Development of the pulmonary fibrosis, pulmonary vascular resistance, six minute walk distance, B-type natriuretic peptide, age (PVD-B65) risk score for patients with chronic lung disease and pulmonary hypertension.

Background: Pulmonary hypertension (PH) confers increased mortality in patients with chronic lung disease, yet there remains a lack of validated risk assessment tools to prognosticate these patients. We aimed to create a risk assessment tool to stratify patients with chronic lung disease and PH by risk of one-year mortality from time of PH diagnosis.

Methods: This was a retrospective cohort study of patients with chronic lung disease and PH.

Vascular Pathology in Alpha 1 Antitrypsin Deficient Chronic Obstructive Pulmonary Disease and Emphysema Patients: Case Reports.

Alpha 1 Antitrypsin Deficiency (AATD) is a genetic condition that results from mutations in the gene, which can lead to deficient or dysfunctional Alpha 1 Antitrypsin (AAT) protein production. AATD is linked to chronic obstructive pulmonary disease (COPD) and emphysema. In addition to pulmonary manifestations, AATD has also been associated with vascular pathology due to excessive protease activity, tissue degradation, and vessel stiffening.

Identifying Subgroups of Intersectional Stigma, Discrimination, and the Association with Mental Health Outcomes Among HIV-Positive Men Who Have Sex with Men: A Latent Class Analysis.

This study aimed to (1) identify latent classes of stigma and discrimination experiences among men who have sex with men (MSM) living with HIV; (2) examine the associations between class membership and mental health outcomes, and (3) investigate the moderating effects of social support and resilience. The study used the baseline (N = 224) and six-month follow-up data (N = 118) from a longitudinal cohort study on HIV and hypertension among African American and Asian Pacific American MSM in Hawai'i and Philadelphia from 2019 to 2023. Latent class analysis was conducted to characterize the patterns of stigma and discrimination experience.

Exploring the effects of adolescent social isolation stress on the serotonin system and ethanol-motivated behaviors.

Rationale: Alcohol is one of the most frequently used drugs of abuse and has a major impact on human health worldwide. People assigned female at birth and those with adverse childhood experiences are stress-vulnerable and more likely to report drinking as a means of "self-medication." Prior studies in our laboratory showed that adolescent social isolation stress (SIS) increases vulnerability to ethanol (EtOH) intake and consumption despite negative consequences in female rats.

Revised Precapillary Pulmonary Hypertension Criteria and Their Prognostic Value in IPF Transplant Waitlist Survival.

Idiopathic pulmonary fibrosis (IPF) is a leading indication for lung transplantation. Pulmonary hypertension (PH), a common comorbidity in IPF, has gained renewed attention following the updated ESC/ERS guidelines, which redefine diagnostic thresholds for PH. This study evaluates the impact of the revised PH criteria on transplant waitlist outcomes among IPF patients.

Psychological Distress in Adults With Myocardial Infarction: Implications for Health Care Utilization and Expenditure.

Background: Myocardial infarction (MI) poses a major financial burden on the U.S. health care system, but its impact on medical expenses and health care utilization when coupled with psychological distress remains unknown.

Health Care Delivery and Financial Considerations in Amyotrophic Lateral Sclerosis Clinics: A Survey of Clinic Directors.

Background And Objectives: Clinical care for people living with amyotrophic lateral sclerosis (PLWALS) is directed at slowing disease progression and symptom management. The American Academy of Neurology recommends a multidisciplinary approach to providing ALS health care because observational studies show that multidisciplinary clinics (MDCs) extend survival and improve quality of life. However, providing multidisciplinary care is a challenging financial proposition.

Long bone fractures with associated vascular injury: Who should go first?

Objectives: Long bone fractures with concomitant vascular injury have the potential to be life and limb threatening injuries, with increased risk for limb loss. There is currently no established surgical order of operations for orthopaedic and vascular intervention. This study compares injury classification, warm ischemia time and patient outcomes in patients with long bone fractures and associated vascular injury after orthopaedic versus vascular primary intervention.

Assessing shared decision-making: a case study of third-year medical student standardized patient encounters.

Objectives: We aimed to determine if shared decision-making (SDM) self-assessment of a standardized patient (SP) scenario was reliable, specifically whether students' communication resulted in each SP-student pair reporting internally consistent final treatment choices. We hypothesized student self-assessment would differ from SP and faculty assessment indicating a need for multisource feedback.

Methods: In this observational case study from 2016-2017, all third-year post-clerkship medical students received evidence-based treatment options for sinusitis and SDM lectures followed by a SP encounter on sinusitis.

Pancreatopleural fistula: A rare cause of recurrent pleural effusion.

Pancreatopleural fistulas, rare complications of chronic pancreatitis, are often overlooked in the initial differential diagnoses of pleural effusions, resulting in delayed diagnosis and management. We present the case of an elderly male with recurrent pleural effusion and a history of chronic pancreatitis. Diagnostic challenges arose, with the initial misdiagnosis as pneumonia.

Ensifentrine in COPD patients taking long-acting bronchodilators: A pooled post-hoc analysis of the ENHANCE-1/2 studies.

Background: The efficacy and safety of ensifentrine, a novel PDE3/PDE4 inhibitor, were previously evaluated in the ENHANCE-1 (NCT04535986) and ENHANCE-2 (NCT04542057) trials. Here, we present a pooled post-hoc subgroup analysis of patients according to background chronic obstructive pulmonary disease (COPD) maintenance medication regimens.

Objective: This analysis aimed to explore the efficacy and safety of ensifentrine in patients receiving long-acting muscarinic antagonists (LAMA) or long-acting beta-agonists with inhaled corticosteroids (LABA + ICS).

Revisiting Equity in Healthcare Spending: Variation in Reimbursement for Aortic Procedures from the Perspective of Medicare Payments.

Background: Medicare insures over 65 million Americans and is a primary driver of private insurance reimbursement rates. However, public data shows Medicare reimbursement for comparatively complex procedures, such as aortic aneurysm repair, is disproportionate. Medicare reimbursement rates are multifactorial and highly localized, yet little is known about nationwide trends.

Inflammation in atherosclerosis: a Big Idea that has underperformed so far.

Purpose Of Review: For many years, inflammation has been a major concept in basic research on atherosclerosis and in the development of potential diagnostic tools and treatments. The purpose of this review is to assess the performance of this concept with an emphasis on recent clinical trials. In addition, contemporary literature may help identify new therapeutic targets, particularly in the context of the treatment of early, rather than end-stage, arterial disease.

Acromioclavicular joint injuries: multicenter expert consensus study using the Delphi method.

Background: Acromioclavicular (AC) joint injuries pose significant challenges in clinical management, necessitating consensus guidelines for optimal treatment. There is a lack of consensus in several areas, including imaging protocols, surgical techniques, and rehabilitation timelines. This study aims to develop a consensus regarding the diagnosis, treatment, and rehabilitation of AC joint separations.

Topographical and Refractive Outcomes After Corneal Cross-linking in Novice Scleral Lens Users.

Objective: To determine if scleral fittings that occur before corneal cross-linking (CXL) are still successful after the procedure.

Methods: This prospective study included seven patients with keratoconus or post-laser-assisted in situ keratomileusis (LASIK) corneal ectasia who were fitted with scleral lenses then underwent CXL. Four patients (six eyes) had keratoconus and three patients (five eyes) had post-LASIK ectasia.

Arthritis: Rheumatoid Arthritis.

Key principles of rheumatoid arthritis (RA) management include early patient evaluation by a rheumatologist and early initiation of pharmacologic therapy in patients at risk for chronic disease. Early diagnosis and appropriate management are essential to prevent joint damage. Patients with RA usually report pain and swelling in multiple joints and prolonged stiffness in the morning that improves with activity.

Predicting Robotic Hysterectomy Incision Time: Optimizing Surgical Scheduling with Machine Learning.

Background And Objectives: Operating rooms (ORs) are critical for hospital revenue and cost management, with utilization efficiency directly affecting financial outcomes. Traditional surgical scheduling often results in suboptimal OR use. We aim to build a machine learning (ML) model to predict incision times for robotic-assisted hysterectomies, enhancing scheduling accuracy and hospital finances.

Evolutionary sparse learning with paired species contrast reveals the shared genetic basis of convergent traits.

Cases abound in which nearly identical traits have appeared in distant species facing similar environments. These unmistakable examples of adaptive evolution offer opportunities to gain insight into their genetic origins and mechanisms through comparative analyses. Here, we present a novel comparative genomics approach to build genetic models that underlie the independent origins of convergent traits using evolutionary sparse learning.

A multicenter study of perioperative and functional outcomes of open vs. robot assisted uretero-enteric reimplantation after radical cystectomy.

Introduction: Open ureteroenteric reimplantation (OUER) of ureteroenteric strictures (UESs) is related to important morbidity. Robot-assisted ureteroenteric reimplantation (RUER) has been proposed to provide similar outcomes with lower morbidity. We aimed to compare perioperative and functional outcomes between RUER and OUER.

Racial and ethnic disparities on the heart transplant waiting list.

Background: Racial disparities continue to affect countless individuals across the United States and is an ongoing issue in heart transplantation (HTx). Though inequities for post-transplant survival have been studied, there remains limited and conflicting data for waitlist outcomes. Our investigation aims to address this by analyzing mortality and transplantation outcomes on the heart transplant waiting list for various racial and ethnic groups.

Glucose transporter 1 in vascular smooth muscle cells is dispensable for abdominal aortic aneurysm induced by angiotensin II.

Treatment with an inhibitor of glucose use via glucose transporters (GLUT) has been shown to attenuate experimental abdominal aortic aneurysm (AAA) development in mice. Vascular smooth muscle cell (VSMC) signaling seems to be essential for angiotensin II (Ang II)-induced AAA in mice. Accordingly, we have tested a hypothesis that VSMC silencing of the major GLUT, GLUT1, prevents AAA development and rupture in mice treated with Ang II plus β-aminopropionitrile.