MicroRNAs (miRNAs) are a class of small non-coding RNAs ~19–22 nt long which post-transcriptionally regulate gene expression. Their ability to exhibit dynamic expression patterns coupled with their wide variety of targets allows miRNAs to regulate many processes, including the innate immune response of Drosophila melanogaster. Recent studies have identified miRNAs in Drosophila which are differentially expressed during infection with different pathogens as well as miRNAs that may affect immune signalling when differentially expressed. This review provides an overview of miRNAswhich have been identified to play a role in the immune response of Drosophila through targeting of the Toll and IMD signalling pathways and other immune processes. It will also explore the role of miRNAs in fine-tuning the immune response in Drosophila and highlight current gaps in knowledge regarding the role of miRNAs in immunity and areas for further research.

Spectral CT represents a novel imaging approach that can noninvasively visualize, quantify, and characterize many musculoskeletal pathologies. This modality has revolutionized the field of radiology by capturing CT attenuation data across multiple energy levels and offering superior tissue characterization while potentially minimizing radiation exposure compared to traditional enhanced CT scans. Despite MRI being the preferred imaging method for many musculoskeletal conditions, it is not viable for some patients. Moreover, this technique is time-consuming, costly, and has limited availability in many healthcare settings. Thus, spectral CT has a considerable role in improving the diagnosis, characterization, and treatment of gout, inflammatory arthropathies, degenerative disc disease, osteoporosis, occult fractures, malignancies, ligamentous injuries, and other bone-marrow pathologies. This comprehensive review will delve into the diverse capabilities of dual-energy CT, a subset of spectral CT, in addressing these musculoskeletal conditions and explore potential future avenues for its integration into clinical practice.

During recent decades, allergy related diseases have emerged as a growing area of concern in developing regions of the world, including Africa. Worldwide prevalence of allergic diseases has grown to an estimated 262 million for asthma, 400 million for allergic rhinitis (or hay fever), 171 million with atopic dermatitis (or eczema), and over 200 million for food allergy. In Africa, considerable variability exists in the data surrounding prevalence at the continent-wide, regional, and study site levels. Furthermore, research conducted in many rural areas and underdeveloped countries in Africa remains limited, and presently, little has been done to characterize and map the extremely heterogeneous body of literature which confounds research efforts. This scoping review will seek to identify studies examining the prevalence, management strategies, outcomes, and associated risk factors for allergy related diseases in Africa. The Joanna Briggs Institute’s scoping review methods will be followed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR) was used for writing the protocol. Four databases (Embase, Global Health, PubMed, African Journals Online) will be searched for literature published from 2003 to 2023 in any language. Title and abstract screening and full-text screening will be completed by two independent reviewers using Covidence; conflicts resolved by a third reviewer. Data will be extracted using Covidence by two reviewers independently. To report the results, we will follow the PRISMA-ScR checklist and report descriptive statistics and a narrative summary.

Background/Objectives: Topical steroid withdrawal syndrome is an underrecognized (and at times controversial) diagnosis, predominantly seen in individuals with a history of prolonged medium- to high-potency steroid use with sudden cessation. We aim to present topical steroid withdrawal clinical cases along with a narrative review of the literature to better characterize this understudied phenomenon. Methods: A total of 16 patients with a history of topical steroid withdrawal were enrolled in an IRB-approved clinical trial (NCT04864886). Participants underwent clinical assessments at the National Institutes of Health, including a history and physical examination, photography, genome sequencing, and comprehensive blood work. A follow-up survey assessed symptom activity and functional impact. Results: All patients reported severe itch, heat and photosensitivity, erythema, skin dryness, and pain. A total of 11 patients exhibited elevated IgE levels, 9 patients noted metallic-smelling skin, and 4 had peripheral blood eosinophilia. Symptomatic relief was observed with dupilumab, berberine, naltrexone, and various home remedies including topical ointments, vitamins, and probiotics, though effectiveness varied and often required trial and error. At follow-up, most respondents reported partial but ongoing symptoms, with several describing residual itch and intermittent interference with daily activities. Some participants continued therapeutic interventions, such as berberine, over two years after their initial evaluation. Conclusions: Our findings report improvement in patient symptoms such as itch and detail emerging management strategies that have not been discussed before. Improved recognition, physician consensus, and systemic evaluation of therapeutic options are needed to guide care and enhance quality of life for affected patients.

MicroRNAs (miRNAs) are small non-coding RNAs ~ 19-22 nt long that post-transcriptionally regulate their mRNA targets. In Drosophila melanogaster, the role of miRNAs has mostly been studied in regard to bacterial infection, yielding insights about their regulatory function in innate immunity. However, fewer studies have focused on viral infections, and importantly, how miRNAs modulate aging immune responses is not fully understood. Here, we performed small RNA-sequencing demonstrating that systemic Flock House Virus (FHV) infection of Oregon-R flies leads to differential microRNA expression and that this response differs with aging. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses identified cellular pathways and biological processes which may be regulated by dynamic expression of microRNAs during infection. For 17 candidate miRNAs, we tested Drosophila lines with in vivo miRNA knockdown for their survival of systemic FHV challenge. In response to infection, among miRNA knockdown lines, females consistently outlived males, and young flies generally outlived their aged counterparts. Furthermore, miRNA knockdown lines generally displayed increased susceptibility to viral infection in comparison to controls, particularly prominent among males. For one miRNA chosen for further study, miR-311, its dysregulation resulted in decreased survival independent of changes in viral load, suggesting a role in disease tolerance rather than resistance. Lastly, knockdown of the immune deficiency (imd) gene - a predicted target of miR-311 - was associated with improved survival of FHV. This work identifies changes in miRNA expression in the aging antiviral response and highlights one miRNA with a role in disease tolerance to FHV in Drosophila.

Background: Physician workforce diversity improves access to care, outcomes, and workforce productivity. Yet, women and sexual minorities remain underrepresented in anesthesiology, while representation for low-income trainees remains poorly characterized. How interest in anesthesiology evolves among these groups during medical school remains unclear. Methods: This retrospective cohort study of U.S. MD-granting medical school matriculants from 2014–2017 used Association of American Medical Colleges data on self-reported sociodemographic characteristics and anesthesiology interest. Students were grouped by interest evolution from matriculation to graduation: never interested (no-no), cultivated (no-yes), lost (yes-no), sustained (yes-yes). Chi-square tests characterized sociodemographic differences across interest paths. Firth logistic regression models assessed odds of cultivated vs never interested and sustained vs lost paths across sociodemographic groups. Results: Among 39,910 students in the cohort, 295 (0.7%) sustained, 2,007 (5.0%) cultivated, 494 (1.2%) lost interest, and 37,114 (93.0%) were never interested in anesthesiology. Women were less likely than men to have initial interest (1.5% vs 2.5%, p < .001), whereas initial interest among low-income (2.1% vs 1.9%, p = .087) and sexual minority (1.8% vs 2.0%, p = .505) students did not significantly differ from majority counterparts. Sustained interest did not differ significantly between women and men (OR: 0.85, 95% CI: 0.63–1.14), according to low-income (OR: 0.89, 95% CI: 0.65–1.22), or sexual minority status (OR: 0.77, 95% CI: 0.41–1.45). Women (OR: 0.50, 95% CI: 0.45–0.55) and sexual minority students (OR: 0.79, 95% CI: 0.65–0.96) were less likely to cultivate interest than men and heterosexual students, respectively. Low-income students had greater (OR: 1.27, 95% CI: 1.16–1.40) odds of cultivating interest compared to non-low-income peers. Conclusions: Women’s underrepresentation in anesthesiology is associated with lower initial and cultivated interest. Sexual minority students also demonstrated lower cultivated interest. These disparities identify time points in training where interest diverges by demographic group and may help prioritize where future research — including studies of targeted interventions — is most needed.