Approaches and Challenges in Managing Treatment-Resistant Hypertension: A Case Report.

Treatment-resistant hypertension (TRH) is defined by consistently elevated blood pressure readings unresponsive to medical management. In clinical practice, it poses a significant challenge due to the intertwining variables that may cause the issue to persist such as lifestyle, genetics, and other comorbidities, as opposed to simple medication non-adherence. This report describes the case of a 68-year-old female patient presenting for a routine follow-up with persistently elevated ambulatory blood pressure readings.

Deep Multimodal Fusion of Data With Heterogeneous Dimensionality via Projective Networks.

The use of multimodal imaging has led to significant improvements in the diagnosis and treatment of many diseases. Similar to clinical practice, some works have demonstrated the benefits of multimodal fusion for automatic segmentation and classification using deep learning-based methods. However, current segmentation methods are limited to fusion of modalities with the same dimensionality (e.

Management strategies for patients with neurologic stimulators during nonneurologic surgery: an update and review.

Purpose Of Review: The goal of this review is to summarize the perioperative management of noncardiac implanted electrical devices (NCIEDs) and update the anesthesiologist on current recommendations for management when a NCIED is encountered during a nonneurosurgical procedure.

Recent Findings: Indications for NCIEDs continue to expand, and increasing numbers of patients with NCIEDs are presenting for nonneurosurgical procedures. Recent case reports demonstrate that NCIEDs may meaningfully affect perioperative management including use of electrocautery and neuromonitoring.

Weakly-supervised detection of AMD-related lesions in color fundus images using explainable deep learning.

Background And Objectives: Age-related macular degeneration (AMD) is a degenerative disorder affecting the macula, a key area of the retina for visual acuity. Nowadays, AMD is the most frequent cause of blindness in developed countries. Although some promising treatments have been proposed that effectively slow down its development, their effectiveness significantly diminishes in the advanced stages.

Assessing risk factors for latent and active tuberculosis among persons living with HIV in Florida: A comparison of self-reports and medical records.

Purpose: This study examined factors associated with TB among persons living with HIV (PLWH) in Florida and the agreement between self-reported and medically documented history of tuberculosis (TB) in assessing the risk factors.

Methods: Self-reported and medically documented data of 655 PLWH in Florida were analyzed. Data on sociodemographic factors such as age, race/ethnicity, place of birth, current marital status, education, employment, homelessness in the past year and 'ever been jailed' and behavioural factors such as excessive alcohol use, marijuana, injection drug use (IDU), substance and current cigarette use were obtained.

Comorbidities among persons living with HIV (PLWH) in Florida: a network analysis.

People living with HIV (PLWH) experience a higher rate of age-related comorbidities at younger ages. Understanding common comorbidities among PLWH and their relationship to one another could be significant in improving aging for PLWH. The goal of the present study is to identify the most common comorbidities among PLWH and the relationship between them using network analysis.

The epidemiology, demographics, and comorbidities of pulmonary and extra-pulmonary non-tuberculous mycobacterial infections at a large central Florida Academic Hospital.

Rationale: In the United States, non-tuberculous mycobacterium (NTM) infections are considered an important cause of morbidity and mortality, especially in people with progressive lung disease. The state of Florida has an extremely high incidence and prevalence of NTM disease which is likely a rapidly emerging infection in the state due to environmental and demographic factors.

Objectives: Adjemian et al.

Management of tubal ectopic pregnancy with methotrexate in the setting of symptomatic Coronavirus disease 2019 (COVID-19): A case report.

Background: Coronavirus Disease 2019 (COVID-19) represents a complex therapeutic challenge. As the pandemic progresses, patients are presenting with ectopic pregnancies (EPs) and symptomatic COVID-19.

Objective: We present the management of a patient with multiple medical comorbidities and tubal EP in the setting of severe symptomatic COVID-19 infection where all management options were precluded.

Simultaneous segmentation and classification of the retinal arteries and veins from color fundus images.

Background And Objectives: The study of the retinal vasculature represents a fundamental stage in the screening and diagnosis of many high-incidence diseases, both systemic and ophthalmic. A complete retinal vascular analysis requires the segmentation of the vascular tree along with the classification of the blood vessels into arteries and veins. Early automatic methods approach these complementary segmentation and classification tasks in two sequential stages.

Comparative bioacoustics: a roadmap for quantifying and comparing animal sounds across diverse taxa.

Animals produce a wide array of sounds with highly variable acoustic structures. It is possible to understand the causes and consequences of this variation across taxa with phylogenetic comparative analyses. Acoustic and evolutionary analyses are rapidly increasing in sophistication such that choosing appropriate acoustic and evolutionary approaches is increasingly difficult.

Seasonal movements of Gulf of Mexico sperm whales following the Deepwater Horizon oil spill and the limitations of impact assessments.

As part of the Deepwater Horizon Oil Spill Natural Resource Damage Assessment in the Gulf of Mexico, we conducted a large passive acoustic survey across the eastern Gulf continental shelf edge to assess impacts to sperm whale population. In the months immediately after the spill, sperm whale occurrence was significantly higher in areas closest to the spill. Over the following seasons in 2010-2011, we documented cyclical patterns of decreased and increased occurrence suggesting that this population exhibits a seasonal occurrence pattern in the region, with seasonal movements to other regions, and not likely directly influenced by the oil spill.

Health Care-Specific Enacted HIV-Related Stigma's Association with Antiretroviral Therapy Adherence and Viral Suppression Among People Living with HIV in Florida.

Among people living with HIV (PLWH) in Florida, <2/3 are virally suppressed (viral load <200 copies/mL). Previous theoretical frameworks have pointed to HIV-related stigma as an important factor for viral suppression; an important outcome related to the HIV continuum of care. This study aims to analyze the association between enacted HIV-related stigma and antiretroviral therapy (ART) adherence and viral suppression among a sample of PLWH in Florida.

The Florida Cohort study: methodology, initial findings and lessons learned from a multisite cohort of people living with HIV in Florida.

In 2013, Florida had the highest rate of new HIV infections and only 56% of persons living with HIV (PLWH) were virally suppressed. In response, we initiated a new HIV cohort in Florida to better understand issues affecting HIV health outcomes. This manuscript will describe the procedures of the Florida Cohort; summarize information regarding enrollment, follow-up, and findings to date; and discuss challenges and lessons learned during the establishment of a multisite cohort of PLWH.

The Florida Mobile Health Adherence Project for People Living With HIV (FL-mAPP): Longitudinal Assessment of Feasibility, Acceptability, and Clinical Outcomes.

Background: For people living with HIV (PLWH), antiretroviral therapy (ART) adherence is crucial to attain better health outcomes. Although research has leveraged consumer health information technologies to enhance ART adherence, no study has evaluated feasibility and clinical outcomes associated with the usage of a commercially available, regularly updated mobile health (mHealth) app for improving ART adherence among PLWH.

Objective: This study aimed to assess the feasibility, acceptability, and clinical outcomes of Care4Today, an existing, free, biprogrammatic mHealth app for improving ART adherence among PLWH.

Bradycardic Arrest During Somatosensory-Evoked Potential Monitoring: A Case Report.

Intraoperative neurophysiological monitoring involves electrical stimulation of nerve pathways and is used to assess the integrity of both motor and sensory pathways. Whereas motor pathway monitoring involves transcranial stimulation and peripheral nerve monitoring, somatosensory monitoring involves peripheral nerve stimulation and cranial monitoring. Arrhythmias are a known complication of motor-evoked potential monitoring but have not been reported with somatosensory monitoring.

The interaction between detectable plasma viral load and increased body mass index on hypertension among persons living with HIV.

Increased body mass index (BMI) and HIV are each associated with hypertension. This study tested interactions between BMI and detectable plasma viral load (pVL) on hypertension among 659 persons living with HIV (PLWH). All participants were categorized into four subgroups based on BMI (<25 and ≥25 kg/m) and pVL (<200 and ≥200 copies/ml).

Attitudes, Beliefs, and Willingness Toward the Use of mHealth Tools for Medication Adherence in the Florida mHealth Adherence Project for People Living With HIV (FL-mAPP): Pilot Questionnaire Study.

Background: Antiretroviral (ART) adherence among people living with HIV (PLWH) continues to be a challenge despite advances in HIV prevention and treatment. Mobile health (mHealth) interventions are increasingly deployed as tools for ART adherence. However, little is known about the uptake and attitudes toward commercially available, biprogrammatic mobile apps (ie, designed for both smartphone and short message service [SMS] messaging) among demographically diverse PLWH.

Impact of Availability of Telehealth Programs on Documented HIV Viral Suppression: A Cluster-Randomized Program Evaluation in the Veterans Health Administration.

Background: Telehealth may improve care for people with HIV who live far from HIV specialty clinics. We conducted a cluster-randomized evaluation to determine the impact of availability of HIV telehealth programs on documented viral suppression in Veterans Administration clinics.

Methods: In 2015-2016, people who previously traveled to HIV specialty clinics were offered telehealth visits in nearby primary care clinics.

Insurance status as a modifier of the association between race and stage of prostate cancer diagnosis in Florida during 1995 and 2013.

Background: Cancer stage at diagnosis is a critical prognostic factor regarding a patient's health outcomes. It has yet to be shown whether insurance status across different race has any implications on the stage of disease at the time of diagnosis. This study aimed to investigate whether insurance status was a modifier of the association between race and stage of previously undetected prostate cancer at the time of diagnosis in Florida between 1995 and 2013.

Evolution of correlated complexity in the radically different courtship signals of birds-of-paradise.

Ornaments used in courtship often vary wildly among species, reflecting the evolutionary interplay between mate preference functions and the constraints imposed by natural selection. Consequently, understanding the evolutionary dynamics responsible for ornament diversification has been a longstanding challenge in evolutionary biology. However, comparing radically different ornaments across species, as well as different classes of ornaments within species, is a profound challenge to understanding diversification of sexual signals.

HIV-related stigma among people living with HIV/AIDS in rural Central China.

Background: HIV-related stigma among people living with HIV/AIDS (PLWHA) has been associated with many negative consequences, including poor adherence to therapy and undue psychological stress. However, the relative influence of specific demographic and situational factors contributing to HIV-related stigma among rural PLWHA in central China remains unknown. The aim of this study was to explore the level of HIV-related stigma among rural PLWHA across specific demographic and situational factors in central China.

Transversus Abdominis Plane Blockade as Part of a Multimodal Postoperative Analgesia Plan in Patients Undergoing Radical Cystectomy.

Background: Radical cystectomy (RC) is a morbid procedure with frequent complications that may benefit from implementation of an enhanced recovery after surgery (ERAS) protocol.

Objective: To examine the benefits of a multimodal analgesic plan that uses continuous transversus abdominis plane (TAP) blockade as part of an ERAS protocol after RC.

Methods: A retrospective comparison of consecutive patients undergoing RC over a 4-year period was conducted.

Zika virus: An emerging infectious disease with serious perinatal and neurologic complications.

Zika virus (ZIKV) is a flavivirus that is primarily transmitted by Aedes aegypti, the mosquito vector also important in transmission of the flaviviruses responsible for dengue fever, yellow fever, and chikungunya. Because of occurrence in the same geographic regions, serologic cross-reactivity, and similar but often less severe clinical manifestations, such as dengue and chikungunya infections, ZIKV infection likely has gone undetected, misdiagnosed, or both for many years. ZIKV is somewhat unique among flaviviruses in its ability to also be transmitted through sexual contact, nonsexual body fluids, and perinatally.