Comparative Effectiveness of Fluticasone Furoate/Umeclidinium/Vilanterol and Budesonide/Glycopyrrolate/Formoterol Fumarate among US Patients with Chronic Obstructive Pulmonary Disease.

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with exacerbations which can reduce quality of life and increase mortality. Single-inhaler triple therapy (SITT) is recommended for maintenance treatment of COPD among patients experiencing exacerbations despite dual-therapy use. This real-world comparative effectiveness study compared the impact of SITTs, fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI), and budesonide/glycopyrrolate/formoterol fumarate (BUD/GLY/FORM), on COPD exacerbations and mortality.

Minimizing for Maximum Benefit: An Illustrative Case-Series of Atrial Only Leadless Pacing.

Leadless pacing technology now includesdedicated atrial helix-fixation leadless pacemakers (LPs), expanding theapplication of leadless devices for patients with sinus node dysfunction andatrioventricular block during sinus rhythm. This first reportedcase-series of atrial LPs describes and discusses the potential use-casescenarios of recently approved helix-fixation atrial LPs. The article highlights important concepts regarding their use, including implantationtechniques, programming, battery conservation, and the low rate of progressionof AV block in patients implanted with AAI(R) pacemakers.

Down-regulation of interlinked inflammatory signalling cascades by ethanolic extract of Suaeda fruticosa Forssk. ex J.F. Gmel. attenuated in vivo inflammatory and nociceptive responses.

Juice and decoction of leaves of Suaeda fruticosa, a halophytic medicinal plant of Cholistan desert, is traditionally used to treat rheumatism. The current study was carried out to probe into in vivo anti-nociceptive, anti-inflammatory, and anti-arthritic potential of ethanolic extract of the whole plant of S. fruticosa (Et-SF) and its bioactive molecules.

The Role of Podocytes in Lupus Pathology.

Purpose Of Review: Kidney injury due to lupus nephritis (LN) is a severe and sometimes life-threatening sequela of systemic lupus erythematosus. Autoimmune injury to podocytes has been increasingly demonstrated to be a key driver of LN-related kidney injury because these cells play key roles in glomerular filtration barrier homeostasis. Irreparable podocyte injury impairs these processes and can lead to proteinuria, which is an indicator of poor prognosis in LN.

A Podcast on Patient and Physician Perspectives in the Holistic Care of Heart-Related Challenges of Type 2 Diabetes.

Type 2 diabetes (T2D) frequently coexists with cardiorenal complications. Therefore, a holistic approach to patient management is required, with specialists such as primary care physicians, cardiologists, endocrinologists, and nephrologists working together to provide patient care. Although glycemic control is important in the management of T2D, patients with T2D and acceptable glycemic control are still at risk from cardiovascular (CV) events such as stroke, heart attack, and heart failure (HF).

Postoperative dorsal step-off predicts olecranon osteotomy union: a retrospective cohort study.

Purpose: Olecranon osteotomy has been associated with loss of reduction, nonunion, implant failure, and migration of wires. We aim to evaluate quality of reduction of the osteotomy site as a predictor of olecranon osteotomy nonunion.

Methods: One hundred and twenty-five distal humerus fractures that underwent open reduction internal fixation (ORIF) were reviewed.

Autistic Adults Experience Higher PTSD Symptoms Relating to Motor Vehicle Accidents than Non-Autistic Adults.

Purpose: Autistic adults experience high rates of traumatic events and PTSD. However, little work has evaluated motor vehicle accident (MVA) related trauma symptoms. The goal of this brief report was to provide pilot data characterizing MVA-related peritraumatic reactions, trauma symptoms, and rates of PTSD diagnosis and mental health service use among Autistic compared to non-autistic adults.

An Exploratory Analysis of Child Characteristics Predicting Clinical Outcomes in Parent-Led Cognitive Behavioral Teletherapy for Anxiety in Autistic Children.

Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders. A recent clinical trial found that parent-led CBT - in which parents led their child through a guided CBT workbook with varying degrees of therapist support - was efficacious for reducing anxiety and associated functional impairment. While such findings demonstrate promise for future intervention development and dissemination efforts with this population, more work is needed to elucidate clinical factors that impact response to treatment as well as drop-out.

Sex Differences in Spatiotemporal Consistency and Effective Connectivity of the Precuneus in Autism Spectrum Disorder.

Autism spectrum disorder (ASD) has been reported to exhibit altered local functional consistency. However, previous studies mainly focused on male samples and explored the temporal consistency in the ASD brain ignoring the spatial consistency. In this study, FOur-dimensional Consistency of local neural Activities (FOCA) analysis was used to investigate the sex differences of local spatiotemporal consistency of spontaneous brain activity in ASD.

The Narrative Coherence of Autistic Children's Accounts of an Experienced Event in Response to Different Interviewer Prompts: A Longitudinal Study.

Purpose: This study explored the narrative coherence of the accounts of an experienced event produced by autistic and neurotypical children (ages 6-15 years) after delays of two weeks and two months.

Methods: The sample comprised 27 autistic children and 32 neurotypical peers, who were interviewed about the event using the Revised National Institute of Child Health and Human Development (NICHD) Investigative Interview Protocol. The study focused on assessing the narrative coherence of children's reports, emphasizing key story grammar elements and temporal features in their narratives.

Acanthamoeba Infection in a Hematopoietic Cell Transplant Recipient: Challenges in Diagnosis, Management, and Source Identification.

We report a case of Acanthamoeba infection in an HCT recipient with steroid-refractory GVHD. We highlight the multiple challenges that free-living ameba infections present to the clinician, the clinical laboratory, transplant infectious disease for review, hospital epidemiology if nosocomial transmission is considered, and public health officials, as exposure source identification can be a significant challenge. Transplant physicians should include Acanthamoeba infections in their differential diagnosis of a patient with skin, sinus, lung, and/or brain involvement.

Outcomes Associated With Blastomycosis in Solid Organ and Hematopoietic Cell Transplant Recipients.

Introduction: With reports of expanding epidemiology of blastomycosis across the United States, the purpose of this study was to evaluate the incidence and outcomes associated with blastomycosis in solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients.

Methods: We conducted a retrospective case series of adult SOT and HCT recipients at a tertiary care medical center between January 1, 2005 and September 30, 2023. Cases were defined as culture-proven blastomycosis.

Being Popular and Being Liked: Goals, Behaviors, and Norm Salience.

Youth's social status (popularity and likability) relates with social status goals as well as bullying and prosocial behaviors within the context of classroom norms for bullying and prosocial behaviors, but less clear is how each of these factors interrelates with each other. The current study empirically analyses the concurrent relationships among social status goals, bullying and prosocial behaviors, and classroom norms with social status. Participants were a nationally representative sample of 6,421 Slovenian early adolescents (50% females; M = 13 years; SD = 6 months).

Warmth and Control: Examining the Associations between Chinese Parenting Behaviors and Children's Academic Performance in Different Parent-Child Dyads.

Few studies have comprehensively examined the reciprocal relation between specific parenting practices and children's academic performance across parent and child gender. The present study investigated the bidirectional associations between parental warmth/control and children's academic performance using a three-wave longitudinal multi-informant design. A total of 814 families (M = 10.

Unveiling root nodulation in Tribulus terrestris and Roystonea regia via metagenomics analysis.

Root nodule symbiosis is traditionally recognized in the Fabales, Fagales, Cucurbitales, and Rosales orders within the Rosid I clade of angiosperms. However, ambiguous root nodule formation has been reported in Zygophyllaceae and Roystonea regia (Arecaceae), although a detailed analysis has yet to be conducted. We aimed to perform morphological analyses of root structures in these plants and utilize metagenomic techniques to identify and characterize the bacterial populations within the nodule-like structures.

Riders on the Storm.

This case involves a 52-year-old male, who underwent a deceased donor orthotopic liver transplant 7 months prior, presented with a 2-week history of persistent fever, anemia, thrombocytopenia, and mild elevation of liver enzymes. Upon hospital admission, the patient was febbrile, alert and oriented, hemodynamically stable. Laboratory exams revealed worsening leukopenia, anemia, thrombocytopenia, hyponatremia, and elevated ferritin.

Effect of Qigong exercise on quality of life and cortisol in patients with cancer: a non-randomized controlled trial.

Purpose: The aim of this study was to investigate the effect of a 6-month Guolin Qigong on quality of life and serum cortisol among patients with cancer.

Methods: This study was a two-arm and non-randomized controlled trial. Forty-nine patients with cancer who were over 18 years of age and diagnosed with cancer were enrolled in this study and assigned to either the Guolin Qigong intervention group (IG, n = 26) or the usual care group (UC, n = 23) for 6 months.

Assessing patient satisfaction with hemodialysis and peritoneal dialysis care and associated factors in Iran.

Purpose: With the increasing demand for dialysis, there is a growing emphasis on patient-centered care. This study investigated patients' satisfaction levels with peritoneal dialysis (PD) and hemodialysis (HD) care in Iran.

Methods: A cross-sectional multicenter study was conducted among 346 patients with chronic kidney disease (CKD) covered by the Iran Health Insurance Organization who received dialysis services from October to December 2022 across the country.

Cetyltrimethylammonium Chloride (CTAC) and Its Formulated Mouthwash Reduce the Infectivity of Streptococcus mutans and Candida albicans in Mono and Dual State.

Early childhood caries (ECC), a severe form of dental caries, is exacerbated by the synergistic interaction between Streptococcus mutans and Candida albicans, leading to greater disease severity than their individual effects. This underscores the need for more targeted and potent therapeutic alternatives. Given the promising anti-infective properties of quaternary ammonium surfactants (QAS), this study explores the microbicidal properties of one such QAS, cetyltrimethylammonium chloride (CTAC), against both individual- and dual-species cultures of S.

Novel Perspectives Focused on the Relationship Between Herpesvirus Encephalitis and Anti-GFAP-Antibody-Positive Astrocytopathy.

Virus encephalitis (VE), recognized as one of the common kinds of central nervous system (CNS) diseases after virus infection, has a surprising correlation with autoimmune encephalitis (AE) when autoimmune antibodies emerge in cerebrospinal fluid (CSF) or serum. Herpes simplex virus and Epstein-Barr virus are the most critical agents worldwide. By molecular mimicry, herpes viruses can invade the brain directly or indirectly.

Assessing modified HEART scores with high-sensitivity troponin for low-risk chest pain in the emergency department.

The accuracy of using HEART (history, electrocardiogram, age, risk factors, and troponin) scores with high-sensitivity cardiac troponin (hs-cTn) to risk stratify emergency department (ED) chest pain patients remains uncertain. We aim to compare the performance accuracy of determining major adverse cardiac event (MACE) among three modified HEART (mHEART) scores with the use of hs-cTn to risk stratify ED chest pain patients. This retrospective single-center observational study included ED patients with suspected acute coronary syndrome who had HEAR scores calculated and at least one hs-cTnI result.

Assessing the impact of clerkships on the growth of clinical knowledge.

Purpose: This study quantified the impact of clinical clerkships on medical students' disciplinary knowledge using the Comprehensive Clinical Science Examination (CCSE) as a formative assessment tool.

Methods: This study involved 155 third-year medical students in the College of Human Medicine at Michigan State University who matriculated in 2016. Disciplinary scores on their individual Comprehensive Clinical Science Examination reports were extracted by digitizing the bar charts using image processing techniques.

Translumbar and Transhepatic Tunneled Dialysis Catheter Placements in the End Stage Renal Disease Population.

For end-stage renal disease (ESRD) patients requiring hemodialysis, reliable vascular access is crucial, especially when conventional supradiaphragmatic options are exhausted. This study reviews the technical aspects, clinical outcomes, and complications of translumbar and transhepatic tunneled dialysis catheter (TDC) placements. These alternative infradiaphragmatic approaches provide essential hemodialysis access for patients with central venous occlusions.

The Utility of Interferon-γ Release Assays in the Diagnosis of Tuberculosis in Patients With Cancer.

Background: Patients with cancer are at elevated risk for tuberculosis (TB) reactivation. Diagnosis of latent TB infection and TB disease remains challenging in this patient population despite the advent of interferon-γ release assays (IGRA).

Methods: We retrospectively reviewed medical records of all patients with cancer who had IGRA testing (QuantiFERON-TB [QFT-TB] or T-SPOT.