Opal is the first published example of a full-stack platform infrastructure for an implementation science designed for ML in anesthesia that solves the problem of leveraging ML for clinical decision support. Users interact with a secure online Opal web application to select a desired operating room (OR) case cohort for data extraction, visualize datasets with built-in graphing techniques, and run in-client ML or extract data for external use. Opal was used to obtain data from 29,004 unique OR cases from a single academic institution for pre-operative prediction of post-operative acute kidney injury (AKI) based on creatinine KDIGO criteria using predictors which included pre-operative demographic, past medical history, medications, and flowsheet information. To demonstrate utility with unsupervised learning, Opal was also used to extract intra-operative flowsheet data from 2995 unique OR cases and patients were clustered using PCA analysis and k-means clustering. A gradient boosting machine model was developed using an 80/20 train to test ratio and yielded an area under the receiver operating curve (ROC-AUC) of 0.85 with 95% CI [0.80–0.90]. At the default probability decision threshold of 0.5, the model sensitivity was 0.9 and the specificity was 0.8. K-means clustering was performed to partition the cases into two clusters and for hypothesis generation of potential groups of outcomes related to intraoperative vitals. Opal’s design has created streamlined ML functionality for researchers and clinicians in the perioperative setting and opens the door for many future clinical applications, including data mining, clinical simulation, high-frequency prediction, and quality improvement.

The actin cytoskeleton is a three‐dimensional scaffold of proteins that is a regulatory, energyconsuming network with dynamic properties to shape the structure and function of the cell. Proper actin function is required for many cellular pathways, including cell division, autophagy, chaperone function, endocytosis, and exocytosis. Deterioration of these processes manifests during aging and exposure to stress, which is in part due to the breakdown of the actin cytoskeleton. However, the regulatory mechanisms involved in preservation of cytoskeletal form and function are not well‐understood. Here, we performed a multipronged, cross‐organismal screen combining a whole‐genome CRISPR‐Cas9 screen in human fibroblasts with in vivo Caenorhabditis elegans synthetic lethality screening. We identified the bromodomain protein, BET‐1, as a key regulator of actin function and longevity. Overexpression of bet‐1 preserves actin function at late age and promotes life span and healthspan in C. elegans. These beneficial effects are mediated through actin preservation by the transcriptional regulator function of BET‐1. Together, our discovery assigns a key role for BET‐1 in cytoskeletal health, highlighting regulatory cellular networks promoting cytoskeletal homeostasis.

As a nongenetic engineering technique, adaptive evolution is an effective and easy-to-operate approach to strain improvement. In this work, a commercial Thermoanaerobacterium aotearoense SCUT27/Δldh-G58 was successfully isolated via sequential batch fermentation with step-increased carbon concentrations. Mutants were isolated under selective high osmotic pressures for 58 passages. The evolved isolate rapidly catabolized sugars at high concentrations and subsequently produced ethanol with good yield. A 1.6-fold improvement of ethanol production was achieved in a medium containing 120 g/L of carbon substrate using the evolved strain, compared to the start strain. The analysis of transcriptome and intracellular solute pools suggested that the adaptive evolution altered the synthesis of some compatible solutes and activated the DNA repair system in the two Thermoanaerobacterium sp. evolved strains. Overall, the results indicated the potential of adaptive evolution as a simple and effective tool for the modification and optimization of industrial microorganisms.

Mitochondria function as a hub of the cellular metabolic network. Mitochondrial stress is closely associated with aging and a variety of diseases, including neurodegeneration and cancer. Cells autonomously elicit specific stress responses to cope with mitochondrial stress to maintain mitochondrial homeostasis. Interestingly, mitochondrial stress responses may also be induced in a non-autonomous manner in cells or tissues that are not directly experiencing such stress. Such non-autonomous mitochondrial stress responses are mediated by secreted molecules called mitokines. Due to their significant translational potential in improving human metabolic health, there has been a surge in mitokine-focused research. In this review, we summarize the findings regarding inter-tissue communication of mitochondrial stress in animal models. In addition, we discuss the possibility of mitokine-mediated intercellular mitochondrial communication originating from bacterial quorum sensing.

<b><i>Introduction:</i></b> The main aim of this article was to study the retinal peripapillary and macular vascular structures in eyes with primary angle-closure suspects (PACS) using optical coherence tomography angiography (OCTA). <b><i>Methods:</i></b> In this cross-sectional study, control and PACS subjects were recruited from a community screening. Only one eye per subject was used for analysis. All participants underwent a questionnaire survey, physical and ophthalmic examinations, ocular biometry measurements, and OCTA. We compared basic demographics and vessel structure parameters between control and PACS eyes. Univariate and multivariate linear regression analyses were performed to investigate factors associated with vascular parameters in both groups. <b><i>Results:</i></b> Data from 254 subjects including 155 PACS and 99 controls were analyzed. In the peripapillary region, PACS eyes showed similar retina nerve fiber layer (RNFL) and vessel densities (VDs) including and excluding large vessels compared to control eyes. Compared to control eyes, all macular OCTA parameters showed significant differences in PACS eyes, including decreased superficial VD (<i>p</i> = 0.006) and deep VD (<i>p</i> = 0.004), larger fovea avascular zone (FAZ) area (<i>p</i> = 0.006), and longer FAZ perimeter (<i>p</i> = 0.004). Gender (<i>p</i> = 0.039), age (<i>p</i> &#x3c; 0.001), and Garway-Heath superior hemisphere RNFL (<i>p</i> &#x3c; 0.001) were risk factors influencing optic disc VD excluding large vessels. Axial length was the major factor affecting macula superficial and deep VDs (<i>p</i> = 0.004 and 0.001 respectively), while PACS was an independent factor associated with larger FAZ perimeter (<i>p</i> = 0.046). <b><i>Conclusion:</i></b> While PACS and control eyes have comparable RNFL and vascular structure around the optic nerve head, macular vascular structures are significantly different.