Lightning Can Strike Twice: Management of an Infant With Anomalous Left Coronary Artery from the Pulmonary Artery Complicated by Coccidioidomycosis Infection.

Cardiac disease in young children can be unrecognized until symptoms are unmasked by a precipitating event, such as an infection. We present a case of anomalous left coronary artery from the pulmonary artery causing clinically significant disease in a four-month-old male with concomitant mitral regurgitation and pulmonary coccidioidomycosis who required modification of his surgical management due to the infection. This case highlights how timely diagnosis and perioperative management and recovery can be affected by concurrent infections in patients with congenital heart disease.

nsP2 Protease Inhibitor Blocks the Replication of New World Alphaviruses and Offer Protection in Mice.

New World alphaviruses, including Venezuelan equine encephalitis virus (VEEV), eastern equine encephalitis virus (EEEV), and western equine encephalitis virus (WEEV), are mosquito-transmitted viruses that cause disease in humans. These viruses are endemic to the western hemisphere, and disease in humans may lead to encephalitis and long-term neurological sequelae. There are currently no FDA-approved vaccines or antiviral therapeutics available for the prevention or treatment of diseases caused by these viruses.

Plasma cell-free RNA signatures of inflammatory syndromes in children.

Inflammatory syndromes, including those caused by infection, are a major cause of hospital admissions among children and are often misdiagnosed because of a lack of advanced molecular diagnostic tools. In this study, we explored the utility of circulating cell-free RNA (cfRNA) in plasma as an analyte for the differential diagnosis and characterization of pediatric inflammatory syndromes. We profiled cfRNA in 370 plasma samples from pediatric patients with a range of inflammatory conditions, including Kawasaki disease (KD), multisystem inflammatory syndrome in children (MIS-C), viral infections, and bacterial infections.

Implementation of an "opt-out" tobacco treatment program in six hospitals in South Carolina.

Objective: Describe the screening, referral, and treatment delivery associated with an opt-out tobacco treatment program (TTP) implemented in six hospitals varying in size, rurality and patient populations.

Methods: Between March 6, 2021 and December 17, 2021, adult patients (≥ 18 years) admitted to six hospitals affiliated with the Medical University of South Carolina were screened for smoking status. The hospitals ranged in size from 82 to 715 beds.

Cell-free RNA Liquid Biopsy to Monitor Hematopoietic Stem Cell Transplantation.

Hematopoietic Stem Cell Transplantation (HSCT) is one of the oldest and most successful immunotherapies. Yet, despite long-standing success in the use of HSCT for the treatment of blood cancers and severe immune disorders, monitoring post-transplant complications remains a challenge due to a lack of informative diagnostic tests. Here, we investigate the utility of cell-free RNA (cfRNA) in plasma as a liquid biopsy to monitor allogeneic HSCT recipients during and after treatment.

Implementation, enrollment, and engagement in an opt-out telehealth pharmacist-assisted tobacco treatment program for patients seen in oncology outpatient clinics.

Objective: To describe the workflow, reach, cost, and self-reported quit rates for an opt-out tobacco treatment program (TTP) for patients seen in 43 oncology outpatient clinics.

Methods: Between May 25, 2021, and December 31, 2022, adult patients (≥18 years) visiting clinics affiliated with the Medical University of South Carolina Hollings Cancer Center were screened for smoking status. Those currently smoking were referred to a telehealth pharmacy-assisted TTP.

Visual outcomes following orbital decompression for orbital infections.

Objective: To analyze the visual outcomes and sequelae of endonasal intervention for orbital infections.

Introduction: Orbital infections pose a serious threat to vision in the pediatric population and can result in complications such as blindness, diplopia, intracranial involvement, and death. [1] Orbital decompression by endonasal intervention is a common treatment to address a variety of orbital infections including orbital cellulitis, orbital abscesses, and subperiosteal abscesses.

Passive microwave Arctic sea ice melt onset dates from the advanced horizontal range algorithm 1979-2022.

The onset of the summer melt season is a key stage of the Arctic sea ice seasonal cycle and is an indicator of climate change. Surface melting of the bare or snow-covered sea ice is detected using passive microwave satellite observations. The data set presented here is a 44 year record of Arctic sea ice annual melt onset (MO) dates for 1979-2022 produced using an updated version of the Advanced Horizontal Range Algorithm (AHRA).

Implementation of an "Opt-Out" Tobacco Treatment Program in Six Hospitals in South Carolina.

Objective: To describe the implementation an opt-out tobacco treatment program (TTP) in 6 diverse hospitals located in different regions of South Carolina.

Methods: Between March 8, 2021 and December 17, 2021, adult patients (≥ 18 years) admitted to 6 hospitals affiliated with the Medical University of South Carolina (MUSC) were screened for their cigarette status. Patients who smoked cigarettes were referred to an TTP offering a brief bedside consult and automated post-discharge follow-up calls with an opportunity to receive a referral to the South Carolina Quitline (SCQL).

A service evaluation of the impact of parental information provision on analgesia administration at home posttonsillectomy.

Introduction: Tonsillectomy and adenotonsillectomy are together the most common pediatric surgical procedure and are increasingly performed as day cases. Postoperative pain is commonly severe for 1-2 weeks, but parental analgesia concerns lead to poor analgesia prescription compliance and under administration. This service evaluation assessed parental compliance with analgesia, elicited parental concerns, and obtained parental suggestions for improving the current written advice.

Sea ice drift tracks from autonomous buoys in the MOSAiC Distributed Network.

A network of autonomous, ice-tethered buoys was deployed around the Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) experiment in late September 2019 for a year-long drift in the Arctic Transpolar Drift Stream. The buoys were deployed as part of the MOSAiC distributed network (DN) which included 12 multi-instrumented ice stations and an additional 116 GPS buoys distributed primarily within a 40 km radius of the MOSAiC Central Observatory. Buoy coverage within the DN was maintained with additional deployments throughout the year-long drift allowing for collection of data over a full sea ice growth and melt cycle.

Difficult Airway Response Team (DART) and Airway Emergency Outcomes: A Retrospective Quality Improvement Study.

Objective: Difficult airways can be associated with significant morbidity and mortality, particularly in the event of a delay in securing the airway. To improve the airway metrics at our institution, we implemented a multidisciplinary team of airway providers to respond to difficult and emergent airways, or the Difficult Airway Response Team (DART). The purpose of the present study is to assess the feasibility of a DART program at a tertiary care center.

Headaches in a Horseback Rider.

An immunocompetent woman presented with headaches. She previouslyworked at a farm in upstate New York. Brain MRI noted pituitary enlargement and neurosurgerypursued trans-sphenoidal pituitary biopsy.

Local Allergen-Specific IgE Production in Turbinate Tissue of Pediatric Patients.

Objectives: The objective of this study is to compare serum allergen-specific IgE to IgE levels in nasal tissue taken from the inferior turbinates of pediatric patients undergoing turbinate reduction.

Methods: Twenty-six pediatric patients were recruited at the time of turbinate reduction surgery. At the time of recruitment, parents of patients completed the validated 22 item Sinonasal Outcome Test (SNOT-22) to describe symptoms prior to surgery.

Characteristics associated with caregiver willingness to consider tonsillectomy for a child's obstructive sleep disordered breathing: Findings from a survey of families in an urban primary care network.

Objective: Tonsillectomy use is lower among Black children than White children in the U.S. despite their higher prevalence of obstructive sleep disordered breathing (oSDB).

The influence of pain, kinesiophobia and psychological comorbidities on the accuracy of rating of perceived exertion in UK military spinal rehabilitation.

Introduction: Chronic low back pain (CLBP) is a leading cause of disability in the UK Military. Pain and psychological comorbidities have been reported to influence the rating of perceived exertion (RPE). Exercise rehabilitation can be monitored using RPE; however, the accuracy of RPE in inpatient CLBP rehabilitation is unknown.

Projected land ice contributions to twenty-first-century sea level rise.

The land ice contribution to global mean sea level rise has not yet been predicted using ice sheet and glacier models for the latest set of socio-economic scenarios, nor using coordinated exploration of uncertainties arising from the various computer models involved. Two recent international projects generated a large suite of projections using multiple models, but primarily used previous-generation scenarios and climate models, and could not fully explore known uncertainties. Here we estimate probability distributions for these projections under the new scenarios using statistical emulation of the ice sheet and glacier models.

Predicting middle-distance track and cross-country performances of national and international level adolescent runners.

This study evaluated the contribution of physiological data collected during laboratory testing in predicting race performances of trained junior middle-distance track (TK) and cross-country (XC) athletes. Participants performed a submaximal incremental ramp test, followed by an incremental test to exhaustion in a laboratory, with the results used to predict either 800 m TK, 1500 m TK or 4000-6000 m XC race performance. Twenty-eight participants (male (M), 15; female (F), 13) were analysed (age = 17 ± 2 years, height = 1.

Variability and physical demands of international seam bowlers in one-day and Twenty20 international matches across five years.

Objectives: To quantify and compare the match demands and variability of international One-Day (ODI) with Twenty20 (T20) cricket matches and to compare ODI match demands when competing home and away.

Design: Single cohort, longitudinal observation.

Methods: Thirteen international male seam bowlers across 204matches (ODI=160; T20=44) were investigated over five-years (2015-2019).

Early bioprosthetic tricuspid valve stenosis due to size mismatch in Ebstein anomaly-Successful transcatheter treatment.

Patients with congenital heart disease are surviving well into adulthood thanks to advances in medical and clinical care. We present a patient with Ebstein anomaly who underwent surgical tricuspid valve replacement and suffered early valve stenosis due to her unique anatomy. This case highlights the importance of the "unnatural" anatomy that can be encounter in this challenging patient population.

Oculocardiac Reflex in A 15-Year-Old With Orbital Fractures and Epidural Hematoma.

The oculocardiac reflex has been well described in the literature and was first defined in 1908 by Aschner. The phenomenon involves the afferent limb of the ophthalmic division of the trigeminal nerve as well as the efferent pathway involving the vagal nerve leading to negative chronotropic effects. It results in a decrease in heart rate and oftentimes a decrease in blood pressure associated with compression of the eye or traction of the extraocular muscles.

Systematic Review of the Effects of Phosphodiesterase-5 Inhibitors and Dexamethasone on High Altitude Pulmonary Edema (HAPE).

Objective: To review and synthesize the current available evidence of the effects of phosphodiesterase-5 inhibitors and dexamethasone on the outcomes of individuals affected by acute mountain sickness symptoms and High Altitude Pulmonary Edema (HAPE).

Methods: In 2015, two authors independently performed separate searches using three different databases (PubMed, Ovid and Web of Science) later reviewed by the third author. The searches used the following terms "High Altitude Pulmonary Edema" and "Phosphodiesterase-5 Inhibitors" while the second search used "High Altitude Pulmonary Edema" and "Dexamethasone".

A comparison of two global positioning system devices for team-sport running protocols.

The comparability and reliability of global positioning system (GPS) devices during running protocols associated with team-sports was investigated. Fourteen moderately-trained males completed 690 m of straight-line movements, a 570 m change of direction (COD) course and a 642.5 m team-sport simulated circuit (TSSC); on two occasions.