of liver biopsy in both non-neoplastic and neoplastic liver diseases in the era of improved noninvasive laboratory, radiologic, and digital technologies.

Identifying and treating metabolic dysfunction-associated steatotic liver disease among at-risk Veterans.

Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD), an increasing public health concern, remains challenging to diagnose and risk-stratify. We assessed the 1) prevalence of MASLD risk factors among Veterans in Veterans Health Administration (VA) care, 2) factors associated with MASLD diagnosis; and 3) associations between MASLD diagnosis and receipt of care.

Methods: Veterans with MASLD risk factors, including obesity, pre-diabetes, diabetes, or dyslipidemia, were identified using International Classification of Diseases-10 codes and followed in 2019-2022.

Harvi Cardiovascular Modeling Accurately Predicts Hemodynamic Improvements Produced by a New Direct Cardiac Compression Device.

Despite advancements in mechanical circulatory support (MCS) technology, persistent critical complications related to blood contact remain unresolved. To provide a safer alternative therapy, CorInnova is developing a non-blood contacting direct cardiac compression (DCC) device for MCS. To support product development toward clinical trials, a simulation platform has been developed to predict clinical outcomes under patient-specific conditions, guiding patient selection for clinical trials.

Endothelial-secreted Endocan activates PDGFRA and regulates vascularity and spatial phenotype in glioblastoma.

Extensive neovascularization is a hallmark of glioblastoma (GBM). In addition to supplying oxygen and nutrients, vascular endothelial cells provide trophic support to GBM cells via paracrine signaling. Here we report that Endocan (ESM1), an endothelial-secreted proteoglycan, confers enhanced proliferative, migratory, and angiogenic properties to GBM cells and regulates their spatial identity.

Metabolic Fitness of NAC1-Deficient Regulatory T Cells in the Tumor Microenvironment Fuels Tumor Growth.

The nucleus accumbens-associated protein-1 (NAC1) has recently emerged as a pivotal factor in oncogenesis by promoting glycolysis. Deletion of NAC1 in regulatory T cells (Tregs) has been shown to enhance FoxP3 stability, a suppressor of glycolysis. This study delves into the intriguing dual role of NAC1, uncovering that Tregs-specific deletion of NAC1 fosters metabolic fitness in Tregs, thereby promoting tumorigenesis.

Comparing the cost of cirrhosis to other common chronic diseases: A longitudinal study in a large national insurance database.

Background Aims: Cirrhosis prevalence is increasing, yet costs associated with its chronic, complex care are poorly understood. The aim was to characterize the costs of care for patients with cirrhosis and compare them to other chronic diseases such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), for which the public health burden is better recognized.

Approach: Patients enrolled in Medicare Advantage plans from a large national insurer between 2011-2020 with cirrhosis, HF, and COPD were identified by ICD-9/-10 codes.

Increased MASH-associated liver cancer in younger demographics.

Background: The incidence of cancer and the prevalence of metabolic disease and metabolic dysfunction-associated steatotic liver disease is increasing in young adults. However, updated global data on metabolic dysfunction-associated steatohepatitis (MASH)-associated primary liver cancer (PLC) in young adults remains scarce.

Methods: This study analyzed data from the Global Burden of Disease study between 2000 and 2021 to assess the age-standardized incidence, mortality, and disability-adjusted life years rates from MASH-associated PLC in young adults (15-49 y).

Nanoscopy reveals integrin clustering reliant on kindlin-3 but not talin-1.

Background: Neutrophils are the most abundant leukocytes in human blood, and their recruitment is essential for innate immunity and inflammatory responses. The initial and critical step of neutrophil recruitment is their adhesion to vascular endothelium, which depends on G protein-coupled receptor (GPCR) triggered integrin inside-out signaling that induces β2 integrin activation and clustering on neutrophils. Kindlin-3 and talin-1 are essential regulators for the inside-out signaling induced β2 integrin activation.

Prior Antidepressant Prescription is Associated with Greater Opioid Prescriptions and Complications in Cervical Spine Surgery: A Propensity Matched Cohort Study.

Study Design: Retrospective cohort study of national database.

Objective: This study evaluates the impact of antidepressant prescriptions on postoperative outcomes and complications in cervical spine surgery.

Summary Of Background Data: Patients who underwent cervical spine surgery often receive antidepressant prescriptions (ADP) to address concurrent mental health issues such as depression and anxiety.

Organizational readiness for implementation: a qualitative assessment to explain survey responses.

Background: One factor considered essential to successful implementation is organizational readiness. The purpose of this study was to explore ways to improve the measurement of organizational readiness, and in particular to refine a preliminary measure based on the Readiness = Motivation x innovation Specific Capacity x General Capacity (R = MC2) heuristic. We assessed the experiences of staff in Federally Qualified Health Centers (FQHC) implementing evidence-based interventions (EBIs) designed to increase colorectal cancer screening (CRCS) who previously completed the survey and aimed to understand their perspectives on why our data were positively skewed.