Lisfranc Fracture-dislocation With Extensor Hallucis Brevis Tendon Interposition: A Case Report.

Case: A 14-year-old adolescent girl sustained a Lisfranc fracture-dislocation with an interposed extensor hallucis brevis (EHB) tendon. Following multiple failed attempts at closed reduction in both the emergency department and the operating room, the patient was treated in a staged manner with temporizing closed reduction and percutaneous pinning in improved alignment, followed by definitive open reduction and internal fixation once soft tissues allowed.

Conclusions: Anatomic reduction and stable fixation of Lisfranc injuries is vital to regain stability and reduce the risk of midfoot arthritis and collapse.

When Numbness and Tingling Play a Role-Sexual Function in Compressive Neuropathy.

Purpose: Compressive neuropathies such as carpal tunnel and cubital tunnel syndrome can lead to sensation loss, muscle weakness, joint contractures, and disrupted sleep. The interplay between these conditions and the effect on patients' intimacy is unknown. The purpose of this study was to examine sexual function before and after surgery in patients undergoing carpal tunnel release or cubital tunnel release.

Discovery of VU0467319: an M Positive Allosteric Modulator Candidate That Advanced into Clinical Trials.

Herein we detail the of VU0467319 (VU319), an M Positive Allosteric Modulator (PAM) clinical candidate that successfully completed a Phase I Single Ascending Dose (SAD) clinical trial. VU319 () is a moderately potent M PAM (M PAM EC = 492 nM ± 2.9 nM, 71.

Occupational Noise Exposure in Foot and Ankle Surgery and the Risk of Noise-Induced Hearing Loss.

Background: Occupational exposure to high levels of noise increases the risk of noise-induced hearing loss (NIHL), resulting in significant long-term quality of life implications. Hearing protection is recommended if occupational noise exposure routinely exceeds 85 decibels (dB). The purpose of this study was to determine if foot and ankle surgeons are exposed to excessive levels of noise, thus putting them at an increased risk for NIHL.

Discovery of VU6016235: A Highly Selective, Orally Bioavailable, and Structurally Distinct Tricyclic M Muscarinic Acetylcholine Receptor Positive Allosteric Modulator (PAM).

Herein, we report structure-activity relationship (SAR) studies to develop novel tricyclic M PAM scaffolds with improved pharmacological properties. This endeavor involved a "tie-back" strategy to replace a 5-amino-2,4-dimethylthieno[2,3-]pyrimidine-6-carboxamide core, which led to the discovery of two novel tricyclic cores. While both tricyclic cores displayed low nanomolar potency against both human and rat M and were highly brain-penetrant, the 2,4-dimethylpyrido[4',3':4,5]thieno[2,3-]pyrimidine tricycle core provided lead compound, , with an overall superior pharmacological and drug metabolism and pharmacokinetics (DMPK) profile, as well as efficacy in a preclinical antipsychotic animal model.

Evaluating inter- and intraobserver reliability in radiographic determination of wrist alignment following scaphoid excision and four-corner arthrodesis.

Background: Four-corner arthrodesis is commonly performed for advanced collapse patterns of wrist arthritis. Reduction of the capitolunate (CL) angle during four-corner fusion is crucial to allow for the greatest radiocarpal joint arc of motion. Previous studies demonstrate variable inter- and intraobserver reliability of measuring the CL angle.

Discovery of VU6008677: A Structurally Distinct Tricyclic M Positive Allosteric Modulator with Improved CYP450 Profile.

This Letter details our efforts to develop novel tricyclic muscarinic acetylcholine receptor subtype 4 (M) positive allosteric modulator (PAM) scaffolds with improved pharmacological properties. This endeavor involved a "tie-back" strategy to replace the 3-amino-5-chloro-4,6-dimethylthieno[2,3-]pyridine-2-carboxamide core, which led to the discovery of two novel tricyclic cores: an 8-chloro-9-methylpyrido[3',2':4,5]thieno[3,2-]pyrimidin-4-amine core and 8-chloro-7,9-dimethylpyrido[3',2':4,5]furo[3,2-]pyrimidin-4-amine core. Both tricyclic cores displayed low nanomolar potency against human M and greatly reduced cytochrome P450 inhibition when compared with parent compound .

Analysis of Costs Associated With Increased Length of Stay After Total Joint Arthroplasty at a Single Private Practice.

Introduction: As the demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) increases, so does the financial burden of these services. Despite efforts to optimize spending and bundled care payments, THA and TKA costs still need to be assessed. Our study explores the relationship between perioperative costs and length of stay (LOS) for THA and TKA.

Using monitoring and mechanistic modeling to improve understanding of eutrophication in a shallow New England estuary.

Anthropogenic nutrient loading has resulted in eutrophication and habitat degradation within estuaries. Study of eutrophication in estuaries has often focused on larger systems, while there has been increasing interest in understanding the governing processes in smaller systems. In this study, we incorporate both monitoring data and mechanistic modeling to improve our understanding of eutrophication in a small, shallow New England estuary.

Posterior Interosseous Neuropathy Related to a Loose Distal Biceps Cortical Button: A Case Series.

Posterior interosseous nerve (PIN) injury is an uncommon yet debilitating complication following distal bicep tendon repair. There are case reports of acute intraoperative PIN injury related to retractor placement, drill trajectory, and nerve incarceration. We report three cases of delayed PIN neuropathy in the setting of a loose cortical button.

Early Diet Liberalization After Anterior Lumbar Interbody Fusion Improves Postoperative Recovery.

Study Design: Retrospective Cohort Study.

Objectives: The objective of this study was to assess the impact of diet liberalization on short-term outcomes in patients undergoing anterior interbody lumbar fusion (ALIF).

Methods: A retrospective review was performed for patients undergoing ALIF at our tertiary care center institution from 2010 to 2022.

Trigger Finger Release: Are Sutures Requiring Removal Necessary?

Purpose: There is no consensus regarding optimal closure for trigger finger release (TFR) surgery. The purpose of this study was to compare the number of postoperative visits and complications following TFR closure with nonabsorbable sutures versus those following TFR closure with absorbable sutures and skin glue. The hypothesis was that wound closure with absorbable sutures and glue will result in fewer postoperative visits, while having similar complication rates as that with nonabsorbable sutures.

Mechanical Complications of Hip and Knee Spacers Are Common.

Introduction Two-stage revision is frequently used for the treatment of periprosthetic joint infection (PJI). Because antibiotic-loaded cement spacers are constructed and implanted as temporary devices, mechanical complications are possible. The purpose of our study was to define the incidence of such mechanical complications, determine associated risk factors, and establish if such complications influence the subsequent success of PJI treatment.

Database discrepancies in understanding the burden of mass shootings in the United States, 2013-2020.

Background: The United States experiences more mass shootings than any other nation in the world. Various entities have sought to collect data on this phenomenon, but there is no scholarly consensus regarding how best to define mass shootings. As a result, existing datasets include different incidents, limiting our understanding of the impact of mass gun violence in the U.

Subcutaneous Immunoglobulin 16.5% (Cutaquig®) in Primary Immunodeficiency Disease: Safety, Tolerability, Efficacy, and Patient Experience with Enhanced Infusion Regimens.

Purpose: To achieve reductions in infusion time, infusion sites, and frequency, a prospective, open-label, multicenter, Phase 3 study evaluated the safety, efficacy, and tolerability of subcutaneous immunoglobulin (SCIG) 16.5% (Cutaquig®, Octapharma) at enhanced infusion regimens.

Methods: Three separate cohorts received SCIG 16.

Does Automated Impaction Improve Femoral Component Sizing and Alignment in Total Hip Arthroplasty?

Background: While automated impaction can provide a more standardized process for femoral canal preparation, little is known regarding its effect on femoral component sizing and position. The purpose of our study was to directly compare femoral component canal fill ratio (CFR) and coronal alignment between primary total hip arthroplasty (THA) procedures performed with automated impaction versus manual mallet impaction.

Methods: A retrospective analysis was performed on 184 patients who underwent primary THA by a single arthroplasty surgeon between 2017 and 2021 with a modern cementless femoral component using either the direct anterior or posterolateral approach.

"Husband, father, coward, killer": The discursive reproduction of racial inequality in media accounts of mass shooters.

Relying on more expansive criteria for defining "mass shootings" than much existing research, we examine a subset of a unique dataset incorporating 7,048 news documents covering 2,170 shootings in the United States between 2013 and 2019. We analyze the descriptive language used to describe incidents and perpetrators and discover significant racial disparities in representation. This research enables a critical examination of the explanatory frames utilized by news media to tell the public who mass shooters are and journalistic attempts to explain why they occur.

Effects of stochastic resonance stimulation on manual function in children with hemiplegic cerebral palsy: A pilot clinical trial.

Objective: To investigate the effect of stochastic resonance stimulation (SRS) on manual abilities in children with hemiplegic cerebral palsy.

Design: This pilot study is a randomized, sham-controlled, one-period, crossover trial.

Setting: A neuroscience clinic with specialty therapy programs at an urban, university-based children's hospital.

Synthesis and characterization of chiral 6-azaspiro[2.5]octanes as potent and selective antagonists of the M muscarinic acetylcholine receptor.

In this manuscript, we report a series of chiral 6-azaspiro[2.5]octanes and related spirocycles as highly potent and selective antagonists of the muscarinic acetylcholine receptor subtype 4 (mAChR). Chiral separation and subsequent X-ray crystallographic analysis of early generation analogs revealed the R enantiomer to possess excellent human and rat M potency, and further structure-activity relationship (SAR) studies on this chiral scaffold led to the discovery of VU6015241 (compound 19).

Intravitreal HDAC Inhibitor Belinostat Effectively Eradicates Vitreous Seeds Without Retinal Toxicity In Vivo in a Rabbit Retinoblastoma Model.

Purpose: Current melphalan-based regimens for intravitreal chemotherapy for retinoblastoma vitreous seeds are effective but toxic to the retina. Thus, alternative agents are needed. Based on the known biology of histone deacetylases (HDACs) in the retinoblastoma pathway, we systematically studied whether the HDAC inhibitor belinostat is a viable, molecularly targeted alternative agent for intravitreal delivery that might provide comparable efficacy, without toxicity.

Discovery of structurally distinct tricyclic M positive allosteric modulator (PAM) chemotypes - Part 2.

This Letter details our efforts to develop novel tricyclic M PAM scaffolds with improved pharmacological properties. This endeavor involved a "tie-back" strategy to replace the 3-amino-4,6-dimethylthieno[2,3-b]pyridine-2-carboxamide core which lead to the discovery of two novel tricyclic cores: a 7,9-dimethylpyrido[3',2':4,5]thieno[3,2-d]pyrimidine core and 2,4-dimethylthieno[2,3-b:5,4-c']dipyridine core. Both tricyclic cores displayed low nanomolar potency against the human M receptor.