Admixture of Liposomal Bupivacaine and Bupivacaine Hydrochloride for Peripheral Nerve Blocks in Adolescents Undergoing Orthopedic Surgery: An Observational Cohort Study.

: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems.

DECENTRALIZED IMMUNIZATION MONITORING: LESSONS LEARNED FROM FOUR STATES - NIGERIA.

Background: Low immunization coverage in Nigeria accounts for 2.3 million children with zero doses, increasing morbidity and mortality. The government prioritizes 100 local government areas for strategic interventions aiming for a 15% reduction in zero-dose (ZD) children by 2024.

Foam Rolling on the Whole Leg and Its Immediate Effects on Postural Control in Collegiate Female Athletes.

The maintenance of body posture relies on mechanoreceptors, suggesting myofascial release could assist postural control. The effects of this have not been well documented, providing room for this investigation. Twenty-one female athletes spent approximately 2.

The Acute Effects in Postural Sway as a Result of Self-Myofascial Release on the Lower Extremities in Collegiate Female Athletes.

Unlabelled: Myofascial release is a popular therapy technique used to manipulate connective muscle tissue to become more pliable. The maintenance of body posture relies on mechanoreceptors located in connective tissue, thus manipulation of connective tissue should affect postural control. The effects of this phenomenon have not been well studied, leaving room for this investigation.

A survey of state and local practices encouraging pediatric COVID-19 vaccination of children ages 6 months through 11 years.

Objective: This report highlights state and local practices for optimizing the pediatric COVID-19 vaccination program for children ages 6 months through 11 years.

Methods: State and local practices designed to optimize pediatric COVID-19 vaccine uptake were identified from a range of sources, including immunization program, CDC, and partner staff; and media stories or program descriptions identified via online searches.

Results: A range of practices were identified across different categories: provider-focused practices, school-based practices, jurisdiction or health department-based activities, community-focused practices involving partners, use of vaccination incentives, and Medicaid-related practices.

Have a vital end-user been overlooked? Developing a shared decision intervention for patients with potential pancreatic cancer regarding the choice of surgery.

Objective: To develop a patient decision aid facilitating shared decision making for patients with potential pancreatic cancer deciding about no treatment, surgical or medical treatment.

Methods: Based on a user-centred design by Wittemann et al., we developed a shared decision making intervention in three phases: 1) Understanding decision needs 2) Development of a patient decision aid (PtDA) based on a generic template 3) Assessment of the intervention from interviews with patients ( = 11), relatives (n = 11), nurses ( = 4) and surgeons ( = 2) analysed with thematic analysis, and measuring patients' perceptions of choice of options with the Decisional Conflict Scale.

Acute Toxicity of Total Body Irradiation Using Volumetric Arc Therapy With a Focus on the Effect of Lung Dose Rate.

Purpose: To report adverse effects of high dose total body irradiation (TBI) delivered using a volumetric arc therapy (VMAT) technique and to assess pulmonary toxicity at dose rates of 40 and 100 monitor units per minute (MU/min).

Methods And Materials: This retrospective study included patients >18 years old who received ≥8 Gy TBI using a VMAT technique. The TBI dose was prescribed to a planning target volume consisting of a 0.

Re-Envisioning the Culture of Undergraduate Biology Education to Foster Black Student Success: A Clarion Call.

The purpose of this paper is to present an argument for why there is a need to re-envision the underlying culture of undergraduate biology education to ensure the success, retention, and matriculation of Black students. The basis of this argument is the continued noted challenges with retaining Black students in the biological sciences coupled with existing research that implicates science contexts (i.e.

Emergency Medicine Procedures: A Review of Approved Instructional Resources from the World of Free Open Access Medical Education.

The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) Series was created in 2014 to address the Free Open Access Medical Education (FOAM) movement's decentralized nature and lack of inherent peer review. The AIR series provides a topic-based, curated list of online educational content vetted by academic emergency medicine (EM) faculty that meets individualized interactive instruction criteria for EM trainees. Relevant FOAM resources were identified from the top 50 FOAM websites using the Social Media Index and then scored by EM faculty using a validated instrument to identify the highest quality posts related to a topic.

Primary Cutaneous Blastomycosis: An Ulcerated Wound in an Immunocompetent Patient.

The report describes a case of cutaneous blastomycosis. The patient was a healthy elderly male with a history of rectal adenocarcinoma, who presented with an ulcerating wound on his left buttock. Fungal culture was positive for Blastomyces dermatitidis, and the patient was treated with itraconazole followed by voriconazole for three months, which led to clinical resolution of the infection.

An Atypical Presentation of Acute Syphilitic Posterior Placoid Chorioretinitis With Concurrent Psoriasis Vulgaris Flare in an African American Male Infected With HIV.

The diagnosis of secondary syphilis can be challenging due to its various clinical and histopathological presentations. A late or incorrect diagnosis can result in disease progression with consequent morbidity or mortality. Due to the importance of a correct diagnosis and specific treatment, it is of the utmost importance for healthcare providers to consider the various manifestations of syphilis.

Sometimes Your Heart Says 'I Don't Know': Insights From Parents of Undervaccinated Children.

Study Objective: To explore drivers of suboptimal vaccination rates by understanding why parents without strong antivaccine beliefs do not fully vaccinate their children.

Methods: Four focus groups were conducted in Washington state with 41 parents of children aged 24 to 48 months who delayed, declined, or missed some but not all vaccines. During the focus groups, parents were asked about reasons their child was undervaccinated, information that might address their concerns, and additional support they needed.

Impact of prophylactic antimalarials in pregnant women living with Human Immunodeficiency Virus on birth outcomes in Botswana.

Objectives: Until late 2015, Botswana recommended preventive treatment for pregnant women in malarial regions with chloroquine and proguanil (CP). The guideline change provided an opportunity to evaluate CP and adverse birth outcomes.

Methods: The Tsepamo Study performed birth outcomes surveillance at large delivery centres throughout Botswana.

Description of the Use of Incentives and Penalties for Point-of-Care Ultrasound Documentation Compliance in an Academic Emergency Department.

Objectives Incomplete documentation and submission to the electronic health record of performed point-of-care ultrasound (POCUS) studies is problematic from a patient care, medicolegal, and billing standpoint. Positive and negative financial incentives may be used to motivate physicians to complete documentation workflow. The most efficacious route to improve POCUS workflow completion remains to be determined.

PI3K/mTOR Dual Inhibitor PF-04691502 Is a Schedule-Dependent Radiosensitizer for Gastroenteropancreatic Neuroendocrine Tumors.

Patients with advanced-stage gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have a poor overall prognosis despite chemotherapy and radiotherapy (e.g., peptide receptor radionuclide therapy (PRRT)).

Rupture, reconstruction, and rehabilitation: A multi-disciplinary review of mechanisms for central nervous system adaptations following anterior cruciate ligament injury.

Background: Despite surgical reconstruction and extensive rehabilitation, persistent quadriceps inhibition, gait asymmetry, and functional impairment remain prevalent in patients after anterior cruciate ligament (ACL) injury. A combination of reports have suggested underlying central nervous system adaptations in those after injury govern long-term neuromuscular impairments. The classic assumption has been to attribute neurophysiologic deficits to components of injury, but other factors across the continuum of care (e.

Molecular View on Mechanical Reinforcement in Polymer Nanocomposites.

The microscopic origin of mechanical enhancement in polymer nanocomposite (PNC) melts is investigated through the combination of rheology and small-angle neutron scattering. It is shown that in the absence of an extensive particle network, the molecular deformation of polymer chains dominates the stress response on intermediate time scales. Quantitative analyses of small-angle neutron scattering spectra, however, reveal no enhanced structural anisotropy in the PNCs, compared with the pristine polymers under the same deformation conditions.

Unplanned hospital admission after ambulatory surgery: a retrospective, single cohort study.

Purpose: We estimated the rate of unplanned hospital and intensive care unit (ICU) admissions following ambulatory surgery centre (ASC) procedures, and identified factors associated with their occurrence.

Methods: This retrospective cohort included adult patients who underwent ASC procedures within a large community practice from January 2010 to December 2014. Patients were categorized into two groups: unplanned postoperative hospital/ICU admission within 24 hr of procedure or uneventful discharge.

Nonmonotonic Strain Rate Dependence on the Strain Hardening of Polymer Nanocomposites.

This Letter investigates the external deformation on modifying the polymer-nanoparticle (NP) and NP-NP interactions as well as their influences on the macroscopic properties of polymer nanocomposites (PNCs). Specifically, the applied uniaxial extension brings together the NPs along the transverse stretching direction and catalyzes the percolation transition from the initially well-dispersed NPs in the PNCs. The percolated NP network thus increases the strength of PNCs and leads to a strong surge in the elongation viscosity at very low strain rates, exhibiting the unexpected nonmonotonic strain rate dependence on the strain hardening.

Neural activation for actual and imagined movement following unilateral hand transplantation: a case study.

Transplantation of a donor hand has been successful as a surgical treatment following amputation, but little is known regarding the brain mechanisms contributing to the recovery of motor function. We report functional magnetic resonance imaging (fMRI) findings for neural activation related to actual and imagined movement, for a 54-year-old male patient, who had received a donor hand transplant 50 years following amputation. Two assessments, conducted 3 months and 6 months post-operatively, demonstrate engagement of motor-control related brain regions for the transplanted hand, during both actual and imagined movement of the fingers.

The Design and Validation of a New Algorithm to Identify Incident Fractures in Administrative Claims Data.

Our study validated a claims-based algorithm for the identification of incident and recurrent fractures in administrative data. We used Centers for Medicare and Medicaid (CMS) claims from 2005 to 2014 linked to the Reasons for Geographic and Racial Differences in Stroke (REGARDS) database. Case qualifying (CQ) fractures were identified among participants with ≥12 months of fee-for-service coverage before first fracture claim and ≥6 months after.

Regional Anesthesia for Ambulatory Anesthesiologists.

Proper pain control is critical for ambulatory surgery. Regional anesthesia can decrease postoperative pain, improve patient satisfaction, and expedite patient discharge. This article discusses the techniques, clinical pearls, and potential pitfalls associated with those blocks, which are most useful in an ambulatory perioperative setting.

Race Plays a Role in the Knowledge, Attitudes, and Beliefs of Women with Osteoporosis.

Using a concurrent mixed methods design, we investigated how knowledge, attitudes, values, and beliefs among women with osteoporosis can explain racial disparities in bone health. We recruited African American and White women ≥ 65 years of age with osteoporosis to participate in focus groups. We quantitatively compared scores of the "Osteoporosis & You" knowledge scale and each domain (internal, powerful others, and chance) of the Multidimensional Health Locus of Control scale by race using t tests.