Clinical diagnosis of cholecystitis in emergency department patients with cholelithiasis is indication for urgent cholecystectomy: A comparison of clinical, ultrasound, and pathologic diagnosis.

Background: Biliary pathology is a common reason for emergency department visits with discharge and outpatient follow up if sonographic evaluation does not reveal evidence of cholecystitis. This retrospective review was conducted to assess the sensitivity of clinical versus sonographic evaluation for indication of urgent cholecystectomy.

Methods: Retrospective chart review of 308 patients who presented to the emergency department (ED) with right upper quadrant (RUQ) pain and cholelithiasis whom underwent cholecystectomy.

Vaccine safety in an era of novel vaccines: a proposed research agenda.

Vaccines have outstanding efficacy and safety records, and the evolving science of vaccines is enabling us to better understand their mechanisms of action as well as the pathways that drive vaccine-related adverse events. This understanding is particularly crucial as novel vaccine antigens, platforms and adjuvants are increasingly being used.

Gut- and oral-dysbiosis differentially impact spinal- and bulbar-onset ALS, predicting ALS severity and potentially determining the location of disease onset.

Background: Prior studies on the role of gut-microbiome in Amyotrophic Lateral Sclerosis (ALS) pathogenesis have yielded conflicting results. We hypothesized that gut- and oral-microbiome may differentially impact two clinically-distinct ALS subtypes (spinal-onset ALS (sALS) vs. bulbar-onset ALS (bALS), driving disagreement in the field.

Child Protection Intervention and the Sexual and Reproductive Health of Female Adolescents Ages 13 to 17 Years.

Importance: Child maltreatment adversely affects health and development, but evidence is needed regarding whether and how Child Protective Services (CPS) interventions may mitigate risks.

Objective: To assess whether different forms of CPS intervention are associated with sexual and reproductive health outcomes among female adolescents investigated by CPS for suspected exposure to maltreatment during childhood.

Design, Setting, And Participants: This cohort study used linked, longitudinal, statewide administrative data from Wisconsin, including medical assistance and CPS records, to examine the rates and correlates of sexual and reproductive health outcomes (sexual transmitted infections, pregnancies, births, and high-risk sexual behavior) among 9392 female adolescents tracked from age 13 through 17 years who were investigated by CPS for suspected exposure to maltreatment prior to their 13th birthday.

Compliance with smoke-free policies at indoor and outdoor public places: an observational study in Pakistan.

Background: In 2002, the Government of Pakistan implemented a national law governing the use of tobacco products. The law included smoke-free policies banning smoking in all public places, and required no-smoking signage to be displayed at all such venues. Compliance with smoke-free policies is imperative, as it protects the health of nonsmokers.

Distinct Homologous and Variant-Specific Memory B-Cell and Antibody Response Over Time After Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccination.

The durability of protective humoral immunity after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and infection is largely dependent on the generation and persistence of antigen-specific isotype-switched memory B cells (MBCs) and long-lived plasma cells that reside in the bone marrow and secrete high-affinity neutralizing antibodies. The reactivity of vaccine-induced MBCs to emerging clinically significant SARS-CoV-2 variants of concern (VoCs) is largely unknown. In a longitudinal cohort study (up to 6 months following coronavirus disease 2019 messenger RNA vaccination), we measured MBCs in concert with other functional antibody measures.

Vertical stratification of the air microbiome in the lower troposphere.

The troposphere constitutes the final frontier of global ecosystem research due to technical challenges arising from its size, low biomass, and gaseous state. Using a vertical testing array comprising a meteorological tower and a research aircraft, we conducted synchronized measurements of meteorological parameters and airborne biomass ( = 480) in the vertical air column up to 3,500 m. The taxonomic analysis of metagenomic data revealed differing patterns of airborne microbial community composition with respect to time of day and height above ground.

Operationalizing Community Assessment Results to Enhance Preparedness for a Radiological Emergency.

Objective: A radiological emergency such as the detonation of a radiological dispersal device would have catastrophic health, environmental, and economic consequences. Community assessments can provide useful information about radiological and other emergency preparedness at the household level. Tools such as logic models can be applied to link data collected in a community assessment to planned activities and targeted outcomes.

Behavioural traits of rainbow trout and brown trout may help explain their differing invasion success and impacts.

Animal behaviour is increasingly recognised as critical to the prediction of non-native species success and impacts. Rainbow trout and brown trout have been introduced globally, but there appear to be differences in their patterns of invasiveness and ecological impact. Here, we investigated whether diploid rainbow trout and diploid and triploid brown trout differ among several key behavioural measures linked to invasiveness and impact.

Mumps virus-specific immune response outcomes and sex-based differences in a cohort of healthy adolescents.

Despite high levels of MMR-II usage in the US, mumps outbreaks continue to occur. Evidence suggests that mumps vaccine-induced humoral immunity wanes over time. Relatively few studies have examined cell-mediated immunity or reported on sex-based differences.

Retrospective review of intervention for traumatic blunt spleen injuries in adolescents by trauma center type.

Background: Management guidelines for pediatric blunt spleen injuries (BSI) include adolescent patients but few studies have compared current management of adolescents with respect to other age groups by center type.

Methods: A retrospective review of 2017-2018 National Trauma Quality Improvement (TQIP) data of children (6-12), adolescents (13-17) and young adults (18-24) with BSI presenting to an adult, pediatric only, or adult/pediatric trauma center, comparing the rate of splenic intervention for adolescents by trauma center was performed.

Results: Children had lower odds of spleen intervention than adolescents at both adult (OR 0.

Proteomic assessment of humoral immune responses in smallpox vaccine recipients.

The availability of effective smallpox vaccines was a critical element of the successful eradication of smallpox in 1980. Antibody responses play a primary role in protective immunity and neutralizing antibody is an established correlate of protection against smallpox. In this study we used a poxvirus proteome array to assess the antibody response to individual viral proteins in a cohort of 1,037 smallpox vaccine recipients.

Trauma transfers discharged from the emergency department-Is there a role for telemedicine?

Background: As the only Level I trauma center in the state, our hospital has seen an increase in the number of traumas requiring transfer for a higher level of care, placing strain on an already strained health care system. Traumas that are transferred to our facility and subsequently discharged back home indicate a subset of patients who may not be appropriate to transfer. The aim of this study is to identify commonalities between patients who were transferred for a higher level of care but do not require inpatient status and to assess patients who may benefit from a telemedicine evaluation.

Investigating the phenology of juvenile potamodromous brown trout (Salmo trutta L.) in two large lake catchments.

There is growing interest in the phenology of juvenile Salmo trutta and evidence of significant downstream migration during the autumn in some anadromous populations. The present study used acoustic telemetry to examine the phenology of potamodromous trout parr across a region encompassing two large lake catchments. One hundred sixty-seven trout parr were tagged in late summer across four lake tributaries between 2018 and 2020.

Ludwig Binswanger's Comments on Hermann Rorschach's .

This article presents an introduction to Ludwig Binswanger's Comments on Hermann Rorschach's , published in the in 1923, after Rorschach's death in 1922. Binswanger, one of the most distinguished psychiatrists of the twentieth century and a close professional colleague and compatriot in the Swiss Psychiatric and Psychoanalytic Societies, was blazing new trails by incorporating turn-of-the-century phenomenology and experimental psychology into Swiss psychiatry. His comments, which have been noted for over 100 years but never before translated, are a critical review of Rorschach's monograph, highlighting the undeveloped status of the test theory and philosophical foundations.

Patients' lived experiences and recommendations for enhanced awareness and use of integrative oncology services in cancer care.

Background: Consuming educational content, adhering to treatment plans and managing symptoms and side-effects can be overwhelming to new oncology patients.

Objective: The purpose of this study is to engage patients in conceptualization of enhanced clinic processes and digital health tools to support awareness and use of integrative oncology services.

Patient Involvement: We engaged patients in participatory design to understand lived experiences surrounding use of integrative oncology services during and after conventional cancer treatment.

The P4 study: Subsequent pregnancy maternal physiology after hypertensive and normotensive pregnancies.

Objectives: Hypertensive disorders of pregnancy are associated with subsequent increased risk of cardiometabolic disease. Adverse cardiometabolic measures are noted soon after hypertensive versus normotensive pregnancy (NP); to what degree these persist into a subsequent pregnancy (SP) is unknown. This study aimed to assess women's physiology early in SP after hypertensive pregnancy (HP: preeclampsia or gestational hypertension) or NP and compare SP to 6 months postpartum findings from the index pregnancy.

THE EVOLUTION OF INFORMATION TECHNOLOGY GOVERNANCE AT THE NIH CLINICAL CENTER.

An information technology governance (ITG) program has helped the National Institutes of Health (NIH) Clinical Center (CC) in the implementation of many systems and has guided the organization through the maturity of its project management methodology. The NIHCC Department of Clinical Research Informatics (DCRI) maintains an electronic health record (EHR) called the clinical research information system (CRIS) along with many clinical information systems (CIS) and research information systems, supporting approximately 3,200 users. ITG involves establishing processes to guide the review, selection, implementation, management, and setting of the IT strategy representing the business owners, stakeholders, and IT.

Rates and predictors of child maltreatment re-perpetration against new victims and prior victims.

Background: Limited prior research has examined the rates or predictors of re-perpetration of child maltreatment. Yet, perpetrators may have multiple victims, and perpetrators, rather than their victims, are often the primary focus of child welfare services.

Objective: We examine rates of child maltreatment re-perpetration of repeat and new victims, and test perpetrator demographics and maltreatment index incident case characteristics as predictors of re-perpetration.

Scalable Synthesis of Pt/SrTiO Hydrogenolysis Catalysts in Pursuit of Manufacturing-Relevant Waste Plastic Solutions.

An improved hydrothermal synthesis of shape-controlled, size-controlled 60 nm SrTiO nanocuboid (STO NC) supports, which facilitates the scalable creation of platinum nanoparticle catalysts supported on STO (Pt/STO) for the chemical conversion of waste polyolefins, is reported herein. This synthetic method (1) establishes that STO nucleation prior to the hydrothermal treatment favors nanocuboid formation, (2) produces STO NC supports with average sizes ranging from 25 to 80 nm with narrow size distributions, and (3) demonstrates how SrCO formation and variation in solution pH prevent the formation of STO NCs. The STO synthesis was scaled-up and conducted in a 4 L batch reactor, resulting in STO NCs of comparable size and morphology ( = 22.

Mapping enzyme catalysis with metabolic biosensing.

Enzymes are represented across a vast space of protein sequences and structural forms and have activities that far exceed the best chemical catalysts; however, engineering them to have novel or enhanced activity is limited by technologies for sensing product formation. Here, we describe a general and scalable approach for characterizing enzyme activity that uses the metabolism of the host cell as a biosensor by which to infer product formation. Since different products consume different molecules in their synthesis, they perturb host metabolism in unique ways that can be measured by mass spectrometry.