Tropical Indian Ocean drives Hadley circulation change in a warming climate.

The weakening and poleward expansion of the Hadley circulation (HC) are considered robust responses of atmospheric meridional circulation to anthropogenic warming. Climate impacts arising from these changes enhance drought conditions and reduce food production in the affected regions. Therefore, understanding the mechanisms of HC changes is critical to anticipating the resultant climate risks.

The overlooked role of microbiota-gut-brain communication in child psychiatry: a call for integration in early intervention strategies.

Emerging research has highlighted the significant role of microbiota-gut-brain communication in child psychiatric disorders, including autism spectrum disorder (ASD) and anxiety disorders. Despite this, mainstream psychiatric interventions for children continue to focus predominantly on neurological and psychological therapies, neglecting the critical influence of gut microbiota on brain development and behavior. This commentary underscores the need for greater integration of microbiota-targeted therapies, such as dietary interventions, prebiotics, and probiotics, into early psychiatric intervention strategies.

A Contemporary Approach to the Treatment of Perioperative Bronchospasm.

The incidence of asthma is increasing, and the ageing of the United States population is leading to an increase in the prevalence of patients living with chronic obstructive pulmonary disease. This has led to an increased need to manage bronchospasm in the perioperative period. Very effective methods to treat bronchospasm like intravenous dexmedetomidine, lidocaine, magnesium, ketamine and steroids as well as inhalational sevoflurane are available but are currently underused.

Cervical Cancer and Cervical Cancer Screening in Women with HIV in Guangxi, China: A Model Simulation Study.

Unlabelled: Cervical cancer screening can effectively reduce the disease burden. In China, the current cervical cancer screening guidelines do not provide separate screening recommendations for women living with HIV (WLWH) to account for their increased risk. We developed a comprehensive individual-based simulation model to provide evidence to support tailored cervical cancer screening programs for WLWH in Guangxi, a region with a high prevalence of HIV in China.

Dissemination of Decision Aids about Hip and Knee Osteoarthritis to Spanish-Speaking Adults through Social Media.

Background: Older adults and Hispanic individuals are increasingly turning to social media platforms to access health-related information. The purpose of this project was to evaluate a social media campaign to disseminate information from decision aids (DAs) on hip and knee osteoarthritis to Spanish-speaking adults.

Methods: A social media marketing team helped create an 8-mo campaign posted across 3 social media platforms to promote visits to a Web site offering free multilingual DAs for treatment of hip or knee osteoarthritis.

Connection between -electron correlations and magnetic excitations in UTe.

The detailed anisotropic dispersion of the low-temperature, low-energy magnetic excitations of the candidate spin-triplet superconductor UTe is revealed using inelastic neutron scattering. The magnetic excitations emerge from the Brillouin zone boundary at the high symmetry and points and disperse along the crystallographic -axis. In applied magnetic fields to at least = 11 T along the , the magnetism is found to be field-independent in the ( 0) plane.

The promises and perils of circulating tumor DNA for monitoring immunotherapy response in non-small cell lung cancer.

There has been a rapid expansion of immunotherapy options for non-small cell lung cancer (NSCLC) over the past two decades, particularly with the advent of immune checkpoint inhibitors. Despite the emerging role of immunotherapy in adjuvant and neoadjuvant settings though, relatively few patients will respond to immunotherapy which can be problematic due to expense and toxicity; thus, the development of biomarkers capable of predicting immunotherapeutic response is imperative. Due to the promise of a noninvasive, personalized approach capable of providing comprehensive, real-time monitoring of tumor heterogeneity and evolution, there has been wide interest in the concept of using circulating tumor DNA (ctDNA) to predict treatment response.

E-Cigarette switching and financial incentives to promote combustible cigarette cessation among adults accessing shelter services: A pilot study.

Background: Smoking prevalence among U.S. adults experiencing homelessness is ≥70 %.

Comparison of Band Percentage vs Immature Granulocyte Percentage in the Setting of Possible Infection Principle Investigators.

Sepsis is a major cause of mortality worldwide. Early identification and treatment are critical to improve survival. Band count has been used as part of SIRS criteria for the early identification of potentially septic patients.

Human iPSC-derived neural stem cells engraft and improve pathophysiology of MPS I mice.

Mucopolysaccharidosis type I (MPS I) is a metabolic disorder characterized by a deficiency in α-l-iduronidase (IDUA), leading to impaired glycosaminoglycan degradation. Current approved treatments seek to restore IDUA levels via enzyme replacement therapy (ERT) and/or hematopoietic stem cell transplantation (HSCT). The effectiveness of these treatment strategies in preventing neurodegeneration is limited due to the inability of ERT to penetrate the blood-brain barrier (BBB) and HSCT's limited CNS reconstitution of IDUA levels.

Challenges of Treating a C2 Odontoid Fracture in an Elderly Patient With Multiple Comorbidities: A Case Report.

An 88-year-old male with a history of cervical spondylosis (status post laminectomy of C2-C3 and laminoplasty of C4-C5), chronic congestive heart failure (CHF), pulmonary embolism, and lumbar spinal stenosis presented to an outpatient sports medicine clinic with neck pain following a fall five days prior due to loss of balance. He reported pain on the left side worsened by movement and accompanied by neck "clicking." A physical exam showed severe limitation in cervical spine extension limited by pain and loss of lordotic curve and a neurologic exam demonstrated weakness in the left leg secondary to a previous back surgery.

Fournier's Gangrene Severity Index and Charlson Comorbidity Index Predict Mortality, Intensive Care Unit Admission, and Length of Hospital Stay in Patients With Fournier's Gangrene: An Analysis of 264 Consecutive Patients.

Introduction Fournier's gangrene (FG) is a rapidly progressing necrotizing fasciitis. The Fournier's Gangrene Severity Index (FGSI), in conjunction with the Charlson Comorbidity Index (CCI), has been used as a mortality predictor during hospitalization. Patients with diabetes have also been shown to be at an increased risk for the development of FG.

Successful Management of Disseminated Intravascular Coagulation in Metastatic Castrate-Resistant Prostate Cancer With Lutetium-177: A Case Report and Review of the Literature.

Disseminated intravascular coagulation (DIC) is a hematological disorder characterized by the abnormal activation of the coagulation system, which leads to widespread clotting and subsequent consumption coagulopathy. DIC is often associated with the progression of prostate cancer and can be a life-threatening condition. In this case report, we present a patient with recurrent DIC in the setting of advanced prostate cancer.

The Future of Giant Cell Arteritis Diagnosis and Management: A Systematic Review of Artificial Intelligence and Predictive Analytics.

Giant cell arteritis (GCA), a systemic vasculitis affecting large and medium-sized arteries, poses significant diagnostic and management challenges, particularly in preventing irreversible complications like vision loss. Recent advancements in artificial intelligence (AI) technologies, including machine learning (ML) and deep learning (DL), offer promising solutions to enhance diagnostic accuracy and optimize treatment strategies for GCA. This systematic review, conducted according to the PRISMA 2020 guidelines, synthesizes existing literature on AI applications in GCA care, with a focus on diagnostic accuracy, treatment outcomes, and predictive modeling.

Job Satisfaction Among Graduate Medical Education Trainees.

Burnout among medical residents and fellows (postgraduate trainees) has been receiving significant attention in the scientific literature with far less focus on the factors that correlate with job satisfaction and well-being. A better understanding of the characteristics that increase job satisfaction (rather than just those that lead to burnout) may allow programs to develop and enhance those positive features, conceivably leading to improved mental health, retention, and recruitment. We hypothesize that job satisfaction among postgraduate trainees is positively impacted by feeling that their work is meaningful, that their work schedules are equitable, and that they are appreciated by their faculty.

A Whodunnit: Anterior ST-Elevation Myocardial Infarction in a Patient Found to Have Apparent Takotsubo Cardiomyopathy, Left Anterior Descending Artery Disease, and Myocardial Bridging.

We present a case of a 52-year-old male with no known past medical history who presented to an outside hospital with acute chest pain. Initial workup revealed anteroseptal ST-elevation myocardial infarction (STEMI) for which the patient was transferred to our facility for emergent percutaneous coronary intervention (PCI). However, the patient's hospital course revealed numerous confounding pathologies that can also present as STEMI, including transthoracic echocardiogram (TTE) abnormalities consistent with takotsubo cardiomyopathy (TCM) as well as myocardial bridging presenting as post-PCI STEMI in the setting of nitroglycerin use.

The Complexities of Sepsis-Induced Cardiomyopathy: A Clinical Case and Review of Inflammatory Pathways and Potential Therapeutic Targets.

Sepsis-induced cardiomyopathy (SICM) is a life-threatening complication of sepsis characterized by myocardial dysfunction. SICM significantly increases mortality rates in sepsis. Despite its clinical relevance, SICM lacks a unified definition and standardized diagnostic criteria, complicating early identification and treatment.

Patient With Post-operative Recurrent Pancreatic Cancer Treated With Cone Beam Computed Tomography-Guided Stereotactic Adaptive Radiotherapy: A Case Report.

CT-guided adaptive radiotherapy (ART) for the treatment of pancreatic adenocarcinoma is rapidly increasing and has been shown to provide advanced treatment tools comparable to magnetic resonance imaging (MRI)-guided adaptive therapy. Here, we provide the first case report of a local pancreatic recurrence treatment after definitive resection using cone beam computed tomography (CBCT)-guided ART (CT-guided ART) enabled by HyperSight imaging (Varian Medical Systems, Inc., Palo Alto, CA, USA) for daily delineation of organs-at-risk (OARs) and target to improve the quality of online ART.

Nd: YAP Laser in the Elimination of Endodontic Nickel-Titanium Files Fractured in Rooted Canals (Part 1: Teeth With Minimal Root Curvature).

Background Fracture of nickel-titanium (Ni-Ti) instruments in root canals is commonly associated with compromised outcomes in endodontic treatment. There is no single, universally accepted approach for managing this complication. The objective of this study is to evaluate the effectiveness of an Nd: YAP laser-assisted protocol in removing fractured Ni-Ti files in teeth with minimal root curvature (less than 15 degrees).

Traumatic Posterior Sternoclavicular Joint Dislocation With a Five-Day Delayed Presentation: A Case Report.

Posterior sternoclavicular joint (SCJ) dislocation is a rare but potentially life-threatening injury due to its proximity to critical mediastinal structures. Early diagnosis and prompt management are essential to prevent severe complications such as vascular or respiratory compromise. We report a case of a 23-year-old male who presented to our emergency department five days after a high-energy motor vehicle accident with isolated, closed posterior dislocation of the SCJ.

When Essential Thrombocythemia Goes Triple-Negative: A Case of Acquired von Willebrand Disease.

Essential thrombocythemia (ET) is a type of myeloproliferative neoplasm (MPN) disorder characterized by persistent thrombocytosis and characterized by frequent association with cellular genetic alterations. The 10%-15% of ET that is not associated with genetic abnormalities is known as triple-negative essential thrombocythemia (TNET). A common complication observed in around 20% of ET patients is the development of acquired von Willebrand disease (AvWD).