The Neurophysiological Effects of Dry Needling: An Update of a Narrative Review.

The interest in dry needling as a treatment option for myofascial pain has flourished for the last decades and will probably continue to do so, since multiple clinical effects can be attributed to this technique. However, evidence about the underlying physiological mechanisms of its effects is still underrepresented in scientific research and caution must be taken in generalizing results from acupuncture or animal research. This review offers an overview of the possible mechanisms involved in the pathophysiology of myofascial trigger points, i.

Ocular Motor and Vestibular Profile in Spinocerebellar Ataxia Type 27B: Toward a Practical Bedside Diagnostic Framework.

Spinocerebellar ataxia type 27B (SCA27B), caused by GAA repeat expansions in FGF14, is an increasingly recognized form of late-onset cerebellar ataxia. However, early diagnosis remains challenging due to mild or absent cerebellar motor signs and often normal brain magnetic resonance imaging (MRI). Oculovestibular abnormalities, although prevalent, are frequently overlooked and not captured by standard clinical scales such as the Scale for the Assessment and Rating of Ataxia (SARA).

International, Multispecialty Expert Consensus on Nomenclature for Facial Paralysis.

Variable terminology is used in the literature to describe facial synkinesis and hypertonicity following incomplete recovery from facial paralysis and its associated medical and surgical treatments. Establish a nomenclature consensus for this condition among a group of facial nerve experts. Consensus study.

Enhanced Clinical Outcomes and Treatment Adherence in Patients Using Compounded Topical Minoxidil to Treat Androgenetic and Traction Alopecia.

Introduction: This study highlights the experiences and clinical outcomes of Black women treated with compounded topical minoxidil (CTM), containing a steroid and retinoid, compared to over the counter (OTC) minoxidil.

Methods: A retrospective chart review included 66 Black women treated at Johns Hopkins Hospital between 2020 and 2024. Patients previously used OTC minoxidil and were currently using CTM.

CFTR Gene Regulation in Human Pancreatic Duct, Bile Duct and Sweat Gland Epithelial Cells.

Epithelial cells at many sites in the body are affected by the inherited disorder cystic fibrosis (CF). The lung was the major focus of research until recently, when effective therapeutics became available for most people with CF. There is now renewed interest in CF aetiology in other locations in the body, where the regulatory mechanisms for the CF transmembrane conductance regulator (CFTR) gene are less well-characterised.

Early peripheral vascular intervention for treating patients with claudication: A decision analysis using national administrative claims data.

Objectives: Claudication, a symptom commonly associated with peripheral artery disease, affects approximately 30-40% of adults in the United States. A decision analysis is needed to integrate data, information, and knowledge from multiple sources about the stages of a patient's journey in this condition to assess the optimal treatment approach.

Methods: We designed a decision model including patient perspective and outcomes of claudication, peripheral vascular intervention, open surgical bypass, chronic limb-threatening ischemia, and amputation.

Percutaneous Endoscopic Decompression for Lumbar Central and Lateral Recess Spinal Stenosis: A Combined Uni-Portal and Bi-Portal Approach.

Background: Endoscopic decompression of lumbar spinal stenosis has been gaining popularity as the least invasive of several minimally invasive surgical treatment options. This procedure offers similar outcomes to those of conventional open procedures; however, endoscopic procedures are technically demanding and involve a substantial learning curve. The typical endoscopic approach is a "uni-portal" approach that utilizes a special spinal endoscope and endoscopic instruments.

Demographic disparities in heart failure with preserved ejection fraction.

This review comprehensively examines the complex influence of demographic factors on heart failure with preserved ejection fraction (HFpEF), an increasingly common clinical syndrome. We examine the impact of age, sex, race/ethnicity, and socioeconomic status on HFpEF, investigating how these factors contribute to disparities in prevalence, risk profiles, diagnostic challenges, treatment responses, and clinical outcomes. Key findings highlight the significant role of age, with HFpEF incidence rising with advancing age advances and distinct pathophysiological mechanisms noted across age groups.

Novel Roles of the GPI-Anchor Cleaving Enzyme, GDE2, in Hippocampal Synaptic Morphology and Function.

Hippocampal synaptic activity is tightly regulated to ensure appropriate synaptic function and plasticity, which are important for critical cognitive processes such as learning and memory. Altered hippocampal synaptic function can lead to cognitive and behavioral deficits observed in neurodegenerative diseases such as Alzheimer's disease (AD), necessitating a deeper fundamental understanding of hippocampal synaptic control mechanisms. Glycerophosphodiester phosphodiesterase 2 (GDE2 or GDPD5) is a surface transmembrane enzyme that cleaves the glycosylphosphatidylinositol anchor that tethers some proteins to the membrane.

Classification of Peripheral Nerve Injury.

This review focuses on the critical role of MR neurography (MRN) in diagnosing and managing peripheral nerve injuries (PNIs). It emphasizes the ability of imaging to differentiate injuries that may heal spontaneously from those requiring surgery, using classification systems like Neuropathy Score Reporting and Data System with imaging findings corresponding to established electrodiagnostic grading systems. MRN also evaluates skeletal muscle denervation and is useful for differentiating pre-ganglionic from post-ganglionic traumatic injuries.

Factors Influencing End-of-Life Decisions in Cancer Patients After Traumatic Injuries.

Introduction: Severe traumatic injuries are frequently associated with poor outcomes, and withdrawal of life-sustaining treatment (WLST) after traumatic brain injury is common. However, the association between WLST and pre-existing cancer in all trauma patients remains underexplored.

Methods: This retrospective cohort study analyzed data from the American College of Surgery Trauma Quality Programs in 2022.

Sustained Molecular Allograft Injury After Episodes of Acute Rejection and Organizing Pneumonia Increases the Risk of Lung Allograft Failure.

Background: Despite treatment of major risk factors such as acute rejection (AR) and organizing pneumonia (OP) in lung transplant recipients, chronic lung allograft dysfunction (CLAD) still develops at high rates, suggesting that traditional methods of assessing response to treatment and resolution remain inadequate. It is unknown whether the degree of molecular allograft injury after treatment of AR/OP modulates the risk of CLAD and death.

Methods: To evaluate the association of molecular allograft injury after AR/OP with the incidence of CLAD/death, we conducted a multicenter prospective cohort study that included 93 patients who underwent lung transplantation between 2015 and 2022.

ATP directly modulates thick filament structure and function in porcine myocardium.

Cardiac contraction is achieved through cyclic cross-bridge interactions between overlapping myosin-containing thick filaments and actin-containing thin filaments. This process is powered by ATP hydrolysis by myosin, which must be sufficient for maintaining cardiac output. Myocardial ATP concentration is tightly maintained via several mechanisms.

Patient Perceptions of Artificial Intelligence in Otolaryngology-Head and Neck Surgery: An International Study.

Objective: To investigate the demographic determinants of patient perception toward the role of artificial intelligence (AI) in otolaryngology-head and neck surgery care.

Methods: Outpatients consulting in otolaryngology-head and neck surgery departments of 18 hospitals were surveyed about the perception of the role of AI in health care. The results were analyzed according to the age, gender, patient use of technology, and the level of education.

High rate of complications in a real-world cohort of youth with T2D: a multicenter analysis.

Introduction: The TODAY2 study reported that 80 % of young adults with youth-onset T2D (YoT2D) had at least one diabetes comorbidity or complication at a mean duration of 13 years. Prevalence rates of comorbidities and microvascular complications in YoT2D with shorter duration and younger age is unclear, particularly in the age of new pharmacotherapies.

Methods: In a multicenter retrospective analysis, presence of comorbidities (hypertension (systolic BP > 130 or diastolic BP > 80), dyslipidemia (LDL > 130 mg/dL or triglycerides>150 mg/dL), elevated liver enzymes (AST > 25 U/L, or ALT U/L > 22 for females or >26 U/L for males)) and microvascular complications (microalbuminuria (microalbumin/creatinine ratio > 30), diabetic retinopathy) in patients with YoT2D at three academic pediatric diabetes centers were assessed.

Development of an Integrative Medicine Rotation for Family Medicine and Preventive Medicine Residency.

Background: Integrative medicine or complementary and alternative medicine (IM/CAM) is widely utilized by patients despite the limited training available across health care education. There is a gap between patient interest and the need for guidance amid a lack of preparation among clinicians in IM/CAM. To address this, the Baltimore Geriatric Research Education and Clinical Center created a US Department of Veterans Affairs-based whole health rotation that incorporates core IM/CAM competencies for family medicine and preventive medicine residents.

Outcomes of Teenage Donor Hearts Transplanted into Adult Heart Transplant Recipients: A UNOS Analysis.

Objective: The safety of utilizing teenage donor hearts for adult recipients is unclear. Moreover, the appropriateness of predicted heart mass ratio (PHMr) as a size metric for teenage donors is unknown.

Methods: We used the United Network for Organ Sharing (UNOS) database to perform a retrospective analysis of heart-only adult transplant recipients (>18 years).

Identification of Long-Term Care Facility Residence From Admission Notes Using Large Language Models.

Importance: An estimated half of all long-term care facility (LTCF) residents are colonized with antimicrobial-resistant organisms, and early identification of these patients on admission to acute care hospitals is a core strategy for preventing intrahospital spread. However, because LTCF exposure is not reliably captured in structured electronic health record data, LTCF-exposed patients routinely go undetected. Large language models (LLMs) offer a promising, but untested, opportunity for extracting this information from patient admission histories.

Systolic Blood Pressure Reduction with Stability as a New Therapeutic Goal in Patients with Intracerebral Hemorrhage: Results of the Pooled Analysis of ATACH 2 and INTERACT 2 Trials.

Background: The American Heart Association/American Stroke Association recommends achieving systolic blood pressure (SBP) therapeutic targets within 60 min of initiating treatment for intracerebral hemorrhage (ICH), emphasizing avoidance of "overshoot" correction and SBP fluctuations. We evaluated the prognostic value of "SBP reduction with stability," a novel end point combining controlled blood pressure reduction and maintenance, using data from two large multinational clinical trials.

Methods: We analyzed patients with ICH from Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 and Intensive BP Reduction in Acute Cerebral Hemorrhage Trial 2 trials presenting with initial SBP 150-220 mm Hg.

Trauma, Gender, and End-of-Life Care: A Propensity-Matched Cohort Study Analyzing Disparities in Withdrawal of Life Support.

Introduction: Men are known to have more severe injuries at younger ages compared to women. However, the relationship between gender and other sociodemographic factors in the context of end-of-life care after traumatic injuries is not well understood.

Methods: This retrospective observational cohort study utilized data from the American College of Surgeons Trauma Quality Programs in 2022 and included all patients who were 18 y or older while those with missing information on withdrawal of life-sustaining treatment (WLST) were excluded.

Resveratrol attenuates the priapism phenotype in sickle cell mice by restoring NO-cGMP-PDE5 signaling and reducing NADPH oxidase 2 expression.

The pathogenesis of priapism in sickle cell disease (SCD) is closely linked to oxidative stress and reduced bioavailability of nitric oxide (NO) in penile tissue. Resveratrol, a potent natural antioxidant, has demonstrated protective effects in various vascular disorders. To evaluate the therapeutic effects of resveratrol on priapism, oxidative stress markers, and NO-cGMP signaling in the penile tissue of transgenic SCD mice.

Proteogenomic reprogramming to a functional human blastomere-like stem cell state via a PARP-DUX4 regulatory axis.

Here, we show that conventional human pluripotent stem cells cultured with non-specific tankyrase-PARP1-inhibited conditions underwent proteogenomic reprogramming to functional blastomere-like tankyrase/PARP inhibitor-regulated naive stem cells (TIRN-SC). TIRN-SCs concurrently expressed hundreds of pioneer factors in hybrid 2C-8C-morula-ICM programs that were augmented by induced expression of DUX4. Injection of TIRN-SCs into 8C-staged murine embryos equipotently differentiated human cells to the extra-embryonic and embryonic compartments of chimeric blastocysts and fetuses.