The first survey of endoparasite infection in the brown rat (Rattus norvegicus) from a synanthropic environment in Hungary.

Urban rats are significant reservoirs of zoonotic endoparasites, posing serious health risks to humans. This study aimed to detect common endoparasites in wild brown rats (Rattus norvegicus) in Budapest, addressing the current lack of endoparasite surveys in Hungary. Carcasses of 131 rats collected following extermination were examined.

Data-Driven Exploration of National Health Service Talking Therapies Care Pathways Using Process Mining: Retrospective Cohort Study.

Background: The National Health Service (NHS) Talking Therapies program treats people with common mental health problems in England according to "stepped care," in which lower-intensity interventions are offered in the first instance, where clinically appropriate. Limited resources and pressure to achieve service standards mean that program providers are exploring all opportunities to evaluate and improve the flow of patients through their service. Existing research has found variation in clinical performance and stepped care implementation across sites and has identified associations between service delivery and patient outcomes.

The Impact of Cognitive Impairment on Postoperative Complications After Spinal Surgery: A Matched Analysis.

Objective: The coprevalence of age-related comorbidities such as cognitive impairment and spinal disorders is increasing. No studies to date have assessed the postoperative spine surgery outcomes of patients with mild cognitive impairment (MCI) or severe cognitive impairment (dementia) compared with those without preexisting cognitive impairment.

Methods: Using all-payer claims database, 235,123 persons undergoing either cervical or lumbar spine procedures between January 2010 and October 2020 were identified.

Enhancing Dementia Knowledge and Self-Efficacy of In-Home Supportive Services Caregivers Through Online Training.

California's In-Home Supportive Services (IHSS) program provides vital home care to low-income consumers, some of whom live with Alzheimer's disease or related dementias (ADRD). Yet, most IHSS caregivers receive little or no training in dementia care. We present preliminary descriptive results of the IHSS + ADRD Training Project, a 10-week, competency-based, dementia training program, delivered online, for IHSS caregivers, in Alameda County.

The impact of smoking and smoking cessation interventions on outcomes following single-level anterior cervical discectomy and fusion procedures.

Background: While several studies explore the impact of smoking tobacco on spinal fusion outcomes, there is a paucity of literature on the influence of modern smoking cessation therapies on such outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF).

Objective: Our study explores the outcomes of single-level ACDF surgery in nonsmokers, active smokers, and smokers undergoing cessation therapy.

Methods: MARINER30, an all-payer claims database, was utilized to identify patients undergoing single-level ACDF between 2010 and 2019.

The Impact of Smoking Cessation Therapy on Lumbar Fusion Outcomes.

Objective: While there are several reports on the impact of smoking tobacco on spinal fusion outcomes, there is minimal literature on the influence of modern smoking cessation therapies on such outcomes. Our study explores the outcomes of single-level lumbar fusion surgery in active smokers and in smokers undergoing recent cessation therapy.

Methods: MARINER30, an all-payer claims database, was utilized to identify patients undergoing single-level lumbar fusions between 2010 and 2019.

Trends in Racial and Ethnic Representation Among Neurosurgery Applicants and Residents: A Comparative Analysis of Procedural Specialties.

Background: Diversity, equity, and inclusion within the healthcare workforce are conducive to providing culturally competent care. However, few existing studies have assessed the level of racial and ethnic diversity among resident physicians and residency applicants. Our objective was to provide a comparative analysis of the trends in racial and ethnic representation within different subspecialties in medicine.

The influence of social determinants of health on single-level anterior cervical discectomy and fusion outcomes.

Objective: Methods of reducing complications in individuals electing to undergo anterior cervical discectomy and fusion (ACDF) rely upon understanding at-risk patient populations, among other factors. This study aims to investigate the interplay between social determinants of health (SDOH) and postoperative complication rates, length of stay, revision surgery, and rates of postoperative readmission at 30 and 90 days in individuals electing to have single-level ACDF.

Methods: Using MARINER30, a database that contains claims information from all payers, patients were identified who underwent single-level ACDF between 2010 and 2019.

Decisional Regret Among Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity: A Single Institutional Study.

Study Design: Retrospective.

Objective: To investigate the prevalence of decisional regret among older adults undergoing surgery for adult spinal deformity (ASD).

Summary Of Background Data: Among older adults (≥65 years old), ASD is a leading cause of disability, with a population prevalence of 60% to 70%.

A pseudo-outbreak of Burkholderia cepacia complex in a Kentucky hospital.

A cluster of Burkholderia cepacia complex cases from January to October 2020 among outpatients undergoing urologic procedures within a Kentucky hospital's operating rooms was investigated. This investigation included a laboratory look-back, chart reviews, exposure tracing, staff interviews, and direct observation of infection prevention and control practices. A significant protocol breach in a laboratory procedure led to contamination of surgical specimens submitted for culture with nonsterile saline.

Patient and Spine Surgeon Perceptions on Shared Decision-Making in the Treatment of Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity.

Study Design: Retrospective.

Objective: To understand patients' and spine surgeons' perspectives about decision-making around surgery for adult spinal deformity.

Summary Of Background Data: Surgery for correction of adult spinal deformity is often beneficial; however, in over 20% of older adults (≥ 65 yrs of age), outcomes from surgery are less desirable.

The early impact of COVID-19 on primary care psychological therapy services: A descriptive time series of electronic healthcare records.

Background: There are growing concerns about the impact of the COVID-19 pandemic on mental health. With government-imposed restrictions as well as a general burden on healthcare systems, the pandemic has the potential to disrupt the access to, and delivery of, mental healthcare.

Methods: Electronic healthcare records from primary care psychological therapy services (Improving Access to Psychological Therapy) in England were used to examine changes in access to mental health services and service delivery during early stages of the COVID-19 pandemic.

The Financial Impact of the COVID-19 Pandemic on Neurosurgery Practice in Spring 2020.

Background: The coronavirus disease 2019 (COVID-19) pandemic has changed health care delivery across the United States. Few analyses have specifically looked at quantifying the financial impact of the pandemic on practicing neurosurgeons. A survey analysis was performed to address this need.

Comparison of Postoperative Opioid Utilization in an ACDF Cohort: Narcotic Naive Patients Versus Preoperative Opioid Users.

Study Design: A retrospective cohort study.

Objective: To compare the postoperative opioid utilization rates and costs after anterior cervical discectomy and fusion (ACDF) procedures between groups of patients who were preoperative opioid users versus opioid naive.

Summary Of Background Data: Opioid medications are frequently prescribed after ACDF procedures.

Sex Differences in Postoperative Complications and Functional Status After Deformity Correction Surgery: Do Men Fare Better Than Women?

Objective: We investigated whether a sex-related difference exists in the postoperative complication risk and health-related quality of life measures after surgery for adult spinal deformity.

Methods: We performed a retrospective study of 156 adult patients with a diagnosis of adult spinal deformity who had undergone spinal surgery. The primary outcome variables included the postoperative complication rates and changes in the health-related quality of life measures.

Controlling the Large-Scale Fabrication of Supraparticles.

Controlling the nanoscale interactions of colloidal building blocks is a key step for the transition from single nanoparticles to tailor-made, architected morphologies and their further integration into functional materials. Solvent evaporation-induced self-assembly within emulsion droplets emerges as a fast, versatile, and low-cost approach to obtain spherical, complex structures, such as supraparticles. Nevertheless, some process-structure relationships able to describe the effects of emulsion conditions on the synthesis outcomes still remain to be understood.

A comparison of prolonged nonoperative management strategies in cervical stenosis patients: Successes versus failures.

A paucity of evidence exists regarding the optimal composition of conservative therapies to best treat patients diagnosed with cervical stenosis prior to consideration of surgery. The purpose of this study was to compare the nonoperative therapy utilization strategies in cervical stenosis patients successfully managed with conservative treatments versus those that failed medical management and opted for an anterior cervical discectomy and fusion (ACDF) surgery. Medical records from adult patients with a diagnosis of cervical stenosis from 2007 to 2017 were collected retrospectively from a large insurance database.

Regional differences in prolonged non-operative therapy utilization prior to primary ACDF surgery.

There is a paucity of data characterizing regional variations in the utilization and costs of conservative management in patients suffering from cervical stenosis prior to anterior cervical discectomy and fusion (ACDF) surgery. An understating of these regional trends becomes critical as outcomes-based reimbursement strategies become standard. The objective of this investigation was to evaluate for regional differences in the utilization and overall costs of maximal non-operative therapy (MNT) prior to ACDF surgery.

A p53-Dependent Checkpoint Induced upon DNA Damage Alters Cell Fate during hiPSC Differentiation.

The ability of human induced pluripotent stem cells (hiPSCs) to differentiate in vitro to each of the three germ layer lineages has made them an important model of early human development and a tool for tissue engineering. However, the factors that disturb the intricate transcriptional choreography of differentiation remain incompletely understood. Here, we uncover a critical time window during which DNA damage significantly reduces the efficiency and fidelity with which hiPSCs differentiate to definitive endoderm.

Association of osteopenia and osteoporosis with higher rates of pseudarthrosis and revision surgery in adult patients undergoing single-level lumbar fusion.

Objective: Patients with osteopenia or osteoporosis who require surgery for symptomatic degenerative spondylolisthesis may have higher rates of postoperative pseudarthrosis and need for revision surgery than patients with normal bone mineral densities (BMDs). To this end, the authors compared rates of postoperative pseudarthrosis and need for revision surgery following single-level lumbar fusion in patients with normal BMD with those in patients with osteopenia or osteoporosis. The secondary outcome was to investigate the effects of pretreatment with medications that prevent bone loss (e.

Timeless couples G-quadruplex detection with processing by DDX11 helicase during DNA replication.

Regions of the genome with the potential to form secondary DNA structures pose a frequent and significant impediment to DNA replication and must be actively managed in order to preserve genetic and epigenetic integrity. How the replisome detects and responds to secondary structures is poorly understood. Here, we show that a core component of the fork protection complex in the eukaryotic replisome, Timeless, harbours in its C-terminal region a previously unappreciated DNA-binding domain that exhibits specific binding to G-quadruplex (G4) DNA structures.

An Assessment of Nonoperative Management Strategies in a Herniated Lumbar Disc Population: Successes Versus Failures.

Study Design: Retrospective cohort study.

Objective: To compare the utilization of conservative treatments in patients with lumbar intervertebral disc herniations who were successfully managed nonoperatively versus patients who failed conservative therapies and elected to undergo surgery (microdiscectomy).

Methods: Clinical records from adult patients with an initial herniated lumbar disc between 2007 and 2017 were selected from a large insurance database.

Communication during crisis.

The importance of leadership, messaging, and overcoming barriers.

Predicting patient engagement in IAPT services: a statistical analysis of electronic health records.

Background: Across England, 12% of all improving access to psychological therapy (IAPT) appointments are missed, and on average around 40% of first appointments are not attended, varying significantly around the country. In order to intervene effectively, it is important to target the patients who are most likely to miss their appointments.

Objective: This research aims to develop and test a model to predict whether an IAPT patient will attend their first appointment.

Competency-based training for in-home supportive services providers of consumers with ADRD.

The In-Home Supportive Services (IHSS) program in California provides direct care for low-income seniors and people with disabilities. Yet, the vast majority of these workers receive little to no training in caring for consumers, especially those with Alzheimer's disease and related dementias (ADRD). We developed and implemented a competency-based training program for IHSS caregivers who provide care for persons with ADRD.