Establishing metrics of clinically meaningful change for treating knee osteoarthritis with a combination of autologous orthobiologics.

Autologous bone marrow concentrate (BMC), platelet-rich plasma (PRP), and platelet lysate (PL) have emerged as promising orthobiologic treatment options for knee osteoarthritis (OA). The present observational study reports minimal clinically important difference (MCID) and substantial clinical benefit (SCB) values for several patient-reported outcome measures (PROMs) used to monitor changes in joint pain and function following percutaneous treatment of knee OA with a combination of BMC and platelet products (n = 295 knees). Distribution-based approaches were used to determine 12-month MCID values for the International Knee Documentation Committee (IKDC) subjective, Lower Extremity Functional Scale (LEFS), Numeric Pain Scale (NPS), and modified Single Assessment Numeric Evaluation (SANE) scores.

A randomized trial of postpartum ibuprofen in severe hypertensive disorders of pregnancy.

Background: Ibuprofen has been shown to increase blood pressure in nonpregnant adults with hypertension, but its impact on blood pressure when used for postpartum analgesia in patients with a hypertensive disorder of pregnancy is less clear, particularly for those with severe hypertension.

Objective: To evaluate the impact of ibuprofen on postpartum blood pressure outcomes in patients with hypertensive disorders of pregnancy with severe hypertension.

Study Design: In this randomized, double-blind trial, we randomly assigned patients with hypertensive disorders of pregnancy with severe hypertension to receive a postpartum analgesic regimen consisting of either ibuprofen 600 mg or acetaminophen 650 mg (control) every 6 hours.

Flavonoids and anthocyanins in seagrasses: implications for climate change adaptation and resilience.

Seagrasses are a paraphyletic group of marine angiosperms and retain certain adaptations from the ancestors of all embryophytes in the transition to terrestrial environments. Among these adaptations is the production of flavonoids, versatile phenylpropanoid secondary metabolites that participate in a variety of stress responses. Certain features, such as catalytic promiscuity and metabolon interactions, allow flavonoid metabolism to expand to produce novel compounds and respond to a variety of stimuli.

Macroevolution along developmental lines of least resistance in fly wings.

Evolutionary change requires genetic variation, and a reigning paradigm in biology is that rates of microevolution can be predicted from estimates of available genetic variation within populations. However, the accuracy of such predictions should decay on longer evolutionary timescales, as the influence of genetic constraints diminishes. Here we show that intrinsic developmental variability and standing genetic variation in wing shape in two distantly related flies, Drosophila melanogaster and Sepsis punctum, are aligned and predict deep divergence in the dipteran phylogeny, spanning >900 taxa and 185 million years.

Chromosomal genome assembly resolves drug resistance loci in the parasitic nematode Teladorsagia circumcincta.

The parasitic nematode Teladorsagia circumcincta is one of the most important pathogens of sheep and goats in temperate climates worldwide and can rapidly evolve resistance to drugs used to control it. To understand the genetics of drug resistance, we have generated a highly contiguous genome assembly for the UK T. circumcincta isolate, MTci2.

Castleman disease presenting as DOTATATE-positive retroperitoneal mass.

Castleman disease is a rare, heterogeneous group of lymphoproliferative disorders whose imaging characteristics can resemble malignancy. We present a case of a patient who initially presented with intermittent hypertension, palpitations, and chest pain. Despite a negative biochemical workup, CT imaging revealed a left retroperitoneal mass intimately associated with the left adrenal gland with 68Ga-DOTATATE positron emission tomography-computed tomography (PET/CT) detecting uptake in the mass as well as several left para-aortic lymph nodes and bone lesions.

Association between change in alcohol use reported during routine healthcare screening and change in subsequent hospitalization: A retrospective cohort study.

Background And Aims: Primary care systems often screen for unhealthy alcohol use with brief self-report tools such as the 3-item Alcohol Use Disorders Identification Test for consumption (AUDIT-C). There is little research examining whether change in alcohol use measured on the AUDIT-C captures meaningful change in outcomes affected by alcohol use. This study aimed to measure the association between change in AUDIT-C and change in all-cause hospitalization risk, measured in the year after each AUDIT-C.

Severe Lymphopenia Predicts Poorer Survival in Patients With Rectal Cancer Undergoing Neoadjuvant Chemoradiation.

Purpose: Chemoradiation-induced lymphopenia is common and associated with poorer survival in multiple solid malignancies. However, the association between chemoradiation-related lymphopenia and survival outcomes in rectal cancer is yet unclear. The objective of this study was to evaluate the prognostic impact of lymphopenia and its predictors in patients with rectal cancer undergoing neoadjuvant chemoradiation.

Life-history adaptation under climate warming magnifies the agricultural footprint of a cosmopolitan insect pest.

Climate change is affecting population growth rates of ectothermic pests with potentially dire consequences for agriculture and global food security. However, current projection models of pest impact typically overlook the potential for rapid genetic adaptation, making current forecasts uncertain. Here, we predict how climate change adaptation in life-history traits of insect pests affects their growth rates and impact on agricultural yields by unifying thermodynamics with classic theory on resource acquisition and allocation trade-offs between foraging, reproduction, and maintenance.

Deep learning model to identify and validate hypotension endotypes in surgical and critically ill patients.

Background: Hypotension is associated with organ injury and death in surgical and critically ill patients. In clinical practice, treating hypotension remains challenging because it can be caused by various underlying haemodynamic alterations. We aimed to identify and independently validate endotypes of hypotension in big datasets of surgical and critically ill patients using unsupervised deep learning.

The nociceptive withdrawal reflex during spinal analgesia in pigs undergoing veno-arterial extracorporeal membrane oxygenation: a prospective observational study.

Introduction: Use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still in the focus of research, in which pigs are commonly involved. During VA-ECMO, cardiovascular parameters are artificially manipulated and therefore not reliable indicators of nociception. Nociceptive withdrawal reflex (NWR) thresholds can be a suitable alternative in such a context.

Self-Reported Comfort and Use of Tobacco Cessation Interventions by Healthcare Providers.

Background The effects of tobacco use create a significant burden on the American healthcare system. The U.S.

Fractures in Oxford unicompartmental knee arthroplasty are associated with a decreased medial keel-cortex distance of the tibial implant.

Purpose: This retrospective single-center study aimed to investigate incidence and risk factors influencing tibial periprosthetic fractures (TPF) in Oxford unicompartmental knee arthroplasty (UKA), with a specific focus on tibial component positioning and sizing.

Methods: A total of 2063 patients with medial UKA using the Oxford® mobile partial knee implant were analyzed between July 2014 and September 2022. Various preoperative and postoperative radiographic parameters determining pre- and postoperative alignment and implant positioning, incidence and characteristics of periprosthetic fractures, and patient demographics were assessed.

Reactivity and Stability of Reduced Ir-Weight TiO-Supported Oxygen Evolution Catalysts for Proton Exchange Membrane (PEM) Water Electrolyzer Anodes.

Reducing the iridium demand in Proton Exchange Membrane Water Electrolyzers (PEM WE) is a critical priority for the green hydrogen industry. This study reports the discovery of a TiO-supported Ir@IrO(OH) core-shell nanoparticle catalyst with reduced Ir content, which exhibits superior catalytic performance for the electrochemical oxygen evolution reaction (OER) compared to a commercial reference. The TiO-supported Ir@IrO(OH) core-shell nanoparticle configuration significantly enhances the OER Ir mass activity from 8 to approximately 150 A g at 1.

The reference window for reduced perturbation of the reference wave in electrical biasing off-axis electron holography.

The perturbation of the reference wave due to electric stray fields represents a major challenge in quantitative electron holographic investigations. By introducing a focused-ion-beam-milled rectangular hole, the reference window, in an area of nearly constant electrostatic potential of the sample, this perturbation can be significantly reduced. The edge of the window forms a closed conducting loop, acting similarly to a Faraday cage, shielding the influence of the stray field on the reference wave to some extent.

Variation in Long-Term Postoperative Mortality Risk by Race/Ethnicity After Major Non-cardiac Surgeries in the Veterans Health Administration.

Background: Few large sample studies have examined whether disparities, as measured by the proxy of race/ethnicity, are observed in long-term mortality after high-risk operations performed in a United States national health system. We compared operation year-related mortality risk by race/ethnicity after high-risk operative interventions among patients receiving care within the VHA.

Methods: From the Veterans Affairs Corporate Data Warehouse and Surgical Quality Improvement Program, data were retrieved for 426,695 patients undergoing high-risk surgical procedures in non-cardiac, general, vascular, thoracic, orthopedic, neurosurgery, and genitourinary specialties between 2000 and 2018.

Extensive transmission and variation in a functional receptor for praziquantel resistance in endemic .

Mass-drug administration (MDA) of human populations using praziquantel monotherapy has become the primary strategy for controlling and potentially eliminating the major neglected tropical disease schistosomiasis. To understand how long-term MDA impacts schistosome populations, we analysed whole-genome sequence data of 570 samples (and the closely related outgroup species, from eight countries incorporating both publicly-available sequence data and new parasite material. This revealed broad-scale genetic structure across countries but with extensive transmission over hundreds of kilometres.