FACTFINDERS FOR PATIENT SAFETY: Minimizing risks with cervical epidural injections.

This series of FactFinders presents a brief summary of the evidence and outlines recommendations to minimize risks associated with cervical epidural injections. Evidence in support of the following facts is presented. - 1) CILESIs should be performed at C6-C7 or below, with C7-T1 as the preferred access point due to the more generous dorsal epidural space at this level compared to the more cephalad interlaminar segments.

FactFinders for patient safety: Preventing local anesthetic-related complications: Local anesthetic chondrotoxicity and stellate ganglion blocks.

This series of FactFinders presents a brief summary of the evidence and outlines recommendations to improve our understanding and management of several potential local anesthetic-related complications. Evidence in support of the following facts is presented. (1) -- There are drug-, concentration-, and time-dependent chondrotoxic effects that vary between local anesthetics.

FACTFINDERS for PATIENT SAFETY: Preventing procedure-related complications: Epidural lipomatosis and postpartum steroid exposure.

This series of FactFinders presents a brief summary of the evidence and outlines recommendations to improve our understanding and management of potential procedure-related complications. Evidence in support of the following facts is presented. (1) -- There is low-level evidence of an association between epidural steroid injections (ESIs) and the development and/or worsening of spinal epidural lipomatosis (SEL).

Maintenance of taste receptor cell presynaptic sites requires gustatory nerve fibers.

The turnover and re-establishment of peripheral taste synapses is vital to maintain connectivity between the primary taste receptor cells and the gustatory neurons which relay taste information from the tongue to the brain. Despite the importance of neuron-taste cell reconnection, mechanisms governing synapse assembly and the specificity of synaptic connections is largely unknown. Here we use the expression of presynaptic proteins, CALHM1 and Bassoon, to probe whether nerve fiber connectivity is an initiating factor for the recruitment of presynaptic machinery in different populations of taste cells.

Lifecourse Growth and Development Determinants of Mammographic Density in Black Women.

Background: High mammographic density is one of the strongest breast cancer risk factors; however, determinants of high mammographic density are understudied in Black women. We assessed growth and development factors across the lifecourse in relation to mammographic density.

Methods: Within the Black Women's Health Study, we used Cumulus software to assess percent mammographic density from digital screening mammograms for 5,905 women ages 40 to 74 years.

Revisiting the Harm of Hate: A Quasi-Experimental Approach Using the National Crime Victimization Survey.

Early legal challenges to the 1990 Hate Crime Statistics Act were originally excused on the argument that hate crimes "hurt more," but there remain some empirical gaps on this topic. Although many works have concluded that biased offenders cause greater harms to their victims relative to unbiased perpetrators, this effect tends to be sensitive to individual and situational factors like victim and offender characteristics, bias motivation, weapon use, or crime location. This type of confounding has the potential to introduce selection bias in the estimation of victimization harms among biased criminal incidents.

Risk of SARS-CoV-2 following joint and epidural corticosteroid injections: A retrospective study.

Objective: The immunosuppressive effects of corticosteroid (CS) injections have come under more scrutiny during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to explore any relationship between joint/epidural CS injection and SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) polymerase chain reaction (PCR) positivity.

Methods: A retrospective chart review was conducted on patients 18 years or over who received at least one joint or epidural CS injection by physiatrists in a tertiary care center between January 1, 2020, and December 31, 2021.

Polarizing Political Polls: How Visualization Design Choices Can Shape Public Opinion and Increase Political Polarization.

While we typically focus on data visualization as a tool for facilitating cognitive tasks (e.g. learning facts, making decisions), we know relatively little about their second-order impacts on our opinions, attitudes, and values.

FactFinders for patient safety: Understanding potential procedure-related complications: RFN/multifidus atrophy, intradiscal biologics, and facet cyst rupture.

This series of FactFinders presents a brief summary of the evidence and outlines recommendations to improve our understanding and management of several potential procedure-related complications. The evidence in support of the following facts is presented: (1) -- There is no conclusive published literature indicating that LMBRFN leads to increased multifidus atrophy relative to natural history. High-quality prospective studies with a natural history comparison group evaluating immediate pre-procedure as well as post-procedure longitudinal cross-sectional imaging are needed to accurately assess for any possible influence of LMBRFN on multifidus atrophy as well as the clinical relevance.

Acquired L718V/ co-mutation and discordant molecular pattern between plasmatic and cerebrospinal fluid in a bone and meningeal metastatic L858R+ non-small cell lung cancer: a case report.

Background: Osimertinib is approved in first line metastatic epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC). Acquired L718V mutation is a rare mechanism of resistance towards osimertinib in L858R+ NSCLC with potential sensibility to afatinib. This case reported an acquired L718V/TP53 V727M resistance co-mutation to osimertinib with discordant molecular pattern between plasmatic and cerebral fluid in a leptomeningeal and bone metastatic L858R mutant NSCLC.

Prevalence and Molecular Analysis of Hellbender (Cryptobranchus alleganiensis) Trypanosomes in Tennessee.

Populations of eastern hellbenders (Cryptobranchus alleganiensis alleganiensis) have been declining for multiple decades because of a variety of stressors associated with anthropogenic habitat disturbance followed by riparian sedimentation. The influence of parasite-associated morbidity and mortality on wild hellbender populations is poorly understood. Research has detected widespread trypanosome infection in hellbenders in Virginia, US, with no other reported detections within the eastern hellbender's extensive range.

Dispersion vs Disparity: Hiding Variability Can Encourage Stereotyping When Visualizing Social Outcomes.

Visualization research often focuses on perceptual accuracy or helping readers interpret key messages. However, we know very little about how chart designs might influence readers' perceptions of the people behind the data. Specifically, could designs interact with readers' social cognitive biases in ways that perpetuate harmful stereotypes? For example, when analyzing social inequality, bar charts are a popular choice to present outcome disparities between race, gender, or other groups.

The importance of biological sex in cardiac cachexia.

Cardiac cachexia is a catabolic muscle-wasting syndrome observed in approximately 1 in 10 patients with heart failure. Increased skeletal muscle atrophy leads to frailty and limits mobility, which impacts quality of life, exacerbates clinical care, and is associated with higher rates of mortality. Heart failure is known to exhibit a wide range of prevalence and severity when examined across individuals of different ages and with comorbidities related to diabetes, renal failure, and pulmonary dysfunction.

Changes in the development of opioid tolerance on re-exposure among people who use heroin: A qualitative study.

Background And Aims: This qualitative study aimed to explore how the development of tolerance to both the psychoactive and respiratory depressant effects of heroin on re-exposure are experienced by people who use heroin.

Methods: Semi-structured one-to-one interviews were conducted with 20 adults who currently or previously used heroin (for at least 6 months), with any type of administration (injected, smoked) and experience of abstinence (at least 2 weeks) and relapse. Topic guides explored the participants understanding of tolerance, their experience of developing tolerance to heroin and of tolerance following relapse.

Atypical knee pain.

The patient found it hard to climb stairs-and to complete a particular task when getting dressed. Difficulty with that task provided a useful diagnostic clue.

Is there an association between lumbosacral epidural lipomatosis and lumbosacral epidural steroid injections? A comprehensive narrative literature review.

Background: Exogenous systemic steroid exposure is a well-established risk factor for spinal epidural lipomatosis (SEL), however the association between lumbosacral epidural steroid injections (LESIs) and lumbosacral epidural lipomatosis (LEL) is generally regarded as poorly understood. Our objective was to investigate the rationale and the evidence implicating LESI(s) as a potential cause of LEL as well as the evidence related to use of LESI(s) as a potential pain relieving treatment option for radicular pain in the setting of LEL.

Methods: PubMed, Embase, Google Scholar, OVID were searched from inception until April 2021.

Estrogenic Activity and Risk of Invasive Breast Cancer Among Postmenopausal Women in the Nurses' Health Study.

Background: Estrogens increase breast cancer risk through estrogen receptor (ER)-mediated pathway activation. It is unclear whether a broader assessment of plasma compounds that lead to ER activation would be more strongly related to risk than measurement of individual estrogens.

Methods: A prospective nested case-control study was conducted among postmenopausal women in the Nurses' Health Study, that included 371 cases with blood samples collected prior to breast cancer diagnosis and 731 matched controls.

Optimal timing of venous thromboembolic chemoprophylaxis initiation following blunt solid organ injury: meta-analysis and systematic review.

Purpose: The need to prevent venous thromboembolism (VTE) following blunt solid organ injury must be balanced against the concern for exacerbation of hemorrhage. The optimal timing for initiation of VTE chemoprophylaxis is not known. The objective was to determine the safety and efficacy of early (≤ 48 h) VTE chemoprophylaxis initiation following blunt solid organ injury.

Clinical and Anatomical Considerations for Management of a Complete Tear of the Distal Rectus Femoris Myotendinous Junction: A Rare Knee Extensor Mechanism Injury.

The knee extensor mechanism is a highly complex multilayered and reinforced structure. Quadriceps muscle injuries are considered to be common, particularly among athletes; however isolated rectus femoris injuries involving the distal myotendinous junction are considered to be exceedingly rare with very few case reports published to date. Thus, the presentation and diagnosis of this injury can be elusive and treatment is nonuniform.

Short communication: Investigation of antibiotic alternatives to improve health and growth of veal calves.

The inherent disease susceptibility of veal calves results in frequent antimicrobial use. Improvements in antimicrobial stewardship necessitate alternative therapies to improve calf health and growth, while reducing the need for antimicrobials important to human health. This study investigated the effect of 2 alternative therapies, lactoferrin (an iron-binding protein found in colostrum) and cinnamaldehyde (an essential oil of the cinnamon plant) on growth, disease incidence, and mortality risk in special-fed veal calves.

Toxicity of Cold Lake Blend and Western Canadian Select dilbits to standard aquatic test species.

Dilbits are blends of bitumen and natural gas condensates or crude oils with only limited toxicity data. Two dilbits, Cold Lake Blend and Western Canadian Select, were tested as either unweathered or weathered oils for acute and chronic toxicity to standard freshwater and estuarine organisms. Water accommodated fractions of the dilbits were characterized for total petroleum hydrocarbons (TPH), polycyclic aromatic hydrocarbons (PAHs), and monoaromatics (BTEX).

Dairy calf management-A comparison of practices and producer attitudes among conventional and organic herds.

Dairy calves are at high risk for morbidity and mortality early in life. Understanding producer attitudes is important for implementation of best management practices to improve calf health. The objectives of this study were to evaluate usage frequency and producer attitudes on key calf management practices between conventional and organic dairy operations.