Temporary mechanical circulatory support utilization and outcomes in cardiogenic shock phenotypes: A comparative analysis of heart failure and acute myocardial infarction.

Introduction: Cardiogenic shock (CS) is marked by substantial morbidity and mortality. The two major CS etiologies include heart failure (HF) and acute myocardial infarction (AMI). The utilization trends of mechanical circulatory support (MCS) and their clinical outcomes are not well described.

Myosin Heavy Chain Myopathy and Immune-Mediated Muscular Disorders.

Several inflammatory myopathies have an infectious or immune-mediated basis in the horse. Myosin heavy chain myopathy is caused by a codominant missense variant in MYH1 and has 3 clinical presentations: immune-mediated myositis, calciphylaxis, and nonexertional rhabdomyolysis in Quarter Horse-related breeds. An infarctive form of purpura hemorrhagica affects numerous breeds, presenting with focal firm, painful muscle swelling, and subsequent infarction of multiple tissues.

Clinical, Psychosocial, and Ethical Consideration in Assisted Reproductive Technology in Lesbian, Gay, Bisexual, Transgender and Queer+ Populations.

When evaluating reproductive care for lesbian, gay, bisexual, transgender, and queer+ patients, there are multiple factors that must be addressed from a clinician, clinic, and social standpoint. Clinicians should be trained in culturally humble and trauma-informed care; clinics should have intake forms that identify sexual orientation, gender identity, and pronouns. The clinic environment should be inclusive, with all gender or single-stall bathrooms, and patient-facing educational materials that are representative of individuals with diverse partnerships, races, and ethnicities.

Updates in the Surgical Management of Pancreatic Ductal Adenocarcinoma.

Surgical management of pancreas cancer is complex, including the timing of surgery, surgical approach, intraoperative techniques, and postoperative management, which are reviewed in detail in this manuscript. Ultimately, referral to a high-volume pancreatic surgeon or pancreatic surgery center is critical to ensuring appropriate short-term and long-term outcomes.

Risk Factors and Mechanisms for Diabetes in Pancreatitis.

Diabetes (DM) can occur as a complication of acute, acute recurrent, or chronic pancreatitis, affecting more than 30% of adults with chronic pancreatitis. Data on the pathophysiology and management are limited, especially in pediatric population. Proposed mechanisms include insulin deficiency, insulin resistance, decreased pancreatic polypeptide, and possible beta-cell autoimmunity (in a small subset).

Updates in the Management of Chronic Pancreatitis: Navigating Through Recent Advances.

This article provides an up-to-date review of the management of chronic pancreatitis, highlighting advancements in medical therapy, nutritional support, endoscopic and surgical approaches, and emerging treatments. Nutritional management accentuates addressing malabsorption and nutrient deficiencies. Advances in endoscopy and parenchyma-sparing surgical techniques have opened new avenues for improved patient outcomes, with total pancreatectomy and islet autotransplantation offering the only definitive solution for selected patients.

Updates in the Diagnosis of Chronic Pancreatitis: Current Approaches and New Possibilities.

This review provides a comprehensive update on the diagnostic approaches to chronic pancreatitis (CP), emphasizing recent advancements in imaging techniques, biomarker research, and multivariable scoring systems. Despite substantial progress in these areas, current diagnostic algorithms have limitations, particularly for early and non-calcific CP. Traditional criteria have focused on classic diagnostic signs, but "minimal change" CP is increasingly recognized through advanced imaging and function tests.

Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000-24.

Introduction: Although the prevalence of chemotherapy-induced peripheral neuropathy (CIPN) has been reported, the proportion of patients with CIPN who report chronic painful neuropathy remains poorly understood, despite its significant impact on patients' quality of life and treatment outcomes.

Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcome was the pooled prevalence of chronic (≥3 months) painful CIPN among patients diagnosed with CIPN.

Dietary carbohydrate quality is associated with epigenetic age acceleration: a cross-sectional study of the CARDIA cohort.

Background: Dietary intake is one lifestyle factor that is expected to impact gene expression by altering DNA methylation (DNAm), thus affecting epigenetic aging. Studies on the association between quality of carbohydrates and epigenetic age acceleration (EAA) are scarce despite the evidence that quality may be more important than amount of carbohydrates consumed.

Objective: We aimed to identify the cross-sectional associations of carbohydrate quality and fiber-rich food score with epigenetic age acceleration in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Molecular basis of vitamin K driven γ-carboxylation at membrane interface.

The γ-carboxylation of glutamate residues enables Ca-mediated membrane assembly of protein complexes that support broad physiological functions including hemostasis, calcium homeostasis, immune response, and endocrine regulation. Modulating γ-carboxylation level provides prevalent treatments for hemorrhagic and thromboembolic diseases. This unique posttranslational modification requires vitamin K hydroquinone (KH) to drive highly demanding reactions catalyzed by the membrane-integrated γ-carboxylase (VKGC).

The evening complex component ELF3 recruits H3K4me3 demethylases to repress PHYTOCHROME INTERACTING FACTOR4 and 5 in Arabidopsis.

In Arabidopsis (Arabidopsis thaliana), light and circadian clock signaling converge on PHYTOCHROME-INTERACTING FACTORS (PIFs) 4 and 5 to produce a daily rhythm of hypocotyl elongation. PIF4 and PIF5 expression is repressed at dusk by the evening complex (EC), consisting of EARLY FLOWERING3 (ELF3), ELF4, and LUX ARRHYTHMO (LUX). Here, we report that ELF3 recruits the JUMONJI (JMJ) H3K4me3 demethylases JMJ17 and JMJ18 to the PIF4 and PIF5 loci in the evening to remove their H3K4me3 marks.

Measurement of antibiotic use in cats and dogs presenting to US primary care and referral practices provides insights for antimicrobial stewardship.

Objective: To measure the prevalence of antibiotic use in dogs and cats, identify the most common antibiotic drugs prescribed, and determine the most common indications for use.

Methods: Point-prevalence survey methodology was used to collect antibiotic prescribing data for cats and dogs from 1 practice day in 2021 at nonacademic primary care and referral practices in the US.

Results: 52 practices participated, comprising records for 2,599 dogs and cats.

Preliminary exploration of ChatGPT-4 shows the potential of generative artificial intelligence for culturally tailored, multilingual antimicrobial resistance awareness messaging.

Objective: Antimicrobial resistance (AMR), a global threat driven by factors such as improper antimicrobial use in humans and animals, is projected to cause 10 million annual deaths by 2050. For behavior change, public health messages must be tailored for diverse audiences. Generative AI may have the potential to create culturally and linguistically suited AMR awareness messages.

New PPARα Agonist A190-Loaded Microemulsion for Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a serious side effect of anticancer agents with limited effective preventive or therapeutic interventions. Although fenofibrate, a peroxisome proliferator-activated receptor-alpha (PPARα) agonist, has demonstrated neuroprotective and analgesic properties, its clinical utility is hindered by low receptor affinity, poor subtype selectivity, and suboptimal bioavailability. A190, a highly selective and potent nonfibrate PPARα agonist, offers a promising alternative but is limited by poor aqueous solubility, resulting in reduced oral bioavailability and therapeutic efficacy.

Organ-specific microenvironments drive divergent T cell evolution in acute graft-versus-host disease.

Tissue-specific T cell immune responses play a critical role in maintaining organ health but can also drive immune pathology during both autoimmunity and alloimmunity. The mechanisms controlling intratissue T cell programming remain unclear. Here, we leveraged a nonhuman primate model of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation to probe the biological underpinnings of tissue-specific alloimmune disease using a comprehensive systems immunology approach including multiparameter flow cytometry, population-based transcriptional profiling, and multiplexed single-cell RNA sequencing and TCR sequencing.

Ketogenesis supports hepatic polyunsaturated fatty acid homeostasis via fatty acid elongation.

Ketogenesis is a dynamic metabolic conduit supporting hepatic fat oxidation particularly when carbohydrates are in short supply. Ketone bodies may be recycled into anabolic substrates, but a physiological role for this process has not been identified. Here, we use mass spectrometry-based C-isotope tracing and shotgun lipidomics to establish a link between hepatic ketogenesis and lipid anabolism.

Early MRI Can Predict the Indication for Surgery in Brachial Plexus Birth Injury: Results of the NAPTIME Study.

Background: Magnetic resonance imaging (MRI) has not been routinely used for infants with brachial plexus birth injury (BPBI); instead, the decision to operate is based on the trajectory of clinical recovery by 6 months of age. The aim of this study was to develop an MRI protocol that can be performed without sedation or contrast in order to identify infants who would benefit from surgery at an earlier age than the age at which that decision could be made clinically.

Methods: This prospective multicenter NAPTIME (Non-Anesthetized Plexus Technique for Infant MRI Evaluation) study included infants aged 28 to 120 days with BPBI from 3 tertiary care centers.

Electronically Nonadiabatic Quenching of Excited States of O by Collisions with O Atoms.

The kinetics of electronically inelastic quenching of O(Δ) and O(Σ) by collisions with O(P) have been investigated using mixed quantum-classical trajectories governed by adiabatic potential energy surfaces and state couplings generated from a recently developed diabatic potential energy matrix (DPEM) for the 14 lowest-energy A' states of O. Using the coherent switching with decay of mixing (CSDM) method, dynamics calculations were performed both with 14 coupled electronic states and with 8 coupled electronical states, and similar results were obtained. The calculated thermal quenching rate coefficients are generally small, but they increase with temperature.

Optimizing Sedation Strategies in the Cardiac ICU: Induction, Maintenance and Weaning.

Purpose Of Review: We aim to summarize the available literature guiding tailored sedation practices for specific conditions encountered in the Cardiovascular Intensive Care Unit (CICU).

Recent Findings: Data specific for the CICU population is lacking. Preclinical data and observational studies guide sedation approaches for specific pathologies that we have used to generate a guideline for sedative choice for various scenarios.

The Impact of Physical Therapy Postprofessional Education Programs on Productivity in a Large Academic Medical Center.

Introduction: Emerging evidence shows positive impact of postprofessional physical therapy education (residency and fellowship) specific to participants; however, outcomes on organizational impact are largely unknown. The purpose of this project was to describe the impact residency and fellowship training has on financial metrics. A secondary purpose of this case study was to describe trends associated with higher productivity.

A Commitment to Gender Equity in Medicine: An American Medical Women's Association Position Paper.

The American Medical Women's Association (AMWA) highlights the ongoing gender inequities in the medical profession, particularly in pay, leadership roles, workplace treatment, and work-life integration. To present evidence of gender disparities in medicine, analyze their root causes, and propose strategies for fostering a more equitable and inclusive environment. Despite progress, women physicians continue to face significant disparities, including lower salaries, underrepresentation in leadership roles, and discrimination.