Mechanisms coupling the mTOR pathway to chronic obstructive pulmonary disease (COPD) pathogenesis.

Chronic Obstructive Pulmonary Disease (COPD) is a poorly reversible respiratory disorder distinguished by dyspnea, cough, expectoration and exacerbations due to abnormality of airways or emphysema. In this review, we consider the therapeutic potential of targeting Mammalian target of Rapamycin (mTOR) for treating COPD. The mTOR is a highly conserved serine-threonine protein kinase that integrates signals from growth factors and nutrients to control protein synthesis, lipid biogenesis and metabolism.

A Comparison of Peripherally Inserted Central Catheter Materials.

Background: New catheter materials for peripherally inserted central catheters (PICCs) may reduce the risk of device failure due to infectious, thrombotic, and catheter occlusion events. However, data from randomized trials comparing these catheters are lacking.

Methods: We conducted a randomized, controlled, superiority trial in three Australian tertiary hospitals.

Empagliflozin in acute myocardial infarction in patients with and without type 2 diabetes: A pre-specified analysis of the EMPACT-MI trial.

Aims: In the EMPACT-MI trial, empagliflozin reduced heart failure (HF) hospitalizations but not mortality in acute myocardial infarction (MI). Contemporary reports of clinical event rates with and without type 2 diabetes mellitus (T2DM) in acute MI trials are sparse. The treatment effect of empagliflozin in those with and without T2DM in acute MI is unknown.

Enhancing provider-patient connection through low-effort interventions: a scoping review protocol.

Introduction: Nudges, or low-effort interventions aimed at influencing behaviour, can improve provider medical decision-making through promoting adherence to practice guidelines. Strengthening provider-patient humanistic connection through nudges may increase provider satisfaction, mitigate burnout and improve patient satisfaction and outcomes. This scoping review aims to map the literature investigating provider-directed, low-effort interventions aimed at enhancing the provider-patient connection.

What Drives Clinicians to Teach While Caring for Patients?

Past medical education scholarship has explored what to teach, how to teach it better, and the evaluation of what these efforts provide learners. Missing from this dialogue has been the question of what clinician-educators gain from teaching. In this Invited Commentary on Frija-Gruman and colleagues' article "Learning Through Teaching: How Physicians Learn Medicine in Authentic Clinical Contexts," the authors go beyond how and what clinician-educators learn through teaching to what drives clinicians to teach while caring for patients.

Gold nanostars and nanourchins for enhanced photothermal therapy, bioimaging, and theranostics.

Photothermal therapy (PTT), a recently emerging method for eradicating tumors, utilizes hyperthermia induced by photo-absorbing materials to generate heat within cancer cells. Gold nanoparticles (AuNPs) have gained reliability for and applications in PTT due to their strong light absorbance, stability, and biocompatibility. Yet, their potential is limited by their spherical shape, impacting their size capabilities, electromagnetic enhancement effects, and localized surface plasmon resonance (LSPR).

Midline vs Peripherally Inserted Central Catheter for Outpatient Parenteral Antimicrobial Therapy.

Importance: Little is known about the safety of midline catheters vs peripherally inserted central catheters (PICCs) for outpatient parenteral antimicrobial therapy (OPAT).

Objective: To compare outcomes from midline catheters vs PICCs for OPAT.

Design, Setting, And Participants: This retrospective cohort study included patients who received antimicrobial therapy through a midline catheter or PICC between January 2017 and November 2023 across 69 Michigan hospitals.

Patient reported outcome and experience measures among patients with central venous access devices: a systematic review.

Purpose: Patients receiving treatment for solid tumours and haematological malignancies, among other acute and chronic health conditions, are highly dependent upon central venous access devices (CVADs) for administering chemotherapy and other complex therapies; thus, CVADs can meaningfully impact their health outcomes and experiences. This systematic review aimed to identify and critique patient-reported outcome measure (PROM) and patient-reported experience measure (PREM) instruments related to CVADs.

Methods: A systematic review was undertaken, commencing with an electronic search of health databases (April 2022).

Applicability of heart failure clinical practice guidelines in low- and middle-income countries.

Aims: Clinical practice guidelines are commonly written by professional societies in high-income countries (HIC) with limited anticipation of implementation obstacles in other environments. We used heart failure (HF) guidelines as a paradigm to examine this concern, by conducting a survey to understand clinicians' ability to implement HF guidelines and their perceptions of the current HF guideline applicability in low- and middle-income countries (LMIC).

Methods And Results: An online survey of physicians in the database of the Translational Medicine Academy who treat HF patients was offered by email from 5 October to 27 November 2023, inquiring of participants' demographic information, experience, and views of HF guidelines as related to their practice.

Psychological morbidity and quality of life of patients with pulmonary tuberculosis.

Tuberculosis (TB) is associated with psychological distress, poor coping, deterioration in health-related quality of life (HRQL), and stigma. However, these issues have never received sufficient attention as a part of routine care. The healthcare workers and physicians of primary contact are not sensitized to use discrete screening questionnaires to identify and address these issues.

Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned.

Objectives: The inpatient setting is a challenging clinical environment where systems and situational factors predispose clinicians to making diagnostic errors. Environmental complexities limit trialing of interventions to improve diagnostic error in active inpatient clinical settings. Informed by prior work, we piloted a multi-component intervention designed to reduce diagnostic error to understand its feasibility and uptake.

Torsemide as a Primary Choice in Edema Associated with Heart Failure.

Heart failure (HF) is the fastest-growing disease with a higher fatality rate. The most differentiating feature of HF is pulmonary or peripheral edema, which is characterized by a gradient between intravascular and extravascular pressure. Loop diuretics were chosen as the primary treatment for edema associated with HF due to their efficacy and early onset of action.

Special Commentary: Reporting Clinical Endpoints in Studies of Minimally Invasive Glaucoma Surgery.

Minimally invasive glaucoma surgery (MIGS) refers to a group of procedures generally characterized by an ab interno approach, minimal trauma to ocular tissue, moderate efficacy, an excellent safety profile, and rapid recovery. The number of MIGS procedures continues to increase, and their use has become widespread among glaucoma and cataract specialists. Standardization of the methodology and reporting of clinical endpoints in MIGS investigations enhances interpretation and comparison across different studies.

Genetic variations in the antioxidant genes and their role in modulating susceptibility towards chronic obstructive pulmonary disease in the North Indian population.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a persistent inflammatory lung condition characterized by an obstruction in removing oxygen from the lungs. Oxidant and antioxidant imbalance have long been hallmarks of COPD development, where the amount of antioxidants produced is less than that of oxidants. Here, polymorphism in the antioxidant enzymes like Catalase, Superoxide dismutase and Glutathione peroxidase plays an essential role in regulating the levels of oxidants.

Survey on nurse-physician communication gaps focusing on diagnostic concerns and reasons for silence.

Diagnosis improvement requires physician-nurse collaboration. This study explored nurses' concerns regarding physicians' diagnoses and how they were communicated to physicians. This cross-sectional study, employing a web-based questionnaire, included nurses registered on Japan's largest online media site from June 26, 2023, to July 31, 2023.

Establishing a paediatric critical care core quality measure set using a multistakeholder, consensus-driven process.

Introduction: Monitoring healthcare quality is challenging in paediatric critical care due to measure variability, data collection burden, and uncertainty regarding consumer and clinician priorities.

Objective: We sought to establish a core quality measure set that (i) is meaningful to consumers and clinicians and (ii) promotes alignment of measure use and collection across paediatric critical care.

Design: We conducted a multi-stakeholder Delphi study with embedded consumer prioritisation survey.

Awareness of peripheral IV catheters among nurses, physicians, and trainees: A prospective cohort study.

Background: Peripheral intravenous catheters (PIVs) are the most frequently used invasive device in hospitalized patients. These devices are not benign and are associated with complications. However, clinician awareness of them is variable and poorly understood.

Improving Appropriate Use of Peripherally Inserted Central Catheters Through a Statewide Collaborative Hospital Initiative: A Cost-Effectiveness Analysis.

Background: Quality improvement (QI) programs require significant financial investment. The authors evaluated the cost-effectiveness of a physician-led, performance-incentivized, QI intervention that increased appropriate peripherally inserted central catheter (PICC) use.

Methods: The authors used an economic evaluation from a health care sector perspective.

1q amplification and PHF19 expressing high-risk cells are associated with relapsed/refractory multiple myeloma.

Multiple Myeloma is an incurable plasma cell malignancy with a poor survival rate that is usually treated with immunomodulatory drugs (iMiDs) and proteosome inhibitors (PIs). The malignant plasma cells quickly become resistant to these agents causing relapse and uncontrolled growth of resistant clones. From whole genome sequencing (WGS) and RNA sequencing (RNA-seq) studies, different high-risk translocation, copy number, mutational, and transcriptional markers can be identified.

Baseline characteristics of patients with heart failure with mildly reduced or preserved ejection fraction: The FINEARTS-HF trial.

Aims: To describe the baseline characteristics of participants in the FINEARTS-HF trial, contextualized with prior trials including patients with heart failure (HF) with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF). The FINEARTS-HF trial is comparing the effects of the non-steroidal mineralocorticoid receptor antagonist finerenone with placebo in reducing cardiovascular death and total worsening HF events in patients with HFmrEF/HFpEF.

Methods And Results: Patients with symptomatic HF, left ventricular ejection fraction (LVEF) ≥40%, estimated glomerular filtration rate ≥ 25 ml/min/1.