Psychometric Properties of the Lactation Assessment and Comprehensive Intervention Tool (LAT).

Background: Despite the short- and long-term acknowledged benefits of breastfeeding for mothers and their infants, worldwide rates trail behind international goals. Prior research confirms that breastfeeding is a nurse sensitive indicator and that problems with latching the baby and painful breastfeeding rank high among the reasons given for not continuing to breastfeed. The Lactation Assessment Tool (LAT) was previously evaluated in a study conducted in Latvia by nurse midwives.

A phase II trial of larotrectinib in tumors with NTRK fusions or extremes of NTRK mRNA overexpression identified by comprehensive genomic profiling.

Background: TRK-inhibitors have demonstrated efficacy across several cancers with NTRK fusions. Their activity in cancers with NTRK overexpression remains unclear.

Methods: This trial enrolled patients with advanced cancers harboring NTRK fusions or extreme mRNA overexpression, defined as NTRK1/2/3 expression by RNA profiling >5 SDs for a given cancer type.

Testing the Feasibility of a Cross-Setting Measure to Address the Rising Trend in Hospital Outpatient TJA Procedures.

Background: Elective primary total hip and total knee arthroplasty (collectively, total joint arthroplasties [TJAs]) are commonly performed procedures that can reduce pain and improve function. TJAs are generally safe, but complications can occur. Although historically performed as inpatient procedures, TJAs are increasingly being performed in the outpatient setting.

Resident Instruction: Improving End-of-Year Medical Student Ultrasound Performance.

Background And Objectives: Having a limited number of trained faculty is a barrier to successful incorporation of ultrasound into undergraduate medical education. We evaluated the effectiveness of a resident-led extended focused assessment with sonography in trauma (eFAST) session administered to fourth-year medical students during their emergency medicine clerkship by measuring students' end-of-year eFAST performance and confidence.

Methods: This was a single-site cross-sectional study of all graduating medical students enrolled in fourth-year clerkships between May 1, 2022 and April 30, 2023.

Oncogenic mutations in the TP53 and PI-3 kinase/AKT pathway are independent predictors of survival for advanced thyroid cancer: Analysis from the Molecular Screening and Therapeutics (MoST) program.

Background: Thyroid cancers with mutations in the phosphatidylinositol-3 kinase/AKT pathway have a poorer prognosis. However, knowledge about the relationship between histology, mutation profile, and outcomes is still developing. This study assessed the prognostic value of genomic profiles for patients with advanced thyroid cancer who experienced progression on conventional treatment.

Attenuation Measuring Ultrasound Shearwave Elastography (AMUSE) as Noninvasive Imaging Biomarker for Liver Acute Cellular Rejection.

Objective: There are over 9000 liver transplants in the United States per year, with acute cellular rejection (ACR) being a prevalent early post-transplant complication (20%-40%) treated using corticosteroids. Ischemia-reperfusion injury (IRI), another early post-transplant pathology, has similar laboratory results but typically resolves without therapy. ACR confirmation requires invasive liver biopsy, bearing risks like hemorrhage and pneumothorax.

Temperature-dependent predation predicts a more reptilian future.

Diversity increases toward the tropics, but the strength of this pattern diverges with thermoregulatory strategy. Synthesizing over 30,000 species distributions, we quantified patterns of richness in terrestrial vertebrates, and present evidence for a latitudinal gradient of community composition. We observe a two orders of magnitude shift in comparative diversity with temperature, from endothermic mammal and avian dominance near the poles, toward ectothermic reptile and amphibian majority in the tropics.

Affordable in-house tests for bacteriuria can improve antimicrobial stewardship and access to care.

Objective: To evaluate the clinical utility of 3 in-house tests to screen for bacteriuria in dogs with urinary conditions: a computerized urine sediment analyzer (SediVue), a rapid immunoassay (RapidBac), and in-house urine culture. Accuracy of culture and antimicrobial susceptibility (C&S) results from submission of the positive in-house culture plate and a 24- to 48-hour refrigerated urine sample was also assessed.

Methods: Sterile urine samples from 101 client-owned dogs were used to evaluate sensitivity, specificity, positive predictive value, and negative predictive value of 3 in-house diagnostic tests to detect bacteriuria using C&S testing at a reference laboratory as the reference standard.

A signal-seeking phase 2 study of Trastuzumab emtansine in tumours harbouring HER2 amplification or mutation.

This single-arm phase II non-randomised trial (ACTRN12619001265167) evaluated trastuzumab emtansine in solid cancers with HER2 amplification or mutation detected by comprehensive genomic profiling. The primary objective was objective response (OR), while secondary objectives included the time to progression (TTP) on study to TTP on prior therapy ratio, progression-free survival (PFS) and overall survival (OS). The cohort included 16 tumours with HER2 mutations (group 1) and 16 with HER2 amplification (group 2).

Clinical Remission of Cutaneous Lymphoma in a Dog Treated with Verdinexor.

A 5 yr old female spayed pit bull terrier mix was evaluated for development of multiple dermal nodules over the previous 2 wk with concurrent weight loss and lethargy. A definitive diagnosis of cutaneous epitheliotropic T-cell lymphoma was obtained through histopathology and immunohistochemistry. Treatment was initiated with 32.

Point-of-care ultrasound associated with shorter length of stay than computed tomography for renal colic.

Background: Despite similar diagnostic effectiveness for renal colic, computed tomography (CT) is more resource intensive than point-of-care ultrasound (PoCUS). We sought to compare Emergency Department (ED) length of stay (LOS) among patients with renal colic according to imaging modality utilized. We secondarily compared rates of infection, return ED visits, missed significant pathology, and urologic intervention.

Standard experimental paradigm designs and data exclusion practices in cognitive psychology can inadvertently introduce systematic "shadow" biases in participant samples.

Standard cognitive psychology research practices can introduce inadvertent sampling biases that reduce the reliability and generalizability of the findings. Researchers commonly acknowledge and understand that any given study sample is not perfectly generalizable, especially when implementing typical experimental constraints (e.g.

A pan-sarcoma landscape of telomeric content shows that alterations in RAD51B and GID4 are associated with higher telomeric content.

Tumor cells need to activate a telomere maintenance mechanism, enabling limitless replication. The bulk of evidence supports that sarcomas predominantly use alternative lengthening of telomeres (ALT) mechanism, commonly associated with alterations in ATRX and DAXX. In our dataset, only 12.

Rescinding evidence-based care and practices during the initial COVID-19 outbreak in the United States: a qualitative study of the experiences of lactation support providers.

Background: The COVID-19 pandemic disrupted healthcare systems and services including along the childbearing continuum. The aim of this study was to explore the experiences and perceptions of professional lactation support providers who cared for breastfeeding families during the early months of the pandemic (March 2020 - August 2020) in the United States.

Design/methods: We conducted a qualitative survey among active lactation support providers in the United States.

Minutes matter: Time it takes to perform point-of-care ultrasound.

Background: While point-of-care ultrasound (PoCUS) is a safe, versatile tool that can improve patient care, the perceived time investment needed to incorporate PoCUS into clinical care is cited as a barrier to performance. We sought to determine the time it takes to perform a PoCUS examination and whether this time was influenced by training level and prior ultrasound experience.

Methods: This was a retrospective study looking at time stamps of all emergency medicine (EM) provider-performed PoCUS examinations during clinical shifts from August 10, 2019, to June 7, 2022, at a suburban academic emergency department that is the site for a 3-year EM residency.

Plantar Fasciitis or Flexor Digitorum Brevis Myositis.

Background: As common as plantar fasciitis is, there's a lack of evidence regarding the true pathophysiologic process causing plantar fasciitis and plantar heel pain in general. This may partially explain the high variability and outcomes with current treatment of recalcitrant plantar fasciitis. Although Lemont reported myxoid degeneration of plantar fascia with histologic analysis of patients with fasciitis, muscle biopsy results were not reported.

A signal-seeking Phase 2 study of olaparib and durvalumab in advanced solid cancers with homologous recombination repair gene alterations.

Purpose: To determine the safety and efficacy of PARP plus PD-L1 inhibition (olaparib + durvalumab, O + D) in patients with advanced solid, predominantly rare cancers harbouring homologous recombination repair (HRR) defects.

Patients And Methods: In total, 48 patients were treated with O + D, 16 with BRCA1/2 alterations (group 1) and 32 with other select HRR alterations (group 2). Overall, 32 (66%) patients had rare or less common cancers.

Disclosure of Complementary and Alternative Medicine Use Among Older Adults: A Cross-Sectional Study.

Although use of complementary and alternative medicine (CAM) is rising among older adults, many do not discuss these healthcare practices with their primary care practitioners (PCPs). This study sought to determine the prevalence of CAM use and to identify factors associated with CAM disclosure among patients ages 65 and older. : Participants completed an anonymous survey, which evaluated their CAM use over the past year and disclosure of CAM to a PCP.

Successful Medical Management of an Acute Traumatic Sternal Luxation in a Cat.

A 5 yr old indoor-outdoor domestic longhair red tabby cat presented for evaluation of a 1-day history of hiding, urinating and defecating outside the litterbox, and vocalizing when picked up. Physical examination revealed significant pain on palpation of the caudal sternum where an approximately 8 × 6 cm contusion was noted. Sedated thoracic radiographs revealed a luxated fifth intersternebral joint with the sixth sternebra being cranioventrally displaced (along with the seventh and eight sternebrae) to the level of the mid fourth sternebra.