A single-cell atlas enables mapping of homeostatic cellular shifts in the adult human breast.

Here we use single-cell RNA sequencing to compile a human breast cell atlas assembled from 55 donors that had undergone reduction mammoplasties or risk reduction mastectomies. From more than 800,000 cells we identified 41 cell subclusters across the epithelial, immune and stromal compartments. The contribution of these different clusters varied according to the natural history of the tissue.

Incidental Perforation of Aortic Valve Leaflet Found on Presentation of Cardiogenic Shock.

Aortic regurgitation (AR) is grouped into acute or chronic AR. Acute AR, unlike chronic AR, can manifest with significant hemodynamic compromise. Acute AR is typically due to endocarditis or aortic dissection, and less commonly due to blunt trauma or iatrogenic causes.

July effect in clinical outcomes of esophagogastroduodenoscopy performed at teaching hospitals in the United States.

Background: Esophagogastroduodenoscopy (EGD) is a common procedure used for both diagnosis and treatment, but carries risks such as bleeding and perforation. The "July effect"-described as increased complication rates during the transition of new trainees-has been studied in other procedures, but has not been thoroughly evaluated for EGD.

Methods: We used the National Inpatient Sample database for 2016 to 2018 to compare outcomes in EGD performed between July to September and April to June.

Predictors of intent to utilize the emergency department among a free clinic's patients.

Objective: Primary care use helps reduce utilization of more expensive modes of care, such as the emergency department (ED). Although most studies have investigated this association among patients with insurance, few have done so for patients without insurance. We used data from a free clinic network to assess the association between free clinic use and intent to use the ED.

Ice nucleation in a Gram-positive bacterium isolated from precipitation depends on a polyketide synthase and non-ribosomal peptide synthetase.

Earth's radiation budget and frequency and intensity of precipitation are influenced by aerosols with ice nucleation activity (INA), i.e., particles that catalyze the formation of ice.

Innovation in resuscitation: A novel clinical decision display system for advanced cardiac life support.

Introduction: The Advanced Cardiac Life Support (ACLS) Clinical Decision Display System (CDDS) is a novel application designed to optimize team organization and facilitate decision-making during ACLS resuscitations. We hypothesized that resuscitation teams would more consistently adhere to ACLS guideline time intervals in simulated resuscitation scenarios with the CDDS compared to without.

Methods: We conducted a simulation-based, non-blinded, randomized, crossover-design study with resuscitation teams comprised of Emergency Medicine physicians, registered nurses, critical care technicians, and paramedics.

The greater snow goose Anser caerulescens atlanticus: Managing an overabundant population.

Between the early 1900s and the 1990s, the greater snow goose Anser caerulescens atlanticus population grew from 3000 individuals to more than 700 000. Because of concerns about Arctic degradation of natural habitats through overgrazing, a working group recommended the stabilization of the population. Declared overabundant in 1998, special management actions were then implemented in Canada and the United States.

Effect of investigator observation on gait parameters in individuals with and without chronic low back pain.

Despite the ubiquity of gait assessment in clinic and research, it is unclear how observation impacts gait, particularly in persons with chronic pain and psychological stress. We compared temporal spatial gait patterns in people with and without chronic low back pain (CLBP) when they were aware and unaware of being observed. This was a repeated-measures, deception study in 55 healthy persons (32.

Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients.

Background: Shoulder pain and loss of function are directly associated with obesity.

Questions/purposes: We hypothesized that significant interactions would exist between total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RSA) and obesity status on functional and quality of life (QOL) outcomes over the long term. Clinical and QOL outcomes (American Shoulder and Elbow Surgeons Evaluation form, Shoulder Pain and Disability Index, University of California at Los Angeles Shoulder Rating scale, Medical Outcomes Short Form 12 (SF-12), range of motion (ROM), and strength) were longitudinally compared in patients with low and high body mass index (BMI) after a TSA or a RSA.

Anthropocene streams and base-level controls from historic dams in the unglaciated mid-Atlantic region, USA.

Recently, widespread valley-bottom damming for water power was identified as a primary control on valley sedimentation in the mid-Atlantic US during the late seventeenth to early twentieth century. The timing of damming coincided with that of accelerated upland erosion during post-European settlement land-use change. In this paper, we examine the impact of local drops in base level on incision into historic reservoir sediment as thousands of ageing dams breach.

Seasonal variation in growth of greater snow goose goslings: the role of food supply.

Even though growth rate is an important fitness component, it is still controversial to what extent parent birds adjust the timing of offspring hatch to natural variations in food supply to maximize offspring growth. We studied the role of food availability in explaining inter- and intra-seasonal variation of growth rate in goslings of greater snow geese over 5 years. The peak of hatching generally coincided with the peak of food availability.