The Decision for Amputation Versus Limb Salvage in Patients with Limb-threatening Lower Extremity Indications: An Ethical Analysis.

Ethical decision-making in the amputation versus limb salvage context requires consideration of respect for patient autonomy, beneficence, and nonmaleficence. The surgical options demonstrate near equivalent outcomes for traumatic indications, while reconstruction is generally favored for threatened limbs due to diabetic complications. The decision for amputation versus limb salvage must be considered in each individual patient's situation, with a shared decision-making process of paramount importance.

Biomarkers in high grade serous ovarian cancer.

High-grade serous ovarian cancer (HGSC) is the most common subtype of ovarian cancer. HGSC patients typically present with advanced disease, which is often resistant to chemotherapy and recurs despite initial responses to therapy, resulting in the poor prognosis associated with this disease. There is a need to utilise biomarkers to manage the various aspects of HGSC patient care.

Keeping Up With Technological Innovation: The Moral Imperative for Pragmatic Clinical Trials in Interventional Pulmonology.

The advances in minimally invasive lung cancer diagnostics of the last decade have transformed patient care but have also raised important concerns about the regulatory processes used to approve new devices and the best way to generate data to support their use. Disruptive technologies, such as robotic bronchoscopy, have been widely adopted by interventional pulmonologists in the absence of robust data demonstrating improved patient outcomes. Comparative research is needed to inform patient care, but traditional methods of conducting clinical trials in which research teams operate separately from clinical teams are ill-suited to testing the safety and effectiveness of technologies being introduced on the market at unprecedented speed.

Health Care Utilization With Telemedicine and In-Person Visits in Pediatric Primary Care.

Importance: Telemedicine is an increasingly used yet understudied vehicle to deliver pediatric primary care. Evidence detailing downstream health care utilization after telemedicine visits is needed.

Objective: To compare pediatric primary care conducted via telemedicine (video or telephone) with in-person office visits with regard to physician medication prescribing and imaging and laboratory ordering and downstream follow-up office visits, emergency department (ED) visits, and hospitalizations.

Spatial and temporal distribution of Ixodes scapularis and tick-borne pathogens across the northeastern United States.

Background: The incidence of tick-borne diseases is increasing across the USA, with cases concentrated in the northeastern and midwestern regions of the country. Ixodes scapularis is one of the most important tick-borne disease vectors and has spread throughout the northeastern USA over the past four decades, with established populations in all states of the region.

Methods: To better understand the rapid expansion of I.

Prions: structure, function, evolution, and disease.

Prions are proteinaceous infectious particles implicated in fatal neurodegenerative disorders known as prion diseases. Herein, we provide an overview of prion biology, emphasizing the structural, functional, and evolutionary aspects of prions, along with their potential applications in protein engineering. Understanding the structure-function relationships of both healthy and disease-associated prion proteins enables a deeper understanding of the mechanisms of prion-induced neurotoxicity.

Team-Based Care of the Patient Receiving Venovenous Extracorporeal Membrane Oxygenation.

Background: Guideline-based care of patients requiring extracorporeal membranous oxygenation, a form of life support for patients with refractory respiratory and/or cardiac failure, requires a multidisciplinary approach, yet a detailed description of the ideal integration of teams of physicians, acute care nurse practitioners, critical care nurses, and other disciplines is lacking in the literature.

Objectives: We sought to define team-based care of the patient receiving venovenous extracorporeal membrane oxygenation with an emphasis on the roles of the critical care nurse and the acute care nurse practitioner.

Methods: A narrative literature review was conducted using the keywords or MeSH terms "team-based care" AND "ECMO" and "nurse practitioner" AND "ECMO.

Postpartum Access to Health Care and Opioid Use Treatment: An Evaluation of a Medicaid Population.

Background: In this study, we aimed to examine postpartum health care utilization and identify gaps in care among a postpartum Medicaid population of patients diagnosed with opioid use disorder (OUD) during pregnancy.

Methods: We queried North Carolina Medicaid medical and pharmacy claims to identify individuals with a live delivery and evidence of OUD during pregnancy from 2015 to 2019. We examined any evidence of postpartum health care utilization and evidence of medications for OUD (MOUD) during postpartum.

Constant light and high fat diet alter daily patterns of activity, feed intake and fecal corticosterone levels in pregnant and lactating female ICR mice.

The prevalence of constant light exposure and high-fat diet in modern society raises concerns regarding their impact on maternal and offspring health outcomes. In rodents, exposure to maternal high-fat diet or continuous light negatively program metabolic and stress response outcomes of offspring. A 2x3 factorial study was conducted to investigate the impact of diet (control-CON, 10% fat, or high fat-HF, 60% fat) and exposure to different lighting conditions: regular 12-hour light-dark cycles (LD), continuous dim light (L5), or continuous bright light (L100) on female ICR mice daily patterns of time in and out of the nest, feed intake, and fecal corticosterone levels during gestation and lactation.

Incidence of diabetes mellitus following hospitalisation for COVID-19 in the United Kingdom: A prospective observational study.

Background: People hospitalised for coronavirus disease 2019 (COVID-19) have elevated incidence of diabetes. However, it is unclear whether this is due to shared risk factors, confounding or stress hyperglycaemia in response to acute illness.

Methods: We analysed a multicentre prospective cohort study (PHOSP-COVID) of people ≥18 years discharged from NHS hospitals across the United Kingdom following COVID-19.

Dorsal root ganglion toxicity after AAV intra-CSF delivery of a RNAi expression construct into non-human primates and mice.

Dorsal root ganglion (DRG) toxicity has been consistently reported as a potential safety concern after delivery of adeno-associated viruses (AAVs) containing gene-replacement vectors but has yet to be reported for RNAi-based vectors. Here, we report DRG toxicity after AAV intra-CSF delivery of an RNAi expression construct-artificial microRNA targeting superoxide dismutase 1 (SOD1)-in non-human primates (NHPs) and provide evidence that this can be recapitulated within mice. Histopathology evaluation showed that NHPs and mice develop DRG toxicity after AAV delivery, including DRG neuron degeneration and necrosis and nerve-fiber degeneration that were associated with increases in cerebrospinal fluid (CSF) and serum phosphorylated neurofilament heavy chain (pNF-H).

Examining threat responses through a developmental lens.

Adolescence has been characterized by risk taking and fearlessness. Yet, the emergence of anxiety disorders that are associated with fear peaks during this developmental period. Moreover, adolescents show heightened sensitivity to stress relative to children and adults.

Shouldering the load: A scoping review of incidence, types, and risk factors of shoulder injuries in weight-lifting athletes.

Lifestyles advocating for proper health and fitness have been trending in recent years, and as such, sports like weightlifting have become very popular worldwide. While these sports improve physical fitness and cardiovascular health, they carry an inherent risk for physical injuries, mainly to the shoulder. In this review, we aimed to explore the epidemiology of shoulder injuries in weightlifting using a systematic search of the literature.

Development of an evidence-based strategy to implement the HIRAID® emergency nursing framework in rural emergency departments using behaviour change theory.

Introduction: Emergency nurses are critical to emergency care delivery, particularly in rural areas with limited medical support. To support nurses, the validated emergency nursing framework, HIRAID®, was to be implemented. Implementing interventions in the emergency context is notoriously difficult and rural areas have added challenges with limited resources across large geographic areas.

Microglia contribute to the production of the amyloidogenic ABri peptide in familial British dementia.

Mutations in ITM2B cause familial British, Danish, Chinese, and Korean dementias. In familial British dementia (FBD), a mutation in the stop codon of the ITM2B gene (also known as BRI2) causes a C-terminal cleavage fragment of the ITM2B/BRI2 protein to be extended by 11 amino acids. This fragment, termed amyloid-Bri (ABri), is highly insoluble and forms extracellular plaques in the brain.

Direct Oral Anticoagulants Versus Warfarin in Patients With Isolated Heparin-Induced Thrombocytopenia or Heparin-Induced Thrombocytopenia With Thrombosis.

No existing studies compare oral anticoagulants to treat heparin-induced thrombocytopenia with or without thrombosis (HIT/HITT). This retrospective study evaluated thrombotic and bleeding outcomes in adults treated for HIT/HITT with a direct oral anticoagulant (DOAC) or warfarin between 2012 and 2023 within the Ochsner Health System. Patients with mechanical heart valves, valvular atrial fibrillation, antiphospholipid syndrome, active malignancy, or venous thromboembolism (VTE) within the previous 6 months were excluded.

Optimizing external advisory committee meetings of Clinical and Translational Science Awards through focused pre-review.

External advisory committees (EACs) are critical peer-review meetings that drive improvement at Clinical and Translational Science Award Program Hubs. Despite their ubiquity, evaluations of EAC optimization and effective implementation remain scarce. We present a two-tiered approach to optimizing EAC meetings through (1) in-depth, topically focused "pre-review" meetings comprised of external topic experts and at least one standing "full-board" EAC member, followed by (2) a traditional "full-board" EAC meeting.