Comparison of software-assisted and freehand methods of rotational assessment for diaphyseal femur fractures.

Objective: Accurate rotational reduction following femoral shaft fracture fixation is absent in up to 28% of cases yet is critical for lower extremity biomechanics. The objective of this cadaveric study was to compare the results of freehand methods of rotational reduction with software-assisted rotational reduction.

Methods: Four fellowship-trained orthopedic trauma surgeons attempted rotational correction in a cadaveric model with fluoroscopic assistance using (1) their method of choice (MoC) and (2) software assistance (SA).

Human AI collaboration for unsupervised categorization of live surgical feedback.

Formative verbal feedback during live surgery is essential for adjusting trainee behavior and accelerating skill acquisition. Despite its importance, understanding optimal feedback is challenging due to the difficulty of capturing and categorizing feedback at scale. We propose a Human-AI Collaborative Refinement Process that uses unsupervised machine learning (Topic Modeling) with human refinement to discover feedback categories from surgical transcripts.

SARS-CoV-2 ORF8 drives osteoclastogenesis in preexisting immune-mediated inflammatory diseases.

Patients with immune-mediated inflammatory diseases (IMIDs) like rheumatoid arthritis (RA) are at higher risk for severe COVID-19 and long-term complications in bone health. Emerging clinical evidence demonstrated that SARS-CoV-2 infection reduces bone turnover and promotes bone loss, but the mechanism underlying worsened bone health remains elusive. This study sought to identify specific immune mediators that exacerbated preexisting IMIDs after SARS-CoV-2 exposure.

Relationship Between Coronary Artery Calcium Score and Vulnerability of Culprit Plaque Assessed by OCT in Patients With Established Coronary Artery Disease.

Background: Coronary artery calcium score (CACS) is widely used for risk stratification. However, in patients with established coronary artery disease, its clinical implication and relationship with plaque vulnerability are unclear. We sought to correlate the CACS and plaque vulnerability assessed by optical coherence tomography.

Impact of race and payor status on patterns of utilization of partial and radical nephrectomy in patients with renal cell carcinoma in California.

Background: Prospective trials have shown similar outcomes with partial nephrectomy (PN) in patients with localized renal cell carcinoma (RCC), and multiple studies suggest increasing the use of the technique. We hypothesize that patients who stem from minority groups, as well as Medicare and Medical, have less access to this specialized procedure and, therefore, have a higher rate of radical nephrectomy (RN).

Methods: We interrogated the California Office of Statewide Health Planning and Development (OSHPD) database, which collects information from all inpatient admissions, emergency room visits and inpatient/outpatient procedures in the state.

Increased mortality from alcohol use disorder, alcohol-associated liver disease, and liver cancer from alcohol among older adults in the United States: 2000 to 2021.

Background: To investigate the trends in alcohol-associated liver disease (ALD), liver cancer from alcohol, and alcohol use disorder (AUD) burden among older adults in the United States (US).

Methods: We gathered the ALD, liver cancer from alcohol, and AUD prevalence, mortality, and age-standardized rates (ASRs) from the Global Burden of Disease (GBD) Study 2021 between 2010 and 2021. We estimated the annual percent change (APC) with confidence intervals (CIs) for the burden of ALD, liver cancer from alcohol, and AUD in older adults (>70 years) in the United States.

Performance of Clinical Scoring Systems in the Diagnosis of Transthyretin Amyloid Cardiomyopathy in a Diverse Patient Cohort.

Background: Two diagnostic clinical scoring systems, the ATTR-CM Score and the T-AMYLO Score, have been proposed but not validated in diverse populations, despite Black race being an important risk factor for transthyretin amyloid cardiomyopathy (ATTR-CM). The aim of this study was to evaluate their performance in diagnosing ATTR-CM in a diverse patient cohort.

Methods: This retrospective single-center study analyzed patients who underwent a 99mTc-pyrophosphate single photon emission computed tomography scan (Tc-PYP) for workup of suspected ATTR-CM.

Silencing PADI-2 induces antitumor effects by downregulating NF-κB, Nrf2/HO-1 and AKT1 in A549 lung cancer cells.

Objective: This study aimed to investigate the tumorigenic role and regulatory pathways of peptidyl arginine deiminase 2 (PAD-2) in A549 lung cancer cells following treatment with small interfering RNA (PADI-2 siRNA) or the pharmacological pan-PAD inhibitor BB-Cl amidine.

Materials And Methods: A549 lung cancer cells were treated with PADI-2 siRNA to knock down PADI-2 expression or with BB-Cl amidine to inhibit PAD2 activity. The effects on cell proliferation, migration, invasion, and cell cycle phases were assessed.

Problematic smartphone use in a representative sample of US adults: Prevalence and predictors.

The exponential growth in worldwide smartphone adoption has led to mounting concerns about problematic smartphone use (PSU), with some studies of variably defined PSU yielding prevalence rates as high as 20 to 30%. The present study aims to (a) estimate the prevalence of PSU while emphasizing functional impairment, and (b) examine the degree to which a set of demographic, contextual, behavioral and mental health variables can predict PSU. A representative U.

Why do we need quality measures in emergency medicine?

Quality measures increasingly influence the delivery and reimbursement of care provided in emergency departments. While emergency physicians are accustomed to using quality measures to improve care delivery, payors, including the Centers for Medicare and Medicaid Services (CMS), are increasingly adjusting reimbursement to measure performance as a means to bend the cost curve and improve the value of healthcare services. The American College of Emergency Physicians Quality and Patient Safety Committee presents this whitepaper to guide practicing emergency physicians through the policy context of implementing measures in emergency care and understanding its impact reimbursement.

Covered Stent Correction for Sinus Venosus Atrial Septal Defects, an Emerging Alternative to Surgical Repair: Results of an International Registry.

Background: Covered stent correction for a sinus venosus atrial septal defect (SVASD) was first performed in 2009. This innovative approach was initially viewed as experimental and was reserved for highly selected patients with unusual anatomic variants. In 2016, increasing numbers of procedures began to be performed, and in several centers, it is now offered as a standard of care option alongside surgical repair.

DeepDoublet identifies neighboring cell-dependent gene expression.

Cells interact with each other for proper function and homeostasis. Often, co-expression of ligand-receptor pairs from the single-cell RNAseq (scRNAseq) has been used to identify interacting cell types. Recently, RNA sequencing of physically interacting multi-cells has been used to identify interacting cell types without relying on co-expression of ligand-receptor pairs.

Changes in Healthcare Professionals' Practice Behaviors Through an Educational Intervention Targeting Weight Bias.

Objective: Weight bias is pervasive in healthcare and leads to worse patient outcomes. A uniquely designed 4-h continuing medical education (CME) intervention was assessed for changing healthcare professionals' (HCPs') weight biases and clinical practice behaviors.

Design: The intervention used a (1) pre/post design examining CME attendees' self-reported weight bias at baseline, after, and 4- and 12-month follow-up, and (2) post/post design examining obesity practice behaviors 12 months after intervention in attendees and non-attendees.

Detection of cardiac amyloidosis using machine learning on routine echocardiographic measurements.

Background: Cardiac amyloidosis (CA) is an underdiagnosed, progressive and lethal disease. Machine learning applied to common measurements derived from routine echocardiogram studies can inform suspicion of CA.

Objectives: Our objectives were to test a random forest (RF) model in detecting CA.

Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.

Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.

Review of Current Normothermic Regional Perfusion Practice in Pediatric Cardiac Donation.

Background: Cardiac allotransplantation is the optimal treatment for end-stage heart failure. However, organ supply remains the principal issue impacting patients. Pediatric patients present unique challenges resulting in long wait-list times and increased mortality.

Global Trend of MASH-associated Liver Cancer A Systematic Analysis from the Global Burden of Disease 2021.

Background & Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are the leading causes of liver disease and are emerging as the main risk factors for primary liver cancer (PLC). However, updated global data on MASH remain scarce.

Methods: This study analyzed data from the Global Burden of Disease (GBD) study between 2000 and 2021 to assess the age-standardized incidence, mortality, and disability-adjusted life years (DALYs) from MASH-associated PLC, stratified by geographical region, sociodemographic index, age, and sex.

2024 Update of the RECOVER-Adult Long COVID Research Index.

Importance: Classification of persons with long COVID (LC) or post-COVID-19 condition must encompass the complexity and heterogeneity of the condition. Iterative refinement of the classification index for research is needed to incorporate newly available data as the field rapidly evolves.

Objective: To update the 2023 research index for adults with LC using additional participant data from the Researching COVID to Enhance Recovery (RECOVER-Adult) study and an expanded symptom list based on input from patient communities.

Innovations in Genicular Outcomes Registry (IGOR): protocol for a real-world registry study of treatments for knee osteoarthritis.

Background: Osteoarthritis (OA) is the leading cause of disability among US adults and most commonly affects the knee. Guidelines for knee OA treatment include behavioral, nonpharmacological, pharmacological, and surgical interventions. While emerging knee OA treatments show promise for pain control, data gaps remain regarding the efficacy, safety, comparative effectiveness, and real-world value of treatments.

Can Intra-Operative Cell Salvage Reduce the Rate of Allogeneic Transfusion in Pediatric Spinal Deformity Surgery?

Study Design: Retrospective cohort study.

Objectives: The objective of this study was to characterize the association between cell-salvage and allogeneic transfusion rate in pediatric patients undergoing posterior arthrodesis for scoliosis.

Methods: NSQIP Pediatric database years 2016-2022 was used.

Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.

Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.

Regulation of sarcomere formation and function in the healthy heart requires a titin intronic enhancer.

Heterozygous truncating variants in the sarcomere protein titin (TTN) are the most common genetic cause of heart failure. To understand mechanisms that regulate abundant cardiomyocyte TTN expression we characterized highly conserved intron 1 sequences that exhibited dynamic changes in chromatin accessibility during differentiation of human cardiomyocytes from induced pluripotent stem cells (hiPSC-CMs). Homozygous deletion of these sequences in mice caused embryonic lethality while heterozygous mice demonstrated allele-specific reduction in Ttn expression.

Development and Initial Outcomes of the Interdisciplinary 'Early Identification and Intervention for Infants Network' (Ei3) in Los Angeles.

: The Early Identification and Intervention for Infants (Ei3) Network is an interdisciplinary team dedicated to improving early detection and intervention of cerebral palsy (CP) in California. This paper describes the key (1) awareness-building and (2) capacity-building strategies utilized by the Ei3 Network in the first two years. : Awareness-building methods included interactive conference discussions, resource deliverable creation, and the creation of a framework for dissemination.

The Prognostic Role of Pulmonary Arterial Elastance in Patients Undergoing Left Ventricular Assist Device Implantation: A Pilot Study.

: Pulmonary arterial elastance (Ea) is a helpful parameter to predict the risk of acute postoperative right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation. A new method for calculating Ea, obtained by the ratio between transpulmonary gradient and stroke volume (Ea), has been proposed as a more accurate measure than the Ea obtained as the ratio between pulmonary artery systolic pressure and stroke volume (Ea). However, the role of Ea in predicting acute RVF post-LVAD implantation remains unclear.