Clinical risk factors for mortality in low severity acute epidural hematoma.

Background: Epidural hematomas (EDH) pose life-threatening risks with considerable morbidity and mortality if left untreated. The prognosis for patients with low-severity acute EDH managed conservatively is variable, with limited understanding of risk factors. This study aims to identify clinical risk factors for mortality in low-severity acute epidural hematoma patients managed conservatively, helping clinicians recognize cases where deviation from conservative management may be necessary.

AGER-dependent macropinocytosis drives resistance to KRAS-G12D-targeted therapy in advanced pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDAC) driven by the mutation presents a formidable health challenge because of limited treatment options. MRTX1133 is a highly selective and first-in-class KRAS-G12D inhibitor under clinical development. Here, we report that the advanced glycosylation end product-specific receptor (AGER) plays a key role in mediating MRTX1133 resistance in PDAC cells.

Abnormal cardiovascular control during exercise: Role of insulin resistance in the brain.

During exercise circulatory adjustments to meet oxygen demands are mediated by multiple autonomic mechanisms, the skeletal muscle exercise pressor reflex (EPR), the baroreflex (BR), and by feedforward signals from central command neurons in higher brain centers. Insulin resistance in peripheral tissues includes sensitization of skeletal muscle afferents by hyperinsulinemia which is in part responsible for the abnormally heightened EPR function observed in diabetic animal models and patients. However, the role of insulin signaling within the central nervous system (CNS) is receiving increased attention as a potential therapeutic intervention in diseases with underlying insulin resistance.

Cell surface protein-protein interaction profiling for biological network analysis and novel target discovery.

The secretome is composed of cell surface membrane proteins and extracellular secreted proteins that are synthesized via secretory machinery, accounting for approximately one-third of human protein-encoding genes and playing central roles in cellular communication with the external environment. Secretome protein-protein interactions (SPPIs) mediate cell proliferation, apoptosis, and differentiation, as well as stimulus- or cell-specific responses that regulate a diverse range of biological processes. Aberrant SPPIs are associated with diseases including cancer, immune disorders, and illness caused by infectious pathogens.

New taxa of butterflies supported by genomic analysis.

Continuing with the genomic analysis of butterflies, we present a taxonomic update. As a result of this work, 3 genera, 6 subgenera, 16 species, and 2 subspecies are described as new. New genera and subgenera are (type species in parenthesis): Grishin, ( W.

Genomic analysis reveals hidden species diversity in Fabricius (Lepidoptera: Riodinidae).

Genomic analysis of [Fabricius], 1807 (Lepidoptera: Riodinidae Grote, 1895) reveals species richness higher than anticipated. As a result, one subgenus, 22 species, and one subspecies are proposed as new (type species or type localities in parenthesis): Grishin, ( Prittwitz, 1865), () Grishin, (Peru: Rio Pachitea, Monte Alegre), () Grishin, (Guyana: Cuyuni-Mazaruni), () Grishin, (Brazil: Santa Catarina), () Grishin, (Panama: Darién), () Grishin, (Ecuador: Santo Domingo), () Grishin, (Peru: Cuzco), () Grishin, (Panama: Chiriquí), () Grishin, (Mexico: Tamaulipas), () Grishin, (Mexico: Nuevo León), () Grishin, (Argentina: Salta), () Grishin, (Peru: Piura), () Grishin, (Bolivia: La Paz), () Grishin, (Mexico: Sonora), () Grishin, (Peru: Madre de Dios), () Grishin, (Bolivia: La Paz), () Grishin, (Mexico: Chiapas), () Grishin, (Panama: Darién), () Grishin, (Panama: Darién), () Grishin, (Panama: Darién), () Grishin, (Panama: Panamá), () Grishin, (Peru: Cuzco), () Grishin, (Brazil: São Paulo), and () Grishin, (Brazil: Paraná). The following five taxa are (not subspecies): () Schaus, 1928, (not () (Linnaeus, 1767)), () Stichel, 1910, (not () Westwood, 1851), () Stichel, 1929, (not () Godman and Salvin, 1886), () R.

The Role of Imaging in Pulmonary Vascular Disease: The Clinician's Perspective.

Pulmonary vascular diseases, particularly when accompanied by pulmonary hypertension, are complex disorders often requiring multimodal imaging for diagnosis and monitoring. Echocardiography is the primary screening tool for pulmonary hypertension, while cardiac MR imaging (CMR) is used for more detailed characterization and risk stratification in right ventricular failure. Chest computed tomography (CT) is used to detect vascular anomalies and parenchymal lung diseases.

Imaging of Acute Pulmonary Embolism: An Update.

Imaging is essential in the evaluation and management of acute pulmonary embolism. Advances in multi-energy CT including dual-energy CT and photon-counting CT have allowed faster scans with lower radiation dose and optimal quality. Artificial intelligence has a potential role in triaging potentially positive examinations and could serve as a second reader.

Structures and mRNP remodeling mechanism of the TREX-2 complex.

mRNAs are packaged with proteins into messenger ribonucleoprotein complexes (mRNPs) in the nucleus. mRNP assembly and export are of fundamental importance for all eukaryotic gene expression. Before export to the cytoplasm, mRNPs undergo dynamic remodeling governed by the DEAD-box helicase DDX39B (yeast Sub2).

Dietary Interventions, Supplements, and Plant-Derived Compounds for Adjunct Vitiligo Management: A Review of the Literature.

Vitiligo is a chronic autoimmune pigmentation disorder shaped by a complex interplay of genetic predispositions and environmental triggers. While conventional therapies-phototherapy, corticosteroids, and immunosuppressants-can be effective, their benefits are often partial and temporary, with recurrence common once treatment stops. As such, there is increasing interest in exploring complementary approaches that may offer a more sustainable impact.

An Updated Systematic Review and Network Meta-Analysis of First-Line Triplet vs. Doublet Therapies for Metastatic Hormone-Sensitive Prostate Cancer.

: The addition of androgen receptor pathway inhibitors (ARPIs) to androgen deprivation therapy (ADT), with or without docetaxel (Doc), is currently recommended for metastatic, hormone-sensitive prostate cancer (mHSPC). Recently, the ARANOTE trial evaluated the efficacy and safety of Darolutamide + ADT in this setting. We aimed to update a network meta-analysis (NMA) of these combination therapies.

Implications of packed red bloods cells production and transfer on post transfusion hemoglobin increase.

Background: Blood loss resulting in severe anemia is the most common indication for postoperative allogenic red blood cell (RBC) transfusions. In high-income countries, the majority of transfusions is received by elderly patients. Preservatives extend the storage of RBCs, though concerns exist about potential harm from transfusing older RBCs.

Cryo-EM structure and regulation of human NAD kinase.

Reduced nicotinamide adenine dinucleotide phosphate (NADPH) is a crucial reducing cofactor for reductive biosynthesis and protection from oxidative stress. To fulfill their heightened anabolic and reductive power demands, cancer cells must boost their NADPH production. Progrowth and mitogenic protein kinases promote the activity of cytosolic NAD kinase (NADK), which produces NADP, a limiting NADPH precursor.

Romosozumab Improves Tissue Thickness-Adjusted Trabecular Bone Score in Women With Osteoporosis and Diabetes.

Context: Trabecular bone score (TBS), a gray-level texture index derived from lumbar spine (LS) dual-energy x-ray absorptiometry (DXA) scans, is decreased in patients with diabetes and is associated with increased fracture risk, independent of areal bone mineral density (aBMD), but potentially influenced by abdominal fat tissue.

Objective: Evaluate effect of romosozumab (210 mg monthly) for 12 months followed by alendronate (70 mg weekly) for 24 months vs alendronate alone (70 mg weekly) for 36 months on LS aBMD and TBS in women with type 2 diabetes (T2D) enrolled in the ARCH study.

Methods: This post hoc analysis included women from ARCH who had T2D at baseline and LS DXA scans at baseline and ≥1 postbaseline visit (romosozumab-to-alendronate, n = 165; alendronate-to-alendronate, n = 195).

Concussion and the Autonomic, Immune, and Endocrine Systems: An Introduction to the Field and a Treatment Framework for Persisting Symptoms.

A significant proportion of patients who sustain a concussion/mild traumatic brain injury endorse persisting, lingering symptoms. The symptoms associated with concussion are nonspecific, and many other medical conditions present with similar symptoms. Medical conditions that overlap symptomatically with concussion include anxiety, depression, insomnia, chronic pain, chronic fatigue, fibromyalgia, and cervical strain injuries.

Meeting Challenges in the Diagnosis and Treatment of Glaucoma.

Glaucoma, a progressive and multifactorial optic neurodegenerative disease, still poses significant challenges in both diagnosis and management and remains a perpetual enigma [...

Factors predicting manipulation under anaesthesia after total knee replacement.

Introduction: Manipulation under anesthesia (MUA) is a standard and effective treatment to correct stiffness and improve range of motion (ROM) following total knee arthroplasty (TKA). Delayed MUA has been associated with increased rates of revision surgeries and infections. Early MUA has been shown to double the mean gain in flexion compared to delayed interventions.

Efficacy of the Optilume paclitaxel drug-coated balloon after urethroplasty: short-term results from a multicenter study.

Background: The Optilume paclitaxel drug-coated balloon (DCB) is a relatively new-to-market alternative in the management of male anterior urethral stricture disease. The pivotal trial excluded patients with a history of urethroplasty, although these strictures may be amenable to endoscopic management. Therefore, we sought to assess the efficacy of the DCB in the management of recurrent strictures following urethroplasty.

Comparison of Telehealth Versus Face-to-Face Administration of the Oral Trail Making Test in Older Adults with and without Cognitive Impairment: A Brief Report.

Objectives: To examine the performance reliability of the Oral Trail Making Test (OTMT) in face-to-face (FTF) and teleneuropsychology (TeleNP) conditions among older individuals with and without cognitive impairment.

Methods: Two hundred participants (with [n = 81], and without cognitive impairment [n = 119]) completed the OTMT in both conditions, in a counterbalanced design. Paired sample t-tests compared OTMT scores and intra-class correlation coefficients examined the degree of agreement between the two testing conditions for both diagnostic groups.

Intermittent documentation of blood pressure values does not provide comprehensive evaluation of the hemodynamic response during continuous intravenous medication administration.

Blood pressure (BP) is a dynamic measure that is frequently discussed in static terms. There exist many limitations in current documentation systems whereby documented BP values may not be reflective of the dynamic variability of BP. This study used an observational, prospective, non-randomized study design to examine the variability in BP response during intravenous vasoactive medication administration in an intensive care unit setting.

Genetics and Pathophysiology of Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disease that manifests clinically in varying forms depending on the degree of enzyme deficiency. CAH is most commonly caused by 21-hydroxylase deficiency (21OHD) due to mutations in the CYP21A2 gene. Whereas there is a spectrum of disease severity, 21OHD is generally categorized into 3 forms.

A silicon rhodamine 1,2-dioxetane chemiluminophore for near-infrared imaging.

Near-infrared (NIR) chemiluminescent probes have attracted increasing attention in recent years due to their attractive properties for imaging. Herein, we developed a NIR chemiluminophore silicon rhodamine (SiRCL-1) based on the intramolecular energy transfer process from excited state benzoate to a silicon rhodamine emitter under aqueous conditions. SiRCL-1 exhibited dual emission peaks at 540 nm and 680 nm with a high signal penetration through tissue at 680 nm (>30 mm) and long-lasting luminescence (>50 min), demonstrating its significance as a chemiluminescence scaffold for biological application.

Carcinogenic air pollutants and breast cancer risk in the Arkansas rural community health study: A nested case-control study.

Background: Previous epidemiological studies on the associations between hazardous air pollutants (HAPs) and breast cancer (BC) have largely neglected rural, medically underserved areas in the United States, which differ in exposures and disparities compared to urban areas.

Objectives: We aimed to examine the associations between carcinogenic HAPs and BC risk in a rural population.

Methods: Using a nested case-control design, 574 cases and 2295 incidence density-sampled controls matched 1:4 on index age and race were included from the Arkansas Rural Community Health study.

Disordered Regions of Condensate-promoting Proteins Have Distinct Molecular Signatures Associated with Cellular Function.

Disordered regions of proteins play crucial roles in cellular functions through diverse mechanisms. Some disordered regions function by promoting the formation of biomolecular condensates through dynamic multivalent interactions. While many have assumed that interactions among these condensate-promoting disordered regions are non-specific, recent studies have shown that distinct sequence compositions and patterning lead to specific condensate compositions associated with cellular function.