Comparative Efficacy and Safety of Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, and Calcium Channel Blockers in Hypertensive Patients With Chronic Kidney Disease: A Systematic Review.

This systematic review evaluates the comparative efficacy and safety of antihypertensive therapies, including angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs), in managing hypertension among chronic kidney disease (CKD) patients. A comprehensive search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted across five databases, identifying eight randomized controlled trials (RCTs) published in the last five years. The included studies examined diverse populations, ranging from pediatric to elderly CKD patients, with interventions tailored to specific subgroups, including those with proteinuria or diabetic kidney disease.

Clinical, genetic, radiological characteristics and management of mediastinal paragangliomas: a literature review and case series.

Paragangliomas (PGLs) are neuroendocrine tumours (NETs) that arise from neural crest derived cells. Up to 40% of cases occur due to the presence of a pathogenic germline variant (PGV) in a known gene. Mediastinal PGLs are rare but are being diagnosed with increasing frequency.

Multi-institutional exploration of pediatric residents' perspectives on anti-racism curricula: a qualitative study.

Background: Anti-racism curricula are increasingly being recognized as an integral component of medical education. To our knowledge, there has not yet been a publication exploring resident perspectives from multiple institutions and explicitly representing both underrepresented in medicine (UIM) and non-UIM perspectives.

Objective: To explore and compare UIM and non-UIM pediatric residents' perspectives on the content and qualities of meaningful anti-racism curricula.

Both Single- and Double-anchor Remplissage Techniques Restore Native Stability in a Cadaveric Model of Hill-Sachs Lesions in Anterior Shoulder Instability.

Purpose: To determine the most effective number and location of fixation points for remplissage of Hill-Sachs lesions (HSL) in a cadaveric model of anterior shoulder instability.

Methods: Eleven fresh-frozen cadaveric shoulder specimens were tested. A robot device tested resistance to anterior translation of the humeral head.

A Visual Arts Activity to Support Residents as They Care for "Difficult Patients".

Certain patients significantly challenge the care team, increasing the risk of burnout as clinicians struggle to perform their best work while meeting the needs of their patients. Imagining another's perspective, a clinical empathy skill, can increase compassion and lower distress when interacting with these patients. To evaluate the effectiveness of an art-based perspective-taking activity on clinicians' feelings of discomfort when anticipating encounters with challenging patients.

Enhancing diagnostic outcomes in kidney genetic disorders: the KidGen national kidney genomics study protocol.

Background: Genetic kidney disease (GKD) significantly affects the community and is responsible for a notable portion of adult kidney disease cases and about half of cases in paediatric patients. It substantially impacts the quality of life and life expectancy for affected children and adults across all stages of kidney disease. Precise genetic diagnosis in GKD promises to improve patient outcomes, provide access to targeted treatments, and reduce the disease burden for individuals, families, and healthcare systems.

Clomiphene citrate throughout the duration of ovarian stimulation in patients with diminished ovarian reserve: an approach to decrease costs, reduce injection burden, and prevent premature ovulation.

Purpose: Clomiphene citrate (CC) is often utilized as an adjunct in in vitro fertilization (IVF) protocols during the first 5 days of stimulation for endogenous FSH release. However, due to its antiestrogenic mechanism of action, CC may also effectively prevent the LH surge, and hence premature ovulation, if continued until the day of trigger. The objective of this study was to evaluate a "long CC" protocol, in which CC is continued throughout the entire cycle in-lieu of GnRH antagonist, and to compare IVF outcomes with a standard 5-day CC + GnRH antagonist protocol in patients with diminished ovarian reserve (DOR) undergoing IVF with high-dose gonadotropins.

Development of small-molecule fluorescent probes targeting neutrophils -formyl peptide receptors.

-Formyl peptide receptors (FPRs) are membrane receptors that are abundantly expressed in innate immune cells, including neutrophils and platelets, demonstrating potential new targets for immune system regulation and the treatment of inflammatory conditions. We report here the development and bio-physical validation of new FPR imaging agents as effective tools to track FPR distribution, localisation and functions, ultimately helping to establish FPR exact roles and functions in pathological and physiological conditions. The new series of probes feature a small molecule-based FPR address system conjugated to suitable fluorophores, resulting in highly specific FPR agents, including a partial agonist endowed with high affinity ( low/sub-nanomolar potency) on FPR-transfected cells and human neutrophils.

Simulation of Flow Around a Finite Rectangular Prism: Influence of Mesh, Model, and Subgrid Length Scale.

This study investigates the flow field around a finite rectangular prism using both experimental and computational methods, with a particular focus on the influence of the turbulence approach adopted, the mesh resolution employed, and different subgrid length scales. Ten turbulence modelling and simulation approaches, including both 'scale-modelling' Reynolds-Averaged Navier-Stokes (RANS) models and 'scale-resolving' Delayed Detached Eddy Simulation (DDES), were tested across six different mesh resolutions. A case with sharp corners allows the location of the flow separation to be fixed, which facilitates a focus on the separated flow region and, in this instance, the three-dimensional interaction of three such regions.

Sublingual progesterone lozenges are a viable alternative to intramuscular progesterone-in-oil for programmed frozen embryo transfer cycles.

Objective: To compare pregnancy outcomes and serum progesterone levels between women who took sublingual (SL) progesterone lozenges vs. intramuscular (IM) administration progesterone-in-oil for endometrial preparation and luteal support in programmed frozen embryo transfer (pFET) cycles.

Design: Retrospective cohort study.

Out-of-Hospital Cardiac Arrest in Ireland 2012 to 2020: Bystander CPR, bystander defibrillation and survival in the Utstein comparator group.

Background: The Irish Out-of-Hospital Cardiac Arrest registry (OHCAR) collects data based on the internationally recognised Utstein template. The Utstein comparator group (bystander witnessed and initial shockable rhythm) has specific relevance in benchmarking out-of-hospital cardiac arrest (OHCA) health system performance.

Aims: To describe OHCA in the Utstein comparator group during 2012 to 2020 in Ireland.

Systematic review of the application of the Kidney Failure Risk Equation and Oxford classification in estimating prognosis in IgA Nephropathy.

Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis in the world and is an important cause of chronic kidney disease (CKD) and kidney failure. Outcomes are heterogeneous, and accurate risk stratification is important to identify the highest risk individuals for treatment and to help prevent disease progression. The Oxford classification (OC) is an internationally adopted standard for renal biopsy reporting in IgAN, which measures the degree of histological abnormalities and predicts prognosis.

Iliopsoas Injections: A Systematic Review of Patient Outcomes and Progression to Surgery.

Background: Iliopsoas injuries are a common cause of anterior hip and groin pain and can be successfully managed with conservative treatment. Corticosteroid and local anesthetic injections can also be offered in conjunction with nonoperative management. Given the variability in reported injection guidelines, composition, and techniques, the purpose of this study was to systematically review the literature to assess progression to surgery and patient outcomes following iliopsoas injections.

Experience of The National Emergency Tele-Critical Care Network.

The COVID-19 pandemic exposed significant frailties of the U.S. healthcare system, especially inequities facing rural areas during surges when critical access and small community hospitals could not transfer patients to referral centers that were already overcapacity.

Cardiac growth patterns and metabolism before and after birth in swine: Role of miR in proliferation, hypertrophy and metabolism.

The adult mammalian heart is unable to undergo cardiac repair, limiting potential treatment options after cardiac damage. However, the fetal heart is capable of cardiac repair. In preparation for birth, cardiomyocytes (CMs) undergo major maturational changes that include exit from the cell cycle, hypertrophic growth, and mitochondrial maturation.

Bridging Educational Procedural Gap Via Analysis of Procedures Performed by Pediatric Nurse Practitioners in Clinical Practice: A Cross Sectional Survey.

Introduction: The complexity of healthcare is dynamic and requires educators to evaluate how to prepare pediatric nurse practitioners (PNPs). The research team sought to evaluate procedures currently being performed by primary and acute care PNPs in clinical practice and determine how this aligns with the educational preparation recommended for certification.

Method: A cross-sectional survey of primary and acute care PNPs were evaluated through an online survey.

Improving the Health and Environmental Health Literacy of Professionals: Evaluating the Effect of a Virtual Intervention on Phthalate Environmental Health Literacy.

The American College of Obstetricians and Gynecologists provided updated guidance in 2021, recommending that reproductive health professionals should include discussion of environmental exposures with their patients. However, environmental health is seldom included in medical training, with endocrine-disrupting chemicals, such as phthalates-linked to adverse pregnancy outcomes-being among the least discussed. We developed a one-hour virtual educational intervention to train reproductive health professionals on the routes of phthalate exposure, potential associated health impacts, and suggestions on how to discuss exposure reduction with patients.

A Novel Playbook for Pragmatic Trial Operations to Monitor and Evaluate Ambient Artificial Intelligence in Clinical Practice.

Background: Ambient artificial intelligence offers promise for improving documentation efficiency and reducing provider burden through clinical note generation. However, challenges persist in workflow integration, compliance, and widespread adoption. This study leveraged a Learning Health System (LHS) framework to align research and operations using a hybrid effectiveness-implementation protocol, embedded as pragmatic trial operations within the electronic health record (EHR).

Tuning the Performance of Metalloporphyrin-Based Pressure-Sensitive Paints through the Nature of the Central Metal Ion.

Since the 1980s, pressure-sensitive paint (PSP) has been used as an optical pressure sensor for measuring surface pressure on aircraft models in wind tunnels. Typically, PSPs have utilized platinum(II)-5,10,15,20-tetrakis(2,3,4,5,6-pentafluorophenyl)-porphyrin due to its high pressure sensitivity, phosphorescence lifetime of ∼50 μs, reasonable quantum yield of emission, and resistance to photo-oxidation. This work investigates the photophysics and electronic structure of metal complexes of 5,10,15,20-tetrakis(2,3,4,5,6-pentafluorophenyl)-porphyrin, namely, Zn(II), Pd(II), and Ir(III), as potentially improved luminophores for polymer-based PSPs.

Novel Phenotypes and Genotype-Phenotype Correlations in a Large Clinical Cohort of Patients With Kleefstra Syndrome.

Kleefstra syndrome (KLEFS) is a genetic neurodevelopmental disorder caused by haploinsufficiency of EHMT1. The full spectrum of clinical features and genotype-phenotype correlations is currently not fully understood. We performed a retrospective chart review of patients with KLEFS evaluated at the Boston Children's Hospital Kleefstra Clinic.

An International Study of Variation in Attitudes to Kidney Biopsy Practice.

Key Points: Attitudes on kidney biopsy practice vary significantly across the world. Male clinicians, younger clinicians, and individuals who perform biopsies more frequently had an increased propensity to recommend a kidney biopsy. Kidney biopsy was most often recommended in the setting of higher proteinuria levels and preserved kidney function.

A multitiered analysis platform for genome sequencing: Design and initial findings of the Australian Genomics Cardiovascular Disorders Flagship.

Purpose: The Australian Genomics Cardiovascular Disorders Flagship was a national multidisciplinary collaboration. It aimed to investigate the feasibility of genome sequencing (GS) and functional genomics to resolve variants of uncertain significance (VUS) in the clinical management of patients and families with cardiomyopathies, primary arrhythmias, and congenital heart disease (CHD).

Methods: Between April 2019 and December 2021, 600 probands meeting cardiovascular disorder criteria from 17 cardiology and genetics clinics across Australia were enrolled in the Flagship and underwent GS.

Impact of a Text Messaging Intervention as an In-Between Support to Diabetes Group Visits in Federally Qualified Health Centers: Cluster Randomized Controlled Study.

Background: In the United States, 1 in 11 people receive primary care from a federally qualified health center (FQHC). Text messaging interventions (TMIs) are accessible ways to deliver health information, engage patients, and improve health outcomes in the health center setting.

Objective: We aimed to evaluate the impact of a TMI implemented with a group visit (GV) intervention among patients with type 2 diabetes mellitus (T2DM) at FQHCs on patient-reported outcomes and clinical outcomes based on patient TMI engagement.