VA Pittsburgh Healthcare System

Subcellular compartment determines signal dominance: Endosomal cAMP overrides concurrent plasma membrane RhoA activation from a single receptor

Cells convey information not only via the identity of activated signaling pathways but also through the subcellular location where those signals originate. Whether spatially distinct signals from a single activated receptor compete to determine net cellular output has remained un...

Quantifying Meaningful Information in Incorrect Naming Responses Following Strategic Word Retrieval Treatment in Primary Progressive Aphasia

Purpose: Anomia is a core feature of both logopenic variant primary progressive aphasia (lvPPA) and semantic variant primary progressive aphasia (svPPA). Naming interventions targeting self-cueing in persons with lvPPA and svPPA have been shown to promote generalized improvement...

Early Experience of a Dedicated Outpatient Palliative Hepatology Clinic: Referral Patterns, Patient Characteristics, and Outcomes

Background and Aims Dedicated outpatient palliative hepatology clinics remain uncommon despite the substantial symptom burden of advanced liver disease. We describe the early experience of a newly established outpatient palliative hepatology clinic. Methods We retrospectively rev...

Discordance between actual care and recommendations by a reinforcement learning model for sepsis

Fluid and vasopressor management of sepsis requires a complex set of sequential treatment decisions tailored to individual responses. We examined the frequency and implications of disagreement between reinforcement-learning (RL), using the AI Clinician as a test example, and actu...

Novel Mechanometabolic Signaling Cascade Linking Efferocytosis to Inflammation Resolution

BACKGROUND: Apoptotic cell clearance by macrophages, termed efferocytosis , resolves inflammation and promotes tissue repair, whereas defective efferocytosis contributes to chronic inflammatory diseases such as atherosclerosis. Putrescine biosynthesis, driven by the rate-limiting...

Preliminary accuracy, inter- and intra-rater reliability of a 4-point cervical artery dissection diagnostic decision support tool in an ambulatory setting using real and simulated cases: a quality improvement project

BACKGROUND: Cervical artery dissection (CeAD) is a rare but life-threatening condition that commonly presents with non-specific symptoms such as neck and head pain, complicating early recognition in ambulatory care settings. The CeAD diagnostic decision support tool (DDST) is a 4...

MELD-based allocation disproportionately prioritizes alcohol-associated hepatitis for liver transplant

Early liver transplantation (LT) is increasingly being adopted as a treatment for alcohol-associated hepatitis (AAH), but the optimal strategy for incorporating AAH into the existing organ allocation framework remains unclear. This retrospective cohort study used the United Netwo...

Spatial transcriptomics reveals atorvastatin modulates the tumor microenvironment to suppress breast cancer liver metastatic outgrowth

Metastatic breast cancer remains incurable, underscoring the need for novel therapeutic strategies. Epidemiological and preclinical evidence suggests statins suppress metastatic outgrowth, however the underlying mechanisms remain unclear. We employed high-resolution spatial trans...

Radiology considerations for the PREMIUM study: a multicenter randomized controlled trial of abbreviated MRI versus ultrasound for liver cancer screening in cirrhosis

Abstract This paper describes the rationale and radiology considerations in the implementation of the Preventing Liver Cancer Mortality through Imaging with Ultrasound versus MRI (PREMIUM) study. PREMIUM is a multicenter, randomized controlled trial sponsored by the Department of...

Dose and Time Dependent Elevations of Initial Unfractionated Heparin Anti-Xa Levels Associated With Low Molecular Weight Heparin Administration

Background: Intravenous unfractionated heparin (UFH) is routinely utilized for anticoagulation in acute care patients. Appropriate laboratory monitoring is an essential component of UFH therapy, including minimizing the effect of variables that interfere with the monitoring assay...