Computed tomography dataset virtual dissection for sternal re-entry in congenital cardiac surgery.

Unlabelled: In congenital heart surgery, redo-sternotomies are very common. In most cases, sternal re-entry is achieved without serious complications. However, sometimes elective institution of peripheral cardiopulmonary bypass is needed for safe sternotomy, albeit with a long cardio-pulmonary bypass time.

Safety and Outcomes of an On-Demand Transfusion Strategy Versus Prophylactic Transfusion of Platelets in Patients With Liver Cirrhosis and Severe Thrombocytopenia Undergoing High-Risk Procedures: A Analysis of Two Randomized Controlled Trials.

Background: There are limited studies assessing whether prophylactic platelet transfusions prior to high-risk procedures reduce the risk of bleeding in patients with liver cirrhosis.

Methods: We performed a analysis of two prior randomized clinical trials (CTRI/2017/12/010822 and CTRI/2021/05/033464), which compared thromboelastography-guided prophylactic platelet transfusion to standard-of-care (empirical prophylactic transfusion for all patients prior to the procedure) or on-demand transfusion (no prophylactic transfusions). We aimed to assess the risk of major procedure-related bleeding or mortality among patients who had received prophylactic platelet transfusions versus those who did not (on-demand transfusions).

Association of the Triglyceride Glucose Index With Outcomes in Acute Ischemic Stroke Injury.

Objectives The study aimed at estimating the triglyceride glucose (TyG) index in patients with ischemic stroke, exploring the correlation between the TyG index and the prognosis of ischemic stroke, and studying the clinical outcome in patients with acute ischemic stroke (AIS) in association with the TyG index. Methods An observational study was conducted on 105 patients with a history of AIS presenting within 24 hours. The TyG index was estimated, and the clinical outcome was studied.

Outcomes of Coccidioides Seropositive Solid Organ Transplant Recipients After Self-discontinuation of Antifungal Prophylaxis: The EIA-IgM-only Conundrum.

Background: Solid organ transplant recipients are at risk of severe coccidioidomycosis and are given prophylaxis to mitigate the risk. Patients with seropositive testing typically receive lifelong prophylaxis; currently, this prophylaxis strategy includes patients who are positive only for IgM by enzyme immunoassay (EIA-IgM-only), although this result may be falsely positive.

Methods: We conducted a retrospective study at a large-volume transplant center in an endemic coccidioidomycosis region to compare outcomes of non-lung transplant recipients who were seropositive for Coccidioides but discontinued prophylaxis (case patients) to outcomes of patients who continued prophylaxis (controls).

Investigating the nature of trust in the medical student-professor relationship: an interview study.

While trust is an essential resource in successful social exchanges, the basis of trust in the student-professor relationship in higher education has not been extensively studied. The purpose of the present study was to gain a better understanding of how trust is developed within a medical school learning environment. To that end, we applied a qualitative approach using semi-structured interviews.

Sensing of -butanol vapours using an oxygen vacancy-enriched ZnSnO-SnO hybrid-composite.

The precise identification of various toxic gases is important to prevent health and environmental hazards using cost-effective, efficient, metal oxide-based chemiresistive sensing methods. This study explores the sensing properties of a chemiresistive sensor based on a ZnSnO-SnO microcomposite for detecting -butanol vapours. The microcomposite, enriched with oxygen vacancies, was thoroughly characterized, confirming its structure, crystallinity, morphology and elemental composition.

Efficacy and safety of daprodustat in patients on peritoneal dialysis in the ASCEND-D trial.

Background And Hypothesis: Daprodustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, is approved for treatment of anemia in dialysis patients with CKD in some parts of the world. This subgroup analysis examined the efficacy and safety of daprodustat versus darbepoetin alfa in patients with anemia of CKD undergoing peritoneal dialysis (PD).

Methods: ASCEND-D (NCT02879305) was an open-label, Phase 3 trial; patients with CKD were randomized to daprodustat daily and epoetin alfa (HD patients) or darbepoetin alfa (PD patients).

Pseudovascular squamous cell carcinoma of the buccal mucosa-a rare case report and review of literature.

Squamous cell carcinoma is the most common malignancy of the head and neck. Pseudovascular squamous cell carcinoma (PSCC) is a rare variant that occurs commonly in the skin of the head and neck. However, oral cavity involvement is extremely rare, with only a few cases reported to date.

Wave ripples formed in ancient, ice-free lakes in Gale crater, Mars.

Symmetrical wave ripples identified with NASA's Curiosity rover in ancient lake deposits at Gale crater provide a key paleoclimate constraint for early Mars: At the time of ripple formation, climate conditions must have supported ice-free liquid water on the surface of Mars. These features are the most definitive examples of wave ripples on another planet. The ripples occur in two stratigraphic intervals within the orbitally defined Layered Sulfate Unit: a thin but laterally extensive unit at the base of the Amapari member of the Mirador formation, and a sandstone lens within the Contigo member of the Mirador formation.

Role of Acorus calamus extract in reducing exosome secretion by targeting Rab27a and nSMase2: a therapeutic approach for breast cancer.

Background: Exosomes are extracellular vesicles released by cells that mediate intercellular communication and actively participate in cancer progression, metastasis, and regulation of immune response within the tumour microenvironment. Inhibiting exosome release from cancer cells could be employed as a therapeutic against cancer.

Methods And Results: In the present study, we have studied the effects of Acorus calamus in inhibiting exosome secretion via targetting Rab27a and neutral sphingomyelinase 2 (nSMase2) in HER2-positive (MDA-MB-453), hormone receptor-positive (MCF-7) and triple-negative breast cancer (MDA-MB-231) cells.

Acquired factor V inhibitor in a case of pediatric venous thrombosis.

Background: The development of acquired factor (F)V with inhibitor (AFVwI) is rare, resulting mainly in bleeding complications, although sporadic cases of thrombosis in adults have been reported.

Key Clinical Question: How do you diagnose and manage a pediatric case of acute deep venous thrombosis associated with the concurrent finding of AFVwI?

Clinical Approach: A 13-year-old female with Crohn's Disease and May-Thurner anatomy developed extensive deep venous thrombosis of the left lower extremity, complicated by the finding of AFVwI, discovered during the evaluation of a prolonged prothrombin time and a low FV activity. Anticoagulation was initiated with low-molecular-weight heparin followed by a direct oral anticoagulant, rivaroxaban, without any complications.

Social jetlag decreases across the lifespan: A prospective big data analysis of objective sleep metrics.

Changes in social zeitgebers across the lifespan affect the interaction between biological and social clocks, potentially contributing to social jetlag. Extant literature suggests a reduction in social jetlag given declining social obligations occurring after retirement, but is limited to self-reported methods and cross-sectional designs. Leveraging longitudinal and ecologically valid data from consumer sleep technology, we analysed objective sleep data from 2439 users of the polysomnography-validated SleepScore mobile application, encompassing 500,415 total nights recorded.

Advances in VEGFR Inhibitors: A Comprehensive Review of Novel Anticancer Agents.

Cancer, characterized by aberrant cell growth, presents a formidable health challenge, impacting millions of individuals worldwide each year. Among the myriad mechanisms facilitating tumor progression, Vascular Endothelial Growth Factor receptors (VEGFR) play a pivotal role in driving angiogenesis the process by which tumors develop their own blood supply. This vascularization not only supports tumor nourishment and growth but also facilitates metastasis, enabling cancer to spread to distant sites.

Unraveling the chains: Exploring the impact of ownership on administrator turnover in nursing homes.

Background: Leadership instability in nursing homes marked by high administrator turnover threatens the well-being of vulnerable residents. Although numerous factors have been implicated, the role of ownership remains unexplored.

Purposes: Based upon the tenets from institutional theory and strategic management theory, the primary goal of this study was to examine the impact of ownership on administrator turnover.

Disruptions in cellular communication: Molecular interplay between glutamate/NMDA signalling and MAPK pathways in neurological disorders.

Neurological disorders significantly impact the central nervous system, contributing to a growing public health crisis globally. The spectrum of these disorders includes neurodevelopmental and neurodegenerative diseases. This manuscript reviews the crucial roles of cellular signalling pathways in the pathophysiology of these conditions, focusing primarily on glutaminase/glutamate/NMDA receptor signalling, alongside the mitogen-activated protein kinase (MAPK) pathways-ERK1/2, C-JNK, and P38 MAPK.

Recruiting Young People for Digital Mental Health Research: Lessons From an AI-Driven Adaptive Trial.

Background: With increasing adoption of remote clinical trials in digital mental health, identifying cost-effective and time-efficient recruitment methodologies is crucial for the success of such trials. Evidence on whether web-based recruitment methods are more effective than traditional methods such as newspapers, media, or flyers is inconsistent. Here we present insights from our experience recruiting tertiary education students for a digital mental health artificial intelligence-driven adaptive trial-Vibe Up.

Three-Dimensional Assessment of the Condylar Position in Different Malocclusions Using Cone-Beam Computed Tomography: A Cross-Sectional Study.

Introduction The role of the condylar position in the correct functioning of the stomatognathic system has been the center of the study. Using cone-beam computed tomography (CBCT), this study looked at the three-dimensional (3D) position of the condylar bone in patients from Class I, Class II, Division 1, and Division 2. Materials and methods This cross-sectional, retrospective study was conducted using 102 CBCT records, with 34 records allocated to each category of malocclusion classification, such as dentoskeletal Class I, skeletal Class II, and dental Class II, Division 1 and 2.

Dietary Chia (Salvia hispanica L.) seeds oil supplementation augments growth performance and gut microbial composition in Labeo rohita fingerlings.

The present study investigates the supplemental effects of chia seed oil (CSO) on the growth performance and modulation of intestinal microbiota in Labeo rohita fingerlings. Four diets were formulated with graded levels of CSO: 1.0%, 2.

Evaluation of subretinally delivered Cas9 ribonucleoproteins in murine and porcine animal models highlights key considerations for therapeutic translation of genetic medicines.

Genetic medicines, including CRISPR/Cas technologies, extend tremendous promise for addressing unmet medical need in inherited retinal disorders and other indications; however, there remain challenges for the development of therapeutics. Herein, we evaluate genome editing by engineered Cas9 ribonucleoproteins (eRNP) in vivo via subretinal administration using mouse and pig animal models. Subretinal administration of adenine base editor and double strand break-inducing Cas9 nuclease eRNPs mediate genome editing in both species.

Clinical Evaluation, Patch Testing, and Quality of Life Assessment in Patients With Cosmetic Dermatitis.

Background Cosmetics have become an integral part of the contemporary lifestyle. Contact dermatitis (CD) is an inflammatory skin disease resulting from exposure to an external chemical present in cosmetics. A patch test is considered the criterion standard method for detecting CD.

Volumetric Comparison of the Temporomandibular Joint Space in Skeletal Class I and II Patients Using Cone-Beam Computed Tomography: A Cross-Sectional Study.

Introduction: The temporomandibular joint (TMJ) is one of the most intricate anatomical entities within the human body and is clinically relevant in the field of dentistry. Therefore, the present study aimed to conduct a three-dimensional (3D) volumetric comparison of the TMJ space in skeletal Class I and II patients using cone-beam computed tomography (CBCT).

Materials And Methods: This cross-sectional, retrospective study was conducted on 40 CBCT records divided into skeletal Class I and skeletal Class II patients.

Associations of perceived discrimination with health outcomes and health disparities in the cohort.

Objective: The goal of this study was to investigate the association of perceived discrimination with health outcomes and disparities.

Materials And Methods: The study cohort consists of 60,180 participants from the four largest SIRE groups in the Research Program participant body: Asian (1,291), Black (4,726), Hispanic (5,336), and White (48,827). A perceived discrimination index (PDI) was derived from participant responses to the "Social Determinants of Health" survey, and the Researcher Workbench was used to analyze associations and mediation effects of PDI and self-identified race and ethnicity (SIRE) with 1,755 diseases.

A composite socioeconomic deprivation index from survey data: associations with health outcomes and disparities.

Socioeconomic deprivation - defined as a lack of social, economic and material resources - is associated with poor health outcomes and health disparities between population groups. The Research Program is a longitudinal cohort study of diverse participants from the United States, with demographic and social determinants of health data gleaned from participant surveys and health outcome data derived from electronic health records. We developed a composite index of socioeconomic deprivation (iSDI) using a cohort of 202,919 participants - based on education, employment, health insurance, housing, and income data - and we associated iSDI with health outcomes and disparities.

Access to timely cancer treatment initiation in India: extent, determinants and trends.

Background: Treatment delays are significantly associated with advanced stage, poor response to treatment, increased mortality risk, poor health outcomes, increased healthcare expenditures among cancer patients. However, factors associated with these delays have not yet been robustly evaluated. In order to bridge this gap, we determined the delayed time to treatment initiation (TTI) among cancer patients in India, ascertained its determinants, and assessed the trends of delayed TTI.