Challenges in the Management of a Difficult-to-Treat Patient With Hairy Cell Leukemia: A Case Report.

Hairy cell leukemia (HCL) is a rare, chronic B-cell malignancy with an indolent course that typically responds well to purine nucleoside analogs, such as cladribine. We present the case of a 74-year-old woman with nearly three decades of recurrent HCL, marked by multiple relapses and significant toxicities to various treatments, including purine analogs, BRAF inhibitors, BTK inhibitors, a cytoreductive agent, and the monoclonal antibody rituximab. Despite severe allergic reactions and intolerances to standard therapies, the patient achieved multiple remissions.

A 21-Year-Old Male With Metastatic Colorectal Cancer: A Case Report and Literature Overview of Early-Onset Colorectal Cancer.

Early-onset colorectal cancer (CRC) has been on the rise since the start of the twenty-first century. While the etiology behind this increase remains unclear, the United States Preventive Services Task Force (USPSTF) has decreased the recommended age to begin screening for CRC to 45 years. This case report reviews the literature on CRC in the young population while presenting a case of a 21-year-old male with early-onset metastatic colorectal cancer without a hereditary etiology.

Successful Diagnosis of a SMARCA4-Deficient Undifferentiated Tumor via Endobronchial Ultrasound-Guided Fine Needle Aspiration and Endobronchial Biopsies.

Lung cancer is the third most prevalent cancer, following breast cancer in women and prostate cancer in men. However, it remains the leading cause of cancer-related mortality. As treatment options have advanced, the significance of accurate diagnosis has increased, enabling targeted and more personalized therapeutic treatments.

A Rare Case of Steroid-Induced Hypothermia in a Patient With Systemic Lupus Erythematosus.

A 75-year-old woman with a history of systemic lupus erythematosus (SLE) presented with isolate ocular symptoms, including a left scleral hematoma, elevated erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Initial evaluation combined with isolated ocular symptoms raised concerns for giant cell arteritis rather than an SLE flare. Thus, prompt initiation of high-dose intravenous methylprednisolone (250 mg every six hours) was warranted.

Practicing What They Preach: Do Medical Specialty and Subspecialty Conferences Incorporate Physician Wellness Into Their Programs?

Background: Depending upon their organization and content, medical conferences can enhance wellness or create additional stress for physician attendees. The objective of our study was to examine the degree to which major medical specialty and subspecialty conferences incorporate wellness into their meeting programs.

Methods: We performed a cross-sectional study of major medical conferences occurring in 2023 representing specialties and subspecialties with the greatest number of active physicians.

Potential Cisatracurium-Induced Malignant Hyperthermia: A Case Report.

Malignant hyperthermia is a pharmacogenetic disorder that manifests clinically as a hypermetabolic crisis when a patient with a mutation in the ryanodine or dihydropyridine receptor genes is exposed to neuromuscular blocking agents. Depolarizing neuromuscular agents are known to cause malignant hyperthermia, but cases caused by nondepolarizing agents are rarely reported. We present a case consistent with malignant hyperthermia after receipt of cisatracurium, a nondepolarizing anesthetic agent.

Outcomes of a pilot randomized clinical trial testing brief interventions to increase HIV pre-exposure prophylaxis uptake among rural people who inject drugs attending syringe services programs.

Background: Kentucky is one of seven states with high, sustained rural HIV transmission tied to injection drug use. Expanding access to pre-exposure prophylaxis (PrEP) has been endorsed as a key HIV prevention strategy; however, uptake among people who inject drugs (PWID) has been negligible in rural areas. Syringe services programs (SSPs) have been implemented throughout Kentucky's Appalachian region, providing an important opportunity to integrate PrEP services.

Wound Healing Splinting Devices for Faster Access and Use.

With the goal of studying skin wound healing and testing new drug treatments to enhance wound healing in rodent models, there is a clear need for improved splinting techniques to increase surgical efficiency and support routine wound monitoring. Splinted wound healing models humanize wound healing in rodents to prevent contraction and instead heal through granulation tissue deposition, increasing the relevance to human wound healing. Current technologies require suturing and heavy wrapping, leading to splint failure and cumbersome monitoring of the wound.

A CONVEX COMPRESSIBILITY-INSPIRED UNSUPERVISED LOSS FUNCTION FOR PHYSICS-DRIVEN DEEP LEARNING RECONSTRUCTION.

Physics-driven deep learning (PD-DL) methods have gained popularity for improved reconstruction of fast MRI scans. Though supervised learning has been used in early works, there has been a recent interest in unsupervised learning methods for training PD-DL. In this work, we take inspiration from statistical image processing and compressed sensing (CS), and propose a novel convex loss function as an alternative learning strategy.

Pulsating Drought and Insect Herbivory Cause Differential Effects on Soybean () Genotypes That Vary in Canopy Wilting Speed.

As a result of climate change, global temperatures are increasing, and water scarcity is on the rise. Soybean [ () Merr] is one of the most important crops in the world due to its importance as food and feed. One of the major limiting factors for soybean production is drought, which can cause up to 80% reduction in yield.

Shifting tides: A survey analysis of urologists' evolving attitudes toward focal therapy for prostate cancer.

Introduction: Focal therapy (FT) is emerging as an alternative to radical treatment for prostate cancer (CaP). The purpose of this study is to assess the current perceptions of FT amongst urologists.

Methods: A 22-item questionnaire was e-mailed to members of the American Urological Association.

Efficacy and safety of in patients with primary hyperoxaluria: A systematic review and meta-analysis of randomized controlled trials.

Background And Objective: Primary hyperoxaluria (PH), a rare autosomal recessive disorder, results in defective metabolism of oxalate, leading to increased oxalate levels. is a nonpathological anaerobic bacterium that uses oxalate for its survival and thus decreases the plasma oxalate levels. We aimed to use randomized controlled trials (RCTs) to evaluate the efficacy of in treating PH.

Single-port robot-assisted pyeloplasty through supine anterior retroperitoneal access.

This video explores the technique of robot-assisted pyeloplasty using the Da-Vinci Single-Port robot through the supine anterior retroperitoneal access in a 28-year-old male with a right-sided ureteropelvic junction obstruction. The patient was placed in a supine position, with a 10°-20° elevation of the ipsilateral flank. Retroperitoneal access was obtained at the McBurney's point for the placement of the port.

Diagnosis and Management of Progressive Corticobasal Syndrome.

Purpose Of Review: The purpose of this review is to discuss the clinical, radiological, and neuropathological heterogeneity of corticobasal syndrome (CBS), which can complicate the determination of underlying etiology and lead to inaccurate treatment decisions. Though the most common diagnosis is corticobasal degeneration (CBD), the spectrum of underlying pathologies expands beyond CBD and can overlap with other neurodegenerative diseases and even the neuroimmunology field. We will review possible clinical presentations and cues that can point towards the etiology.

Hospital Financial Burden of Surgical Procedures for Periprosthetic Total Hip Arthroplasty Infection.

Background: For reimbursement purposes, current coding fails to reflect the true complexity and resource utilization of hospital encounters for surgeries performed to treat periprosthetic total hip arthroplasty (THA) infection. Therefore, when compared to aseptic revisions, we sought to determine (1) Is length of stay (LOS) longer for septic surgeries? (2) Are septic procedures more expensive? and (3) How do different surgical procedures for infection compare with aseptic revisions on hospital LOS and charges?

Methods: Retrospective chart review of 596 unilateral THA reoperations (473 patients) performed at a single institution (January 2015 to November 2020). Demographics, professional (ie, physicians), and technical (ie, room, implants) hospital charges per case were compared between 6 different surgery types: (1) aseptic revision (control; n = 364); (2) debridement, antibiotics, and implant retention (n = 11); (3) explantation (n = 145); (4) spacer exchange (n = 7); (5) 2-stage reimplantation (n = 59); and (6) 1-stage reimplantation (n = 10).

Influenza vaccine effectiveness against influenza-associated hospitalizations in children, Hong Kong, November 2023 to June 2024.

We conducted a test negative study from November 2023 to June 2024, enrolling 4,367 children hospitalized with acute respiratory illness in Hong Kong. Among the children who tested negative for influenza virus and SARS-CoV-2, 56.8 % had received influenza vaccination.

AI-driven multi-omics integration for multi-scale predictive modeling of genotype-environment-phenotype relationships.

Despite the wealth of single-cell multi-omics data, it remains challenging to predict the consequences of novel genetic and chemical perturbations in the human body. It requires knowledge of molecular interactions at all biological levels, encompassing disease models and humans. Current machine learning methods primarily establish statistical correlations between genotypes and phenotypes but struggle to identify physiologically significant causal factors, limiting their predictive power.

HiGen: Hierarchy-Aware Sequence Generation for Hierarchical Text Classification.

Hierarchical text classification (HTC) is a complex subtask under multi-label text classification, characterized by a hierarchical label taxonomy and data imbalance. The best-performing models aim to learn a static representation by combining document and hierarchical label information. However, the relevance of document sections can vary based on the hierarchy level, necessitating a dynamic document representation.

An extracellular vesicle based hypothesis for the genesis of the polycystic kidney diseases.

Autosomal dominant polycystic kidney (ADPKD) disease is the commonest genetic cause of kidney failure (affecting 1:800 individuals) and is due to heterozygous germline mutations in either of two genes, and . Homozygous germline mutations in are responsible for autosomal recessive polycystic kidney (ARPKD) disease a rare (1:20,000) but severe neonatal disease. The products of these three genes, (polycystin-1 (PC1 4302(3)aa)), (polycystin-2 (PC2 968aa)) and (fibrocystin (4074aa)) are all present on extracellular vesicles (EVs) termed, PKD-exosome-like vesicles (PKD-ELVs).

Patient Advisory Groups in Inflammatory Bowel Disease: A Collaborative Relationship Between Patients and Researchers.

Background: Patient advisory groups are key to guiding research studies through meaningful engagement with the population of interest. Although patient advisory groups are greatly valuable to research studies, they are underutilized in inflammatory bowel disease research. Thus, this study aims to describe the development and implementation of a patient advisory group and evaluate the perspectives of researchers and members.

Double Fortified Salt Containing Iodine and Folic Acid and Triple Fortified Salt Containing Iodine, Folic Acid, and Vitamin B Are Acceptable to Ethiopian Women of Reproductive Age.

Recognizing the broader accessibility of iodized salt compared to wheat flour, the Ethiopian government is considering fortification of iodized salt with folic acid, and possibly vitamin B, to address the high incidence of neural tube defects (NTDs) in Ethiopia. To prepare for this program, we assessed practices related to edible salt procurement and consumption, and the acceptability of novel salts fortified with iodine and folic acid (double-fortified salt, DFS) or iodine, folic acid, and vitamin B (triple-fortified salt, TFS) compared to iodized salt (IS). We surveyed 840 women of reproductive age in urban (Addis Ababa) and rural (Gimbichu Woreda) areas to describe their salt preferences and practices and used a three-point hedonic scale to evaluate the sensory acceptability of fine and coarse forms of DFS, TFS, and IS for color, taste, aroma, texture and overall acceptability.

A critical review of heat pump adoption in empirical and modeling literature.

Household electrification is an important pillar of decarbonization in the US and requires the rapid adoption of electric heat pumps. Household energy models that project adoption rates do not represent these decisions well. To what extent are they limited by fundamental knowledge gaps, or is there scope to incorporate insights from the social science literature? We review the energy modeling and social science literature on heating equipment adoption to synthesize our understanding of adoption decisions, to identify best practices on representing decision-making behavior among energy models, and to suggest model improvements.

Phenotypic consequences of logarithmic signaling in MAPK stress response.

How cells respond to dynamic environmental changes is crucial for understanding fundamental biological processes and cell physiology. In this study, we developed an experimental and quantitative analytical framework to explore how dynamic stress gradients that change over time regulate cellular volume, signaling activation, and growth phenotypes. Our findings reveal that gradual stress conditions substantially enhance cell growth compared to conventional acute stress.

Provider Lifestyle Counseling Among Adults With Cardiometabolic Disease Diagnosis Differs by Sociodemographic Characteristics and Lifestyle Modification: NHANES 2017-2020.

Background: Provider lifestyle counseling is important for improving lifestyles and cardiometabolic disease (CMD) prognosis. However, an examination of the relationship between sociodemographic characteristics, lifestyle modification and provider lifestyle counseling receipt among adults with CMD is scarce. The study examined the prevalence and associations of lifestyle modification and sociodemographic characteristics with provider lifestyle counseling among adults with CMD diagnosis.