Role of Monoclonal Antibodies in the Management of Eosinophilic COPD: A Meta-analysis of Randomized Controlled Trials.

Background: COPD remains a leading cause of morbidity and mortality worldwide. Acute exacerbations are associated with progressive decline in lung function and quality of life. After recognition of the role of type 2 inflammation in the pathogenesis of eosinophilic COPD, there was increased interest in studying monoclonal antibodies as a therapeutic agent.

Incorporating structured metacognitive training into an undergraduate anatomy classroom.

Metacognition includes the processes that learners use to plan, monitor, and assess their learning and is tied to academic performance and growth-oriented attitudes toward learning. Learning anatomy presents challenges to learners at all levels, and for many, necessitates a change in learning strategies and metacognitive awareness. We sought to examine whether structured metacognitive training situated in an undergraduate anatomy course could improve these skills.

The strand exchange domain of tumor suppressor PALB2 is intrinsically disordered and promotes oligomerization-dependent DNA compaction.

The partner and localizer of BRCA2 (PALB2) is a scaffold protein linking BRCA1 with BRCA2 and RAD51 during homologous recombination (HR). PALB2 interaction with DNA strongly enhances HR in cells, while the PALB2 DNA-binding domain (PALB2-DBD) supports DNA strand exchange . We determined that PALB2-DBD is intrinsically disordered beyond a single N-terminal α-helix.

The Microbiome: From the Beginning to the End.

The human microbiota, a community of microorganisms in our bodies, is crucial for our health. This paper explores its development from birth through old age, highlighting some of the unique roles at key life stages-infancy, adulthood, and in the elderly years. Understanding the significant health impacts and consequences of changes in the microbiota offers insights for both the public and clinicians.

Dermatology Program Coordinators' Role and Insight in the Resident Selection Process.

Background: With the evolution of residency applications and the myriad of roles that program coordinators (PCs) undertake, there is a gap in the medical education literature surrounding PCs' role in the resident selection process.

Objective: We sought to quantify the role of Dermatology residency PCs in the resident selection process and the unique perspective they gain from their interactions with applicants.

Methods: PC- and program director (PD)-specific surveys were designed and distributed in 2023 via email to Dermatology PDs via the Association of Professors of Dermatology (APD) listserv and to PCs via email using the contact information found on publicly available residency program websites.

Association between patient medications and postoperative outcomes in early-stage non-small cell lung cancer.

Background: Currently, there is no consensus on how to comprehensively assess comorbidities in lung cancer patients in the clinical setting. Prescription medications may be a preferred comorbidity assessment tool and provide a simple mechanism for predicting postoperative outcomes for lung cancer. We examined the relationship between prescription medications and postoperative outcomes for early-stage non-small cell lung cancer (NSCLC).

Membrane lipid nanodomains modulate HCN pacemaker channels in nociceptor DRG neurons.

Cell membranes consist of heterogeneous lipid nanodomains that influence key cellular processes. Using FRET-based fluorescent assays and fluorescence lifetime imaging microscopy (FLIM), we find that the dimension of cholesterol-enriched ordered membrane domains (OMD) varies considerably, depending on specific cell types. Particularly, nociceptor dorsal root ganglion (DRG) neurons exhibit large OMDs.

Proton-Pump Inhibitors and Fat Absorption in Cystic Fibrosis and Pancreatic Insufficiency: A Randomized Crossover Pilot Trial.

Background: Dietary fat malabsorption contributes to poor nutritional status in patients with cystic fibrosis (CF) and exocrine pancreatic insufficiency (EPI). Prescribing gastric acid-reducing agents such as proton-pump inhibitors (PPI) as an adjunct to pancreatic enzyme replacement therapy (PERT) to improve dietary fat absorption has been accepted in clinical practice despite limited evidence.

Aims: This was a pilot randomized, double-blind, placebo-controlled crossover trial of subjects aged 12 and older with CF and EPI assessed on placebo and omeprazole to determine if PPI improved the efficacy of PERT as indicated by measures of dietary fat absorption.

Endovascular thrombectomy for distal medium vessel occlusions: A literature review.

Background: There is a lack of substantial evidence supporting the safety and effectiveness of endovascular thrombectomy in treating distal medium vessel occlusions (DMVOs).

Objective: To summarize the current evidence regarding endovascular thrombectomy for DMVOs.

Methods: We conducted a narrative review of key articles related to the diagnosis and management of DMVOs.

Cholate Shunt, Oral Cholate Challenge and Endoscopic Lesions of Portal Hypertension: The SHUNT-V Study.

Background: The accuracy of current criteria for ruling out large oesophageal varices (LEV) and other endoscopic lesions of portal hypertension (PH) may be compromised by obesity and MASLD/MASH.

Aims: In the US multicentre SHUNT-V study, we evaluated the disease severity index (DSI) for detecting LEV and other lesions of PH at endoscopy.

Methods: Subjects were adults with compensated cirrhosis scheduled for endoscopy to screen for varices.

Phase 3 Validation of PAaM for Hepatocellular Carcinoma Risk Stratification in Cirrhosis.

Background & Aims: Hepatocellular carcinoma (HCC) risk stratification is an urgent unmet need for cost-effective HCC screening and early detection in patients with cirrhosis to improve poor HCC prognosis.

Methods: Molecular (prognostic liver secretome signature with α-fetoprotein) and clinical (aMAP [age, male sex, albumin-bilirubin, and platelets] score) variable-based scores were integrated into PAaM (prognostic liver secretome signature with α-fetoprotein plus age, male sex, albumin-bilirubin, and platelets), which was subsequently validated in 2 phase 3 biomarker validation studies: the statewide Texas HCC Consortium and nationwide HCC Early Detection Strategy prospective cohorts, following the prospective specimen collection, retrospective blinded evaluation design. The associations between baseline PAaM and incident HCC were assessed using Fine-Gray regression, with overall death and liver transplantation as competing events.

Association between glucagon-like peptide-1 receptor agonist use and progression of monoclonal gammopathy of uncertain significance to multiple myeloma among patients with diabetes.

Background: In patients with diabetes and monoclonal gammopathy of uncertain significance (MGUS), the impact of glucagon-like peptide-1 (GLP-1) receptor agonists on the natural history of MGUS is unknown. We aimed to assess the association of GLP-1 receptor agonist use in the progression of MGUS to multiple myeloma in patients with diabetes.

Methods: This is a population-based cohort study of veterans diagnosed with MGUS from 2006 to 2021 with a prior diagnosis of diabetes.

The Efficacy of the Psychiatry Clerkship in Developing Students' Comprehensive Clinical Skills.

Objective: This study investigates the impact of the psychiatry rotation in developing students' clinical skills that are applicable across various medical specialties.

Methods: Medical students at Saint Louis University completed the same survey before and after completing a 3½-week psychiatry rotation. Students rated 18 statements on a Likert scale.

Substance use disorder and severe maternal morbidity: is there a differential impact?

Background: Substance use disorder (SUD) is a disease characterized by behavior patterns of substance use leading to dysfunction in cognition, mood, and quality of life. The prevalence of perinatal SUD in the United States continues to rise and has adverse effects on the maternal-infant dyad. Mirroring the rise in SUD is an increasing prevalence of severe maternal morbidity (SMM).

ChatGPT-4 Omni Performance in USMLE Disciplines and Clinical Skills: Comparative Analysis.

Background: Recent studies, including those by the National Board of Medical Examiners, have highlighted the remarkable capabilities of recent large language models (LLMs) such as ChatGPT in passing the United States Medical Licensing Examination (USMLE). However, there is a gap in detailed analysis of LLM performance in specific medical content areas, thus limiting an assessment of their potential utility in medical education.

Objective: This study aimed to assess and compare the accuracy of successive ChatGPT versions (GPT-3.

Hepatic Failure and Hyperbilirubinemia Secondary to Hemolytic Disease of the Newborn.

Anti-D antibody is the most common cause of hemolytic disease of the newborn (HDN). Other antigens have emerged, causing significant damage to the newborn. We report a case of a 31-week dichorionic diamniotic twin born emergently to a mother with anti-C and anti-D antibodies who required multiple percutaneous umbilical cord blood sampling (PUBS) and transfusions.

A hypothesis to explain malaria-induced neurocognitive sequelae.

The development of malaria-induced neurocognitive and behavioral sequelae is not entirely understood. We hypothesize that liver dysfunction caused by Plasmodium infection is responsible for malaria-induced neurocognitive and behavioral sequelae. Our metabolic hypothesis not only explains neurocognitive sequelae after cerebral malaria (CM) but also after other severe, non-severe, and asymptomatic malaria infections.

Oscillatory Blood Pressure Values in Newborn Infants: Observational Data Over Gestational Ages.

Introduction: Normative blood pressure (BP) values on preterm infants exist but are based on small cohorts of infants. Utilizing electronic medical records (EMR), we can explore earlier gestational ages (GA) and follow their progression to 40 weeks corrected gestational age (CGA).

Methods: A retrospective cohort study of infants within the SSM Health System from July 1, 2013 through June 30, 2023.