A Reflective Verbalization Strategy to Trigger Alternative Diagnostic Hypotheses.

Rationale: Physicians sometimes encounter various types of gut feelings (GFs) during clinical diagnosis. The type of GF addressed in this paper refers to the intuitive sense that the generated hypothesis might be incorrect. An appropriate diagnosis cannot be obtained unless these GFs are articulated and inventive solutions are devised.

PET/CT imaging of the late-gestation fetal brain in pregnant rats: A proof-of-concept study.

Preclinical PET studies offer the opportunity to elucidate molecular mechanisms underlying early neurodevelopment with minimal invasiveness. We demonstrated the feasibility of fetal brain PET in four pregnant rats ( = 42 fetuses). [F]FDG uptake in rat fetuses was readily visualized by PET imaging.

Association of Omeprazole-Related Myopathy With Drug-Drug and Drug-Gene Interactions Involving CYP2C19 and CYP3A4: A Nested Case-Control Study.

Background: Omeprazole, a widely used proton pump inhibitor, has been associated with rare but serious adverse events such as myopathy. Previous research suggests that concurrent use of omeprazole with fluconazole, a potent cytochrome P450 (CYP) 2C19/3A4 inhibitor, may increase the risk of myopathy. However, the contribution of genetic polymorphisms in CYP enzymes remains unclear.

The role of neutrophils in vasospasm and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: Is it time for a SAH clinical trial targeting neutrophils?

Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating neurological disease, and one of the primary drivers of morbidity after aneurysm rupture is the phenomenon of delayed cerebral ischemia (DCI). Significant knowledge has been gained over the past two decades of the impact of neuroinflammation in DCI; and neutrophils are now believed to play a major role. There is significant human subject data showing the rise of neutrophil related inflammatory markers and neutrophil's association with poor outcome after aSAH, but as of yet no trials involving human subjects have been done specifically targeting neutrophils.

Current Trends and Future Directions of Statistical Methods in Medical Research: A Scientometric Analysis.

Aims And Objective: The field of medical statistics has experienced significant advancements driven by integrating innovative statistical methodologies. This study aims to conduct a comprehensive analysis to explore current trends, influential research areas, and future directions in medical statistics.

Methods: This paper maps the evolution of statistical methods used in medical research based on 4,919 relevant publications retrieved from the Web of Science.

Quantifying evidence for phenotypic specificity (PP4) for syndromic phenotypes: Large-scale integration of rare germline FH variants from diagnostic laboratory testing for HLRCC (Hereditary Leiomyomatosis and Renal Cell Cancer) and renal cancer.

Purpose: Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) is a rare cancer susceptibility syndrome exclusively attributable to pathogenic variants in FH (HGNC:3700). This paper quantitatively weights the phenotypic context (PP4/PS4) of such very rare variants in FH.

Methods: We collated clinical diagnostic testing data on germline FH variants from 387 individuals with HLRCC and 1,780 individuals with renal cancer, and compared the frequency of 'very rare' variants in each phenotypic cohort against 562,295 population controls.

Predicting Breath Hold Task Compliance From Head Motion.

Background: Cerebrovascular reactivity reflects changes in cerebral blood flow in response to an acute stimulus and is reflective of the brain's ability to match blood flow to demand. Functional MRI with a breath-hold task can be used to elicit this vasoactive response, but data validity hinges on subject compliance. Determining breath-hold compliance often requires external monitoring equipment.

Genomewide association study of a homogeneous multiple sclerosis cohort: Tumefactive demyelination.

Background: Tumefactive demyelination (TD) is a rare variant of multiple sclerosis (MS) characterized by tumor-like lesions that often require aggressive management. Genome-wide association studies (GWAS) identified variants associated with MS; similar analyses in TD are lacking.

Objective: A GWAS was performed to identify variants associated with TD.

Tailoring butane-1,2,3,4-tetraol-based maltosides (BTMs) group-swapping and detergent unsymmetry: new detergent design strategies for membrane protein studies.

Membrane proteins are essential bio-macromolecules involved in numerous critical biological processes and serve as therapeutic targets for a wide range of modern pharmaceuticals. Small amphipathic molecules, called detergents or surfactants, are widely used for the isolation and structural characterization of these proteins. A key requirement for such studies is their ability to maintain membrane protein stability in aqueous solution, a task where conventional detergents often fall short.

Composite chronic lymphocytic leukemia and mantle cell lymphoma involving the bone marrow: a case report and literature review.

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a clinically indolent lymphoproliferative disorder characterized by accumulation of mature B-cell lymphocytes. Given the common CD5 co-expression, mantle cell lymphoma (MCL) is one of the most important entities in the differential diagnosis. MCL and CLL/SLL might exhibit overlapping morphologic and immunohistochemical features, making diagnosis particularly difficult in cases of composite lymphomas.

Efficacy of Liposomal Bupivacaine in Ultrasound-Guided Peripheral Nerve Blocks for Postoperative Pain Management in Foot and Ankle Surgery.

Background: In response to the opioid epidemic, many surgical specialties have adopted nonopioid pain management strategies. Ultrasound (US)-guided peripheral nerve blocks (PNBs) are effective in reducing pain and opioid consumption postsurgery. Liposomal bupivacaine (LB), shown effective in shoulder surgery, was approved in November 2023 for use in US-guided lower extremity blocks.

Harnessing volatile organic compound biomarkers for early cancer detection: molecular to nanotechnology-based approaches.

Early-stage cancer diagnosis is considered a grand challenge, and even though advanced analytical assays have been established through molecular biology techniques, there are still clinical limitations. For example, low concentration of target biomarkers at early stages of cancer, background values from the healthy cells, individual variation, and factors like DNA mutations, remain the limiting factor in early cancer detection. Volatile organic compound (VOC) biomarkers in exhaled breath are produced during cancer cell metabolism, and therefore may present a promising way to diagnose cancer at the early stage since they can be detected both rapidly and non-invasively.

Minimal Clinically Important Difference of the Scale for the Assessment and Rating of Ataxia.

Background: The Scale for the Assessment and Rating of Ataxia (SARA) is the most used outcome measure in clinical trials for cerebellar ataxias. The minimal clinically important difference (MCID), a parameter used to assess meaningful change, is not clearly defined.

Objective: To help define MCID for SARA.

A vegetarian diet improves hepatic steatosis in MASLD patients through weight loss: a randomized controlled trial in China.

: The therapeutic potential of vegetarian diets in metabolic dysfunction-associated steatotic liver disease (MASLD) remains understudied in Asian populations. This randomized controlled trial aimed to evaluate the effects of a culturally adapted 6-month lacto-ovo-vegetarian diet (LOV-D) on hepatic steatosis and cardiometabolic risk factors through weight loss. : In this randomized trial, 220 Chinese adults with MASLD were assigned to LOV-D ( = 110) or an omnivore diet ( = 110) for 6 months.

Window of opportunity evaluation of blood-brain barrier permeability heterogeneity within and across high-grade glioma patients.

Background: Disruption of the blood-brain barrier (BBB) in high-grade brain tumors is characterized by contrast accumulation on diagnostic imaging. This window of opportunity study correlates contrast imaging features with the tumor distribution of BBB-permeable (levetiracetam) and -impermeable (cefazolin) drugs.

Methods: Patients with a clinical diagnosis of a high-grade brain tumor underwent MRI for surgical planning.

"Why Would You Say That? That Is the Worst Thing You Could Possibly Say": Communication Work Among Young Breast Cancer Survivors.

Communication is a salient aspect of coping with cancer. Research suggests that young adult cancer survivors may experience unique challenges, including social isolation, fertility and family planning concerns, dating and marriage, and financial challenges. Little is known, however, about the types of communicative work young breast cancer survivors face.

A National Cancer Database Analysis of the Trends in Conversion from Robotic-Assisted Proctectomy to Laparotomy in Rectal Cancer.

Robotic-assisted proctectomy (RAP) has been reportedly associated with lower rates of conversion to laparotomy than laparoscopy in several cohort studies. This st0udy aimed to assess the temporal trends in conversion from RAP to laparotomy stratified by patient and treatment-related factors. This retrospective observational study was undertaken to analyse the temporal trends in unplanned conversion from RAP to laparotomy.

A Woman's Burden: Mental Health Outcomes Among US Women with Heavy Drinkers in Their Lives.

Alcohol's secondhand effects include violence, financial problems, and emotional abuse. We examined mental health among adult women with a heavy drinker in their life. Using a sample of 1,503 women (13.

Association between perioperative prealbumin level and outcomes in coronary bypass surgery patients.

Background: Albumin and BMI have been used as nutritional markers of morbidity and mortality. Recently, prealbumin has grown in interest in other surgical disciplines, but less so in cardiac surgery. Thus, this study examined the association between prealbumin and bleeding, mortality, and readmission in coronary artery bypass graft (CABG) patients.

Promoting Palliative Care to Patients in Developing Countries-Global Perspectives and Future Recommendations.

Despite a plethora of evidence available on the benefits of palliative care (PC), it is estimated that only about 14% of those living in low- to middle-income countries (LMIC) or developing countries have access to PC. To globally examine PC expert perspectives regarding PC infrastructure and resources within each country, drug and opioid availability to provide PC, and workforce and educational issues. Descriptive, open-ended survey seeking first-hand qualitative perspectives.

Prenatal Body Image: Association with Disordered Eating Behaviors and Depressive Symptoms Across Pregnancy.

Disordered eating behaviors and depressive symptoms can be problematic during pregnancy for both the individual and their offspring. Our study aimed to determine the extent to which body image dissatisfaction early in pregnancy predicts eating disorder behaviors and/or depressive symptoms across pregnancy. Participants ( = 253) completed self-report assessments of depressive and eating disorder symptoms alongside the modified Body Image in Pregnancy Scale in their first, second, and third trimesters.

Grain boundary tuning determines iodide and lithium-ion migration in a solid adiponitrile-LiI molecular crystal electrolyte.

This work presents the synthesis of a molecular crystal of adiponitrile (Adpn) and LiI a simple melting method. The molecular crystal has both Li and I channels and can be either a Li or an I conductor. In the stoichiometric crystal (Adpn)LiI, the Li ions interact only with four CN groups of Adpn, while the I ions are uncoordinated.