Hunting for heroes: Brain neurons mediating GLP-1R agonists in obesity treatment.

Glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1RAs) have proven to be highly effective in reducing obesity across species and ages, gaining unmet popularity in clinical treatments against obesity. Although extensive research efforts have been made to explore how the brain regulates body weight homeostasis including the effect brought up by GLP-1 and its synthetic analogs GLP-1RAs, the identity of neurons and neural pathways that are responsible for the observed anti-obesity effect of GLP-1RAs remain largely elusive. Excitingly, three recent high-profile studies presented compelling evidence that each argues for the importance of GLP-1Rs in the dorsomedial hypothalamus, hindbrain, or lateral septum, respectively, in mediating the anti-obesity effect of GLP-1RAs.

Case Report: Percutaneous Peripheral Nerve Stimulation for the Treatment of Occipital Neuralgia.

Headaches are among the most prevalent medical complaints globally. Occipital neuralgia is a chronic headache disorder characterized by unilateral or bilateral severe pain originating in the neck or skull base and radiating up along the occipital nerve distribution. Effective treatment options for occipital neuralgia can be challenging and some patients may prove to be refractory to conventional medical and interventional therapies.

Confirming Subarachnoid Hemorrhage Induction in the Endovascular Puncture Mouse Model.

Background And Purpose: Experimental studies of subarachnoid hemorrhage (SAH) using the endovascular perforation model routinely use either cerebral blood flow (CBF) or intracranial pressure (ICP) monitoring to confirm SAH induction. We designed this study to test the hypothesis that contralateral CBF is a better marker of SAH induction than ipsilateral CBF.

Methods: Sixty-eight adult C57BL/6J mice were subjected to endovascular perforation.

Incidence and Factors in Delayed Neurological Deficits after Subarachnoid Hemorrhage in Mice.

Background: Delayed cerebral ischemia (DCI) is one of the most feared complications in aneurysmal subarachnoid hemorrhage (SAH). Animal models are crucial to studying the disease mechanisms and potential treatments. DCI in rodents was thought to not exist; herein we examine literature and our experience with DCI in rodents.

Attention and language as mediators of academic outcomes following early psychosocial deprivation.

Children adopted from institutions at older ages are at increased risk of persistent attention problems, lower cognition, and academic difficulties. This study examined cognitive and behavior problems as mediators of the association between early psychosocial deprivation and academic functioning. Participants were 8-17-year-old children adopted from psychosocially-depriving Russian institutions after 14 months of age ( = 34) and before 9 months of age ( = 39).

Improving the Clinical Diagnostic Criteria for Genetically Confirmed Adult-Onset Huntington Disease: Considering Nonmotor Presentations.

Background: Huntington disease (HD) is a genetic neurodegenerative disorder. Given the focus on motor manifestations, nonmotor symptoms are frequently underappreciated in clinical evaluations, despite frequently contributing to primary functional impairment.

Recent Findings: A diagnosis of motor-onset as the definition of manifest symptoms misrepresents the complex nature of HD presentation.

Discovering novel prognostic biomarkers of hepatocellular carcinoma using eXplainable Artificial Intelligence.

Hepatocellular carcinoma (HCC) remains a global health challenge with high mortality rates, largely due to late diagnosis and suboptimal efficacy of current therapies. With the imperative need for more reliable, non-invasive diagnostic tools and novel therapeutic strategies, this study focuses on the discovery and application of novel genetic biomarkers for HCC using explainable artificial intelligence (XAI). Despite advances in HCC research, current biomarkers like Alpha-fetoprotein (AFP) exhibit limitations in sensitivity and specificity, necessitating a shift towards more precise and reliable markers.

Antipsychotic Use in Older Adults With Dementia: Community and Nursing Facility Trends in Texas, 2015-2020.

Objectives: To assess recent trends in antipsychotic use among older adults with Alzheimer's disease and related dementias (ADRDs) according to their residential status and determine the factors associated with the use of antipsychotics.

Design: Population-based, cross-sectional study using Texas Medicare Fee-for-Service data.

Setting And Participants: Individuals ≥ 65 years of age with ADRDs who had at least 3 months of Medicare Part A and B, and Part D for prescription drug coverage, in any year between 2015 and 2020.

Management of Chronic Post-Endodontic Pain with a Standardized Gabapentin Pyramid Protocol: A Case Series and Clinical Guidelines.

Introduction: Persistent post-endodontic pain following endodontic therapy is a rare but substantial clinical challenge. Mechanisms that mediate peripheral neuropathy and/or central sensitization likely play a pivotal role in its development and chronification. The objective of this case series is to describe a management plan for persistent post-endodontic pain and provide prescription guidelines using a standardized "Gabapentin Pyramid Protocol" for clinical practice.

The Association Between Pulmonary Embolism and Deep Vein Thrombosis in the Upper or Lower Extremities in Neurocritical Care Patients.

Introduction: Patients in the neurological intensive care unit (ICU) are at an increased risk of venous thromboembolism (VTE). Anticoagulation is often indicated because deep venous thrombosis (DVT) can develop into pulmonary embolism (PE). However, anticoagulation also increases the risk of intracranial bleeding.

Self-Directed Violence Among Black Young Adults with Negative Police Experiences.

The current study assessed associations between negative experiences with police and self-directed violence (SDV) among a United States (US) sample of Black young adults ages 18-29 reporting lifetime police stops. Data come from the "INtervening on Self-Harm and Policing to Increase Racial Equity" (INSPIRE) survey (N = 672) and were collected between December 2023 and March 2024. This high-risk sample exhibited elevated rates of self-harm ideation or NSSI (27.

A pathway from fragmentation to interoperability through standards-based enterprise architecture to enhance patient safety.

Creating an ontology is the essential step in natural language processing (NLP). To improve patient safety in this era of generative AI, it is crucial to develop a standards-driven, ontology-based architecture for patient safety that can seamlessly integrate with health systems, thereby facilitating effective detection and monitoring potentially preventable harms in healthcare. This visionary, whole-system approach to patient safety addresses a significant gap in establishing resilient safety systems within the healthcare sector.

A meta-analysis of the utility of cryotherapy for preventing peripheral neuropathy among breast cancer patients receiving paclitaxel and nab-paclitaxel.

Background: Cryotherapy with taxane infusion is a noninvasive strategy for preventing peripheral neuropathy (PN), but the efficacy of this approach has not been proven.

Methods: A systematic search was conducted, and 477 records were initially identified. The titles were screened independently by 2 reviewers.

The Role of Hospital Performance on Race and Ethnicity Outcome Disparities for US Non-Traumatic Out-of-Hospital Cardiac Arrests.

Background: Factors contributing to worse outcomes for out-of-hospital cardiac arrests (OHCA) from minoritized communities are poorly understood. We sought to evaluate the impact of receiving hospital performance on OHCA outcome disparities.

Methods: We performed a retrospective cohort study of non-traumatic OHCAs from the National Cardiac Arrest Registry to Enhance Survival from 2013-2022 that survived hospital admission.

Fine-tuning of gene expression through the Mettl3-Mettl14-Dnmt1 axis controls ESC differentiation.

The marking of DNA, histones, and RNA is central to gene expression regulation in development and disease. Recent evidence links N6-methyladenosine (mA), installed on RNA by the METTL3-METTL14 methyltransferase complex, to histone modifications, but the link between mA and DNA methylation remains scarcely explored. This study shows that METTL3-METTL14 recruits the DNA methyltransferase DNMT1 to chromatin for gene-body methylation.

Pharmacologic Management of Heart Failure with Preserved Ejection Fraction (HFpEF) in Older Adults.

There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.

Progression of chronic kidney disease after non-cardiac surgery: A retrospective cohort study.

Background: Chronic-kidney-disease (CKD) is prevalent among adults undergoing noncardiac surgery, with surgery-related factors potentially worsening CKD or triggering acute kidney injury (AKI). We hypothesized that CKD patients experience more kidney function decline within one to two years post-surgery than those without CKD, particularly if they develop AKI.

Methods: We conducted a single-center retrospective cohort study, including noncardiac surgery patients with documented creatinine preoperative and between 1 and 2 years after surgery.

Efficacy of peripheral nerve stimulation in refractory postamputation pain: A narrative review.

The management of postamputation pain remains a significant clinical challenge, with existing therapeutic approaches often yielding inconsistent outcomes. Neuromodulation techniques, particularly peripheral nerve stimulation (PNS), have emerged as promising interventions. However, the evidence supporting their effectiveness in treating phantom limb pain (PLP) and residual limb pain (RLP) remains limited.

The Role of Complicated Grief in Health Inequities in American Indian Communities.

Complicated grief is both a cause and a consequence of health inequities in Native (American Indian/Alaska Native [AI/AN]) communities. Given disproportionately high rates of physical (e.g.

Chimeric Osteocutaneous Free Flap Solution to Variation in Vascular Anatomy.

When squamous cell carcinoma necessitates mandibular resection, the resultant defect can be complex. An osteocutaneous fibula free flap is an effective reconstruction option, typically supplied by the peroneal artery for both the fibula and skin flap. In this case report, an anatomical variation was found: the skin paddle was supplied by soleus musculocutaneous perforators of the posterior tibial artery, whereas the fibula was supplied by the peroneal artery.

Motivators and Barriers to Seeking Metabolic and Bariatric Surgery Among Adolescents: A Qualitative Study.

Background: The prevalence of severe obesity among adolescents has increased the use of metabolic and bariatric surgery (MBS) as a therapeutic option. Understanding factors influencing adolescent MBS choice and the support needed to undergo MBS is crucial for improving health outcomes. This study examines the motivations and support needs of a diverse sample of adolescents seeking MBS via the patient voice.

Plasma proteomic biomarkers as mediators or moderators for the association between poor cardiovascular health and white matter microstructural integrity: The UK Biobank study.

Introduction: The plasma proteome's mediating or moderating roles in the association between poor cardiovascular health (CVH) and brain white matter (WM) microstructural integrity are largely unknown.

Methods: Data from 3953 UK Biobank participants were used (40-70 years, 2006-2010), with a neuroimaging visit between 2014 and 2021. Poor CVH was determined using Life's Essential 8 (LE8) and reversing standardized z-scores (LE8 ).

Insights into the Role of the Glymphatic System in the Pathogenesis of Post-hemorrhagic Hydrocephalus.

Recently, it has been well-established that the glymphatic or glial-lymphatic system plays a vital role in the pathophysiology of various neurological compromise, especially hydrocephalus (HCP). Till now, the complete pathway is not yet fully understood, and little evidence is available from the literature that links hydrocephalus to disorders of the glymphatic system. Most published molecular studies and animal research have shown that, in models with hydrocephalus, the drainage of cerebrospinal fluid (CSF) via the glymphatic system is disrupted.

Hepcidin, Incident Heart Failure and Cardiac Dysfunction in Older Adults: the ARIC Study.

Aims: Hepcidin regulates plasma and tissue iron levels. We studied the association of hepcidin levels with the risk of incident heart failure (HF) and cardiac dysfunction in older adults.

Methods: We included adults from the ongoing, longitudinal Atherosclerosis Risk in Communities (ARIC) study who were free from prevalent anemia and HF at Visit 5 (2011-2013) and had available hepcidin and covariate data.