Enhancing representation of special populations: An approach to the inclusion of women veterans in VA clinical trials.

The under-recruitment of historically marginalized populations into clinical trials thwarts equitable inclusion of individuals who could benefit from healthcare innovations and limits the generalizability of results. For decades, the Veterans Health Administration (VA) has conducted large clinical trials that impact clinical guidelines for veterans and civilians alike. Within the VA, women are a numeric minority, and recruitment of this population into trials is challenged by gender-specific care structures, distinct demographic characteristics, and mistreatment such as higher rates of military sexual trauma and harassment on VA grounds.

Uromodulin and Risk of Upper Urinary Tract Infections: A Mendelian Randomization Study.

Rationale & Objective: Observational studies suggest that uromodulin, produced by the kidneys, is associated with a reduced the risk of upper urinary tract infections, but inferences are limited by potential confounding factors. This study sought to explore further the validity of this association using Mendelian randomization.

Study Design: Two-sample Mendelian randomization study.

Evaluation of a content-based image retrieval system for radiologists in high-resolution CT of interstitial lung diseases.

Background: This retrospective study aims to evaluate the impact of a content-based image retrieval (CBIR) application on diagnostic accuracy and confidence in interstitial lung disease (ILD) assessment using high-resolution computed tomography CT (HRCT).

Methods: Twenty-eight patients with verified pattern-based ILD diagnoses were split into two equal datasets (1 and 2). The images were assessed by two radiology residents (3rd and 5th year) and one expert radiologist in four sessions.

Heart failure risk stratification using artificial intelligence applied to electrocardiogram images: a multinational study.

Background And Aims: Current heart failure (HF) risk stratification strategies require comprehensive clinical evaluation. In this study, artificial intelligence (AI) applied to electrocardiogram (ECG) images was examined as a strategy to predict HF risk.

Methods: Across multinational cohorts in the Yale New Haven Health System (YNHHS), UK Biobank (UKB), and Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), individuals without baseline HF were followed for the first HF hospitalization.

Exploring the Role of [Ga]Ga-DOTAGA-IAC and Comparison of Its Diagnostic Performance with [F]F-FDG PET/CT in Radioiodine Refractory Differentiated Thyroid Carcinoma.

Integrin antagonist complex (IAC), a novel αvβ3 integrin antagonist peptidomimetic, has emerged as a promising agent for molecular imaging of tumor angiogenesis. This study evaluates the biodistribution and clinical efficacy of [Ga]Ga-DOTAGA-IAC PET/CT in detecting radioiodine-refractory differentiated thyroid carcinoma (RAIR-DTC), comparing its diagnostic performance with [F]F-FDG PET/CT. In this prospective pilot study, RAIR-DTC patients underwent whole-body imaging with [F] F-FDG PET/CT, followed by [Ga]Ga-DOTAGA-IAC PET/CT.

Utilizing Quantitative Analysis of CSF Volume from Clinical T1-Weighted MRI to Predict Thrombectomy Outcomes.

Background And Purpose: Endovascular thrombectomy (EVT) is the standard for acute ischemic stroke from large vessel occlusion, but post-EVT functional independence varies. Brain atrophy, linked to higher cerebrospinal fluid volume (CSFV), may affect outcomes. Baseline CSFV could predict EVT benefit by assessing brain health.

Erlotinib-induced Perioral Lesions Resembling Scleroderma.

Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is currently used in the therapy of several solid malignancies. This agent has been associated with several dermatological side-effects, the most common being papulo-pustular acneiform rash. Herein we describe a unique skin effect in a patient treated with erlotinib for non-small cell lung cancer.

Nde1 Promotes Lis1 Binding to Full-Length Autoinhibited Human Dynein-1.

Cytoplasmic dynein-1 (dynein) is the primary motor for the retrograde transport of intracellular cargoes along microtubules. The activation of the dynein transport machinery requires the opening of its autoinhibited Phi conformation by Lis1 and Nde1/Ndel1, but the underlying mechanism remains unclear. Using biochemical reconstitution and cryo-electron microscopy, we show that Nde1 significantly enhances Lis1 binding to autoinhibited dynein and facilitates the opening of Phi.

Molecular basis for the assembly of the dynein transport machinery on microtubules.

Cytoplasmic dynein-1, a microtubule-based motor protein, requires dynactin and an adaptor to form the processive dynein-dynactin-adaptor (DDA) complex. The role of microtubules in DDA assembly has been elusive. Here, we reveal detailed structural insights into microtubule-mediated DDA assembly using cryo-electron microscopy.

Septic Pelvic Thrombophlebitis Status Post-Laparoscopic Hysterectomy: A Case Report Investigating a Rare Yet Perilous Adverse Outcome.

Septic pelvic thrombophlebitis is defined as an endovascular thrombus of infectious etiology. It is frequently diagnosed only after excluding other more common pathologies. A high level of suspicion should be maintained in the context of a fever refractory to broad-spectrum antibiotics that improves after initiation of systemic anticoagulation.

Complications of Post-Roux-en-Y Gastric Bypass: A Case of Excluded Stomach Perforation.

Roux-en-Y gastric bypass (RYGB) is a common surgical treatment for morbid obesity, but rare complications involving the excluded gastric remnant can pose significant challenges. A 65-year-old female with a history of RYGB presented with sudden onset of left upper quadrant abdominal pain, bloating, nausea, and loss of appetite. Laboratory tests revealed leukocytosis.

Comparison of the Degree of Chest CT Scan Abnormalities in COVID-19 and Influenza Patients.

Introduction In the emergency department (ED), COVID-19 and influenza are two common viral diseases. They cause similar symptoms in the respiratory system, and most patients' symptoms are relatively mild. We have reported previously that COVID-19 and influenza infections cause similar abnormalities in chest X-ray readings in the ED.

Axillary to Superior Mesenteric Artery Bypass as a Viable Solution for Chronic Mesenteric Ischemia.

Chronic mesenteric ischemia (CMI) is a progressive condition that primarily affects the elderly, causing chronic abdominal pain and malnutrition. Timely treatment is essential to prevent further deconditioning or bowel ischemia. Surgical repair options include both endovascular and open procedures.

Cryptococcal Pneumonia in Multiple Myeloma: A Case Report.

Patients with multiple myeloma (MM) often experience infections due to aberrant immunoglobulin production by malignant plasma cells and immunosuppressive therapeutic interventions that are used to treat the condition. A rare but serious infection that may occur in these patients is Cryptococcus, an encapsulated fungus that typically infects immunocompromised individuals. Cryptococcus infections often present as pneumonia but can disseminate to the central nervous system, potentially causing meningitis.

Mechanisms of immunotherapy resistance in small cell lung cancer.

Small-cell lung cancer (SCLC) is an aggressive neuroendocrine tumor with a poor prognosis. Although the addition of immunotherapy to chemotherapy has modestly improved outcomes, most patients rapidly develop resistance. Resistance to immunotherapy can be broadly categorized into primary resistance and acquired resistance, as proposed by the Society for Immunotherapy of Cancer (SITC) consensus definition.

Breaking the Silence on Obesity.

Obesity is a significant global public health concern, and health care providers play a crucial role in addressing it by offering healthy lifestyle counseling and weight management support. Evidence demonstrates that even brief counseling on healthy behaviors can lead to meaningful changes and sustained weight management. However, weight consultations are often underutilized in primary care due to various barriers, including biases against patients with obesity, misconception of physicians with obesity, or concerns about stigmatizing them by initiating discussions about weight.

Molecular epidemiology, evolution, and transmission dynamics of raccoon rabies virus in Connecticut.

In North America, raccoon rabies virus (RRV) is a public health concern due to its potential for rapid spread, maintenance in wildlife, and impact on human and domesticated animal health. RRV is an endemic zoonotic pathogen throughout the eastern USA. In 1991, an outbreak of RRV in Fairfield County, Connecticut, spread through the state and eventually throughout the Northeast and into Canada.

Impact of NAFLD-related SNPs on the carotid atherosclerosis development; a five-year prospective observational study.

Background And Aims: The prevalence of metabolic dysfunction associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), has become a significant public health concern with an increased atherosclerotic cardiovascular disease risk. This study investigates the impact of NAFLD-related single nucleotide polymorphisms (SNPs) on carotid atherosclerosis development in a Japanese population without diabetes, dyslipidemia, and hypertension.

Methods: The prospective observational study, part of the Kyushu and Okinawa Population Study (KOPS), included 945 participants (median age 55 [47, 63]) without carotid atherosclerosis, increased alcohol intake, diabetes, dyslipidemia, hypertension, or chronic hepatitis at baseline.

Effectiveness and safety of oral vancomycin for the treatment of inflammatory bowel disease associated with primary sclerosing cholangitis: a systematic review and pooled analysis.

Background: Inflammatory bowel disease (IBD) occurs in up to 70%-80% of patients with primary sclerosing cholangitis (PSC). Oral vancomycin therapy (OVT) has been reported to be effective in the treatment of IBD associated with PSC (IBD-PSC).

Objectives: To examine the effectiveness and safety of OVT in the treatment of IBD-PSC by performing a systematic review and pooled analysis of the literature.

Neural hyperscanning in caregiver-child dyads: A paradigm for studying the long-term effects of facilitated vs. disrupted attention on working memory and executive functioning in young children.

Parent-child interactions shape children's cognitive outcomes such that caregivers can guide attention and facilitate learning opportunities. These interactions provide infants and toddlers with rich, naturalistic experiences that engage complex cognitive functions and lay the groundwork for the development of mature executive functions. Although most caregivers seek to engage children optimally, they can unintentionally impede this developmental process by being under-engaged or intrusive.

Patient specific variables impact sensitivity to association between joint balance and 2 Year outcomes.

Background: This study investigates the association between intra-operative balance and 2-year outcomes within subgroups defined by demographics and pre-operative joint balance. Our hypothesis is that patient demographics and the pre-operative state of the joint will impact patient sensitivity to post-operative balance and laxity and subsequent impact on outcome.

Methods: A retrospective analysis of prospectively captured data across 5 sites with 5 surgeons was performed.

Fat droplets in the cerebrospinal fluid (CSF) spaces of the brain.

It is rare to find free floating fat droplets in the cerebral spinal fluid (CSF) spaces of the brain. When fat droplets are seen in the CSF spaces, the most common cause is the rupture of a dermoid cyst. Dermoid cysts are congenital inclusion cysts that form during the neural tube closure between the third and fifth weeks of embryogenesis.

A Contemporary Analysis of Discharge Disposition Following Total Joint Arthroplasty.

Background: Total joint arthroplasty (TJA) represents the single largest procedural cost for the Centers for Medicare & Medicaid Services. Discharge to a skilled nursing facility (SNF) remains a primary driver of post-acute care costs. The COVID-19 pandemic led to a decrease in number of discharges to SNFs.

Changes in Physical Activity and Cardiovascular Disease Risk in Cancer Survivors: A Nationwide Cohort Study.

Background: Cancer survivors face an elevated risk of cardiovascular disease, with physical inactivity after cancer treatment potentially worsening this risk.

Objectives: The aim of this study was to investigate the association between physical activity before and after a cancer diagnosis and the risk for heart disease.

Methods: A nationwide cohort of 269,943 cancer survivors (mean age 56.