Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index.

Background: Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep inferior epigastric perforator (DIEP) flap reconstruction. To provide a clearer understanding of the challenges faced by patients with obesity, we present a single-center outcome analysis of individuals who underwent DIEP flap reconstruction.

Recommendations for Specialty Palliative APRN Graduate Education.

Background: Advanced practice registered nurses (APRNs) are essential to care for the growing number of individuals with advanced illness given the shortage of palliative care clinicians.

Problem: Graduate education for specialty practice palliative APRNs lacks consistency in structure, content, and standardization of specialty palliative APRN education.

Approach: A workgroup of expert palliative APRNs and graduate faculty conducted focused discussions and a literature review to develop consensus recommendations based on national palliative APRN competencies and aligned with the 8 core concepts of the AACN Essentials.

False-Negative Review from the Mammography Audit: Refining Breast Imaging Practice.

Annual review of false-negative (FN) mammograms is a mandatory and critical component of the Mammography Quality Standards Act (MQSA) annual mammography audit. FN review can help hone reading skills and improve the ability to detect cancers at mammography. Subtle architectural distortion, asymmetries (seen only on one view), small lesions, lesions with probably benign appearance (circumscribed regular borders), isolated microcalcifications, and skin thickening are the most common mammographic findings when the malignancy is visible at retrospective review of FN mammograms.

A Pharmacokinetic/Toxicodynamic Model of Cisplatin Nephrotoxicity Using the Kidney Injury Molecule-1 Biomarker.

Cisplatin is a platinum-based chemotherapeutic that causes acute kidney injury in over 30% of patients. The aim of this study was to develop a population pharmacokinetic/toxicodynamic (PKTD) model of cisplatin-induced kidney injury that incorporated plasma total platinum and urinary kidney injury molecule-1 (KIM-1) concentrations. Cancer patients receiving their first or second round of cisplatin-containing chemotherapy (n=39) were prospectively randomized to a 5-HT antagonist (5-HTA) antiemetic (ondansetron, granisetron, or palonosetron) and had blood and urine collected over 10 days.

A conserved role for ALG10/ALG10B and the -glycosylation pathway in the sleep-epilepsy axis.

Congenital disorders of glycosylation (CDG) comprise a class of inborn errors of metabolism resulting from pathogenic variants in genes coding for enzymes involved in the asparagine-linked glycosylation of proteins. Unexpectedly to date, no CDG has been described for , encoding the alpha-1,2-glucosyltransferase catalyzing the final step of lipid-linked oligosaccharide biosynthesis. Genome-wide association studies (GWAS) of human traits in the UK Biobank revealed significant SNP associations with short sleep duration, reduced napping frequency, later sleep timing and evening diurnal preference as well as cardiac traits at a genomic locus containing a pair of paralogous enzymes and .

Population Pharmacokinetic Model of Platinum Disposition in Cancer Patients Receiving Cisplatin and Randomized to 5-HT Antagonist Antiemetic Drugs.

Cisplatin is a platinum-based chemotherapeutic drug used to treat many types of cancer. The aim of this study was to develop a population pharmacokinetic model that incorporates plasma unbound and bound platinum levels. Cancer patients undergoing their first or second cycle of cisplatin-containing chemotherapy (n = 33) were prospectively randomized to receive a 5-hydroxytryptamine (5-HT) antagonist (5-HTA) antiemetic (ondansetron, granisetron, or palonosetron) followed by blood collection over 10 days.

Strategies for the design of biomimetic cell-penetrating peptides using AI-driven in silico tools for drug delivery.

Cell-penetrating peptides (CPP) have gained rapid attention over the last 25 years; this is attributed to their versatility, customisation, and 'Trojan horse' delivery that evades the immune system. However, the current CPP rational design process is limited, as it requires several rounds of peptide synthesis, prediction and wet-lab validation, which is expensive, time-consuming and requires extensive knowledge in peptide chemistry. Artificial intelligence (AI) has emerged as a promising alternative which can augment the design process, for example by determining physiochemical characteristics, secondary structure, solvent accessibility, disorder and flexibility, as well as predicting in vivo behaviour such as toxicity and peptidase degradation.

The Sequence and Reconstructive Modality of Breast Cancer Treatments Affects Wait Times to Adjunctive Therapies in Patients Undergoing Mastectomy with Immediate Breast Reconstruction.

Breast cancer care requires both oncologists and plastic surgeons. Coordinating these specialists and combining extirpative and reconstructive procedures before adjunctive therapies can cause delays in care. For patients with less advanced disease, surgery is performed before adjunctive therapies, requiring early specialist coordination and the possibility of surgical complications.

Undergraduate Physiotherapists' Use of the Internet to Fulfil Their Information Needs During a Theoretical Examination: A Randomized Crossover Trial.

Background: The internet is widely used by healthcare students and professionals alike to fulfil their information needs, yet limited research has utilised web log analysis to evaluate how they do so.

Aims: To elicit information needs among students via the administration of a multiple choice questionnaire (MCQ) and to evaluate how they use the internet to fulfil these needs.

Methods: Forty final-year physiotherapy students (63% female) completed a MCQ under two conditions: i) 'assisted' with internet access and ii) 'unassisted' without internet access.

An Evaluation of the Effect of App-Based Exercise Prescription Using Reinforcement Learning on Satisfaction and Exercise Intensity: Randomized Crossover Trial.

Background: The increasing prevalence of sedentary lifestyles has prompted the development of innovative public health interventions, such as smartphone apps that deliver personalized exercise programs. The widespread availability of mobile technologies (eg, smartphone apps and wearable activity trackers) provides a cost-effective, scalable way to remotely deliver personalized exercise programs to users. Using machine learning (ML), specifically reinforcement learning (RL), may enhance user engagement and effectiveness of these programs by tailoring them to individual preferences and needs.

An Arabidopsis Cell Culture With Weak Circadian Rhythms Under Constant Light Compared With Constant Dark Can Be Rescued by ELF3.

Callus and cell suspension culture techniques are valuable tools in plant biotechnology and are widely used in fundamental and applied research. For studies in callus and cell suspension cultures to be relevant, it is essential to know if the underlying biochemistry is similar to intact plants. This study examined the expression of core circadian genes in Arabidopsis callus from the cell suspension named AT2 and found that the circadian rhythms were impaired.

Incorporating model selection and uncertainty into forecasts of economic conditions in companion animal clinical veterinarian labor markets.

Following the onset of COVID-19, demand for US veterinary services rapidly increased, similarly driving up demand in upstream veterinary labor markets. This increasing demand starkly contrasted with the "excess capacity" period following the Great Recession, marked by fewer opportunities and low wages for veterinarians. Better models and forecasts of veterinary labor market conditions improve information for decision-making by veterinarians, relevant business owners, professional associations, and educational institutions.

Imaging blood-brain barrier dysfunction in drug-resistant epilepsy: A multi-center feasibility study.

Objective: Blood-brain barrier dysfunction (BBBD) has been linked to various neurological disorders, including epilepsy. This study aims to utilize dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to identify and compare brain regions with BBBD in patients with epilepsy (PWE) and healthy individuals.

Methods: We scanned 50 drug-resistant epilepsy (DRE) patients and 58 control participants from four global specialized epilepsy centers using DCE-MRI.

Rapid Weight Changes and Competitive Outcomes in Muay Thai and Mixed Martial Arts: A 14-Month Study of 24 Combat Sports Events.

This study investigates the rapid weight loss (RWL) and rapid weight gain (RWG) of contest winners and losers from Muay Thai (MT) and mixed martial arts (MMA) events. The relationship between rapid weight change variables of males and females, and competitive success is also examined. Data from a weight management questionnaire was collected one day post-competition from 185 participants across 24 fight events, resulting in 263 responses (MMA: n = 78, MT: n = 185).

T lymphocyte-dependent IL-10 down-regulates a cytokine storm driven by GRA24.

As a model organism in the study of immunity to infection, has been instrumental in establishing key principles of host anti-microbial defense and its regulation. Here, we employed an attenuated uracil auxotroph strain of Type I designated OMP to further untangle the early immune response to this parasitic pathogen. Experiments using αβ T cell-deficient mice unexpectedly revealed that an intact αβ T lymphocyte compartment was essential to survive infection with OMP.

Temporal Sequencing of Multimodal Treatment in Immediate Breast Reconstruction and Implications for Wait Times: A Regional Canadian Cross-Sectional Study.

Treatment of breast cancer requires a multimodal approach with numerous independent specialists. Immediate breast reconstruction (IBR) adds another layer of coordination to comprehensive breast cancer care. To optimize health outcomes for patients seeking IBR, it is essential to efficiently coordinate the temporal sequence of care modalities inclusive of reconstruction.

An integrated approach combining experimental, informatics and energetic methods for solid form derisking of PF-06282999.

The landscapes of observed and predicted three-dimensional crystal packing arrangements of small-molecule drug candidates can be complex. The possible appearance of a more thermodynamically stable solid form during drug development has led to the digital workflow of informatics-based risk assessments, named a Solid Form Health Check. Herein, we describe the use of a combined approach consisting of experiments, informatics together with energetic calculations in analysis of four competing polymorphs of PF-06282999, a myeloperoxidase (MPO) inhibitor with conformational flexibility and multiple plausible hydrogen bond networks.

A Remote Behaviorally Designed Intervention to Promote Physical Activity in Patients With Knee Osteoarthritis: Results of a Pilot Randomized Clinical Trial.

Objective: We evaluated a behaviorally designed intervention utilizing gamification and social support to improve physical activity and reduce symptoms in patients with osteoarthritis of the knee (KOA).

Methods: Veterans with KOA, aged 40-80 years, were enrolled in this randomized controlled trial. Participants received a Fitbit and completed a 2- to 4-week baseline period.

The Validity of Apple Watch Series 9 and Ultra 2 for Serial Measurements of Heart Rate Variability and Resting Heart Rate.

The widespread use of wearable devices has enabled continuous monitoring of biometric data, including heart rate variability (HRV) and resting heart rate (RHR). However, the validity of these measurements, particularly from consumer devices like Apple Watch, remains underexplored. This study aimed to validate HRV measurements obtained from Apple Watch Series 9 and Ultra 2 against the Polar H10 chest strap paired with the Kubios HRV software, which together served as the reference standard.

Implementation and evaluation of specialist heart failure pharmacist prescribing clinics.

Background: Medications form the basis of treatment for heart failure (HF) and adherence is crucial as untreated HF has a mortality of greater than 30%. As such, specialist HF pharmacists with expertise in prescribing and promoting adherence have become an integral part of the wider HF multidisciplinary team (MDT).

Aim: To implement specialist HF pharmacist prescribing clinics and evaluate their impact.