Elevated body mass index and obesity are associated with pain-associated psychological distress in patients with hip pain.

Introduction: Little research has investigated the relationship between musculoskeletal pain and body mass index (BMI) in the context of pain-associated psychological distress. This study aims to determine if independent associations exist between BMI, obesity, demographic variables, and psychological distress in patients presenting with hip pain.

Materials And Methods: Using a retrospective cross-sectional study design, 428 patients completed the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and were categorized into pain-associated psychological distress phenotypes using latent class analysis.

Expert consensus on the management of pharmacodynamic breakthrough-hemolysis in treated paroxysmal nocturnal hemoglobinuria.

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired, non-malignant hematologic disease characterized by complement-mediated hemolysis (with or without hemoglobinuria), fatigue, increased susceptibility to thrombosis, and bone marrow dysfunction. The development of complement inhibitors has transformed outcomes for patients with PNH, but patients may still experience pharmacodynamic breakthrough hemolysis (BTH), which can be caused by exposure to a complement amplifying condition (CAC), such as vaccination, infection, or surgery.

Materials And Methods: A 13-member expert panel used a validated methodology (a RAND/UCLA modified Delphi panel) to develop consensus on how to classify pharmacodynamic BTH in patients with complement-inhibitor treated PNH.

Decision-making in borderline hip dysplasia and concomitant femoracetabular impingement syndrome: using a discrete choice experiment to explore patient preferences.

Decision-making regarding surgical treatment of patients showing radiographic evidence of femoroacetabular impingement syndrome (FAIS) in the setting of borderline hip dysplasia (BHD) remains a challenge as there is no consensus on treatment in current literature. When medical evidence is unclear, understanding patient preferences becomes particularly important in deciding the optimal treatment for each patient. The purpose of this study was to measure the patient-determined importance of factors surrounding surgical treatment of FAIS in BHD.

Surgery for Medication Refractory Epilepsy in Africa: A Review of Seizure Freedom Outcomes.

Background: Epilepsy is a chronic condition that confers social stigma, reduced engagement in work and social activities, increased risks of comorbidities, and premature death. It is often treated with medications, but in about a third of patients, epilepsy may be refractory to medications. It is estimated that each year 211,456 new individuals across Africa meet criteria for surgically treatable epilepsy, and the current volume of surgically treatable epilepsy is 1,819,067 cases across the region.

Rise of the Machines - Normothermic Regional Perfusion Use in Heart Transplantation in the United States.

Objective: Recently, normothermic regional perfusion (NRP) and direct procurement and perfusion (DPP) have allowed for heart transplantation following donation after circulatory death (DCD). This study aimed to characterize utilization and variation of NRP and DPP in the United States.

Methods: Heart transplants from 12/1/19-3/31/24 were identified from the United Network for Organ Sharing Database.

Exploring the optimal factor structure of mind-wandering: Associations with neuroticism.

Mind-wandering is an essential cognitive process in which people engage for 30-50% of their waking day and is highly associated with neuroticism. The current study identified the factor structure of retrospective self-report items related to mind-wandering and perseverative cognition content and explored these associations with neuroticism. In an adult community sample (N = 309), items from the NYC Cognition Questionnaire, the Penn State Worry Questionnaire Short Form, and the Rumination Responses Brooding Subscale were entered into factor analyses to test the optimal factor structure of these items.

"It's his cheerfulness that gives me hope": A qualitative analysis of access to pediatric cancer care in Northern Tanzania.

Pediatric cancer is a significant and growing burden in low- and middle-income countries. The objective of this project was to describe the factors influencing access to pediatric cancer care in Northern Tanzania using the Three Delays Model. This was a cross-sectional qualitative study conducted between June and August 2023 at Kilimanjaro Christian Medical Centre (KCMC).

Systemic Treatment Followed by Radical Resection Combined with Intestinal Autotransplantation (RRCIA) for Locally Advanced Pancreatic Cancer: A Retrospectively Observational and Prospectively Validated Study.

Objective: The present study aimed to assess the efficacy of this approach and establish the criteria that identify LAPC patients who may achieve survival benefits from RRCIA.

Summary Background Data: Surgical resection for locally advanced pancreatic cancer (LAPC) remains challenging and associated with high morbidity and mortality, especially for surgery with major arterial reconstruction. We previously showed the feasibility and safety of Radical Resection Combined with Intestinal Autotransplantation (RRCIA) after systemic treatment.

Lipid discovery enabled by sequence statistics and machine learning.

Bacterial membranes are complex and dynamic, arising from an array of evolutionary pressures. One enzyme that alters membrane compositions through covalent lipid modification is MprF. We recently identified that MprF synthesizes lysyl-phosphatidylglycerol (Lys-PG) from anionic PG, and a novel cationic lipid, lysyl-glucosyl-diacylglycerol (Lys-Glc-DAG), from neutral glycolipid Glc-DAG.

Accelerating evidence generation: Addressing critical challenges and charting a path forward.

Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all stakeholders. On October 25-26, 2023, the Duke Clinical Research Institute brought together leaders from academia, industry, government agencies, patient advocacy, and nonprofit organizations to explore how different entities and influencers in drug development and healthcare can realign incentive structures to efficiently accelerate evidence generation that addresses the highest public health needs.

Optical clearing with tartrazine enables deep transscleral imaging with optical coherence tomography.

Significance: Imaging deep structures with optical coherence tomography (OCT) is difficult in highly scattering biological tissue, such as the sclera. There is a need to visualize the suprachoroidal space and choroid through the sclera to study suprachoroidal drug delivery.

Aim: We aim to develop optical methods to image through the highly scattering sclera with a custom-built OCT system to visualize the suprachoroidal space and drug delivery within.

Leptomeningeal metastatic disease: new frontiers and future directions.

Leptomeningeal metastatic disease (LMD), encompassing entities of 'meningeal carcinomatosis', neoplastic meningitis' and 'leukaemic/lymphomatous meningitis', arises secondary to the metastatic dissemination of cancer cells from extracranial and certain intracranial malignancies into the leptomeninges and cerebrospinal fluid. The clinical burden of LMD has been increasing secondary to more sensitive diagnostics, aggressive local therapies for discrete brain metastases, and improved management of extracranial disease with targeted and immunotherapeutic agents, resulting in improved survival. However, owing to drug delivery challenges and the unique microenvironment of LMD, novel therapies against systemic disease have not yet translated into improved outcomes for these patients.

Disparities in educational attainment and assault mortalities among Asian Americans in the USA, 2009-2021.

Background: In 2021, a spike in Asian American hate crimes resurged discussion on Asian health disparities. This study describes the association between education and assault among Asian Americans and their subgroups.

Methods: This cross-sectional study used individual-level data from the mortality multiple cause-of-death data from the National Center for Health Statistics from 2009 to 2021.

Soft-Tissue Chondroma of the Eyelid.

A woman in her early 20s underwent excision of a 6-mm diameter, tender, mobile mass in the temporal left upper eyelid associated with eyelid swelling and blurred vision. Surgery disclosed a large tarsal lesion that appeared to be a cyst but was found to be a soft-tissue chondroma featuring an island of hyaline cartilage surrounded by dense tarsal fibrous connective tissue containing smaller foci of myxoid cartilage. The woman reported that a nodule had been present at this site since childhood.

Dermoid Cyst of Conjunctival Origin Attached to the Tarsus in a Pediatric Patient.

Dermoid cysts of cutaneous origin are common orbital lesions, whereas dermoid cysts of conjunctival origin are rare. The authors present a case of a dermoid cyst of conjunctival origin that was attached to the tarsus in a pediatric patient. A 2-year-old boy presented to the clinic with an approximately 2 cm in diameter mobile nodule in the upper eyelid on the temporal side that distorted the eyelid architecture with temporal ptosis.

Diagnostic Test Characteristics of Ultrasound-Based Hydronephrosis for Chronic Kidney Disease in Children and Adolescents With Myelomeningocele: Results From the UMPIRE and NSBPR Cohort Studies.

Purpose: Renal ultrasounds are performed in patients with myelomeningocele to screen for markers of kidney health, including hydronephrosis. We evaluated the diagnostic accuracy of hydronephrosis to screen for low kidney function defined by estimated glomerular filtration rate (eGFR).

Materials And Methods: We performed a retrospective cross-sectional study using data from 2 cohorts of children and youth with myelomeningocele.

Dynamics of cytokine and antibody responses in community versus hospital SARS-CoV-2 infections.

Introduction: Dysregulated host cytokine responses to SARS-CoV-2 infection are a primary cause of progression to severe disease, whereas early neutralizing antibody responses are considered protective. However, there are gaps in understanding the early temporal dynamics of these immune responses, and the profile of productive immune responses generated by non-hospitalized people with mild infections in the community.

Methods: Here we conducted a prospective cohort study of people with suspected infections/exposures in the US state of North Carolina, before vaccine availability.