A sophisticated virulence repertoire and colistin resistance of Citrobacter freundii ST150 from a patient with sepsis admitted to ICU in a tertiary care hospital in Uganda, East Africa: Insight from genomic and molecular docking analyses.

Sepsis and multidrug resistance comprise a complex of factors attributable to mortality among intensive care unit (ICU) patients globally. Pathogens implicated in sepsis are diverse, and their virulence and drug resistance remain elusive. From a tertiary care hospital ICU in Uganda, we isolated a Citrobacter freundii strain RSM030 from a patient with sepsis and phenotypically tested it against a panel of 16 antibiotics including imipenem levofloxacin, cotrimoxazole and colistin, among others.

Exploration of the integration of microbiology and immunology emerging topics into undergraduate medical education.

Purpose: Medical school educators face challenges determining which new and emerging topics to incorporate into medical school curricula, and how to do so. A study was conducted to gain a better understanding of the integration of emerging topics related to microbiology and immunology in the undergraduate medical curriculum (UME).

Methods: An anonymous survey with 17 questions was emailed to medical school faculty who teach immunology and/or microbiology through the DR-Ed listserv, the American Society for Microbiology (ASM) Connect listserv, and attendees of the Association of Medical School Microbiology and Immunology Chairs (AMSMIC) Educational Strategies Workshop.

Agitated and depressed with a traumatic brain injury.

Mr. N, age 46, has a history of alcohol use disorder, insomnia, anxiety, and depression. He is brought to the ED with a TBI after repeatedly beating his head into a table.

Enhancing Uterine Fibroid Care: Clinician Perspectives on Diagnosis, Disparities, and Strategies for Improving Health Care.

Objective: To explore clinicians' perspectives on diagnosing, treating, and managing uterine fibroids, identifying gaps and challenges in health care delivery, and offering recommendations for improving care.

Materials And Methods: A qualitative design was used to conduct 14 semistructured interviews with clinicians who treat fibroid patients in central Indiana. Interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis techniques.

Responding to a Non-Imminently Dying Patient's Request for Pacemaker Deactivation.

Based on Nathan Goldstein's case report, "But I have a pacer…there is no point in engaging in hypothetical scenarios": A Non-imminently Dying Patient's Request for Pacemaker Deactivation, it is reasonable to conclude that it was, all-things-considered, ethically appropriate to grant the patient's request to deactivate her pacemaker. Philosophically, and as a clinical bioethicist, I support the team's decision to honor the patient's request for pacemaker deactivation. However, it is worth exploring a bit further whether the distress on the part of the outside hospital's ethics committee and providers-who declined to honor the patient's request for pacemaker deactivation-may actually track something of moral significance.

Assessing muscular power in older adults: evaluating the predictive capacity of the 30-second chair rise test.

Timed chair rise tests are frequently used as a substitute for assessing leg muscle strength or power. To determine if timed chair rise tests are an indicator of lower extremity muscle power, we examined the relationship between the repetitions completed in a 30-s chair rise test and the power generated during the test. Seventy-five individuals participated in this study (n = 30 < 65 years and 45 ≥ 65 years).

Student-Led Curricular Development in the Biomedical Science Master's Program Using Virtual Dissection.

The Anatomage table is a virtual dissection technology increasingly used to supplement anatomy education while its efficacy and integration is still being evaluated. To address the gap in student curricular leadership in such technological integration, previous master's and current medical students led a curricular development effort to design, create, and incorporate hands-on Anatomage learning activities into a master's level anatomy course during the 2021-2022 academic year. To assess changing perspectives regarding the table's role in curriculum integration and content retention, surveys were conducted before and after voluntary participants completed the learning activities.

Loss of the auxiliary αδ voltage-sensitive calcium channel subunit impairs bone formation and anabolic responses to mechanical loading.

Voltage-sensitive calcium channels (VSCCs) influence bone structure and function, including anabolic responses to mechanical loading. While the pore-forming (α) subunit of VSCCs allows Ca influx, auxiliary subunits regulate the biophysical properties of the pore. The αδ subunit influences gating kinetics of the α pore and enables mechanically induced signaling in osteocytes; however, the skeletal function of αδ in vivo remains unknown.

Efficacy of photodynamic therapy as an adjunct to scaling and root planing on clinical parameters and microbial composition in subgingival plaque of periodontitis patients: A split-mouth randomized clinical trial.

Background: The aim of this study was to assess the efficacy of photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) on clinical parameters and microbial composition in subgingival plaque of periodontitis patients.

Methods: Seventeen patients were included in this split-mouth randomized clinical trial. Sites with probing pocket depth (PPD) ≥5 mm in combination with bleeding on probing in different quadrants were randomized into the control group, the group with a single PDT application right after SRP, and the group with three repeated PDT applications 1 week after SRP.

Deletion of the auxiliary α2δ1 voltage sensitive calcium channel subunit in osteocytes and late-stage osteoblasts impairs femur strength and load-induced bone formation in male mice.

Osteocytes sense and respond to mechanical force by controlling the activity of other bone cells. However, the mechanisms by which osteocytes sense mechanical input and transmit biological signals remain unclear. Voltage-sensitive calcium channels (VSCCs) regulate calcium (Ca2+) influx in response to external stimuli.

PTHrP intracrine actions divergently influence breast cancer growth through p27 and LIFR.

The role of parathyroid hormone (PTH)-related protein (PTHrP) in breast cancer remains controversial, with reports of PTHrP inhibiting or promoting primary tumor growth in preclinical studies. Here, we provide insight into these conflicting findings by assessing the role of specific biological domains of PTHrP in tumor progression through stable expression of PTHrP (-36-139aa) or truncated forms with deletion of the nuclear localization sequence (NLS) alone or in combination with the C-terminus. Although the full-length PTHrP molecule (-36-139aa) did not alter tumorigenesis, PTHrP lacking the NLS alone accelerated primary tumor growth by downregulating p27, while PTHrP lacking the NLS and C-terminus repressed tumor growth through p27 induction driven by the tumor suppressor leukemia inhibitory factor receptor (LIFR).

A unique variation of the jugular veins and its clinical significance.

The authors report a rare variation of the anterior jugular and internal jugular veins in a 78-year-old male donor. An enlarged and curved left anterior jugular vein (AJV) was formed as the continuation of the left common facial vein (CFV). The left AJV's diameter was wider than the internal jugular vein (IJV) and measured around 5 mm greater than the IJV's diameter and a channel connected the two veins.

Mechanistic and therapeutic relationships of traumatic brain injury and γ-amino-butyric acid (GABA).

Traumatic brain injury (TBI) is a highly prevalent medical condition for which no medications specific for the prophylaxis or treatment of the condition as a whole exist. The spectrum of symptoms includes coma, headache, seizures, cognitive impairment, depression, and anxiety. Although it has been known for years that the inhibitory neurotransmitter γ-amino-butyric acid (GABA) is involved in TBI, no novel therapeutics based upon this mechanism have been introduced into clinical practice.

Using Bedside Spectral Doppler Ultrasound for the Assessment of Patients With Thyrotoxicosis.

Objective: To assess the bedside utility of Spectral Doppler Ultrasound (SDUS) in the initial evaluation of patients presenting with thyrotoxicosis.

Methods: This is a retrospective cross-sectional study of patients diagnosed with thyrotoxicosis at an academic outpatient endocrinology clinic from August 2019 to November 2022. The thyroid arteries' peak systolic velocities (PSV) were measured bilaterally using SDUS.

Am I big boned? Bone length scaled reference data for HRpQCT measures of the radial and tibial diaphysis in White adults.

Cross-sectional size of a long bone shaft influences its mechanical properties. We recently used high-resolution peripheral quantitative computed tomography (HRpQCT) to create reference data for size measures of the radial and tibial diaphyses. However, data did not take into account the impact of bone length.

Lumbar Spine Anatomy in Supine versus Weight- Bearing Magnetic Resonance Imaging: Detecting Significant Positional Changes and Testing Reliability of Quantification.

Study Design: Testing between and within group differences and assessing reliability of measurements.

Purpose: To study and compare lumbar spine morphology in supine and weight-bearing (WB) magnetic resonance imaging (MRI).

Overview Of Literature: Upright lumbar MRI may uncover anatomical changes that may escape detection when using conventional supine imaging.

Obstructive sleep apnea detection during wakefulness: a comprehensive methodological review.

Obstructive sleep apnea (OSA) is a chronic condition affecting up to 1 billion people, globally. Despite this spread, OSA is still thought to be underdiagnosed. Lack of diagnosis is largely attributed to the high cost, resource-intensive, and time-consuming nature of existing diagnostic technologies during sleep.

Deep Sedation in Pediatric Patients With Single Ventricle Physiology Outside of the Operating Room.

Advancements in palliative surgery of patients with single ventricle physiology have led to an increase in the need for deep sedation protocols for painful procedures. However, positive pressure ventilation during anesthesia can result in unfavorable cardiopulmonary interactions. This patient population may benefit from sedation from these painful procedures.

"A Friendly Conversation." Developing an eHealth Intervention to Increase COVID-19 Testing and Vaccination Literacy Among Women with Criminal and Legal System Involvement.

Many women leaving jails are ill-prepared to follow recommended COVID-19 mitigation practices, including testing and vaccination. Low COVID-19-related health literacy, exposure to disinformation, and mistrust in authorities put women at increased risk. Research on this population has shown significant use of mobile devices for communication and web access and public Wi-fi for the internet.

Clinical research in the community.

Most patients with high-risk hematologic malignancies are treated in community oncology practices near their residence. This is partly due to patients' ardent desire to be closer to home and trust in local caregivers. Treatments are increasingly complex, even as initial therapy, and more so upon relapse.