Co-Existent Central and Peripheral Demyelination: Related or Coincidental?

Background: Hereditary Sensory Motor Neuropathy (HSMN) 1A and Multiple Sclerosis (MS) are distinct demyelinating disorders affecting the peripheral and central nervous systems, respectively. We present a case of simultaneous occurrence of both conditions, exploring the clinical presentation, diagnostic workup, and potential interplay between these diseases. Case presentation and clinical approach: A 49-year-old male with a history of optic neuritis presented with progressive numbness, weakness, and sensory loss in all extremities over four years.

Trifold technique for pupil reconstruction in large non-appositional iris defects.

Large iris defects are challenging to close due to shortage of tissue and opposite vector force. By using two pupilloplasty methods, we can close large iris defects with less tractional force or tethering. The trifold technique is a combination of trocar-assisted iris repair and single-pass four-throw (SFT) pupilloplasty for non-appositional large iris defects.

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

Method of accessing alcohol and binge drinking status in youth and young adults.

Aims: The study investigated relationships between how youth and young adults access alcohol and their binge drinking behaviors.

Methods: Data from the Rhode Island Student Survey (11- to 18-year-olds) and the Mobile Screen Time project (18- to 24-year-old) were included. Participants were asked whether they access alcohol through several different methods (e.

Dose-volume predictors of cardiac adverse events after high-dose thoracic radiation therapy for lung cancer: a systematic review and meta-analysis.

Background: Lung cancer is a leading cause of cancer mortality and may require high-dose thoracic radiation therapy (RT). However, RT significantly increases the risk of radiation-induced cardiac events, such as pericarditis, cardiomyopathy, and ischemic heart diseases. Despite evidence from clinical trials showing that higher RT doses are associated with poorer survival outcomes due to these cardiac effects, data on dose-volume predictors of such events in lung cancer remain sparse.

DO HEALTHY COQUEREL'S SIFAKAS IN CAPTIVITY HAVE UNUSUALLY LOW CIRCULATING CORTISOL?

Cortisol, and other glucocorticoids, are routinely used as markers of physiological stress in wildlife. Typically, stress activates the hypothalamic-pituitary-adrenal (HPA) axis, with adrenocorticotropic hormone (ACTH) signaling the adrenal glands to release cortisol. Nevertheless, recent anecdotes in captive Coquerel's sifakas (), strepsirrhine primates that are difficult to maintain under human care, may challenge the assumption that physiological stress universally increases circulating cortisol.

The NExT trial: Protocol for a two-phase randomized controlled trial testing transcranial magnetic stimulation to augment exposure therapy for youth with OCD.

Background: Exposure with Response Prevention (ERP) is a first-line treatment for OCD, but even when combined with first-line medications it is insufficiently effective for approximately half of patients. Compulsivity in OCD is thought to arise from an imbalance of two distinct neural circuits associated with specific subregions of striatum. Targeted modulation of these circuits via key cortical nodes (dorsolateral prefrontal cortex [dlPFC] or presupplementary motor area [pSMA]) has the potential to improve ERP efficacy by decreasing compulsions during therapy.

Focus on patient perspectives in climate action policies for healthcare. A German survey analysis on what patients are willing to do.

Background: The healthcare sector, while dedicated to improving health, paradoxically contributes significantly to global carbon emissions, accounting for approximately 4.9% of global emissions. Despite growing public concern about climate change, few studies have explored patients' awareness and attitudes toward the environmental impact of healthcare.

Universal Energy Fluctuations in Inelastic Scattering Processes.

Quantum scattering is used ubiquitously in both experimental and theoretical physics across a wide range of disciplines, from high-energy physics to mesoscopic physics. In this Letter, we uncover universal relations for the energy fluctuations of a quantum system scattering inelastically with a particle at arbitrary kinetic energies. In particular, we prove a fluctuation relation describing an asymmetry between energy absorbing and releasing processes which relies on the nonunital nature of the underlying quantum map.

Molecular Analysis of ApiA, a Multi-Functional Protein.

ApiA is a trimeric autotransporter outer membrane protein (Omp) that participates in multiple functions, enabling to adapt to a variety of environments. The goal of this study is to identify regions in the gene responsible for three of these functions: auto-aggregation, buccal epithelial cell binding, and complement resistance. Initially, was expressed in .

Expression of EMT Markers Snail, Slug, and Twist and their Association with Known Prognostic Indicators of Breast Cancer.

Breast cancer is trending its way as the most common cancer globally. Surgery remains the mainstream treatment modality. The gene expression signatures predict the prognosis in cancer patients.

Outcomes of lung volume reduction surgery for emphysema: unilateral and bilateral.

Background: Lung volume reduction surgery (LVRS) has historically been performed as a bilateral operation. We aimed to compare the short-term morbidity and mortality between unilateral and bilateral LVRS.

Methods: We performed a retrospective analysis of patients who underwent LVRS for emphysema at two hospital sites over 10 years.

Using disease-modifying treatments in multiple sclerosis: Association of British Neurologists (ABN) 2024 guidance.

The Association of British Neurologists last published guidelines on disease-modifying treatment (DMT) in multiple sclerosis (MS) in 2015. Since then, additional DMTs have been licensed and approved for prescribing within the National Health Service for relapsing-remitting MS, early primary progressive MS and active secondary progressive MS. This updated guidance provides a consensus-based approach to using DMTs.

Corneal Allogenic Intrastromal Ring Segments (CAIRS) Versus Synthetic Segments: A Single Segment Comparative Analysis Using Propensity Score Matching.

Purpose: To compare and assess the visual, refractive, and tomographic results of patients with corneal ectasia treated with either corneal allogenic intrastromal ring segments (CAIRS) or synthetic intrastromal corneal ring segments (ICRS) without concomitant corneal cross-linking.

Methods: In this retrospective cohort study, 34 eyes with CAIRS were matched to 34 eyes with ICRS using the propensity score matching technique. Each group was matched on a oneto-one basis using multiple parameters such as central corneal thickness, vertical and horizontal coma, maximum anterior keratometry, steepest keratometry, and age.

Dosimetric Impact of Prescription Point Placement in Heterogeneous Medium for Conformal Radiotherapy Dose Calculation with Various Algorithms.

Objective: The aim of the study is to compare the accuracy of dose calculation for different dose calculation algorithms with different prescription points (air, tissue, air-tissue interface in carcinoma lung patients and bone, tissue, and bone-tissue interface in carcinoma buccal Mucosa tumors).

Materials And Methods: Forty-one patients with carcinoma lung and buccal mucosa were retrospectively selected for this study. A three-dimensional conformal radiotherapy reference plan was created using the prescription point in the tissue with Monte Carlo (MC) algorithms for both the groups of patients.

Phase II trial of pembrolizumab, ipilimumab, and aspirin in melanoma: clinical outcomes and translational predictors of response.

Objective: Many patients with melanoma treated with immune checkpoint inhibitors (ICIs) do not derive response. Preclinical and retrospective studies identified that inhibition of the cyclooxygenase (COX) pathway may improve response to ICI treatment.

Methods: This prospective single site phase II trial accrued patients with advanced/metastatic melanoma.

Osteopathic Manipulative Treatment: A Safe and Feasible Adjunct in Sickle Cell Disease Pain Management.

Children and adolescents and young adults (CAYAs) with sickle cell disease (SCD) suffer from recurrent acute pain episodes that result in hospitalization and confer substantial morbidity. Pharmacologic pain control is often inadequate, thus non-pharmacologic modalities are needed. Osteopathic manipulative treatment (OMT) is a potentially valuable non-pharmacologic addition to pain management.

Autosomal recessive -related disorder: comprehensive analysis of phenotypic variability and genetic mutations.

A newly identified subtype of hereditary axonal motor neuropathy, characterized by early proximal limb involvement, has been discovered in a cohort of 34 individuals with biallelic variants in von Willebrand factor A domain-containing 1 (). This study further delineates the disease characteristics in a cohort of 20 individuals diagnosed through genome or exome sequencing, incorporating neurophysiological, laboratory and imaging data, along with data from previously reported cases across three different studies. Newly reported clinical features include hypermobility/hyperlaxity, axial weakness, dysmorphic signs, asymmetric presentation, dystonic features and, notably, upper motor neuron signs.