A Rare Combination of Bleeding Disorders in South Dakota: A Case Report.

Hemophilia A is a clotting disorder due to factor VIII deficiency, leading to prolonged bleeding. Acquired hemophilia A results from the immune system attacking factor VIII, typically occurring later in life. Factor V Leiden is a genetic mutation causing abnormal blood clot formation, primarily in veins.

Effort-reward imbalance among dental and dental hygiene faculty and turnover intention.

Purpose: The impact of effort-reward imbalance (ERI) on the decision to leave academia among dental and dental hygiene faculty in the United States (US) has yet to be explored. This study examined the effect of effort, reward, and overcommitment on turnover intention to leave academia in dental and dental hygiene faculty in the US.

Methods: Cross-sectional survey research design was conducted with a convenience sample of dental hygiene and dental faculty (n = 273) currently teaching in the US.

The effect of post-exercise heat exposure (passive heat acclimation) on endurance exercise performance: a systematic review and meta-analysis.

Background: "Active" heat acclimation (exercise-in-the-heat) can improve exercise performance but the efficacy of "passive" heat acclimation using post-exercise heat exposure is unclear. Therefore, we synthesised a systematic review and meta-analysis to answer whether post-exercise heat exposure improves exercise performance.

Methods: Five databases were searched to identify studies including: (i) healthy adults; (ii) an exercise training intervention with post-exercise heat exposure via sauna or hot water immersion (treatment group); (iii) a non-heat exposure control group completing the same training; and (iv) outcomes measuring exercise performance in the heat (primary outcome), or performance in thermoneutral conditions, V̇Omax, lactate threshold, economy, heart rate, RPE, core temperature, sweat rate, and thermal sensations.

Medical Students' Attitudes Toward the COVID-19 Vaccine and Medical School Vaccine Education: A Survey Study.

Objective: The aim of this study is to investigate how demographic factors influence medical students' attitudes toward COVID-19 vaccines and their perceptions of vaccine education in medical school curricula.

Methods: A 28-question anonymous online survey was distributed to 640 medical students at one academic medical institution. Individual attitudes toward vaccines were evaluated using a 5-point Likert scale.

Treat the Patient as a Whole, Not Just the Laboratory Findings: A Case of Contaminated Blood Cultures With Subsequent Iatrogenic Complications.

Sepsis is a serious condition involving life-threatening infection-driven immune response and organ dysfunction. In the emergency department (ED), patients at high risk for sepsis or those with suspected sepsis are managed with a standardized protocol which includes empiric broad-spectrum antibiotic therapy pending blood culture results and susceptibilities, if applicable. While the benefits generally outweigh the risks, this approach may lead to complications, including allergic reactions, gastrointestinal irritation, acute kidney injury, and even financial toxicity, particularly in cases of contaminated blood cultures.

Expanded Endoscopic Endonasal Clipping of a Giant Cavernous Carotid Aneurysm.

Cavernous carotid aneurysms are typically small, asymptomatic, and often do not require treatment. We present the case of a 59-year-old woman, a 3-pack-a-day smoker, who presented with the primary complaint of left retro-orbital pain, left complete ophthalmoplegia, left-sided blindness, and right abducens palsy. Imaging revealed a giant right cavernous carotid aneurysm, which had expanded to the contralateral cavernous sinus wall and superiorly through the diaphragm sellae.

Neuropsychiatric considerations in treating anorexia nervosa patients with osteopathic manipulative medicine: a narrative review.

Osteopathic manipulative medicine (OMM) has a growing recognition in serving as an effective treatment to promote adaptation and homeostasis of the body by addressing musculoskeletal, neural, vascular, and lymphatic structures to promote self-healing and regulation. OMM can treat the musculoskeletal tension and sympathetic hyperactivity resulting from the increased cortisol response and hypersensitivity found in varying psychiatric illnesses, including anorexia nervosa (AN). This paper addresses the considerations necessary for treating AN patients with OMM, emphasizing the need to evaluate their abnormal high-level neuronal processing of sensory information, including differences in touch perception compared to the general population.

An Introductory Guide to Survey Research.

In the dental hygiene discipline, evidence-based practice serves as a cornerstone for delivering high quality patient care and moving professional standards forward. As practitioners delve deeper into research to inform clinical decision making, the integration of robust survey methodologies becomes imperative. However, the complexities of survey design, implementation, and analysis pose notable challenges, particularly in ensuring the reliability and validity of research outcomes.

Assessment of Generative Artificial Intelligence (AI) Models in Creating Medical Illustrations for Various Corneal Transplant Procedures.

Purpose: This study aimed to task and assess generative artificial intelligence (AI) models in creating medical illustrations for corneal transplant procedures such as Descemet's stripping automated endothelial keratoplasty (DSAEK), Descemet's membrane endothelial keratoplasty (DMEK), deep anterior lamellar keratoplasty (DALK), and penetrating keratoplasty (PKP).  Methods: Six engineered prompts were provided to Decoder-Only Autoregressive Language and Image Synthesis 3 (DALL-E 3) and Medical Illustration Manager (MIM) to guide these generative AI models in creating a final medical illustration for each of the four corneal transplant procedures. Control illustrations were created by the authors for each transplant technique for comparison.

Evaluating the Accuracy of Artificial Intelligence (AI)-Generated Illustrations for Laser-Assisted In Situ Keratomileusis (LASIK), Photorefractive Keratectomy (PRK), and Small Incision Lenticule Extraction (SMILE).

Purpose: To utilize artificial intelligence (AI) platforms to generate medical illustrations for refractive surgeries, aiding patients in visualizing and comprehending procedures like laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and small incision lenticule extraction (SMILE). This study displays the current performance of two OpenAI programs in terms of their accuracy in common corneal refractive procedures.

Methods: We selected AI image generators based on their popularity, choosing Decoder-Only Autoregressive Language and Image Synthesis 3 (DALL-E 3) for its leading position and Medical Illustration Master (MiM) for its high engagement.

"Let's Chat!" Improving Emergency Department Staff Satisfaction with the Medication Reconciliation Process.

Introduction: Patients who stay in the emergency department (ED) for prolonged periods of time require verification of home medications, a process known as medication reconciliation. The complex nature of medication reconciliation can lead to adverse events and staff dissatisfaction. A multidisciplinary team was formed to improve accuracy, timing, and staff satisfaction with the medication reconciliation process.

Long-term biotic homogenization in the East African Rift System over the last 6 million years of hominin evolution.

Eastern Africa preserves the most complete record of human evolution anywhere in the world but we have little knowledge of how long-term biogeographic dynamics in the region influenced hominin diversity and distributions. Here, we use spatial beta diversity analyses of mammal fossil records from the East African Rift System to reveal long-term biotic homogenization (increasing compositional similarity of faunas) over the last 6 Myr. Late Miocene and Pliocene faunas (~6-3 million years ago (Ma)) were largely composed of endemic species, with the shift towards biotic homogenization after ~3 Ma being driven by the loss of endemic species across functional groups and a growing number of shared grazing species.

Comparing outcomes of balloon-expandable vs. self-expandable valves in transcatheter aortic valve replacement: a systematic review and meta-analysis.

Background: Aortic stenosis (AS) is a common heart condition categorized into congenital and acquired forms. Transcatheter aortic valve replacement (TAVR) is an innovative method for AS management, and two valve types, self-expanding valves (SEV) and balloon-expandable valves (BEV), are used in TAVR. The objective of this study is to compare the clinical outcomes associated with balloon-expandable and self-expandable valves in transcatheter aortic valve replacement.

An Unusual Case Presentation of Non-Pathergy Induced Severe Pyoderma Gangrenosum Localized to the Perianal and Intragluteal Regions.

Pyoderma gangrenosum is a rare neutrophil based disorder presenting as a painful sterile ulcer usually below the knee. The disease is also linked to comorbid conditions including inflammatory bowel disease (IBD) and pathergy. Mainstay treatment begins with high dose steroids, either topical for limited disease or systemic for extensive or rapidly progressing disease.

Immune Checkpoint Inhibition for High Grade Meningiomas: A Systematic Review.

Background: World Health Organization grade II/III meningiomas frequently recur despite maximal safe surgical resection and adjuvant radiation. Notoriously resistant to medical therapy, no well-established guidelines for pharmacologic treatment currently exist. In recent years, a small number of clinical trials have investigated immune checkpoint inhibitors (ICIs) for patients with recurrent grade II/III meningiomas.

Rapid Creation of Knowledge-Balanced Student Groups Using ChatGPT4.

We demonstrated use of ChatGPT4 for efficient group formation in undergraduate medical education. ChatGPT4 created balanced groups considering students' backgrounds in microbiology, physiology, genetics, and immunology considerably faster than manual efforts. Manual refinements included gender balance and discipline distribution.

Relationship of thyroid function with genetic subtypes and treatment with growth hormone in Prader-Willi syndrome.

Prader-Willi syndrome (PWS) is the most common genetic syndrome with obesity and results from loss of expression of paternally inherited genes on chromosome 15q11-q13 by a variety of mechanisms which include large deletions (70%-75%), maternal uniparental disomy (UPD) (20%-30%), and imprinting defects (2%-5%) or balanced translocations. Individuals often have a characteristic behavior disorder with mild intellectual disability, infantile hypotonia associated with poor sucking, short stature, and obesity. PWS is characterized by hypothalamic-pituitary axis dysfunction with growth hormone (GH) deficiency, hypogonadism, and several other hormonal deficiencies resulting in short stature, centrally driven excessive appetite (hyperphagia), central obesity, cryptorchidism, and decreased lean body mass.