The Efficacy of Transversus Abdominis Plane (TAP) Blocks When Completed by Anesthesiologists Versus by Surgeons: A Systematic Review and Meta-Analysis.

: Current literature has demonstrated the benefits of transversus abdominis plane (TAP) blocks for reducing postoperative pain and opioid consumption for an array of surgical procedures. Some randomized controlled trials and retrospective studies have compared ultrasound guidance TAP blocks completed by anesthesiologists (US-TAP) to laparoscopic guidance TAP blocks completed by surgeons (LAP-TAP). However, the findings of these studies have not been consolidated to improve recommendations and patient outcomes.

A randomized trial of at-home COVID-19 tests, telemedicine, and rapid prescription delivery for immunocompromised individuals.

Background: COVID-19 continues to impose substantial risks to people who are immunocompromised and over 65 years old.

Objective: Using a randomized control trial, we evaluated whether access to at-home COVID-19 tests, telemedicine, and same-day prescription delivery could reduce COVID cases, hospitalizations, and the cost of COVID care for the high-risk populations.

Design: Individuals participated remotely, half (n = 346) receiving the option to access 10 at-home COVID-19 tests per month for themselves and others in their household as well as telemedicine and same-day Paxlovid delivery, and half following their standard testing and treatment practices (n = 325).

Efficacy and Safety of Barbed Sutures for Capsulorrhaphy in Implant-Based Breast Reconstruction.

Background: A common postoperative challenge following implant-based breast reconstruction surgery is lateral or inferior displacement of the implant, which ultimately requires surgical intervention to shape the pocket for improved symmetry. Capsulorrhaphy is traditionally performed with smooth sutures, but the use of barbed sutures has proven to be more efficient and effective in other plastic surgery procedures. This study aimed to demonstrate the safety and efficacy of barbed sutures for breast reconstruction implant capsulorrhaphy.

Long-term changes in wearable sensor data in people with and without Long Covid.

To better understand the impact of Long COVID on an individual, we explored changes in daily wearable data (step count, resting heart rate (RHR), and sleep quantity) for up to one year in individuals relative to their pre-infection baseline among 279 people with and 274 without long COVID. Participants with Long COVID, defined as symptoms lasting for 30 days or longer, following a SARS-CoV-2 infection had significantly different RHR and activity trajectories than those who did not report Long COVID and were also more likely to be women, younger, unvaccinated, and report more acute-phase (first 2 weeks) symptoms than those without Long COVID. Demographic, vaccine, and acute-phase sensor data differences could be used for early identification of individuals most likely to develop Long COVID complications and track objective evidence of the therapeutic efficacy of any interventions.

Feasibility of wearable sensor signals and self-reported symptoms to prompt at-home testing for acute respiratory viruses in the USA (DETECT-AHEAD): a decentralised, randomised controlled trial.

Background: Early identification of an acute respiratory infection is important for reducing transmission and enabling earlier therapeutic intervention. We aimed to prospectively evaluate the feasibility of home-based diagnostic self-testing of viral pathogens in individuals prompted to do so on the basis of self-reported symptoms or individual changes in physiological parameters detected via a wearable sensor.

Methods: DETECT-AHEAD was a prospective, decentralised, randomised controlled trial carried out in a subpopulation of an existing cohort (DETECT) of individuals enrolled in a digital-only observational study in the USA.

Lense-Thirring precession after a supermassive black hole disrupts a star.

An accretion disk formed around a supermassive black hole after it disrupts a star is expected to be initially misaligned with respect to the equatorial plane of the black hole. This misalignment induces relativistic torques (the Lense-Thirring effect) on the disk, causing the disk to precess at early times, whereas at late times the disk aligns with the black hole and precession terminates. Here we report, using high-cadence X-ray monitoring observations of a tidal disruption event (TDE), the discovery of strong, quasi-periodic X-ray flux and temperature modulations.

Palliative care patients' attitudes and openness towards psilocybin-assisted psychotherapy for existential distress.

Introduction: Patients with incurable illnesses often experience existential distress, profoundly impacting their well-being. Current medical approaches have limitations in addressing these burdens. Psilocybin, a promising psychedelic compound, may offer therapeutic benefits.

A case for a binary black hole system revealed via quasi-periodic outflows.

Binaries containing a compact object orbiting a supermassive black hole are thought to be precursors of gravitational wave events, but their identification has been extremely challenging. Here, we report quasi-periodic variability in x-ray absorption, which we interpret as quasi-periodic outflows (QPOuts) from a previously low-luminosity active galactic nucleus after an outburst, likely caused by a stellar tidal disruption. We rule out several models based on observed properties and instead show using general relativistic magnetohydrodynamic simulations that QPOuts, separated by roughly 8.

Robotics vs Laparoscopy in Foregut Surgery: Systematic Review and Meta-Analysis Analyzing Hiatal Hernia Repair and Heller Myotomy.

Background: Laparoscopic surgery remains the mainstay of treating foregut pathologies. Several studies have shown improved outcomes with the robotic approach. A systematic review and meta-analysis comparing outcomes of robotic and laparoscopic hiatal hernia repairs (HHR) and Heller myotomy (HM) repairs is needed.

Association of Common Foods with Inflammation and Mortality: Analysis from a Large Prospective Cohort Study.

Some dietary patterns are associated with inflammation, while others lower inflammation and improve health. However, many people cannot follow a complete, healthy diet. Therefore, this study's aim was to identify specific foods associated chronic inflammation and mortality.

Phase Behavior of Charged Star Block Copolymers at Fluids Interface.

The phase behavior of block copolymers (BCPs) at the water-oil interface is influenced by the segmental interaction parameter ( ) and chain architecture. We synthesized a series of star block copolymers (s-BCPs) having polystyrene (PS) as core and poly(2-vinylpyridine) (P2VP) as corona. The interaction parameters of block-block ( ) and block-solvent ( ) were varied by adjusting the pH of the aqueous solution.

Pelvic Incidence as a Predictor of Proximal Junctional Failure in Patients Undergoing Anterior Column Realignment with Anterior Longitudinal Ligament Release to Restore Lordosis in Adult Spinal Deformity: A Retrospective Cohort Study.

Objective: To identify variables that may contribute to the development of proximal junctional failure (PJF) in patients with long lumbo-sacral and thoraco-lumbo-pelvic constructs undergoing anterior column realignment (ACR) with anterior longitudinal ligament release (ALLR).

Methods: Data of patients with adult spinal deformity who underwent ACR with ALLR at L3-4 were collected retrospectively from medical records and a prospectively maintained spine research database between 2016 and 2022.

Results: Eleven (41%) developed PJF at a mean of 24 ± 21 months from the index surgery.

Breastfeeding Ability After Breast Reductions: What does the Literature Tell us in 2023?

Introduction: Reduction mammaplasties are routinely performed on women of child-bearing age, yet there still exists some uncertainty regarding a patient's ability to breastfeed following the procedure. This is due to inconsistent definitions of "successful" breastfeeding, a variety of pedicles implemented, and inadequate follow-up in the published literature. Our aim was to summarize the current data and provide clear recommendations for counseling patients on expected breastfeeding outcomes following reduction mammaplasty.

Comparing Outcomes of Musculoskeletal Radiographs from In-Person and Telemedicine Primary Care Cohorts, April 2019-June 2021.

Purpose: Musculoskeletal conditions are a common reason for primary care visits, and they are being increasingly addressed at televisits. We therefore examined outcomes of musculoskeletal radiographs ordered at in-person and telemedicine primary care visits, which have implications for patient care and the economic impact of telemedicine.

Methods: We performed a retrospective cohort study of musculoskeletal radiograph orders placed April 1, 2019-March 31, 2021 at a major academic health system.

A Retrospective Analysis of Vitamin D Levels in Hospitalized COVID-19 Patients With Suspected Pulmonary Embolism.

Introduction Despite using anti-coagulation therapy in hospitalized coronavirus disease 2019 (COVID-19) patients, they have high rates of pulmonary embolism (PE) and deep vein thrombosis (DVT). The main objective of this study was to evaluate the association between vitamin D deficiency and thrombotic events (defined as the occurrence of a new PE or DVT) in hospitalized COVID-19 patients. Materials and Methods This was a retrospective, cross-sectional study of 208 hospitalized COVID-19 patients who received a computed tomographic pulmonary angiography (CTPA) based on clinical suspicion of PE between January 1, 2020, and February 5, 2021.

Implementing a Stepwise Shivering Protocol During Targeted Temperature Management.

Shivering is often encountered in patients undergoing targeted temperature management (TTM) after cardiac arrest. The most efficient, safe way to prevent shivering during TTM is not clearly defined. The purpose of this study was to evaluate the impact of shivering management using a stepwise shivering protocol on time to target temperature (TT), medication utilization and nursing confidence.

Patient perceptions of urgency of their pelvic floor disorders during the COVID-19 pandemic.

Introduction And Hypothesis: During the COVID-19 pandemic, many surgical societies released guidelines that included cancellation of elective cases. The aim of this study was to better understand our patients' perceptions of the severity of their pelvic floor disorders (PFDs) and to determine what factors influenced this perception. We also aimed to better understand who might be amenable to telemedicine visits and what factors influenced this decision.

Effect of Resident Involvement in Ophthalmic Surgery on Patient Outcomes: A Systematic Review and Meta-analysis.

Purpose: To determine the effect of resident- vs attending-led surgeries on patient outcomes in ophthalmic surgery.

Design: Systematic review and meta-analysis.

Methods: Two independent authors searched PubMed, EMBASE, and Cochrane Library from inception to March 2022.

Thiol-ene Click Chemistry Incorporates Hydroxyl Functionality on Polycyclooctene to Tune Properties.

Polyolefins compose the majority of plastic waste, but conventional mechanical recycling degrades their properties, thereby reducing their value. We report the functionalization of a model for dehydrogenated polyethylene, polycyclooctene (PCOE), with thiol-ene click chemistry to install pendant hydroxyl ethyl thioethers. Functionalization of PCOE using mercaptoethanol via thiol-ene click chemistry yielded functionalization between 1.

Assembly of polyelectrolyte star block copolymers at the oil-water interface.

To understand and resolve adsorption, reconfiguration, and equilibrium conformations of charged star copolymers, we carried out an integrated experimental and coarse-grained molecular dynamics simulation study of the assembly process at the oil-water interface. This is important to guide development of novel surfactants or amphiphiles for chemical transformations and separations. The star block copolymer consisted of arms that are comprised of hydrophilic-hydrophobic block copolymers that are covalently tethered the hydrophobic blocks to one point.

Physically fit with a higher cancer risk? Influences of cervical cancer screening among a sample of physically active women ages 21-49 living in the United States.

To achieve the lowest risk level for various cancers, individuals would engage in several healthy lifestyle behaviors and age-eligible cancer screenings as recommended. Nonetheless, research has largely omitted exploration of concurrent primary and secondary prevention behaviors. This study was designed to explore influences of cervical cancer screening among physically active women who reported participation in recreational sports.