It is thought that human T-cell lymphotropic virus type I (HTLV-I) preferentially infects CD4⁺ T cells in vivo. However, observations of high HTLV-I proviral load in patients with HTLV-I–associated myelopathy/tropical spastic paraparesis suggest that HTLV-I may infect other cell types in addition to CD4⁺ T cells. To identify in vivo T-cell tropisms of HTLV-I, real-time quantitative polymerase chain reaction (PCR) and intracellular protein staining were used. A high amount of HTLV-I proviral DNA was detected from purified CD8⁺ T cells by quantitative PCR (between 1.64 and 62.83 copies of HTLV-I provirus per 100 isolated CD8⁺ T cells). CD8⁺ T cells expressed HTLV-I–related antigens (HTLV-I Tax and p19 protein) after a short time in cultivation. These results demonstrate that CD8⁺ T cells are also infected with HTLV-I and express HTLV-I antigens at levels that are comparable to HTLV-I–infected CD4⁺ cells. Therefore, CD8⁺ cells are an additional viral reservoir in vivo for HTLV-I and may contribute to the pathogenesis of HTLV-I–mediated disorders.

Blood loss and transfusion of blood products are key concerns during liver transplantation. Whole blood viscoelastic testing (VET) devices have been used to monitor hemostatic function and guide transfusion of blood products in this patient population. The Quantra System with the QStat Cartridge is a new point-of-care, closed-system VET device that measures changes in clot stiffness during coagulation and fibrinolysis using ultrasound detection of resonance. The aim of this multicenter prospective observational study was to evaluate the Quantra System against the ROTEM delta device in monitoring coagulation and fibrinolysis in patients undergoing liver transplantation. One-hundred twenty-five (125) adult subjects (>18 y old) were enrolled across 5 medical centers in the United States. Blood samples were collected at a minimum of 3 time points: pre-incision (baseline), during the anhepatic phase, and after the start of reperfusion. Performance was assessed as the correlation of equivalent measurements from the QStat Cartridge and ROTEM delta INTEM, EXTEM, and FIBTEM assays. In addition, a clinical concordance analysis was performed to assess the agreement between the two devices related to detection of fibrinolysis. The correlation between the two VET devices was strong, with r-values ranging between 0.88 and 0.95, and the overall agreement with respect to detecting fibrinolysis was 90.3% (C.I.: 86.9% - 93.2%). The results indicate that the Quantra with the QStat Cartridge provides comparable information as the ROTEM delta in the assessment of hemostatic function during liver transplant. The Quantra’s simplicity of use and availability of rapid results may provide clinicians with a faster, more convenient means to assess coagulation and fibrinolysis status in the operating room and critical care setting.

Background: Artificial intelligence (AI) is increasingly influencing medical student education, with AI-driven chatbots, such as ChatGPT, emerging as powerful study tools. While these technologies offer numerous benefits, they also pose challenges that warrant the adaptation of medical school curricula. Objective: This study examines medical students’ perceptions and use of ChatGPT. We hypothesize that ChatGPT is widely used for academic support, but concerns remain regarding reliability and academic integrity. Methods: We conducted a cross-sectional study from August 25 to December 10, 2024, in the United States. Students in all years of medical training who were enrolled in accredited allopathic or osteopathic medical schools were eligible to participate. Data were collected using an anonymous online questionnaire, which was distributed through institutional mailing lists. Overall, 188 schools were reached, of which 14 (7.4%) responded and agreed to distribute the survey. A total of 177 participants completed the survey. Survey items consisted primarily of Likert-scale and multiple-choice questions. Primary outcome measures included self-reported frequency of ChatGPT use, perceived usefulness of ChatGPT, and ChatGPT use habits. Results: Overall, 98.9% (175/177) of participants had heard of ChatGPT, with 88.7% (157/177) reporting having used it; 62.7% (111/177) identified as female, and 52% (92/177) had completed at least 1 block of clinical rotations. Medical students most often used ChatGPT to understand complex medical concepts, prepare for exams, and generate study materials. Moreover, 46.5% (73/157) used it to help complete medical school assignments. Medical students also reported using it clinically, with the most common use being to generate differential diagnoses. Notably, 21.0% (33/157) of participants responded having used ChatGPT to help write clinical notes. Moreover, 73.9% (116/157) reported that their experience with ChatGPT improved their overall perception of AI’s potential to assist in medical practice, and 86.6% (135/157) believed that having ChatGPT as a resource would make them more effective physicians. Statistical analyses were performed using the Pearson chi-square test with α=.05. Students who reported moderate or advanced baseline understanding of AI were more likely to practice conscientious use habits, such as cross-checking (odds ratio [OR] 2.31, 95% CI 1.08-4.97) and editing (OR 2.45, 95% CI 1.05-5.71) ChatGPT output before using it, than those who reported a basic or limited understanding. Conclusions: Our study is among the few to examine medical student perceptions of ChatGPT at a national level. We examined responsible use habits to identify areas in which reliance on this technology may lead users astray. We found that ChatGPT is being used to complete academic assignments and write clinical notes, raising concerns about information verification, AI literacy, patient confidentiality, and ethical use. Together, these findings highlight the need for structured AI education to help students leverage these technologies effectively while mitigating risks associated with misinformation and overreliance on AI.

Background: Trauma-induced coagulopathy (TIC) occurs in a quarter of trauma patients and is associated with death due to uncontrolled bleeding. Current guidelines recommend viscoelastic testing (VET) to assess coagulopathy and guide transfusions. The Quantra with the QStat Cartridge is a point-of-care (POC) VET device that measures changes in clot stiffness (CS) during coagulation and fibrinolysis using ultrasound detection of resonance. This study aimed to evaluate the performance of the QStat Cartridge in trauma patients compared with rotational thromboelastometry (ROTEM) delta and thromboelastography (TEG) 6s VET devices. Methods: A multicenter prospective observational study was conducted in adult patients meeting criteria for a full trauma team response at eight US level 1 trauma centers. Citrated blood samples drawn on arrival at the hospital or after blood transfusions were analyzed in parallel on QStat, ROTEM or TEG. Correlation between QStat and equivalent VET measurements was assessed by linear regression. Concordance was assessed by agreement of results relative to device-specific normal reference ranges. Results: 259 severely injured patients were enrolled, yielding 271 samples for analysis. Moderate to strong correlations between QStat and corresponding ROTEM and TEG measurements were observed (r=0.64–0.88). The concordance between CS results was 84.5% for QStat CS and EXTEM A10 and 83.3% for CS and citrated rapid TEG maximum amplitude. For fibrinogen-related results, concordance was 81.5% for QStat fibrinogen contribution to clot stiffness (FCS) and FIBTEM A10 and 93.8% for FCS and citrated functional fibrinogen maximum amplitude. For fibrinolysis measurements, the overall agreement between QStat clot stability to lysis and EXTEM ML or CK-LY30 was 97.5% and 92.9%, respectively. Conclusion: QStat provides comparable information to the ROTEM delta and TEG 6s in trauma patients and can be useful for diagnosing TIC and guiding treatment. The Quantra’s simplicity of use, ability to deploy at the POC, and rapid availability of results may provide clinicians with a faster, more convenient means to assess and manage TIC. Level of evidence: Diagnostic test, level II. Trial registration number: NCT04312958.

Perioperative Practice Patterns of Anaesthesiologists Surrounding Glucagon-Like Peptide-1 (GLP-1) Agonist Medications - Turkish Journal of Anaesthesiology and Reanimation