Appropriate Use Criteria for Neoplastic Compression Fractures.

Background Context: Clinical outcomes are directly related to patient selection and treatment indications for improved quality of life. With emphasis on quality and value, it is essential that treatment recommendations are optimized.

Purpose: The purpose of the North American Spine Society (NASS) Appropriate Use Criteria (AUC) is to determine the appropriate (ie, reasonable) multidisciplinary treatment recommendations for patients with metastatic neoplastic vertebral fractures across a spectrum of more common clinical scenarios.

Improving Firearm Screening and Safe Storage Counseling in a Primary Care Pediatric Practice.

We conducted a quality improvement (QI) study to increase rates of firearm screening/safety counseling by 25% over 10 months for children (4-18 years) at preventive visits in an academic continuity clinic. Plan-Do-Study-Act (PDSA) cycles consisted of 1) (January 2023) educating providers about best practices for screening, safe storage counseling, and use of cable firearm locks; 2) (May 2023) revising the preventive visit note template to prompt providers on best practices; and 3) (September 2023) providing caregiver educational resources to support safe storage practices. The baseline firearm screening rate was 38%.

Developing a New Expected Goals Metric to Quantify Performance in a Virtual Reality Soccer Goalkeeping App Called CleanSheet.

As virtual reality (VR) sports training apps start to become more mainstream, it is important that human performance is measured from VR gameplay interaction data in a more meaningful way. is a VR training app that is played by over 100,000 users around the world. Many of those players are aspiring goalkeepers who want to use the app as a new way to train and improve their general goalkeeping performance.

Medical Ethics and Informed Consent to Treatment: Past, Present and Future.

It has been asserted that there was an erosion of medical ethics during the Covid-19 pandemic and a departure from the principle of obtaining fully informed consent from patients before treatment. In light of these assertions, this article reviews the historical development of medical ethics and the approach to obtaining informed consent and critiques the consent practices before and during the pandemic. It then describes a new tool for displaying key statistics on the benefits and risks of interventions to help explain them to patients and suggests a more rigorous process for seeking fully informed consent in the future.

A Thematic Analysis of Lived Experiences of Falls in Middle-Aged and Older Adults.

Objectives: Fall-related injuries occur at a similar prevalence rate in middle-aged and older adults and may increase concerns about falling and future falls. No research to date has examined how experiences of falls and related concerns, differ between middle-aged and older fallers. This study aimed to address this using qualitative interviews.

Democratizing Access to Microfluidics: Rapid Prototyping of Open Microchannels with Low-Cost LCD 3D Printers.

Microfluidics offer user-friendly liquid handling for a range of biochemical applications. 3D printing microfluidics is rapid and cost-effective compared to conventional cleanroom fabrication. Typically, microfluidics are 3D printed using digital light projection (DLP) stereolithography (SLA), but many models in use are expensive (≥$10,000 USD), limiting widespread use.

Molecular basis of convergent evolution of ACE2 receptor utilization among HKU5 coronaviruses.

DPP4 was considered a canonical receptor for merbecoviruses until the recent discovery of African bat-borne MERS-related coronaviruses using ACE2. The extent and diversity with which merbecoviruses engage ACE2 and their receptor species tropism remain unknown. Here, we reveal that HKU5 enters host cells utilizing (P.

HPV Vaccination Rates in Military Females: The Need for a Multi-Level and Evidence-Based Approach.

To mitigate the impact of personal and structural barriers hindering HPV vaccination in military women, multiple research studies have advocated for adding the HPV vaccine to the mandatory list for enlistees. Intervention Mapping (IM) is a systematic and stepwise theory-based approach that has been used to inform the development of health promotion interventions and implementation strategies in community and clinical settings at national, regional, and global levels. Development and evaluation of effective strategies and multi-level interventions using IM may increase the uptake of the HPV vaccine among military females who are at-risk of HPV infections and associated co-morbidities.

What Is the Accuracy of Clinical Staging for Stage III-Single-station N2 NSCLC? A Multi-Centre UK Study.

Introduction: Single-station N2 (ssN2) versus multi-station N2 has been used as a selection criterion for treatment recommendations between surgical versus non-surgical multimodality treatment in stage III-N2 NSCLC. We hypothesized that clinical staging would be susceptible to upstaging on pathologic staging and, therefore, challenge this practice.

Methods: A retrospective study of prospectively collected routine clinical data for patients with stage III-N2 NSCLC that had completed computed tomography (CT), positron emission tomography (PET), and staging endobronchial ultrasound (EBUS) and had been confirmed clinical stage III-ssN2 at multidisciplinary team discussion and went on to complete surgical resection as the first treatment to provide pathologic staging.

Saturation transposon mutagenesis enables genome-wide identification of genes required for growth and fluconazole resistance in the human fungal pathogen .

Fungi can cause devastating invasive infections, typically in immunocompromised patients. Treatment is complicated both by the evolutionary similarity between humans and fungi and by the frequent emergence of drug resistance. Studies in fungal pathogens have long been slowed by a lack of high-throughput tools and community resources that are common in model organisms.

Technical Recommendations for Computed Tomography Guidance of Intervention in the Right Ventricular Outflow Tract: Native RVOT, Conduits and Bioprosthetic Valves: A White Paper of the Society of Cardiovascular Computed Tomography (SCCT), Congenital Heart Surgeons' Society (CHSS), and Society for Cardiovascular Angiography & Interventions (SCAI).

This consensus document for the performance of cardiovascular computed tomography (CCT) to guide intervention in the right ventricular outflow tract (RVOT) in patients with congenital disease (CHD) was developed collaboratively by pediatric and adult interventionalists, surgeons and cardiac imagers with expertise specific to this patient subset. The document summarizes definitions of RVOT dysfunction as assessed by multi-modality imaging techniques and reviews existing consensus statements and guideline documents pertaining to indications for intervention. In the context of this background information, recommendations for CCT scan acquisition and a standardized approach for reporting prior to surgical or transcatheter pulmonary valve replacement are proposed and presented.

Evidence That Pervasive Body Gaze Behavior in Heterosexual Men Is a Social Marker for Implicit, Physiological, and Explicit Sexual Assault Propensities.

Deliberate and effortful attempts to gaze at the bodies of women is emerging as a valuable marker of sexual objectification in men. Some preliminary evidence suggests that pervasive body gaze behavior may also accompany insidious attitudes which can facilitate sexual assault. The present study aimed to further explore this potential by examining pervasive body gaze associations with explicit, implicit, and physiological sexual assault propensity measures.

Evaluation of the impact of the COVID-19 pandemic on a smoking cessation service in Derbyshire: An interrupted time series analysis.

Background: Data published early in the COVID-19 pandemic suggested that smokers infected with SARS-CoV-2 were more likely to need hospital treatment or die than non-smokers, and thus this was seen as a motivator to encourage smokers to make a quit attempt. Live Life Better Derbyshire (LLBD) is an integrated lifestyle service providing free support for residents Derbyshire, UK, who want to quit smoking. On 19 March 2020, LLBD converted from offering face-to-face cessation support to a smoking cessation service delivered remotely.

Exploring Combat Tourniquet Application Errors and Duration Among Skilled and Novice Medical Trainees.

Introduction: The use of tourniquets in combat medicine continues to be a key focus as they have consistently been shown to combat one of the leading causes of preventable death on the battlefield, massive hemorrhage to extremities. The present study analyzed tourniquet application among combat medics (68W) and combat lifesavers (CLSs) in a training environment to determine whether trainees' performance is consistent among one another and whether performance can be associated with participant demographics such as experience or role.

Materials And Methods: Study participants treated male and female patient simulators within a tactical field care phase, both of which experienced an amputated leg and required the application of a Combat Application Tourniquet (CAT).

Factors associated with hand hygiene adherence among healthcare workers in Guatemala during the COVID-19 pandemic.

Background: Healthcare-associated infections are prevalent in low- and middle-income countries and may be reduced through proper hand hygiene (HH) adherence during patient care.

Aim: We produced and distributed alcohol-based hand rub (ABHR) to 19 public primary- and secondary-level healthcare facilities in Quetzaltenango, Guatemala, and carried out HH observations to assess healthcare workers' (HCWs) HH adherence, and to identify factors associated with this practice. HH adherence was defined as washing hands with soap and water or using ABHR.

Hand hygiene perceptions, preferences, and practices among hospital staff in the Dominican Republic in the context of COVID-19: a qualitative study.

Background: Proper hand hygiene (HH), which includes sanitizing with alcohol-based hand rub (ABHR) (or handwashing with soap and water if ABHR is unavailable), is key for preventing healthcare-associated infections (HCAI), including COVID-19. Understanding drivers of HH is key to improving adherence.

Aim: This study aims to explore drivers and barriers to HH practice at two hospitals in the Dominican Republic in the context of the COVID-19 pandemic to inform development of HH behaviour change interventions.

Water, Sanitation, and Hygiene Infrastructure and Resources in Schools in Belize during the COVID-19 Pandemic, 2021-2023.

Access to water, sanitation, and hygiene (WASH) resources in schools is critical for disease prevention and control, especially during public health emergencies. In Belize, systematic, national data on WASH in schools are needed to inform public health decisions and interventions. From December 2021 to January 2022, a national survey was sent electronically to government and government-aided primary and secondary schools in Belize (N = 308) to gather information on WASH services.

Clinical Protocol for Selecting Intracardiac or Transesophageal Echocardiography-Guided Left Atrial Appendage Occlusion.

Intracardiac echocardiography (ICE) has emerged as an alternative to transesophageal echo (TEE) to guide left atrial appendage occlusion (LAAO). We established a protocol to select patients appropriate for ICE guidance. Patients who underwent LAAO with the Watchman or Watchman FLX device (Boston Scientific, Marlborough, Massachusetts) from January 2018 to March 2022 at a large United States center were included.

Entanglement and ingestion of microfibers by the oyster pea crab Zaops ostreum, an endosymbiont of the eastern oyster Crassostrea virginica.

The kleptoparasitic pea crab Zaops ostreum lives within the gills of bivalves, including the economically important eastern oyster Crassostrea virginica. Previous research along the east coast of central Florida has found an average of 2.3 pieces of plastic per oyster.

Learning to Lead: An Exploration of Leadership Development in Obstetrics and Gynaecology.

Despite the demonstrated value of leadership in medicine, there is limited research on how physicians develop leadership skills. We administered a national survey (225 respondents) and conducted eight interviews of residents, fellows, and staff physicians in obstetrics and gynaecology to explore leadership skill development. Most (87%) positively rated the effectiveness of their leadership skills; however, the majority (98%) stated they would benefit from further training.

Evaluation of driver navigational errors and acceptance of a simulated J-turn intersection.

The J-turn intersection is a novel roadway design which decreases the points of conflict at an intersection, by restricting straight crossing and left-turning movements from the minor road across the highway. The novelty of the intersection design may lead to driver errors and dissatisfaction. This study provides an examination of how naïve or first-time drivers may initially navigate J-turns during their first and early exposures to the novel intersection design.