Extra-capsular proximal femoral fractures: a cohort comparison of union and complication rates after ballistic versus blunt trauma.

Purpose: This study seeks to (1) describe the management of civilian ballistic extra-capsular proximal femur fractures (2) assess the rate of nonunion and complications and (3) compare the time to union of ballistic and blunt pertrochanteric femur fractures. Given the enhanced and widened extensive inflammatory response with ballistic trauma, we hypothesized that hip fractures from ballistic mechanisms would have faster times to union.

Methods: Patients were included if they were skeletally mature with extra-capsular pertrochanteric femur fractures and radiographic and clinical follow-up of at least 6 months.

PLXNB1 and other signaling drives a pathologic astrocyte state contributing to cognitive decline in Alzheimer's Disease.

Alzheimer's disease (AD) is marked by the coordinated emergence of disease-associated cell states across multiple cell types. Here, we first performed a meta-analysis of single-nucleus transcriptomic (snRNAseq) data from 869 brains of diverse decedents, confirming the critical role of an astrocyte subset, Astrocyte 10 (Ast10), in AD and aging-related cognitive decline. We then investigated the signaling drivers of Ast10's emergence in the aging brain, focusing on interactions among microglial and astrocytic subsets.

The phagosome-mediated anti-bacterial immunity is governed by the proton-activated chloride channel in peritoneal macrophages.

Phagosome degradation is an evolutionally conserved and highly effective innate immune response against pathogen infections. The success of this process relies on the ability of phagocytes to regulate the maturation of phagosomes. However, the underlying molecular mechanisms and its roles in shaping downstream immune activation remain poorly understood.

Coordinated differentiation of human intestinal organoids with functional enteric neurons and vasculature.

Human intestinal organoids (HIOs) derived from human pluripotent stem cells co-differentiate both epithelial and mesenchymal lineages in vitro but lack important cell types such as neurons, endothelial cells, and smooth muscle, which limits translational potential. Here, we demonstrate that the intestinal stem cell niche factor, EPIREGULIN (EREG), enhances HIO differentiation with epithelium, mesenchyme, enteric neuroglial populations, endothelial cells, and organized smooth muscle in a single differentiation, without the need for co-culture. When transplanted into a murine host, HIOs mature and demonstrate enteric nervous system function, undergoing peristaltic-like contractions indicative of a functional neuromuscular unit.

Metabolic engineering to facilitate anti-tumor immunity.

Fructose consumption is elevated in western diets, but its impact on anti-tumor immunity is unclear. Fructose is metabolized in the liver and small intestine, where fructose transporters are highly expressed. Most tumors are unable to drive glycolytic flux using fructose, enriching fructose in the tumor microenvironment (TME).

The Relationship Between Syncope and Cardiac Index in Acute Pulmonary Embolism.

The relationship between syncope and invasive hemodynamics in patients with pulmonary embolism (PE) remains unknown. The objective of this study was to assess the ability of syncope, as a single clinical variable, to predict a low cardiac index in patients with acute PE. This retrospective study included patients with acute intermediate- and high-risk PE who underwent catheter-based therapies between October 2020 and June 2024.

Loss of the proton-activated chloride channel in neurons impairs AMPA receptor endocytosis and LTD via endosomal hyper-acidification.

Hippocampal long-term potentiation (LTP) and long-term depression (LTD) are forms of synaptic plasticity, thought to be the molecular basis of learning and memory, dependent on dynamic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) trafficking. Alteration of endosomal pH negatively affects synaptic transmission and neural development, but it is unclear how pH is involved in AMPAR trafficking. We show that the proton-activated chloride (PAC) channel localizes to early and recycling endosomes in neurons and prevents endosome hyper-acidification.

Challenging the Paradigm: Rates of Mandibular Infection Following Fracture.

Little consensus exists regarding the proper timing of mandibular fracture fixation. Given the proximity of the oral flora to the mandible, many surgeons advocate for early fixation to mitigate infection risk. This retrospective study evaluates the safety of treating mandible fractures in a subacute period.

Effect of a Volunteer-Staffed Outreach Call Initiative on Video Usage and Attendance for Telehealth Visits in an Urban Primary Care Safety-Net Setting.

Rationale: Telehealth navigation programmes have shown potential to improve video visit usage and attendance. However, their effectiveness in safety-net healthcare settings remains uncertain.

Aims And Objectives: This project assessed the impact of a volunteer-staffed telehealth navigation programme on video visit usage and attendance at an urban safety-net primary care clinic.

Single-cell atlas of human pancreatic islet and acinar endothelial cells in health and diabetes.

Characterization of the vascular heterogeneity within the pancreas has previously been lacking. Here, we develop strategies to enrich islet-specific endothelial cells (ISECs) and acinar-specific endothelial cells (ASECs) from three human pancreases and corroborate these findings with three published pancreatic datasets. Single-cell RNA sequencing reveals the unique molecular signatures of ISECs, including structural genes COL13A1, ESM1, PLVAP, UNC5B, and LAMA4, angiocrine genes KDR, THBS1, BMPs and CXCR4, and metabolic genes ACE, PASK and F2RL3.

Outcomes after revision total shoulder arthroplasty with pectoralis major transfer.

Background: Irreparable tears of the subscapularis muscle pose a difficult problem to patients and the treating physician. Pectoralis major transfers (PMTs) are often used in patients with irreparable tears of the subscapularis muscle with good outcomes. Similarly, PMT used in conjunction with shoulder arthroplasty has been proposed for patients with deficient subscapularis muscles and end stage glenohumeral arthritis.

Vascularization of human islets by adaptable endothelium for durable and functional subcutaneous engraftment.

Tissue-specific endothelial cells (ECs) are critical for the homeostasis of pancreatic islets and most other tissues. In vitro recapitulation of islet biology and therapeutic islet transplantation both require adequate vascularization, which remains a challenge. Using human reprogrammed vascular ECs (R-VECs), human islets were functionally vascularized in vitro, demonstrating responsive, dynamic glucose-stimulated insulin secretion and Ca influx.

A missing link: The interdependence between sugar-sweetened beverage and cigarette consumption from China.

Sugar-sweetened beverages (SSBs) and cigarettes are addictive substances and addictive substances are often related in consumption with each other. However, the potential interdependence between SSB and cigarette consumption has not been explored in the literature. As SSB and cigarette consumption have posed a great threat to individual health, the knowledge of such interdependence is critical for policymakers to design and coordinate government interventions.

Single-Institution Experience With Nononcologic Total Femoral Replacement.

Background: Revision hip and knee arthroplasty volume continues to rise, and total femur replacement (TFR) remains a key salvage option in patients with extensive bone loss. Prior research has demonstrated mixed results of this procedure, and this study aimed to characterize the outcomes of nononcologic TFR in one of the largest single-center modern series.

Methods: A retrospective analysis was conducted on 23 nononcologic TFR procedures performed on 22 patients between 2012 and 2021.

How does habit strength affect reactions to warning labels? evidence from Chinese consumers' choices of carbonated beverages.

Effectively regulating the excessive consumption of sugar-sweetened beverages (SSBs) has been an important task for public health authorities around the world. The rapid increase in SSB consumption in China necessitates robust regulations. This study employed a choice experiment to simulate the market scenario in which a text warning label was presented on SSBs.

Inflammation switches the chemoattractant requirements for naive lymphocyte entry into lymph nodes.

Sustained lymphocyte migration from blood into lymph nodes (LNs) is important for immune responses. The CC-chemokine receptor-7 (CCR7) ligand CCL21 is required for LN entry but is downregulated during inflammation, and it has been unclear how recruitment is maintained. Here, we show that the oxysterol biosynthetic enzyme cholesterol-25-hydroxylase (Ch25h) is upregulated in LN high endothelial venules during viral infection.

The Use of the Procedure Room for Wide-Awake Local Anesthesia, No Tourniquet Hand Surgery in "High-Risk" Patients.

Purpose: To study if patients who would be deemed high-risk individuals by traditional classifications of American Society of Anesthesiologists (ASA) or the updated guidelines of ASA Practice Advisory (ASAPA) can safely undergo surgery under wide-awake local anesthesia, no tourniquet in a procedure room setting without any increased risks of complications.

Methods: We analyzed 436 surgeries performed in our procedure room over a 4-year period. No medical comorbidities precluded a patient from surgery within the procedure room, and no preoperative clearance was required.

Mining single-cell data for cell type-disease associations.

A robust understanding of the cellular mechanisms underlying diseases sets the foundation for the effective design of drugs and other interventions. The wealth of existing single-cell atlases offers the opportunity to uncover high-resolution information on expression patterns across various cell types and time points. To better understand the associations between cell types and diseases, we leveraged previously developed tools to construct a standardized analysis pipeline and systematically explored associations across four single-cell datasets, spanning a range of tissue types, cell types and developmental time periods.

Engineered extrachromosomal oncogene amplifications promote tumorigenesis.

Focal gene amplifications are among the most common cancer-associated mutations but have proven challenging to engineer in primary cells and model organisms. Here we describe a general strategy to engineer large (more than 1 Mbp) focal amplifications mediated by extrachromosomal DNAs (ecDNAs) in a spatiotemporally controlled manner in cells and in mice. By coupling ecDNA formation with expression of selectable markers, we track the dynamics of ecDNA-containing cells under physiological conditions and in the presence of specific selective pressures.

AM-PAC 6-Clicks Basic Mobility and Daily Activities Scores Predict 90-Day Modified Rankin Score in Patients with Acute Ischemic Stroke Secondary to Large Vessel Occlusion.

The relative level of functional impairment in stroke patients is a significant determinant of post-acute care. The Activity Measure for Post Acute Care 6-Clicks (AM-PAC) scores for basic mobility and daily activity are rapid standardized assessments whose utilities in predicting long-term stroke outcomes have not yet been studied. We performed a retrospective analysis of acute ischemic stroke patients and their outcomes.

Managing Low-Velocity Mandibular Gunshot Wounds: An Institutional Review and the "FLOSS" Severity Scoring System.

Objective: Management of mandibular ballistic trauma is poorly delineated, given the variable injury complexity. This study examines surgical outcomes and presents a novel scoring system to define and guide the management of low-velocity ballistic mandibular fractures.

Methods: A retrospective chart review was performed from 2015 to 2022 to collect data on patients who suffered ballistic mandibular fractures.

Bleeding, stroke, and mortality risk of patients with septic shock receiving anticoagulation for atrial fibrillation.

Background: There are limited data on the effects of therapeutic anticoagulation (AC) on stroke and bleeding risk in patients with sepsis-induced atrial fibrillation (AF).

Objective: This study aimed to determine the effect of therapeutic AC on the development of inpatient strokes and significant bleeding in hospitalized patients with septic shock and AF.

Methods: This single-center, retrospective study examined 604 patients with septic shock and AF.

The Los Angeles Motor Scale is independently associated with cerebral blood flow < 30% volume in large vessel occlusions.

Background And Purpose: Mechanical thrombectomy (MT) is the treatment standard for large vessel occlusion (LVO) stroke. Under current guidelines, only patients with smaller ischemic core volumes (ICV) are eligible for MT. Thus, it is of interest to quickly estimate ICV in stroke patients.