Governance Considerations for Point-of-Care Ultrasound: a HIMSS-SIIM Enterprise Imaging Community Whitepaper in Collaboration with AIUM.

Point-of-care ultrasound (POCUS) has emerged as a standard of care across a variety of healthcare settings due to its ability to provide critical clinical information and as well as procedural guidance to clinicians directly at the bedside. Implementation of enterprise imaging (EI) strategies is needed such that POCUS images can be appropriately captured, indexed, managed, stored, distributed, viewed, and analyzed. Because of its unique workflow and educational requirements, reliance on traditional order-based workflow solutions may be insufficient.

Clustering of > 145,000 symptom logs reveals distinct pre, peri, and menopausal phenotypes.

The transition to menopause is associated with disappearance of menstrual cycle symptoms and emergence of vasomotor symptoms. Although menopausal women report a variety of additional symptoms, it remains unclear which emerge prior to menopause, which occur in predictable clusters, how clusters change across the menopausal transition, or if distinct phenotypes are present within each life stage. We present an analysis of symptoms in premenopausal to menopausal women using the MenoLife app, which includes 4789 individuals (23% premenopausal, 29% perimenopausal, 48% menopausal) and 147,501 symptom logs (19% premenopausal, 39% perimenopausal, 42% menopausal).

Clinical Manifestations.

Intrasubject variability is an important, but often overlooked, measure that has shown to be predictive of important clinical outcomes in ADRD research. Intrasubject variability is often quantified using the intrasubject standard deviation (ISD) that is derived from longitudinal measures or cross-sectional observations from similarly scaled variables. This talk will begin with an overview of ISD and its application in both longitudinal and cross-sectional analyses.

Education Research: Has Video Killed the Interview Star?: A Survey of Current Neurology Residents on In-Person vs Virtual Residency Interviews.

Background And Objectives: The residency application process relies on interviews, which allow programs and applicants to assess one another. Historically, interviews were conducted in person at each program. With the advent of the coronavirus disease 2019 pandemic, residency interviews shifted to a virtual format.

Emerging Alzheimer's disease treatment paradigms: A late-stage clinical trial review.

Introduction: Without disease-modifying interventions, Medicare and Medicaid spending on Alzheimer's disease (AD) management is expected to reach 637 billion USD annually by 2050. The recent advent of promising AD therapies after decades of a near-total failure rate in clinical trials suggests that more disease-modifying therapies are on the horizon. In this review, we assess the late-stage pipeline of disease-modifying candidates for AD and offer a novel classification of intervention candidates by treatment paradigms-groups of candidates that share an underlying biological mechanism of action and general disease target.

Melanoma toolkit for early detection for primary care clinicians: a 1-year follow-up on outcomes.

Introduction: Primary care providers or clinicians (PCPs) have the potential to assist dermatologists in screening patients at risk for skin cancer, but require training to appropriately identify higher-risk patients, perform skin checks, recognize and biopsy concerning lesions, interpret pathology results, document the exam, and bill for the service. Very few validated dermatology training programs exist for PCPs and those that are available focus primarily on one emphasis area, which results in variable efficacy and single-topic limited scope.

Methods: We have created a free, online, continuing education program (Melanoma Toolkit for Early Detection, MTED) that allows learners to choose from a variety of multimedia tools (image recognition, videos, written material, in-person seminars, self-tests, etc.

Utility of color Doppler imaging in patients with retinoblastoma treated by intra-arterial chemotherapy.

Background: There are no clinical parameters that predict response to intra-arterial chemotherapy (IAC), which is a first-line treatment for primary and recurrent unilateral retinoblastoma. We evaluated the utility of ophthalmic ultrasound with color Doppler imaging to predict retinoblastoma response to IAC treatment.

Methods: The medical records of 14 retinoblastoma patients (20 eyes) treated with IAC were reviewed retrospectively.

Resting-state fMRI seizure onset localization meta-analysis: comparing rs-fMRI to other modalities including surgical outcomes.

Objective: Resting-state functional MRI (rs-fMRI) may localize the seizure onset zone (SOZ) for epilepsy surgery, when compared to intracranial EEG and surgical outcomes, per a prior meta-analysis. Our goals were to further characterize this agreement, by broadening the queried rs-fMRI analysis subtypes, comparative modalities, and same-modality comparisons, hypothesizing SOZ-signal strength may overcome this heterogeneity.

Methods: PubMed, Embase, Scopus, Web of Science, and Google Scholar between April 2010 and April 2020 via PRISMA guidelines for SOZ-to-established-modalities were screened.

Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa.

Anorexia nervosa (AN) is a psychiatric eating disorder characterized by body mass index (BMI) ≤ 18.5, fear of gaining weight, and a distorted perception of body weight. With increasing rates of myopia, there is a population of patients who concurrently develop AN and may seek corneal refractive surgery.

Severe Ectopic Adrenocorticotropic Hormone Syndrome Due to Pulmonary Carcinoid Tumor: A Case Report and Literature Review.

Background/objective: Pulmonary carcinoid tumors are a rare cause of Cushing's syndrome and usually present with an indolent course. Here, we present a case of rapid onset and severe Cushing's syndrome due to a typical pulmonary carcinoid tumor.

Case Report: A 32-year-old woman developed diabetes, hypertension, and weight gain of 50 pounds over 3 months.

Satisfaction With Multidisciplinary Team Structure and Function in a Pediatric Outpatient Clinic.

Background: Multidisciplinary teams (MDTs) are integral to navigating complex patient care. Implementation of MDTs may improve patient outcomes, reduce physician burnout, and decrease hospital costs. Systemic obstacles to optimizing pediatric MDTs remain unexplored.

Association between triglyceride to high-density lipoprotein cholesterol ratio and microalbuminuria in the Chinese population.

The evidence for the association between the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-c) ratio and the risk of developing microalbuminuria is still limited in the Chinese population. Therefore, our research will endeavor to explore the relationship between the two. The cross-sectional survey enrolled 32,877 general population from eight regional centers in China.

Current Approaches to Optimize Donor Heart for Transplantation.

Heart transplantation remains a critical therapy for patients with end-stage heart failure, offering incremental survival and improved quality of life. One of the key components behind the success of heart transplantation is the condition and preservation of the donor heart. In this review, we provide a comprehensive overview of ischemic reperfusion injury, risk factors associated with primary graft dysfunction, current use of various preservation solutions for organ procurement and recent advancements in donor heart procurement technologies.

Antivenom Administration After Rattlesnake Envenoming in Arizona Does Not Directly Diminish Pain.

The onset, progression, and severity of pain following rattlesnake envenomation are highly variable between patients. Pain can be severe and persistent, seemingly refractory to opioid analgesics. The ability of antivenom to directly relieve pain has not been well studied.

Ethical Challenges of Artificial Intelligence in Medicine.

Artificial intelligence (AI) and machine learning (ML) have become critical components in the transformation of healthcare. They offer enhanced diagnostic accuracy, personalized treatment plans, and support for clinical decision-making. However, with these advancements come significant ethical challenges, including concerns around transparency, bias, data privacy, and the potential displacement of healthcare professionals.

Putting Trainees at the Center of the Family Medicine Research Workforce of Tomorrow.

The Family Medicine Research Summit culminated in a strategic action plan to enhance research in family medicine and expand the primary care research workforce. The strategic plan focuses on infrastructure, mentorship, and funding objectives needed for robust family medicine research. Trainees play a central role in the success of the strategic plan.

Triple Therapy IDP-126 Gel for Acne Treatment: A Systematic Review and Meta-Analysis.

Acne vulgaris (AV) is a common dermatological condition that ranges from mild comedones to severe inflammatory nodules and scarring. Effective management is essential for improving patients' quality of life. The recent FDA approval of IDP-126 (Cabtreo™), a novel triple-combination gel, meets these needs by combining clindamycin phosphate, benzoyl peroxide, and adapalene into a single formulation.

A Multisite, 6-Month, Open-Label Study of Maintenance Transcranial Magnetic Stimulation for Adolescents with Treatment-Resistant Depression.

Transcranial magnetic stimulation (TMS) is a promising intervention for adolescents with treatment-resistant depression (TRD). However, the durability of TMS-related improvement in adolescents is unclear. This 6-month study followed adolescents with TRD who had responded to TMS and provided TMS retreatment for adolescents with a partial relapse.

A Modern Education Theory Approach to Development of a Benchtop Simulation Model for Ultrasound-Guided Percutaneous Nephrolithotomy.

To develop and validate a high-fidelity, nonbiohazardous simulator model for the ultrasound-guided percutaneous nephrolithotomy procedure. We employed a systematic framework based on Delphi consensus and modern education theory to design a simulation model. Twelve expert surgeons provided input through a hierarchal task analysis and identified procedural tasks, anatomical landmarks, and potential errors.

Prenatal Dexamethasone Programs Autonomic Dysregulation in Female Rats.

Autonomic dysfunction is associated with cardiovascular and neurological disease, including hypertension, heart failure, anxiety, and stress-related disorders. Prior studies demonstrated that late gestation exposure to dexamethasone (DEX) resulted in female-biased increases in stress-responsive mean arterial pressure (MAP) and heart rate (HR), suggesting a role for glucocorticoid-mediated programming of autonomic dysfunction. The present study investigated the influence of sympathetic (SYM) or parasympathetic (PS) blockade on cardiovascular function in male and female rat offspring of mothers injected with DEX (gestation days [GD]18-21).

Comparing Patient Communication Event Demand for External Ring Fixators to Other Common Foot and Ankle Orthopaedic Procedures: A Retrospective Study.

Background: Surgeons may hesitate to apply external ring fixators (ERFs) due to perceived high clinical burden. This study aims to quantify the relative demand of ERFs compared with other common foot and ankle procedures. Understanding the demand of ERFs can provide insights into postoperative experiences, potentially decreasing intimidation of their use.

Socioeconomic and Ethnic Disparities in Timing and Outcome of Interarytenoid Injection Augmentation.

Objectives: To investigate the relationship between social determinants of health and timeliness of management, adherence to follow-up, and outcomes of treatment with interarytenoid injection augmentation (IAIA).

Methods: Retrospective cohort study of all pediatric patients treated with IAIA at a large pediatric institution's multidisciplinary aerodigestive clinic between August 2022 and February 2024. Retrieved demographic factors, dates of referral, consultation, treatment, and follow-up, as well as objective measures of dysphagia and aspiration via videofluoroscopic swallow study (VFSS) reports, using dysphagia outcome and severity scale (DOSS) scores and the greatest unsafe thickness, or 'aspiration score'.

The shortcomings of the Medina compared to the Movahed coronary bifurcation classification.

The Medina classification separates true bifurcation lesions into three unnecessary groups: 1.1.1, 1.

Bactrim-Induced Hepatotoxicity.

Sulfamethoxazole/trimethoprim (SMX/TMP) is a commonly used antimicrobial agent for treating common bacterial infections such as urinary tract infection (UTI), combined with doxycycline for community-acquired methicillin-resistant (MRSA), and invaluable in pneumonia (PJP), previously classified as . Of its known adverse reactions, hepatotoxicity rarely comes to mind, but indeed, it is a recognized but very rare adverse reaction that may lead to liver failure in adults and even rarer in children. We present a case of hepatotoxicity in a 43-year-old male patient on no prior medication who developed jaundice and highly elevated liver enzymes one week after the administration of Bactrim for the treatment of UTI in association with prostatism, symptoms of decreased urinary force due to obstruction of flow through the prostate gland.

Innovative Dual Combination Cospray-Dried Rock Inhibitor/l-Carnitine Inhalable Dry Powder Aerosols.

This study introduces novel cospray-dried (Co-SD) formulations of simvastatin, a Nrf2 activator ROCK inhibitor, with l-carnitine as molecular mixtures in various molar ratios for targeted pulmonary inhalation aerosol delivery in pulmonary hypertension, optimized for excipient-free dry powder inhalers (DPIs). The two components were spray-dried at various molar ratios by using different starting feed solution concentrations and process parameters. In addition to comprehensive physicochemical characterization, in vitro aerosol dispersion performance as DPIs using two FDA-approved DPI devices with different shear stress properties, in vitro viability as a function of dose on 2D human pulmonary cellular monolayers and on 3D small airway epithelia human primary cultures at the air-liquid interface (ALI), and in vitro transepithelial electrical resistance (TEER) at the ALI were conducted.