Transactions of the American Clinical and Climatological Association最新文献

Health care-associated infections (HAIs) remain a major challenge in the U.S. health care system, with Clostridioides difficile (C. difficile or C. diff) being the most prevalent. The use of antibiotics disrupts the gut microbiota, predisposing individuals to infection. Recent research has highlighted the role of the gut microbiome in preventing and treating C. difficile infections (CDI). Strategies such as fecal microbiota transplantation (FMT) and live biotherapeutic products (LBPs) offer promising alternatives to conventional antibiotic treatments. This paper explores the mechanisms underlying CDI, the role of the gut microbiome in infection prevention, and innovative therapeutic approaches.

The scientific research article is a careful balance of factual information and social interaction in which academic writers need to make the results of their research public and persuasive. Although scientific communication through journal articles has a history spanning over 350 years, there remains significant potential for improvement. I hypothesize that compositional strategies employed by artists-particularly landscape artists-can enhance academic scientific writing by promoting interaction and improving persuasive communication. This article explores how principles fundamental to landscape art, such as notan, focal point, element hierarchy, the 80/20 rule, simplification, and repetition, can enhance scientific writing. Awareness and adoption of these artistic techniques can make the scientific writing process more engaging and enjoyable for lovers of science and art alike.

The National Institutes of Health's All of Us Research Program is building one of the most comprehensive research cohorts in the United States. Launched in 2018, the program has enrolled more than 849,000 individuals to empower precision medicine relevant to all populations. Participants in All of Us share complete surveys, share electronic health records, donate biospecimens, and contribute other data, such as wearable device data. To date, All of Us has generated whole genome sequences for more than 414,000 participants and returned actionable genetic health information to more than 100,000. By examining the technological, engagement, and data integration challenges encountered, this paper highlights how All of Us builds on pioneering efforts in biomedical research and points to future directions, including expanded data sharing, international cooperation, and the potential to drive transformative discoveries in personalized health care. Current successes also highlight necessary future directions: even larger and more comprehensive cohorts, better data sharing, and more international cooperation.

Stroke is the fifth leading cause of death in the United States and disproportionately affects Black Americans. The Reasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort study is investigating why this disparity exists by comparing Black and White adults age 45+. Seminal findings included that higher stroke incidence in Black than in White persons, but not higher case fatality, drives the disparity. Higher prevalence of stroke risk factors in Black participants, especially hypertension and diabetes, explained 50% of the racial disparity. Elevated lipoprotein(a) was three times more frequent in Black participants and was a race-specific stroke risk factor only among Black participants. Higher interleukin-6 was a strong stroke risk factor in both Black and White participants with a hazard ratio of 2.0 for concentrations in the top versus bottom quartile. In mediation analysis, higher interleukin-6 with presence of stroke risk factors party explained the race disparity in stroke. Findings highlight the potential that prevention of stroke risk factors, treatment of higher Lp(a), and inflammation reduction have in reducing the race disparity in stroke.

Even before the COVID-19 pandemic, acute respiratory infections represented one of the most common reasons for patients to seek urgent medical care. S. pneumoniae is one of the most frequent bacterial causes of acute respiratory infections, especially community-acquired pneumonia. In the latter part of the twentieth century, the emergence of multidrug resistance among clinical isolates of S. pneumoniae threatened to render standard empiric antibiotic therapy ineffective. One of the biggest drivers of pneumococcal drug resistance is antibiotic overuse, among both adults and children. While the introduction of the pneumococcal conjugate vaccine in 2000 dramatically impacted the overall incidence of pneumococcal pneumonia in both children and adults, the levels of antibiotic resistance have remained significant. To reduce the overuse of antibiotics requires multidimensional interventions targeting patients, clinicians, and health systems. Studies have demonstrated improvement in this area, but the quality gap remains high. Future work will focus on organizational strategies and policies that optimize antibiotic use for patients with antibiotic responsive acute illnesses.