Surgical Resection of Bilateral Polycystic Ovaries Causing Ureteral Obstruction.

Ovarian cysts in adolescents are typically managed conservatively given the low rate of malignancy and the cysts typically regress over time. We present a case of a 14 year-old female with large bilateral adnexal cysts causing ureteral obstruction which was successfully treated with surgical resection and ensuring maximum preservation of ovarian tissue.

Management of Hidden Cutaneous Melanoma of the Umbilicus.

Melanoma is currently the fifth most common cancer in the United States (US) and most often develop on areas that have increased sun exposure, such as the arms, legs, back or face. The incidence of primary cutaneous melanoma increases each year and curative treatment improves with earlier detection of disease. Primary cutaneous umbilical melanoma is extremely rare with as few as 46 cases reported worldwide.

Refining manual annotation effort of acoustic data to estimate bird species richness and composition: The role of duration, intensity, and time.

Manually annotating audio files for bird species richness estimation or machine learning validation is a time-intensive task. A premium is placed on the subselection of files that will maximize the efficiency of unique additional species identified, to be used for future analyses. Using acoustic data collected in 17 plots, we created 60 subsetting scenarios across three gradients: intensity (minutes in an hour), day phase (dawn, morning, or both), and duration (number of days) for manual annotation.

Population Density and Triage of Pediatric Firearm Injuries in a Rural Trauma System.

Background: Rural pediatric firearm injuries require regional pediatric and trauma expertise. We evaluated county-level population density associations with transport, hospital interventions, and patient outcomes at a Level I pediatric trauma center serving a rural, statewide catchment area.

Material And Methods: The trauma registry of the only in-state pediatric trauma center was reviewed for firearm injuries in patients < 18 between 1/2013 and 3/2020.

Functional status of heart transplant recipients predicts survival.

Introduction: Recipient functional status prior to transplantation can significantly impact post-transplant survival.

Methods: The United Network for Organ Sharing database was queried for adult heart transplants including data on functional capacity and from February 1, 2005 to March 1, 2021; there were 32 875 cases included. The four functional categories studied were based on adult daily activities of living and were separated into total assistance required, some assistance required, no assistance required, and near death.

Impella 5.0: An intermediate strategy for bridging a patient from infected durable LVAD to cardiac transplant.

Cardiac transplant remains the gold-standard treatment for end-stage heart failure more than 50 years after the procedure was first pioneered. The number of transplant operations performed annually has been limited by the global imbalance of donor organs to recipients. This imbalance helped fuel the development of left ventricular assist devices (LVADs) first as a bridge to cardiac transplant and subsequently as destination therapy.

Better together: a reappraisal of heterotopic heart transplantation.

Heterotopic heart transplantation (HHT) is rare in the modern era. When used as a biologic left ventricular assist, HHT provides pulsatile flow, supports the left ventricle with a physiologic cardiac output, responds to humoral stimuli, and with modern immunosuppression may offer long-term untethered survival. This study was undertaken to compare survival of HHT with orthotopic heart transplantation (OHT) to assess its viability in the modern era.

Burkitt Lymphoma Presenting as Perforated Appendicitis.

Appendicitis is the most common indication for an emergent abdominal operation in the pediatric population. Fewer than .015% of patients who undergo appendectomy for presumed appendicitis are diagnosed with primary lymphoma after evaluation of pathology specimen.

Closed Gastroschisis: A Rare Abdominal Wall Defect.

Gastroschisis is a rare congenital abdominal wall defect characterized by intestinal evisceration to the right of the umbilical stalk. In less than 6% of cases, the fascial defect closes around the herniated viscera in utero. The mechanism of fascial closure in these cases is unknown; however, the tourniquet effect on the mesenteric vasculature is thought to lead to intestinal atresia and midgut infarction.

Surgical Control of Bleeding From Ovarian Torsion in the Setting of Immune Thrombocytopenic Purpura Without Splenectomy.

Immune thrombocytopenic purpura (ITP) is a disorder caused by autoimmune antibodies which target glycoprotein IIb/IIIa complex or other platelet membrane antigens leading to platelet destruction. These platelets are then cleared by the spleen resulting in thrombocytopenia. Immune thrombocytopenic purpura affects about 1 to 6.

Does pediatric heart transplant survival differ with various cardiac preservation solutions?

Background: Few studies directly compare outcomes between the most commonly used preservation solutions in pediatric heart transplantation in a large cohort of recipients. The purpose of this study is to investigate the effect of cardiac preservation solution on survival in pediatric heart transplant recipients.

Methods: The United Network for Organ Sharing (UNOS) database was retrospectively reviewed from 01/2004-03/2018 for pediatric donor hearts.

Height and health in late eighteenth-century England.

Adult stature has become a widely used indicator of childhood nutritional status in historical populations and may provide insights into health inequalities that are not discernible in mortality rates. However, most pre-twentieth-century British data on heights suffer from selection biases. Here we present unique evidence on heights of adult males by occupation from an unbiased sample of adult males in Dorset in 1798-99.

An introduction to the history of infectious diseases, epidemics and the early phases of the long-run decline in mortality.

This article, written during the COVID-19 epidemic, provides a general introduction to the long-term history of infectious diseases, epidemics and the early phases of the spectacular long-term improvements in life expectancy since 1750, primarily with reference to English history. The story is a fundamentally optimistic one. In 2019 global life expectancy was approaching 73 years.

Neuroticism mediates the relationship between industrial history and modern-day regional obesity levels.

Objective: The historical factors and contemporary mechanisms underlying geographical inequalities in obesity levels remain uncertain. In this study, we examine whether modern regional variation in obesity is partly a result of the impact of large-scale industry on the personality traits of those living in regions once at the center of the Industrial Revolution.

Method: Exposure to the effects of the Industrial Revolution was assessed using unique historical data from English/Welsh counties (N = 111).

Geometric determinants of local hemodynamics in severe carotid artery stenosis.

In cases of severe carotid artery stenosis (CAS), carotid endarterectomy (CEA) is performed to recover lumen patency and alleviate stroke risk. Under current guidelines, the decision to surgically intervene relies primarily on the percent loss of native arterial lumen diameter within the stenotic region (i.e.

Cholera as a 'sanitary test' of British cities, 1831-1866.

The malign contribution of northern industrial cities to the stagnation of national life expectancy over the period 1820-1870 forms part of one of the most long-running debates in English economic history, regarding the impact of early industrialisation on living standards. The deteriorating quality of urban water supplies often features in these arguments as the key driver of worsening mortality in this period. Here we use mortality reported from cholera in the epidemic years 1831-1832 and 1848-1849 as an indicator of the extent of sewage contamination of water in English and Welsh towns in this period.

Species diversity in restoration plantings: Important factors for increasing the diversity of threatened tree species in the restoration of the Araucaria forest ecosystem.

The Araucaria forest ecosystem in southern Brazil is highly threatened: less than one percent of the original forest remains, and what is left is a fragmented agro-mosaic of mostly early-to-late secondary forest patches among high-yield agriculture and timber monocultures. Forest restoration initiatives in this region aim to restore degraded areas, however the limited number of species used in restoration projects represents a missed opportunity for species-rich plantings. High diversity plantings represent a larger number of functional groups and provide a targeted conservation strategy for the high number of threatened species within this ecosystem.

The geography of smallpox in England before vaccination: A conundrum resolved.

Smallpox is regarded as an ancient and lethal disease of humans, however very little is known about the prevalence and impact of smallpox before the advent of vaccination (c.1800). Here we use evidence from English burial records covering the period 1650-1799 to confirm a striking geography to smallpox patterns.

In the shadow of coal: How large-scale industries contributed to present-day regional differences in personality and well-being.

Recent research has identified regional variation of personality traits within countries but we know little about the underlying drivers of this variation. We propose that the Industrial Revolution, as a key era in the history of industrialized nations, has led to a persistent clustering of well-being outcomes and personality traits associated with psychological adversity via processes of selective migration and socialization. Analyzing data from England and Wales, we examine relationships between the historical employment share in large-scale coal-based industries (coal mining and steam-powered manufacturing industries that used this coal as fuel for their steam engines) and today's regional variation in personality and well-being.

Barcoded nanoparticles for high throughput in vivo discovery of targeted therapeutics.

Nucleic acid therapeutics are limited by inefficient delivery to target tissues and cells and by an incomplete understanding of how nanoparticle structure affects biodistribution to off-target organs. Although thousands of nanoparticle formulations have been designed to deliver nucleic acids, most nanoparticles have been tested in cell culture contexts that do not recapitulate systemic in vivo delivery. To increase the number of nanoparticles that could be tested in vivo, we developed a method to simultaneously measure the biodistribution of many chemically distinct nanoparticles.

RNAi targeting multiple cell adhesion molecules reduces immune cell recruitment and vascular inflammation after myocardial infarction.

Myocardial infarction (MI) leads to a systemic surge of vascular inflammation in mice and humans, resulting in secondary ischemic complications and high mortality. We show that, in ApoE(-/-) mice with coronary ligation, increased sympathetic tone up-regulates not only hematopoietic leukocyte production but also plaque endothelial expression of adhesion molecules. To counteract the resulting arterial leukocyte recruitment, we developed nanoparticle-based RNA interference (RNAi) that effectively silences five key adhesion molecules.