Lifespan Trajectories of Asymmetry in White Matter Tracts.
Bogdanov S, Kanakaraj P, Kim ME, Samir J, Gao C, Ramadass K, Rudravaram G, Newlin NR, Archer D, Hohman TJ, Jefferson AL, Morgan VL, Roche A, Englot DJ, Resnick SM, Beason Held LL, Cutting LE, Barquero LA, D’Archangel MA, Nguyen TQ, Humphreys KL, Niu Y, Vinci-Booher S, Cascio CJ; HABS‐HD Study Team; Alzheimer’s Disease Neuroimaging Initiative; BIOCARD Study Team; Li Z, Vandekar SN, Zhang P, Gore JC, Forkel SJ, Landman BA, Schilling KG.
Hum Brain Mapp. 2026 Jun 1;47(8):e70519. doi: 10.1002/hbm.70519.
PMID: 42249731 Free PMC article.
Abstract: Asymmetry in white matter is believed to give rise to the brain’s capacity for specialized processing and is involved in the lateralization of various cognitive processes, such as language and visuo-spatial reasoning. Although studies of white matter asymmetry have been previously documented, they have often been constrained by limited age ranges, sample sizes, or the scope of the tracts and structural features examined. While normative lifespan charts for brain structures are emerging, comprehensive charts detailing white matter asymmetries across numerous pathways and diverse structural measures have been notably absent. This study addresses this gap by leveraging a large-scale dataset of 35,120 typically developing and aging individuals, ranging from 0 to 100 years of age, from 50 primary neuroimaging studies. We generated comprehensive lifespan trajectories for 30 lateralized association and projection white matter tracts, examining six distinct microstructural and macrostructural features of these pathways. Our findings reveal that: (1) asymmetries are widespread across the brain’s white matter and are present in all 30 pathways; (2) for a given pathway, the degree and direction of asymmetry differ between features of tissue microstructure and pathway macrostructure; (3) asymmetries vary across and within pathway types (association and projection tracts); and (4) these asymmetries are not static, following unique trajectories across the lifespan, with distinct changes during development, and a general trend of becoming more asymmetric with increasing age (particularly in later adulthood) across pathways. This study represents the most extensive characterization of white matter asymmetry across the lifespan to date, charting how lateralization patterns emerge, mature, and change throughout life. It provides a foundational resource for understanding the principles of white matter organization from early to late life, its relation to functional specialization and inter-individual variability, and offers a key reference for interpreting deviations during healthy development and aging as well as those associated with clinical populations.
Keywords: asymmetry; diffusion MRI; lateralization; lifespan development; tractography; white matter.
A metabolic boost to mRNA vaccines.
Chada NC, Wilson JT.
Nat Mater. 2026 Jun 12. doi: 10.1038/s41563-026-02628-0. Online ahead of print.
PMID: 42286109 No abstract available.
Staphylococcus aureus ZigA is implicated in survival in zinc-deplete and genotoxic environments.
Enriquez KT, Weiss A, Perera YR, Bhatia I, Togashi M, Akizuki T, McDonald WH, Chazin WJ, Skaar EP.
Microbiol Spectr. 2026 Jun 11:e0045426. doi: 10.1128/spectrum.00454-26. Online ahead of print.
PMID: 42274258 Free article.
Abstract: Zinc is a trace nutrient transition metal important to the host-microbe interface, as zinc is a cofactor for upwards of 10% of the pan-proteome. Given the importance of first-row transition metals, including zinc, to cellular life, it is predicted that Staphylococcus aureus and other pathogens have developed methods to distribute intracellular zinc across a hierarchy of protein clients. COG0523 proteins are a family of GTPase proteins present in all domains of life that act as post-translational regulators of client activity through direct protein-protein interactions. The pathogen S. aureus maintains three predicted COG0523 proteins, including ZigA. We confirm that S. aureus zigA is regulated by the zinc-responsive transcriptional regulator Zur. We further demonstrate that ZigA exhibits zinc-dependent GTPase activity and, in the presence of GTP, ZigA dimerizes. Co-immunoprecipitation and yeast-2-hybrid approaches resulted in a prioritized list of potential interacting partners for ZigA, including proteins involved in DNA repair, and in protection against oxidative stress. The loss of ZigA resulted in modest growth and survival defects when S. aureus experiences low zinc and DNA-damaging stresses, including UV crosslinking and reactive oxygen species. The loss of ZigA was not associated with phenotypes in the setting of other stressors, including iron limitation, antibiotic use, or stressors associated with COG0523 activity in other bacteria. During systemic infection, the loss of ZigA appears to only marginally impact S. aureus pathogenesis in the lung. Taken together, these data suggest that Zur-regulated ZigA may act as a dimer to support zinc-dependent, DNA damage repair by multiple mechanisms.
Importance: In this work, Enriquez et al. study the response of Staphylococcus aureus to zinc limitation. Among these genes are those encoding the COG0523 proteins, which in bacteria and eukaryotes can act as metallochaperones. Zinc plays critical roles in S. aureus DNA damage repair machinery, which is particularly important during infection. This work proposes COG0523 protein ZigA as a minor contributor to staphylococcal pathogenesis in zinc-limited, genotoxic environments. Biochemical approaches suggest that ZigA dimerizes in the presence of GTP and that GTP activity is accelerated in the presence of zinc. Furthermore, the loss of ZigA results in modest S. aureus growth and survival defects associated with low-zinc and DNA-damaging environments. Taken together, these data suggest that Zur-regulated ZigA may act as a dimer to support zinc-dependent, DNA damage repair by multiple mechanisms.
Keywords: COG0523 proteins; Staphylococcus aureus; nutritional immunity; zinc; zinc-binding proteins.
Updating CMV protocols in lung transplant patients: a single-center case study modeling use of generative AI for antimicrobial stewardship protocol development and economic impact analysis.
Enriquez KT, Dulanto Chiang A, Smiley C, Staub M.
Infect Control Hosp Epidemiol. 2026 Jun 8:1-8. doi: 10.1017/ice.2026.10480. Online ahead of print.
PMID: 42252971
Abstract
Objective: Antimicrobial Stewardship Programs (ASPs) need healthcare economic analyses to support and inform ASP strategies. This work aimed to determine whether widely available artificial intelligence (AI) platforms like Microsoft CopilotTM could facilitate healthcare economics analyses for ASP programs without dedicated healthcare economic supports.
Design: AI (Microsoft CopilotTM) was prompted to develop a cytomegalovirus prophylaxis protocol for lung transplant recipients using only PubMed-indexed articles. CopilotTM was then prompted to produce probabilistic samples of simulated patients from aggregate statistics of a 165-patient cohort from Vanderbilt University Medical Center and to analyze cost-effectiveness across four distinct cytomegalovirus prophylaxis protocols, including its own.
Setting: Tertiary care academic medical center, including outpatient and inpatient environments.
Patients or participants: Simulated patient data was developed via random, single-blind, probabilistic selection from pre-defined aggregate cohort statistics.
Results: The AI-generated prophylaxis protocol was evidence-based without hallucination, but this conservative protocol relied on outdated evidence and was associated with significant increases in expected per-patient cost (mean +$4740, P < .01) compared to recent guideline-based and institutional protocols. AI independently identified and executed sensitivity analyses, which revealed that in this simplified model, letermovir use had a large impact on expected per-patient cost.
Conclusions: The AI-proposed protocol was less cost-effective, but data suggest that careful prompting can provide appropriate PubMed-indexed literature to support ASP protocol development. Additionally, CoPilotTM provided a thorough cost-effectiveness analysis comparing all potential and existing protocols. With appropriate oversight, AI and Microsoft CopilotTM can conduct healthcare economic analyses suitable for ASP strategic planning and implementation.
State Medicaid Programs Face Increased Spending On Medicare Premiums.
Fernandez S, Bunker J, Kosar CM, Nothelle S, Samuel LJ, Thomas KS, Keohane LM.
Health Aff (Millwood). 2026 Jun;45(6):646-653. doi: 10.1377/hlthaff.2025.01429.
PMID: 42224627
Abstract: Medicaid covers Medicare premiums and out-of-pocket expenses for low-income older adults, who make up a growing segment of the US population. Using administrative data, we characterized the change in the number of beneficiaries dually enrolled in Medicare and Medicaid and corresponding changes in Medicaid spending on Medicare Part A and Part B premiums during the period 2013-24. The number of dually enrolled beneficiaries increased by 27 percent, while Medicaid spending on Medicare premiums nearly doubled, primarily as a result of growing Part B premium spending. We estimated that at least half of the growth in Part B premium spending was attributed to the increasing per beneficiary Part B premium cost over time, with a smaller portion attributed to rising enrollment. Dual enrollment per capita increased in all but nine states. State Medicaid programs face a greater burden from rising Part B premium costs, yet they have little opportunity to control this spending without federal action.
Evidence-based Guidelines for Appropriate and Timely Management of Acute Spine Injuries in Athletes.
Okonkwo DD, Jonzzon S, Zuckerman SL, Abtahi AM.
Sports Med Arthrosc Rev. 2026 Jun 1;34(2):38-46. doi: 10.1097/JSA.0000000000000450. Epub 2026 May 28.
PMID: 42204421 Review.
Abstract: Although rare, sports-related spine injuries can result in devastating, life-altering consequences, with the cervical spine injury being the most common with potentially devastating consequences, including quadriplegia and immediate death from cardiopulmonary compromise. Sports remain a leading cause of spinal cord injury (SCI) in the first 3 decades of life. Early, appropriate on-field management is critical to prevent further harm and improve outcomes. This manuscript outlines current evidence-based best practices for sideline evaluation and management of athletes with suspected spine injuries. Assessing and managing airway, breathing, and circulation (ABCs) as needed, along with minimizing spinal motion, are critical components of effective on-field emergency management. Rapid and accurate injury severity assessment is essential to guide the appropriate emergency response. Thorough preplanning and training are also vital to ensuring effective on-field management. Numerous practical considerations such as criteria for immobilization, helmet and shoulder pad removal, and transfer techniques are discussed.
Keywords: athletes; cervical spine; emergency response; on-field management; spinal immobilization; spine injury; sports-related.
RANKL inhibits macrophage proinflammatory Toll-like receptor 2 and 4 signaling and impairs killing of intracellular bacteria.
Si CD, Peek CT, Fatah SR, Beaudoin AJ, Zhelonkin AR, Eichelberger KR, Hahn SL, Watson RO, Mogilenko DA, Cassat JE.
Immunohorizons. 2026 May 13;10(5):vlag023. doi: 10.1093/immhor/vlag023.
PMID: 42177796 Free PMC article.
Abstract: Monocyte-macrophage lineage cells, crucial components of the innate immune system, can uniquely form bone-resorbing osteoclasts upon exposure to the cytokine receptor activator of nuclear factor κB ligand (RANKL) in the bone microenvironment. Recent studies have also begun to uncover extensive extraskeletal roles of RANKL. However, how monocyte-macrophage lineage cells respond to RANKL outside of the bone, and the impact that this signaling pathway exerts on the host immune response, is not fully understood. In this study, we sought to define how RANKL exposure shapes the macrophage inflammatory response to pathogens by using the model intracellular bacterium Salmonella enterica serovar Typhimurium, which coopts macrophages to cause life-threatening infections. We found that exposing both mouse and human macrophages to subosteoclastogenic levels of RANKL increased intracellular Salmonella enterica serovar Typhimurium burdens and decreased proinflammatory cytokine production. RNA sequencing revealed downregulation of pattern recognition receptor signaling pathways in RANKL-treated macrophages during the early stages of infection. Therefore, we hypothesized that RANKL impairs pattern recognition receptor-dependent signaling pathways that are important for proinflammatory cytokine production. We discovered that RANKL-treated macrophages exhibit reduced nuclear factor κB and interferon regulatory factor 3 activation, specifically in response to Toll-like receptor 2 (TLR2) and TLR4 stimulation. We determined that prior RANKL exposure decreases abundance of the TLR2 and TLR4 adaptor proteins TRAM (TRIF-related adaptor molecule) and TIRAP (TIR domain-containing adaptor protein). Together, these data suggest that RANKL exposure negatively impacts the macrophage TLR-mediated inflammatory response to bacteria.
Keywords: Salmonella Typhimurium; RANKL; TLR signaling; innate immunity; macrophages.
Photocontrolled immunotherapy: a BODIPY-caged MSA-2 for spatiotemporal activation of STING with visible light.
Arora K, Lee AE, Chada NC, Schulman JA, Wilson JT.
New J Chem. 2026 Jun 2. doi: 10.1039/d6nj00620e. Online ahead of print.
PMID: 42239620 Free PMC article.
Characterizing Continuous and Discrete Hybrid Latent Spaces for Structural Connectomes.
Rudravaram G, Zuo L, Saunders AM, Kim ME, Kanakaraj P, Newlin NR, Krishnan AR, McMaster EM, Cho C, Resnick SM, Beason Held LL, Archer D, Hohman TJ, Moyer DC, Landman BA.
Proc SPIE Int Soc Opt Eng. 2026 Feb;13925:139250A. doi: 10.1117/12.3086529. Epub 2026 Apr 3.
PMID: 42181986 Free PMC article.
Phenotype discovery of traumatic brain injury segmentations from heterogeneous multi-site data.
Saunders AM, Kim ME, Rudravaram G, Remedios LW, Cho C, McMaster EM, Gillis DR, Liu Y, Zuo L, Landman BA, Rex TS.
Proc SPIE Int Soc Opt Eng. 2026 Feb;13925:1392508. doi: 10.1117/12.3085847. Epub 2026 Apr 3.
PMID: 42266432 Free PMC article.
Modeling a Shared Reality of Tractography through Varied Structural Imaging.
Schwartz TM, McMaster EM, Rudravaram G, Cho C, Krishnan A, Kim ME, Samir J, Bilgel M, Resnick S, Beason-Held L, Landman BA, Li Z.
Proc SPIE Int Soc Opt Eng. 2026;13925:139250H. doi: 10.1117/12.3086475. Epub 2026 Apr 3.
PMID: 42266433 Free PMC article.
The Wheezing, Asthma and Viral effects on the Epithelial Structure and function (WAVES) birth cohort study: rationale, design and methods to understand airway development and the role of early-life respiratory viral infections on childhood asthma inception.
Hartert T, Rosas-Salazar C, Newcomb DC, Snyder BM, Berdnikovs S, McKennan C, Osmundson S, Liu Z, Tafoya E, Folad W, Simon P, Reiss S, Poleon K, Cephus JY, Kuehnle SN, McKernan KE, Ma S, Anderson LJ, Gebretsadik T.
BMJ Open Respir Res. 2026 Jun 9;13(1):e004049. doi: 10.1136/bmjresp-2025-004049.
PMID: 42264881 Free article.
Air pollution modifies clonal hematopoiesis-associated non-small cell lung cancer risk in non-smoking individuals.
Buttigieg MM, Vlasschaert C, Pershad Y, Lanktree M, Aldrich MC, Rauh MJ, Bick AG.
J Natl Cancer Inst. 2026 May 27:djag159. doi: 10.1093/jnci/djag159. Online ahead of print.
PMID: 42202166 Free article.
Structured Exercise Regimen in Pulmonary Hypertension-Right Ventricular Failure in an Ovine Model.
Bulard BA, Kumpfbeck AR, Woo Y, Simonds E, Adesanya T, Glomp G, Schanz B, Said B, Kane S, Cagnolatti C, Petrovic M, Bapatla S, Adjei E, Austin E, Stokes J, Demarest CT, Ukita R, Bacchetta M.
J Vis Exp. 2026 May 5;(231). doi: 10.3791/70664.
PMID: 42184261
Vasoplegia as a Distinct Hemodynamic Phenotype After Heart Transplantation: Prevalence, Determinants, and Clinical Consequences Despite Preserved Allograft Function.
Ahmad A, Wang CC, Williams AM, Bommareddi S, Trahanas J, McGann K, Absi T, Quintana E, Petrovic M, Navid W, Eidson C, McRae AS, Devries S, Lowman J, Siddiqi H, Brinkley M, Menachem JN, Pedrotty D, Tsai S, Punnoose L, Rali AS, Sacks S, Zalawadiya S, Jelly C, Bacchetta M, Schlendorf K, Shah AS, Lima B.
J Thorac Cardiovasc Surg. 2026 May 14:S0022-5223(26)00980-3. doi: 10.1016/j.jtcvs.2026.04.052. Online ahead of print.
PMID: 42140552
The Impact of Vascularized Lymph Node Transfer in Reducing the Rate of Cellulitis in Patients with Breast Cancer-Related Lymphedema.
Abbas H, Gutama B, Reddy A, Lee E, Lineaweaver W, Zhang F, Karagoz H.
Plast Reconstr Surg. 2026 May 20. doi: 10.1097/PRS.0000000000013200. Online ahead of print.
PMID: 42160627 No abstract available.
Leonard T. Furlow-Reflections From the Archive-Innovation at the Intersection of Surgery and Imagination.
Gergoudis FR, Furlow J, Ryland C, Johnson J, Giannas E, Karamitros G, Gutama B, Torres-Guzman R, Reddy A, Pontell M, Lineaweaver WC.
Ann Plast Surg. 2026 Jun 4. doi: 10.1097/SAP.0000000000004783. Online ahead of print.
PMID: 42240438
Small Joint Denervation: Cutting the Cord Without Burning the Bridge.
Gergoudis F, Gutama B, Chennupati V, Giannas E, Johnson J, Reddy A, Karamitros G, Torres-Guzman R, Hill JB.
Ann Plast Surg. 2026 May 28. doi: 10.1097/SAP.0000000000004787. Online ahead of print.
PMID: 42213505
Tracking Scholarly Productivity in Academic Plastic Surgery: A Departmental Scholarly Index Analysis.
Giannas E, Karamitros G, James AJ, Alter NE, Johnson J, Gergoudis FR, Reddy AP, Gutama B, Torres-Guzman RA, Assi PE, Pontell ME, Thayer WP, Perdikis G, Lineaweaver WC.
Ann Plast Surg. 2026 Jun 10. doi: 10.1097/SAP.0000000000004754. Online ahead of print.
PMID: 42268598
Dehydration promotes intracellular lipid synthesis and accumulation.
Carty JS, Selvasingh J, Zuchowski Y, Nam HJ, Pénalva C, Nanayakkara G, Jennings EQ, Voss K, Adame ET, Tossberg JT, Yap WS, Melzer M, Viquez O, McCall AS, Piotrowski ER, Bessho R, Cao S, Leaptrot KL, Schrimpe-Rutledge AC, Codreanu SG, Sherrod SD, McLean JA, Trapani JB, Cottam MA, Wan M, Shrivastava D, Delker DA, Wilson MH, Hasenour CM, Lantier L, Chernova I, Young JD, Haase VH, Vazquez-Medina JP, Kosma DK, Kim PK, Cartailler JP, Zhang M, Zent R, Harris RC, Watts JA, Terker AS, Bock F, Rathmell JC, Rodan AR, Arroyo JP.
Nat Commun. 2026 May 25. doi: 10.1038/s41467-026-73534-x. Online ahead of print.
PMID: 42185304 Free article.
Spinal cord imaging for multiple sclerosis: Advances, priorities, and opportunities.
Laule C, Cohen-Adad J, Witt AA, De Luca GC, Granziera C, Keegan BM, Kerbrat A, Klawiter EC, Kolind S, O’Grady KP, Oh J, Schilling KG, Sivakolundu DK, Smith SA, Tozlu C, Vavasour IM, Bagnato F, Gauthier SA, Mainero C, Alonso-Ortiz E, Bakshi R, Beck ES, Brier MR, Hemond CC, Krieger S, Li DK, Shinohara RT, Henry RG; North American Imaging in Multiple Sclerosis (NAIMS) Cooperative.
Mult Scler. 2026 Jun 1:13524585261444600. doi: 10.1177/13524585261444600. Online ahead of print.
PMID: 42224274 Review.