How to do a hip disarticulation.

Hip disarticulation is a salvage procedure for several hip and pelvic pathologies including recalcitrant pressure sores and pelvic soft tissue and bone neoplasms. This 'How I do it' article provides a detailed technique for hip disarticulation utilizing an anteromedial thigh myocutaneous flap.

Development and Validation of an Instrument to Measure Career Decision-Making Challenges of International Medical Students in China.

Introduction: International medical students (IMSs) experience various problems preventing them from making career decisions. Assessing the difficulties involved in the career decision-making process is instrumental for identifying the sources of their career indecision, which may assist them in making more informed career decisions. This study aims to develop and validate an instrument to measure career decision-making challenges of IMSs in China, who are mainly from low- and middle-income countries.

Challenges and strategies for navigating Australian healthcare access: experience from Chinese international students.

Background: Australia hosts over 680,000 international students, contributing $47.8 billion to the Australian economy in 2023, and Chinese students rank first among all nationalities. However, despite their considerable numbers, research focusing on their access to healthcare services is scant.

Eco-evolutionary Guided Pathomics Analysis to Predict DCIS Upstaging.

Cancers evolve in a dynamic ecosystem. Thus, characterizing cancer's ecological dynamics is crucial to understanding cancer evolution and can lead to discovering novel biomarkers to predict disease progression. Ductal carcinoma in situ (DCIS) is an early-stage breast cancer characterized by abnormal epithelial cell growth confined within the milk ducts.

A qualitative study of career decision making among African and Asian international medical students in China: process, challenges, and strategies.

China hosts around 68,000 international medical students (IMSs) primarily from lower income countries in Africa and Asia, who have the potential to contribute to international medical services. Understanding how these IMSs make career decisions can help better address the issue of global medical workforce shortage. However, such research is limited.

L-DOS47 Elevates Pancreatic Cancer Tumor pH and Enhances Response to Immunotherapy.

Acidosis is an important immunosuppressive mechanism that leads to tumor growth. Therefore, we investigated the neutralization of tumor acidity to improve immunotherapy response. L-DOS47, a new targeted urease immunoconjugate designed to neutralize tumor acidity, has been well tolerated in phase I/IIa trials.

Alterations in plasma protein N-glycosylation after caloric restriction and bariatric surgery.

Background: Protein glycosylation is an enzymatic process known to reflect an individual's physiologic state and changes thereof. The impact of metabolic interventions on plasma protein N-glycosylation has only been sparsely investigated.

Objective: To examine alterations in plasma protein N-glycosylation following changes in caloric intake and bariatric surgery.

Aqueous Humor Circulation in the Era of Minimally Invasive Surgery for Glaucoma.

Glaucoma surgery with implantation of aqueous humor draining microstents may compromise long-term corneal health by disrupting aqueous humor circulation. The effect of stent numbers on this circulation was interrogated to determine the number of stents associated with minimal circulation disruption. An in vitro anterior eye model perfusion system was constructed with multiple exit ports.

L-DOS47 enhances response to immunotherapy in pancreatic cancer tumor.

Acidosis is an important immunosuppressive mechanism that leads to tumor growth. Therefore, we investigated the neutralization of tumor acidity to improve immunotherapy response. L-DOS47, a new targeted urease immunoconjugate designed to neutralize tumor acidity, has been well tolerated in phase I/IIa trials.

A Study of Cardiac Outcomes After Droperidol Administration in an Inpatient Psychiatric Cohort.

Purpose/background: Droperidol is an antipsychotic medication used in psychiatric emergencies to manage acute behavioral disturbance. Droperidol use carries a risk of prolonged QT interval on the electrocardiogram and associated cardiac arrhythmias including torsades de pointes and ventricular fibrillation. This study aimed to evaluate the safety of droperidol in adults admitted to the psychiatric inpatient unit of a large Australian hospital.

Intraperitoneal Delivery of Iopamidol to Assess Extracellular pH of Orthotopic Pancreatic Tumor Model by CEST-MRI.

The extracellular pH (pHe) of solid tumors is often acidic, as a consequence of the Warburg effect, and an altered metabolic state is often associated with malignancy. It has been shown that acidosis can promote tumor progression; thus, many therapeutic strategies have been adopted against tumor metabolism; one of these involves alkalinization therapies to raise tumor pH to inhibit tumor progression, improve immune surveillance, and overcome resistance to chemotherapies. Chemical exchange saturation transfer-magnetic resonance imaging (CEST-MRI) is a noninvasive technique that can measure pH using pH-sensitive contrast agents.

Evolutionary Analysis of TCGA Data Using Over- and Under- Mutated Genes Identify Key Molecular Pathways and Cellular Functions in Lung Cancer Subtypes.

We identify critical conserved and mutated genes through a theoretical model linking a gene’s fitness contribution to its observed mutational frequency in a clinical cohort. “Passenger” gene mutations do not alter fitness and have mutational frequencies determined by gene size and the mutation rate. Driver mutations, which increase fitness (and proliferation), are observed more frequently than expected.

Back to basic: Trials and tribulations of alkalizing agents in cancer.

Unlabelled: "Dysregulated" metabolism is a characteristic of the cancer cell phenotype. This includes persistent use of glycolytic metabolism in normoxic environments (Warburg effect) leading to increased acid production and accumulation of protons in the interstitial space. Although often thought to be disordered, altered cancer metabolism is the outcome of intense Darwinian selection and, thus, must have evolved to maximize cancer cell fitness.

South Asian black carbon is threatening the water sustainability of the Asian Water Tower.

Long-range transport of black carbon from South Asia to the Tibetan plateau and its deposition on glaciers directly enhances glacier melt. Here we find South Asian black carbon also has an indirect effect on the plateau's glaciers shrinkage by acting to reduce the water supply over the southern Tibetan plateau. Black carbon enhances vertical convection and cloud condensation, which results in water vapor depletion over the Indian subcontinent that is the main moisture flux source for the southern Tibetan plateau.

Functional analysis of RYR1 variants in patients with confirmed susceptibility to malignant hyperthermia.

Background: A major bottleneck to the introduction of noninvasive presymptomatic diagnostic tests for the pharmacogenetic disorder malignant hyperthermia is the lack of functional data for associated variants.

Methods: We screened 50 genes having a potential role in skeletal muscle calcium homeostasis using the HaloPlex™ (Agilent Technologies, Santa Clara, CA, USA) target enrichment system and next-generation sequencing. Twenty-one patients with a history of a clinical malignant hyperthermia reaction together with a positive in vitro contracture test were included.

A simulation of parental and glycolytic tumor phenotype competition predicts observed responses to pH changes and increased glycolysis after anti-VEGF therapy.

Clinical cancers are typically spatially and temporally heterogeneous, containing multiple microenvironmental habitats and diverse phenotypes and/or genotypes, which can interact through resource competition and direct or indirect interference. A common intratumoral evolutionary pathway, probably initiated as adaptation to hypoxia, leads to the "Warburg phenotype" which maintains high glycolytic rates and acid production, even in normoxic conditions. Since individual cancer cells are the unit of Darwinian selection, intraspecific competition dominates intratumoral evolution.

Sex-dependent Effect of In-utero Exposure to ΔTetrahydrocannabinol on Glucagon and Stathmin-2 in Adult Rat Offspring.

Objectives: Administration of Δ-tetrahydrocannabinol (Δ-THC) to pregnant rats results in glucose intolerance, insulin resistance and reduced islet mass in female, but not male, offspring. The effects of Δ-THC on other islet hormones is not known. One downstream target of the cannabinoid receptor, stathmin-2 (Stmn2), has recently been shown to suppress glucagon secretion, thereby suggesting Δ-THC may also affect alpha-cell function.

Management strategies for perioperative anaemia in the severely burn-injured Jehovah's Witness patients who decline a blood transfusion: A systematic review with illustrative case reports.

Background: The management of severe burn-injured Jehovah's Witness patients who decline a blood transfusion poses unique challenges. The literature is scant for guiding perioperative anaemia management in these patients. We present a systematic review of this patient group, along with illustrative, consecutive case reports of our experience.

Proton export upregulates aerobic glycolysis.

Introduction: Aggressive cancers commonly ferment glucose to lactic acid at high rates, even in the presence of oxygen. This is known as aerobic glycolysis, or the "Warburg Effect." It is widely assumed that this is a consequence of the upregulation of glycolytic enzymes.