Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment.

Pyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology.

Cohesin drives chromatin scanning during the RAD51-mediated homology search.

Cohesin folds genomes into chromatin loops, whose roles are under debate. We report that double strand breaks (DSB) induce formation of chromatin loops, with the break positioned at the loop base. These loops form only in S/G2 phases and occur during repair via homologous recombination (HR), concomitant with DNA end resection and RAD51 assembly.

Safety of Same-Day Discharge After Gastric Peroral Endoscopic Myotomy in Patients with Refractory Gastroparesis: An International Multi-Center Study.

Background And Aims: The post operative management of gastric peroral endoscopic myotomy (G-POEM) lacks standardization. This study aimed to evaluate adverse events, readmission rates, and feasibility of same-day discharge (SDD) after G-POEM.

Methods: A multi-center retrospective review of prospectively collected G-POEM data was conducted.

Short-course antibiotic strategies for ventilator-associated pneumonia.

Purpose Of Review: Evidence behind antibiotic duration while treating ventilator-associated pneumonia (VAP) remains unclear. There is a need to balance minimizing the development of antimicrobial resistance without compromising clinical outcomes given the high mortality.

Recent Findings: Recent studies have suggested that shorter antibiotic courses, when individualized to clinical response, may be adequate for treating VAP without increasing the incidence of mortality or recurrence, regardless of pathogens.

Molecular profiling of frontal and occipital subcortical white matter hyperintensities in Alzheimer's disease.

White matter hyperintensities (WMHs) are commonly detected on T2-weighted magnetic resonance imaging (MRI) scans, occurring in both typical aging and Alzheimer's disease (AD). Despite their frequent appearance and their association with cognitive decline in AD, the molecular factors contributing to WMHs remain unclear. In this study, we investigated the transcriptomic profiles of two commonly affected brain regions with coincident AD pathology-frontal subcortical white matter (frontal-WM) and occipital subcortical white matter (occipital-WM)-and compared with age-matched cognitively intact controls.

Detecting white adipose tissue browning in mice with in vivo R∗ mapping at 9.4T MRI.

White adipose tissue (WAT) browning is considered a promising strategy to combat obesity and related metabolic diseases. Currently, fat-water fraction (FWF) has been used as a marker for the loss of lipids associated with WAT browning. However, FWF may not be sensitive to metabolic changes and cannot specifically reflect iron-regulated metabolism during browning.

Instationary metabolic flux analysis reveals that NPC1 inhibition increases glycolysis and decreases mitochondrial metabolism in brain microvascular endothelial cells.

Niemann Pick Disease Type C (NP-C), a rare neurogenetic disease with no known cure, is caused by mutations in the cholesterol trafficking protein NPC1. Brain microvascular endothelial cells (BMEC) are thought to play a critical role in the pathogenesis of several neurodegenerative diseases; however, little is known about how these cells are altered in NP-C. In this study, we investigated how NPC1 inhibition perturbs BMEC metabolism in human induced pluripotent stem cell-derived BMEC (hiBMEC).

Quantitative Liver Fat Assessment by Handheld Point-of-Care Ultrasound: A Technical Implementation and Pilot Study in Adults.

Objectives: To implement, examine the feasibility of, and evaluate the performance of quantitative ultrasound (QUS) with a handheld point-of-care US (POCUS) device for assessing liver fat in adults.

Materials And Methods: This prospective IRB-approved, HIPAA-compliant pilot study enrolled adults with overweight or obesity. Participants underwent chemical-shift-encoded magnetic resonance imaging to estimate proton density fat fraction (PDFF) and, within 1 mo, QUS with a POCUS device by expert sonographers and novice operators (no prior US scanning experience).

Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI).

Background: Mislabelled penicillin allergies are associated with a myriad of adverse outcomes and development of anti-microbial resistance. With the overwhelming need for specialist allergy services, pharmacist initiatives such as the Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) have been advocated. However, evidence of their effectiveness, safety and impact on health-related quality-of-life (HR-QoL) are lacking.

Impersonating expertise: The ethics of misleading dermatology advertising.

The proliferation of medical spas has led to an increase in misleading advertising practices, particularly relating to the qualifications of practitioners and the risks of cosmetic procedures. Estheticians manage many spas without having the extensive and rigorous training that board-certified dermatologists undergo. By advertising physician oversight when there is none and promoting procedures as minimally invasive, these facilities create a false sense of security for patients.

Two-ended recombination at a Flp-nickase-broken replication fork.

Replication fork collision with a DNA nick can generate a one-ended break, fostering genomic instability. The opposing fork's collision with the nick could form a second DNA end, enabling conservative repair by homologous recombination (HR). To study mechanisms of nickase-induced HR, we developed the Flp recombinase "step arrest" nickase in mammalian cells.

Diversity and Meta-Analysis of Microbial Differential Abundance in Nasal Metatranscriptomic Profiles of Asthma.

Asthma affects millions worldwide and involves complex genetic, immunological, and environmental factors. The nasal microbiome is increasingly recognized for its role in asthma development, but inconsistent results and small sample sizes have limited a clear understanding. We aimed to clarify the nasal microbiome's role in asthma using large datasets and meta-transcriptomic analysis.

Cost-effectiveness of a short-course antibiotic treatment strategy for the treatment of ventilator-associated pneumonia: an economic analysis of the REGARD-VAP trial.

Background: The REGARD-VAP trial showed that individualised shortened antibiotic therapy was non-inferior to usual care for mortality and pneumonia recurrence in patients with ventilator-associated pneumonia (VAP). We aimed to assess the cost-effectiveness of an individualised shortened antibiotic therapy approach in this planned economic analysis.

Methods: REGARD-VAP was a phase 4, multicentre, open-label, randomised trial to assess a short-course antibiotic treatment strategy for treatment of VAP.

Clinical, Electrophysiological, and Intraoperative Analysis and Postoperative Success of Revision Surgery for Persistent and Recurrent Carpal Tunnel Syndrome.

Background: This paper reviews the signs and symptoms of recurrent or persistent carpal tunnel syndrome and examines some of the causes of failed primary carpal tunnel release.

Methods: A retrospective review of the surgical findings and outcomes of 29 consecutive patients who underwent 30 revision carpal tunnel operations was performed. Patient outcomes were recorded at a minimum of 1 year postoperatively.

Administration of low intensity vibration and a RANKL inhibitor, alone or in combination, reduces bone loss after spinal cord injury-induced immobilization in rats.

We previously reported an ability of low-intensity vibration (LIV) to improve selected biomarkers of bone turnover and gene expression and reduce osteoclastogenesis but lacking of evident bone accrual. In this study, we demonstrate that a prolonged course of LIV that initiated at 2 weeks post-injury and continued for 8 weeks can protect against bone loss after SCI in rats. LIV stimulates bone formation and improves osteoblast differentiation potential of bone marrow stromal stem cells while inhibiting osteoclast differentiation potential of marrow hematopoietic progenitors to reduce bone resorption.

Implications of the 2022 lung function update and GLI global reference equations among patients with interstitial lung disease.

Background: Lung function testing remains a cornerstone in the assessment and management of interstitial lung disease (ILD) patients. The clinical implications of the Global Lung function Initiative (GLI) reference equations and the updated interpretation strategies remain uncertain.

Methods: Adult patients with ILD with baseline forced vital capacity (FVC) were included from the Australasian ILD registry and the National Healthcare Group ILD registry, Singapore.

Comparison of clinicopathological features and treatment outcomes for cutaneous melanomas of the head and neck and melanomas arising at other sites: Implications for systemic therapy.

Background: Melanoma is increasingly recognized as a heterogeneous disease, with conflicting evidence regarding whether cutaneous head and neck melanoma (CHNM) represents a distinct entity.

Objective: Comparison of clinicopathological features and treatment outcomes of CHNM and cutaneous melanomas of other sites (CMOS).

Methods: Patients with CHNM and CMOS diagnosed between 2000 and 2018 were included.