Prognostic value of exercise tolerance and exercise-induced diastolic dysfunction in elderly patients referred for exercise stress echocardiography.

Background: We studied the prognostic value of exercise tolerance and exercise-associated diastolic dysfunction (Ex-DD) in elderly patients referred for exercise stress echocardiography (ExE).

Methods: A total of 674 patients ≥60 years who underwent ExE using the Bruce protocol between January 2017 and December 2020 were included in this study. The prognostic factors examined were exercise tolerance, quantified in metabolic equivalents of tasks (METs), and Ex-DD.

Cardiogenic and obstructive shock: primary laryngeal synovial sarcoma with cardiac metastasis.

A man in his 20s with a history of laryngeal synovial sarcoma presented with dyspnoea. Imaging revealed a large right ventricular (RV) mass, which was resected, and histological analysis indicated synovial sarcoma recurrence. Within 1 month of RV mass resection, the tumour progressed with paratracheal metastasis.

An enzyme-centric approach for constructing an amperometric l-malate biosensor with a long and programmable linear range.

l-Malate is a key flavor enhancer and acidulant in the food and beverage industry, particularly winemaking. Enzyme-based amperometric biosensors offer convenience for monitoring its concentration. However, only a small number of off-the-shelf malate-oxidizing enzymes have been used in previous devices.

McKittrick-Wheelock syndrome presenting with presumed paraneoplastic syndrome extra-ocular muscle enlargement masquerading as thyroid eye disease.

Summary: Paraneoplastic syndromes (PS) are uncommon and are known to mimic other clinical entities, often carrying significant morbidity and mortality. The commonest cause of extra-ocular muscle enlargement (EOME) is thyroid eye disease (TED). Rarely, PS can cause EOME and masquerade as TED.

Substantial P-Type Conductivity of AlN Achieved via Beryllium Doping.

Beryllium has long been predicted by first principle theory as the best p-type dopant for GaN and AlN. But experimental validation of these theories has not, until now, borne out the original predictions. A key challenge is the dopant-induced strain leading to Be rejection from substitutional sites in favor of interstitial sites, leading to self-compensation.

Prolonged hypo-salinity to control Neobenedenia spp. monogenean infection in large display aquaria.

The majority of public aquaria have at least one very large tank (>370,000 liters, 100,000 gallons) as part of their collection. The large water volumes can make treatment difficult when pathogens escape quarantine or cross contamination occurs. The cost and methods of dispersion of chemotherapeutics to control infectious agents (bacterial, protozoal, or metazoan) can be prohibitive in large volumes.

Enzyme-based amperometric biosensors for malic acid - A review.

Malic acid is a key flavour component of many fruits and vegetables. There is significant interest in technologies for monitoring its concentration, particularly in winemaking. In this review we systematically and comprehensively chart progress in the development of enzyme-based amperometric biosensors for malic acid.

Aquarium Tank Design Is Integral to the Elimination of Mantle Abrasion in the Captive Curled Octopus (): A Case Study at Macduff Marine Aquarium.

Macduff Marine Aquarium is a native species aquarium situated on the Moray Firth coastline and houses the curled octopus, , for public display. Historically, the designated octopus display tank has been in-keeping with the overall theme of the aquarium, consisting of artificially created rock work mimicking the local rocky coastline, within an angular glass tank. This tank was not originally designed for housing octopus and as a consequence, if individuals on display exhibited jetting behavior mantle abrasion occurred.

Risk of Incident Diabetes Mellitus, Weight Gain, and Their Relationships With Integrase Inhibitor-Based Initial Antiretroviral Therapy Among Persons With Human Immunodeficiency Virus in the United States and Canada.

Background: Integrase strand transfer inhibitor (INSTI)-based combination antiretroviral therapy (cART) is associated with greater weight gain among persons with human immunodeficiency virus (HIV), though metabolic consequences, such as diabetes mellitus (DM), are unclear. We examined the impact of initial cART regimen and weight on incident DM in a large North American HIV cohort (NA-ACCORD).

Methods: cART-naive adults (≥18 years) initiating INSTI-, protease inhibitor (PI)-, or nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens from January 2007 through December 2017 who had weight measured 12 (±6) months after treatment initiation contributed time until clinical DM, virologic failure, cART regimen switch, administrative close, death, or loss to follow-up.

Comprehensive Analysis of Metal Modulated Epitaxial GaN.

While metal modulated epitaxy (MME) has been shown useful for hyperdoping, where hole concentrations 40 times higher than other techniques have been demonstrated, and the ability to control phase separation in immiscible III-nitrides, the complexity of the dynamically changing surface conditions during the cyclic growth is poorly understood. While MME is capable of superb crystal quality, performing MME in an improper growth regime can result in defective material. These complications have made the transfer of MME knowledge challenging.

Food assessment: a discursive analysis of diet talk in interviews with older men who are obese.

Obesity rates are increasing faster in men than in women, with particular concerns raised regarding older men. However, men are less likely than women to engage in weight-loss activities such as dieting, typically constructed as a feminine practice. Previous research has argued that men's food consumption is notably different and unhealthier than women's.

Medical care in unlicensed combat sports: A need for standardised regulatory frameworks.

Objectives: To explore the provision of medical care at 'unlicensed', full-contact amateur and lower-level professional combat sports competitions in England.

Design: Qualitative, mixed methods.

Methods: Observations totalling 200h of fieldwork shadowing medical professionals at 27 individual combat sports events, alongside formal, semi-structured interviews with 25 medical professionals, 7 referees and 9 promoters/event staff.

Integrating the Principles and Practice of Scholarly Activity Into Undergraduate Medical Education: A Narrative Review and Proposed Model for Implementation.

The osteopathic undergraduate medical education standards have evolved over the past 2 decades to require undergraduate medical student participation in research and scholarly activity. The authors' objective was to review those evolving standards and develop a model for introducing the principles and practice of research that combines core content with experiential learning. They identified fundamental topics pertinent to the research process and herein provide their recommendations for incorporating these topics into the curriculum as self-study, online modules, and team-based and active learning exercises.

Evaluating the Influence of Research on Match Success for Osteopathic and Allopathic Applicants to Residency Programs.

Context: Analyzing factors that may enhance osteopathic applicants' likelihood of matching is warranted given that United States osteopathic and allopathic residency programs will have a single accreditation system in 2020.

Objectives: To determine the impact of research accomplishments and experiences on osteopathic and allopathic residency matching.

Methods: Analysis of variance, t test, and odds ratios were used to examine data from the National Resident Matching Program Charting Outcomes from 2016 and 2018.

Does an Elastic Compression Bandage Provide Any Benefit After Primary TKA?

Background: Compression bandages often are used after TKA to reduce swelling. However, the degree to which they are helpful has not been well characterized.

Questions/purposes: The purpose of this study was to determine whether use of a compression bandage after TKA was associated with (1) less leg swelling (our primary endpoint); or (2) secondary study endpoints, including improved ROM of flexion and extension, lower visual analog scale (VAS) pain scores for worst pain and pain during physical therapy just before surgery, postoperative day (POD) 1, POD 2, and POD 28, or fewer wound complications within 90 days of surgery.

Outcomes of Primary Reverse Total Shoulder Arthroplasty in Patients Younger Than 65 Years Old.

Purpose: We compare clinical outcomes of primary reverse total shoulder arthroplasty (RTSA) in patients 65 years old or younger with a matched control group of patients 70 years old or older.

Methods: Forty-three patients (17 men and 26 women) 65 years old or younger were retrospectively identified. The mean age was 60 years and average follow-up was 4.

Physical Activity Intensity is Associated with Symptom Distress in the CNICS Cohort.

Symptom distress remains a challenging aspect of living with HIV. Physical activity is a promising symptom management strategy, but its effect on symptom distress has not been examined in a large, longitudinal HIV-infected cohort. We hypothesized that higher physical activity intensity would be associated with reduced symptom distress.

The "Bundle Busters": Incidence and Costs of Postacute Complications Following Total Joint Arthroplasty.

Background: Recently, a bundled payment model was implemented in the United States to improve quality and reduce costs. While hospitals may be rewarded for lowering costs, they may be financially exposed by high cost complications, the so-called bundle busters. We aimed at determining the incidence, etiology, and costs of postacute complications after total joint arthroplasty (TJA).

Diffuse Pigmented Villonodular Synovitis as a Rare Cause of Graft Failure Following Anterior Cruciate Ligament Reconstruction.

This case report describes a 42-year-old woman who was diagnosed with pigmented villonodular synovitis (PVNS) in the knee. The patient had received a bone-patella tendon-bone autograft reconstruction of her anterior cruciate ligament (ACL) 22 years prior to her diagnosis of PVNS. After a traumatic event that tore her ACL graft, she underwent a second surgery to repair the initial reconstruction.

Are Preoperative Serologic Type and Screen Tests Necessary for Primary Total Joint Arthroplasty Patients in Specialty Surgical Hospitals?

Background: Blood loss during total joint arthroplasty (TJA) has been a major concern requiring routine preoperative patient type and screen (T&S); however, with the implementation of blood conserving therapy, a marked decrease for perioperative transfusions has been observed. Many TJAs are now being performed in T&S mandated specialty surgical hospitals (SSHs) that lack on-site blood banks; therefore, the purpose of our study was to determine whether T&S (1) is necessary in SSH for TJA patients and (2) identifies patient risk factors associated with perioperative blood transfusion in SSH.

Methods: A retrospective study was conducted on 1034 consecutive primary TJAs performed between 2013 and 2014 at a 12-bed SSH who all received T&S.

A Robust Damage-Reporting Strategy for Polymeric Materials Enabled by Aggregation-Induced Emission.

Microscopic damage inevitably leads to failure in polymers and composite materials, but it is difficult to detect without the aid of specialized equipment. The ability to enhance the detection of small-scale damage prior to catastrophic material failure is important for improving the safety and reliability of critical engineering components, while simultaneously reducing life cycle costs associated with regular maintenance and inspection. Here, we demonstrate a simple, robust, and sensitive fluorescence-based approach for autonomous detection of damage in polymeric materials and composites enabled by aggregation-induced emission (AIE).

Periarticular Injection of Liposomal Bupivacaine Offers No Benefit Over Standard Bupivacaine in Total Knee Arthroplasty: A Prospective, Randomized, Controlled Trial.

Background: Periarticular injection of liposomal bupivacaine has been adopted as part of multimodal pain management after total knee arthroplasty (TKA).

Methods: In this prospective, randomized clinical trial, we enrolled 162 patients undergoing primary TKA in a single institution between January 2014 and May 2015. Eighty-seven patients were randomized to liposomal bupivacaine (experimental group), and 75 patients were randomized to free bupivacaine (control group).

Autonomous Indication of Mechanical Damage in Polymeric Coatings.

High-resolution in situ autonomous visual indication of mechanical damage is achieved through a microcapsule-based polymeric material system. Upon mechanical damage, ruptured microcapsules release a liquid indicator molecule. A sharp color change from light yellow to bright red is triggered when the liberated indicator 2',7'-dichlorofluorescein reacts with the polymeric coating matrix.

Urinary Retention is Rare After Total Joint Arthroplasty When Using Opioid-Free Regional Anesthesia.

Background: Postoperative urinary retention (POUR) is a relatively common complication after total joint arthroplasty (TJA). Based on the findings of a randomized, prospective study from our institution, we abandoned the routine use of indwelling urinary catheters in patients undergoing elective TJA using opioid-free spinal anesthesia. The aim of this study was to determine the incidence of and the risk factors for POUR in this patient population.