End-stage ankle arthritis alters dynamic stability during gait as measured by margin of stability between limbs and compared to healthy controls.

Objective: This study aimed to assess dynamic stability in individuals with end-stage ankle arthritis compared to healthy controls by evaluating the margin of stability (MoS) during gait.

Design: A cohort of 50 participants with end-stage ankle arthritis (AA) and 50 matched healthy controls (HC) were analyzed from an IRB approved database. Kinematic data were collected using an eight-camera motion analysis system, and MoS was calculated based on the extrapolated center of mass (XCoM) and the base of support (BoS).

Impact of Liposomal Bupivacaine on Enhanced Recovery After Surgery Protocol for Lung Resection.

Background: There is limited data showing the benefit of liposomal bupivacaine as part of an Enhanced Recovery After Surgery (ERAS) protocol in reducing opioid use in minimally invasive lobectomies.

Methods: A retrospective observational study compared 3 cohorts of patients who underwent lobectomies between January 2015 and December 2021. The control group neither received liposomal bupivacaine intraoperatively nor underwent an ERAS protocol.

Synthesis and Energetic Characterization of Borane-Amines on High-Nitrogen Heterocycles.

Borane-amines have garnered attention over the last several decades in a variety of applications, ranging from hydrogen storage materials to hypergolic fuel systems. An investigation into the synthesis of borane-amines with high-nitrogen content heterocycles was undertaken in this work. Borane-amines were formed by the reaction of BH·MeS in tetrahydrofuran (THF) with the requisite nitrogen-containing heterocycle and isolated by placing the crude reaction mixture in hexanes to precipitate the product.

Utilizing Telenursing to Supplement Acute Care Nursing in an Era of Workforce Shortages: A Feasibility Pilot.

Hospitals are experiencing a nursing shortage crisis that is expected to worsen over the next decade. Acute care settings, which manage the care of very complex patients, need innovations that lessen nurses' workload burden while ensuring safe patient care and outcomes. Thus, a pilot study was conducted to evaluate the feasibility of implementing a large-scale acute care telenurse program, where a hospital-employed telenurse would complete admission and discharge processes for hospitalized patients virtually.

Systems-Based Physical Assessments: Earlier Detection of Clinical Deterioration and Reduced Mortality.

Background: Despite efforts to improve early detection of deterioration in a patient's condition, delays in activating the rapid response team remain common.

Objectives: To evaluate delays in activating the rapid response team and the occurrence of serious adverse events before and after implementation of a quality improvement initiative aimed at nurses' performing systems-based physical assessments.

Methods: A retrospective observational cohort design was used to evaluate all patients who had a rapid response team activation during the study period.

Pancreaticoduodenal Artery Aneurysm Complicated by Median Arcuate Ligament Syndrome.

Purpose: To highlight median arcuate ligament syndrome as a potential cause for celiac artery stenosis and pancreaticoduodenal artery aneurysm, and describe treatment options in this setting.

Case Report: A 63-year-old male presented with a pancreaticoduodenal artery aneurysm and concomitant celiac artery stenosis that was treated with celiac artery stenting and aneurysm coiling. He subsequently developed stent fracture and celiac artery occlusion secondary to previously unrecognized median arcuate ligament syndrome causing reperfusion of the aneurysm.

350 mJ electro-optically Q-switched 2.79 µm Cr:Er:YSGG MOPA.

We report on developing three flashlamp-pumped electro-optically Q-switched Cr:Er:YSGG lasers with the Q-switch based on a LaGaSiO crystal. The "short" laser cavity was optimized for high peak power applications. In this cavity, 300 mJ output energy in 15 ns pulses at a 3 Hz repetition rate was demonstrated with pump energy below 52 J.

Impact of a High Observation Trauma Protocol on Patients with Isolated Traumatic Brain Injury.

Background: Nationally, the volume of geriatric falls with intracranial hemorrhage is increasing. Our institution began observing patients with intracranial hemorrhage, Glasgow Coma Scale of 14 or greater, and no midline shift or intraventricular hemorrhage with hourly neurologic examinations outside of the ICU in a high observation trauma (HOT) protocol. We first excluded patients on anticoagulants or antiplatelets (HOT I), then included antiplatelets and warfarin (HOT II), and finally, included direct oral anticoagulants (HOT III).

Self-Evisceration of Intestines as the Initial Presentation of Schizoaffective Disorder.

Schizoaffective disorder is categorized by major mood episodes and symptoms of schizophrenia that include disorganized speech, delusions, paranoia, and hallucinations. It is associated with risk factors, including a history of abuse and cannabis use, and patients are typically diagnosed in adolescence and young adulthood. In this case report, we describe the unusual case of a 39-year-old male patient with undiagnosed schizoaffective disorder who self-eviscerated his intestines during an episode of psychosis.

Endovascular therapy for Stanford B aortic dissection for patients with Marfan Syndrome: systematic review and meta-analysis.

Introduction: The role of thoracic endovascular aortic repair (TEVAR) in patients with Marfan Syndrome with Stanford type B aortic dissection (TBAD) remains under debate.

Evidence Acquisition: MEDLINE and EMBASE were searched through December 2021 to identify studies that investigated outcomes in MFS patients with TBAD who underwent TEVAR. Data regarding patient characteristics, perioperative and late outcomes were extracted.

Physical assessment competencies for nurses: A quality improvement initiative.

As the only healthcare providers caring for hospitalized patients every hour of every day, nurses have a responsibility to keep patients safe. Physical assessment is a basic but essential nursing skill that fosters patient safety. Assessing a patient's current status enables nurses to recognize early patient deterioration.

Utilization of the Revised American College of Rheumatology (rACR) Scoring to Avoid Unnecessary Temporal Artery Biopsies-A Case Series.

Introduction: The American College of Rheumatology (ACR) criteria, and more recently the revised ACR criteria (rACR), are a scoring system developed to aid in the diagnosis of giant cell arteritis (GCA). Our aim was to investigate the value of the non-biopsy criteria of the original ACR criteria and rACR criteria to predict GCA, and investigate the utilization of such scores to avoid biopsy when a very high or very low likelihood of a positive temporal artery biopsy TAB was predicted. Method: We conducted a retrospective cohort study of 59 patients undergoing TAB from 2013 to 2017 in Beaumont Hospital, a tertiary referral centre in Dublin, Ireland.

Multireader evaluation of radiologist performance for COVID-19 detection on emergency department chest radiographs.

Background: Chest radiographs (CXR) are frequently used as a screening tool for patients with suspected COVID-19 infection pending reverse transcriptase polymerase chain reaction (RT-PCR) results, despite recommendations against this. We evaluated radiologist performance for COVID-19 diagnosis on CXR at the time of patient presentation in the Emergency Department (ED).

Materials And Methods: We extracted RT-PCR results, clinical history, and CXRs of all patients from a single institution between March and June 2020.

Imaging Manifestations of Chest Trauma.

Trauma is the leading cause of death among individuals under 40 years of age, and pulmonary trauma is common in high-impact injuries. Unlike most other organs, the lung is elastic and distensible, with a physiologic capacity to withstand significant changes in contour and volume. The most common types of lung parenchymal injury are contusions, lacerations, and hematomas, each having characteristic imaging appearances.

Superior inhibitory efficacy of butyrate over propionate and acetate against human colon cancer cell proliferation via cell cycle arrest and apoptosis: linking dietary fiber to cancer prevention.

Intake of dietary fiber may protect against colon cancer. The anticancer property is associated with an increased production of short chain fatty acids (SCFAs), including acetate, propionate and butyrate, during dietary fiber fermentation in the colon. However, the mechanisms remain to be determined.

Return on Investment of the Primary Health Care Integrated Geriatric Services Initiative Implementation.

Background: Since June 2017, the Primary Health Care Integrated Geriatric Services Initiative (PHC IGSI) has been implemented in Alberta, Canada to, among other aims, reduce costs of unplanned health service utilization while maximizing the utilization of available community resources to support people living with dementia living in communities.

Aim Of The Study: We performed an economic evaluation of this initiative to inform policy regarding sustainability, scale up and spread.

Methods: We used a cohort design together with a difference-in-difference approach and a propensity score matching technique to calculate impacts of the intervention on patient's health service utilization, including inpatient, outpatient and physician services, as well as prescription drugs.

Imaging review of sickle cell disease for the emergency radiologist.

Sickle cell disease (SCD), one of the most common inherited genetic syndromes in the USA, is characterized by recurring episodes of acute illness and progressive multisystem organ injury. Individuals with SCD frequently present to the emergency department for a spectrum of complications, such as vaso-occlusive crises, infection, cholecystitis, and stroke. Imaging correlates for most of these presentations exist, positioning the emergency radiologist to play a pivotal role in facilitating patient care.

Animal-Assisted Activity in Critically Ill Older Adults: A Randomized Pilot and Feasibility Trial.

Background: Limited evidence suggests the efficacy of animal-assisted activities (AAA) in improving biobehavioral stress responses in older patients in intensive care units (ICUs).

Objectives: To assess the feasibility of an AAA (dog) intervention for improving biobehavioral stress response, measured by self-reported stress and anxiety and salivary cortisol, C-reactive protein, and interleukin-1β in older ICU patients, we examined enrollment, attrition, completion, data collection, and biobehavioral stress responses.

Methods: ICU patients ≥60 years old were randomly assigned to a 10-min AAA intervention or control/usual ICU care.

Butyrate Inhibits Deoxycholic-Acid-Resistant Colonic Cell Proliferation via Cell Cycle Arrest and Apoptosis: A Potential Pathway Linking Dietary Fiber to Cancer Prevention.

Scope: Butyrate, an intestinal microbiota metabolite of dietary fiber, exhibits colon cancer preventive effects. In contrast, a high fat intake increases fecal secondary bile acids, such as deoxycholic acid (DCA, a potential cancer promoter), which selectively enrich mutant epithelial cells with an abnormally high resistance to DCA-induced apoptosis in the colon. This study is conducted to test the hypothesis that physiological concentrations of butyrate inhibit DCA-resistant colonic cell proliferation.

Factors related to episiotomy practice: an evidence-based medicine systematic review.

Episiotomy practice is influenced by many factors studied in the scientific literature. Evidence-based medicine has isolated many factors that are linked to episiotomy practice, thus creating a need to group all these factors to create a relevant and useful database for scientific research. Based on the PRISMA methodology, the authors conducted a systematic literature review with the aim of covering this very need.

Socio-historical evolution of the episiotomy practice: A literature review.

Episiotomy is an enlargement of the vaginal orifice made by a surgical incision of the perineum. This review aimed to provide a socio-historical retrospective on the practice or episiotomy. Using the criteria from the PRISMA guidelines, the authors conducted a literature review, browsing twenty databases and several papers available in the gray literature.

The evolution of birth medicalisation: A systematic review.

First described at the beginning of the 1970s, the concept of birth medicalisation has experienced a theoretical and ideological evolution influenced by the lines of research that have been associated with it. This evolution has given rise to different schools of thought concerning medicalisation, but also various methodologies used in different scientific fields. It seems relevant to propose a global synthesis of the various lines of thought related to birth medicalisation.

Statistical trends of episiotomy around the world: Comparative systematic review of changing practices.

The authors' purpose for this article is to identify, review and interpret all publications about the episiotomy rates worldwide. Based on the criteria from the PRISMA guidelines, twenty databases were scrutinized. All studies which include national statistics related to episiotomy were selected, as well as studies presenting estimated data.

Tumor Lysis Syndrome: A Unique Solute Disturbance.

Tumor lysis syndrome (TLS) is a life-threatening disorder that is an oncologic emergency. Risk factors for TLS are well-known, but the current literature shows case descriptions of unexpected acute TLS. Solid tumors and untreated hematologic tumors can lyse under various circumstances in children and adults.