This issue includes new clinical practice guidelines for management of patients at risk for suicide from the VA and the DoD. The editorialist discusses how these recommendations reflect the state of the evidence, in terms of not only achievements but also how little we know with certainty.
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A recently announced change in U.S. Department of Health and Human Services policy would dramatically restrict, and potentially end, fetal tissue research. The authors discuss the potential implications for medical progress and public health.
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One of the hallmarks of a trustworthy clinical guideline or guidance statement is a comprehensive process for disclosure of interests (DOI) and management of conflicts of interest (COIs). The American College of Physicians (ACP) Clinical Guidelines Committee (CGC) aims to disclose all health care–related interests and manage conflicts in a manner that is transparent, proportional, and consistent. Any person involved in the development of an ACP clinical guideline or guidance statement must disclose...
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Background:Suicide is a growing public health problem, with the national rate in the United States increasing by 30% from 2000 to 2016.Purpose:To assess the benefits and harms of nonpharmacologic and pharmacologic interventions to prevent suicide and reduce suicide behaviors in at-risk adults.Data Sources:MEDLINE, EMBASE, PsycINFO, and other databases from November 2011 through May 2018.Study Selection:Systematic reviews (SRs) and randomized controlled trials (RCTs) that assessed nonpharmacologic...
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The editorialists discuss the importance of Whitney and colleagues' findings to patients, health professionals, policymakers, and researchers.
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Background:Delirium is common in hospitalized patients and is associated with worse outcomes. Antipsychotics are commonly used; however, the associated benefits and harms are unclear.Purpose:To conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults.Data Sources:PubMed, Embase, CENTRAL, CINAHL, and PsycINFO from inception to July 2019 without language restrictions.Study Selection:Randomized controlled trials (RCTs) of antipsychotic versus placebo...
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Background:Delirium is an acute disorder marked by impairments in attention and cognition, caused by an underlying medical problem. Antipsychotics are used to prevent delirium, but their benefits and harms are unclear.Purpose:To conduct a systematic review evaluating the benefits and harms of antipsychotics for prevention of delirium in adults.Data Sources:PubMed, Embase, CENTRAL, CINAHL, and PsycINFO from inception through July 2019, without restrictions based on study setting, language of publication,...
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In this issue, Schwabl and colleagues begin to address the fate of ingested microplastics by examining whether they can be detected in human stool. The editorialists discuss the findings and the priorities for future research.
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Background:Microplastics are ubiquitous in natural environments. Ingestion of microplastics has been described in marine organisms, whereby particles may enter the food chain.Objective:To examine human feces for the presence of microplastics to determine whether humans involuntarily ingest them.Design:Prospective case series in which participants completed a food diary and sampled stool according to step-by-step instructions.Setting:Europe and Asia.Participants:Eight healthy volunteers aged 33 to...
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Nikooie and colleagues systematically reviewed the evidence on treatment of delirium, particularly focusing on antipsychotics. The editorial discusses the findings, why we need to abandon old habits of using antipsychotics to treat delirium, and priorities for future research.
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Background:Mutations in the LMNA (lamin A/C) gene have been associated with neuromuscular and cardiac manifestations, but the clinical implications of these signs are not well understood.Objective:To learn more about the natural history of LMNA-related disease.Design:Observational study.Setting:13 clinical centers in Italy from 2000 through 2018.Patients:164 carriers of an LMNA mutation.Measurements:Detailed cardiologic and neurologic evaluation at study enrollment and for a median of 10 years of...
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This study was performed to identify the prognostic impact of lymphovascular invasion (LVI) in patients with upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). A systematic search in PubMed, Embase, and the Cochrane Library was performed to identify relevant studies. The outcomes of interest, including progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS), were extracted, and the pooled hazard ratios (HRs) and 95% confidence...
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Diversity is a hallmark of life and it shows up in unexpected places. A multi-national team of evolutionary biologists investigated how two types of poison frog co-exist when we expect only one. An innovative study offers new perspectives on chemical defense.
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Abstract Aspects of personality in nonhuman primates have been linked to health, social relationships, and life history outcomes. In humans as well as nonhuman primates, facial morphology is associated with assertiveness, aggression, and measures of dominance status. In this study we aimed to examine the relationship among facial morphology, age, sex, dominance status, and ratings on the personality dimensions Confidence, Openness, Assertiveness, Friendliness, Activity, and Anxiety...
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Abstract Coastal areas prone to flooding are relatively neglected in primate studies. Eight out of 29 known populations of Critically Endangered Sapajus flavius occur in areas very close to, or containing, mangrove and várzea (i.e., tidal forests) forests, suggesting that these habitats are important for the species. We monitored Sapajus flavius in a mosaic of mangrove forest, estuarine várzea forest, and terra firme forest (i.e., nonfloodable forest) in northeastern Brazil. We...
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Abstract To evaluate the effect of high-intensity laser therapy (HILT) in patients with calcaneal spur. The patients were randomized to receive either HILT + exercise (n = 21) (five times a week for a period of 3 weeks) or placebo HILT + exercise (n = 21) (five times a week for a period of 3 weeks). Pain severity (with visual analog scale (VAS) and with Roles and Maudsley score (RMS)), functionality (with Foot and Ankle Outcome Score (FAOS)), plantar pressure measurement, and quality...
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Abstract Urachal anomalies are classified into four types depending on the level of persistence of the embryonic urachal remnants between the urinary bladder and the umbilicus: patent urachus, umbilical–urachal sinus, urachal cyst, and vesico-urachal diverticulum. Due to the increasing use of cross-sectional imaging, urachal anomalies are frequently detected as incidental findings. Imaging plays a pivotal role in the initial diagnosis, evaluation of complications, treatment follow-up,...
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Abstract Although the niche differentiation of anammox bacteria has been extensively observed in a lab-scale reactor, the inherent mechanism for this ecological phenomenon is still elusive. Here, we combined the long-term reactor operation, genome-centered metagenome, and metatranscriptome analyses to gain insight into the substrate competition and niche differentiation of Candidatus Jettenia and Candidatus Brocadia. After 146 days of operation, we found the anammox bacterial population...
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Abstract Background Ebiino, a form of Infant Oral Mutilation (IOM), involves the gauging or enucleation of primary canine tooth buds in infants, and is believed to be a form of remedy to a range of childhood diseases. The effects of this practice have ranged from the child experiencing excessive bleeding, opportunistic infections and even death, besides the potential negative dental effects on primary and the developing permanent...
Mon Sep 02, 2019 03:00
Abstract Reliable prediction of epileptic seizures is of prime importance as it can drastically change the quality of life for patients. This study aims to propose a real-time low computational approach for the prediction of epileptic seizures and to present an efficient hardware implementation of this approach for portable prediction systems. Three levels of feature extraction are performed to characterize the pre-ictal activities of the EEG signal. In the first-level, the line...
Mon Sep 02, 2019 03:00
Nature, Published online: 02 September 2019; doi:10.1038/d41586-019-02631-3Genetic modification to enable industrial-scale production of cannabinoids, how scientists are investigating a deadly Russian explosion and an ambitious plan to improve mental-health support for graduate students.
Mon Sep 02, 2019 03:00
Nature, Published online: 02 September 2019; doi:10.1038/d41586-019-02602-8Robert P. Crease enjoys Sean Carroll’s foray into a 60-year-old theory.
Mon Sep 02, 2019 03:00
Nature, Published online: 02 September 2019; doi:10.1038/d41586-019-02597-2The Japanese woman’s vision has improved since the transplant, say her doctors.
Mon Sep 02, 2019 03:00
Nature, Published online: 02 September 2019; doi:10.1038/s41586-019-1529-0Comparisons between past regional drivers of precipitation extremes found time series data from Lake Ohrid and modern climate models of the Mediterranean may help to reduce simulation uncertainties in predictions of the Mediterranean climate.
Mon Sep 02, 2019 03:00
Nature, Published online: 02 September 2019; doi:10.1038/d41586-019-02619-zHow workflow tools can make your computational methods portable, maintainable, reproducible and shareable.
Mon Sep 02, 2019 03:00
Mon Sep 02, 2019 03:00
Oncogenesis, Published online: 02 September 2019; doi:10.1038/s41389-019-0156-9NCAM1/FGF module serves as a putative pleuropulmonary blastoma therapeutic target
Mon Sep 02, 2019 03:00
The use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment ...
Mon Sep 02, 2019 03:00
Abstract Most of the anatomic variations of the extensor hallucis longus (EHL) muscle are related to the tendon of insertion. We show a double origin of the EHL from the medial aspect of the fibula and the lateral aspect of the tibia. A 27-year-old male with a double closed fracture of tibia and fibula showed an involuntary extension of the big toe during foot plantar flexion after surgery. A tendon fibrosis by the fixation plates could be the cause of the foot functional alteration....
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Fri Aug 30, 2019 03:00
Summary The diagnosis of cutaneous mycobacterial infections may be challenging. Owing to the broad spectrum of their clinical presentations, mycobacterioses have to be considered as differential diagnoses to many inflammatory dermatoses. Diagnostic measures comprise histology including special staining, cultures and molecular microbiological examinations as well as the detection of cellular immune reactions of the patient by means of interferon‐γ release assays and skin testing. Clinicians should...
Mon Sep 02, 2019 12:27
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