Recent ucsf_postprints items

Evidence Over Eminence: Rethinking Specialty Guidelines Amid the ATS-IDSA Debate

Wed, 13 May 2026 00:00:00 +0000

Evidence Over Eminence: Rethinking Specialty Guidelines Amid the ATS-IDSA Debate

The phage nucleus synergizes with an anti-defense protein to resist bacterial immunity

Wed, 13 May 2026 00:00:00 +0000

Chimallivirus bacteriophages enclose their replicating genomes in a protein-based compartment termed the phage nucleus. While the phage nucleus segregates phage DNA from host immune proteins, it is not known if additional factors are required to protect against DNA-targeting host defenses. Here, we identify a chimallivirus-encoded DarG2-like antitoxin that localizes to the phage nucleus and provides protection against phage-targeting DarTG2 toxin-antitoxin systems. This protein, which we term AdfM (anti-darT factor macro), contains a macrodomain and removes DarT2-mediated ADP-ribose modifications from DNA. In the absence of AdfM, DarT2 modifies phage DNA and restricts chimallivirus replication despite being largely excluded from the phage nucleus. Increasing the nuclear concentration of DarT2 while decreasing the nuclear concentration of AdfM reduces phage replication. These results show that the phage nucleus is insufficient to completely protect the chimallivirus genome from...

Neuroeconomic Measures of Impaired Decision-Making in Frontotemporal Dementia (S18.001)

Tue, 12 May 2026 00:00:00 +0000

Neuroeconomic Measures of Impaired Decision-Making in Frontotemporal Dementia (S18.001)

Testing the Presumption of Consent to Emergency Thrombolysis for Stroke (S35.005)

Tue, 12 May 2026 00:00:00 +0000

Testing the Presumption of Consent to Emergency Thrombolysis for Stroke (S35.005)

Equity-enhanced glaucoma progression prediction from OCT with knowledge distillation

Tue, 12 May 2026 00:00:00 +0000

Glaucoma is a progressive disease that can lead to permanent vision loss, making progression prediction vital for guiding effective treatment. Deep learning aids progression prediction but may yield unequal outcomes across demographic groups. We proposed a model called FairDist, which utilized baseline optical coherence tomography scans to predict glaucoma progression. An equity-aware EfficientNet was trained for glaucoma detection, which was then adapted for progression prediction with knowledge distillation. Model accuracy was measured by the AUC, Sensitivity, Specificity, and equity was assessed using equity-scaled AUC, which adjusts AUC by accounting for subgroup disparities. The mean deviation, fast progression, and total deviation pointwise progression were explored in this work. For both progression types, FairDist achieved the highest AUC and equity-scaled AUC for gender and racial groups, compared to methods with and without unfairness mitigation strategies. FairDist...

Changing Trends in Glaucoma Surgery Over the Past 5 Years in China

Tue, 12 May 2026 00:00:00 +0000

PURPOSE: To analyze the trends of glaucoma surgery procedures over the past 5 years among hospitals across major provinces in China. MATERIALS AND METHODS: This was a retrospective observational study based on medical records. We obtained the annual numbers of commonly performed glaucoma incisional surgeries from 57 hospitals of 30 provincial regions in the Chinese Glaucoma Study Consortium (CGSC) from January 2015 to September 2019. The trend of glaucoma surgery was analyzed by Cochrane-Armitage trend test. RESULTS: Trabeculectomy, cataract extraction combined with goniosynechialysis, cataract extraction combined with trabeculectomy, and surgical peripheral iridotomy (SPI) were the top 4 surgical procedures percentages of which have the most substantial change over the course of 2015 to 2019 (all Ptrend <0.001). Numbers of trabeculectomies decreased significantly from 47.59% in 2015 to 31.21% in 2019; cataract extraction combined with goniosynechialysis increased from 12.12%...

Multi-Dataset Comparison of Vision Transformers and Convolutional Neural Networks for Detecting Glaucomatous Optic Neuropathy from Fundus Photographs

Tue, 12 May 2026 00:00:00 +0000

Glaucomatous optic neuropathy (GON) can be diagnosed and monitored using fundus photography, a widely available and low-cost approach already adopted for automated screening of ophthalmic diseases such as diabetic retinopathy. Despite this, the lack of validated early screening approaches remains a major obstacle in the prevention of glaucoma-related blindness. Deep learning models have gained significant interest as potential solutions, as these models offer objective and high-throughput methods for processing image-based medical data. While convolutional neural networks (CNN) have been widely utilized for these purposes, more recent advances in the application of Transformer architectures have led to new models, including Vision Transformer (ViT,) that have shown promise in many domains of image analysis. However, previous comparisons of these two architectures have not sufficiently compared models side-by-side with more than a single dataset, making it unclear which model is...

Cost-effectiveness of a pictorial medication sheet for older adults with heart failure and cognitive impairment

Mon, 11 May 2026 00:00:00 +0000

BackgroundOlder adults with chronic health conditions like heart failure (HF) and cognitive impairment face challenges managing complex medication regimens, leading to poor adherence, worsening clinical status, and increased healthcare costs. Many existing interventions to improve medication adherence depend on digital technologies that may be too complex or require consistent caregiver support limiting their effectiveness in this population. Prior research demonstrated the efficacy of a simple pictorial medication sheet intervention compared to usual care. This study evaluates the cost-effectiveness of a pictorial medication sheet compared to usual care for older adults with HF and cognitive impairment.MethodsWe developed a decision tree model with disease states in Microsoft Excel to evaluate changes in costs and quality-adjusted life years (QALYs) after implementing the intervention for older adults living with cognitive impairment and HF. The base case model used a one-year...

MENOPAUSE IS ASSOCIATED WITH LOWER LUNG FUNCTION IN WOMEN WITH AND WITHOUT HIV

Fri, 8 May 2026 00:00:00 +0000

BACKGROUND: Menopause accelerates lung function decline in women without HIV, but whether menopause modifies lung function in women with HIV (WWH) is unknown. RESEARCH QUESTION: Is menopause associated with lung function in women with and at-risk for HIV? STUDY DESIGN AND METHODS: Pulmonary function tests (1116 spirometry, 615 diffusing capacity for carbon monoxide [DLco]) collected from 2018-2019 in 1,206 participants from the Women's Interagency HIV Study were included. In this cross-sectional analysis, women were categorized into groups defined by age (41-50, 51-60) and by menopausal phase as determined by anti-Müllerian hormone, a biomarker of ovarian reserve. Linear regression models determined the differences in mean FEV1, FVC, and DLco by menopausal phase compared to women in the same age group. RESULTS: Overall, 71% were WWH, 65% were Black, and the median age was 52 years; 36% and 31% reported current and former smoking, respectively, and 30% were premenopausal/early...

Spatial coupling of enlarged perivascular spaces and white matter lesions across the Alzheimer's disease continuum

Fri, 8 May 2026 00:00:00 +0000

Introduction: Emerging evidence suggests that impaired waste-clearance systems contribute to Alzheimer's disease pathogenesis, yet the etiology of clearance dysfunction markers, such as enlarged perivascular spaces, remains unclear. Because enlarged perivascular spaces and white matter lesions are both consequences of microvascular injury involving neuroinflammation and impaired cerebrovascular function, we hypothesize that these markers may be spatially coupled through local interstitial fluid stagnation, where impaired perivascular clearance associates with white matter injury. Methods: We assessed global perivascular space differences and correlations across diagnostic and biomarker-informed groups in the Alzheimer's Disease Neuroimaging Initiative dataset within whole brain, white matter, and basal ganglia regions, as well as within and outside of white matter lesions. To assess the spatial relationships between enlarged perivascular spaces and white matter lesions, we examined...

Bridging community-engaged research and implementation science methods to advance public health practice

Thu, 7 May 2026 00:00:00 +0000

Addressing public health challenges through equitable, evidence-based strategies remains a pressing global need. Implementation science bridges research and practice, offering methods to improve intervention design, delivery, and evaluation. Concurrently, community-engaged research embeds equity and trust into public health initiatives. This paper introduces selected community engagement methods and related implementation science approaches to address characteristic common constraints in public health practice, illustrated with real-world examples. Adapting the Knowledge to Action framework, we present a discussion of community-engaged methods and accompanying case studies. The discussion follows four phases present in applied public health research: (1) identifying and defining the problem, (2) designing and modifying the intervention, (3) evaluating the intervention, and (4) communicating and disseminating findings. For each phase, we highlight...

Age-dependent reference intervals for cerebrospinal fluid and urine biomarkers of mucopolysaccharidoses

Thu, 7 May 2026 00:00:00 +0000

Mucopolysaccharidoses (MPSs) are characterized by deficient activity of lysosomal hydrolase enzymes, leading to progressive accumulation of glycosaminoglycans. These glycosaminoglycans can be assayed in biofluids as potential markers of disease severity and response to disease-modifying therapies. This study sought to calculate control reference intervals in a largely pediatric population for key MPS biomarkers: heparan sulfate (HS) and dermatan sulfate (DS) in cerebrospinal fluid (CSF) and urine, and CSF monosialic gangliosides GM2 and GM3. We also explored the effect of age on biomarker levels. Biomarker levels were measured using liquid chromatography-tandem mass spectrometry in CSF and urine samples from pediatric and young adult donors and were compared with baseline CSF and urine biomarker levels from an ongoing Phase 1/2 study of children with MPS II. Age-specific reference intervals were estimated for CSF HS, DS, and GM2, and for urine HS, DS, and the sum of HS and DS,...

Five strategies for clinicians to advance diagnostic excellence

Thu, 7 May 2026 00:00:00 +0000

Five strategies for clinicians to advance diagnostic excellence

Problem representation in the age of artificial intelligence: the state of a dying art?

Thu, 7 May 2026 00:00:00 +0000

Since its introduction into clinical reasoning education, the concept of the problem representation (PR) - a clinician's evolving mental model of a patient's illness - has helped frame how we teach reasoning to trainees. Despite PR's popularity and promise as an educational tool, its use has also prompted persistent questions about terminology, teaching methods, and its role in developing diagnostic expertise. The recent emergence of generative artificial intelligence (GAI) capable of rapidly synthesizing and summarizing clinical has raised new concerns: If GAI can perform PR, what clinical reasoning skills remain essential for learners to master? In this perspective, we explore the history, current state of the art, and projected future of PR in a world with widespread GAI use. We argue that problem representation remains a critical cognitive process for trainees to master on their path toward expertise, even as generative AI may change or improve how it is taught.

Patient reported barriers and facilitators of chronic kidney disease care in Sub-Saharan Africa: a mixed methods systematic review using the COM-B model

Thu, 7 May 2026 00:00:00 +0000

BackgroundIn Sub-Saharan Africa (SSA), the prevalence of chronic kidney disease (CKD) is on the rise. Treatment for CKD in SSA is characterized by delayed initiation, early discontinuation, inadequate duration of therapy, and suboptimal follow-up. To our level of understanding, evidence on the barriers and facilitators of CKD care in SSA has not been comprehensively reported and is the focus of this mixed methods systematic review.MethodsThis convergent integrated Joanna Briggs Institute (JBI) methodology for mixed systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. Six databases were utilized and included Medline, Ovid, Cumulative Nursing and Allied Health Literature (CINAHL), EMBASE, Web of Science, and Scopus for studies. Peer-reviewed articles published in the English language between 2000 and July 30, 2024, were included. Qualitative, quantitative, or mixed-method studies that reported health care, treatment...

Next-Generation Artificial Intelligence for Diagnosis

Thu, 7 May 2026 00:00:00 +0000

This Viewpoint explains how artificial intelligence (AI) tools have the potential to do more than predict final diagnostic labels and how AI can help reduce clinician error and more accurately diagnose and manage illness.

Electronic health record–based patient tracking by emergency medicine physicians

Thu, 7 May 2026 00:00:00 +0000

Objectives: Emergency medicine (EM) physicians commonly track the progress of former patients to learn about their clinical outcome. While some studies have described the behavior, little is known about the specific information sought during tracking. The objective of this study was to determine how often EM physicians track patients and the motivations, strategies, and barriers to tracking. Methods: In June 2019 we surveyed EM physicians practicing at six hospitals. We defined patient tracking as viewing the chart of a patient who was no longer under the physician's care or contacting the patient or the patient's subsequent providers to learn about the patient's progress. The survey asked respondents how often they track patients, by what mechanisms, and for what reasons. The survey also asked what information physicians sought when tracking and what barriers to tracking exist. Results: Of the 156 EM physicians invited to respond, 111 completed the survey (72% response rate)....

Early-life liquefied petroleum gas cooking intervention and lung function in Guatemalan children: A randomized clinical trial

Thu, 7 May 2026 00:00:00 +0000

RATIONALE: Household air pollution is a risk factor for obstructive lung diseases. OBJECTIVES: We estimated the effect of an early-life liquefied petroleum gas cooking intervention on childhood lung function. METHODS: The multi-country Household Air Pollution Intervention Network trial randomized 800 pregnant women (9-19 weeks gestation, 18-34 years) in Guatemala to receive a gas cookstove and free fuel intervention or continue cooking with biomass until the child is aged 1 year. The present analysis includes only Guatemalan children. At age 3 years, we measured lung function using oscillometry at 7-41 Hertz (Tremoflo C-100, Thorasys). Outcomes were resistance and reactance at 7 Hertz, area of reactance, resistance at 19 Hertz, resistance difference between 7 and 19 Hertz, and, as exploration, resistance across frequencies. Upper airway artifacts were removed using Tremoflo software. The effect of the intervention was estimated using linear regression models, unadjusted and adjusted...

Phylogenetic diversity, functional pathways, and network interactions of ocular chlamydia-like organisms (CLOs) in trachoma-endemic Ethiopia.

Thu, 7 May 2026 00:00:00 +0000

Trachoma is the leading infectious cause of blindness worldwide and classically attributed to Chlamydia trachomatis (Ct). However, other members of the phylum Chlamydiae, particularly environmental chlamydia-like organisms (CLOs), may modulate ocular ecology and influence disease outcomes. Here, we investigated CLO distribution, phylogeny, and microbiome associations among 1,059 individuals from trachoma-endemic communities in Ethiopia using targeted 16S rRNA sequencing and metagenomic shotgun sequencing. CLOs were detected in 249 (23.3%) participants of all ages and sexes and were significantly less likely to be associated with Ct or trachomatous scarring (TS) and trichiasis (TT). Phylogenetic analyses revealed extensive CLO diversity with six novel phylotypes, the most abundant of which was ancestral to Sorochlamydiaceae-a family linking pathogenic Chlamydiaceae, which includes the genus Chlamydia, and symbionts of protists. CLO-positive microbiomes...

Tweaking the complex fibrogenic role of lymphocytes in IPF

Thu, 7 May 2026 00:00:00 +0000

Idiopathic pulmonary fibrosis is a deadly lung disease primarily affecting aged individuals. Even though there are two U.S. Food and Drug Administration-approved drugs, nintedanib and pirfenidone, with a recent addition of another drug, nerandomilast, yet they only reduce the progress of the disease. The mean survival rate is between 5 and 7 years even after treatment with antifibrotics. Cells of lymphoid lineage have been long reported to modulate the outcome of pulmonary fibrosis. In this review, we discuss how the cell of lymphoid lineage regulates the inflammatory niche within the lungs, leading to the development and progress of pulmonary fibrosis. The review also addresses possible therapeutic strategies that can be leveraged by specifically targeting the lymphoid cells in the pulmonary fibrotic niche.

Use of Paracervical Blocks for Patients Who Undergo Intrauterine Device Insertion

Thu, 7 May 2026 00:00:00 +0000

Paracervical blocks can reduce pain during intrauterine device (IUD) insertions, but the extent and context in which they are used in practice are unclear. To evaluate paracervical block use during IUD insertions in an academic health system. This retrospective cross-sectional time-series study was performed at the University of California, San Francisco (UCSF), academic health care system using electronic health record data. Participants included individuals who underwent IUD insertions between July 2, 2012, and August 16, 2024. Data were analyzed from October 2023 to April 2025. Clinic-, clinician-, and patient-level variables. Paracervical block receipt was determined from clinical notes. Associations of paracervical block receipt with variables at the clinic, clinician, and patient levels were estimated with multilevel models. The role of clinic specialty (pediatrics or adolescent medicine vs all other specialties) in accounting for the association of age less than 18 years...

Bots and fake participants: ensuring valid and reliable data collection using online participant recruitment methods

Thu, 7 May 2026 00:00:00 +0000

Recruitment for successful health sciences research requires balancing efficiency, cost, accessibility, and reliability of available recruitment methods. Our case-control study used online recruitment methods, which broadened our reach to potential participants across the United States. However, this approach also exposed us to challenges associated with bot interference and fraudulent participation. This paper focuses on maintaining data integrity, specifically when utilizing online participant recruitment methods. Drawing from our experience, we propose The Swiss Cheese Model of Study Participant Fraud Prevention, adapted from Reason's Swiss Cheese Model, and illustrate ten prevention and verification measures that can be taken to minimize fraud in research studies that rely on online recruitment. We emphasize the importance of a layered approach, including carefully designed recruitment media and compensation protocols, vetting of participant eligibility, and data verification...

C-Type Natriuretic Peptide Derivatives: Orthopaedic Implications in Achondroplasia

Thu, 7 May 2026 00:00:00 +0000

The recent development of C-type natriuretic peptide (CNP) analogs to increase growth velocity in achondroplasia is now being used alongside limb lengthening procedures. Animal studies have shown that CNP analogs may affect bone density and the speed of callus consolidation during fracture healing. Although achondroplasia is primarily associated with a defect in endochondral ossification, pharmaceutical treatments for the condition may also influence intramembranous ossification. The availability of these non-surgical treatments warrants further investigation into their potential impact on surgical risks and outcomes. Data suggest they may affect bone quality, healing, and anatomical parameters such as medullary canal area, which could influence treatment decisions and surgical planning. This review aims to synthesize current evidence on CNP analog pathways and their intersection with biological processes involved in the surgical management of children with achondroplasia. Key...

Unleashing Diffusion and State Space Models for Medical Image Segmentation

Thu, 7 May 2026 00:00:00 +0000

Existing segmentation models trained on a single medical imaging dataset often lack robustness when encountering unseen organs or tumors. Developing a robust model capable of identifying rare or novel tumor categories not present during training is crucial for advancing medical imaging applications. We propose DSM, a novel framework that leverages diffusion and state space models to segment unseen tumor categories beyond the training data. DSM utilizes two sets of object queries trained within modified attention decoders to enhance classification accuracy. Initially, the model learns organ queries using an object-aware feature grouping strategy to capture organ-level visual features. It then refines tumor queries by focusing on diffusion-based visual prompts, enabling precise segmentation of previously unseen tumors. Furthermore, we incorporate diffusion-guided feature fusion to improve semantic segmentation performance. By integrating CLIP text embeddings, DSM captures category-sensitive...

Personal household air pollution exposure and SARS-CoV-2 antibody responses among women and infants: an analysis within the HAPIN trial

Thu, 7 May 2026 00:00:00 +0000

Background While extensive research has linked ambient air pollution to increased COVID-19 infection rates and severity, the role of household air pollution (HAP)—a major public health exposure affecting nearly 3 billion people globally—remains understudied. Here, we evaluate associations between a clean cooking intervention, personal household air pollution exposure, and serologic evidence of prior SARS-CoV-2 infection using exploratory intention-to-treat and exposure–response analyses. Methods The Household Air Pollution Intervention Network (HAPIN) Trial randomized 3,200 households in Guatemala, India, Peru, and Rwanda to either continue using traditional solid fuel cookstoves or receive liquefied petroleum gas stoves with continuous fuel supply and behavioral messaging. The current ancillary study leveraged personal exposures to PM2.5 and carbon monoxide (CO) and dried blood spot (DBS) samples collected in the Guatemala, India, and Peru HAPIN sites to study the association...

The VA My Life My Story Project: Keeping Medical Students and Veterans Socially Connected While Physically Distanced.

Thu, 7 May 2026 00:00:00 +0000

INTRODUCTION: Narrative competence comprises the skills of acknowledging, interpreting, and acting on the stories of others. Developing narrative competence is integral to providing patient-centered care. In January 2020, we designed a narrative medicine curriculum in which medical students at the San Francisco Veteran Affairs (VA) Medical Center in California participated as interviewers in My Life My Story (MLMS) program. The curricular objectives for medical students were to build life story skills, appreciate the impact of storytelling on a veteran's health care experience, and understand the VA mission. OBSERVATIONS: Students attended a training session to build narrative medicine skills, interviewed a veteran, entered their life story into the health record, and attended a second session to debrief. Students completed a survey after the MLMS program. From March to July 2020, COVID-19-related restrictions prompted transition of the program to a virtual format. Sixty-two veteran...

“A place to have fellowship”: implementing group counseling in a clinical fellowship program

Thu, 7 May 2026 00:00:00 +0000

BackgroundThe American College of Graduate Medical Education (ACGME) has endorsed recommendations to promote individual counseling services to support trainees. However, there are limited data and no clear recommendations related to group counseling services, a format that may be scalable and support peer connection. This paper has two primary objectives: (1) to describe the implementation of group counseling as a method of providing formative, normative, and restorative supervision to GME trainees and (2) to report participants’ experiences within the program.MethodsIn September 2019, the fellowship program implemented regular group counseling for fellows, with ongoing feedback collected to optimize logistics. Between November 2023 and January 2024, we worked within an interpretivist paradigm to explore experiences with group counseling by conducting semi-structured individual interviews with former and current fellows, which were transcribed and analyzed thematically. This study...

Dietary tryptophan mitigates lung ischemia-reperfusion injury via microbiota-derived indole-3-propionate and aryl hydrocarbon receptor signaling.

Thu, 7 May 2026 00:00:00 +0000

Background: Lung ischemia-reperfusion (IR) injury drives early morbidity after lung transplantation and cardiothoracic surgery, yet targeted preventive therapies are lacking. The gut-lung axis and microbiota-derived tryptophan metabolites, including indole-3-propionate (IPA), may regulate pulmonary immunity and inflammation. We investigated whether a tryptophan-rich (Trp-Rich) diet attenuates sterile lung IR injury by increasing microbiota-derived indole metabolites and reprogramming alveolar macrophage (AM) inflammatory responses. Methods: C57BL/6 mice received isocaloric tryptophan-standard (Trp-Std; 0.18%) or Trp-Rich (0.60%) diets for 14 days, then underwent unilateral left lung IR (60 min ischemia followed by 60 min reperfusion). Oxygen saturation, lung cytokines, and aryl hydrocarbon receptor (AhR) signaling readouts ( Cyp1a1 / Cyp1b1 ) were evaluated. Gut microbiota was profiled by 16S rRNA sequencing, and targeted metabolomics quantified tryptophan metabolites...

Exploitive Adolescent Labor and Labor Trafficking: Clinical Perspectives for Adolescent Healthcare Providers

Thu, 7 May 2026 00:00:00 +0000

Exploitive Adolescent Labor and Labor Trafficking: Clinical Perspectives for Adolescent Healthcare Providers

Exposure–response relationship of household air pollution on body mass index among women in rural areas of Guatemala, India, Peru and Rwanda: household air pollution intervention network trial

Thu, 7 May 2026 00:00:00 +0000

BackgroundHousehold air pollution from burning biomass materials, the main cooking fuel in low- and middle-income countries, may be linked to metabolic dysfunction. We assessed cross-sectional associations between household air pollution and body mass index (BMI), expecting to see increased BMI with higher pollution concentrations.MethodsWe analyzed data from 414 women aged 40 to 79 years who resided in the households using biomass fuel and were enrolled in the multi-country Household Air Pollution Intervention Network (HAPIN) Trial. We explored associations of 24-h average personal exposure to fine particulate matter (PM2.5), black carbon (BC), and carbon monoxide (CO) with BMI through single pollutant linear and logistic models adjusted for potential confounders (i.e., age, socioeconomic indicators, education, dietary diversity, secondhand smoke exposure, alcohol and grain consumption).Sensitivity analyses explored air pollutants as quartiles, and other variables...

Barriers and Facilitators to Higher Education Applications and Admissions Among People in Recovery

Tue, 5 May 2026 00:00:00 +0000

People in substance use disorder recovery represent a marginalized and underserved student population. Improving access to higher education for people in recovery can benefit the individual, institution, and society at large. This study explored the barriers to college applications and admissions that people in recovery face and the resources that they draw on to overcome these barriers. Semistructured interviews were completed with 17 undergraduate students in recovery at a large public university without a collegiate recovery program. Inductive thematic analysis was used to document students' experiences related to applications and admissions. Participants described barriers to higher education at multiple levels, including personal challenges (e.g., competing priorities), consequences of past use (e.g., a record of criminal legal system involvement), challenges in the social environment (e.g., substance use on campus), complex admission processes (e.g., regarding transfer credits),...

Anti-Latine bias and drug-induced homicide law support: Evidence from a nationally diverse, randomized survey experiment in the United States

Tue, 5 May 2026 00:00:00 +0000

Anti-Latine bias and drug-induced homicide law support: Evidence from a nationally diverse, randomized survey experiment in the United States

“Knowing or not knowing”: Living as harm reductionists in Twelve Step recovery

Tue, 5 May 2026 00:00:00 +0000

“Knowing or not knowing”: Living as harm reductionists in Twelve Step recovery

Beyond the 5-year recovery mark: Perspectives of researchers with lived and living experience on public engagement and discourse

Tue, 5 May 2026 00:00:00 +0000

There has been growing attention toward including people with lived and living experience (PWLLE) with substance use, substance use disorders, and recovery in public-facing activities. The goals of including PWLLE in sharing their perspectives often include demonstrating that recovery is possible, destigmatizing and humanizing people who have substance use experiences, and leveraging their lived experience to illuminate a particular topic or issue. Recently, the National Council for Mental Wellbeing issued a set of guidelines entitled, "Protecting Individuals with Lived Experience in Public Disclosure," which included a "Lived Experience Safeguard Scale." We offer the present commentary to bolster some of the ideas presented by the Council and to articulate suggested changes to this guidance, with the goal of reducing unintentional gatekeeping and stigma. Specifically, we offer that there are numerous problems with the recommendation to only invite people who have "five or more...

Medications for opioid use disorder and other evidence-based service offerings in faith-affiliated treatment centers: Implications for implementation partnerships

Tue, 5 May 2026 00:00:00 +0000

INTRODUCTION: Amidst an ongoing surge of opioid use disorder (OUD) incidence, clinicians and policymakers are seeking partnerships with faith communities - including with faith-affiliated treatment centers (FATCs) - to expand access to evidence-based OUD treatment. However, little is known whether FATCs differentially offer such evidence-based treatment services, particularly medications for opioid use disorder (MOUD) and co-occurring mental health care. METHODS: We use the 2021 National Substance Use and Mental Health Services Survey (N-SUMHSS) to examine differences in provision of several OUD services, including MOUD, psychological treatments, mental health services, medical services, recovery support services, and services related to treatment accessibility, between self-identified FATCs and non-FATCs. We also explored differences in characteristics related to insurance, licensure, and accreditation. RESULTS: FATCs were less likely than non-FATCs to offer almost all measure...

Integrating Mobile Text Messaging Pre-Exposure Prophylaxis Navigation Services Into a Home HIV and Sexually Transmitted Infection Self-Testing Program in the United States: Formative Work and Pilot Implementation Study.

Fri, 1 May 2026 00:00:00 +0000

Background

HIV testing is the gateway to the HIV prevention continuum and offers an important opportunity to provide HIV prevention services. TakeMeHome.org is an online program that enables state and local health departments to offer free in-home HIV and sexually transmitted infection self-testing. As few TakeMeHome users have used pre-exposure prophylaxis (PrEP), there is an opportunity to link TakeMeHome users to PrEP information and services.

Objective

The aim of this study is to develop an implementation strategy to link HIV or sexually transmitted infection self-testers from online orders to PrEP services via direct digital linkage to a novel SMS text messaging navigation program.

Methods

PrEPmate is an evidence-based bidirectional text-messaging platform that has demonstrated increased PrEP retention and adherence. We developed a novel program to link TakeMeHome testers to mobile SMS text messaging PrEP navigation via PrEPmate. We conducted focus groups...

Growing stronger: Nine decades of physical disability representation in children's media and implications for pediatric rehabilitation.

Mon, 27 Apr 2026 00:00:00 +0000

BackgroundChildren's media both reflects and shapes societal attitudes toward physical disability. Despite its potential impact on self-concept and stigma, longitudinal, data-driven analysis of these portrayals remains scarce. This study aimed to quantify longitudinal trends in the tone and framing of physical disability representation in children's media and to explore implications for pediatric rehabilitation.MethodsA quantitative content analysis was conducted on 68 children's media productions (1933-2025) sourced from the Vanderbilt Peabody database. Content was filtered to age-appropriate ratings (G, PG, PG-13, TV-14). Three trained reviewers classified depictions of physical disability by clinical category (e.g., spinal cord injury, limb difference) and tone (Positive, Neutral, Negative) and coded for the presence of rehabilitation themes. Inter-rater reliability (κ = 0.83) was achieved. Statistical testing included Mann-Kendall trend analysis and Fisher's exact tests to...

Genetic modifiers of APOE-ε4-associated cognitive decline

Mon, 27 Apr 2026 00:00:00 +0000

The APOE-ε4 allele is the strongest genetic risk factor for late-onset Alzheimer’s disease. However, APOE-ε4 is not deterministic, highlighting the need to identify additional genetic and environmental factors. APOE-ε4 has been linked to accelerated cognitive decline, so we sought to investigate genetic factors that modify APOE-ε4–associated cognitive decline. We conduct cross-ancestry APOE-ε4-stratified and interaction GWAS using harmonized cognitive data from 32,778 participants, including 29,354 non-Hispanic White and 3,424 non-Hispanic Black individuals. Our primary outcome is late-life cognition, measured using harmonized composite scores for memory, executive function, and language, modeled as continuous traits reflecting both normative cognitive aging and disease-related decline. We identify two genome-wide significant loci in APOE-ε4 carriers, reaching genome-wide significance for executive function. These loci also demonstrate nominal associations across the other domains,...

Recurrent episodes of pneumonia are associated with worse lung function in people with HIV.

Sat, 25 Apr 2026 00:00:00 +0000

BACKGROUND: HIV is associated with a decreased diffusing capacity for carbon monoxide (DLco), decreased spirometry, and an increased risk for developing obstructive lung disease, even in never-smokers. Pneumonia is a risk factor for impaired pulmonary function in people with HIV (PWH), but whether recurrent pneumonia results in a commensurate decline in lung function is unknown. METHODS: We reviewed the electronic medical records and PFT data for PWH in San Francisco, CA. Participants were categorized by number of pneumonias since HIV diagnosis. We analyzed the association between the number of pneumonias and lung function using linear and logistic regression models after adjusting for substance use and HIV-associated factors. RESULTS: Among 259 participants, the mean age was 51 years, 15% were female, and 42% were current smokers. One hundred (39%) participants had no prior pneumonia, 52 (20%) had 1 pneumonia, 50 (19%) had 2 pneumonias and 57 (22%) had ≥3 pneumonias. Multiple...

297: High-dose misoprostol with subsequent foley versus low-dose misoprostol with concurrent foley for cervical ripening

Fri, 24 Apr 2026 00:00:00 +0000

297: High-dose misoprostol with subsequent foley versus low-dose misoprostol with concurrent foley for cervical ripening

Palliative Care Intervention for Patients With End-Stage Liver Disease

Fri, 24 Apr 2026 00:00:00 +0000

Importance: Palliative care improves quality of life (QoL) in advanced illnesses, but data in end-stage liver disease (ESLD) are limited. It is unknown whether palliative care delivered by hepatologists is effective when compared with palliative care specialists. Objective: To compare the effectiveness of palliative care delivered by trained hepatologists with the care delivered by conventional palliative care specialists in improving QoL at 3 months. Design, Setting, and Participants: This comparative effectiveness cluster randomized trial for US patients treated for ESLD in 19 US medical centers compared a palliative care intervention delivered by palliative care-trained hepatologists (hepatologist group; 11 centers) with palliative care specialists (consultative group; 8 centers). Eligible patients were US adults with either decompensated cirrhosis or hepatocellular cancer who had a life expectancy of at least 6 months, had not received or scheduled liver transplantation, or...

HIVST in the presence of a partner among fishermen in Western Kenya: A qualitative study

Fri, 24 Apr 2026 00:00:00 +0000

BACKGROUND: HIV self-testing (HIVST) enables individuals to test privately and can serve as an important tool to mitigate stigma and fear of HIV testing and unintended disclosure, especially among men, who have lower voluntary testing rates than women. AIM: Within an intervention study involving distribution of HIVST kits by fishermen to their peers [NCT04772469], we explore the experiences and the motivations of men who chose to self-test for HIV in the presence of their female partners. METHOD: We conducted in-depth interviews (n = 32) with fishermen from three fishing communities along Lake Victoria, Kenya. Interviews were conducted at three months post-intervention and explored fishermen's experiences with HIVST and the context under which they tested. Interviews were analysed using a framework analysis approach. RESULTS: Though they were not prompted by the study to do so, 17 participants described testing for HIV at home in the presence of partners. Fishermen who...

ABCC1 protects skin dendritic cells from FITC-induced toxicity by efflux and extracellular glutathione buffering

Thu, 23 Apr 2026 00:00:00 +0000

Dendritic cell (DC) migration is critical for initiating adaptive immune responses. Previous work suggested a role for ATP-binding cassette transporter C1 (ABCC1) in skin DC migration following cutaneous fluorescein isothiocyanate (FITC) exposure, but the precise mechanism involved was unclear. Here, we establish that the primary contribution of ABCC1 to skin DC function following FITC exposure is not modulation of migration, but enhancement of survival. Our findings demonstrate that ABCC1 operates on a dual level: Intracellularly, by transporting toxic FITC and fluorescein out of DCs, and extracellularly, by contributing to a glutathione (GSH) buffer zone that protects surrounding cells. DCs are particularly susceptible to FITC-mediated toxicity, possibly due to their high endocytic activity. This study elucidates the critical dependence of DCs on ABCC1 and extracellular GSH for resistance to toxic organic molecules and thereby identifies potential therapeutic avenues targeting...

The 2024 Brain Tumor Segmentation (BraTS) Challenge: Glioma Segmentation on Post-treatment MRI

Thu, 23 Apr 2026 00:00:00 +0000

Gliomas are the most common malignant primary brain tumors in adults and one of the deadliest types of cancer. There are many challenges in treatment and monitoring due to the genetic diversity and high intrinsic heterogeneity in appearance, shape, histology, and treatment response. Treatments include surgery, radiation, and systemic therapies, with magnetic resonance imaging (MRI) playing a key role in treatment planning and post-treatment longitudinal assessment. The 2024 Brain Tumor Segmentation (BraTS) challenge on post-treatment glioma MRI will provide a community standard and benchmark for state-of-the-art automated segmentation models based on the largest expert-annotated post-treatment glioma MRI dataset. Challenge competitors will develop automated segmentation models to predict four distinct tumor sub-regions consisting of enhancing tissue (ET), surrounding non-enhancing T2/fluid-attenuated inversion recovery (FLAIR) hyperintensity (SNFH), non-enhancing tumor core (NETC),...

Rethinking Mitochondria: The Extracellular Dimension

Thu, 23 Apr 2026 00:00:00 +0000

Mitochondria are essential organelles that transform the energy contained in metabolic substrates into ATP while supporting numerous cellular processes. Traditionally regarded as strictly intracellular, growing evidence now demonstrates that mitochondria and mitochondria-derived components can also be released into the extracellular space, giving rise to extracellular mitochondria. extracellular mitochondria display remarkable heterogeneity, ranging from intact organelles to individual molecular components, free to vesicle-encapsulated structures, and with functional states spanning from severely damaged to metabolically active. Their release is mediated by tightly regulated mechanisms in both living and dying cells, and is influenced by cellular stress, activation state, and pathways that control mitochondrial selection, compartmentalization, trafficking, and extrusion. Extracellular release fulfills multiple functions across the organism, including quality control, modulation...

Musculoskeletal Imaging

Thu, 23 Apr 2026 00:00:00 +0000

Nuclear medicine and the array of different radiotracers have an important role in the diagnosis and evaluation of a variety of musculoskeletal diseases. Conventional radiography has long been considered the first‐line diagnostic for suspected traumatic fracture. Broadly speaking, stress fractures fall into one of two categories: fractures that arise from normal loading on abnormal bone, termed “insufficiency fractures,” and fractures that arise from abnormal loading on normal bone, termed “fatigue fractures”. Rheumatoid arthritis is an inflammatory disorder with a main target for the synovial membrane of joints, bursae, and tendon sheaths. Radiography is the mainstay in the preliminary evaluation of rheumatoid arthritis. Diabetic patients are at risk for foot infections due to underlying diabetic neuropathy, which leads to a loss of protective sensation and development of anatomic deformities and altered weight‐bearing, and peripheral vascular disease, which limits access of...

Role of Chest CT in Resource-Driven Healthcare Systems.

Thu, 23 Apr 2026 00:00:00 +0000

Role of Chest CT in Resource-Driven Healthcare Systems.

Quantitative and Qualitative Correlation of 0.55T MRI to CT for Normal Anatomic Structures and Common Pulmonary Pathologies

Thu, 23 Apr 2026 00:00:00 +0000

Motivation: Although MRI has had low adoption in lung imaging due to susceptibility artifacts, limiting its utility in pulmonary parenchymal imaging, low-field MRI (0.55T) has potential to address those limitations. Goal(s): However, its thoracic diagnostic capabilities remain indeterminate, so our goal was to compare its ability to detect common lung pathologies to chest CT and provide comparable quantitative measurements. Approach: Structures and pathologies were measured with both modalities, and two radiologists identified lung pathologies with MRI only. Results: Results indicated that readers were able to detect pathologies using 0.55T MRI, serving as a first step in exploring 0.55T MRI as an alternative modality. Impact: Our study revealed potential for 0.55T MRI as an emerging tool for MR-based anatomic evaluation of the lung, and its limitations. This can expand lung imaging options and potentially provide better tissue characterization for diagnoses like lung cancer.

Veillonella Bacteremia in Alcoholic Hepatitis

Thu, 23 Apr 2026 00:00:00 +0000

Veillonella species are commensal bacteria of the human oral, gut, and vaginal microbiota that are rarely identified as clinically relevant pathogens. Here, we describe a novel case of Veillonella atypica bacteremia in a patient with biopsy-proven alcoholic hepatitis. Veillonella species have been correlated with disease severity and hepatic encephalopathy in liver diseases such as autoimmune hepatitis and cirrhosis. Their abundance has also been recently observed to be increased in alcoholic hepatitis, where postinflammatory infections are known to impact mortality. This case report highlights the possible clinical manifestations that result from significant gut dysbiosis in patients with severe alcoholic hepatitis. Early identification and treatment of Veillonella bacteremia in susceptible populations could be crucial to survival given this organism's predilection for causing life-threatening infections, including meningitis, endocarditis, and osteomyeliti...

The Brain Tumor Sequence Registration (BraTS-Reg) Challenge: Establishing Correspondence Between Pre-Operative and Follow-up MRI Scans of Diffuse Glioma Patients

Thu, 23 Apr 2026 00:00:00 +0000

Registration of longitudinal brain MRI scans containing pathologies is challenging due to dramatic changes in tissue appearance. Although there has been progress in developing general-purpose medical image registration techniques, they have not yet attained the requisite precision and reliability for this task, highlighting its inherent complexity. Here we describe the Brain Tumor Sequence Registration (BraTS-Reg) challenge, as the first public benchmark environment for deformable registration algorithms focusing on estimating correspondences between pre-operative and follow-up scans of the same patient diagnosed with a diffuse brain glioma. The BraTS-Reg data comprise de-identified multi-institutional multi-parametric MRI (mpMRI) scans, curated for size and resolution according to a canonical anatomical template, and divided into training, validation, and testing sets. Clinical experts annotated ground truth (GT) landmark points of anatomical locations distinct across the temporal...

Radiomics Analysis for Predicting Growth of Subsolid Lung Nodules on CT

Thu, 23 Apr 2026 00:00:00 +0000

Abstract Background Accurate identification of growing subsolid nodules is crucial for effective risk stratification and the early detection of invasive lung cancer, allowing for timely treatment while avoiding unnecessary surgery on low-risk nodules that would otherwise remain stable. The traditional method of risk stratification, which relies on qualitative visual analysis of CT scans, remains challenging. Therefore, this study aims to leverage a longitudinal dataset of subsolid nodules on CT and develop radiomic and clinical feature-based models to identify nodules that are likely to grow over time. Purpose The purpose of this study is to develop a machine learning model to predict the growth of subsolid nodules using a combination of radiomic and clinical features. Materials and Methods A retrospective study was conducted on a cohort of patients who had undergone chest CT scans at a single institution between 2015 and 2019. Corresponding radiology reports were used to...

Compressed Sensing MR Imaging (CS-MRI) of the Knee: Assessment of Quality, Inter-reader Agreement, and Acquisition Time

Thu, 23 Apr 2026 00:00:00 +0000

We compared 3 Tesla (3T) compressed sensing (CS)-MRI of different pulse sequences with various acceleration factors to standard fast spin-echo (FSE) sequences in terms of time, quality, and inter-reader agreement. Each sequence was qualitatively ranked and then qualitatively scored for blurring, artifact, low contrast detection, noise pattern, signal-to-noise ratio, and overall quality. The CS-MRI sequences demonstrated very good overall quality compared with routine FSE sequences with overall good inter-reader agreement.

Identification of fibronectin 1 as a candidate genetic modifier in a Col4a1 mutant mouse model of Gould syndrome

Thu, 23 Apr 2026 00:00:00 +0000

Collagen type IV alpha 1 and alpha 2 (COL4A1 and COL4A2) are major components of almost all basement membranes. COL4A1 and COL4A2 mutations cause a multisystem disorder that can affect any organ but typically involves the cerebral vasculature, eyes, kidneys and skeletal muscles. In recent years, patient advocacy and family support groups have united under the name of Gould syndrome. The manifestations of Gould syndrome are highly variable, and animal studies suggest that allelic heterogeneity and genetic context contribute to the clinical variability. We previously characterized a mouse model of Gould syndrome caused by a Col4a1 mutation in which the severities of ocular anterior segment dysgenesis (ASD), myopathy and intracerebral hemorrhage (ICH) were dependent on genetic background. Here, we performed a genetic modifier screen to provide insight into the mechanisms contributing to Gould syndrome pathogenesis and identified a single locus [modifier of Gould syndrome 1 (MoGS1)]...

The SNO+ experiment

Thu, 23 Apr 2026 00:00:00 +0000

The SNO+ experiment is located 2 km underground at SNOLAB in Sudbury, Canada. A low background search for neutrinoless double beta (0νββ) decay will be conducted using 780 tonnes of liquid scintillator loaded with 3.9 tonnes of natural tellurium, corresponding to 1.3 tonnes of 130Te. This paper provides a general overview of the SNO+ experiment, including detector design, construction of process plants, commissioning efforts, electronics upgrades, data acquisition systems, and calibration techniques. The SNO+ collaboration is reusing the acrylic vessel, PMT array, and electronics of the SNO detector, having made a number of experimental upgrades and essential adaptations for use with the liquid scintillator. With low backgrounds and a low energy threshold, the SNO+ collaboration will also pursue a rich physics program beyond the search for 0νββ decay, including studies of geo- and reactor antineutrinos, supernova and solar neutrinos, and exotic physics such as the search for invisible...

Risk factors for immune checkpoint inhibitor colitis: a retrospective multi-center cohort study using electronic health records

Thu, 23 Apr 2026 00:00:00 +0000

BackgroundImmune checkpoint inhibitors (ICIs) are effective for many cancers but often cause immune-related adverse events, particularly gastrointestinal (GI) complications such as colitis. Identifying risk factors for ICI colitis (CIC) could improve patient selection and discover potential mechanisms relevant to idiopathic inflammatory bowel disease (IBD). We aim to identify risk factors with a robust methodological approach in a large multi-center longitudinal cohort.MethodsWe used electronic health record data from six University of California institutions with 10,260 adults on ICIs. Baseline and time-varying predictors were defined based on prior IBD epidemiology studies, including interactions. LASSO Cox regression was applied to data from UCSF Central Data Warehouse to select the most predictive model, with coefficients estimated using multi-center data.Results and conclusionFourteen significant predictors of CIC were identified. The strongest predictors were concurrent...

Imaging Approach to Pediatric and Adolescent Familial Cancer Syndromes

Thu, 23 Apr 2026 00:00:00 +0000

Recent advances in our understanding of the genetic and pathophysiologic mechanism of human malignancies have led to the recognition of frequent hereditary basis of many cancers. Hereditary cancer syndromes, which are now believed to cause up to 5% of human malignancies, are characterized by the early onset of various, multifocal, often advanced malignancies of usually more than one organ system. Frequently, multiple family members are involved. These hereditary cancer syndromes may pose specific diagnostic and therapeutic challenges, as they warrant contemporary paradigms for their screening protocols and targeted therapies. Here, we review imaging approaches to the most common hereditary cancer syndromes, including multiple endocrine neoplasia (MEN) syndromes, von Hippel-Lindau (VHL) syndrome, and Li-Fraumeni cancer syndrome.

Comment on “Delayed Disease Onset Report in UK Biobank: Implications for Prodromal Studies in Parkinson's Disease”

Thu, 23 Apr 2026 00:00:00 +0000

Comment on “Delayed Disease Onset Report in UK Biobank: Implications for Prodromal Studies in Parkinson's Disease”

Voltage-gated potassium channels (Kv) in GtoPdb v.2025.4

Thu, 23 Apr 2026 00:00:00 +0000

The 6TM family of K channels comprises the voltage-gated KV subfamilies, the EAG subfamily (which includes hERG channels), the Ca2+-activated Slo subfamily (actually with 7TM, termed BK) and the Ca2+-activated SK subfamily. These channels possess a pore-forming α subunit that comprises tetramers of identical subunits (homomeric) or of different subunits (heteromeric). Heteromeric channels can only be formed within subfamilies (e.g. Kv1.1 with Kv1.2; Kv7.2 with Kv7.3). The pharmacology largely reflects the subunit composition of the functional channel.Kv7 channelsKv7.1-Kv7.5 (KCNQ1-5) K+ channels are voltage-gated K+ channels with major roles in neurons, muscle cells and epithelia where they underlie physiologically important K+ currents, such as the neuronal M-current and the cardiac IKs. Genetic deficiencies in all five KCNQ genes result in human excitability disorders, including epilepsy, autism spectrum disorders, cardiac arrhythmias and deafness. Thanks to the recent knowledge...

Imaging of COVID-19: CT, MRI, and PET

Thu, 23 Apr 2026 00:00:00 +0000

Soon after reports of a novel coronavirus capable of causing severe pneumonia surfaced in late 2019, expeditious global spread of the Severe Acute Respiratory Distress Syndrome Coronavirus 2 (SARS-CoV-2) forced the World Health Organization to declare an international state of emergency. Although best known for causing symptoms of upper respiratory tract infection in mild cases and fulminant pneumonia in severe disease, Coronavirus Disease 2019 (COVID-19) has also been associated with gastrointestinal, neurologic, cardiac, and hematologic presentations. Despite concerns over poor specificity and undue radiation exposure, chest imaging nonetheless remains central to the initial diagnosis and monitoring of COVID-19 progression, as well as to the evaluation of complications. Classic features on chest CT include ground-glass and reticular opacities with or without superimposed consolidations, frequently presenting in a bilateral, peripheral, and posterior distribution. More recently,...

COVID-19 in pregnancy: a systematic review of chest CT findings and associated clinical features in 427 patients

Thu, 23 Apr 2026 00:00:00 +0000

PURPOSE: Our purpose was to conduct a comprehensive systematic review of all existing literature regarding imaging findings on chest CT and associated clinical features in pregnant patients diagnosed with COVID-19. MATERIALS & METHODS: A literature search was conducted on April 21, 2020 and updated on July 24, 2020 using PubMed, Embase, World Health Organization, and Google Scholar databases. Only studies which described chest CT findings of COVID-19 in pregnant patients were included for analysis. RESULTS: A total of 67 articles and 427 pregnant patients diagnosed with COVID-19 were analyzed. The most frequently encountered pulmonary findings on chest CT were ground-glass opacities (77.2%, 250/324), posterior lung involvement (72.5%, 50/69), multilobar involvement (71.8%, 239/333), bilateral lung involvement (69.4%, 231/333), peripheral distribution (68.1%, 98/144), and consolidation (40.9%, 94/230). Pregnant patients were also found to present more frequently with consolidation...

Coronavirus disease 2019 (COVID-19) pandemic: Review of guidelines for resuming non-urgent imaging and procedures in radiology during Phase II

Thu, 23 Apr 2026 00:00:00 +0000

Since the spread of the coronavirus disease 2019 (COVID-19) was designated as a pandemic by the World Health Organization, health care systems have been forced to adapt rapidly to defer less urgent care during the crisis. The United States (U.S.) has adopted a four-phase approach to decreasing and then resuming non-essential work. Through strong restrictive measures, Phase I slowed the spread of disease, allowing states to safely diagnose, isolate, and treat patients with COVID-19. In support of social distancing measures, non-urgent studies were postponed, and this created a backlog. Now, as states transition to Phase II, restrictions on non-essential activities will ease, and radiology departments must re-establish care while continuing to mitigate the risk of COVID-19 transmission all while accommodating this backlog. In this article, we propose a roadmap that incorporates the current practice guidelines and subject matter consensus statements for the phased reopening of non-urgent...

PREDICTORS FOR PATIENTS UNDERSTANDING REASON FOR HOSPITALIZATION

Thu, 23 Apr 2026 00:00:00 +0000

PREDICTORS FOR PATIENTS UNDERSTANDING REASON FOR HOSPITALIZATION

Latent Tuberculosis Infection Care Cascade Outcomes in Primary Care Clinics in the Tuberculosis Epidemiologic Studies Consortium-III

Thu, 23 Apr 2026 00:00:00 +0000

Purpose Tuberculosis (TB) was the leading infectious cause of death worldwide in 2023. U.S. tuberculosis (TB) cases mostly result from reactivation of latent TB infection (LTBI). LTBI treatment is about 90% effective in preventing TB disease; thus, screening and treatment are essential for U.S. TB elimination efforts. Persons at higher risk of infection seek care at primary care clinics, which represent a critical setting for scaling up TB testing and LTBI treatment. Methods Using longitudinal electronic health record (EHR) data, we described a comprehensive LTBI care cascade among individuals at higher risk of infection seeking care in U.S. primary care clinics – from identification of higher-risk persons through testing, diagnosis, and treatment. Results Among 3.5 million patients, 48% were determined to be at higher risk; 86% were not tested. Among those tested, there was a 17% test positivity rate. Only 61% of persons diagnosed with LTBI were prescribed treatment; 44% did...

MicroRNA-19b Associates with Ago2 in the Amygdala Following Chronic Stress and Regulates the Adrenergic Receptor Beta 1

Thu, 23 Apr 2026 00:00:00 +0000

Activation of the stress response in the presence of diverse challenges requires numerous adaptive molecular and cellular changes. To identify specific microRNA molecules that are altered following chronic stress, mice were subjected to the chronic social defeat procedure. The amygdala from these mice was collected and a screen for microRNAs that were recruited to the RNA-induced silencing complex and differentially expressed between the stressed and unstressed mice was conducted. One of the microRNAs that were significantly altered was microRNA-19b (miR-19b). Bioinformatics analysis revealed the adrenergic receptor β-1 (Adrb1) as a potential target for this microRNA with multiple conserved seed sites. Consistent with its putative regulation by miR-19b, Adrb1 levels were reduced in the basolateral amygdala (BLA) following chronic stress. In vitro studies using luciferase assays showed a direct effect of miR-19b on Adrb1 levels, which were not evident when miR-19b seed sequences...

Pharmacokinetics and Dose Optimization of Ethambutol in Children on First-line Antituberculosis Therapy: An Individual Patient Data Meta-Analysis

Thu, 23 Apr 2026 00:00:00 +0000

BACKGROUND: Tuberculosis affects over a million children annually. Ethambutol (EMB) is a key component of the standard four-drug therapy for drug-susceptible tuberculosis in children, yet comprehensive pharmacokinetic studies have been lacking. We characterized the population pharmacokinetics of EMB through an individual patient data meta-analysis to determine optimal dosing strategies. METHODS: EMB concentrations and individual-level patient data from three studies were analyzed using nonlinear mixed effects modeling. Simulations compared current World Health Organization (WHO)-recommended doses and model-informed optimized doses. Target exposure distribution (AUC 13.8-17.7 mg·h/L), which had been previously established in adult clinical trials, guided dose optimization. RESULTS: A total of 220 participants, aged from 0.2 to 15 years and weighing between 3.6 and 43.0 kg, contributed 1,085 plasma concentrations of EMB for model development. The effect of weight was incorporated...

NANETS/SNMMI Procedure Standard for Somatostatin Receptor–Based Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE

Wed, 22 Apr 2026 00:00:00 +0000

With the recent approval of ¹⁷⁷Lu-DOTATATE for use in gastroenteropancreatic neuroendocrine tumors, access to peptide receptor radionuclide therapy is increasing. Representatives from the North American Neuroendocrine Tumor Society and the Society of Nuclear Medicine and Molecular Imaging collaborated to develop a practical consensus guideline for the administration of ¹⁷⁷Lu-DOTATATE. In this paper, we discuss patient screening, maintenance somatostatin analog therapy requirements, treatment location and room preparation, drug administration, and patient release as well as strategies for radiation safety, toxicity monitoring, management of potential complications, and follow-up. Controversies regarding the role of radiation dosimetry are discussed as well. This document is designed to provide practical guidance on how to safely treat patients with this therapy.

Muscle mass, function and performance across the adult lifespan: the study of muscle, mobility and ageing

Wed, 22 Apr 2026 00:00:00 +0000

BACKGROUND: D3-creatine (D3Cr) dilution provides an accurate estimate of total body skeletal muscle mass, yet few studies have examined its relationship with function and performance across the lifespan, particularly before age 70. We modelled the association of age with D₃Cr muscle mass across adulthood and compared it with age-related differences in muscle function and performance. METHODS: Adults aged 30-69 years (n = 69; 33 men) and 70+ (n = 826; 344 men) from the Study of Muscle, Mobility and Ageing completed assessments of D3Cr muscle mass, magnetic resonance imaging (MRI) thigh muscle volume, 1-RM leg strength and leg extension power, 4 m walking speed and cardiorespiratory fitness (VO2 peak). Regression models estimated annualised percent differences with age for each outcome. RESULTS: In men, progressively lower D₃Cr muscle mass with advancing age (-0.5%/year in young adults to -1.4%/year in oldest-old) paralleled the pattern observed for leg strength and walking...

In Response to Chad Kollas Reply “Right Assessment, Wrong Conclusion”

Wed, 22 Apr 2026 00:00:00 +0000

In Response to Chad Kollas Reply “Right Assessment, Wrong Conclusion”

Polycyclic aromatic hydrocarbons and cannabinoids in secondhand cannabis smoke

Wed, 22 Apr 2026 00:00:00 +0000

The legalization of cannabis is exposing more people to secondhand smoke (SHS) generated during cannabis use. Given the serious health effects caused by tobacco SHS, there is a need to assess the potential health effects of exposure to cannabis SHS. As a step toward this, we measured the concentrations of cannabinoids, nicotine and polycyclic aromatic hydrocarbons (PAHs) in air samples collected in public places where cannabis was being consumed. These were compared with concentrations in exhaled aerosols from cannabis smoking and vaping, and in tobacco SHS. Tetrahydrocannabinol concentrations were 22 to 255 µg/m3 in field samples, below the threshold for psychoactive effects. Nicotine concentrations in field samples did not exceed 1 µg/m3. The total PAH concentrations in field samples were from 3.2 to 80.5 ng/m3, depending on location type. By contrast, PAH levels averaged 72 ng/m3 in tobacco SHS and 220 ng/m3 in the more concentrated, exhaled cannabis aerosols. A total of 22...

Association Between Biologic Therapy and Reduced Acute Rhinosinusitis Episodes: A Retrospective Database Study.

Fri, 17 Apr 2026 00:00:00 +0000

Objective

To assess whether biologics (dupilumab, mepolizumab, and omalizumab) used for conditions other than chronic rhinosinusitis with nasal polyps (CRSwNP) reduce the frequency of acute bacterial rhinosinusitis (ABRS) episodes.

Methods

This retrospective cohort study utilized the All of Us Research Program database to identify patients treated with dupilumab, mepolizumab, or omalizumab, excluding those with CRSwNP. A control group matched by race, gender, and comorbidities (asthma, allergic rhinitis, atopic dermatitis, smoking status) was created using propensity score matching (1:1 ratio) and K-nearest neighbors. The primary outcome was the frequency of ABRS episodes in biologic-exposed versus control groups, analyzed using χ² tests to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Out of 2094 subjects, the biologic group had a significantly lower ABRS rate (6%) compared to controls (14%) (OR 0.4349, p < 0.0001)....

Precision Labeling of Native Antibodies with Lock Coupling

Wed, 15 Apr 2026 00:00:00 +0000

The formation of stable protein complexes enables much of biotechnology, but even high-affinity complexes can dissociate, limiting potential applications in biomaterials, bioimaging, nanomedicine, and other protein-based technologies. Here, we describe lock coupling, a simple and selective one-step reaction between interfacial lysine and glutamate or aspartate side chains to form stable isopeptide bonds and be used for the precise labeling of native antibodies. We identify conditions in which short-lived activated esters formed by the aqueous carbodiimide EDC promote isopeptide bond formation specifically at preassociated amine-acid pairs. Indiscriminate cross-linking is minimized by formation of protein complexes before addition of catalyst, use of acidic pH to suppress exposed Lys reactivity, and limiting the aqueous stability of activated esters. For native antibody (Ab) labeling, we show that the small IgG-binding protein GB1 can be covalently attached to the Ab Fc domain...

Type 2 lymphocytes restrict type 3 lymphocytes during liver fibrosis and colocalize in fibroblast niches.

Tue, 14 Apr 2026 00:00:00 +0000

Fibroblasts are dynamic structural cells that direct both beneficial tissue repair and pathological organ fibrosis through interactions with tissue-resident type 2 lymphocytes (T2Ls) and type 3/17 lymphocytes (T3Ls). The cytokines interleukin-13 (IL-13) and IL-17A, produced by T2Ls and T3Ls, respectively, are linked to both tissue inflammation and fibrosis, but how their spatial positioning influences beneficial or pathological organ remodeling remains unclear. Using mouse models of liver injury and fibrosis, three-dimensional microscopy, and spatial transcriptomics, we found an accumulation of periportal and fibrotic tract T2Ls, predominantly group 2 innate lymphoid cells (ILC2s), positioned near T3Ls and niche adventitial fibroblasts and adjacent to discrete profibrotic myofibroblasts. Unexpectedly, T2L ablation worsened both carbon tetrachloride- and bile duct ligation-induced liver fibrosis, accompanied by increased IL-17A⁺ T3Ls, predominantly γδ T cells. In contrast,...

Timing and Convergence of Ensemble Activity Govern Auditory Thalamocortical Transmission.

Mon, 13 Apr 2026 00:00:00 +0000

Coordinated neuronal activity plays an important role in information processing and transmission in the brain. While ensembles' activity provides a more specific and less noisy version of sensory stimulus information than single neurons, their role in information transmission in the auditory pathway remains unclear. We investigated the effects of ensemble activity in the medial geniculate body (MGB) on the activation of neurons in the primary auditory cortex (A1) in female rats. MGB ensembles synchronized within narrow time windows more effectively induced A1 responses than single neurons or ensembles defined in broader time windows. This was facilitated by the convergence of ensemble inputs onto target neurons. Transmission efficacy was higher for narrow-spiking (NS) A1 neurons compared to broad-spiking (BS) neurons. Cortical UP states in isolation had no discernable effect on the transmission efficacy of thalamic cNEs. These findings highlight neuronal ensembles as focal functional...

Auditory cortical forward masking effects in squirrel monkeys with unilateral noise-induced hearing loss

Mon, 13 Apr 2026 00:00:00 +0000

Forward masking provides a sensitive measure of temporal and spectral processing in the auditory system and reflects underlying inhibitory mechanisms in auditory cortex. The present study examined how unilateral, noise-induced hearing loss (NIHL) alters cortical forward-masking properties in the primary auditory cortex (A1) of squirrel monkeys. Multi-unit responses were recorded from A1 of two control and two NIHL animals six months after right-ear acoustic overstimulation (1 kHz, 136 dB SPL, 3 h). Sequential masker-probe tones were presented with a 10 ms interval while masker frequency was varied around each site's best frequency (BF). In control cortex, probe responses were predominantly suppressed by the preceding masker with strong forward suppression centered near BF. In contrast, NIHL animals exhibited markedly fewer suppressive sites and more facilitatory responses. Suppression strength and inhibitory bandwidth were reduced particularly for low-BF neurons near the 1 kHz...

Perceived benefits of community-based TB preventive treatment in children in Uganda: When she sees other children getting the same medication, she will feel not alone.

Mon, 13 Apr 2026 00:00:00 +0000

Tuberculosis preventive treatment (TPT) uptake among children at risk for TB remains low in sub-Saharan Africa. Community-based TPT delivery is effective at increasing uptake and completion in children compared to clinic-based models, but implementation research is needed to inform scale-up in real-world settings. In this qualitative study, we assessed community and health care provider perspectives on the anticipated benefits and barriers of a community-based TPT differentiated delivery model comprising three components: (1) initial screening and TPT initiation at the nearest public health facility; (2) community health worker (CHW)-led TB education with community-based medication delivery; and (3) CHW-facilitated delivery in a Community Adherence Group (CAG). From 5 September to 12 October 2023, we conducted in-depth semi-structured interviews (N = 20) with a purposively selected sample of six public health care providers, four CHWs, and ten caregivers of children with latent...

Prioritizing cervical cancer screening services during the COVID-19 pandemic: Response of an academic medical center and a public safety net hospital in California