The utility of ultrasound in sports medicine is improving the sports medicine physician's ability to rapidly diagnose and treat a multitude of sports related pathologies. In this article, we clearly outline the current status of the evidence in support of using sports ultrasound in the setting of acute ocular injury, evaluation of elevated intracranial pressures, deep venous thrombosis, and soft tissue complaints.Electronic sports (esports), or competitive video gaming, is a rapidly growing industry and phenomenon. While around 90% of American children play video games recreationally, the average professional esports athlete spends 5.5 to 10 h gaming daily. These times and efforts parallel those of traditional sports activities where individuals can participate at the casual to the professional level with the respective time commitments. Given the rapid growth in esports, greater emphasis has been placed on identification, management, and prevention of common health hazards that are associated with esports participation while also focusing on the importance of health promotion for this group of athletes. This review outlines a three-point framework for sports medicine providers, trainers, and coaches to provide a holistic approach for the care of the esports athlete. This esports framework includes awareness and management of common musculoskeletal and health hazards, opportunities for health promotion, and recommendations for performance optimization.Although evidence indicates that muscular fitness is foundational for ongoing participation in active play, exercise and sport, current national and international youth physical activity guidelines underplay the critical importance of strength-building activities during this developmental phase of life. In view of troubling trends in muscular fitness in today's youth, specific recommendations to address neuromuscular deficiencies are required. An understanding of the multidimensional development of youth physical inactivity and the importance of muscular fitness are needed to have the most significant impact on youth physical activity at the population level. The mounting evidence of the detrimental effects of physical inactivity on youth warrant a review of existing physical activity recommendations and guidelines. The proposed pediatric activity pyramid recognizes the shared importance of strength, skill, and aerobic activities required for the successful implementation of sustainable youth physical activity interventions.The role of the sports medicine physician has been challenged in several ways during the COVID-19 pandemic, potentially eroding a sense of well-being. Four universal human needs related to flourishing and a sense of life satisfaction are the framework we use to examine the effects of a pandemic on sports medicine clinicians. We offer two evidence-based practices to promote well-being and resilience within each of the four universal needs.
  Clip closure is effective for large (≥ 20 mm) nonpedunculated polyps in the proximal colon. The cost-effectiveness analysis by Albeniz et al. found that selective clipping of polyps at a minimum risk (>13% in the United States, >10% in Spain) is worthwhile clipping. Although such model is theoretically sound, clinical practice should be primarily guided by efficacy data. Moreover, the analysis is very sensitive to the high price of clips, which is likely to reduce in the foreseeable future.
 10% in Spain) is worthwhile clipping. Although such model is theoretically sound, clinical practice should be primarily guided by efficacy data. Moreover, the analysis is very sensitive to the high price of clips, which is likely to reduce in the foreseeable future.
  This study explored the relationship between patatin-like phospholipase domain-containing 3 gene (PNPLA3 rs738409), nutrient intake, and liver histology severity in patients with nonalcoholic fatty liver disease (NAFLD).
 
  PNPLA3-rs738409 variant was genotyped in 452 non-Hispanic whites with histologically confirmed NAFLD who completed Food Frequency Questionnaire within 6 months of their liver biopsy. The fibrosis severity on liver histology was the outcome of interest.
 
  The distribution of PNPLA3 genotypes was CC 28%, CG 46%, and GG 25%. High-carbohydrate (% of energy/d) intake was positively associated (adjusted [Adj] odds ratio [OR] 1.03, P < 0.01), whereas higher n-3 polyunsaturated fatty acids (n-3 PUFAs) (g/d) (Adj. OR 0.17, P < 0.01), isoflavones (mg/d) (Adj. OR 0.74, P = 0.049), methionine (mg/d) (Adj. OR 0.32, P < 0.01), and choline (mg/d) (Adj. OR 0.32, P < 0.01) intakes were inversely associated with increased risk of significant fibrosis (stage of fibrosis ≥2). By using an additiveosis in patients with NAFLD.
  It is still sometimes difficult to differentiate alcohol-associated hepatitis (AH) from other liver problems. In this edition of AJG, Atkinson et al. showed that keratin-18 (intermediate filament protein) is a promising biomarker for predicting histological severity of AH, defining the type of hepatocyte death (necrosis vs apoptosis), predicting 90-day mortality, and predicting the response to corticosteroid therapy in severe AH. The authors conclude that K18 is diagnostic, prognostic, and may be a theragnostic marker for prednisolone therapy and note that "serum K18 estimation should be adopted into routine clinical practice." We agree.
 It is still sometimes difficult to differentiate alcohol-associated hepatitis (AH) from other liver problems. In this edition of AJG, Atkinson et al. showed that keratin-18 (intermediate filament protein) is a promising biomarker for predicting histological severity of AH, defining the type of hepatocyte death (necrosis vs apoptosis), predicting 90-day mortality, and predicting the response to corticosteroid therapy in severe AH. The authors conclude that K18 is diagnostic, prognostic, and may be a theragnostic marker for prednisolone therapy and note that "serum K18 estimation should be adopted into routine clinical practice." We agree.Neurosurgical treatments for trigeminal neuralgia (TN) can provide long-lasting pain relief, however, some patients fail to respond and undergo multiple, repeat procedures. Surgical outcomes can vary depending on the type of TN, but the reasons for this are not well understood. Neuroimaging studies of TN point to abnormalities in the brainstem trigeminal fibers, however, whether this is a common characteristic of treatment non-response across different subtypes of TN is unknown. Here, we used diffusion tensor imaging (DTI) to determine whether the brainstem trigeminal fiber microstructure is a common biomarker of surgical response in TN and whether the extent of these abnormalities is associated with the likelihood of response across subtypes of TN.  https://www.selleckchem.com/products/GDC-0449.html  We studied 98 patients with TN (61 classical TN, 26 TN secondary to multiple sclerosis, and 11 TN associated with a solitary pontine lesion) who underwent neurosurgical treatment and 50 healthy controls. We assessed treatment response using pain intensity measures and examined microstructural features by extracting pre-treatment DTI metrics from the proximal pontine segment of the trigeminal nerves.