Longitudinal Analysis of Obesity Drug Use and Public Awareness.

Importance: Obesity, a chronic disease with escalating global prevalence, poses considerable health risks. Glucagon-like peptide 1 receptor agonists (GLP-1RAs), including liraglutide, semaglutide, and tirzepatide, have demonstrated efficacy for weight loss in clinical trials. The paradigm shift in the approach to obesity management drugs (OMDs) may offer an opportunity to examine online search activity and prescription trends.

Reimagining Physician Assistant Education: Championing Cognitive Diversity to Promote Inclusivity, Neurodiversity Awareness, and a Sense of Belonging.

Neurodiversity, encompassing conditions such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and dyslexia, represents a significant and often under-recognized segment of the population, including within science, technology, engineering, mathematics, and medicine fields like medicine. Neurodiverse individuals possess unique skills, including enhanced creativity, analytical thinking, and meticulous attention to detail, which are valuable in health care professions. However, failure to recognize and support these individuals can result in missed opportunities, social isolation, and mental health challenges.

Adrenal Venous Sampling in the Investigation of Hyperaldosteronism: A Retrospective Practice Review from a Large Academic Medical Center.

Background: Hyperaldosteronism involves complex, multidisciplinary management, including clinical testing, radiological exams, and adrenal venous sampling (AVS). This study assesses AVS outcomes at a large referral center, focusing on cannulation success, lateralization of aldosterone-producing adenomas, and correlation with radiological and surgical findings.

Methods: A retrospective review of 153 patients who underwent AVS from September 2016 to January 2024 was conducted.

Structural analysis of extracellular ATP-independent chaperones of streptococcal species and protein substrate interactions.

Unlabelled: During infection, bacterial pathogens rely on secreted virulence factors to manipulate the host cell. However, in gram-positive bacteria, the molecular mechanisms underlying the folding and activity of these virulence factors after membrane translocation are not clear. Here, we solved the protein structures of two secreted parvulin and two secreted cyclophilin-like peptidyl-prolyl isomerase (PPIase) ATP-independent chaperones found in gram-positive streptococcal species.

TccP4: a novel effector identified in the strain 1551-2 required for attaching and effacing lesion formation on infected Nck-null cells.

is a pathogen that causes sporadic cases and outbreaks of diarrhea. The main virulence feature of this bacterium is the attaching and effacing (AE) lesion formation on infected intestinal epithelial cells, which is characterized by the formation of pedestal-like structures that are rich in F-actin. The Brazilian 1551-2 strain can recruit F-actin using both the Nck-dependent and the Nck-independent pathways, the latter of which uses an adaptor protein named Tir-cytoskeleton coupling protein (TccP/EspF).

Cervical cancer stage distribution and survival outcomes in Africa: a systematic review and meta-analysis.

Objective: Cervical cancer is a leading cause of cancer-related deaths among women, with a disproportionate burden in sub-Saharan Africa. Understanding the cervical cancer stage and outcomes is crucial for developing effective interventions and reducing its burden. We aimed to undertake a systematic review and meta-analysis of cervical cancer stage distribution and survival outcomes in Africa.

What Is the State of the Literature About Refugees Aged 45 and Older from Burma in Third-Country Resettlement Contexts?: A Scoping Review.

Background And Objective: Older adult refugees from Burma face unique challenges in third-country resettlement, yet their experiences are often overlooked in research and policy. This scoping review aims to examine the literature on refugees aged 45 and older from Burma in third-country resettlement contexts, identify factors contributing to successful integration, and elucidate the unique challenges they encounter.

Research Design And Methods: We systematically searched seven databases using Arksey and O'Malley's framework.

Second-line treatment patterns and outcomes in advanced HCC after progression on atezolizumab/bevacizumab.

Background & Aims: Atezolizumab/bevacizumab (A/B) is now a standard first-line treatment for advanced hepatocellular carcinoma (HCC), but the optimal second-line regimen is not known. We evaluated real-world treatment patterns and outcomes to investigate factors associated with post-progression survival (PPS).

Methods: In this multicenter, international, retrospective study, we examined clinical characteristics and outcomes of patients with advanced HCC who progressed on first-line A/B.

Effect of Ibuprofen on Markers of Acute Kidney Injury, Intestinal Injury, and Endotoxemia after Running in the Heat.

Purpose: To test the hypothesis that ibuprofen ingestion exacerbates markers of acute kidney injury (AKI), gastrointestinal (GI) injury, and endotoxemia after running in the heat.

Methods: Using a randomized double-blind crossover design, eleven physically active individuals (six women) ingested 600 mg of ibuprofen or placebo 12- and one-hour prior to running one-hour in a heated chamber (35 °C, 20%-60% R.H.

Robotic Nipple Sparing Mastectomy and Breast Reconstruction with Profunda Artery Perforator Flaps.

The single port robotic nipple sparing mastectomy (SPrNSM) was recently introduced. This approach is safe and has led to favorable outcomes in relation to cosmetic result, patient satisfaction, and breast sensation. The typical reconstruction with all robotic nipple sparing mastectomies is implant based; however, this is not always what a patient desires.

Abnormal cardiovascular control during exercise: Role of insulin resistance in the brain.

During exercise circulatory adjustments to meet oxygen demands are mediated by multiple autonomic mechanisms, the skeletal muscle exercise pressor reflex (EPR), the baroreflex (BR), and by feedforward signals from central command neurons in higher brain centers. Insulin resistance in peripheral tissues includes sensitization of skeletal muscle afferents by hyperinsulinemia which is in part responsible for the abnormally heightened EPR function observed in diabetic animal models and patients. However, the role of insulin signaling within the central nervous system (CNS) is receiving increased attention as a potential therapeutic intervention in diseases with underlying insulin resistance.

Markers for Pressure Injury Risk in Individuals with Chronic Spinal Cord Injury: A Pilot Study.

Objective: To identify markers associated with pressure injury (PrI) history in individuals with spinal cord injury (SCI) using two approaches: skin blood flow (SBF) response toward localized heating, and serum marker for insulin resistance.

Methods: For this cross-sectional, observational study of adults with chronic traumatic SCI at T12 and above, researchers recruited two groups of participants: with history of PrI (group 1), and without history of PrI (group 2). The study protocol included obtaining fasting blood samples and measurement of SBF at bilateral heels with localized heating of 42 °C for 30 minutes from all participants.

Changing Epidemiology of Emergency Medical Services Calls for Children in the United States during the COVID-19 Pandemic and Reopening.

Objectives: To describe changes in the volume and types of emergency medical services (EMS) calls for children during the COVID-19 pandemic and after availability of the COVID-19 vaccine ("reopening period").

Methods: A retrospective cross-sectional study of EMS 9-1-1 responses to children under 18 years for all causes over a 4-year period (2019-2022) reported in the National Emergency Medical Services Information System (NEMSIS) dataset. Data was stratified into three periods, Pre-pandemic, Pandemic and Reopening.

Sexual Dimorphism in the Downregulation of Extracellular Matrix Genes Contribute to Aortic Structural Stiffness in Female Mice.

The contribution of sex hormones to cardiovascular disease, including arterial stiffness, is established; however, the role of sex chromosome interaction with sex hormones, particularly in women, is lagging. Arterial structural stiffness depends on the intrinsic properties and transmural wall geometry that comprise a network of cells and extracellular matrix (ECM) proteins expressed in a sex-dependent manner. In this study, we used four-core genotype (FCG) mice to determine the relative contribution of sex hormones versus sex chromosomes or their interaction with arterial structural stiffness.

Cardiopulmonary Exercise Testing.

AbstractBecause symptoms of cardiopulmonary disease often occur with exertion, cardiopulmonary exercise testing (CPET) has a unique role in the assessment of patient symptoms, disease severity, prognosis, and response to therapy. In addition to the evaluation of cardiovascular and pulmonary physiology, CPET provides an assessment of the interaction of the cardiovascular and pulmonary systems with the musculoskeletal, nervous, and hematological systems. In this article, we review key CPET variables, protocols, and clinical indications.

Cell surface protein-protein interaction profiling for biological network analysis and novel target discovery.

The secretome is composed of cell surface membrane proteins and extracellular secreted proteins that are synthesized via secretory machinery, accounting for approximately one-third of human protein-encoding genes and playing central roles in cellular communication with the external environment. Secretome protein-protein interactions (SPPIs) mediate cell proliferation, apoptosis, and differentiation, as well as stimulus- or cell-specific responses that regulate a diverse range of biological processes. Aberrant SPPIs are associated with diseases including cancer, immune disorders, and illness caused by infectious pathogens.

New Mediastinal and Hilar Lymphadenopathy After Adjuvant Pembrolizumab in a Patient With Stage III Clear Cell Renal Cell Carcinoma.

The advent of immune checkpoint inhibitors (ICIs) has transformed the management of advanced and high-risk renal cell carcinoma (RCC). In the adjuvant setting, ICIs, such as pembrolizumab, aim to reduce the risk of recurrence following potentially curative nephrectomy. However, this therapeutic approach introduces unique challenges, particularly related to immune-related adverse events (irAEs).

Two-Year Progressive Cranial Changes Following the Melbourne Technique for Sagittal Craniosynostosis.

Objective: The Melbourne technique for total cranial vault remodeling aims to address all aspects of scaphocephaly in sagittal craniosynostosis. These features include anterior-posterior excessive length, anteriorly displaced vertex position, frontal bossing, vertex narrowing, and occipital bulleting. This study aimed to determine the progressive cranial changes that occur following the Melbourne technique for sagittal craniosynostosis.

Preclinical use of a clinically-relevant scAAV9/SUMF1 vector for the treatment of multiple sulfatase deficiency.

Background: Multiple Sulfatase Deficiency (MSD) is a rare inherited lysosomal storage disorder characterized by loss of function mutations in the SUMF1 gene that manifests as a severe pediatric neurological disease. There are no available targeted therapies for MSD.

Methods: We engineered a viral vector (AAV9/SUMF1) to deliver working copies of the SUMF1 gene and tested the vector in Sumf1 knock out mice that generally display a median lifespan of 10 days.

Current Practices and Evidence of Aspirin Usage in Microvascular Surgery: A Systematic Review and Meta-Analysis.

Background: Acetylsalicylic acid (ASA) has been used in reconstructive microsurgery since the inception of the field. However, when compared to placebo groups, its efficacy is not confirmed. In our study, we hypothesize that the utility of ASA postoperatively in microvascular surgery is not associated with improved outcomes.

Shooter's Abscess: Foot Infections in People Who Inject Drugs.

Musculoskeletal infections are common among people who inject drugs. Little is known about the prevalence and characteristics of skin and soft-tissue infections in this patient population, especially in the lower extremity. The aim of this study is to describe the clinical characteristics, bacterial pathogens, and clinical outcomes in adults with foot infections due to intravenous drug use.

Caught in the Crossfire: A Single Institution's 10-Year Experience with Pediatric Firearm Injury.

Introduction: Pediatric firearm-related injuries are now the leading cause of death among children in the United States. We sought to characterize the experience of a large free-standing children's hospital treating children with firearm injuries.

Methods: We reviewed all 2012-2022 gunshot wound encounters using the institutional trauma database of an urban Level 1 pediatric trauma center in Texas.

LIG1 is a synthetic lethal target in BRCA1 mutant cancers.

Synthetic lethality approaches in BRCA1/2-mutated cancers have focused on poly(ADP-ribose) polymerase (PARP) inhibitors, which are subject to high rates of innate or acquired resistance in patients. Here, we used CRISPR/Cas9-based screening to identify DNA Ligase I (LIG1) as a novel target for synthetic lethality in BRCA1-mutated cancers. Publicly available data supported LIG1 hyperdependence of BRCA1-mutant cells across a variety of breast and ovarian cancer cell lines.

Transaxillary endovascular aortic aneurysm repair using a reverse mounted Gore Excluder endograft for a patient with abdominal aortic aneurysm and severe iliofemoral occlusive disease.

Adverse iliofemoral anatomy represents a unique challenge for endovascular aortic aneurysm repair (EVAR). This report describes a transaxillary EVAR in a patient with severe iliofemoral occlusive disease and an infrarenal aortic aneurysm. A reversely mounted Gore Excluder graft was advanced and deployed in the infrarenal aorta using the left axillary artery.