Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.

Klebsiella pneumoniae employs a type VI secretion system to overcome microbiota-mediated colonization resistance.

Microbial species must compete for space and nutrients to persist in the gastrointestinal (GI) tract, and our understanding of the complex pathobiont-microbiota interactions is far from complete. Klebsiella pneumoniae, a problematic, often drug-resistant nosocomial pathogen, can colonize the GI tract asymptomatically, serving as an infection reservoir. To provide insight on how K.

Rurality and neighborhood socioeconomic status are associated with overall and cause-specific mortality and hepatic decompensation in type 2 diabetes.

Introduction: Social determinants of health are key factors driving disease progression. In type 2 diabetes there is limited literature on how distal or intermediate factors (e.g.

Pediatric relapsed/refractory ALK+ anaplastic large cell lymphoma treatment and outcomes in the targeted drug era.

Treatment options for patients with relapsed or refractory (R/R) anaplastic large cell lymphoma (ALCL) have increased in the era of targeted therapies such as brentuximab vedotin (BV) and Anaplastic Lymphoma Kinase (ALK) inhibitors. However, there is no standard treatment and limited published data evaluating their use. The goal of this retrospective study is to describe current real-world treatment and outcomes of pediatric, adolescent, and young adult patients with R/R ALK-positive ALCL.

Artificial Intelligence In Health And Health Care: Priorities For Action.

The field of artificial intelligence (AI) has entered a new cycle of intense opportunity, fueled by advances in deep learning, including generative AI. Applications of recent advances affect many aspects of everyday life, yet nowhere is it more important to use this technology safely, effectively, and equitably than in health and health care. Here, as part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2025 initiative, which is designed to provide guidance on pressing health care issues for the incoming presidential administration, we describe the steps needed to achieve these goals.

Exploring the Scholarly Value and Impact of DNP-Prepared Nurses Through the Lens of Nursing Leaders.

Objective: To explore organizational nursing leaders' perceptions of impact, value, and support for doctor of nursing practice (DNP)-prepared nurses engaging in practice scholarship.

Background: DNP nurses are educated to lead change at the system level and direct practice-based initiatives to enhance health outcomes. Organizational support and the value of DNP scholarship need to be better understood.

Top Ten Tips Palliative Care Clinicians Should Know About Rheumatology.

Systemic autoimmune rheumatic diseases (SARDs) consist of a broad range of immune-mediated multisystem diseases. They are chronic, incurable illnesses that often present in early to mid-life and can be associated with a high symptom burden, disability, and early mortality. Treatment guidelines for similar chronic, life-limiting conditions with uncertain disease courses now recommend palliative care (PC) assessment at the time of diagnosis.

A systematic review to determine the effect of strategies to sustain chronic disease prevention interventions in clinical and community settings.

This review assessed the effect of strategies designed to sustain the delivery of evidenced based interventions (EBIs) which target behavioural risk factors linked to leading causes of chronic disease in clinical and community settings. Seven electronic databases were searched for randomised controlled studies published from earliest record to November 2022. Studies were included if they tested a strategy to sustain the delivery of an EBI within clinical or community settings.

Study of Histotripsy With Subsequent Heating on In Vitro VX2 Cancer Cells.

Objective: Focused ultrasound has emerged as a precise and minimally invasive modality for effective cancer treatment. In this study, we propose a novel method that integrates the mechanical effects of focused ultrasound, known as histotripsy, with heating to enhance both the immediate and sustained cytotoxic effects on cancer cells.

Methods: Our investigation focused on VX2 cancer cells in suspension, examining five experimental groups: blank control, negative control, heating alone, histotripsy alone, and histotripsy with subsequent heating.

Performance of the 1 h oral glucose tolerance test in predicting type 2 diabetes and association with impaired β-cell function in Asians: a national prospective cohort study.

Background: Postprandial glucose concentration 1-h (1 h-PG) after an oral glucose tolerance test (OGTT) has similar or superior performance to 2 h-PG in predicting type-2 diabetes mellitus (T2DM) in several populations, and is simpler to obtain in clinical practice. However, studies in Asians are scarce. We investigated the utility of elevated baseline 1 h-PG in predicting T2DM incidence within three years, and its relationship with β-cell function in 1250 non-diabetic Asian participants.

A Group Approach to Clinical Research Mentorship at a Veterans Affairs Medical Center.

Background: The US Department of Veterans Affairs (VA) is committed to conducting research that improves the health and quality of life of veterans. Mentorship is vital for developing and advancing a novice VA investigator's research agenda; however, there are several barriers to effective research mentorship.

Observations: The VA Clinical Research Mentorship Program was developed to assist clinician investigators with writing and submitting competitive grant applications.

Optimizing Masks and Random Screening Test Usage within K-12 Schools.

Unlabelled: COVID-19 tremendously disrupted the global health system. People of all ages were at risk of becoming infected. Frequent school closures raised concerns about both the physical and mental health of school-age children.

Rapid Adaptation to Prevent Drug Use (RAPD): protocol of a pilot randomized trial to enhance the impact of an evidence-based intervention for youth.

Background: Drug use trends change rapidly among youth, leaving intervention experts struggling to respond promptly. Delays in responses can lead to preventable morbidity and mortality. The COVID-19 pandemic underscored the need for implementation science to facilitate rapid, equitable responses using existing treatment and prevention efforts.

Identifying Core Functions and Forms of "Discharge by Noon" Interventions.

Background: Many hospitals have implemented Discharge by Noon (DBN) programs to improve hospital throughput but have had mixed results.

Objective: Use a complex health intervention framework to define core functions and forms of DBN interventions.

Design: Qualitative study combined with scoping review.

Travel Time as an Indicator of Poor Access to Care in Surgical Emergencies.

Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.

Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.

Variation in compressive mechanical properties between subacute and chronic venous thrombosis in a novel unilateral iliac thrombosis model.

Interventional therapies to relieve chronic deep vein thrombosis (DVT) fail through inability to penetrate, cross, and remove the occlusion. Development of suitable tools requires fundamental understanding of chronic DVT mechanical properties and a reliable model for testing. Female farm swine underwent a novel, endovenous generation of long-segment unilateral iliac vein thrombosis.

Experiences of sexual and reproductive health screening and counseling in the clinical setting among adolescents and young adults with rheumatic disease.

Background: Our objective was to describe differences among adolescents and young adults (AYAs) with rheumatic disease using teratogens compared to non-users in receipt of sexual and reproductive health (SRH) counseling, teratogenicity knowledge, perceived importance of SRH topics, and preferences around counseling.

Methods: AYAs ages 14-23 years and assigned female at birth were recruited from pediatric rheumatology clinics at a Midwest tertiary care program. Participants completed a one-time online survey assessing SRH.

A high-performance brain-computer interface for finger decoding and quadcopter game control in an individual with paralysis.

People with paralysis express unmet needs for peer support, leisure activities and sporting activities. Many within the general population rely on social media and massively multiplayer video games to address these needs. We developed a high-performance, finger-based brain-computer-interface system allowing continuous control of three independent finger groups, of which the thumb can be controlled in two dimensions, yielding a total of four degrees of freedom.

An Educational Intervention to Promote Central Nervous System-Active Deprescribing in Dementia: A Pilot Study.

Background: Central nervous system (CNS)-active polypharmacy (defined as concurrent exposure to three or more antidepressant, antipsychotic, antiseizure, benzodiazepine, opioid, or nonbenzodiazepine benzodiazepine receptor agonists) is associated with significant potential harms in persons living with dementia (PLWD).We conducted a pilot trial to assess a patient nudge intervention's implementation feasibility and preliminary effectiveness to prompt deprescribing conversations between PLWD experiencing CNS-active polypharmacy and their primary care clinicians ("clinicians").

Methods: We used the electronic health record to identify PLWD prescribed CNS-active polypharmacy in primary care clinics from two health systems.

Histopathologic Progression and Metastatic Relapse Outcomes in Small Cell Neuroendocrine Carcinomas of the Urinary Tract.

Introduction: Small cell neuroendocrine carcinoma of the urinary tract (SCNEC-URO) has an inferior prognosis compared to conventional urothelial carcinoma (UC). Here, we evaluate the predictors and patterns of relapse after surgery.

Materials And Methods: We identified a definitive-surgery cohort (n = 224) from an institutional database of patients with cT1-T4NxM0 SCNEC-URO treated in 1985-2021.

Prevalence of prescription medication use that can exacerbate heart failure among US adults with heart failure.

Introduction: Heart failure (HF) affects more than 6 million adults in the United States, contributing to substantial morbidity, mortality, and health care costs. Despite advances in medical care, many medications can exacerbate HF, yet their prevalence of use remains unknown. This study examined the national use of prescription medications that could exacerbate HF in adults with self-reported HF.

Adult Withdrawal of Long-term Benzophenone-3 Treatment Induces Regression of Mammary Ductal Branching in a Diet-Dependent Manner.

Benzophenone-3 (also referred to as oxybenzone) is a putative endocrine disrupting chemical and common ingredient in sunscreens and other personal care products. We previously showed that benzophenone-3 can have both promotional and protective effects on mammary tumorigenesis dependent upon dietary fat. The current study examined diet-dependent effects of benzophenone-3 in mammary ductal development in BALB/c mice.

Adherence to multi-target stool DNA testing for colorectal cancer screening in the United States.

Purpose: Colorectal cancer (CRC) is the second leading cause of cancer mortality in the USA and is highly preventable, with early screening vital for improving outcomes. This study aimed to evaluate adherence rates of multi-target stool DNA (mt-sDNA) testing, following updated guidelines recommending screening starting at age 45.

Methods: This retrospective cohort study used aggregated data from Exact Sciences Laboratories LLC, examining new users (first-time testers) aged 45-85 with commercial, Medicare, or Medicaid insurance who received mt-sDNA test kits (point-of-care) between January 1, 2023, and June 1, 2023.

Postoperative Outcomes Following Lung Resection Performed at Private Equity-Acquired Hospitals.

Objective: Private equity acquisition of hospitals performing complex operations is increasingly prevalent in the United States healthcare landscape. While comparative health outcomes for common medical conditions have been investigated, the quality of thoracic surgical care in private equity-acquired hospitals is unknown.

Methods: Medicare Beneficiaries, aged 65-99 years, undergoing elective lung resection between 2016 to 2020 were included.