Exploring the composition of placental microbiome and its potential origin in preterm birth.

Introduction: For years, the placenta was believed to be sterile, but recent studies reveal it hosts a unique microbiome. Despite these findings, significant questions remain about the origins of the placental microbiome and its effects on pregnancy and fetal health. Some studies suggest it may originate from the vaginal tract, while others indicate that oral bacteria can enter the maternal bloodstream and seed the placenta.

The Spectrum of Genetic Risk in Alzheimer Disease.

Alzheimer disease (AD), the most common dementing syndrome in the United States, is currently established by the presence of amyloid-β and tau protein biomarkers in the setting of clinical cognitive impairment. These straightforward diagnostic parameters belie an immense complexity of genetic architecture underlying risk and presentation in AD. In this review, we provide a focused overview of the current state of AD genetics.

Transcatheter Management of Tricuspid Regurgitation: A Review of Contemporary Evidence.

Tricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. Traditional surgical interventions, though definitive, carry considerable complexities and risks, especially for high-risk patients, with in-hospital mortality rates of ˜9%. This resulted in the undertreatment of many patients with TR, creating a substantial unmet need.

Impact of using time-averaged exposure metrics on binary endpoints in exposure-response analyses.

Exposure-response (ER) analyses are routinely performed as part of model-informed drug development to evaluate the risk-to-benefit ratio for dose selection, justification, and confirmation. For logistic regression analyses with binary endpoints, several exposure metrics are investigated, based on pharmacological plausibility, including time-averaged concentration to event (C). C is informative because it accounts for dose interruptions, modifications, and reductions and is therefore often compared against ER relationships identified using steady-state exposures.

Development of a portable testing chamber to assess imaging performance of laparoscopes in low- and middle-income countries.

Significance: Laparoscopic surgery is generally unavailable in low- and middle-income countries (LMICs) due to the high cost of installation and lack of qualified personnel to maintain and repair equipment. We developed a low-cost, durable, reusable laparoscopic system, called the KeyScope laparoscope, for use in LMICs. To reliably build and service the KeyScope in LMICs, a portable testing chamber (PTC) is needed to assess image performance.

Classification performance and reproducibility of GPT-4 omni for information extraction from veterinary electronic health records.

Large language models (LLMs) can extract information from veterinary electronic health records (EHRs), but performance differences between models, the effect of hyperparameter settings, and the influence of text ambiguity have not been previously evaluated. This study addresses these gaps by comparing the performance of GPT-4 omni (GPT-4o) and GPT-3.5 Turbo under different conditions and by investigating the relationship between human interobserver agreement and LLM errors.

Temporal trends of liver cancer burden, comparative analysis of risk factors and trend forecasts to 2024 in China, USA, the Republic of Korea, and Mongolia: an analysis based on multiple data sources from Global Burden of Disease 2019, the Global Cancer Observatory, and Cancer Incidence in Five Continents.

Background: Liver cancer represents a significant burden of disease globally, with variations in liver cancer status among countries. In this study, we aimed to evaluate the epidemiological burden of liver cancer in four representative countries - China, the USA, the Republic of Korea, and Mongolia - and cover the highest number of incidence cases, the highest prevalence rates and the burden in developed countries. In addition, we intended to predict the trends in liver cancer in these countries over the next six years.

Organic Micropollutants in Waterways of a Large-Scale Water Diversion Project: Insights from Nontarget Screening and "Community" Analysis.

Large-scale water diversion projects are essential for meeting the needs of water-stressed regions, necessitating an evaluation of their impact on water quality and aquatic ecosystems. This study provides the first snapshots of organic micropollutants (OMPs) along the 1466 km Eastern Route of China's South-to-North Water Diversion Project. Using nontarget analysis with ultrahigh-performance liquid chromatography and high-resolution mass spectrometry, we identified and quantified 357 OMPs from water samples collected during the water diversion period (WDP) and the nonwater diversion period (NWDP).

A Regulatory Roadmap for Repurposing: Comparing Pathways for Making Repurposed Drugs Available In The EU, UK, And US.

To help academic and non-profit investigators interested in drug repurposing navigate regulatory approval processes, we compared pathways for repurposed drugs to obtain approval at EMA, UK MHRA, and the US FDA. Though we found no pathways specifically for repurposed drugs, pathways to market are available in all repurposing scenarios.

The Need for IRB Leadership to Address the New Ethical Challenges of Research with Highly Portable Neuroimaging Technologies.

The emergence of innovative neuroimaging technologies, particularly highly portable magnetic resonance imaging (pMRI), has the potential to spawn a transformative era in neuroscience research. Resourced academic institutional review boards (IRBs) with experience overseeing traditional MRI have a special role to play in ethical governance of pMRI research and should facilitate the collaborative development of nuanced and culturally sensitive guidelines and educational resources for pMRI protocols. This paper explores the ethical challenges of pMRI in neuroscience research and the dynamic leadership role that IRBs should play to promote ethical oversight of emerging pMRI research.

The Realization of Portable MRI for Indigenous Communities in the USA and Canada.

The paucity of existing baseline data for understanding neurologic health and the effects of injury on people from Indigenous populations is causally related to the limited representation of communities in neuroimaging research to date. In this paper, we explore ways to change this trend in the context of portable MRI, where portability has opened up imaging to communities that have been neglected or inaccessible in the past. We discuss pathways to engage local leadership, foster the participation of communities for this unprecedented opportunity, and empower field-based researchers to bring the holistic worldview embraced by Indigenous communities to neuroimaging research.

Conducting Research with Highly Portable MRI in Community Settings: A Practical Guide to Navigating Ethical Issues and ELSI Checklist.

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions.

The Power and Limits of Political Philosophy in Analyzing Healthcare Markets.

Bioethics is taking an institutional turn, where organizations are being taken seriously as moral agents. Within US healthcare, this is difficult to do without confronting "the market" as a highly influential context for organizational behavior. In the 1990s, pioneering thinkers such as David Mechanic, Brad Gray, and Mark Schlesinger undertook a first round of organizational ethics scholarship focused on how market forces influence health insurer behavior - motivated by a particular concern for health maintenance organizations (HMOs).

Payers are Morally Responsible for Reimbursing Social Care by Medical Facilities: How to Make Value-Based Payments Work for Vulnerable Patients.

Payers have shaped the healthcare system in the United States as fee-for-service has facilitated a care model that prioritizes volume over the sake of patient care. This worsens health disparities, especially in safety net facilities where ancillary social work is both necessary clinically and completely uncompensated. Using concepts from Iris Marion Young's Responsibility for Justice, it can be concluded that payers have a moral responsibility for reimbursing social care to address historical injustices.

Ethical Oversight and Social Licensing of Portable MRI Research.

This article explores two questions: (1) whether portable MRI research might escape regulatory oversight altogether under existing U.S. privacy and research ethical frameworks, leaving research participants without adequate protections, and (2) whether existing regulatory frameworks, when they do apply, can guard society's broader interest in ensuring that portable MRI research pursues socially beneficial, ethically sound aims that minimize the potential for externalities affecting nonparticipating individuals and groups, who might be stigmatized or otherwise harmed even if they decline participation in the research.

State-Mandated Ethics Oversight Is Inappropriate for Gender-Affirming Care.

A proposed state administrative rule would have required medical ethicists to approve certain aspects of gender-affirming care. The authors argue the proposed rule lacked appropriate justification compared to other instances of state-mandated ethics oversight and would undermine trust, raise practical challenges, and send harmful messages to society, patients, and providers.

How Leaders at High-Performing Healthcare Organizations Think About Organizational Professionalism.

This pilot study is the first formal exploration of the concept of "Organizational Professionalism" (OP) among health system leaders in high-performing healthcare organizations. Semi-structured key informant interviews with 23 leaders from 8 healthcare organizations that were recipients of the Malcolm Baldrige National Quality Award (MBNQA) or Baldrige-based state quality award programs explored conceptualization, operationalization, and measurement of OP. Further exploration and understanding of OP in healthcare organizations has the potential to establish and sustain professional and ethical organizational cultures that bolster trust through the sound implementation of laws, policies, and procedures to support the delivery of high-quality patient care.

Expert Stakeholder Perspectives on Emerging Technology for Neuroimaging Research with Highly Portable MRI: The Need for Guidance on Ethical, Legal, and Societal Issues.

Portable MRI (pMRI) technology, which promises to transform brain imaging research by facilitating scanning in new geographic areas and the participation of new, diverse populations, raises many ethical, legal, and societal issues (ELSI). To understand this emerging pMRI ELSI landscape, we surveyed expert stakeholder views on ELSI challenges and solutions associated with pMRI research.

Diminution of Public Health Agency Authorities Post-.

In a new era of regulatory oversight, the US Supreme Court upended traditional deference to agency interpretations of ambiguous Congressional provisions in in June 2024. Federal courts were instructed to make their own assessments of statutory authorities amid an onslaught of public health agency challenges surfacing nationally. Even so, SCOTUS may be eyeing further limits on agency powers despite clear and substantial repercussions for the health of the nation.

Detection of Oral Fluid Stains on Fabric via Solution Extraction Combined with Deep Ultraviolet Raman Spectroscopy.

DNA phenotyping plays a central role in modern practical forensics, yet an overwhelming amount of evidence creates significant backlogs in all major crime laboratories. A fast nondestructive test of a potential biological stain prior to DNA phenotyping should reduce the number of irrelevant samples for the analysis and increase the efficiency of the overall process. Evidence items recovered from the crime scene can often include body fluid traces, such as oral fluid (OF).

Transformer Graph Variational Autoencoder for Generative Molecular Design.

In the field of drug discovery, the generation of new molecules with desirable properties remains a critical challenge. Traditional methods often rely on SMILES (Simplified Molecular Input Line Entry System) representations for molecular input data, which can limit the diversity and novelty of generated molecules. To address this, we present the Transformer Graph Variational Autoencoder (TGVAE), an innovative AI model that employs molecular graphs as input data, thus captures the complex structural relationships within molecules more effectively than string models.

The impact of quantitative platform on candidacy for bronchoscopic lung volume reduction: a multi-center retrospective cohort study.

Background: Bronchoscopic lung volume reduction (BLVR) can be an effective treatment for highly selected patients with severe emphysema but only half of carefully selected patients derive clinical benefit. Two commercially available platforms exist to help determine candidacy for BLVR via quantitative analysis of computed tomography (CT) scans.

Objectives: To determine if the two commercially available quantitative platforms identified the same patient population that may benefit from BLVR.