2P or not 2P: The Question of Seizure Initiation.

[Box: see text].

Rural America's Hospitals are Not Prepared to Protect Older Adults From a Surge in COVID-19 Cases.

Rural communities with predominantly older adult populations could be especially vulnerable to poor outcomes from COVID-19 due to lacking intensive care unit (ICU) capacity. Our objective is to describe the scope of the problem by summarizing population totals of older adults in rural America and their community's ICU bed availability. We performed a review of peer-reviewed literature, in addition to hand searching non-peer-reviewed and governmental/non-governmental agency reports, using the Kaiser Health News data report to assess the number of ICU beds in 10 predominantly rural states with the highest older adult populations.

Early Results from Severe Acute Respiratory Syndrome Coronavirus 2 Polymerase Chain Reaction Testing of Healthcare Workers at an Academic Medical Center in New York City.

Coronavirus disease 2019 (COVID-19) reverse-transcription polymerase chain reaction employee testing was implemented across New York University Langone Health. Over 8 weeks, 14 764 employees were tested; 33% of symptomatic employees, 8% of asymptomatic employees reporting COVID-19 exposure, and 3% of employees returning to work were positive. Positivity rates declined over time, possibly reflecting the importance of community transmission and efficacy of personal protective equipment.

Preclinical contraceptive development for men and women.

This manuscript endeavors to present research considerations for the preclinical development of non-hormonal contraceptives. Topics include (1) how advances in genomics and bioinformatics impact the identification of novel targets for non-hormonal contraception, (2) the importance of target validation prior to investment in a contraceptive development campaign, (3) considerations on targeting gametogenesis vs gamete maturation/function, (4) how targets from the male reproductive system are expanding women's options for 'on demand' contraception, and (5) some emerging non-hormonal methods that are not based on a specific molecular target. Also presented are ideas for developing a pipeline of non-hypothalamic-pituitary-gonadal-acting contraceptives for men and women while balancing risk and innovation, and our perspective on the pros and cons of industry and academic environments on contraceptive development.

A Systematic Review of Interventions to Improve Nursing Home to Emergency Department Care Transitions.

This study aimed to identify interventions that are effective in improving the transitions of care for patients from nursing homes (NHs) to emergency departments (EDs). A total of 607 studies were identified, from which 19 studies were included for full-text review. Nine pre-post intervention studies and two retrospective cohort studies met all criteria for inclusion.

The association of lung ultrasound images with COVID-19 infection in an emergency room cohort.

Lung ultrasound could facilitate the triage of patients with suspected COVID-19 infection admitted to the emergency room. We developed a predictive model for COVID-19 diagnosis based on lung ultrasound and clinical features. We used ultrasound to image the lung bilaterally at two anterior sites, one and two hands below each clavicle, and a posterolateral site that was the posterior transverse continuation from the lower anterior site.

SCN3A-Related Neurodevelopmental Disorder: A Spectrum of Epilepsy and Brain Malformation.

Objective: Pathogenic variants in SCN3A, encoding the voltage-gated sodium channel subunit Nav1.3, cause severe childhood onset epilepsy and malformation of cortical development. Here, we define the spectrum of clinical, genetic, and neuroimaging features of SCN3A-related neurodevelopmental disorder.

Heterogeneity in the rate of molecular sequence evolution substantially impacts the accuracy of detecting shifts in diversification rates.

As species richness varies along the tree of life, there is a great interest in identifying factors that affect the rates by which lineages speciate or go extinct. To this end, theoretical biologists have developed a suite of phylogenetic comparative methods that aim to identify where shifts in diversification rates had occurred along a phylogeny and whether they are associated with some traits. Using these methods, numerous studies have predicted that speciation and extinction rates vary across the tree of life.

High-Flow Nasal Cannula Oxygen in Patients Having Anesthesia for Advanced Esophagogastroduodenoscopy: HIFLOW-ENDO, a Randomized Clinical Trial.

Background: Over 6 million esophagogastroduodenoscopy (EGD) procedures are performed in the United States each year. Patients having anesthesia for advanced EGD procedures, such as interventional procedures, are at high risk for hypoxemia.

Methods: Our primary study aim was to evaluate whether high-flow nasal cannula (HFNC) oxygen reduces the incidence of hypoxemia during anesthesia for advanced EGD.

Development of an affirming and customizable electronic survey of sexual and reproductive health experiences for transgender and gender nonbinary people.

To address pervasive measurement biases in sexual and reproductive health (SRH) research, our interdisciplinary team created an affirming, customizable electronic survey to measure experiences with contraceptive use, pregnancy, and abortion for transgender and gender nonbinary people assigned female or intersex at birth and cisgender sexual minority women. Between May 2018 and April 2019, we developed a questionnaire with 328 items across 10 domains including gender identity; language used for sexual and reproductive anatomy and events; gender affirmation process history; sexual orientation and sexual activity; contraceptive use and preferences; pregnancy history and desires; abortion history and preferences; priorities for sexual and reproductive health care; family building experiences; and sociodemographic characteristics. Recognizing that the words people use for their sexual and reproductive anatomy can vary, we programmed the survey to allow participants to input the words they use to describe their bodies, and then used those customized words to replace traditional medical terms throughout the survey.

Effects of fasting on isolated murine skeletal muscle contractile function during acute hypoxia.

Stored muscle carbohydrate supply and energetic efficiency constrain muscle functional capacity during exercise and are influenced by common physiological variables (e.g. age, diet, and physical activity level).

15 Smartphone Apps for Older Adults to Use While in Isolation During the COVID-19 Pandemic.

The maintenance of well-being, healthcare, and social connection is crucial for older adults (OA) and has become a topic of debate as much of the world faces lockdown during the coronavirus disease 2019 (COVID-19) pandemic. OAs have been advised to isolate themselves because they are at higher risk for developing serious complications from severe acute respiratory syndrome coronavirus. Additionally, nursing homes and assisted-living facilities across the country have closed their doors to visitors to protect their residents.

How Inflammation Blunts Innate Immunity in Aging.

The collective loss of immune protection during aging leads to poor vaccine responses and an increased severity of infection for the elderly. Here, we review our current understanding of effects of aging on the cellular and molecular dysregulation of innate immune cells as well as the relevant tissue milieu which influences their functions. The innate immune system is composed of multiple cell types which provide distinct and essential roles in tissue surveillance and antigen presentation as well as early responses to infection or injury.

The Imperative for Transgender and Gender Nonbinary Inclusion: Beyond Women's Health.

We aim to make evident that solely referencing cisgender women in the context of sexual and reproductive health-particularly pregnancy planning and care-excludes a diverse group of transgender and gender nonbinary people who have sexual and reproductive health needs and experiences that can be similar to but also unique from those of cisgender women. We call on clinicians and researchers to ensure that all points of sexual and reproductive health access, research, sources of information, and care delivery comprehensively include and are accessible to people of all genders. We describe barriers to sexual and reproductive health care and research participation unique to people of marginalized gender identities, provide examples of harm resulting from these barriers, and offer concrete suggestions for creating inclusive, accurate, and respectful care and research environments-which will lead to higher quality health care and science for people of all genders.

Cervical spine MRI phenotypes and prediction of pain, disability and adjacent segment degeneration/disease after ACDF.

Degenerative spine imaging findings have been extensively studied in the lumbar region and are associated with pain and adverse clinical outcomes after surgery. However, few studies have investigated the significance of these imaging "phenotypes" in the cervical spine. Patients with degenerative cervical spine pathology undergoing anterior cervical discectomy and fusion (ACDF) from 2008 to 2015 were retrospectively and prospectively assessed using preoperative MRI for disc degeneration, narrowing, and displacement, high-intensity zones, endplate abnormalities, Modic changes, and osteophyte formation from C2-T1.

and Mutations Promote 4NQO-Initated Head and Neck Tumor Progression and Metastasis in Mice.

The PI3K signaling pathway is frequently mutated in head and neck squamous cell carcinoma (HNSCC), often via gain-of-function (GOF) mutations in the gene. Here, we present novel genetically engineered mouse models (GEMM) carrying a GOF allele (E20) alone or in combination with heterozygous - (p53) mutation with tissue-specific expression to interrogate the role of oncogenic in transformation of upper aerodigestive track epithelium. We demonstrated that the GOF mutation promoted progression of 4-nitroquinoline 1-oxide-induced oral squamous cell carcinoma (OSCC) in both E20 single mutant and E20/p53 double mutant mice, with frequent distal metastasis detected only in E20/p53 GEMM.

Sliced Human Cortical Organoids for Modeling Distinct Cortical Layer Formation.

Human brain organoids provide unique platforms for modeling development and diseases by recapitulating the architecture of the embryonic brain. However, current organoid methods are limited by interior hypoxia and cell death due to insufficient surface diffusion, preventing generation of architecture resembling late developmental stages. Here, we report the sliced neocortical organoid (SNO) system, which bypasses the diffusion limit to prevent cell death over long-term cultures.

Development and validation of a novel scoring tool for predicting facility discharge after elective posterior lumbar fusion.

Background Context: Discharge to acute/intermediate care facilities is a common occurrence after posterior lumbar fusion and can be associated with increased costs and complications after these procedures. This is particularly relevant with the growing popularity of bundled payment plans, creating a need to identify patients at greatest risk.

Purpose: To develop and validate a risk-stratification tool to identify patients at greatest risk for facility discharge after open posterior lumbar fusion.

Interneuron Desynchronization Precedes Seizures in a Mouse Model of Dravet Syndrome.

Recurrent seizures, which define epilepsy, are transient abnormalities in the electrical activity of the brain. The mechanistic basis of seizure initiation, and the contribution of defined neuronal subtypes to seizure pathophysiology, remains poorly understood. We performed two-photon calcium imaging in neocortex during temperature-induced seizures in male and female Dravet syndrome (+/-) mice, a neurodevelopmental disorder with prominent temperature-sensitive epilepsy.

Oral typhoid vaccine Ty21a elicits antigen-specific resident memory CD4 T cells in the human terminal ileum lamina propria and epithelial compartments.

Background: Salmonella enterica serovar Typhi (S. Typhi) is a highly invasive bacterium that infects the human intestinal mucosa and causes ~ 11.9-20.

Care Transition Decisions After a Fall-related Emergency Department Visit: A Qualitative Study of Patients' and Caregivers' Experiences.

Objective: Falls are a leading cause of injury-related emergency department (ED) visits and may serve as a sentinel event for older adults, leading to physical and psychological injury. Our primary objective was to characterize patient- and caregiver-specific perspectives about care transitions after a fall.

Methods: Using a semistructured interview guide, we conducted in-depth, qualitative interviews using grounded theory methodology.

Memory in Trait Macroevolution.

The history of a trait within a lineage may influence its future evolutionary trajectory, but macroevolutionary theory of this process is not well developed. For example, consider the simplified binary trait of living in cave versus surface habitat. The longer a species has been cave dwelling, the more accumulated loss of vision, pigmentation, and defense may restrict future adaptation if the species encounters the surface environment.

Celebrating the Silver Anniversary of the North American Testis Workshop.

Objective: To provide an overview of the history of the North American Testis Workshop (NATW), of its relationship to the American Society of Andrology (ASA), and of the publications that resulted from the first 25 workshops.

Methods: The collection of volumes and journal articles that relate to the NATW was searched.

Discussion And Conclusion: During the first twenty-five meetings of the NATW, a remarkable number of breakthroughs regarding every aspect of the testis were presented.