Waterborne toxicity of several dichlorodiphenyltrichloroethane congeners to Hyalella azteca and its implications for contaminated sediment assessment.

Although banned long ago in many countries and jurisdictions, the organochlorine pesticide dichlorodiphenyltrichloroethane (DDT) and compounds related to it remain in the aquatic environment, particularly in sediments, and can pose risks to aquatic life. To inform ecological risk assessment of these compounds, we tested the toxicity of six DDT congeners, specifically the p, p' (4,4') forms of DDT, dichlorodiphenyldichloroethylene (DDE), dichlorodiphenyldichloroethane (DDD), and dichlorodiphenylchloroethylene (DDMU), as well as the o, p' (2,4') isomers of DDT and DDD. The epibenthic amphipod, Hyalella azteca, was exposed for 7 days to waterborne chemical and assessed for changes in survival and growth.

COVID-19-Associated Encephalopathy: A Case Series Demonstrating the Rapid Deterioration of Mental Status and a Review of the Literature.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is known for its severe inflammatory response, often leading to multi-organ dysfunction. Among the less-recognized complications is COVID-19-associated encephalopathy, particularly in the elderly, where it contributes significantly to morbidity and mortality. This report explores the rapid neurocognitive decline observed in six hospitalized patients with COVID-19, with or without pre-existing neurological conditions.

Recombinant expression systems for production of stabilised virus-like particles as next-generation polio vaccines.

Polioviruses have caused crippling disease in humans for centuries, prior to the successful development of vaccines in the mid-1900's, which dramatically reduced disease prevalence. Continued use of these vaccines, however, threatens ultimate disease eradication and achievement of a polio-free world. Virus-like particles (VLPs) that lack a viral genome represent a safer potential vaccine, although they require particle stabilization.

Comparison of Multi-Drug Resistant Organisms Causing Early Ventilator-Associated Pneumonia in Three Geographically Distinct Trauma Intensive Care Units.

It is unclear why differences in patient location change organisms causing ventilator-associated pneumonia (VAP). We investigated VAP organisms in three geographically separate trauma intensive care units (TICUs). A retrospective review of organisms causing VAP (bronchoalveolar lavage [BAL] performed ≤7 d after admission and growing ≥10 cfu/mL) in three geographically separate TICUs was conducted.

Time-driven cost analysis of pediatric liver biopsy completed in pediatric sedation clinic and operating room.

Background: Pediatric ultrasound (US)-guided percutaneous liver biopsy is a commonly performed procedure in children, and may be performed in a variety of clinical settings. However, there is little research on the relative costs associated with different sedation methods and locations.

Objective: This study uses time-driven activity-based costing (TDABC) to identify relevant costs associated with different biopsy sedation techniques and locations to help inform providers and patients as well as guide value-conscious care.

Development and Implementation of a Context-Specific Multi-modal Point-of-Care Ultrasound Curriculum for a Kenyan Family Medicine Residency Program.

Access to diagnostic imaging is significantly limited in much of the world, and sub-Saharan Africa is no exception. Clinician-performed point-of-care ultrasound (POCUS) may provide increased access to diagnostic imaging for many patients in low-resource settings, but training in this modality is limited. We describe the development and implementation of a context-specific, multi-modal pilot POCUS curriculum involving hands-on instruction, in-person and online didactics, asynchronous online image review, and quantitative evaluation.

Design, Structure-Activity Relationships, and Computational Modeling Studies of a Series of α-Helix Biased, Ultra-Short Glucagon-like Peptide-1 Receptor Agonists.

A systematic structure-activity and computational modeling analysis of a series of glucagon-like peptide-1 receptor (GLP-1R) agonists based upon an ultra-short GLP-1 peptide, H-His-Aib-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Bip-Bip-NH2, was conducted. This highly potent 11-mer peptide led to a deeper understanding of the α-helical bias of strategic α-methylation within the linear parent template as well as optimization of GLP-1R agonist potency by 1000-fold. These data were correlated with previously reported co-structures of both full-length GLP-1 analogs and progenitor N-terminal GLP-1 fragment analogs related to such ultra-short GLP-1R agonist peptides.

Mid-life anti-inflammatory metabolites are inversely associated with long-term cardiovascular disease events.

Background: Preclinical data have shown that low levels of metabolites with anti-inflammatory properties may impact metabolic disease processes. However, the association between mid-life levels of such metabolites and long-term ASCVD risk is not known.

Methods: We characterised the plasma metabolomic profile (1228 metabolites) of 1852 participants (58.

In utero progression of cephaloceles: prenatal to postnatal analysis.

Objective: The natural history of cephaloceles is not well understood. The goal of this study was to better understand the natural history of fetal cephaloceles from prenatal diagnosis to the postnatal period.

Methods: Between January 2013 and April 2023, all patients evaluated with a cephalocele at the Center for Fetal Diagnosis and Treatment were identified.

Primary Rhinoplasty for Unilateral Cleft Lip: A Long-Term Cohort Assessment of Aesthetic and Anthropometric Outcomes.

The decision to undertake rhinoplasty maneuvers during cleft lip repair remains controversial. Little data compare long-term outcomes with and without primary rhinoplasty (PR). This study compared nasolabial outcomes in cohorts with unilateral cleft lip (UCL) treated with and without PR at the Children's Hospital of Philadelphia using standardized aesthetic and anthropometric assessments.

A Comparison of Endoscope-Assisted and Open Frontoorbital Distraction for the Treatment of Unicoronal Craniosynostosis.

Background: Frontoorbital distraction osteogenesis (FODO) is an established surgical technique for patients with unicoronal craniosynostosis. The authors' institution has used an endoscope-assisted technique (endo-FODO) in recent years to decrease cutaneous scarring and lessen the impact on the functional growth matrix. This study compared perioperative outcomes in patients undergoing endo-FODO to those in patients undergoing the traditional coronal approach.

Endoscopic-assisted versus open fronto-orbital distraction for unicoronal craniosynostosis: morphometric and technique considerations.

Introduction: In an effort to maximize benefit and minimize morbidity when performing fronto-orbital distraction osteogenesis (FODO) for unilateral coronal synostosis (UCS), we have transitioned to an endoscopic-assisted approach ("endo-FODO"). This study compares photogrammetric outcomes of patients who underwent FODO via an endoscopic-assisted versus open approach.

Methods: We retrospectively reviewed patients treated for UCS from 2013 to 2023.

Long-Term Surgical Outcomes of Intermediate Cleft Rhinoplasty.

Background: The risk/benefit ratio of operating on the cleft nasal deformity in the period of mixed dentition remains debated. This study characterizes our 18-year experience with intermediate cleft rhinoplasties to add data and nuance to the discussion.

Methods: We performed a retrospective cohort study of patients who underwent intermediate cleft rhinoplasty from 2006 to 2023.

Fragmented Care, Commission on Cancer Accreditation, and Overall Survival in Patients Receiving Surgery and Chemotherapy for Lung Cancer.

Background: Patients may receive their adjuvant therapy at a facility different from where they had their lung cancer operation. Whether this fragmentation of care affects outcomes is unclear.

Methods: We used the National Cancer Database to identify lung cancer patients undergoing resection and adjuvant chemotherapy from 2006-2020.

Multiscale Responsive Kinetic Modeling: Quantifying Biomolecular Reaction Flux under Varying Electrochemical Conditions.

Attaining a complete thermodynamic and kinetic characterization for processes involving multiple interconnected rare-event transitions remains a central challenge in molecular biophysics. This challenge is amplified when the process must be understood under a range of reaction conditions. Herein, we present a novel condition-responsive kinetic modeling framework that can combine the strengths of bottom-up rate quantification from multiscale simulations with top-down solution refinement using both equilibrium and nonequilibrium experimental data.

Condylar Volumetric Asymmetry Predicts Need for Surgical Intervention in Patients With Cleft Lip and/or Palate.

Objective: In this study, the authors investigate the associations between the mandibular condyle and facial asymmetry in patients with cleft lip and/or palate (CLP).

Methods: Condylar volume was calculated by measuring the bony volume of the posterior mandible superior to the sigmoid notch in skeletally mature patients with CLP and controls. Relationships between condylar asymmetry, facial deviation, and malocclusion were compared using t-tests, correlation analysis, and receiver operating characteristic curves.

Growing Macrophages Regulate High Rates of Solute Flux by Pinocytosis.

In metazoan cells, growth factors stimulate solute ingestion by pinocytosis. To examine the role of pinocytosis in cell growth, this study measured cell proliferation and the attendant rates of solute flux by pinocytosis in murine macrophages in response to the growth factor colony-stimulating factor-1 (CSF1). During CSF1-dependent growth in rich medium, macrophages internalized 72 percent of their cell volume in extracellular fluid every hour.

Nernst equilibrium, rectification, and saturation: Insights into ion channel behavior.

The dissipation of electrochemical gradients through ion channels plays a central role in biology. Herein we use voltage-responsive kinetic models of ion channels to explore how electrical and chemical potentials differentially influence ion transport properties. These models demonstrate how electrically driven flux is greater than the Nernstian equivalent chemically driven flux yet still perfectly cancels when the two gradients oppose each other.

The Evolution of Unicoronal Synostosis Correction: Long-Term Aesthetic Outcomes of Fronto-Orbital Distraction Versus Traditional Advancement.

Introduction: This study compares the long-term aesthetic outcomes of patients with unicoronal synostosis (UCS) who underwent fronto-orbital distraction osteogenesis (FODO) versus traditional fronto-orbital advancement and remodeling (FOAR).

Methods: Patients treated for nonsyndromic UCS from 2009 to 2023 were retrospectively reviewed. Perioperative and complication characteristics were compared between all patients who underwent FOAR, open FODO, and endoscopic-assisted FODO ("endo-FODO").

Characteristics and Predictors of Fluctuating Attention-Deficit/Hyperactivity Disorder in the Multimodal Treatment of ADHD (MTA) Study.

Recent studies report a fluctuating course of attention-deficit/ hyperactivity disorder (ADHD) across development characterized by intermittent periods of remission and recurrence. In the Multimodal Treatment of ADHD (MTA) study, we investigated fluctuating ADHD including clinical expression over time, childhood predictors, and between- and within-person associations with factors hypothesized as relevant to remission and recurrence. Children with ADHD, combined type (N 483), participating in the MTA adult follow-up were assessed 9 times from baseline (mean age = 8.

Surgical Management of 2,350 Pediatric Dermoid Cysts.

Background: We examined operative and pathologic findings of a large series of dermoid cysts at a high-volume pediatric hospital over 23 years.

Methods: A retrospective review was performed of all dermoid cysts excised from 2000 to 2023 at the Children's Hospital of Philadelphia. Lesions were classified by location.

APOBEC3B expression in 293T viral producer cells drives mutations in chimeric antigen receptors and reduces CAR T cell efficacy.

Chimeric antigen receptor (CAR) T cells are a clinically approved therapy for blood cancers. To produce clinical-grade CAR T cells, a retroviral or lentiviral vector is used to deliver the CAR and associated genes to patient T cells. Apolipoprotein B editing enzyme, catalytic polypeptide 3 (APOBEC3) enzymes are known to be upregulated after transfection and retroviral infection and to deaminate cytidine to uracil in nucleic acids, resulting in cytidine-to-thymine mutations in DNA.

An Interactive, Case-Based Workshop on the Patient Experience for Internal Medicine Residents.

Introduction: The technological revolution has narrowed the information gap between physician and patient. This has led to an evolution in medicine from paternalistic to patient-centric, with health care systems now prioritizing patient experience to achieve higher satisfaction scores. Therefore, it is imperative to start early in educating trainees on how to best address the holistic needs of the patient while also delivering high-quality care.