Improving the Flow: Optimization of Available Triage Standing Medication Orders in the Pediatric Emergency Department.

Background: Emergency department (ED) overcrowding has led to longer waits for patients to be seen, treated, and released. This has been coupled with an increased number of patients who leave without ever being seen by an ED provider. Improving patient throughput and decreasing ED patient length of stay while continuing to provide high-quality care is of paramount importance.

Intrinsic Origin of Nonhysteretic Oxygen Capacity in Conventional Na-Excess Layered Oxides.

An intriguing redox chemistry via oxygen has emerged to achieve high-energy-density cathodes and has been intensively studied for practical use of anion-utilization oxides in A-ion batteries (A: Li or Na). However, in general, the oxygen redox disappears in the subsequent discharge with a large voltage hysteresis after the first charge process for A-excess layered oxides exhibiting anion redox. Unlike these hysteretic oxygen redox cathodes, the two Na-excess oxide models NaIrO and NaRuO unambiguously exhibit nonhysteretic oxygen capacities during the first cycle, with honeycomb-ordered superstructures.

Therapy-related myeloid leukemia during erlotinib treatment in a non-small cell lung cancer patient: A case report.

Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are tolerable drugs used for patients with EGFR-mutant advanced non-small cell lung cancer (NSCLC). Serious adverse reactions are uncommon compared with cytotoxic drugs.

Case Summary: A 52-year-old man presented with general weakness and cytopenia.

Synthesis of Oligoribonucleotides Containing a 2'-Amino-5'--phosphorothiolate Linkage.

Oligoribonucleotides containing a photocaged 2'-amino-5'--phophorothiolate linkage have potential applications as therapeutic agents and biological probes to investigate the RNA structure and function. We envisioned that oligoribonucleotides containing a 2'-amino-5'--phosphorothiolate linkage could provide an approach to identify the general base within catalytic RNAs by chemogenetic suppression. To enable preliminary tests of this idea, we developed synthetic approaches to a dinucleotide, trinucleotide, and oligoribonucleotide containing a photocaged 2'-amino-5'--phosphorothiolate linkage.

Inhibitory Activity of 4--Benzoyl-3'--(OMethylsinapoyl) Sucrose from on -Glucuronidase.

Bacterial -glucuronidase in the intestine is involved in the conversion of 7-ethyl-10- hydroxycamptochecin glucuronide (derived from irinotecan) to 7-ethyl-10-hydroxycamptothecin, which causes intestinal bleeding and diarrhea (side effects of anti-cancer drugs). Twelve compounds (1-12) from were evaluated in terms of -glucuronidase inhibition in vitro. 4--Benzoyl-3'-O-(O-methylsinapoyl) sucrose (C3) was highly inhibitory at low concentrations.

Nanocomplex-Mediated In Vivo Programming to Chimeric Antigen Receptor-M1 Macrophages for Cancer Therapy.

Chimeric antigen receptor-T (CAR-T) cell immunotherapy has shown impressive clinical outcomes for hematologic malignancies. However, its broader applications are challenged due to its complex ex vivo cell-manufacturing procedures and low therapeutic efficacy against solid tumors. The limited therapeutic effects are partially due to limited CAR-T cell infiltration to solid tumors and inactivation of CAR-T cells by the immunosuppressive tumor microenvironment.

Relationship between radiographic measurements and knee adduction moment using 3D gait analysis.

Background: Radiographic factors estimate the state of the static knee joint, and it is questionable how well these parameters reflect the dynamic knee condition. The external knee adduction moment (KAM) during gait is known to be a kinetic variable contributing to osteoarthritis progression. This study aims to investigate the effects of static radiographic parameters on the dynamic KAM during gait.

Clinicopathologic Characterization of IgG4-Rich Pediatric Head and Neck Lesions.

Context.—: Immunoglobulin G4 (IgG4)-related disease is rare but well characterized in adults; however, the clinical and histologic manifestations in children may differ.

Objective.

Kinematic instability in the joints of flatfoot subjects during walking: A biplanar fluoroscopic study.

Abnormal foot kinematics is observed in flatfoot subjects with postural foot deformity. We aimed to investigate joint instability in flatfoot subjects by analyzing the abnormal rotational position and speed of their joints while walking. Five flatfoot subjects participated in our study.

Inappropriate requesting of parathyroid scintigraphy at an academic medical center.

Background: Primary hyperparathyroidism is a biochemical, not radiologic diagnosis. Parathyroid scintigraphy should only be requested for surgical planning, not to confirm diagnosis. Here we determined reasons for inappropriately ordered parathyroid scintigraphy.

Harnessing α-l-fucosidase for cellular senescence imaging.

Precise detection of cellular senescence may allow its role in biological systems to be evaluated more effectively, while supporting studies of therapeutic candidates designed to evade its detrimental effect on physical function. We report here studies of α-l-fucosidase (α-fuc) as a biomarker for cellular senescence and the development of an α-fuc-responsive aggregation induced emission (AIE) probe, termed designed to complement more conventional probes based on β-galactosidase (β-gal). Using , the onset of replicative-, reactive oxygen species (ROS)-, ultraviolet A (UVA)-, and drug-induced senescence could be probed effectively.

Liver-Specific Deletion of Mouse CTCF Leads to Hepatic Steatosis via Augmented PPARγ Signaling.

Background & Aims: The liver is the major organ for metabolizing lipids, and malfunction of the liver leads to various diseases. Nonalcoholic fatty liver disease is rapidly becoming a major health concern worldwide and is characterized by abnormal retention of excess lipids in the liver. CCCTC-binding factor (CTCF) is a highly conserved zinc finger protein that regulates higher-order chromatin organization and is involved in various gene regulation processes.

Mitochondrial HS-Mediated Anti-Inflammatory Theranostics.

The insistent demand for space-controllable delivery, which reduces the side effects of non-steroidal anti-inflammatory drugs (NSAIDs), has led to the development of a new theranostics-based approach for anti-inflammatory therapy. The current anti-inflammatory treatments can be improved by designing a drug delivery system responsive to the inflammatory site biomarker, hydrogen polysulfide (HS). Here, we report a novel theranostic agent 1 (TA1), consisting of three parts: HS-mediated triggering part, a two-photon fluorophore bearing mitochondria targeting unit (Rhodol-TPP), and anti-inflammatory COX inhibitor (indomethacin).

Anomalous Gait Feature Classification From 3-D Motion Capture Data.

The gait kinematics of an individual is affected by various factors, including age, anthropometry, gender, and disease. Detecting anomalous gait features aids in the diagnosis and treatment of gait-related diseases. The objective of this study was to develop a machine learning method for automatically classifying five anomalous gait features, i.

Uniqueness of gait kinematics in a cohort study.

Gait, the style of human walking, has been studied as a behavioral characteristic of an individual. Several studies have utilized gait to identify individuals with the aid of machine learning and computer vision techniques. However, there is a lack of studies on the nature of gait, such as the identification power or the uniqueness.

Selective use of Peptide Receptor Radionuclide Therapy following comparative imaging of Ga-68 DOTATATE PET/CT against I-131 MIBG scintigraphy in a small Asian cohort of Adult Neuroblastoma.

Adult neuroblastoma (AN) is rare with an extremely poor prognosis. No standard therapy exists for this entity and treatment options are limited in recurrent or refractory disease. I-MIBG has been used in combination with myeloablative therapy before autologous bone marrow transplantation or in a salvage therapy setting.

Extraordinary Photostability and Davydov Splitting in BN-Sandwiched Single-Layer Tetracene Molecular Crystals.

Two-dimensional molecular crystals have been beyond the reach of systematic investigation because of the lack or instability of their well-defined forms. Here, we demonstrate drastically enhanced photostability and Davydov splitting in single and few-layer tetracene (Tc) crystals sandwiched between inorganic 2D crystals of graphene or hexagonal BN. Molecular orientation and long-range order mapped with polarized wide-field photoluminescence imaging and optical second-harmonic generation revealed high crystallinity of the 2D Tc and its distinctive orientational registry with the 2D inorganic crystals, which were also verified with first-principles calculations.

A Novel Ureteroscopy Training Platform That Utilizes CT Urograms to Replicate Complex Renal Collecting System Anatomies.

Flexible ureteroscopy (fURS) is a one-person surgical technique, limiting trainees' ability to practice intraoperatively. Although well suited for simulation training, few existing fURS simulators can accurately reproduce complex renal collecting system anatomies. We developed an anatomically accurate fURS simulator using three-dimensional (3D) reconstruction of CT urograms and 3D printing technology to address this need.

Intrasubject Radiographic Progression of Hallux Valgus Deformity in Patients With and Without Metatarsus Adductus: Bilateral Asymmetric Hallux Valgus Deformity.

This study was to analyze intrasubject radiographic progression of the hallux valgus deformity by comparing the mildly and severely affected sides in patients with bilateral asymmetric hallux valgus in the whole group as well as the metatarsus adductus and the nonmetatarsus adductus subgroups. A total of 186 patients with bilateral asymmetrical hallux valgus deformity with a difference of 5° or greater in the hallux valgus angle were included, and 11 radiographic measurements were analyzed. The radiographic differences between the mildly and severely affected sides were compared.

Application of Principal Component Analysis Approach to Predict Shear Strength of Reinforced Concrete Beams with Stirrups.

The reinforced concrete (RC) member's shear strength estimation has been experimentally studied in most cases due to its nonlinear behavior. Many empirical equations have been derived from the experimental data; however, even those adopted in the construction codes do not thoroughly and accurately describe their shear behavior. Theoretically explained equations, on the other hand, are aligned with the experiment; however, they are complicated to use in practice.

Relationship between ankle varus moment during gait and radiographic measurements in patients with medial ankle osteoarthritis.

Background: Kinetic data obtained during gait can be used to clarify the biomechanical pathogenesis of osteoarthritis of the lower extremity. This study aimed to investigate the difference in ankle varus moment between the varus angulation and medial translation types of medial ankle osteoarthritis, and to identify the radiographic measurements associated with ankle varus moment.

Methods: Twenty-four consecutive patients [mean age 65.

Migration Behavior of Lubricants in Polypropylene Composites under Accelerated Thermal Aging.

The surface migration of lubricants degrades the quality of thermoplastic polymer composites. In this study, the surface migration of lubricants in polypropylene composites were studied to improve the quality of the composites. Polypropylene (PP)/lubricant composites were manufactured using a co-rotating twin-screw extruder and injection molding, and the migration phenomena of the lubricant in the PP/lubricant composites were investigated under accelerated aging conditions with temperatures in the range of 20 to 90 °C and humidity of 100% for 72 h.

Gastroblastoma with a novel EWSR1-CTBP1 fusion presenting in adolescence.

Gastroblastomas are rare tumors with a biphasic epithelioid/spindle cell morphology that typically present in early adulthood and have recurrent MALAT1-GLI1 fusions. We describe an adolescent patient with Wiskott-Aldrich syndrome who presented with a large submucosal gastric tumor with biphasic morphology. Despite histologic features consistent with gastroblastoma, a MALAT1-GLI1 fusion was not found in this patient's tumor; instead, comprehensive molecular profiling identified a novel EWSR1-CTBP1 fusion and no other significant genetic alterations.

Depletion of in Adipocytes Impairs Glucose Homeostasis in Diet-Induced Obesity.

Protein arginine methyltransferase (PRMT) 1 is involved in the regulation of various metabolic pathways such as glucose metabolism in liver and atrophy in the skeletal muscle. However, the role of PRMT1 in the fat tissues under the disease state has not been elucidated to date. In this study, we delineate the function of this protein in adipocytes in vivo.