Analysis of Urinary Metanephrines Using Liquid Chromatography Tandem Mass Spectrometry.

Metanephrines (metanephrine [MN] and normetanephrine [NMN]) are O-methylated metabolites derived from the catecholamines, epinephrine, and norepinephrine, respectively. High concentrations of metanephrines have been observed in individuals with pheochromocytoma, a neuroendocrine tumor. Measurement of metanephrines in urine is used to screen for the tumor.

Quality Assurance in Metabolomics and Metabolic Profiling.

Metabolic profiling (untargeted metabolomics) aims for a global unbiased analysis of metabolites in a cell or biological system. It remains a highly useful research tool used across various analytical platforms. Incremental improvements across multiple steps in the analytical process may have large consequences for the end quality of the data.

Decontamination of DNA sequences from a Streptomyces genome for optimal genome mining.

Despite meticulous precautions, contamination of genomic DNA samples is not uncommon, which can significantly compromise the analysis of microorganisms' whole-genome sequencing data, thus affecting all subsequent analyses. Thanks to advancements in software and bioinformatics techniques, it is now possible to address this issue and prevent the loss of the entire dataset obtained in a contaminated whole-genome sequencing, where the DNA of another bacterium is present. In this study, it was observed that the sequencing reads from Streptomyces sp.

Carbon-dot pequi-nut in the development of immunosensor to detect pathogenic bacteria.

Carbon dots in biosensing have advanced significantly, adding improvements to different detection techniques. In this study, an amperometric immunosensor for Salmonella Thyphimurium was designed using antibodies labeled with carbon dots (Cdots) from pequi almond (Caryocar brasiliensis). Cdots were synthesized by pyrolysis and characterized by FTIR, UV/fluorescence, electrochemistry, zeta potential, and transmission electron microscopy (TEM).

Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.

Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.

Guidance for Prescribing Oral Antihypertensive Medications in the Emergency Department.

Purpose Of Review: To review the most current recommendations regarding assessment and treatment of asymptomatic hypertension treatment in the emergency department (ED) and to provide guidance for prescribing oral antihypertensive therapy for ED providers.

Recent Findings: There are varying management strategies for the treatment of asymptomatic hypertension in the ED likely due to a lack of direct guidelines for treatment. There is an increasing body of evidence for the safety of initiating therapy to treat chronic asymptomatic hypertension in the ED.

Right ventricular subclinical dysfunction in high-burden idiopathic outflow tract premature ventricular contraction population.

Background: The relationship between premature ventricular contractions (PVC) and right ventricular (RV) function is not widely known. Left ventricular (LV) dysfunction due to PVC is known as PVC-induced cardiomyopathy (PIC) and suppressing the PVC substrate would improve LV function. The effect of PVC ablation on changes in RV function in patients with subtle RV subclinical dysfunction remains unknown.

Vascular outflow reconstruction in right lobe living donor liver transplantation with and without middle hepatic vein.

Although living donor liver transplantation has evolved, small-for-size syndrome remains a feared complication. Achieving optimal outflow for the graft with limited donor risk is possible with an experienced team and different techniques. Here we describe the technical aspects of living donor liver transplantation using a right lobe graft, including the different types of grafts, venous reconstructions and the importance of preoperative workup.

HIV Prevention in Syringe Service Programs Since the Start of COVID-19: Where Do We Go From Here?

Purpose: This narrative review addresses post-2020, specific, complex challenges for use of and adherence to pre-exposure prophylaxis (PrEP) for HIV prevention among out-of-treatment people who use drugs (PWUD) at syringe services programs (SSPs).

Recent Findings: The COVID-19 pandemic and its associated changes to the provision of healthcare have significantly impacted HIV prevention, especially for PWUD. Through a synthesis of literature and clinical experience, we (1) characterize the operational changes imposed by the pandemic on SSPs that shaped the current HIV prevention landscape; (2) describe three levels of current challenges for PWUD, including consumer attitudes, non-medical and medical provider attitudes, and structural and scalability barriers; (3) characterize current models for PrEP in SSPs; and (4) offer practical recommendations for HIV prevention in harm reduction programs.

Functional Magnetic Resonance Imaging of Post-Traumatic Headache: A Systematic Review.

Purpose Of Review: To evaluate existing functional magnetic resonance imaging (fMRI) studies on post-traumatic headache (PTH) following traumatic brain injury (TBI).

Recent Findings: We conducted a systematic search of PubMed and Embase databases from inception to February 1, 2024. Eligible fMRI studies were required to include adult participants diagnosed with acute or persistent PTH post-TBI in accordance with any edition of the International Classification of Headache Disorders.

Opioid Prescriptions for Low Back Pain among Military-Connected Older Adults Across Multiple Care Systems.

Background: Untreated low back pain (LBP) in older adults can lead to disability and development of chronicity. Due to the potential development of medical comorbidities and negative risks associated with pharmacological use, chronic LBP management for older adults requires a responsive approach.

Methods: The objective of this study is to evaluate the probability of (1) opioid prescription receipt and (2) opioid-sedative coprescription, in a sample of military-service-connected patients enrolled in the Veterans Health Administration (VHA) or TRICARE, ages 30-85 years, receiving care in three systems: VHA, Military Health System (MHS), and nonfederal (civilian) healthcare facilities.

Evaluating the prognostic role of glucose-to-lymphocyte ratio in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors in first line: a study by the Turkish Oncology Group Kidney Cancer Consortium (TKCC).

Purpose: Identifying prognostic indicators for risk stratification in metastatic renal cell carcinoma (mRCC) is crucial for optimizing treatment strategies and follow-up plans. This study aims to investigate the prognostic role of the glucose-to-lymphocyte ratio (GLR) in patients with mRCC receiving tyrosine kinase inhibitors (TKIs) as first-line therapy.

Methods: A retrospective cohort study was conducted using data from the Turkish Oncology Group Kidney Cancer Consortium Database.

Quantification of Particle-Associated Viruses in Secondary Treated Wastewater Effluent.

Viruses can interact with a broad range of inorganic and organic particles in water and wastewater. These associations can protect viruses from inactivation by quenching chemical disinfectants or blocking ultraviolet light transmission, and a much higher dosage of disinfectants is required to inactivate particle-associated viruses than free viruses. There have been only few studies of the association of viruses with particles in wastewater, particularly in secondary treated effluent.

Hematuria in the ER patient: optimizing detection of upper tract urothelial - A pictorial essay.

Upper tract urothelial carcinoma (UTUC) is a rare and challenging subset of the more frequently encountered urothelial carcinomas (UCs), comprising roughly 5-7% of all UCs and less than 10% of all renal tumors. Hematuria is a common presenting symptom in the emergency setting, often prompting imaging to rule out serious etiologies, with UTUC especially posing as a diagnostic challenge. These UTUC lesions of the kidney and ureter are often small, mimicking other pathologies, and are more aggressive than typical UC of the bladder, emphasizing the importance of timely and accurate diagnosis.

Translation, cross-cultural adaptation and psychometric evaluation of the Serbian Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire (refers to r-axSpA) and its relations with disease activity and functional status indices.

Objectives: To translate, cross-culturally adapt and validate the Serbian Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, e.g. according to the new nomenclature Radiographic-Axial Spondyloarthritis (r-axSpA), and to relate it to disease activity and functional status domains.

CAR-T therapy toxicities: the importance of macrophages in their development and possible targets for their management.

CAR-T cell therapies have risen to prominence over the last decade, and their indications are increasing with several products approved as early as second line in Large B Cell non-Hodgkin Lymphomas. Their major toxicities are the cytokine release syndrome (CRS) and the Immune-effector Cell Associated Neurotoxicity Syndrome (ICANS). These entities involve a hyperinflammatory cascade which is amplified through the mononuclear phagocytic system (MPS).

Primary Graft Dysfunction after Heart Transplantation: Current Evidence and Implications for Clinical Practice.

Purpose Of Review: This review summarizes the current literature on primary graft dysfunction highlighting the current definition, reviewing epidemiology, and describing donor, recipient, and perioperative risk factors in the contemporary era.

Recent Findings: PGD, in its most severe form, complicates 8% of heart transplants and portends a 1-year mortality of close to 40%. PGD is multifactorial and heterogeneous with contributions from donor and recipient risk as well as organ recovery and preservation modalities.

Can the supplementation of autolyzed yeast (Saccharomyces cerevisiae) affect the diet digestibility, feeding behavior, levels of blood metabolites, and performance of Dorper × Santa Ines lambs finished in feedlot?

This study aimed to evaluate the effect of autolyzed yeast (obtained from culture of Saccharomyces cerevisiae in sugarcane derivatives) supplementation on diet digestibility, feeding behavior, levels of blood metabolites associated with protein and energy metabolism, and performance of Dorper × Santa Ines lambs finished in feedlot. Twenty-four non-castrated male lambs with an average age of 4 months and a body weight (BW) of 19.49 ± 3.

Conspecific interactions between corals mediate the effect of submarine groundwater discharge on coral physiology.

Land-based inputs, such as runoff, rivers, and submarine groundwater, can alter biologic processes on coral reefs. While the abiotic factors associated with land-based inputs have strong effects on corals, corals are also affected by biotic interactions, including other neighboring corals. The biologic responses of corals to changing environmental conditions and their neighbors are likely interactive; however, few studies address both biotic and abiotic interactions in concert.

Homelessness and Birth Outcomes in the Pregnancy Risk Assessment Monitoring System, 2016-2020.

Objectives: This study aimed to estimate the prevalence of homelessness shortly before or during pregnancy and describe differences in maternal characteristics and adverse birth outcomes between people reporting homelessness and not reporting homelessness.

Methods: We used 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 31 sites to estimate the prevalence of self-reported homelessness during the 12 months before giving birth. We used logistic regression models to evaluate the association between homelessness and adverse birth outcomes, specifically small for gestational age (SGA), low birth weight (LBW), and preterm birth (PTB).

Can ChatGPT4-vision identify radiologic progression of multiple sclerosis on brain MRI?

Background: The large language model ChatGPT can now accept image input with the GPT4-vision (GPT4V) version. We aimed to compare the performance of GPT4V to pretrained U-Net and vision transformer (ViT) models for the identification of the progression of multiple sclerosis (MS) on magnetic resonance imaging (MRI).

Methods: Paired coregistered MR images with and without progression were provided as input to ChatGPT4V in a zero-shot experiment to identify radiologic progression.

Time course of hospitalizations in patients with heart failure and chronic obstructive pulmonary disease around sleep-disordered-breathing diagnosis.

Purpose: In heart failure (HF) and chronic obstructive pulmonary disease (COPD) populations, sleep-disordered breathing (SDB) is associated with impaired health outcomes. We evaluated whether in patients with HF, concomitant HF and COPD or COPD, the number of hospitalizations would be reduced in the year after testing for SDB with and without treatment initiation compared to the year before.

Methods: We performed a multicentre retrospective study of 390 consecutive sleep-clinic patients who had a primary diagnosis of chronic HF, HF and COPD or COPD and a secondary diagnosis of SDB.

Closing the Gap: Digital Innovations to Address Hypertension Disparities.

Purpose Of Review: Significant inequities persist in hypertension detection and control, with minoritized populations disproportionately experiencing organ damage and premature death due to uncontrolled hypertension. Remote blood pressure monitoring combined with telehealth visits (RBPM) is proving to be an effective strategy for controlling hypertension. Yet there are challenges related to technology adoption, patient engagement and social determinants of health (SDoH), contributing to disparities in patient outcomes.

Explaining cognitive function in multiple sclerosis through networks of grey and white matter features: a joint independent component analysis.

Cognitive impairment (CI) in multiple sclerosis (MS) is only partially explained by whole-brain volume measures, but independent component analysis (ICA) can extract regional patterns of damage in grey matter (GM) or white matter (WM) that have proven more closely associated with CI. Pathology in GM and WM occurs in parallel, and so patterns can span both. This study assessed whether joint-ICA of GM and WM features better explained cognitive function compared to single-tissue ICA.

Diagnostic value of CT scans in pediatric patients with acute non-traumatic altered mental status: a systematic review and meta-analysis.

Background: Computed tomography (CT) scans are widely used for evaluating children with acute atraumatic altered mental status (AMS) despite concerns about radiation exposure and limited diagnostic yield. This study aims to assess the efficacy of CT scans in this population and provide evidence-based recommendations.

Methods: A systematic review was conducted according to PRISMA guidelines.