Dose-dependent relationship between levothyroxine and health-related quality of life in survivors of differentiated thyroid cancer.

Background: Long-term survival for patients with differentiated (papillary, follicular, and Hürthle cell) thyroid cancer exceeds 95% but self-reported health-related quality of life scores remain low compared with survivors of cancers with worse prognoses. There are reports that thyroid hormone replacement therapy is associated with lower health-related quality of life. This hypothesis was tested in a sample of Medicare Advantage survivors of differentiated thyroid cancer.

A Qualitative Study Defining Perspectives on Rurality and Surgery From Midwestern Medical Schools.

Introduction: Rural general surgery faces a crisis as more surgeons undergo fellowship training and then practice in metropolitan areas, leaving rural Americans with decreasing surgical care. This study aims to identify how hometown rurality affects medical students' current level of knowledge and potential educational gaps within their understanding of the definition, benefits, and challenges of rural general surgery to define the need for enhanced education within medical schools.

Methods: In Spring 2021, 11 Midwestern medical schools participated in an electronic survey.

Altered extracellular matrix and mechanotransduction gene expression in rat bone tissue following long-term estrogen deficiency.

Osteoporosis is primarily associated with bone loss, but changes in bone tissue matrix composition and osteocyte mechanotransduction have also been identified. However, the molecular mechanisms underlying these changes and their relation to bone loss are not fully understood. The objectives of this study were to (1) conduct comprehensive temporal gene expression analyses on cortical bone tissue from ovariectomized rats, with a specific focus on genes known to govern matrix degradation, matrix production, and mechanotransduction, and (2) correlate these findings with bone mass, trabecular and cortical microarchitecture, and mineral and matrix composition.

Transverse Myelitis as a Presenting Symptom of Celiac Disease.

Celiac disease (CD) is associated with several neurological diseases. We report a case of a 25-year-old man with CD that was discovered during hospitalization for acute transverse myelitis. The diagnosis of CD was suspected after positive serological tests and was confirmed with duodenal biopsy.

Bacteriophages from human skin infecting coagulase-negative Staphylococcus: diversity, novelty and host resistance.

The human skin microbiome comprises diverse populations that differ temporally between body sites and individuals. The virome is a less studied component of the skin microbiome and the study of bacteriophages is required to increase knowledge of the modulation and stability of bacterial communities. Staphylococcus species are among the most abundant colonisers of skin and are associated with both health and disease yet the bacteriophages infecting the most abundant species on skin are less well studied.

Wake up to gastro-oesophageal reflux disease: The interplay between arousal and night-time reflux.

This review examines the temporal association between nocturnal gastro-oesophageal reflux and sleep-arousal cycles. Most nocturnal gastro-oesophageal reflux events occur during the awake cycle, and arousals precede most nocturnal gastro-oesophageal reflux events, indicating that arousal from sleep predisposes to nocturnal gastro-oesophageal reflux. This sheds light on the complex relationship between nocturnal gastro-oesophageal reflux and sleep, and has implications for managing nocturnal gastro-oesophageal reflux symptoms.

Understanding the Impact of Temperate Bacteriophages on Their Lysogens Through Transcriptomics.

Temperate phages are found integrated as prophages in the majority of bacterial genomes. Some prophages are cryptic and fixed in the bacterial chromosome, but others are active and can be triggered into a replicative form either spontaneously or by exposure to inducing factors. Prophages are commonly associated with the ability to confer toxin production or other virulence-associated traits on their host cell.

Let's Move with Leon-A qualitative evaluation of a UK digital intervention to improve physical activity in people with a musculoskeletal condition.

Objective: This article presents a qualitative evaluation of a 13-week digital intervention, 'Let's Move with Leon', designed to improve physical activity in people with a musculoskeletal condition.

Study Design: A qualitative evaluation embedded within a randomised controlled trial assessing the effectiveness of the intervention at improving self-reported physical activity.

Methods: A total of 184 participants received the intervention and were asked each week for 13 weeks to provide comment on their use and the usefulness of the digital physical activity behaviour change intervention.

Outcomes of Preoperative Medical Therapy for Thyroidectomy in Autoimmune Thyroid Disease.

Introduction: Thyroidectomy provides definitive treatment for autoimmune thyroid disease (AITD) often resulting in improved quality of life. Historically, patients with AITD undergoing thyroidectomy have increased rates of postoperative hypoparathyroidism and recurrent laryngeal nerve palsy. We investigated the outcomes of preoperative medications in patients with AITD undergoing thyroidectomy.

Efficient screening of adsorbed receptors for phage LP31 and identification of receptor-binding protein.

The adsorption process is the first step in the lifecycle of phages and plays a decisive role in the entire infection process. Identifying the adsorption mechanism of phages not only makes phage therapy more precise and efficient but also enables the exploration of other potential applications and modifications of phages. Phage LP31 can lyse multiple serotypes, efficiently clearing biofilms formed by serovar Enteritidis (.

A national study confirms that Escherichia coli from Australian commercial layer hens remain susceptible to critically important antimicrobials.

Controlling the use of the most critically important antimicrobials (CIAs) in food animals has been identified as one of the key measures required to curb the transmission of antimicrobial resistant bacteria from animals to humans. Expanding the evidence demonstrating the effectiveness of restricting CIA usage for preventing the emergence of resistance to key drugs amongst commensal organisms in animal production would do much to strengthen international efforts to control antimicrobial resistance (AMR). As Australia has strict controls on antimicrobial use in layer hens, and internationally comparatively low levels of poultry disease due to strict national biosecurity measures, we investigated whether these circumstances have resulted in curtailing development of critical forms of AMR.

Nontechnical Skills for Surgeons as a Framework to Evaluate Cardiopulmonary Bypass Management Skills of Resident Trainees.

Background: Nontechnical skills are critical in cardiac surgery but currently there is no formal paradigm to teach these in residency training. We investigated the use of the Nontechnical skills for surgeons (NOTSS) system as a framework to assess and teach nontechnical skills related to cardiopulmonary bypass (CPB) management.

Methods: Single-center retrospective analysis of Integrated and Independent pathway thoracic surgery residents who participated in dedicated nontechnical skills evaluation and training.

A missing dusk-side loss process in the terrestrial electron ring current.

The Earth's magnetic field traps charged particles which are transported longitudinally around Earth, generating a near-circular current, known as the ring current. While the ring current has been measured on the ground and space for many decades, the enhancement of the ring current during geomagnetic storms is still not well understood, due to many processes contributing to its dynamics on different time scales. Here, we show that existing ring current models systematically overestimate electron flux observations of 10-50 keV on the nightside during storm onset.

Second Opinions in Breast Cancer Surgery: What Have We Learned?

Introduction Second-opinion consultations (SOCs) provide many benefits. However, duplicate office visits and the logistics of transferring medical records may be concerning for delaying treatment. There is currently no clear understanding regarding the characteristics of patients with breast cancer who desire second surgical opinions or if this contributes to delays in care.

Homogeneous, Micron-Scale High-Energy-Density Matter Generated by Relativistic Laser-Solid Interactions.

Short-pulse, laser-solid interactions provide a unique platform for studying complex high-energy-density matter. We present the first demonstration of solid-density, micron-scale keV plasmas uniformly heated by a high-contrast, 400 nm wavelength laser at intensities up to 2×10^{21}  W/cm^{2}. High-resolution spectral analysis of x-ray emission reveals uniform heating up to 3.

Demographics and medical school exposures to rural health influence future practice.

Background: One-fifth of the US population lives in rural areas. A record number of rural hospitals have closed, creating increased burdens on regional centers and delays in care. This study aimed to assess medical student perceptions of rural surgery and health care, and to elucidate influential factors for future practice.

Depletions of Multi-MeV Electrons and Their Association to Minima in Phase Space Density.

Fast-localized electron loss, resulting from interactions with electromagnetic ion cyclotron (EMIC) waves, can produce deepening minima in phase space density (PSD) radial profiles. Here, we perform a statistical analysis of local PSD minima to quantify how readily these are associated with radiation belt depletions. The statistics of PSD minima observed over a year are compared to the Versatile Electron Radiation Belts (VERB) simulations, both including and excluding EMIC waves.

Uncovering the Overlap of Global and Domestic Rural Surgery for Medical Trainees.

Introduction: Medical trainees who participate in global rotations demonstrate improved cultural sensitivity, increased involvement in humanitarian efforts, and ability to adapt to limited resources. The global coronavirus pandemic halted global rotations for medical trainees. Domestic rural surgery (DRS) may offer a unique alternative.

Temporal changes in cortical microporosity during estrogen deficiency associated with perilacunar resorption and osteocyte apoptosis: A pilot study.

Osteocytes can actively regulate bone microporosity, through either perilacunar resorption or micropetrosis following apoptosis. Osteocyte apoptosis is more prevalent in estrogen deficiency and changes in the lacunar-canalicular network of osteocytes have been reported. Temporal changes in bone mineralisation and osteocytes cellular strains occur, which might be associated with osteocyte-driven microporosity changes, although time dependant changes in bone microporosity are not yet fully understood.

Naloxegol to Prevent Constipation in ICU Adults Receiving Opioids: A Randomized Double-Blind Placebo-Controlled Pilot Trial.

Background: Constipation is frequent in critically ill adults receiving opioids. Naloxegol (N), a peripherally acting mu-receptor antagonist (PAMORA), may reduce constipation. The objective of this trial was to evaluate the efficacy and safety of N to prevent constipation in ICU adults receiving opioids.

Amoebicidal Activity of Poly-Epsilon-Lysine Functionalized Hydrogels.

Purpose: To determine the amoebicidal activity of functionalized poly-epsilon-lysine hydrogels (pɛK+) against Acanthamoeba castellanii.

Methods: A. castellanii trophozoites and cysts were grown in the presence of pɛK solution (0-2.

Tracing the fate of wastewater viruses reveals catchment-scale virome diversity and connectivity.

The discharge of wastewater-derived viruses in aquatic environments impacts catchment-scale virome composition. To explore this, we used viromic analysis of RNA and DNA virus-like particles to holistically track virus communities entering and leaving wastewater treatment plants and the connecting river catchment system and estuary. We reconstructed >40 000 partial viral genomes into 10 149 species-level groups, dominated by dsDNA and (+)ssRNA bacteriophages (Caudoviricetes and Leviviricetes) and a small number of genomes that could pose a risk to human health.

Biomarker Risk Score Algorithm and Preoperative Stratification of Patients with Pancreatic Cystic Lesions.

Background: Pancreatic cysts are incidentally detected in up to 13% of patients undergoing radiographic imaging. Of the most frequently encountered types, mucin-producing (mucinous) pancreatic cystic lesions may develop into pancreatic cancer, while nonmucinous ones have little or no malignant potential. Accurate preoperative diagnosis is critical for optimal management, but has been difficult to achieve, resulting in unnecessary major surgery.

Millijoule few-cycle pulses from staged compression for strong and high field science.

Intense few-cycle laser pulses have a breadth of applications in high energy density science, including particle acceleration and x-ray generation. Multi-amplifier laser system pulses have durations of tens of femtoseconds or longer. To achieve high intensities at the single-cycle limit, a robust and efficient post-compression scheme is required.

Gyroresonant wave-particle interactions with chorus waves during extreme depletions of plasma density in the Van Allen radiation belts.

The Van Allen Probes mission provides unique measurements of the most energetic radiation belt electrons at ultrarelativistic energies. Simultaneous observations of plasma waves allow for the routine inference of total plasma number density, a parameter that is very difficult to measure directly. On the basis of long-term observations in 2015, we show that the underlying plasma density has a controlling effect over acceleration to ultrarelativistic energies, which occurs only when the plasma number density drops down to very low values (~10 cm).