Citations

ABSTRACT Nonsteroidal anti‐inflammatory drugs (NSAID)‐exacerbated respiratory disease (N‐ERD) is a mainly type 2 inflammatory condition that combines asthma, nasal polyps, and hypersensitivity to NSAIDs. Its pathogenesis involves both upper and lower airways, yet most studies to date have examined these compartments separately. It remains unclear whether the molecular mechanisms in the nose, sinuses, and lungs are distinct or overlapping—an important gap, given that clinical manifestations of N‐ERD involve both sites. In this review, we summarize available omics studies—transcriptomics, proteomics, metabolomics, and epigenomics—performed on upper and lower airways in patients with N‐ERD. While omics approaches have revealed new molecular insights, comparisons across studies are limited by heterogeneity in design, controls, and methodology. We emphasize the need for integrated multi‐omics analyses and standardized frameworks to better characterize the disease across airways. Such efforts are essential for identifying robust biomarkers and therapeutic targets and for moving toward a systems‐level understanding of N‐ERD.

Abstract Active learning strategies enhance medical education by fostering self‐directed learning, communication, and problem‐solving skills. The paper puzzle, a game‐based learning approach, provides an engaging way to reinforce anatomical knowledge and promote collaboration. This study assessed its impact on student performance and perceptions in clinical anatomy, comparing it to PowerPoint‐based imaging reviews and evaluating the role of Near Peer Teachers (NPTs). A prospective, longitudinal, quasi‐experimental study with a mixed‐methods approach was conducted on first‐year medical students enrolled in the Human Anatomy course. Surveys using a Likert scale assessed student and NPT perceptions, while focus groups and interviews provided qualitative insights. Thematic analysis identified key themes related to engagement, knowledge reinforcement, and effectiveness. A total of 907 medical students and 30 NPTs completed a survey, while 75 students and 10 NPTs participated in the qualitative phase. Students perceived the paper puzzle as an engaging and interactive review tool that reduced stress, increased involvement, and enhanced knowledge retrieval through collaboration and a structured gameplay loop. They also valued the emotional impact on learning. NPTs reported benefits for student motivation and teamwork but noted that time constraints limited content coverage. The activity's effectiveness was highly dependent on the NPT's facilitation, emphasizing the need for structured implementation. Findings suggested that game‐based learning strategies like the paper puzzle can improve motivation, teamwork, and content retrieving in anatomy education when carefully designed and effectively executed by NPTs.

ABSTRACTTherapeutic treatment of lung nodules by ablation is a new field. Even though not considered standard of care, lung nodule ablation can be appropriate for select cases. Even though ablation is a safe and well‐tolerated procedure, bleeding is a potential complication. We introduce our stepwise approach through two cases on how we AIM (Anticipate/Adjust, Image, Manage) to prevent uncontrolled bleeding during Robotically Assisted Bronchoscopic Ablation: 1. Anticipate structures with high risk for bleeding and adjust accordingly, accounting for the needle ablation field; 2. Image: utilise cone beam CT before the first and after each ablation session to screen for bleeding; 3. Manage bleeding by pre‐emptively utilising Fogarty balloon occlusion.

OBJECTIVES The 2-bag intravenous (IV) fluid system for diabetic ketoacidosis (DKA) has been associated with shorter duration of insulin and faster resolution of acidosis. Our aims were to increase the use of 2-bag IV fluids among children with medium- or high-risk DKA treated at 2 tertiary care pediatric hospitals and to increase the proportion of children who receive timely administration of fluid and insulin treatments. METHODS We conducted a quality improvement initiative using data from January 1, 2014, to December 31, 2021, among patients 21 years or younger with medium- or high-risk DKA. The study spanned pre- and post-initiative periods and a stability period. Our interventions included development of a clinical practice guideline, education, and electronic medical record updates. Statistical process control methods were used to evaluate outcome changes. RESULTS We identified 876 eligible encounters. Age, sex, and the proportion of children with medium- or high-risk DKA were similar across study periods. A higher proportion of non-Hispanic Black children was observed in the stability period (26.3%) than the pre- (17.7%) and post-initiative (18.2%) periods. We observed an increase in 2-bag IV fluid use from an average of 41.3% to 77.7%. We did not observe changes in time to isotonic fluid bolus, continuous insulin, or 2-bag IV fluids. There was no change in hypoglycemic events. CONCLUSION We increased the proportion of children with medium- or high-risk DKA treated with 2-bag IV fluids through a combination of interventions, including implementation and refinement of a clinical guideline, creation of a nurse algorithm, and nursing education.

Background and Objectives Neurolytic celiac plexus block is often performed for analgesia from pancreatic cancer, but it is not known if the cancer alters the anatomy relevant to the successful performance of retrocrural celiac plexus block. Methods Abdominal computed tomographic scans were used to simulate retrocrural celiac plexus block in patients with and without pancreatic cancer. Results Simulated right-sided needle placement in the retrocrural space was more likely to fail in patients with pancreatic cancer than in patients without cancer. Such predicted failure often occurred when the cross-sectional area of the right retrocrural space was less than 1.0 cm2. Conclusions The predicted success of simulated retrocrural celiac plexus block differed between patients with and without pancreatic cancer. These findings have implications for the performance of celiac plexus block.