Cytology to More Clearly Distinguish Solitary Plasmacytoma at the Skull Base.

Solitary plasmacytomas are localized single tumors of monoclonal plasma cells that occur in two variants: solitary plasmacytoma of bone and extraosseous plasmacytoma. Solitary plasmacytoma of bone accounts for only 1%-2% of plasma cell lesions, and extraosseous plasmacytoma is also approximately 1%. These are both very uncommon at the skull base.

Resilience Profiles among Grandparents Raising Grandchildren in the United States: White and Black Differences.

Background And Objectives: Grandparents raising grandchildren face many challenges and stress regardless of race and ethnicity; however, they are generally resilient. The present study aims to classify resilience profiles of these grandfamilies using a person-centered approach and examine the association of race and ethnicity with these profiles.

Research Design And Methods: The present study analyzed cross-sectional survey data collected from grandparents raising grandchildren in the United States (N = 287).

The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study.

Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.

Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.

Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).

SIGNALING SEPSIS SCENARIO DEVELOPMENT & VALIDATION.

Patient-based scenario-driven usability tests are routinely created for health information technology and clinical decision support evaluations. Due to low clinician awareness of sepsis, a study was undertaken to understand clinician performance and preference of different display types for sepsis clinical decision support through multi-centered usability testing. Patient-based clinical scenarios were created to mimic the environment in which providers would interact with clinical decision support.

A Narrative Persuasion Approach to Promoting COVID-19- Related Policy Support.

Communication scholars warn against focusing on individual behaviors when discussing health issues, arguing that doing so can reduce affect and policy support. Although COVID-19 outcomes are linked to structural barriers to treatment, policy interventions appear to improve outcomes for vulnerable groups. Thus, strategic messages must promote public understanding of social determinants and policy support related to COVID-19.

Population variability across geographical ranges: perspectives and challenges.

Populations fluctuate over time and across geographical space, and understanding how different factors contribute to population variability is a central goal in population ecology. There is a particular interest in identifying trends of population variability within geographical ranges as population densities of species can fluctuate substantially across geographical space. A common assumption is that populations vary more near species geographical range edges because of unsuitable environments and higher vulnerability to environmental variability in these areas.

Quantifying Muscle Volume Deficits Among 38 Lower Extremity Muscles in Collegiate Football Athletes After Anterior Cruciate Ligament Reconstruction.

Background: Quadriceps dysfunction is ubiquitous after anterior cruciate ligament (ACL) reconstruction (ACLR). Addressing quadriceps dysfunction is crucial to improve function, reduce the reinjury risk, and maintain long-term knee health. While deficits specific to the quadriceps are well documented, less is known about the effect of an ACL injury on other lower extremity muscle groups.

Cardiovascular disease, bone fracture, and all-cause mortality risks among postmenopausal women by arthritis and veteran status: A multistate Markov transition analysis.

Arthritis, a chronic inflammatory condition linked to cardiovascular disease (CVD) and bone fracture, is more frequent among military veterans and postmenopausal women. This study examined correlates of arthritis and relationships of arthritis with risks of developing CVD, bone fractures, and mortality among postmenopausal veteran and non-veteran women. We analyzed longitudinal data on 135,790 (3,436 veteran and 132,354 non-veteran) postmenopausal women from the Women's Health Initiative who were followed-up for an average of 16 years between enrollment (1993-1998) and February 17, 2024.

Enhanced phosphorus weathering contributed to Late Miocene cooling.

Late Miocene climate evolution provides an opportunity to assess Earth's climate sensitivity to carbon cycle perturbation under warmer-than-modern conditions. Despite its relevance for understanding the climate system, the driving mechanisms underlying profound climate and carbon cycle changes - including the enigmatic Late Miocene cooling from 7 to 5.4 million years ago - remain unclear.

Structure and function of a near fully-activated intermediate GPCR-Gαβγ complex.

Unraveling the signaling roles of intermediate complexes is pivotal for G protein-coupled receptor (GPCR) drug development. Despite hundreds of GPCR-Gαβγ structures, these snapshots primarily capture the fully activated complex. Consequently, the functions of intermediate GPCR-G protein complexes remain elusive.

Deciphering the interplay between SETD2 mediated H3K36me3 and RNA N6-methyladenosine in clear cell renal cell carcinoma (ccRCC).

RNA N6-methyladenosine (m6A) plays diverse roles in RNA metabolism and its deregulation contributes to tumor initiation and progression. Clear cell renal cell carcinoma (ccRCC) is characterized by near ubiquitous loss of followed by mutations in epigenetic regulators , , and . Mutations in , a histone H3 lysine 36 trimethylase (H3K36me3), are associated with reduced survival, greater metastatic propensity, and metabolic reprogramming.

Long-term efficacy of superior laryngeal nerve block for the treatment of chronic neurogenic cough.

Purpose: The study aimed to evaluate the long-term efficacy and safety of superior laryngeal nerve (SLN) block for treating chronic neurogenic cough (CNC) in a large patient cohort.

Methods: A retrospective review was conducted on patients treated between January 2019 and October 2023. Data collected included patient demographics, number of injections, follow-up times, subjective cough severity, and Leicester Cough Questionnaire (LCQ) scores.

Larsucosterol for the Treatment of Alcohol-Associated Hepatitis.

Background: Larsucosterol is a DNA methyltransferase inhibitor in development for alcohol-associated hepatitis (AH), a disease for which there is no approved therapy.

Methods: In this phase 2b trial, patients with severe AH were randomly assigned 1:1:1 to receive 30 mg or 90 mg of larsucosterol or placebo; a second dose was administered after 72 hours if the patient remained hospitalized. All patients received supportive care as determined by investigators.

Comparative Outcomes of Babesiosis in Immunocompromised and Non-Immunocompromised Hosts: A Multicenter Cohort Study.

Background: Babesiosis poses significant risks of adverse outcomes in individuals with immunocompromising conditions (IC) and asplenia/hyposplenia (AH). This study compares clinical outcomes between these vulnerable groups and immunocompetent patients.

Methods: A multicenter retrospective cohort study included adult patients with laboratory-confirmed babesiosis from 2009 to 2023.

Wildland Firefighters Suffer Increasing Risk of Job-Related Death.

Wildland firefighting is a niche specialization in the fire service - inherently dangerous with unique risks. Over the past decade, fatalities amongst all firefighters have decreased; however, wildland firefighter fatalities have increased. This subject has only been described in the grey literature, and a paucity of medical literature exists.

Diversity in Medical School, Orthopaedic Surgery Residency, and ACGME-Accredited Foot and Ankle Orthopaedic Surgery Fellowship Training by Gender, Race, and Ethnicity.

Introduction: Increasing diversity in the US health care workforce is a topic of increasing scrutiny and interest. This study analyzes the pipeline of demographic diversity for Accreditation Council for Graduate Medical Education (ACGME)-accredited foot and ankle orthopaedic surgery fellowship training.

Methods: This was a cross-sectional study of medical students, orthopaedic surgery residents, and orthopaedic foot and ankle fellows at US-accredited training programs from 2013 to 2022.

Near-universal prevalence of central adiposity in heart failure with preserved ejection fraction: the PARAGON-HF trial.

Background And Aims: An expansion of fat mass is an integral feature of patients with heart failure and preserved ejection fraction (HFpEF). While body mass index (BMI) is the most common anthropometric measure, a measure of central adiposity-the waist-to-height ratio (WHtR)-focuses on body fat content and distribution; is not distorted by bone or muscle mass, sex, or ethnicity; and may be particularly relevant in HFpEF.

Methods: The PARAGON-HF trial randomized 4796 patients with heart failure and ejection fraction ≥45% to valsartan or sacubitril/valsartan.

The deuterated glucose insulin tolerance test: a new tool to delineate insulin-stimulated glucose uptake from suppression of endogenous glucose production.

Graphical Abstract.

Drought as an emergent driver of ecological transformation in the twenty-first century.

Under climate change, ecosystems are experiencing novel drought regimes, often in combination with stressors that reduce resilience and amplify drought's impacts. Consequently, drought appears increasingly likely to push systems beyond important physiological and ecological thresholds, resulting in substantial changes in ecosystem characteristics persisting long after drought ends (i.e.

Continuous risk monitoring and management of heart failure: Rationale and design of the ALLEVIATE-HF trial.

Aims: Early identification and management of worsening heart failure (HF) is necessary to prevent disease progression and hospitalizations. The ALLEVIATE-HF (Algorithm Using LINQ Sensors for Evaluation and Treatment of Heart Failure) trial is a prospective, randomized, controlled, double-blind, multicentre trial that aims to assess the safety and efficacy of using the Reveal LINQ™ insertable cardiac monitor (ICM) in patients with HF to continuously monitor and evaluate HF risk status and guide timely interventions.

Methods: The ICM algorithm uses parameters derived from electrocardiogram (atrial fibrillation [AF], ventricular rate during AF, heart rate variability, and night heart rate), three-axis accelerometer (patient activity duration), and subcutaneous bioimpedance (fluid volume, respiration rate).

Bilateral hippocampal toxicity in a patient using kratom.

As an emerging toxic recreational drug, kratom use has been associated with a range of adverse effects, but reports of structural changes in the central nervous system are rare. We report a case of a young man in his 20s with a history of anxiety and depression who presented with an altered mental status and anterograde and retrograde amnesia following kratom use. His labs showed elevated alanine aminotransferase and ammonia levels, and his MRI revealed bilateral hippocampal T2 hyperintensity signal changes.