Vonoprazan in Management of Refractory Gastroesophageal Reflux Disease: An Indian Expert Group Consensus Statements.

Background: Approximately, 40% of gastroesophageal reflux disease (GERD) patients experience insufficient symptom relief from proton-pump inhibitors (PPI), resulting in PPI-refractory GERD (rGERD).

Objective: To review the existing literature and develop an Indian expert group consensus statement on the place of vonoprazan in the management of rGERD.

Materials And Methods: A panel of 35 leading Indian gastroenterologists extensively reviewed the literature to develop consensus statements for the management of rGERD in Indian patients, with a focus on the newly available potassium-competitive acid blocker (P-CAB), vonoprazan.

Unusual Cardiovascular Response to Sildenafil: Complete Heart Block in a Healthy Young Adult.

Sildenafil, a phosphodiesterase-5 (PDE5) inhibitor, is widely used for erectile dysfunction and pulmonary hypertension, with its cardiovascular safety profile being well documented. However, its potential to induce conduction abnormalities remains largely unexplored, both due to a lack of clinical reports and limited mechanistic studies. While tachyarrhythmias have been frequently associated with sildenafil use, bradyarrhythmias, particularly complete heart block, are an unreported complication.

The Impact of Type, Dose, and Duration of Prebiopsy Corticosteroids Use on Histomorphology and Immunohistochemical Stains in B-Cell Lymphoma: A Case-Control Study to Highlight the "Atypical" Cytoplasmic and Extra-Cellular Granular Staining Pattern of CD20.

Large/aggressive B-cell lymphomas are diverse both in terms of clinical presentations and treatment response. Diagnostic pathologic evaluation typically begins with a CD20/CD3 immunohistochemical panel. Prebiopsy steroid treatment has been reported to delay diagnosis and subsequent treatment due to altering histomorphology and immunohistochemical staining patterns.

7-Hydroxycannabidiol and 7-carboxycannabidiol induced cytotoxicity via apoptosis and endoplasmic reticulum stress in human hepatic cells.

Cannabidiol (CBD), a major component of extract from the plant Cannabis sativa L., has demonstrated efficacy in treating childhood-onset epilepsy; however, animal studies and clinical trials have reported elevated liver enzymes after CBD use, suggesting potential liver toxicity. In a previous study, we demonstrated that CBD caused cytotoxicity with apoptosis and endoplasmic reticulum (ER) stress in human hepatic cells.

Metastable states assisted homogeneous nucleation in supercooled liquid aluminum alloys: Insights from a phenomenologically coupled atomistic, phase-field, and machine learning investigation.

Crystallization due to liquid → solid transformation is observed in many natural and engineering processes. Extant literature indicates that crystallization in supercooled liquids is initiated by precursory metastable phases or states, also called non-classical nucleation. For face-centered cubic (FCC) materials, latest experimental and computational studies suggest that metastable hexagonal-closed packed (HCP) structures facilitate equilibrium FCC formation.

LoCS-Net: Localizing convolutional spiking neural network for fast visual place recognition.

Visual place recognition (VPR) is the ability to recognize locations in a physical environment based only on visual inputs. It is a challenging task due to perceptual aliasing, viewpoint and appearance variations and complexity of dynamic scenes. Despite promising demonstrations, many state-of-the-art (SOTA) VPR approaches based on artificial neural networks (ANNs) suffer from computational inefficiency.

The Impact of Applicant Sex on Pulmonary and Critical Care Medicine Fellowship Letters of Recommendation: A Multisite Study.

Letters of recommendation (LORs) are crucial for fellowship applications, but implicit biases can affect their quality. The aim of this study was to examine sex-based differences among multiinstitutional pulmonary and critical care medicine (PCCM) fellowship LORs. All 2021 PCCM fellowship applications submitted to five regional U.

Comparing the cannabidiol-induced transcriptomic profiles in human and mouse Sertoli cells.

Cannabidiol (CBD), a major cannabinoid found in Cannabis sativa L., has been used in the treatment of seizures associated with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. Recently, concerns have been raised regarding the male reproductive toxicity of CBD in animal models, such as monkeys, rats, and mice.

Diagnosis and management of monoclonal gammopathy of renal significance: A British Society for Haematology good practice paper.

This guideline provides consensus opinion on the investigations required for people presenting with suspected monoclonal gammopathy of renal significance to both nephrology and haematology physicians. The guideline discusses the principles of treating a patient with MGRS and provides recommendations for both supportive management and haematological therapy. It details the recommended on-going monitoring required for both specialty areas.

A Unique Case of Candida auris Infection Presenting With Hydropneumothorax and Bronchopleural Fistula: A Diagnostic and Therapeutic Challenge.

 is an emerging multidrug-resistant fungal pathogen that has become a significant global health concern, particularly in critically ill patients within hospital settings. It is known for its high mortality rates, diagnostic challenges, and frequent misidentification, which delays appropriate treatment. We present a case of a 72-year-old male with diabetes and hypertension who initially presented with a persistent cough, hemoptysis, and fever and was initially suspected of having pulmonary tuberculosis.

Comparison of the Analgesic Efficacy of Ultrasound-Guided Transperineal Approach Using Pudendal Nerve Block Versus Caudal Block in Children Undergoing Urological Surgeries: A Randomized Controlled Trial.

Introduction: Caudal block is an effective regional anesthesia technique for perineal surgeries but is associated with various adverse effects. Recently, pudendal nerve block has emerged as a promising alternative for these procedures. This study assessed the effectiveness of a novel transperineal technique for ultrasound-guided pudendal nerve block and compares it with ultrasound-guided caudal block for perineal surgeries in pediatric patients.

Using phage display for rational engineering of a higher affinity humanized 3' phosphohistidine-specific antibody.

Histidine phosphorylation (pHis) is a non-canonical post-translational modification (PTM) that is historically understudied due to a lack of robust reagents that are required for its investigation, such as high affinity pHis-specific antibodies. Engineering pHis-specific antibodies is very challenging due to the labile nature of the phosphoramidate (P-N) bond and the stringent requirements for selective recognition of the two isoforms, 1-phosphohistidine (1-pHis) and 3-phosphohistidine (3-pHis). Here, we present a strategy for engineering of antibodies for detection of native 3-pHis targets.

PIDA as an Iodinating Reagent: Visible-Light-Induced Iodination of Pyrazolo[1,5-a]pyrimidines and Other Heteroarenes.

We have developed a visible-light-mediated convenient and efficient strategy for the iodination of heteroarenes using diacetoxyiodobenzene (PIDA) under photocatalyst-free conditions. This unique approach is the first report on photocatalytic C-H iodination employing PIDA as the iodinating agent. The new photocatalyst-free strategy is applicable to a wide range of pyrazolo[1,5-a]pyrimidine derivatives with various functionalities.

Ab Initio Molecular Dynamics Investigation of Water and Butanone Adsorption on UiO-66 with Defects.

Volatile organic compounds (VOCs) are harmful chemicals that are found in minute quantities in the atmosphere and are emitted from a variety of industrial and biological processes. They can be harmful to breathe or serve as biomarkers for disease detection. Therefore, capture and detection of VOCs is important.

Computational approach for decoding malaria drug targets from single-cell transcriptomics and finding potential drug molecule.

Malaria is a deadly disease caused by Plasmodium parasites. While potent drugs are available in the market for malaria treatment, over the years, Plasmodium parasites have successfully developed resistance against many, if not all, front-line drugs. This poses a serious threat to global malaria eradication efforts, and the continued discovery of new drugs is necessary to tackle this debilitating disease.

Arsenic exposure is associated with elevated sweat chloride concentration and airflow obstruction among adults in Bangladesh: a cross sectional study.

Arsenic is associated with lung disease and experimental models suggest that arsenic-induced degradation of the chloride channel CFTR (cystic fibrosis transmembrane conductance regulator) is a mechanism of arsenic toxicity. We examined associations between arsenic exposure, sweat chloride concentration (measure of CFTR function), and pulmonary function among 285 adults in Bangladesh. Participants with sweat chloride ≥ 60 mmol/L had higher arsenic exposures than those with sweat chloride < 60 mmol/L (water: median 77.

The hunt for transnitrosylase.

The biochemical interplay between antioxidants and pro-oxidants maintains the redox homeostatic balance of the cell, which, when perturbed to moderate or high extents, has been implicated in the onset and/or progression of chronic diseases such as diabetes mellitus, cancer, and neurodegenerative diseases. Thioredoxin, glutaredoxin, and lipoic acid-like thiol oxidoreductase systems constitute a unique ensemble of robust cellular antioxidant defenses, owing to their indispensable roles as S-denitrosylases, S-deglutathionylases, and disulfide reductants in maintaining a reduced free thiol state with biological relevance. Thus, in cells subjected to nitrosative stress, cellular antioxidants will S-denitrosylate their cognate S-nitrosoprotein substrates, rather than participate in trans-S-nitrosylation via protein-protein interactions.

Pelvicalyceal anatomy and stone related factors as predictors of stone free rate in retrograde intrarenal surgery for lower calyceal stone.

Introduction: The objective of the present study is to evaluate the various pelvi-calyceal anatomy related and stone related parameters and their influence on stone free rate in retrograde intrarenal surgery for lower calyceal stones.

Methods: The retrospective analysis of records of 206 patients who underwent retrograde intrarenal surgery for lower calyceal stones from December 2021 and November 2023.The patients were divided into two groups: stone free group and residual stone group.

β-Silyl alkynoates: Versatile reagents for biocompatible and selective amide bond formation.

The study introduces a previously unidentified method for amide bond formation that addresses several limitations of conventional approaches. It uses the β-silyl alkynoate molecule, where the alkynyl group activates the ester for efficient amide formation, while the bulky TIPS (triisopropylsilane) group prevents unwanted 1,4-addition reactions. This approach exhibits high chemoselectivity for amines, making the method compatible with a wide range of substrates, including secondary amines, and targets the specific ε-amino group of lysine among the native amino ester's derivatives.

Ligand-induced segregation from large cell-surface phosphatases is a critical step in γδ TCR triggering.

Gamma/delta (γδ) T cells are unconventional lymphocytes that recognize diverse ligands via somatically recombined T cell antigen receptors (γδ TCRs). The molecular mechanism by which ligand recognition initiates γδ TCR signaling, a process known as TCR triggering, remains elusive. Unlike αβ TCRs, γδ TCRs are not mechanosensitive and do not require co-receptors or typical binding-induced conformational changes for triggering.

Immunophenotypic, genetic, and clinical characterization of adult T-cell leukemia/lymphoma: A single tertiary care center experience in the United States.

Objectives: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive mature T-cell neoplasm caused by human T-cell lymphotropic virus type 1 (HTLV-1). Its most common immunophenotype is CD4+/CD7-/CD25+, although unusual immunophenotypes can occur and may lead to misdiagnosis.

Methods: The immunophenotypes, cytogenetics, molecular features, clinical presentations, treatment, and prognosis of 131 patients with ATLL were retrospectively studied in a large tertiary medical center in the United States.

Hybrid Diffusion Model for Stable, Affinity-Driven, Receptor-Aware Peptide Generation.

The convergence of biotechnology and artificial intelligence has the potential to transform drug development, especially in the field of therapeutic peptide design. Peptides are short chains of amino acids with diverse therapeutic applications that offer several advantages over small molecular drugs, such as targeted therapy and minimal side effects. However, limited oral bioavailability and enzymatic degradation have limited their effectiveness.