Faculty Bibliography

Point-of-care ultrasound (POCUS) offers unique, real-time advantages for assessing liver disease, benefiting both health care providers and patients. It has been shown to enhance patient care and satisfaction across a variety of medical specialties. Although liver POCUS is practiced widely in many parts of the world, its use in the United States remains limited. Liver POCUS enables rapid assessment of specific hepatic conditions, including both vascular and parenchymal abnormalities, and can play a key role in timely management decision-making-such as guiding the use of diuretics or volume expanders. Once liver POCUS is established, ultrasonography-enabled procedures, such as procedure guidance and shear wave elastography, may be adopted and enrich the practice of hepatology in the future. This paper serves as a summary of the American Association for the Study of Liver Diseases' (AASLD) current position on liver POCUS, offering proposed imaging protocols, recommendations for training and credentialing, and practical guidelines for implementation in clinical settings.

BACKGROUND:Major depressive disorder and generalized anxiety disorder frequently co-occur, leading to heterogeneous presentations that complicate diagnosis and treatment. While diagnostic categories often obscure symptom variability, network approaches offer a powerful way to examine how symptoms relate to one another within and across conditions. By identifying symptom clusters, these methods can provide insights into potential mechanisms of comorbidity and symptom maintenance and may ultimately help guide more personalized treatment. METHODS: = 10,718), we examined the relationship between baseline cluster probabilities and three outcome trajectories over 12 weeks of treatment. RESULTS:We found four baseline symptom clusters relating to Affective Dysregulation, Worries, Neurovegetative symptoms, and Hyperarousal. Affective Dysregulation and Neurovegetative clusters were associated with poorer outcomes, whereas Worries and Hyperarousal were associated with recovery over partial improvement; Hyperarousal also differentiated recovery from non-response. CONCLUSIONS:Symptom clusters derived from standard screening measures were associated with differential treatment trajectories. Targeting these symptom configurations may be particularly effective at disrupting multiple symptom pathways. Future research should examine whether personalized treatment strategies that consider symptom clusters based on simple screening in practice settings yield greater clinical improvement than traditional diagnostic categories.

Children and youth seeking asylum encounter a range of unique experiences and obstacles in their efforts to secure protected immigration status. This study used a consensual qualitative research approach to analyze data that centered lived experience voice gathered from first-person interviews with 12 adults, six men, and six women aged 18-29 years, who entered the United States as minor asylum seekers. Results indicated that they experienced premigratory exposure to violence or harm, psychological distress, financial instability, and obstacles to health care. Participants also reported fear, adversity, and time spent in immigration detention centers as they sought asylum in the United States. Further, they disclosed current mental health concerns, as well as barriers to education, employment, and legal representation. Participants identified a series of effective internal and external supports they leveraged to adaptively respond to systemic challenges, described their aspirations for the future, and provided recommendations for guiding clinicians in service provision. The results of the study can inform psychologists and allied professionals about the impact of exposure to harm that asylum-seeking minors face, this population's resilience, and possible strengths-based strategies for responding to the needs of young people experiencing forced displacement and areas of potential advocacy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PURPOSE/UNASSIGNED:To evaluate whether a non-invasive approach to treat keratoconus with corneal cross-linking (CXL) using oral riboflavin and natural sunlight could represent a cost-effective alternative. METHODS/UNASSIGNED:In a prospective, controlled study, 16 male New Zealand White rabbits (32 eyes) underwent a two-step protocol. Step 1 quantified stromal riboflavin in 4 rabbits (8 eyes) after 14 days of oral riboflavin (6 mg/kg/day). Step 2 randomized the remaining 12 rabbits (24 eyes) 1:1 to oral riboflavin plus natural sunlight or sunlight alone. After a 2,700 klux·h cumulative sunlight dose, corneal biomechanics were assessed by optical coherence tomography elastography and uniaxial stress-strain extensometry. RESULTS/UNASSIGNED:= .039), consistent with reduced apparent stiffness. CONCLUSIONS/UNASSIGNED:Oral riboflavin combined with ambient sunlight did not induce corneal stiffening under the tested conditions. Stromal riboflavin levels were nearly 500-fold lower than those achieved with standard CXL, indicating the tested approach is unlikely to serve as an effective standalone cross-linking strategy. The observed posterior corneal stiffness reduction may reflect ultraviolet-A-induced stromal degradation or subthreshold photochemical effects rather than true cross-linking.

L-Glutamic acid (L-Glu) is central to carbon-nitrogen metabolism, yet its ability to improve starch quality by regulating grain metabolism and by directly modulating starch structure remains unclear. In this study, we integrated a field experiment with an in vitro experiment and combined untargeted metabolomics, microscopy, structural characterization, physicochemical and processing property analyses, and molecular dynamics simulations. It was found that under drought, L-Glu spraying reprogrammed the grain metabolome, with pathway enrichment in aminoacyl-tRNA biosynthesis and starch/sucrose metabolism. In vitro, L-Glu increased the full width at half maximum of the Raman band at 480 cm^-1 and altered the FTIR absorbance ratio of 1047/1022 cm^-1. L-Glu enhanced in vitro digestibility and reduced swelling power and paste transparency, while decreasing setback viscosity, suggesting a potential inhibition of short-term starch retrogradation; however, freeze-thaw stability was reduced. Microscopy revealed a more disordered gel network after L-Glu addition. Simulations showed that L-Glu formed 1.47-2.18 persistent hydrogen bonds with amylose chain per system and extensive hydrogen bonds with water.

Daraxonrasib is an orally bioavailable RAS(ON) multi-selective tri-complex inhibitor of the oncogenic mutant and wild-type variants of N, H and KRAS. We previously reported encouraging efficacy in a phase 1/2 clinical trial evaluating daraxonrasib monotherapy at clinically active dose levels in patients with previously treated, RAS mutant metastatic pancreatic adenocarcinoma (PDAC), providing the basis for confirmatory evaluation in the randomized phase 3 RASolute 302 clinical trial. Here we report mechanisms of acquired resistance to daraxonrasib monotherapy observed through targeted sequencing of over 800 genes in paired pretreatment and end of treatment circulating tumor DNA samples from 44 patients in the phase 1/2 clinical trial. Treatment-emergent genomic alterations in the RAS signaling pathway were observed in more than half (26 of 44; 59%) of these patients, including, most notably, mutant KRAS amplifications in one-third (16 of 44; 36%), as well as alterations in receptor tyrosine kinase (RTK) (4 of 44; 9%), MAPK (11 of 44; 25%) and PI3K (4 of 44; 9%) pathways. Notably, no acquired secondary KRAS mutations were observed, distinct from resistance profiles of mutant-selective KRAS G12C(OFF) inhibitors. To corroborate these clinical findings, we found, or mechanistically established, concordant mechanisms of daraxonrasib resistance in human and murine preclinical models of PDAC, including mutant KRAS and MYC amplification and RTK upregulation, with these alterations guiding various combination therapy concepts. Notably, daraxonrasib combined with agents targeting DNA damage response, RTKs or the mutant-selective RAS(ON) G12D inhibitor zoldonrasib averted resistance in preclinical models. Collectively, these results show that most daraxonrasib genomic resistance mechanisms drive reactivation of RAS pathway signaling and guide potential combination strategies in PDAC for further investigation.

Explaining the low-temperature limit of trees requires in situ information on the actual temperature conditions, the trees' phenology and freezing tolerance. Here, we report the seasonal course of freezing resistance and its response to local temperature in species of Larix and Abies, forming the treeline (4350-4400 m) in the south-eastern Himalayas, and Quercus and tree-size Rhododendron, reaching their upper limit in the immediate neighborhood (4270-4290 m). By linking tree-crown temperatures with on-site air temperature, we can utilize long-term meteorological records to hindcast critical freezing events. Deciduous Larix flushes earliest and exhibits the greatest freezing tolerance and largest safety margin. The evergreen species flush 2 months later and operate near their freezing damage limit. The conifers can compensate for freezing damage by rapid resprouting from small auxiliary buds, not an option for Quercus and Rhododendron with their bigger buds. Freezing damage does not appear to constrain the two treeline conifers. Their range limit most likely reflects the general low-temperature growth limit of the tree life form. Freezing tolerance is most likely controlling the upper limits of the evergreen broad-leaved species. The results offer a mechanistic explanation of the range limit of these high-elevation tree species.

This consensus statement represents an update to Mental Health in Elite Athletes: International Olympic Committee Consensus Statement (2019) To advance a more standardised, evidence-based approach to mental health in elite athletes, an International Olympic Committee (IOC) Consensus Group critically evaluated the current science via a systematic literature review, sought consensus using Delphi methodology and provided recommendations relevant to this topic. Key themes include that mental health symptoms and disorders are (1) common among elite athletes; (2) may have sport-related aetiologies and manifestations; and (3) can impact performance. Routine screening for and monitoring of mental health symptoms and disorders in elite athletes using validated instruments is recommended. Management strategies should promote mental well-being in addition to preventing and treating mental health symptoms and disorders. These strategies should address all contributors to mental health symptoms, including factors within the environments in which athletes train and compete. Treatment may include psychotherapy, medication and other culturally or contextually appropriate modalities. With appropriate support and treatment, many athletes experiencing mental health symptoms and disorders can continue to train and compete safely, but sometimes modification of sport participation may be necessary. Elite athletes who are transitioning out of sport, elite Para athletes and elite young (adolescent) athletes are relatively understudied and may have distinct mental health concerns, in addition to those impacting elite athletes in general.