Evaluating Harms Associated with Prolonged Antibiotic Duration of Therapy in Community Dwelling Older Adults: A Cohort Study using Instrumental Variable Analysis.

Background: Shorter courses of antibiotic therapy are increasingly recommended to reduce antibiotic exposure. However quantifying the real-world impact of duration of therapy is hindered by bias common in observational studies. We aimed to evaluate the harms and benefits of longer versus shorter duration of therapy in older adults.

Characterization of genetic diversity and identification of genetic loci associated with carbon allocation in N fixing soybean.

Background: Efficient capture and use of resources is critical for optimal plant growth and productivity. Both shoot and root growth are essential for resource acquisition, namely light and CO by the shoot and water and mineral nutrients by roots. Soybean [Glycine max (L.

Surgical Time and Complication Risk in Conversion Total Hip Arthroplasty With Implant Removal: Finding an Optimal Surgical Duration.

Background: Although longer surgical times in primary total hip arthroplasty (THA) are associated with higher complication rates, this has yet to be explored in conversion THA. The purpose of this study is to investigate the relationship between surgical time and complications in the setting of conversion THA with implant removal. We aim to establish a length of surgery after which the risk of complications increases.

Outcomes in Acetabular Revision for Acute Pelvic Discontinuity Utilizing Plating of the Posterior Column.

Background: Acute pelvic discontinuity (PD) is a rare, yet challenging complication following total hip arthroplasty (THA). Although several techniques, such as plating of the posterior column and spanning of the discontinuity with a cup cage, have been described for the management of acute PD, few studies have determined the survivorship of acetabular constructs in this setting. The purpose of this study was to determine the outcomes of acetabular fixation of the posterior column in patients who had acute PD following THA.

Developmental Thermal Reaction Norms of Leatherback Marine Turtles at Nesting Beaches.

Accurate scientific information is critical for undertaking appropriate conservation and management practices for imperiled species. One source of concern is that research findings might vary for non-biological reasons, including experimental design and analytical methods. To illustrate, we provide detailed modern analysis of reproductive data for leatherback turtles ().

Mapping the Institutional Healthcare Payer Mix for Total Hip and Knee Arthroplasty: Insight Into a Large Practice.

Background: As the demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) continues to grow exponentially, the economic burden on practices and healthcare payers simultaneously increases. Medicare accounts for over 60% of total joint arthroplasty (TJA) cases nationwide, and the reimbursements are worsening despite alternative payment models. Trending the active payers at an institution provides invaluable insight into the financial health of a practice and projects if annual run rates are sustainable.

Does Resurfacing the Patella Increase the Risk of Extensor Mechanism Injury within the First 2 Years after Total Knee Arthroplasty?

Extensor mechanism injury (EMI) following total knee arthroplasty (TKA) is a potentially catastrophic complication and may lead to significant morbidity or need for revision reconstructive procedures. Patellar resurfacing (PR), while commonly performed during TKA, reduces overall patella bone stock and may increase the risk of EMI after TKA. The purpose of this study was to assess if PR in elderly patients raises the risk for subsequent EMI.

Rising Costs and Diminishing Surgeon Reimbursement From Primary to Revision Total Hip and Knee Arthroplasty: An Analysis of Medicare Advantage and Commercial Insurance.

Background: Revision total joint arthroplasty (rTJA) is a resource-intensive procedure addressing failed primary total joint hip (total hip arthroplasty [THA]) and knee arthroplasty (total knee arthroplasty [TKA]). Despite predictions of increased demand, reimbursement for rTJA has not kept pace with increasing costs and may be insufficient compared with primary procedures. The study aimed to highlight the diminishing surgeon reimbursement between primary and revision THA (rTHA) and TKA.

Therapeutic potential of co-signaling receptor modulation in hepatitis B.

Reversing CD8 T cell dysfunction is crucial in treating chronic hepatitis B virus (HBV) infection, yet specific molecular targets remain unclear. Our study analyzed co-signaling receptors during hepatocellular priming and traced the trajectory and fate of dysfunctional HBV-specific CD8 T cells. Early on, these cells upregulate PD-1, CTLA-4, LAG-3, OX40, 4-1BB, and ICOS.

Adding corticosteroids to intra-operative periarticular injections in total knee arthroplasty: A systematic review.

Background: Adding corticosteroids to intraoperative periarticular injections (PAIs) have become a current trend in total knee arthroplasty (TKA). Periarticular corticosteroid injections (PACSIs) intend to improve postoperative pain and function. However, preoperative corticosteroid injections for symptomatic arthritis increase the rates of prosthetic joint infection (PJI) when given months prior to TKA.

Differences in P-Type and Type 1 Uropathogenic Urinary Anti-Adhesion Activity of Cranberry Fruit Juice Dry Extract Product and D-Mannose Dietary Supplement.

Background: Urinary tract infection (UTI) prevention benefits of cranberry intake are clinically validated, especially for women and children. To ensure the benefits of cranberry dietary supplement products, the anti-adhesion activity (AAA) against uropathogenic bacteria is routinely used in in vitro bioassays to determine the activity in whole product formulations, isolated compounds, and ex vivo bioassays to assess urinary activity following intake. D-mannose is another dietary supplement taken for UTI prevention, based on the anti-adhesion mechanism.

Analysis of Costs Associated With Increased Length of Stay After Total Joint Arthroplasty at a Single Private Practice.

Introduction: As the demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) increases, so does the financial burden of these services. Despite efforts to optimize spending and bundled care payments, THA and TKA costs still need to be assessed. Our study explores the relationship between perioperative costs and length of stay (LOS) for THA and TKA.

The Effect of Cemented Implants Placed During Initial TKA on Surgical Time and Expenses in Revision TKA.

Introduction: Revision total knee arthroplasty (rTKA) is a complex procedure that often requires the removal of previous implants. There is little information evaluating the difference between removing cemented or noncemented knee prostheses in revision surgeries. The purpose of this study was to determine whether removing cemented or noncemented implants would affect surgical time and expenses incurred during revision procedures.

Identification of Surgeon Outliers to Improve Cost Efficiency: A Novel Use of the Centers for Medicare and Medicaid Quality Payment Program.

Background: Bundled payment programs for total joint arthroplasty (TJA) have become popular among both private and public payers. Because these programs provide surgeons with financial incentives to decrease costs through reconciliation payments, there is an advantage to identifying and emulating cost-efficient surgeons. The objective of this study was to utilize the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) in combination with institutional data to identify cost-efficient surgeons within our region and, subsequently, identify cost-saving practice patterns.

Antibiotic Laden Bone Cement Does Not Reduce Acute Periprosthetic Joint Infection Risk in Primary Total Knee Arthroplasty.

Background: Periprosthetic joint infection (PJI) can be a serious complication of total knee arthroplasty (TKA). A method believed to decrease the incidence of PJI is antibiotic-laden bone cement (ALBC). Current clinical practice guidelines do not recommend ALBC in primary TKA.

Identification of QTLs for symbiotic nitrogen fixation and related traits in a soybean recombinant inbred line population.

The genetic architecture of symbiotic N fixation and related traits was investigated in the field. QTLs were identified for percent N derived from the atmosphere, shoot [N] and C to N ratio. Soybean [Glycine max (L.

Next generation risk assessment: an case study to assess the systemic safety of the cosmetic ingredient, benzyl salicylate, after dermal exposure.

We performed an next-generation risk assessment (NGRA) for a fragrance ingredient, benzyl salicylate (BSal), to demonstrate how cosmetic ingredients can be evaluated for systemic toxicity endpoints based on non-animal approaches. New approach methodologies (NAMs) used to predict the internal exposure included skin absorption assays, hepatocyte metabolism, and physiologically based pharmacokinetic (PBPK) modeling, and potential toxicodynamic effects were assessed using pharmacology profiling, ToxProfiler cell stress assay, transcriptomics in HepG2 and MCF-7 cells, ReproTracker developmental and reproductive toxicology (DART) assays, and cytotoxicity assays in human kidney cells. The outcome of the NGRA was compared to that of the traditional risk assessment approach based on animal data.

Heritable CRISPR Mutagenesis of Essential Maternal Effect Genes as a Simple Tool for Sustained Population Suppression of Invasive Species in a Zebrafish Model.

Invasive species control is important for ecological and agricultural management. Genetic methods can provide species specificity for population control. We developed heritable maternal effect embryo lethality (HMEL), a novel strategy allowing negative population pressure from HMEL individuals to be transmitted within a population across generations.

Prior Authorization Leads to Administrative Burden and Delays in Treatment in Primary Total Joint Arthroplasty Patients.

Background: The prior authorization (PA) process is often criticized by physicians due to increased administrative burden and unnecessary delays in treatment. The effects of PA policies on total hip arthroplasty (THA) and total knee arthroplasty (TKA) have not been well described. The purpose of this study was to analyze the use of PA in a high-volume orthopaedic practice across 4 states.