Interaction of the Gut-Liver-Brain Axis and the sterolbiome with sexual dysfunction in patients with cirrhosis.

There is a complex interplay between the gut microbes, liver, and central nervous system, a gut-liver-brain axis, where the brain impacts intestinal and hepatic function while the gut and liver can impact cognition and mental status. Dysregulation of this axis can be seen in numerous diseases. Hepatic encephalopathy, a consequence of cirrhosis, is perhaps the best studied perturbation of this system.

A noninvasive urinary microRNA-based assay for the detection of pancreatic cancer from early to late stages: a case control study.

Background: Pancreatic cancer is highly aggressive and has a low survival rate primarily due to late-stage diagnosis and the lack of effective early detection methods. We introduce here a novel, noninvasive urinary extracellular vesicle miRNA-based assay for the detection of pancreatic cancer from early to late stages.

Methods: From September 2019 to July 2023, Urine samples were collected from patients with pancreatic cancer (n = 153) from five distinct sites (Hokuto Hospital, Kawasaki Medical School Hospital, National Cancer Center Hospital, Kagoshima University Hospital, and Kumagaya General Hospital) and non-cancer participants (n = 309) from two separate sites (Hokuto Hospital and Omiya City Clinic).

Body composition as a novel biomarker of recurrence risk in patients with triple-negative breast cancer.

Background and Hypothesis Triple-negative breast cancer (TNBC) patients are at increased risk for recurrence compared to other subtypes of breast cancer. Previous evidence showed that adiposity may contribute to worsened cancer control. Current measures of obesity, such as body-mass index (BMI), are poor surrogates of adiposity, while visceral-to-subcutaneous adiposity ratio (VSR), which can be measured from routine computed tomography (CT) imaging, is a direct adiposity measure.

Phosphoribosyl pyrophosphate synthetase 1 () associated retinal degeneration: an international study.

Introduction: Phosphoribosyl pyrophosphate synthetase 1 () is an X-linked gene critical for nucleotide metabolism. Pathogenic variants cause three overlapping phenotypes: Arts syndrome (severe neurological disease), Charcot-Marie-Tooth type 5 [CMTX5] (peripheral neuropathy), and non-syndromic sensorineural hearing loss (SNHL). Each may be associated with retinal dystrophy.

[A Case of Primary Mediastinal Germ Cell Tumor Requiring Multidisciplinary Treatment Due to Circulatory Disturbance Associated with Cardiopulmonary Compression].

A 28-year-old male presented to his physician with a chief complaint of fever and cough. Contrastenhanced computed tomography revealed a 17×16×8 cm heterogeneous tumor in the anterior mediastinum, as well as right heart and inferior vena cava compression due to the tumor. He was referred to our hospital for close examination and treatment.

Buprenorphine and postpartum contraception utilization among people with opioid use disorder: a multi-state analysis.

Background: The postpartum period provides an opportunity for birthing people with opioid use disorder (OUD) to consider their future reproductive health goals. However, the relationship between the use of medication for opioid use disorder (MOUD) and contraception utilization is not well understood. We used multistate administrative claims data to compare contraception utilization rates among postpartum people with OUD initiating buprenorphine (BUP) versus no medication (psychosocial services receipt without MOUD (PSY)) in the United States (US).

Morphological variation of Ficus johannis subsp. afghanistanica (Warb.) Browicz in Sistan-va-Baluchestan province, Iran.

Background: Ficus johannis subsp. afghanistanica (Warb.) Browicz is an important plant species belonging to the Moraceae family and is part of the Ficus genus.

Beyond symptom reduction: Veterans' goals for posttraumatic stress disorder treatment.

Despite a varied selection of available trauma-focused evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD), few veterans receive a full course of an evidence-based treatment. A better understanding of and alignment with veterans' PTSD treatment goals could be one way to improve treatment engagement and adherence, consistent with veteran-oriented care within the U.S.

Disparities in treatment delays among metastatic breast cancer patients: insights from nationwide electronic health records, 2011-2022.

Purpose: While previous research has highlighted treatment delay inequities in early-stage breast cancer and identified potential contributing factors, there is limited research on disparities in treatment delays for metastatic breast cancer (MBC). This study investigates these disparities in MBC treatment initiation, aiming to identify key factors crucial for improving timely access to care.

Method: Nationwide Flatiron Health electronic health records-derived deidentified database, including females aged 18+ diagnosed with either De novo or relapsed MBC in the U.

Changes in the Levels of Short-Chain Acids and Tryptophan Metabolites in Mouse Intestine during Experimental Colitis.

The optimal balance of the intestinal microbiota is considered to be an essential part of the human body that affects many metabolic processes. However, the exact role of the gut microbiota in metabolism is still not fully understood. To investigate the metabolic role of gut microbiota, the content of short-chain fatty acids and tryptophan metabolites was studied in mice with sodium dextran sulfate-induced colitis.

Electronic Health Record Time Allocation Among Primary Care Clinicians at the Veterans Health Administration Using Virtual Observations.

Background: Prior research has shown that primary care clinicians (PCPs) spend a large portion of clinic visits on tasks within the electronic health record (EHR). However, no time allocation studies have been done in the Veterans Health Administration (VHA) and little is known about EHR time spent during virtual visits.

Objective: To estimate the proportion of clinician time spent working within the EHR during primary care visits at VHA clinics.

Comparing Single-Hospital and National Models to Predict 30-Day Inpatient Mortality.

Background: Advances in artificial intelligence and machine learning have facilitated the creation of mortality prediction models which are increasingly used to assess quality of care and inform clinical practice. One open question is whether a hospital should utilize a mortality model trained from a diverse nationwide dataset or use a model developed primarily from their local hospital data.

Objective: To compare performance of a single-hospital, 30-day all-cause mortality model against an established national benchmark on the task of mortality prediction.

Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts.

Purpose: Our goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems.

Methods:  Participants (n = 7,998) were from 37 cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program. Cross-sectional information on demographic factors, parent-report of an ASD diagnosis by clinician, Social Responsiveness Scale (SRS) scores, and Child Behavior Checklist (CBCL) scores were obtained for children aged 2.

Effect of DLPFC rTMS on anhedonia and alpha asymmetry in depressed patients.

Anhedonia, a core symptom of depression, has been defined as the loss of pleasure or lack of reactivity to pleasurable stimuli. Considering the relevance of alpha asymmetry to MDD and anhedonia, we explored the effect of dorsolateral prefrontal cortex (DLPFC) stimulation on frontal and posterior EEG alpha asymmetry (FAA and PAA, respectively), in this exploratory investigation. 61 participants randomly received sham (n = 11), bilateral (BS; n = 25), or unilateral stimulation (US; n = 25) of the DLPFC.

Autogene cevumeran with or without atezolizumab in advanced solid tumors: a phase 1 trial.

Effective targeting of somatic cancer mutations to enhance the efficacy of cancer immunotherapy requires an individualized approach. Autogene cevumeran is a uridine messenger RNA lipoplex-based individualized neoantigen-specific immunotherapy designed from tumor-specific somatic mutation data obtained from tumor tissue of each individual patient to stimulate T cell responses against up to 20 neoantigens. This ongoing phase 1 study evaluated autogene cevumeran as monotherapy (n = 30) and in combination with atezolizumab (n = 183) in pretreated patients with advanced solid tumors.

Umbrella review of social inequality in digital interventions targeting dietary and physical activity behaviors.

Digital interventions are increasingly utilized as a lever to promote population health, yet not everyone may equally benefit from them. This umbrella review pooled the insights from available systematic and scoping reviews regarding potential social inequalities in digital intervention uptake, engagement and effectiveness, focusing on the promotion of weight-related behaviors (diet, physical activity, sedentary behavior) and weight loss (maintenance) in adults. Six databases were searched from 1970 to October 2023.

MAT2A inhibitor AG-270/S095033 in patients with advanced malignancies: a phase I trial.

Homozygous MTAP deletion occurs in ~15% of cancers, making them vulnerable to decreases in the concentration of S-adenosylmethionine (SAM). AG-270/S095033 is an oral, potent, reversible inhibitor of methionine adenosyltransferase 2 A (MAT2A), the enzyme primarily responsible for the synthesis of SAM. We report results from the first-in-human, phase 1 trial of AG-270/S095033 as monotherapy in patients with advanced malignancies (ClinicalTrials.

Future of Artificial Intelligence (AI) - Machine Learning (ML) Trends in Pathology and Medicine.

Artificial Intelligence (AI) and Machine Learning (ML) are transforming the field of medicine. Healthcare organizations are now starting to establish management strategies for integrating such platforms (AI-ML toolsets) which leverage the computational power of advanced algorithms to analyze data and to provide better insights which ultimately translates to enhanced clinical decision-making and improved patient outcomes. Emerging AI-ML platforms and trends in pathology and medicine are reshaping the field by offering innovative solutions to enhance diagnostic accuracy, operational workflows, clinical decision support, and clinical outcomes.

Vascular access: Femoral, radial and large-bore alternative access.

Vascular access for coronary, peripheral, and structural interventions has changed significantly over the past two decades. The evolving demand for both large-bore access for valvular interventions and mechanical support devices, and for safer access for coronary interventions, in patients with comorbidities have driven progress in these areas. This review will provide an overview of the techniques of arterial access in the femoral, forearm (radial and ulnar), and alternative (transcarotid, transaxillary, and transcaval) locations based on the latest evidence and experience.

Pegylated solid lipid nanoparticles for the intranasal delivery of combination antiretroviral therapy composed of Atazanavir and Elvitegravir to treat NeuroAIDS.

Intranasal drug administration offers a promising strategy for delivering combination antiretroviral therapy (cART) directly to the central nervous system to treat NeuroAIDS, leveraging the nose-to-brain route to bypass the blood-brain barrier. However, challenges such as enzymatic degradation in the nasal mucosa, low permeability, and mucociliary clearance within the nasal cavity must first be addressed to make this route feasible. To overcome these barriers, this study developed solid lipid nanoparticles (SLNs) with varying PEGylation levels (0 %, 5 %, 10 %, and 15 % w/w of PEGylated lipid), co-encapsulated with Elvitegravir (EVG) and Atazanavir (ATZ) as an integrase and protease inhibitor, respectively.

Sternum drop as a kinematic measure of trip recovery performance.

Deficient trip recovery kinematics have been implicated in many trip-induced falls. Three key requisites for successful trip recovery include limiting trunk flexion, maintaining adequate hip height to enable repeated stepping, and completing recovery steps to extend the base of support. The purpose of this study was to evaluate sternum drop as a new measure of trip recovery performance.

Evaluation of Generative Artificial Intelligence Models in Predicting Pediatric Emergency Severity Index Levels.

Objective: Evaluate the accuracy and reliability of various generative artificial intelligence (AI) models (ChatGPT-3.5, ChatGPT-4.0, T5, Llama-2, Mistral-Large, and Claude-3 Opus) in predicting Emergency Severity Index (ESI) levels for pediatric emergency department patients and assess the impact of medically oriented fine-tuning.