Circadian rhythms, metabolism, and nutrition support in critically ill adult patients: a narrative review.

Purpose Of Review: The human circadian system regulates several physiological processes, including metabolism, which becomes significantly disrupted during critical illness. The common use of 24-h continuous nutrition support feeding in the intensive care unit (ICU) may further exacerbate these disruptions; this review evaluates recent evidence comparing continuous and intermittent feeding schedules in critically ill adults.

Recent Findings: Research comparing different feeding schedules in critically ill adults remains limited.

Hip-Spine Relationship in Femoroacetabular Impingement: Does Hip Arthroscopy Affect Pelvic Mobility?

Background: Femoroacetabular impingement (FAI) is a well-recognized cause of hip pain in adults. The hip-spine relationship between the femur, pelvis, and lumbosacral spine has garnered recent attention in hip arthroplasty. However, the hip-spine relationship has not been well described in patients with FAI.

Non-Invasive Assessment of VEGF and Prognosis in Gastric Cancer through Radiomic Features.

Introduction: Gastric cancer (GC) is a leading cause of cancer-related deaths worldwide, with delayed diagnosis often limiting effective treatment options. This study introduces a novel, non-invasive radiomics-based approach utilizing [18F] FDG PET/CT to predict VEGF status and survival in GC patients. The ability to non-invasively assess these parameters can significantly influence therapeutic decisions and outcomes.

How Is Preoperative Opioid Use Associated With Readmissions and Outcomes in Lower Extremity Trauma?

Background: Opioid use disorder (OUD) has been implicated as a potential risk factor for adverse outcomes and readmissions in various surgical procedures. Patients admitted with an open fracture of the lower extremity often have multifarious pain needs, require surgical procedures, and have prolonged rehabilitation; previous OUD complicates this process. Our goal was to describe at a national level how OUD is associated with readmission, complications, and healthcare expenditure for patients admitted with open lower extremity fractures.

SAFETY, PHARMACOKINETICS, AND CLINICAL EFFICACY OF ADS051, A NEUTROPHIL MODULATOR, IN ULCERATIVE COLITIS: RESULTS OF A RANDOMIZED PHASE 1B TRIAL.

Objectives: Ulcerative colitis (UC) is characterized by colonic inflammation, with neutrophils playing a key role in UC activity, prognosis, and response to therapies. Current UC therapeutics can have significant side effects and limited efficacy. ADS051 is a novel, oral, gut-restricted small molecule that modulates neutrophil migration and activation without in vitro suppression of T-cell activation.

Multi-target Stool DNA Testing for Colorectal Cancer Screening in Clinical Practice.

Background And Aims: Few studies have evaluated multi-target stool DNA (mt-sDNA) in clinical practice. We analyzed mt-sDNA utilization at the University of Pittsburgh Medical Center (UPMC).

Methods: We assessed mt-sDNA orders between 1/1/2017 to 12/31/2021.

Systematic Review: Efficacy of Medical Therapy on Outcomes Important to Pediatric Patients with X-Linked Hypophosphatemia.

Objective: To examine the evidence addressing the management of X-linked hypophosphatemia (XLH) in children to inform treatment recommendations.

Methods: We searched Embase, MEDLINE, Web of Science, and Cochrane Central up to May 2023. Eligible studies included RCTs and observational studies of individuals less than 18yrs with clinically or genetically confirmed XLH.

Increased medication utilization precedes incidentally diagnosed inflammatory bowel disease: a multicenter, case-control study.

This study investigates whether subclinical inflammation in asymptomatic inflammatory bowel disease (IBD) patients leads to increased medication use. In a multicenter, retrospective analysis of patients diagnosed with incidental ulcerative colitis or Crohn's disease during colorectal cancer screening (2010-2021), medication use was compared with symptomatic patients and healthy non-IBD controls. Asymptomatic patients showed a higher use of cardiovascular, antiparasitic, musculoskeletal, respiratory, and sensory organ medications up to five years before diagnosis.

Neuroimmunometabolism: How Metabolism Orchestrates Immune Response in Healthy and Diseased Brain.

Neuroimmunometabolism describes how neuroimmune cells, such as microglia, adapt their intracellular metabolic pathways to alter their immune functions in the CNS. Emerging evidence indicates that neurons also orchestrate the microglia mediated immune response through neuro-immune crosstalk perhaps through metabolic signalling. However, little is known about how the brain's metabolic microenvironment and microglial intracellular metabolism orchestrate the neuroimmune response in healthy and diseased brains.

Updating an HIV Knowledge Questionnaire With Pre-exposure Prophylaxis Through Expert Opinions in the United States Using Delphi Methodology: A Qualitative Study.

Our study was designed to update the HIV Knowledge Questionnaire by incorporating pre-exposure prophylaxis (PrEP) knowledge questions, as previous HIV knowledge tools lack this focus. Four rounds of Delphi surveys were conducted with 47 expert participants, each with extensive HIV-related expertise (mean experience: 18.94 years).

HIV Vulnerability Typologies Among Adolescent Girls and Young Women in Lesotho: A Population-Based, Cross-Sectional, Latent Class Analysis.

Adolescent girls and young women ages 15-29 years (AGYW) living in Lesotho experience a disproportionate HIV burden. Using a household-based national survey in Lesotho, we conducted a three-step latent class analysis to identify typologies of AGYW most vulnerable to HIV infection. We first classified AGYW into HIV vulnerability groups based on self-reported sexual behaviors, then identified associations between typology and HIV diagnosis.

Osteochondral Allograft Transplantation as a Salvage Procedure After Failed Index Cartilage Surgery of the Knee: A Systematic Review.

Background: Osteochondral allograft transplantation (OCA) is well established as a viable chondral restoration procedure for the treatment of symptomatic, focal chondral defects of the knee. The efficacy of secondary OCA in the setting of failed index cartilage repair or restoration is poorly understood.

Purpose: To evaluate radiographic and clinical outcomes, failures, and reoperations after OCA after failed index cartilage repair or restoration of the knee.

Predicting high-performance decathlon career best.

The decathlon is a 10-event discipline in the sport of track and field, typically offered only for men at the elite level of competition (heptathlon is the complementary event for women). It is composed of 10 distinct events contested over 2 days. Using event-specific coefficients, marks are converted to scores, which sum to produce an overall score.

Endovascular laser fenestration of a frozen elephant trunk stent graft for treatment of chronic cerebral malperfusion.

Objectives: Mal-deployment of the thoracic endovascular aortic repair (TEVAR) stent graft during a frozen elephant trunk (FET) procedure for an acute type A aortic dissection (ATAAD) leads to devastating complications. We report a hemiarch replacement with TEVAR stent graft covering the aortic arch vessels salvaged through an endovascular approach.

Methods: A 69-year-old man with ATAAD in 2018, status post-hemiarch repair with TEVAR, presented in 2023 with progressive dizziness/syncope and lower extremity hypertension with inability to tolerate anti-hypertensives.

Sociodemographic Disparities in the Use of Hospice by U.S. Nursing Home Residents: A Systematic Review.

Hospice can improve end-of-life (EOL) outcomes in U.S. nursing homes (NHs).

Scaling and spreading age-friendly care: Early lessons from the VA National Age-Friendly Action Community.

Background: The Age-Friendly Health System (AFHS) initiative seeks to improve care for older adults through assessing and acting on the 4Ms (What Matters, Medication, Mentation, Mobility). The Department of Veterans Affairs (VA) joined the initiative in 2020, and from 2022 to 2023, VA led its first Age-Friendly Action Community, a 7-month online educational series to teach clinicians about implementing the 4Ms across VA care settings.

Methods: The VA Action Community was designed to spread awareness about Age-Friendly care for older Veterans, improve interprofessional team knowledge for providing care guided by the 4Ms, and support AFHS implementation across multiple care settings.

A long-ignored skeletal tissue filled with oil.

Lipid-rich cartilage points to nonmetabolic functions of lipid vacuoles in mammals.

Stress drives a switch in sex preference.

Distinct brain circuits control sex preferences in mice.

Ena-bile-ing liver cancer growth.

Bile acids differentially affect immune cell responses to liver cancer.

Built to remove carbon.

Building materials could facilitate long-term removal of atmospheric carbon dioxide.

Fluorine-rich poly(arylene amine) membranes for the separation of liquid aliphatic compounds.

We explored the potential for membrane materials to reduce energy and carbon requirements for the separation of aliphatic hydrocarbon feedstocks and products. We developed a series of fluorine-rich poly(arylene amine) polymer membranes that feature rigid polymer backbones with segregated perfluoroalkyl side chains. This combination imbues the polymers with resistance to dilation induced by hydrocarbon immersion without the loss of solution-based membrane fabrication techniques.

Sexually dimorphic dopaminergic circuits determine sex preference.

Sociosexual preference is critical for reproduction and survival. However, neural mechanisms encoding social decisions on sex preference remain unclear. In this study, we show that both male and female mice exhibit female preference but shift to male preference when facing survival threats; their preference is mediated by the dimorphic changes in the excitability of ventral tegmental area dopaminergic (VTA) neurons.

Tropical forest clearance impacts biodiversity and function, whereas logging changes structure.

The impacts of degradation and deforestation on tropical forests are poorly understood, particularly at landscape scales. We present an extensive ecosystem analysis of the impacts of logging and conversion of tropical forest to oil palm from a large-scale study in Borneo, synthesizing responses from 82 variables categorized into four ecological levels spanning a broad suite of ecosystem properties: (i) structure and environment, (ii) species traits, (iii) biodiversity, and (iv) ecosystem functions. Responses were highly heterogeneous and often complex and nonlinear.