VA physicians intent to leave and correlations to drivers of burnout: a cross-sectional study.

Background: Physician well-being and workforce retention within the healthcare system is of critical importance. Understanding physicians' intent to leave the organization will inform efforts on optimizing the physician workforce. In this study, we examine the association of burnout and specific drivers of burnout on turnover intentions.

Factors associated with lung cancer among firefighters: a systematic literature review.

This short review addresses the pressing issue of lung cancer among firefighters, a population facing unique occupational hazards such as smoke inhalation and asbestos exposure. With lung cancer being a leading global cause of death, the study emphasizes the disproportionate burden on firefighters. Notably, wildfire smoke, containing carcinogenic elements, poses a rising significant threat to firefighters' respiratory health.

Profiles of innovative behavior and associated predictors among clinical nurses: a multicenter study using latent profile analysis.

Background: Innovative Behavior (IB) is a key prerequisite for nurses in solving clinical problems. However, existing research on IB among clinical nurses is relatively limited.

Objective: To identify profiles and characteristics of IB among clinical nurses and explore the associated predictors, as well as the relationships with research outputs.

Real-world short-term outcomes and treatment regimen comparisons in patients with metastatic renal cell carcinoma treated with first-line immune combinations.

Background: Immune-combinations have recently become the standard first-line treatment for patients with metastatic renal cell carcinoma (mRCC). This study evaluated the applicability of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk model in predicting outcomes for patients treated with either immune-oncologic drug doublet (IO-IO) or immune-oncologic drug tyrosine kinase inhibitor combinations (IO-TKI). A secondary objective to compare the effectiveness of IO-IO versus IO-TKI within the IMDC risk groups over a short follow-up period.

A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound.

Background: Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS to evaluate spermatic vein hemodynamics in patients with VC and establish a clear correlation between specific hemodynamic patterns and impaired semen parameters.

Serum ALT activity and its isoenzymes as potential biomarkers for diagnosis of Sarcopenia in older adults: a retrospective, cross-sectional study.

Background: Alanine aminotransferase (ALT) is an enzyme crucial for energy and protein metabolism in muscle cells. Despite this, its association with sarcopenia remains inadequately explored. This study aims to investigate the correlation between serum levels of ALT-related indicators (ALT activity, ALT1, ALT2, and ALT1/ALT2 ratio) and sarcopenia measures, as well as to develop a diagnostic model for sarcopenia in older individuals.

Nationwide trends in diagnosed sedative, hypnotic or anxiolytic use disorders in adolescents and young adults enrolled in Medicaid: 2001-2019.

Background And Aim: Sedative, hypnotic or anxiolytic use disorders (SHA-UD) are defined by significant impairment or distress caused by recurrent sedative, hypnotic or anxiolytic use. This study aimed to measure trends in the prevalence of SHA-UD diagnoses in adolescent and young adult US Medicaid enrollees from 2001 to 2019.

Design: Annual, cross-sectional study, 2001-2019.

Ras Guanine Nucleotide-Releasing Protein-4 Inhibits Erythropoietin Production in Diabetic Mice with Kidney Disease by Degrading HIF2A.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes.

First-line cadonilimab plus chemotherapy in HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a randomized, double-blind, phase 3 trial.

Programmed cell death protein-1 (PD-1) inhibitors plus chemotherapy have been the standard of care in the first-line treatment of advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma; however, the survival benefits are modest in patients with low programmed death ligand 1 (PD-L1) expression. Here we investigated the efficacy and safety of cadonilimab (PD-1/cytotoxic T lymphocyte antigen-4 (CTLA-4) bispecific antibody) plus chemotherapy as first-line treatment in G/GEJ adenocarcinoma. The prespecified interim analysis is reported here.

Treadmill exercise prevents stress-induced anxiety-like behaviors via enhancing the excitatory input from the primary motor cortex to the thalamocortical circuit.

Physical exercise effectively prevents anxiety disorders caused by environmental stress. The neural circuitry mechanism, however, remains incomplete. Here, we identified a previously unrecognized pathway originating from the primary motor cortex (M1) to medial prefrontal cortex (mPFC) via the ventromedial thalamic (VM) nuclei in male mice.

Presenteeism caused by health conditions and its economic impacts among Japanese workers in the post-COVID-19 era.

Objectives: This study investigated the common health conditions leading to presenteeism and the economic impact among Japanese workers in the post-COVID-19 era.

Methods: Between February and March 2023, 10,000 workers responded to a web-based, cross-sectional survey on health problems that interfered with their work, degree of presenteeism, and teleworking status.

Results: Approximately 35.

An educational case of toluene intoxication: importance of kidney function and timing in diagnosis.

Metabolic acidosis (MA) is common in daily clinical settings and requires evaluation not only by serum anion gap (AG) but also by urine AG (UAG) and urine osmolal gap (UOG) to investigate potential causes and determine appropriate treatment. Herein, we report an educational case of non-gap (normal AG) MA (pH 7.16, HCO 8.

Prevalence of malnutrition among adult inpatients in China: a nationwide cross-sectional study.

Malnutrition substantially contributes to adverse clinical outcomes. However, no national survey has been conducted to characterize its epidemiology in hospital settings in China. We conducted the China Nutrition Fundamental Data 2020 project among a multistage stratified cluster sample of adult inpatients from 291 study sites across 30 provinces, autonomous regions and municipalities (except for Hong Kong, Macao, Taiwan Province, and the Xizang Autonomous Region, please see MATERIALS AND METHODS for details of the causes) of China to generate reliable data on the prevalence of malnutrition and explore the associated risk factors.

The Impact of Family History on Clinical Presentation and Biologic Treatment Response in Patients with Psoriasis: A Multicenter Prospective Cohort Study.

Background: Family history (FH) of psoriasis has been implicated as a risk factor for developing psoriasis. However, whether FH also carries information on clinical presentation and treatment response to biological agents in patients with psoriasis remains unclear.

Objective: This prospective, multicenter observational study aimed to analyze the clinical presentation and efficacy differences between patients with psoriasis with and without a FH.

Challenges in cellular agriculture: lessons from Pacific white shrimp, Litopenaeus vannamei.

The overall goal of this research was to develop an embryonic stem cell (ESC) line from the Pacific white shrimp, Litopenaeus vannamei, to support production of cell-based cultivated seafood products towards meeting a growing global demand for sustainable seafood. It was hypothesized that characteristics of ESCs, such as high proliferation and pluripotency, would facilitate development of a continuous cell line that could be triggered to differentiate into a muscle cell phenotype. The targeted approach was based on collection of ESCs from fertilized shrimp eggs at the blastomere stage.

Adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation and tyrosine kinase inhibitors: development and validation of a clinical prediction model based on cytogenetics, IKZF1 deletions and minimal residual disease.

The aim of this study was to develop and validate a nomogram predicting progression-free survival (PFS) for adult patients with positive acute lymphoblastic leukemia(Ph + ALL) who have undergone allogeneic hematopoietic stem cell transplantation(allo-HSCT) and tyrosine kinase inhibitor(TKI) treatment. Data were retrospectively collected from 176 adult patients diagnosed with Ph + ALL and treated with allo-HSCT and TKIs at The First Affiliated Hospital, Zhejiang University School of Medicine, between January 2015 and May 2023. 70% of the patients were randomly assigned to the training group(n = 124) and 30% of the patients were assigned to the validation group(n = 52).

Clioquinol 3% Cream Improves Clinical Symptoms and Restores the Skin Microbiome in Interdigital Tinea Pedis.

Background: Interdigital tinea pedis is a common type of tinea pedis that occurs between toes and is easy to recur. Recently, the skin microbiome analysis of interdigital tinea pedis showed changes in bacterial microbiome in addition to fungal infection.

Objectives: To investigate the efficacy and safety of clioquinol 3% cream in treating interdigital tinea pedis as well as characterize changes in the skin microbiome during treatment.

Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.

Leveraging a phased pangenome for haplotype design of hybrid potato.

The tetraploid genome and clonal propagation of the cultivated potato (Solanum tuberosum L.) dictate a slow, non-accumulative breeding mode of the most important tuber crop. Transitioning potato breeding to a seed-propagated hybrid system based on diploid inbred lines has the potential to greatly accelerate its improvement.

Immune evasion through mitochondrial transfer in the tumour microenvironment.

Cancer cells in the tumour microenvironment use various mechanisms to evade the immune system, particularly T cell attack. For example, metabolic reprogramming in the tumour microenvironment and mitochondrial dysfunction in tumour-infiltrating lymphocytes (TILs) impair antitumour immune responses. However, detailed mechanisms of such processes remain unclear.

m1A-regulated DIAPH3 promotes the invasiveness of colorectal cancer via stabilization of KRT19.

Background: In recent years, the emphasis has shifted to understanding the role of N1-methyladenosine (m1A) in tumor progression as little is known about its regulatory effect on mRNA and its role in the metastasis of colorectal cancer (CRC).

Methods: We performed methylated RNA immunoprecipitation sequencing of tumor tissues and tumor-adjacent normal tissues from three patients with CRC to determine the m1A profile of mRNA in CRC. The expression of diaphanous-related formin 3 (DIAPH3) and its correlation with clinicopathological characteristics of CRC were evaluated using immunohistochemistry and online datasets.

Evolving Immunotherapy Strategies in Gastrointestinal Neuroendocrine Neoplasms.

Treatment for neuroendocrine neoplasms (NENs) is tailored to the tumor's site of origin, grade, and differentiation. NENs are categorized into two main types: well-differentiated neuroendocrine tumors (NETs), which tend to grow more slowly and are less aggressive, and poorly differentiated neuroendocrine carcinomas (NECs), which are highly aggressive and harder to treat. Treatment options for NETs range from somatostatin analogues and mTOR inhibitors to peptide receptor radionuclide therapy (PRRT) with Lutetium-177 dotatate.

Kidney Function, Cognitive Impairment, and Trajectories: A Longitudinal Biracial Study.

Background: Chronic kidney disease (CKD) is associated with incident cognitive impairment (ICI) and disproportionately affects older adults and Black persons.

Objective: To determine (1) whether age or race differences exist in the association of CKD and ICI and (2) whether cognitive trajectories differ in people with and without CKD.

Design: Nationwide cohort study.