Cytosolic LPS-induced caspase-11 oligomerization and activation is regulated by extended synaptotagmin 1.

Caspase-11 (Casp-11) is known to induce pyroptosis and defends against cytosol-invading bacterial pathogens, but its regulation remains poorly defined. Here, we identified extended synaptotagmin 1 (E-Syt1), an endoplasmic reticulum protein, as a key regulator of Casp-11 oligomerization and activation. Macrophages lacking E-Syt1 exhibited reduced production of interleukin-1β (IL-1β) and impaired pyroptosis upon cytosolic lipopolysaccharide (LPS) delivery and cytosol-invasive bacterial infection.

Association between breakthrough labor pain, patient-controlled epidural analgesia use, and numeracy: A pilot observational study.

Objective: Labor analgesia can be maintained with a continuous epidural infusion, supplemented by patient-controlled epidural boluses. patient-controlled epidural boluses use and timing require numeric understanding, as patients need to understand when they can administer supplemental boluses, lockout intervals, and total doses. We hypothesized that women with lower numeric literacy have a higher rate of provider-administered supplemental boluses for breakthrough pain because they do not understand the concept behind patient-controlled epidural boluses.

Association of rural living with COPD-related hospitalizations and deaths in US veterans.

It is unclear whether the high burden of COPD in rural areas is related to worse outcomes in patients with COPD or is because the prevalence of COPD is higher in rural areas. We assessed the association of rural living with acute exacerbations of COPD (AECOPDs)-related hospitalization and mortality. We retrospectively analyzed Veterans Affairs (VA) and Medicare data of a nationwide cohort of veterans with COPD aged ≥ 65 years with COPD diagnosis between 2011 and 2014 that had follow-up data until 2017.

Metabolic reprogramming in response to cell mechanics.

Much attention has been dedicated to understanding how cells sense and respond to mechanical forces. The types of forces cells experience as well as the repertoire of cell surface receptors that sense these forces have been identified. Key mechanisms for transmitting that force to the cell interior have also emerged.

Empathy levels among health professional students at a large midwestern public university - a cross-sectional study.

Background: Empathic care is considered extremely important by patients and providers alike but there is still an ample need for assessing empathy among healthcare students and professionals and identifying appropriate educational interventions to improve it. This study aims to assess empathy levels and associated factors among students at different healthcare colleges at the University of Iowa.

Methods: An online survey was delivered to healthcare students, including nursing, pharmacy, dental, and medical colleges (IRB ID #202,003,636).

Risk factors and predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke: insights from the Stroke Thrombectomy and Aneurysm Registry (STAR).

Background: Reducing intracranial hemorrhage (ICH) can improve patient outcome in acute ischemic stroke (AIS) intervention. We sought to identify ICH risk factors after AIS thrombectomy.

Methods: This is a retrospective review of the Stroke Thrombectomy and Aneurysm Registry (STAR) database.

Metastatic Disease to a Concurrent Thyroid Neoplasm: A Case Series and Review of the Literature.

Background: Metastatic disease to the thyroid gland is uncommon but well-described. Metastatic disease to a concurrent primary thyroid neoplasm is a rare phenomenon. We sought to study patients with metastasis to the thyroid with a focus on the histopathologic and clinical features in tumor-to-tumor metastasis.

Major Bleeding After Paracentesis Associated With Apixaban Use: Two Case Reports.

We report 2 patients with compensated cirrhosis and moderate renal impairment who experienced severe bleeding complications from paracentesis during concurrent therapy with apixaban. While paracentesis has traditionally been considered a low bleeding-risk procedure and safe to perform without interruption of therapeutic anticoagulation, the increased concentrations observed in patients with impaired liver function may place these patients at unexpectedly high bleeding risk. Further investigation into the safety of paracentesis in patients with cirrhosis on apixaban may be warranted, as well as additional understanding of the clinical safety of this drug in Child-Pugh B cirrhosis.

Technical and clinical outcomes in concurrent multivessel occlusions treated with mechanical thrombectomy: insights from the STAR collaboration.

Background: Endovascular thrombectomy (EVT) has become the mainstay treatment for large vessel occlusion, with favorable safety and efficacy profile. However, the safety and efficacy of EVT in concurrent multi-territory occlusions (MTVOs) remains unclear.

Objective: To investigate the prevalence, clinical and technical outcomes of concurrent EVT for MTVOs.

Avelumab-Induced Scleroderma in a Patient with Metastatic Squamous Cell Carcinoma of the Lung.

Immune checkpoint inhibitors are associated with a spectrum of cutaneous immune-related adverse events. While maculopapular eruptions are the most common cutaneous adverse event, scleroderma can rarely develop. Herein, we report a case of new-onset scleroderma associated with avelumab treatment in the setting of metastatic squamous cell carcinoma of the lung.

Office of Diversity, Equity, and Inclusion: Engagement and Leadership Opportunities for Trainees.

Introduction: To achieve a healthier future for all, improving diversity through efforts such as diversifying faculty and leadership in academic medicine is imperative. Therefore, medical trainees (medical students, residents, fellows) from groups underrepresented in medicine (UiM) are encouraged to pursue academic careers and have opportunities to gain faculty leadership skills during their training. Trainees also need exposure to the leadership positions within various offices of an academic institution such as the Office of Diversity, Equity, and Inclusion (DEI).

Impacts of the Pandemic on Social Determinants of Health in an Academic Emergency Department.

Introduction: The coronavirus 2019 (COVID-19) pandemic caused significant disruptions in daily life. Given the role that social determinants of health play in the overall well-being of individuals and populations, we wanted to determine the effects of the COVID-19 pandemic on our patient population in the emergency department (ED).

Methods: We adapted the Centers for Medicare and Medicaid Services social risk assessment to assess changes to participants' social situations throughout the COVID-19 pandemic from January 2020-February 2021.

Bronchodilator Responsiveness in Tobacco-Exposed People With or Without COPD.

Background: Bronchodilator responsiveness (BDR) in obstructive lung disease varies over time and may be associated with distinct clinical features.

Research Question: Is consistent BDR over time (always present) differentially associated with obstructive lung disease features relative to inconsistent (sometimes present) or never (never present) BDR in tobacco-exposed people with or without COPD?

Study Design And Methods: We retrospectively analyzed data from 2,269 tobacco-exposed participants in the Subpopulations and Intermediate Outcome Measures in COPD Study with or without COPD. We used various BDR definitions: change of ≥ 200 mL and ≥ 12% in FEV (FEV-BDR), change in FVC (FVC-BDR), and change in in FEV, FVC or both (ATS-BDR).

Development of a coordinated registry network for pelvic organ prolapse technologies.

Objectives: The accumulation of data through a prospective, multicenter Coordinated Registry Network (CRN) could be a robust and cost-effective way to gather real-world evidence on the performance of pelvic organ prolapse (POP) technologies for device-based and intervention-based studies. To develop the CRN, a group of POP experts consisting of representatives from professional societies, the Food and Drug Administration, academia, industry, and the patient community, was convened to discuss the role and feasibility of the CRN and to identify the core data elements important to assess POP technologies.

Design: A Delphi method approach was employed to achieve consensus on a core minimum dataset for the CRN.

Patient Safety in Anesthesia: Hand Hygiene and Perioperative Infection Control.

Purpose Of Review: This review highlights the importance of the anesthesia team in minimizing perioperative infection risks and prevention of surgical site infection. Due to the immense financial and patient care burden that results from perioperative infection, a foundational knowledge in preventive measures is essential.

Recent Findings: Perioperative infection control, the role of the anesthesia team in reducing infection risk, and more specifically the outsized importance of hand hygiene in this space have become increasingly apparent.

Associations among enacted weight stigma, weight self-stigma, and multiple physical health outcomes, healthcare utilization, and selected health behaviors.

Background: This study examined the relationship among enacted weight stigma, weight self-stigma, and multiple health outcomes. Weight stigma, a stressor experienced across all body sizes, may contribute to poorer physical health outcomes by activating the nervous and endocrine system or by triggering counterproductive health behaviors like lower physical activity, maladaptive eating patterns, and delayed health care, as well as provider bias that may cause a medical concern to be discounted. While associations of weight stigma with mental health issues are well documented, less is known about its association with physical health.