Improving Hurricane Preparedness Among Galveston County Older Adults: Description of a Successful Community-Based Quality Improvement Model.

Older adults are at high risk of experiencing injury, exacerbations of their chronic conditions, and death when evacuations are ordered because of hurricanes or natural disasters. The Homebound seniors residing in Galveston County are at a particularly high risk of morbidity and mortality during evacuations for hurricanes. This paper described the impact of a quality improvement intervention designed and implemented by nurse practitioners during the 2022 and 2023 hurricane season.

Armond S. Goldman (1930-2023) and the development of the immunobiology of human milk.

The understanding of the immunobiology of human milk is primarily a 20th-century phenomenon, but, even with our contemporary understanding, it remains a bit of a mystery. Breastfeeding of human milk, although the most obvious and natural form of nutrition for human infants, has been hindered by cultural and societal norms since ancient times. Thus, not all infants have experienced the advantages this form of nutrition may offer.

Conquering the common bile duct: outcomes in minimally invasive transcystic common bile duct exploration versus ERCP.

Introduction: Given the increasing interest for surgeons to reclaim the common bile duct in managing choledocholithiasis, there is a growing movement to perform common bile duct exploration (CBDE). Advantages of concomitant CBDE with cholecystectomy include fewer anesthetic events and decreased length of stay. As there is a paucity of literature evaluating the use of the robotic platform for CBDE, our study aims to compare intraoperative and post-operative outcomes between robotic-assisted one-stage and two-stage management of choledocholithiasis.

Case-control analysis of hip fractures with concurrent benzodiazepine and opioid use and surgery class at a single teaching institution.

In this study, we analyze the relationship between polypharmacy and surgical treatment in a population at a single teaching institution. The design of the study is a case-control analysis of hip fractures. The setting is at a single teaching institution located in Galveston, Texas, USA.

Alternative hybrid access in endovascular neurosurgery: Scoping review and technical considerations.

Background: The common femoral artery and radial artery constitute the most common access sites in contemporaneous endovascular neurosurgery. Oftentimes, it may be impossible to reach the vascular target safely due to different circumstances, necessitating alternative approaches. We aim to review these "last resource" access sites described in the literature, focusing on the technical aspects as a convenient reference.

Group-Based Interventions in Lifestyle Medicine.

Group-based interventions in health care have demonstrated a positive influence on patient outcomes by strengthening patient-healthcare professional relationships and providing an avenue for patient empowerment through shared experiences and belongingness. Groups have been shown to enhance social and psychological support, improve self-management behaviors, and encourage peer-support. However group settings also present challenges, such as discomforts in sharing within a group context and managing diverse group dynamics.

Roles of Randomized Controlled Trials in Establishing Evidence-Based Gender-Affirming Care and Advancing Health Equity.

This article reviews the design of a recently published randomized controlled trial (RCT) on immediate vs delayed access to gender-affirming hormones for transgender and gender-diverse (TGD) people and outlines key learning points that clinicians should know about how RCTs can and cannot contribute to advancing health equity for TGD people.

Trem2/Syk/PI3K axis contributes to the host protection against Toxoplasma gondii-induced adverse pregnancy outcomes via modulating decidual macrophages.

Decidual macrophages residing at the maternal-fetal interface have been recognized as pivotal factors for maintaining normal pregnancy; however, they are also key target cells of Toxoplasma gondii (T. gondii) in the pathology of T. gondii-induced adverse pregnancy.

Failure Rates of Conservative Management of Minimally Symptomatic Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis.

Background: Conservative treatments for minimally symptomatic chronic subdural hematoma (cSDH) are debated, with surgery as the primary option.

Objective: To assess failure rates of a conservative approach for management of cSDH.

Methods: We searched PubMed, SCOPUS, Web of Science, and ClinicalTrials.

Mechanisms of Intracellular Communication in Cancer and Pathogen Spreading.

Cell-to-cell interactions are essential for proper development, homeostasis, and complex syncytia/organ formation and function. Intercellular communication are mediated by multiple mechanisms including soluble mediators, adhesion molecules and specific mechanisms of cell to cell communication such as Gap junctions (GJ), tunneling nanotubes (TNT), and exosomes. Only recently, has been discovered that TNTs and exosomes enable the exchange of large signaling molecules, RNA, viral products, antigens, and organelles opening new avenues of research and therapeutic approaches.

Protection against fibrosis by a bacterial consortium in metabolic dysfunction-associated steatohepatitis and the role of amino acid metabolism.

The gut microbiota drives progression to liver fibrosis, the main determinant of mortality in metabolic dysfunction-associated steatohepatitis (MASH). In this study, we aimed to identify bacterial species associated with protection against liver fibrosis in a high-risk population, and test their potential to protect against liver fibrosis . Based on stool shotgun metagenomic sequencing of 340 subjects from a population cohort disproportionally affected by MASH, we identified bacterial species from the and orders associated with reduced risk of liver fibrosis.

Human Papillomavirus Vaccination and Human Papillomavirus-Related Cancer Rates.

Importance: To inform the design and implementation of targeted interventions to reduce the future burden of human papillomavirus (HPV)-related cancers in Texas, it is necessary to examine the county and health service region (HSR) levels of (1) the proportion of children and teenagers aged 9 to 17 years who initiated and were up to date for HPV vaccination series and (2) HPV-related cancer incidence rates (IRs).

Objective: To evaluate temporal trends and geospatial patterns of HPV vaccination initiation and up-to-date status as well as HPV-related cancer rates at county and HSR levels in Texas.

Design, Setting, And Participants: This population-based cross-sectional study used data from the Texas Immunization Registry, the National Cancer Institute's Surveillance, Epidemiology, and End Results Program database, and Texas Department of State Health Services annual population counts from 2006 to 2022.

Quality and Readability Analysis of Turbinoplasty on the Web.

This study aimed to assess the quality, credibility, and readability of online health information concerning turbinoplasty, given the increasing reliance on internet resources for health education. Using four search terms related to turbinoplasty, we analyzed 71 text-based webpages from Google.com, Bing.

Effect of Perioperative Blood Transfusion on Complications Following Emergency Non-trauma Laparotomy in Mulago Hospital: A Prospective Cohort Study.

Background Although blood transfusion may be required during emergency non-trauma laparotomy, several retrospective cohort studies have identified blood transfusion as a significant predictor of postoperative infections and mortality. However, no study has explored such an association in a resource-limited setting. This study aims to determine the effect of perioperative blood transfusion on the 30-day risk of surgical site infections (SSIs) and mortality among patients undergoing emergency non-trauma laparotomy in a large urban tertiary hospital in a resource-limited setting.

Clinical Trends in Granulomatous Mastitis Incidence, Prevalence, and Treatment: A Retrospective Study Highlighting Ethnic Differences in Care.

Introduction: This study focuses on granulomatous mastitis (GM), a rare inflammatory condition of the breast that has been increasingly diagnosed over the recent years. This research attempts to understand the incidence and prevalence of GM and its treatments.

Methods: This is a retrospective study over 9 y (January 2015-December 2023).

Cryptococcal Osteomyelitis of the Patella: A Case Report.

Case: A 38-year-old woman presented to our clinic with right knee pain and difficulty ambulating. After cultures were obtained, a cryptococcal infection of the patella was identified. Subsequent workup revealed previously undiagnosed HIV/AIDS and a disseminated cryptococcal infection.

Machine-Learning-Enabled Diagnostics with Improved Visualization of Disease Lesions in Chest X-ray Images.

The class activation map (CAM) represents the neural-network-derived region of interest, which can help clarify the mechanism of the convolutional neural network's determination of any class of interest. In medical imaging, it can help medical practitioners diagnose diseases like COVID-19 or pneumonia by highlighting the suspicious regions in Computational Tomography (CT) or chest X-ray (CXR) film. Many contemporary deep learning techniques only focus on COVID-19 classification tasks using CXRs, while few attempt to make it explainable with a saliency map.

Inhibition of Calcineurin with FK506 Reduces Tau Levels and Attenuates Synaptic Impairment Driven by Tau Oligomers in the Hippocampus of Male Mouse Models.

Alzheimer's disease (AD) is the most common age-associated neurodegenerative disorder, characterized by progressive cognitive decline, memory impairment, and structural brain changes, primarily involving Aβ plaques and neurofibrillary tangles of hyperphosphorylated tau protein. Recent research highlights the significance of smaller Aβ and Tau oligomeric aggregates (AβO and TauO, respectively) in synaptic dysfunction and disease progression. Calcineurin (CaN), a key calcium/calmodulin-dependent player in regulating synaptic function in the central nervous system (CNS) is implicated in mediating detrimental effects of AβO on synapses and memory function in AD.

Requirement of the N-terminal region of nonstructural protein 1 in cis for SARS-CoV-2 defective RNA replication.

SARS-CoV-2 belongs to the family and carries a single-stranded positive-sense RNA genome. During coronavirus (CoV) replication, defective or defective interfering RNAs that lack a large portion of the genome often emerge. These defective RNAs typically carry the necessary RNA elements that are required for replication and packaging.

Trends in HPV-associated cancer incidence in Texas medically underserved regions.

Background: While cervical cancer incidence rates (IR) in the United States have dropped in the last 20 years, non-cervical human papillomavirus (HPV) associated cancers increased. Many people in Texas (TX) live in medically underserved areas and have higher risk of developing HPV-associated cancers. Since previous studies of these regions focused on cervical cancer, we included other HPV-associated cancers in our analysis of IR in East TX and the TX-Mexico Border compared to other TX regions.