Validation of targeted next-generation sequencing of cell-free DNA from archival cerebrospinal fluid specimens for the detection of somatic variants in cancer involving the leptomeninges: Cytopathologic and radiographic correlation.

Background: Leptomeningeal metastases occur across multiple solid and lymphoid cancers, and patients typically undergo cytopathologic assessment of cerebrospinal fluid (CSF) in this setting. For patients diagnosed with metastatic cancer, the detection of actionable somatic mutations in CSF can provide clinically valuable information for treatment without the need for additional tissue collection.

Methods: The authors validated a targeted next-generation sequencing assay for the detection of somatic variants in cancer (OncoPanel) on cell-free DNA (cfDNA) isolated from archival CSF specimens in a cohort of 25 patients who had undergone molecular testing of a prior tumor specimen.

In-Hospital and One-Year Outcomes of Transcatheter Aortic Valve Replacement in Patients Requiring Supplemental Home Oxygen Use.

Background: There have been limited reports with inconsistent results on the impact of long-term use of oxygen therapry (LTOT) in patients treated with transcatheter aortic valve replacement (TAVR).

Methods: We compared in-hospital and intermediate TAVR outcomes in 150 patients requiring LTOT (home O cohort) with 2,313 non-home O patients.

Results: Home O patients were younger, and had more comorbidities including chronic obstructive pulmonary disease (COPD), diabetes, carotid artery disease, lower forced expiratory volume (FEV) (50.

Extreme low-flow conditions in a dual-chamber denitrification bioreactor contribute to pollution swapping with low landscape-scale impact.

Denitrification bioreactors are an effective edge-of-field conservation practice for nitrate (NO) reduction from subsurface drainage. However, these systems may produce other pollutants and greenhouse gases during NO removal. Here a dual-chamber woodchip bioreactor system experiencing extreme low-flow conditions was monitored for its spatiotemporal NO and total organic carbon dynamics in the drainage water.

Intermediate Follow-Up of Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve Implantation in Patients With Small Aortic Annuli.

The clinical impact of prosthesis-patient mismatch (PPM) in patients with small aortic annuli who underwent transcatheter aortic valve (AV) implantation with either balloon-expandable (BE) or self-expanding (SE) valves remains controversial. We assessed in-hospital and intermediate clinical outcomes in 573 patients with transfemoral transcatheter AV implantation with a small AV annulus, defined as an AV annulus area ≤430 mm. A total of 337 patients treated with a 23-mm BE valve (SAPIEN 3, Ultra) were compared with 236 patients treated with a 26-mm SE valve (Evolut series).

Amending woodchip bioreactors with corncobs reduces nitrogen removal cost.

Woodchip denitrification bioreactors are an effective agricultural practice to reduce nitrogen (N) export from subsurface drainage via the conversion of nitrate (NO) to nitrogen gas (N), but there are challenges associated with limited woodchip supplies and increasing prices. Previous lab studies indicate that corncobs could be a promising woodchip alternative from the perspectives of N removal rate and cost. This field study aimed to provide early performance and cost assessment of denitrification bioreactors with two woodchip-corncob treatments.

Transcarotid Versus Transfemoral Transcatheter Aortic Valve Replacement (from a Propensity-Matched Comparison).

Previous reports comparing transcarotid (TC) versus transfemoral (TF) approaches for patients undergoing transcatheter aortic valve replacement have had inconsistent conclusions. We compared in-hospital and 1-year clinical outcomes, changes in quality of life, and direct hospital costs for 138 TC versus 1,926 TF procedures. Propensity matching based on the Society of Thoracic Surgery Predicted Risk of Mortality was used to compare 130 patients who underwent TC with 813 patients who underwent TF.

Racial and Ethnic Disparities in the Use of Transcatheter Aortic Valve Replacement in the State of Connecticut.

Background: Although prior national reports have identified trends in the underutilization of transcatheter aortic valve replacement (TAVR) in Afro-American and Latino populations, racial and ethnic healthcare disparities in TAVR use in the State of Connecticut have not been previously reported.

Methods: We conducted a retrospective analysis of 1461 patients undergoing TAVR at our institute between from 2012 to 2020. Baseline demographics, procedural characteristics, clinical outcomes, median incomes and insurance coverage were compared between 1417 Caucasian and 44 minority patients, including 23 patients designated as Afro-American and 10 designated as Latino.

Financial Sustainability of an Oregon Rural Health, Primary Care, and Pharmacist-Run Comprehensive Medication Management Program Through Direct Medical Billing.

Background: Although several states recognize pharmacists as providers and allow credentialing, this practice is not recognized nationwide. Following adoption of Oregon House Bill 2028, pharmacists are recognized as providers, allowing "health insurers to provide payment or reimbursement for their services to patients." Before this law, and in several instances currently, pharmacist-run programs were financially justified through soft dollars saved by improving patient outcomes, reducing emergency department use, and decreasing readmission rates.

Long-term impact of poultry manure on crop yield, soil and water quality, and crop revenue.

A long-term poultry manure fertilizer study was initiated in 1998 and continued until 2009 under corn-soybean (CS) rotation. To match changing landscape trends, the plots were switched to continuous corn (CC) from 2010 to 2017. In both CS and CC phases, poultry manure (PM) was applied at the crop rotation recommended agronomic N rate and either half (CC phase) or double (CS phase) the recommended rate.

Novel Cerebral Protection Technique During Right Transcarotid TAVR in Bicuspid Aortic Stenosis and Porcelain Aorta.

Periprocedural stroke related to transcatheter aortic valve replacement (TAVR) is associated with increased morbidity and mortality. Cerebral embolic protection using the Sentinel device (Claret Medical) has demonstrated reduced rates of stroke during TAVR. However, alternative access such as a transcarotid approach precludes the use of the Sentinel device.

Woodchip Denitrification Bioreactors: Impact of Temperature and Hydraulic Retention Time on Nitrate Removal.

Woodchip denitrification bioreactors, a relatively new technology for edge-of-field treatment of subsurface agricultural drainage water, have shown potential for nitrate removal. However, few studies have evaluated the performance of these reactors under varied controlled conditions including initial woodchip age and a range of hydraulic retention times (HRTs) and temperatures similar to the field. This study investigated (i) the release of total organic C (TOC) during reactor start up for fresh and weathered woodchips, (ii) nitrate (NO-N) removal at HRTs ranging from 2 to 24 h, (iii) nitrate removal at influent NO-N concentrations of 10, 30, and 50 mg L, and (iv) NO-N removal at 10, 15, and 20°C.

Speed of blood withdrawal and accurate measurement of oxygen content in mixed venous blood.

Background: Measurement of mixed venous oxygen saturation helps determine whether cardiac output and oxygen delivery are sufficient for metabolic needs. As recommended by the American Association of Critical-Care Nurses guideline, blood samples for determining mixed venous oxygen saturation are obtained by slowly, in 1 to 2 minutes, withdrawing 1.5 mL of blood from the distal port of the pulmonary artery catheter.

Risk of leakage and tissue dissemination with various contained tissue extraction (CTE) techniques: an in vitro pilot study.

Study Objective: To evaluate risk of leakage and tissue dissemination associated with various contained tissue extraction (CTE) techniques.

Design: In vitro study (Canadian Task Force classification: II-1).

Setting: Academic hospital simulation laboratory.

Use of CT-arthrography and ultrasound in ACL surgery during Operation Enduring Freedom in Afghanistan: a case report and practice recommendations.

The availability of magnetic resonance imaging is severely limited in a deployed environment. However, advanced imaging for diagnosis and treatment of musculoskeletal soft-tissue injuries in theater does exist. Computed tomography (CT), arthrography, and ultrasound are readily available at Role 2 and 3 Medical Treatment Facilities in Afghanistan in support of Operation Enduring Freedom.

A non-genetic route to aneuploidy in human cancers.

Aneuploidy is common in human tumours and is often indicative of aggressive disease. Aneuploidy can result from cytokinesis failure, which produces binucleate cells that generate aneuploid offspring with subsequent divisions. In cancers, disruption of cytokinesis is known to result from genetic perturbations to mitotic pathways or checkpoints.

Enhanced fluid management with continuous venovenous hemofiltration in pediatric respiratory failure patients receiving extracorporeal membrane oxygenation support.

Background/purpose: Children receiving extracorporeal membrane oxygenation (ECMO) for respiratory failure can have significant fluid overload and renal insufficiency. Addition of inline continuous venovenous hemofiltration (CVVH) could provide additional benefits in fluid management compared to use of standard medical therapies with ECMO.

Methods: Patients with pediatric respiratory failure receiving ECMO with CVVH were case-matched to similar patients receiving ECMO without CVVH to compare fluid balance, medication use, and clinical outcomes.

Tuning supported catalyst reactivity with dendrimer-templated Pt-Cu nanoparticles.

The effects of particle composition on heterogeneous catalysis were studied using dendrimer-encapsulated nanoparticles (DENs) as precursors to supported Pt-Cu catalysts. Bimetallic Pt-Cu DENs with varying Pt/Cu ratios were prepared in an anaerobic aqueous solution and deposited onto a high-purity commercial alumina support. The dendrimer template was then thermally removed to yield supported nanoparticle catalysts, which were studied with toluene hydrogenation and CO oxidation catalysis as well as infrared spectroscopy of adsorbed CO.

Case of adolescent with Paget-Schroetter syndrome and underlying thrombophilia due to an elevated lipoprotein (A).

Upper extremity deep vein thrombosis (UEDVT) is a rare disorder in children and is most often associated with a central venous catheter (CVC), cancer, or an underlying thrombophilia. In adults, repetitive or strenuous upper extremity activity has been linked to mechanical compression of the thoracic outlet resulting in subclavian vein thrombosis, also known as Paget-Schroetter Syndrome (PSS). We present the case of a 14 year old female who was found to have an UEDVT consistent with PSS.

Treatment of acute low back pain in Wisconsin: results of the State Medical Society's Medical Outcomes Research Project.

Background: Acute low back pain is the fifth most common reason for physician visits. Multiple treatment options are available, but not all physicians and patients are satisfied with the results. This study evaluated treatment outcomes from patients' perspectives using standardized measures.

Combinatorial and cross-fiber averaging transform muscle electrical responses with a large stochastic component into deterministic contractions.

Pyloric muscles of the stomatogastric neuromuscular system of the lobster Panulirus interruptus produce highly deterministic (range, less than +/- 6% of mean amplitude) contractions in response to motor nerve stimulation with unchanging spike bursts containing physiological (5-10) spike numbers. Intracellular recordings of extrajunctional potentials (EJPs) evoked in these muscles by motor nerve stimulation revealed a large, apparently stochastic amplitude variation (range, +/- 36% of mean amplitude). These observations raised the question of how do electrical responses with a large amplitude variation give rise to deterministic muscle output? We show here that this question is likely resolved by (1) combinatorial averaging within individual muscle fibers of the multiple EJPs that occur in motor neuron bursts, and (2) averaging across muscle fibers whose electrical responses are uncorrelated.

Preharvest sources of Salmonella colonization in turkey production.

An ecological survey was conducted from March, 1995 to February 1996 to determine sources of Salmonella colonization in two flocks of turkeys reared consecutively in a newly constructed facility. Sampling was conducted prior to placement of poults, at Day 0, and again at 2, 10, 14, and 18 wk. Samples were collected at comparable times for the second flock except that final sampling occurred at 22 wk instead of 18 wk.