Perioperative and periprocedural management of GLP-1 receptor-based agonists and SGLT2 inhibitors: narrative review and the STOP-GAP and STOP DKA-2 algorithms.

The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major 21 century breakthroughs in diabetes and obesity medicine but there are important safety considerations regarding the perioperative and periprocedural management of individuals who are treated with these agents. GLP-1RAs have been linked to an increased risk of retained gastric contents and pulmonary aspiration while SGLT2i can be associated with diabetic ketoacidosis. This manuscript provides a narrative review of the available evidence for perioperative and periprocedural risks in people prescribed GLP-1RAs and SGLT2i.

Characterization of SARS-CoV-2 Entry Genes in Skeletal Muscle and Impacts of In Vitro Versus In Vivo Infection.

Background: COVID-19 has been associated with both respiratory (diaphragm) and non-respiratory (limb) muscle atrophy. It is unclear if SARS-CoV-2 infection of skeletal muscle plays a role in these changes. This study sought to: 1) determine if cells comprising skeletal muscle tissue, particularly myofibres, express the molecular components required for SARS-CoV-2 infection; 2) assess the capacity for direct SARS-CoV-2 infection and its impact on atrophy pathway genes in myogenic cells; and 3) in an animal model of COVID-19, examine the relationship between viral infection of skeletal muscle and myofibre atrophy within the diaphragm and limb muscles.

Decision-making regarding place of end-of-life care for children with life-limiting and life-threatening conditions: a systematic integrative review.

Background: Due to medical advancements the number of children living with life-limiting and life-threatening conditions is rising, meaning more children and their families will require palliative and end-of-life care in the future. While 'home' is often the preferred place of end-of-life care, the evidence around best practice for decision-making about place of end-of-life care remains inadequate.

Aim: To synthesise evidence on the factors influencing decision-making regarding place of end-of-life care for children with life-limiting and life-threatening conditions.

Evaluating stakeholder coordination and partnerships for NTD elimination in Taraba state, Nigeria: a multi-level analysis.

Introduction: Nigeria has a significant burden of NTDs with more than 120 million people at risk of the dominant NTDs namely Lymphatic Filariasis, Onchocerciasis, and Schistosomiasis. Control efforts have involved the four levels of governance with programs focused on vector control, preventive chemotherapy, water, sanitation and health education. However, the coordination across these levels and with multiple stakeholders remains unclear especially in states like Taraba that have received significant funding from local non-governmental organisations.

Prevalence and dynamics of antimicrobial resistance in pioneer and developing Arctic soils.

Antimicrobial resistance (AMR) in soil is an ancient phenomenon with widespread spatial presence in terrestrial ecosystems. However, the natural processes shaping the temporal dissemination of AMR in soils are not well understood. We aimed to determine whether, how, and why AMR varies with soil age in recently deglaciated pioneer and developing Arctic soils using a space-for-time approach.

Strong turbulent flow in the subauroral region in the Antarctic can deteriorate satellite-based navigation signals.

In the subauroral zone at the boundary of the auroral oval in the evening and night hours during geomagnetic disturbances, a narrow (about 1°-2°) and extended structure (several hours in longitude) is formed. It is known as a polarization jet (PJ) or the subauroral ion drift (SAID). The PJ/SAID is a fast westward ion drift and is one of the main signatures of a geomagnetic disturbance in the subauroral ionosphere at the altitudes of the F-layer, when the geomagnetic AE index reaches more than 500 nT.

Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS-A multicentre case-control study.

It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case-control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases).

Splicing accuracy varies across human introns, tissues, age and disease.

Alternative splicing impacts most multi-exonic human genes. Inaccuracies during this process may have an important role in ageing and disease. Here, we investigate splicing accuracy using RNA-sequencing data from >14k control samples and 40 human body sites, focusing on split reads partially mapping to known transcripts in annotation.

Activation of Primary C-H Bonds in Oxidative Cyclizations of Tambjamines Catalyzed by Rieske Oxygenases TamC and TamC.

Tambjamines are complex bipyrrole-containing natural products that possess promising bioactive properties. Although is known to produce both cyclic tambjamine MYP1 and the linear precursor (YP1), the biosynthetic machinery used to catalyze the site-selective oxidative carbocyclization at the unactivated 1° carbon of YP1 has remained unclear. Here, we demonstrate that a three-component Rieske system consisting of an oxygenase (TamC) and two redox partner proteins is responsible for this unprecedented activity on YP1 and potentially, a non-native substrate (BE-18591).

The Soundtrack of a Clinic Day.

There is a hum and drum to the clinical day, sounds and rhythms that pervade physician and patient's soundscape. We hear but we do not listen. The soundtrack of the daily grind is experienced as an audio blanket of white noise.

Informed Consent and Shared Decision-Making in Modern Medicine. Case-based Approach, Current Gaps and Practical Proposal.

Advances in personalized medicine and Systems Biology have introduced probabilistic models and error discovery to cardiovascular care, aiding disease prevention and procedural planning. However, clinical application faces cultural, technical, and methodological hurdles. Patient autonomy remains essential, with shared decision-making (SDM) gaining importance in managing complex cardiovascular treatment options.

Singularity of Lévy walks in the lifted Pomeau-Manneville map.

Since groundbreaking works in the 1980s it is well-known that simple deterministic dynamical systems can display intermittent dynamics and weak chaos leading to anomalous diffusion. A paradigmatic example is the Pomeau-Manneville (PM) map which, suitably lifted onto the whole real line, was shown to generate superdiffusion that can be reproduced by stochastic Lévy walks (LWs). Here, we report that this matching only holds for parameter values of the PM map that are of Lebesgue measure zero in its two-dimensional parameter space.

The development and implementation of an innovative community-based intervention to strengthen community capacity for HIV prevention and care among Canadians of African Caribbean and Black (ACB) women in Ontario: a research protocol.

African, Caribbean, and Black (ACB) women are overrepresented among new HIV diagnoses due to social and structural factors. This study seeks to create, implement, and evaluate a community-based peer-led intervention to improve access to HIV prevention and care for ACB women in Canada. This multisite, five-year project, using community-based participatory research, implementation science and evaluation frameworks, will be implemented in five non-iterative phases.

Carbonyl Reductase 1: a novel regulator of blood pressure in Down Syndrome.

Approximately one in every 800 children is born with the severe aneuploid condition of Down Syndrome, a trisomy of chromosome 21. Low blood pressure (hypotension) is a common condition associated with DS and can have a significant impact on exercise tolerance and quality of life. Little is known about the factors driving this hypotensive phenotype and therefore therapeutic interventions are limited.

An MRI assessment of mechanisms underlying lesion growth and shrinkage in multiple sclerosis.

Objective: To assess the pathological mechanisms contributing to white matter (WM) lesion expansion or contraction and remyelination in multiple sclerosis (MS).

Methods: We assessed 1,613 lesions in 49 people with relapsing-remitting MS in the CCMR-One bexarotene trial (EudraCT 2014-003145-99). We measured lesion orientation relative to WM tracts, surface-in gradients and veins.

The Changing pathogenesis of liver cancer in Hawaii over three decades.

Background: Worldwide trends support the increasing contribution of hepatic steatosis on the incidence of hepatocellular carcinoma (HCC). This study investigates if similar changes are seen in Hawaii, where the incidence of HCC is higher than most of the United States. Methods; This is a retrospective study of 1651 patients diagnosed with HCC (1991-2023) that includes 60-70% of Hawaii's HCC cases.

Association of MASLD Phenotypes With Liver Fibrosis in Hepatitis C: The Role of Cardiometabolic Risk Factors.

Steatotic liver disease is prevalent among people with hepatitis C virus (HCV). The new definition of metabolic dysfunction-associated steatotic liver disease (MASLD) emphasises the metabolic drivers of steatosis and recognises its frequent coexistence with other chronic liver diseases, including HCV. We aimed to evaluate the association of coexisting MASLD and HCV with liver fibrosis.

Maintenance of prehospital anaesthesia in trauma patients: inconsistencies and variability in practice.

Background: Literature on prehospital anaesthesia predominantly focuses on preparation and induction, while there is limited guidance on anaesthesia maintenance. The hypothesis of this study was that for prehospital trauma patients, protocols and practice for anaesthesia maintenance may vary considerably between services. Hence, we sought to describe the practice of prehospital anaesthesia maintenance for trauma patients in Australia, New Zealand, and the UK.

Modifiable Risk Factors Including Self-Perceived Stress for Breast Cancer in Hong Kong: A Case-Control Study of 10 757 Subject.

Background: In Hong Kong, breast cancer is the commonest female cancer. In addition to intrinsic risk factors that cannot be modified, other factors may be potentially modifiable. The objective of this report was to determine modifiable risk factors in association with breast cancer among Chinese women in our locality.

Mechanism of hsa_circ_0069443 promoting early pregnancy loss through ALKBH5/FN1 axis in trophoblast cells.

Studies have shown that circRNAs play an important regulatory role in trophoblast function and embryonic development. Based on sequencing and functional experiments, we found that hsa_circ_0069443 can regulate the function of trophoblast cells, and its presence is found in the exosomes secreted by trophoblast cells. It is known that exosomes mediate the interaction between the uterus and embryo, which is crucial for successful pregnancy.

Preoperative and intraoperative neuromonitoring and mapping techniques impact oncological and functional outcomes in supratentorial function-eloquent brain tumours: a systematic review and meta-analysis.

Background: Supratentorial function-eloquent brain tumour surgeries challenge the balance between maximal tumour resection and preservation of neurological function. This study aims to evaluate the efficacy of preoperative and intraoperative mapping techniques on resection outcomes and post-operative deficits.

Methods: This systematic review and meta-analysis examined literature up to March 2023, sourced from PubMed, Embase, and Medline.

The Limits and Contributions of Formal Support: Service Providers' Perspectives on Balancing Formal and Natural Support for People with Disabilities and their Families in Canada.

Evidence suggests that integrated support, combining both natural and formal supports, is often essential for individuals with developmental disabilities to achieve their preferred quality of life. However, studies are limited on how to organize supports so that people with developmental disabilities and their families find a balance between formal and natural supports. Often, there are systemic and personal boundaries around the nature and extent of support that can be offered to persons with developmental disabilities through formal mechanisms, yet the value of natural supports in the lives of persons with developmental disabilities is often undervalued in society.

Clinical Efficacy and Outcomes of Electro-Pneumatic Intracorporeal Lithotripsy in the Management of Sialolithiasis.

Objective: This study aims to evaluate the clinical efficacy of electro-pneumatic intracorporeal lithotripsy for the treatment of salivary gland stones.

Study Design: A prospective cohort study of patients diagnosed with obstructive salivary gland syndrome, where basket-assisted sialendoscopy alone failed to remove the calculi.

Setting: This study was conducted at the "Queen Maria" Military Hospital in Brașov, Romania, and a private practice, between February 2023 and May 2024.

Is the Future of Materials Amorphous? Challenges and Opportunities in Simulations of Amorphous Materials.

Amorphous solids form an enormous and underutilized class of materials. In order to drive the discovery of new useful amorphous materials further we need to achieve a closer convergence between computational and experimental methods. In this review, we highlight some of the important gaps between computational simulations and experiments, discuss popular state-of-the-art computational techniques such as the Activation Relaxation Technique (ARTn) and Reverse Monte Carlo (RMC), and introduce more recent advances: machine learning interatomic potentials (MLIPs) and generative machine learning for simulations of amorphous matter (e.