Resilience in Medical Education: Examining the Effects of the COVID-19 Pandemic on Pre-clerkship Curriculum Outcomes and Learner Perceptions at the University of Hawai'i John A. Burns School of Medicine.

The transition to virtual learning formats during the COVID-19 pandemic necessitated substantial curricular adjustments to the University of Hawai'i John A. Burns School of Medicine. This study compares student satisfaction and academic performance between the pre-pandemic (up through March 25, 2020) and pandemic (after March 25, 2020) periods.

Differences in tumor size, clinical, demographic, and socioeconomic profiles of central nervous system tumors among a racially diverse cohort: A retrospective case-control study.

Background: One avenue to improve outcomes among brain tumor patients involves the mitigation of healthcare disparities. Investigating clinical differences among brain tumors across socioeconomic and demographic strata, such can aid in healthcare disparity identification and, by extension, outcome improvement.

Methods: Utilizing a racially diverse population from Hawaii, 323 cases of brain tumors (meningiomas, gliomas, schwannomas, pituitary adenomas, and metastases) were matched by age, sex, and race to 651 controls to investigate the associations between tumor type and various demographic, socioeconomic, and medical comorbidities.

SARS-CoV-2-induced cytokine storm drives prolonged testicular injury and functional impairment in mice that are mitigated by dexamethasone.

Compromised male reproductive health, including reduced testosterone and sperm count, is one of the long COVID symptoms in individuals recovering from mild-severe disease. COVID-19 patients display testicular injury in the acute stage and altered serum fertility markers in the recovery phase, however, long-term implications on the testis remain unknown. This study characterized the consequences of SARS-CoV-2 on testis function.

Racial-Ethnic Disparities of Obesity Require Community Context-Specific Biomedical Research for Native Hawaiians and Other Pacific Islanders.

Compared to the general population of Hawai'i, Native Hawaiians and Other Pacific Islanders (NHPI) shoulder a disproportionately high risk for obesity-related cardiometabolic disorders, such as type 2 diabetes and cardiovascular disease. The gut microbiome is an area of rapid research interest for its role in regulating adjacent metabolic pathways, offering novel opportunities to better understand the etiology of these health disparities. Obesity and the gut microbiome are influenced by regional, racial-ethnic, and community-specific factors, limiting the generalizability of current literature for understudied populations.

A Practical Clinical Approach to Navigate Pulmonary Embolism Management: A Primer and Narrative Review of the Evolving Landscape.

Advances in imaging, pharmacological, and procedural technologies have rapidly expanded the care of pulmonary embolism. Earlier, more accurate identification and quantification has enhanced risk stratification across the spectrum of the disease process, with a number of clinical tools available to prognosticate outcomes and guide treatment. Direct oral anticoagulants have enabled a consistent and more convenient long-term therapeutic option, with a greater shift toward outpatient treatment for a select group of low-risk patients.

AI in Biomedicine-A Forward-Looking Perspective on Health Equity.

As new artificial intelligence (AI) tools are being developed and as AI continues to revolutionize healthcare, its potential to advance health equity is increasingly recognized. The 2024 Research Centers in Minority Institutions (RCMI) Consortium National Conference session titled "Artificial Intelligence: Safely, Ethically, and Responsibly" brought together experts from diverse institutions to explore AI's role and challenges in advancing health equity. This report summarizes presentations and discussions from the conference focused on AI's potential and its challenges, particularly algorithmic bias, transparency, and the under-representation of minority groups in AI datasets.

Loss of PKM2 dysregulates inflammatory signaling in the infarcted murine heart.

Inflammation and a metabolic shift from oxidative metabolism to glycolysis are common in the ischemic heart, the latter partly controlled by pyruvate kinase (muscle, PKM). We previously identified alternative splicing promoting the PKM2 isoform after myocardial infarction (MI). We examined the role of PKM2 physiological upregulation after MI, modeled by ligation of the left anterior descending coronary artery, using global PKM2 knockout (PKM2) mice.

Serial biomarker measurements may be helpful to predict the successful application of high flow nasal cannula in COVID-19 pneumonia patients.

High flow nasal cannula (HFNC) can reduce the need for intubation in patients with coronavirus disease-19 (COVID-19) pneumonia induced acute hypoxemic respiratory failure (AHRF), but predictors of HFNC success could be characterized better. C-reactive protein (CRP) and D-dimer are associated with COVID-19 severity and progression. However, no one has evaluated the use of serial CRP and D-dimer ratios to predict HFNC success.

Optimizing Management of Acute Respiratory Distress Syndrome in Critically Ill Surgical Patients: A Systematic Review.

Introduction: This systematic review aims to evaluate the optimal management of acute respiratory distress syndrome (ARDS) in critically ill surgical patients, specifically focusing on positioning, extracorporeal membrane oxygenation (ECMO) use, ventilation, fluid resuscitation, and pharmacological treatments.

Methods: A systematic review was conducted utilizing four databases including PubMed, Google Scholar, EMBASE, and ProQuest. This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with The International Prospective Register of Systematic Reviews.

Unintentional exposure to leuprolide acetate during early pregnancy with a huge intramural myoma.

Leuprolide acetate is commonly used to reduce the size of myomas before surgery. Initially, it stimulates pituitary gonadotropin secretion, followed by sustained suppression of gonadal function. However, the impact on pregnancy outcomes from inadvertent exposure remains unclear.

Sepsis-induced cardiogenic shock: controversies and evidence gaps in diagnosis and management.

Sepsis often leads to vasoplegia and a hyperdynamic cardiac state, with treatment focused on restoring vascular tone. However, sepsis can also cause reversible myocardial dysfunction, particularly in the elderly with pre-existing heart conditions. The Surviving Sepsis Campaign Guidelines recommend using dobutamine with norepinephrine or epinephrine alone for patients with septic shock with cardiac dysfunction and persistent hypoperfusion despite adequate fluid resuscitation and stable blood pressure.

Comparing Patient-Reported Outcomes Following the Minimally Invasive Treatment of Benign Prostatic Hyperplasia (BPH)-Related Lower Urinary Tract Symptoms: Rezum Versus UroLift.

Purpose The purpose of this study is to compare patient-reported outcomes of minimally invasive treatments for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), namely, transurethral water vapor therapy (Rezum) and prostatic urethral lift (UroLift), due to the lack of direct comparison in the existing literature. Methods A retrospective single-institution study was conducted comparing Rezum and UroLift procedures performed by three surgeons between January 2019 and June 2022. The difference in American Urological Association Symptom Scores (AUA SS) was the primary outcome measure.

Clinical Outcomes Following Component Therapy Only Versus Whole Blood Plus Component Versus Whole Blood Only in Geriatric Trauma Patients With Isolated Chest or Abdominal Injuries With or Without Traumatic Brain Injury.

Introduction: This study aims to evaluate clinical outcomes in geriatric trauma patients with isolated chest or abdominal injuries with or without traumatic brain injury (TBI) receiving whole blood (WB), component (COMP), or WB and component therapy (WB + COMP).

Methods: This retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program Participant Use File dataset from 2017 to 2021 evaluated geriatric (age ≥65) trauma patients with moderate-to-severe isolated chest (abbreviated injury scale (AIS) chest ≥2) or abdominal (AIS abdomen ≥2) injuries with or without TBI (AIS head ≥2) receiving WB, COMP, or WB + COMP. Outcomes included emergency department and 24-h mortality, blood product volume (mL) at 4 hs, and intensive care unit-length of stay.

Salivary extracellular vesicles isolation methods impact the robustness of downstream biomarkers detection.

Extracellular vesicles (EVs), crucial mediators in cell-to-cell communication, are implicated in both homeostatic and pathological processes. Their detectability in easily accessible peripheral fluids like saliva positions them as promising candidates for non-invasive biomarker discovery. However, the lack of standardized methods for salivary EVs isolation greatly limits our ability to study them.

An unusual case of varicella zoster encephalitis mimicking a glioblastoma on magnetic resonance imaging and magnetic resonance spectroscopy.

The authors report a case of varicella zoster encephalitis, mimicking a glioblastoma on Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS). The limitations of MRI/MRS, may lead to delayed treatment with antiviral agents, which can result in increased morbidity and mortality. The possibility of viral encephalitis should remain in the differential diagnosis of all patients presenting with headaches and confusion, even when imaging results are indicative of a neoplastic process.

Correlation-weighted Na magnetic resonance fingerprinting in the brain.

We developed a new sodium magnetic resonance fingerprinting (Na MRF) method for the simultaneous mapping of and sodium density with built-in (radiofrequency transmission inhomogeneities) and corrections (frequency offsets). We based our Na MRF implementation on a 3D FLORET sequence with 23 radiofrequency pulses. To capture the complex spin dynamics of the Na nucleus, the fingerprint dictionary was simulated using the irreducible spherical tensor operators formalism.

Reproductive factors and risk of epithelial ovarian cancer: results from the Asia Cohort Consortium.

Background: There are scarce data on risk factors for epithelial ovarian cancer (EOC) in Asian populations. Our goal was to advance knowledge on reproductive -related risk factors for EOC in a large population of Asian women.

Methods: This study used pooled individual data from baseline questionnaires in 11 prospective cohorts (baseline years, 1958-2015) in the Asia Cohort Consortium.

Considerations for Measuring Caregiver Talk in Interactions With Infants at Elevated and Population-Level Likelihood for Autism: Deriving Stable Estimates.

Purpose: This study aims to help researchers design observational measurement systems that yield sufficiently stable scores for estimating caregiver talk among caregivers of infant siblings of autistic and non-autistic children. Stable estimates minimize error introduced by facets of the measurement system, such as variability between coders or measurement sessions.

Method: Analyses of variance were used to partition error variance between coder and session and to derive coefficients.