POCUS-first in acute diverticulitis: Quantifying cost savings, length-of-stay reduction, and radiation risk mitigation in the ED.

Background: Recent studies have validated the efficacy of point-of-care ultrasound (POCUS) as an alternative diagnostic imaging approach to computed tomography (CT) for patients with suspected acute diverticulitis. This study aimed to quantify the national impact of this approach in cost savings, ED length-of-stay (LOS), and radiation risk mitigation using a POCUS-first approach for acute diverticulitis in the emergency department (ED).

Methods: Using published data, we constructed a Monte Carlo simulation model to compare two POCUS-first strategies (nonselective and selective approaches) for evaluating patients with suspected acute diverticulitis in the ED.

Translating Evidence-Based Self-Management Interventions Using a Stepped-Care Approach for Patients With Cancer and Their Caregivers: A Pilot Sequential Multiple Assignment Randomized Trial Design.

Background: Self-directed interventions are cost-effective for patients with cancer and their family caregivers, but barriers to use can compromise adherence and efficacy.

Aim: Pilot a Sequential Multiple Assignment Randomized Trial (SMART) to develop a time-varying dyadic self-management intervention that follows a stepped-care approach in providing different types of guidance to optimize the delivery of Coping-Together, a dyadic self-directed self-management intervention.

Methods: 48 patients with cancer and their caregivers were randomized in Stage 1 to: (a) Coping-Together (included a workbook and 6 booklets) or (b) Coping-Together + lay telephone guidance.

Accelerometry-assessed sleep clusters and obesity in adolescents and young adults: a longitudinal analysis in GINIplus/LISA birth cohorts.

Background: Some studies have revealed various sleep patterns in adolescents and adults using multidimensional objective sleep parameters. However, it remains unknown whether these patterns are consistent from adolescence to young adulthood and how they relate to long-term obesity.

Methods: Seven-day accelerometry was conducted in German Infant Study on the influence of Nutrition Intervention PLUS environmental and genetic influences on allergy development (GINIplus) and Influence of Lifestyle factors on the development of the Immune System and Allergies in East and West Germany (LISA) birth cohorts during the 15-year and 20-year follow-ups, respectively.

Goniodomic Acid, a Transient Oxirane Intermediate in the Conversion of the Macrolide Algal Toxin Goniodomin A to Seco Acids.

The algal macrolide goniodomin A (GDA) undergoes ring-cleavage under unusually mild, alkaline conditions to form mixtures of stereoisomers of seco acids GDA-sa and iso-GDA-sa. In the primary fragmentation pathway, opening of the macrolide ring occurs by displacement of the carboxyl group by a base-catalyzed attack of the C32 hemiketal hydroxy group on C31, yielding an oxirane-carboxylic acid, named goniodomic acid. The oxirane ring is unstable, undergoing solvolytic opening to form mainly GDA-sa.

Combined Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament Reconstruction With Single Knotless Anchor.

Lateral patellar dislocations represent a common orthopaedic condition in young, active individuals who experience patellar instability. Despite increasing interest in re-creating the natural biomechanics and native knee anatomy when performing medial patellar soft-tissue reconstructive procedures, there is no consensus among surgeons regarding the best techniques to use when reconstructing the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament. This article details a method to reconstruct the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament using a single graft and a single all-suture knotless anchor on the patella.

Recapitulation of physiologic and pathophysiologic pulsatile CSF flow in purpose-built high-throughput hydrocephalus bioreactors.

Background: Hydrocephalus, an accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain, is often treated via a shunt system to divert the excess CSF to a different compartment; if left untreated, it can lead to serious complications and permanent brain damage. It is estimated that one in every 500 people are born with hydrocephalus. Despite more than 60 years of concerted efforts, shunts still have the highest failure rate of any neurological device requiring follow-up shunt revision surgeries and contributing to the $2 billion cost of hydrocephalus care in the US alone.

Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients.

Social media provides platforms for transplant infectious diseases (TIDs) clinicians to network, exchange ideas, and educate each other and the broader public. A #TxIDChat on the social media platform X was conducted on the perceptions of social media in TID by the account @TxID_Fellows. This article examines the current usage of social media by TID clinicians, and its role in education, patient outreach, and networking.

Disparities in Access to Valganciclovir Cytomegalovirus Prophylaxis in High-Risk African American Kidney Transplant Patients.

Background: While access and outcomes disparities for African American (AA) kidney transplant recipients are documented, there are limited studies assessing medication access disparities in transplantation. Cytomegalovirus (CMV) causes severe complications for transplant recipients, and we aimed to understand differences in access to CMV prophylaxis valganciclovir and its impact on CMV infection rates in AA transplant recipients.

Methods: This single-center, retrospective longitudinal cohort study examined high-risk (CMV serostatus D+/R-) adult kidney transplant recipients between June 1, 2010, and May 31, 202, through EMR abstraction.

Magnesium Supplementation Modifies Arthritis Synovial and Splenic Transcriptomic Signatures Including Ferroptosis and Cell Senescence Biological Pathways.

Background: Rheumatoid arthritis (RA) is a common systemic autoimmune inflammatory disease that can cause joint damage. We have recently reported that oral magnesium supplementation significantly reduces disease severity and joint damage in models of RA.

Methods: In the present study, we analyzed the transcriptome of spleens and synovial tissues obtained from mice with KRN serum-induced arthritis (KSIA) consuming either a high Mg supplemented diet (Mg2800; n = 7) or a normal diet (Mg500; n = 7).

Labor Status at Delivery and Lung Function in Extremely Prematurely Born Young Adults.

Background: There has been conflicting evidence regarding the impact of mode of delivery on respiratory outcomes in later childhood and adulthood. It is possible labor status, rather than mode of delivery, influences later respiratory morbidity. We hypothesized that extremely premature infants born to mothers in labor would have better lung function at follow-up than those born to mothers not in labor.

Closed-loop automated oxygen control in late preterm and term, ventilated infants: A randomised controlled trial.

Aim: To compare the time spent above the target oxygen saturation range (SpO > 96%) and the duration of supplemental oxygen between ventilated infants receiving closed-loop automated oxygen control (CLAC) or manual oxygen control in late preterm and term ventilated infants.

Methods: Infants were randomised to receive CLAC or manual oxygen control from recruitment and within 24 h of mechanical ventilation until successful extubation.

Results: Forty infants with a median (IQR) gestational age of 37.

Racial and nonracial discrimination and tobacco use among high school students in California.

Background: The public health literature has established a relationship between discrimination, health outcomes, and health and well-being in adolescence. The objective of this study is to add vaping to the existing studies on discrimination and tobacco use among youth. To achieve this objective, the analysis examined the relationship between discrimination, type of discrimination, and current tobacco use, including current vape use, among adolescents in California.

Associations of chronic liver disease and liver cancer with glyphosate and its metabolites in Thailand.

Glyphosate [N-(phosphonomethyl) glycine], a systemic herbicide, is used globally (825 million kg/year) in 750+ formulations. The International Agency for Research on Cancer classified glyphosate is a probable human carcinogen (Group 2A), but epidemiological studies have been lacking for its association with liver cancer and chronic liver disease. We analyzed urine specimens from 591 patients with newly diagnosed liver cancer, chronic liver disease (CLD), and healthy individuals from five different medical centers between 2011 to 2016 in Thailand.

Mapping the Void: Understanding Diversity, Equity, & Inclusion Training in Medicine.

Objective: To delineate how identity-based bias exposure evolves with rank and/or context among healthcare workers, and assess their attitudes toward existing DEI education.

Background: Although Diversity, Equity and Inclusion (DEI) training is widely mandated for healthcare workers, few studies examine how clinicians' needs evolve across a career, how context impact recipients' ability to respond, or how well existing programs adapt to individual context.

Methods: A 54-question electronic survey was distributed during Morbidity & Mortality conferences beginning December 2020.

Psychological Symptom Cluster Severity Profiles Are Associated With Higher Levels of Stress and Worse Quality of Life in Postmenopausal Women With Breast Cancer.

Background: Although common, the severity of the psychological symptom cluster (PSC) (ie, co-occurrence of anxiety, depression, fatigue, sleep disturbance) varies among women with breast cancer. In addition, the impact of various types of stress and other risk factors on its severity are understudied, and the influence of the PSC on quality of life (QOL) outcomes remains poorly characterized.

Objective: To identify subgroups of postmenopausal women with breast cancer with distinct PSC severity profiles following surgery and evaluate whether these subgroups differed in terms of demographic and clinical characteristics, symptoms, social and posttraumatic stress, and QOL.

Psychological interventions for weight reduction and sustained weight reduction in adults with overweight and obesity: a scoping review.

Introduction: Overweight and obesity are growing public health problems worldwide. Both diet and physical activity have been the primary interventions for weight reduction over the past decade. With increasing rates of overweight and obesity, it is evident that a primary focus on diet and exercise has not resulted in sustained obesity reduction within the global population.

Features of hyperinflammation link the biology of EBV infection and cytokine storm syndromes.

Background: Overt immune activation by viral infections can lead to cytokine storm syndromes, such as hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS).

Objective: We aim to compare the immune response to different viral pathogens to understand the connection between infections and cytokine storm syndromes.

Methods: We recruited children who presented to the emergency room with fever for ≥ 3 days.

School-based indicated prevention interventions for anxiety in children and adolescents: A commentary on a systematic review.

Mental health problems such as anxiety are on the increase in children and adolescents. However, rising demand and cuts to mental health services make it difficult for young people to access the support they need. School-based interventions aimed at preventing or reducing anxiety have the potential to provide help to large numbers of children and adolescents.

EZH2 directly methylates PARP1 and regulates its activity in cancer.

DNA repair dysregulation is a key driver of cancer development. Understanding the molecular mechanisms underlying DNA repair dysregulation in cancer cells is crucial for cancer development and therapies. Here, we report that enhancer of zeste homolog 2 (EZH2) directly methylates poly(adenosine diphosphate-ribose) polymerase-1 (PARP-1), an essential enzyme involved in DNA repair, and regulates its activity.

Not Just an Oxymoron: The Utilitarian's Guide to Antimicrobial Stewardship in Transplant Infectious Diseases.

Solid organ transplant and hematopoietic cell transplant patients face an increased risk of infectious diseases, greater exposure to antibiotics, and heightened risk of multidrug-resistant organisms (MDROs) due to their immunosuppressed state. Antimicrobial stewardship programs (ASP) are essential in reducing the incidence of MDRO by conserving antimicrobial use, minimizing treatment durations, and improving the appropriate use of diagnostic testing. However, the role of ASP in transplant infectious diseases (TID) is still evolving, necessitating greater collaboration between ASP and transplant programs.

Investigating the role of allelochemicals in the interaction between Alexandrium monilatum and other phytoplankton species.

Species of the dinoflagellate genus Alexandrium can release bioactive extracellular compounds with allelopathic effects (e.g., immobilization, inhibition of growth, photosynthesis or lysis) towards other phytoplanktonic organisms.