Multiscale Analysis of Alzheimer's Disease Using Feature Fusion in Cognitive and Sensory Brain Regions.

Introduction: This research is focused on early detection of Alzheimer's disease (AD) using a multiscale feature fusion framework, combining biomarkers from memory, vision, and speech regions extracted from magnetic resonance imaging and positron emission tomography images.

Methods: Using 2D gray level co-occurrence matrix (2D-GLCM) texture features, volume, standardized uptake value ratios (SUVR), and obesity from different neuroimaging modalities, the study applies various classifiers, demonstrating a feature importance analysis in each region of interest. The research employs four classifiers, namely linear support vector machine, linear discriminant analysis, logistic regression (LR), and logistic regression with stochastic gradient descent (LRSGD) classifiers, to determine feature importance, leading to subsequent validation using a probabilistic neural network classifier.

Pulmonary langerhans cell histiocytosis secondary to Marijuana use: a case report and systematic review of the literature.

Background: Pulmonary Langerhans Cell Histiocytosis (PLCH) is a rare interstitial lung disease primarily affecting young to middle-aged smokers. While traditionally linked to tobacco use, there is growing evidence that cannabis use may contribute to PLCH.

Methods: We present a case of a 52-year-old male with PLCH associated with heavy cannabis use.

Vancomycin-induced acute generalised exanthematous pustulosis.

Antibiotics have been well documented to result in several dermatological adverse reactions. Many of these adverse reactions are rashes that are difficult to distinguish. We present a case of a female patient in her 30s with acute generalised exanthematous pustulosis following vancomycin treatment for left breast cellulitis.

Intermittent Sinus Pause/Asystole in the Setting of Anticholinergic Overdose.

Anticholinergic toxicity typically presents with symptoms of cutaneous vasodilation, delirium, mydriasis, urinary retention, hyperthermia, anhidrosis, and tachycardia. This case report presents a 68-year-old female patient who exhibited some of these signs and symptoms after ingesting an unknown quantity of dicyclomine. However, she displayed one notable exception to the classic toxidrome.

Developing a patient toolkit for opioid use and management through co-creation.

Canada has been experiencing an opioid use crisis, and urgent efforts are being made to stem the tide. With funding support from Health Canada, the Association of Faculties of Medicine of Canada (AFMC) recently developed a series of asynchronous online bilingual modules to educate key players across the medical education spectrum on chronic pain and opioid use. The curriculum for the modules which informed the development of the Patient-Physician Partnership Toolkit was co-created through an authentic collaboration between healthcare professionals (HCPs), and patient subject matter experts who were patients with lived experience.

Perceptions of Machine Learning among Therapists Practicing Applied Behavior Analysis: A National Survey.

Unlabelled: Collecting data and logging behaviors of clients who have autism spectrum disorder (ASD) during applied behavior analysis (ABA) therapy sessions can be challenging in real time, especially when the behaviors require a rapid response, like self-injury or aggression. Little information is available about the automation of data collection in ABA therapy, such as through machine learning (ML). Our survey of ABA therapists nationally revealed mixed levels of familiarity with ML and generally neutral responses to statements endorsing the benefits of ML.

The impact of osteopathic recognition on multiple medical specialty residencies in a university-based setting.

Context: In 2020, the allopathic and osteopathic residency programs were merged into a single residency system, with the Accreditation Council for Graduate Medical Education (ACGME) as the sole accreditor for residencies and fellowships in the United States. As a result of this merger, osteopathic recognition (OR) emerged as a unique approach to promoting osteopathic training and practice. However, there is a lack of data on the effects of OR in residency, specifically university-based residency programs.

Stuck in the Sump: A Rare Complication of Biliary Surgery.

Sump syndrome is a rare complication of biliary surgery that is now rarely seen in the era of Endoscopic Retrograde Cholangiopancreatography (ERCP). It occurs when the distal common bile duct becomes obstructed between an anastomosis from a choledochoduodenostomy (CDD) and the ampulla of Vater, forming a sump that accumulates debris. Sump syndrome should be considered as a diagnosis in patients who present with cholangitis or pancreatitis and any history of biliary diversion, regardless of the time of presentation.

G-quadruplex stabilization provokes DNA breaks in human PKD1, revealing a second hit mechanism for ADPKD.

The "secondhit" pathway is responsible for biallelic inactivation of many tumor suppressors, where a pathogenic germline allele is joined by somatic mutation of the remaining functional allele. The mechanisms are unresolved, but the human PKD1 tumor suppressor is a good experimental model for identifying the molecular determinants. Inactivation of PKD1 results in autosomal dominant polycystic kidney disease, a very common disorder characterized by the accumulation of fluid-filled cysts and end-stage renal disease.

Capnocytophaga Meningitis: A Rare Case of Bacterial Infection With Neurological Manifestation.

We discuss a case of meningitis caused by infection in a previously healthy elderly male who presented with altered mental status and new-onset seizures requiring intensive care. An open wound had served as an entry point for the infectious organism. After 25 days of treatment with meropenem, he recovered with persistent functional limitations and was discharged.

Seizing the Teachable Moment: A Pilot Study of Preventive Lifestyle Education in the Emergency Department.

Background Preventive measures are critical in avoiding and limiting the severity of diseases. Key lifestyle behaviors include sleep hygiene, habitual exercise, a healthy diet, and avoidance of risky substances, particularly the use of tobacco. The transtheoretical model (TTM) of change suggests that patients can move towards healthful changes through education.

Inclisiran as a siRNA Inhibitor of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9); Past, Present, and Future.

Reducing low-density lipoprotein cholesterol (LDL-C) levels has been shown to reduce the risk of developing atherosclerotic cardiovascular disease (ASCVD). Statins are the foundation of LDL-C lowering therapy with other non-statin agents used in circumstances where goal LDL-C levels are not reached or owing to intolerance to adverse effects of statins. In 2003, the discovery of the role of the proprotein convertase subtilisin/kexin type 9 (PCSK9) system in promoting elevated LDL-C levels led to new avenues of drug development to achieve target LDL-C.

Case report: HSV lymphadenitis in immunocompromised patient with CLL.

Background: Richter's transformation (RT) in chronic lymphocytic leukemia (CLL) is associated with poor prognosis and requires prompt modifications in patient care. CLL patients are susceptible to severe infections due to immune dysregulation induced by their malignancy and immunosuppressive therapies.

Case Presentation: We present a case of a 63-year-old man with CLL who previously achieved remission and presented with a right inguinal mass.

The Rise, Fall, and Readjustment of Telehealth: Effect of COVID-19 on its Use in an Academic Health Clinic.

Background: The COVID pandemic accelerated the adoption of telehealth. Long-term implications for continued telehealth use on a large scale in primary care are still emerging, and the key to this understanding is how telehealth adoption impacts the delivery of health care.

Objectives: Our objective was to quantify how telehealth adoption during the pandemic impacted patients' access to healthcare and the usage patterns of different access modalities (in-office, audio, and video).

Iatrogenic Cardiac Arrest During Thyroid Storm.

Introduction: Thyroid storm is a life-threatening condition with often severe cardiac implications. Correct treatment choices can vary depending on underlying cardiac systolic function.

Case Description: We present a case of a 47-year-old male with untreated Grave's disease who presented with a thyroid storm.

A Systematic Review of the Attitudes, Beliefs, and Acceptance of the COVID-19 Vaccine in the Western and Eastern Hemispheres.

The availability of an effective vaccine does not equate to its use; its effectiveness primarily depends on vaccine acceptance by the targeted population. Despite the rapid development and widespread access to the COVID-19 vaccine, herd immunity is yet to be achieved, with vaccine hesitancy as a major barrier. This study sought to systematically assess the beliefs, attitudes, and acceptance towards COVID-19 vaccines, including factors contributing to vaccination hesitancy in the Eastern and Western Hemispheres.

Impact of an Inpatient Family Medicine Exposure: Changing Student Perception.

Introduction: Currently there is a primary care physician shortage in the United States, and this shortage is expected to worsen into the foreseeable future. In 2023, only 7.5 % of US allopathic graduates entered family medicine (FM) residencies.

Hypoxia-induced PD-L1 expression and modulation of muscle stem cell allograft rejection.

Stem cell therapy has shown immense promise in treating genetic disorders, particularly muscular diseases like Duchenne muscular dystrophy (DMD). This study investigates a novel method to enhance the viability of stem cell transplants in DMD by upregulating Programmed Death Ligand 1 (PD-L1) in muscle stem cells (MuSCs) through preconditioning with hypoxia and/or interferon-γ (IFN-γ) to mitigate T cell immune rejection. MuSCs were treated with 5% hypoxia for 72 h and further treated with IFN-γ to enhance PD-L1 expression.

Educational Benefits of Rural Rotations: Insights From General Surgery Residency Program Leaders.

Objective: Rural rotations have become increasingly common. However, little is known about whether they offer educational benefits for residents who do not eventually practice in rural facilities.

Design: Starting with an ACGME-provided roster of general surgery programs, the authors conducted a website review (12/2022-7/2023) of the 342 civilian programs located in U.