Establishment of a Robot-Assisted Bronchoscopy Program at a Veterans Affairs Hospital.

Lung cancer has high mortality rates attributed to late diagnosis and treatment. Robot-assisted bronchoscopy (RAB) offers promising solutions to these challenges, enabling precise navigation and biopsy of small and difficult-to-reach lung nodules. We present the early outcomes and challenges encountered in establishing an RAB program at a Veterans Affairs (VA) Medical Center.

Respiratory Health Associated With Systemic Metal Exposure in Post-9/11 Veterans in the Department of Veterans Affairs Toxic Embedded Fragment Registry.

Objective: Adverse respiratory outcomes in post-9/11 veterans with elevated urinary metal measures and enrolled in the VA's Toxic Embedded Fragment registry were compared to those without elevated urinary metals.

Methods: Veterans completed questionnaires, underwent pulmonary physiology tests (pulmonary function and oscillometry), and provided urine samples for analysis of 13 metals. Respiratory symptoms, diagnoses, and physiology measures were compared in veterans with ≥1 urine metal elevation to those without metal elevations, adjusted for covariates, including smoking.

Optimal Electrodermal Activity Segment for Enhanced Emotion Recognition Using Spectrogram-Based Feature Extraction and Machine Learning.

In clinical and scientific research on emotion recognition using physiological signals, selecting the appropriate segment is of utmost importance for enhanced results. In our study, we optimized the electrodermal activity (EDA) segment for an emotion recognition system. Initially, we obtained EDA signals from two publicly available datasets: the Continuously annotated signals of emotion (CASE) and Wearable stress and affect detection (WESAD) for 4-class dimensional and three-class categorical emotional classification, respectively.

Canadian Newspapers Support Mifepristone Medication Abortion to Improve Fulfillment of the AAAQ Right to Health Framework (2015-2019).

Background: In 2015, mifepristone in combination with misoprostol, the international gold standard for medication abortion, was approved for use in Canada. By 2019, all Canadian provinces had included the medication as a publicly insured health benefit.

Methods: Our content analysis of Canadian newspaper coverage describes arguments in favor of or against medication abortion and the evolving regulatory framework for mifepristone from 6 months before regulatory approval until the last significant regulatory barrier to use was removed (2015-2019).

Murine fetal bone marrow does not support functional hematopoietic stem and progenitor cells until birth.

While adult bone marrow (BM) hematopoietic stem and progenitor cells (HSPCs) and their extrinsic regulation is well studied, little is known about the composition, function, and extrinsic regulation of the first HSPCs to enter the BM during development. Here, we functionally interrogate murine BM HSPCs from E15.5 through P0.

Hotspots in action: near-infrared light mediated photoelectrochemical oxygen evolution on high index faceted plasmonic gold nanoarchitectures.

Photo-induced electrochemical water splitting is a fascinating approach to overcome the present energy demands as well as environmental issues. To this end, near-infrared (NIR) photocatalysts stand out as promising candidates (where 53% of the solar light is NIR light) to solve the present energy crisis but the lack of NIR-activated photocatalysts has remained a great challenge for decades. Herein, for the first time, we report the synthesis of high-index faceted plasmonic Au nano-branched 12 tip nanostars, which can absorb the whole spectral region of electromagnetic radiation (UV-vis-NIR), for efficient water splitting.

Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia.

Purpose: Severe community-acquired pneumonia (CAP) requiring intensive care unit admission is associated with significant acute and long-term morbidity and mortality. We hypothesized that downregulation of systemic and pulmonary inflammation with prolonged low-dose methylprednisolone treatment would accelerate pneumonia resolution and improve clinical outcomes.

Methods: This double-blind, randomized, placebo-controlled clinical trial recruited adult patients within 72-96 h of hospital presentation.

Impact of the Heartfulness program on loneliness in high schoolers: Randomized survey study.

High levels of loneliness are prominent in teenagers ranging from ages 14-19. The 4-week Self-Care program, offered by the Heartfulness Institute, is designed to develop social-emotional skills and self-observation. This study examined the impact of the Self-Care program on loneliness in high school students in the United States in a randomized, wait-list control trial with baseline and postintervention assessments.

Contrastive learning of heart and lung sounds for label-efficient diagnosis.

Data labeling is often the limiting step in machine learning because it requires time from trained experts. To address the limitation on labeled data, contrastive learning, among other unsupervised learning methods, leverages unlabeled data to learn representations of data. Here, we propose a contrastive learning framework that utilizes metadata for selecting positive and negative pairs when training on unlabeled data.

Evaluation of the Veterans Affairs Pharmacogenomic Testing for Veterans (PHASER) clinical program at initial test sites.

The first Plan-Do-Study-Act cycle for the Veterans Affairs Pharmacogenomic Testing for Veterans pharmacogenomic clinical testing program is described. Surveys evaluating implementation resources and processes were distributed to implementation teams, providers, laboratory and health informatics staff. Survey responses were mapped to the Consolidated Framework for Implementation Research constructs to identify implementation barriers.

A 67-Year-Old Woman With Abdominal Pain, Paresthesia, and Rapidly Expanding Lung Nodule.

A 67-year-old woman with a medical history significant for hypertension, hyperlipidemia, type 2 diabetes mellitus, OSA, and schizophrenia was admitted multiple times the previous 3 months for generalized abdominal pain. Her most recent admission was unique for new onset bilateral upper and lower extremity weakness with paresthesia. Pertinent review of systems included malaise, fever, cough, left lower quadrant pain without weight loss, and rash.

Role of dephasing on the conductance signatures of Majorana zero modes.

Conductance signatures that signal the presence of Majorana zero modes in a three terminal nanowire-topological superconductor hybrid system are analyzed in detail, in both the clean nanowire limit and in the presence of non-coherent dephasing interactions. In the coherent transport regime for a clean wire, we point out contributions of the local Andreev reflection and the non-local transmissions toward the total conductance lineshapes while clarifying the role of contact broadening on the Majorana conductance lineshapes at the magnetic field parity crossings. Interestingly, at larger-field parity crossings, the contribution of the Andreev reflection process decreases which is compensated by the non-local processes in order to maintain the conductance quantum regardless of contact coupling strength.

Design and Evaluation of Sustained Release of Ornidazole by Dental Inserts.

Unlabelled: Aim & Background: Ornidazole is an antimicrobial drug used to treat certain types of vaginal, urinary tract, and interstitial infections. The study aims to formulate and evaluate the dental inserts by using a drug candidate to sustained drug release to improve patient compliance, reduce dosing frequency, reduce the risk of dose dumping, and avoid the first-pass metabolism. They have better therapeutic efficacy and fewer side effects.

Veterans Affairs Pharmacogenomic Testing for Veterans (PHASER) clinical program.

In 2019, the Veterans Affairs (VA), the largest integrated US healthcare system, started the Pharmacogenomic Testing for Veterans (PHASER) clinical program that provides multi-gene pharmacogenomic (PGx) testing for up to 250,000 veterans at approximately 50 sites. PHASER is staggering program initiation at sites over a 5-year period from 2019 to 2023, as opposed to simultaneous initiation at all sites, to facilitate iterative program quality improvements through Plan-Do-Study-Act cycles. Current resources in the PGx field have not focused on multisite, remote implementation of panel-based PGx testing.

Hybridizing Plasmonic Materials with 2D-Transition Metal Dichalcogenides toward Functional Applications.

Recently, 2D transition metal dichalcogenides (TMDs) have become intriguing materials in the versatile field of photonics and optoelectronics because of their strong light-matter interaction that stems from the atomic layer thickness, broadband optical response, controllable optoelectronic properties, and high nonlinearity, as well as compatibility. Nevertheless, the low optical cross-section of 2D-TMDs inhibits the light-matter interaction, resulting in lower quantum yield. Therefore, hybridizing the 2D-TMDs with plasmonic nanomaterials has become one of the promising strategies to boost the optical absorption of thin 2D-TMDs.

Metoprolol for the Prevention of Acute Exacerbations of COPD.

Background: Observational studies suggest that beta-blockers may reduce the risk of exacerbations and death in patients with moderate or severe chronic obstructive pulmonary disease (COPD), but these findings have not been confirmed in randomized trials.

Methods: In this prospective, randomized trial, we assigned patients between the ages of 40 and 85 years who had COPD to receive either a beta-blocker (extended-release metoprolol) or placebo. All the patients had a clinical history of COPD, along with moderate airflow limitation and an increased risk of exacerbations, as evidenced by a history of exacerbations during the previous year or the prescribed use of supplemental oxygen.

Pharmacokinetics and relative bioavailability of tiamulin in broiler chicken as influenced by different routes of administration.

The bioavailability and pharmacokinetic disposition of tiamulin in broiler chicken were investigated after administration through the crop, drinking water, and feed at 40 mg/kg body weight. Residues of tiamulin in tissues of broiler chicken were also assessed. Plasma and tissue concentrations of tiamulin were analyzed by reverse-phase high-performance liquid chromatography (HPLC) method.

Porous aluminum electrodes with 3D channels and zig-zag edges for efficient hydrogen evolution.

An eco-friendly electrochemical approach, including base and acid treatments, and anodization, has been developed for preparation of defect-rich porous aluminum electrodes for efficient hydrogen evolution. A small Tafel slope value of 43 mV dec-1 reveals improved reaction kinetics through the micropores, 3D channels, and zig-zag edges of the aluminum electrode. It exhibits an onset potential of 460 mV and an overpotential of 580 mV at the current density of 10 mA cm-2 due to the porous and edge structures that enhance the charge transfer and mass transport.

Diagnostic Yield of the Virtual Bronchoscopic Navigation System Guided Sampling of Peripheral Lung Lesions using Ultrathin Bronchoscope and Protected Bronchial Brush.

Objectives: The use of an ultrathin bronchoscope (UB) to diagnose peripheral pulmonary lesions is described. A virtual bronchoscopic navigation system was used to direct the ultrathin scope to the nodule. One of the constraints of this technique was the inability to confirm the target lesion position during biopsy by using a conventional linear endobronchial ultrasound probe, since the probe does not fit into a 1.

A snapshot of gut microbiota of an adult urban population from Western region of India.

The human gut microbiome contributes to a broad range of biochemical and metabolic functions that directly or indirectly affect human physiology. Several recent studies have indicated that factors like age, geographical location, genetic makeup, and individual health status significantly influence the diversity, stability, and resilience of the gut microbiome. Of the mentioned factors, geographical location (and related dietary/socio-economic context) appears to explain a significant portion of microbiome variation observed in various previously conducted base-line studies on human gut microbiome.

Factors Affecting Visual Field Outcome Post-Surgery in Sellar Region Tumors: Retrospective Study.

Background: Despite the broad category of differentials for sellar region, most of them present with similar clinical signs and symptoms. Headache and visual disturbance are among the frequently seen as presenting symptom. Visual field (VF) assessment is one of the crucial component of neuroophtalmologic assessment and mean deviation (MD) value from automated perimetry allows quantification of the visual field defect.