One Dose Versus Two Doses of Intravenous Tranexamic Acid in Total Joint Arthroplasty.

Introduction: Despite its widespread use, a single formulation or dosing regimen of tranexamic acid (TXA) has not been universally agreed on for total joint arthroplasty. The purpose of this study is to compare previously uninvestigated single-dose and two-dose regimens in postoperative hemoglobin level and secondary outcomes within 30 days of surgery.

Methods: A retrospective search of our institution's database of patients who underwent primary total knee arthroplasty and primary total hip arthroplasty between January 1, 2017, and July 1, 2019, was performed.

The Effect of Acute Hypohydration on Indicators of Glycemic Regulation, Appetite, Metabolism and Stress: A Systematic Review and Meta-Analysis.

Evidence synthesizing the effects of acute body water losses on various markers of glycemic regulation, appetite, metabolism, and stress is lacking. Thus, the purpose of this review was to summarize the response of various hormonal changes involved in these physiologic functions to dehydration. A comprehensive literature search for peer-reviewed research in the databases PubMed, Scopus, CINAHL, and SportDiscus was conducted.

Influence of State-Level Emergency Planning Policy Requirements on Secondary School Adoption.

Context: Emergency action plans (EAPs) are a critical component in the management of catastrophic sport-related injury. Some state high school athletics associations and state legislation have required that schools develop EAPs, but little research exists on the influence of a statewide policy requirement on local adoption of these policies.

Objective: To examine the efficacy of a statewide policy requirement on local adoption of an EAP.

The potential for salt toxicity: Can the trans-epithelial potential (TEP) across the gills serve as a metric for major ion toxicity in fish?

An emerging Multi-Ion Toxicity (MIT) model for assessment of environmental salt pollution is based on the premise that major ion toxicity to aquatic organisms is related to a critical disturbance of the trans-epithelial potential across the gills (ΔTEP), which can be predicted by electrochemical theory. However, the model has never been evaluated physiologically. We directly tested key assumptions by examining the individual effects of eight different salts (NaCl, NaSO, MgCl, MgSO, KCl, KSO, CaCl, and CaSO) on measured TEP in three different fish species (fathead minnow, Pimephales promelas = FHM; channel catfish, Ictalurus punctatus = CC; bluegill, Lepomis macrochirus = BG).

Zeaxanthin and Lutein: Photoprotectors, Anti-Inflammatories, and Brain Food.

This review compares and contrasts the role of carotenoids across the taxa of life-with a focus on the xanthophyll zeaxanthin (and its structural isomer lutein) in plants and humans. Xanthophylls' multiple protective roles are summarized, with attention to the similarities and differences in the roles of zeaxanthin and lutein in plants versus animals, as well as the role of -zeaxanthin in humans. Detail is provided on the unique control of zeaxanthin function in photosynthesis, that results in its limited availability in leafy vegetables and the human diet.

Unintended consequences of institutionalizing peer support work in mental healthcare.

The widespread shift towards recovery-oriented mental healthcare has led to the extensive growth of peer-delivered services. Peer support workers draw on lived experience of mental health challenges and service use to provide non-clinical support services. As peer support services have grown, they have also formalized.

Evaluating Postoperative Outcomes of Patients Undergoing Elective Procedures in an Ambulatory Surgery Center During the COVID-19 Pandemic.

Background: Despite the rapid increase in the number of publications pertaining to COVID-19, there is a lack of data examining patient outcomes following elective procedures performed during this pandemic.

Objectives: The purpose of this investigation was to examine the postoperative outcomes of patients who underwent elective procedures in an ambulatory surgery center during the COVID-19 pandemic, and to share the preoperative screening and patient selection protocol implemented in our center.

Methods: Elective procedures performed in an ambulatory surgery center between March 1, 2020 and April 16, 2020 were retrospectively reviewed.

Gradual decline in outpatient antibiotic prescriptions in paediatrics: A data warehouse-based 11-year cohort study.

Aim: To describe trends in antibiotic (AB) prescriptions in children in primary care over 11 years, using a large data warehouse.

Methods: A retrospective cohort study assessed outpatient AB prescriptions 2007-2017, using the Massachusetts Health Disparities Repository. The evolution of paediatric outpatient AB prescriptions was assessed using time-series analyses through annual per cent change (APC) for the population and for children with or without comorbid condition.

Improving HPV Vaccination Rates: A Stepped-Wedge Randomized Trial.

Objectives: To evaluate the effectiveness of a stepped-wedge randomized trial of Development of Systems and Education for Human Papillomavirus Vaccination (DOSE HPV), a multilevel intervention.

Methods: DOSE HPV is a 7-session program that includes interprofessional provider education, communication training, data feedback, and tailored systems change. Five primary care pediatric and/or family medicine practices completed interventions between 2016 and 2018; all chose to initiate vaccination at ages 9 to 10.

Chemogenetic inhibition of dopaminergic projections to the nucleus accumbens has sexually dimorphic effects in the rat gambling task.

Women and men can differ in their propensity to take risks and develop impulse control and addiction disorders. Sexual dimorphisms in behavioral control by the mesolimbic dopaminergic reward system may underlie these phenomena, given its sensitivity to gonadal hormones. However, this is hard to test experimentally using humans.

A novel telemedicine technique for evaluation of ocular exam findings via smartphone images.

In this study, we compared the assessment of remote smartphone photographs to in-office exams in the diagnosis of two groups of external eye diseases, red-eye pathology and post-operative eyelid surgery complications. Participants were examined and received an in-office diagnosis by either a corneal or oculoplastic specialist. After viewing an educational video on smartphone photography, the patient's companion then took a series of standardized photographs.

Updated Multiple Linear Regression Models for Predicting Chronic Aluminum Toxicity to Freshwater Aquatic Organisms and Developing Water Quality Guidelines.

Multiple linear regression (MLR) models for predicting chronic aluminum toxicity to a cladoceran (Ceriodaphnia dubia) and a fish (Pimephales promelas) as a function of 3 toxicity-modifying factors (TMFs)-dissolved organic carbon (DOC), pH, and hardness-have been published previously. However, the range over which data for these TMFs were available was somewhat limited. To address this limitation, additional chronic toxicity tests with these species were subsequently conducted to expand the DOC range up to 12 mg/L, the pH range up to 8.

Growth and Essential Carotenoid Micronutrients in as a Function of Growth Light Intensity.

Duckweed is a promising food crop with multiple benefits for space applications. Fresh duckweed could deliver synergistically acting essential antioxidant nutrients to a crew - but only if growth conditions provide the plant with the right cues to trigger antioxidant formation. We grew under continuous growth light ranging from low to very high intensities (photosynthetic photon flux densities = PPFDs) in order to investigate the effect on plant growth, photosynthesis, and level of carotenoid antioxidants that are essential human micronutrients.

Momentary Physical Activity Co-Occurs with Healthy and Unhealthy Dietary Intake in African American College Freshmen.

Research investigating interrelations between physical activity and dietary intake has primarily used retrospective, summary-based measures of behavior subject to increased recall bias. This study used ecological momentary assessment (EMA) methods with accelerometry to determine within-day, momentary associations between physical activity and dietary intake behaviors in African American college freshmen. Methods: Participants ( = 50) completed a dietary EMA protocol that assessed food/fluids consumed over the past 2 h at five random times per day and wore an activPAL accelerometer for 7 days to measure physical activity.

Exploring Opportunities for Household-Level Chronic Care Management Using Linked Electronic Health Records of Adults and Children: A Retrospective Cohort Study.

Objective: Linking electronic health records (EHR) of pediatric and adult patients living in the same household has the potential to improve chronic care management efficiencies by facilitating the delivery of services to multiple household members at once. However, little is known about relationship between the chronic medical (CM) and behavioral health (CBH) of adults and children living in common households.

Methods: EHR data for children were linked to the EHR data of adults living at the same address during the same time in a retrospective cohort study from 2006 to 2014 to evaluate associations between adult and child CM and CBH conditions within a Boston safety-net primary care patient sample.

Racial and Sex Differences in 24 Hour Urinary Hydration Markers among Male and Female Emerging Adults: A Pilot Study.

The purpose of this study was to examine 24 h urinary hydration markers in non-Hispanic White (WH) and non-Hispanic Black (BL) males and females. Thirteen males (BL, = 6; WH, = 7) and nineteen females (BL, = 16, WH, = 3) (mean ± SD; age, 20 ± 4 y; height, 169.2 ± 12.

Stimulation of water and calcium dynamics in astrocytes with pulsed infrared light.

Astrocytes are non-neuronal cells that govern the homeostatic regulation of the brain through ions and water transport, and Ca -mediated signaling. As they are tightly integrated into neural networks, label-free tools that can modulate cell function are needed to evaluate the role of astrocytes in brain physiology and dysfunction. Using live-cell fluorescence imaging, pharmacology, electrophysiology, and genetic manipulation, we show that pulsed infrared light can modulate astrocyte function through changes in intracellular Ca and water dynamics, providing unique mechanistic insight into the effect of pulsed infrared laser light on astroglial cells.

Which Internal Medicine Clerkship Characteristics Are Associated With Students' Performance on the NBME Medicine Subject Exam? A Multi-Institutional Analysis.

Purpose: To identify which internal medicine clerkship characteristics may relate to NBME Medicine Subject Examination scores, given the growing trend toward earlier clerkship start dates.

Method: The authors used linear mixed effects models (univariable and multivariable) to determine associations between medicine exam performance and clerkship characteristics (longitudinal status, clerkship length, academic start month, ambulatory clinical experience, presence of a study day, involvement in a combined clerkship, preclinical curriculum type, medicine exam timing). Additional covariates included number of NBME clinical subject exams used, number of didactic hours, use of a criterion score for passing the medicine exam, whether medicine exam performance was used to designate clerkship honors, and United States Medical Licensing Examination Step 1 performance.

Water Intake, Body Water Regulation and Health.

The biological feedback provided by human water intake upon our physiology is grossly under-investigated [...

Impact of general surgery rotation exposure on surgery clerkship performance.

Background: Medical students often have variable exposures to general surgery (GS) and subspecialty surgery (SS) during their surgical clerkship. We will evaluate the relationship between clinical exposure to GS and performance on the NBME Subject Examination in Surgery.

Methods: Student data was collected retrospectively from 2015 to 2018 at a single academic institution.