Pre-Operative Management of the Penicillin Allergic Patient: A Narrative Review.

Penicillin is a frequently reported medication allergy. The beta-lactam ring shared between cephalosporins and penicillin often leads to the use of alternative antibiotics for surgical prophylaxis due to concern for cross-reactivity, despite a true IgE-mediated hypersensitivity being very rare. This misconception leads to the use of less effective second line antibiotics, such as clindamycin or vancomycin, for penicillin-allergic patients which has been shown to increase odds of postoperative infection in elective knee arthroplasty, shoulder arthroplasty and spine surgery.

Pivotal Trial Toward Effectiveness of Self-administered OCT in Neovascular Age-related Macular Degeneration. Report 2-Artificial Intelligence Analytics.

Purpose: To validate the performance of the Notal OCT Analyzer (NOA) in processing self-administered OCT images from an OCT system designed for home use (home OCT [HOCT]) as part of a pivotal study aimed at achieving de novo United States Food and Drug Admininstration marketing authorization.

Design: A prospective quantitative cross-sectional artificial intelligence study.

Participants: The study enrolled adults aged ≥55 years diagnosed with neovascular age-related macular degeneration (nAMD) in ≥1 eligible eye with a best-corrected visual acuity of 20/320 or better.

Visual Acuity, Full-field Stimulus Thresholds, and Electroretinography for 4 Years in The Rate of Progression of USH2A-related Retinal Degeneration (RUSH2A) Study.

Purpose: To describe progression of best-corrected visual acuity (BCVA), full-field stimulus thresholds (FST), and electroretinography (ERG) over 4 years in the -related Retinal Degeneration study and to assess their suitability as clinical trial endpoints.

Design: Prospective natural history study.

Participants: Participants (n = 105) with biallelic disease-causing sequence variants in USH2A and BCVA letter scores of ≥54 were included.

Standardized Multimodal Pain Protocol Minimizes Inpatient Opioid Administration in Pediatric Orthopedic Surgery Population.

Background: Optimal management of post-operative pain is a critical component of orthopedic surgical care. There is a heightened awareness of narcotic prescribing habits given the current "opioid epidemic." The lack of standardized protocols has led to increased errors, delayed access to prescribed medications, and excessive narcotic prescribing.

Efficacy of Intraoperative Cell Salvage on Perioperative Blood Transfusion in Pelvic and Acetabular Surgery: A Matched Cohort Analysis.

Background: Pelvic fractures often result in traumatic and intraoperative blood loss. Cell salvage (CS) is a tool where autologous blood lost during surgery is collected and recycled with anticoagulation, centrifugation to separate red blood cells, and washing to be reinfused back to the patient. The purpose of this study was to investigate our experience with CS in pelvic and acetabular surgery and its relationship to perioperative transfusion requirements.

Cancer in Orthopaedic Surgeons: Results of an American Academy of Orthopaedic Surgeons (AAOS) Survey.

Background: There is a currently limited data regarding cancer risk in Orthopaedic Surgeons. This study summarizes a survey on cancer prevalence in orthopaedic surgeons.

Methods: A cancer prevalence survey was emailed to all 23,370 members of the American Academy of Orthopaedic Surgeons (AAOS).

Trochleoplasty Utilization in the Management of Patellofemoral Instability: Results From an International Survey of Surgeons.

Background: Considerable variability exists in the described clinical and radiographic indications for use, surgical techniques, postoperative management, and risk profile after trochleoplasty for the management of patellofemoral instability (PFI). In areas of clinical uncertainty, a cohesive summary of expert opinion and identification of areas of variation in current practice can be useful in guiding current practice and future research efforts.

Purpose: To assess the current indications for use, surgical techniques, postoperative rehabilitation practices, and observed complication profile for trochleoplasty in the management of PFI among surgeons who perform this procedure.

Outcome-guided Bayesian clustering for disease subtype discovery using high-dimensional transcriptomic data.

Due to the tremendous heterogeneity of disease manifestations, many complex diseases that were once thought to be single diseases are now considered to have disease subtypes. Disease subtyping analysis, that is the identification of subgroups of patients with similar characteristics, is the first step to accomplish precision medicine. With the advancement of high-throughput technologies, omics data offers unprecedented opportunity to reveal disease subtypes.

Effects of Gamification on Student Success and Perception of Instruction in Neuroanatomy: A Retrospective Analysis.

As a subset of active learning, gamification involves the application of gaming principles as a means of improving student outcomes in the classroom. Recent work has shown that such active learning strategies may be particularly effective at reducing the rate of failure in STEM courses. In this retrospective case study, I examined the effects on student exam performance, rate of failure, and perception of instruction following a semester-long course improvement project that involved implementing a novel tabletop style roleplaying game () during lab sessions in an undergraduate neuroanatomy course.

Economic Evaluation of a Novel Lung Cancer Diagnostic in a Population of Patients with a Positive Low-Dose Computed Tomography Result.

Early detection of lung cancer is crucial for improving patient outcomes. Although advances in diagnostic technologies have significantly enhanced the ability to identify lung cancer in earlier stages, there are still limitations. The alarming rate of false positives has resulted in unnecessary utilization of medical resources and increased risk of adverse events from invasive procedures.

Early Versus Late Initiation of Dialysis in CKD Stage 5: Time for a Consensus.

Chronic kidney disease (CKD), a major global public health problem, emerged as one of the leading causes of death, affecting over 800 million individuals worldwide, with significant burden to patients and their caregivers, and may lead to end-stage kidney disease (ESKD). The decision on optimal initiation of chronic dialysis is a common problem faced by nephrologists, patients, and caregivers due to lack of adequate data. Determining the ideal time to initiate maintenance dialysis for individuals struggling with ESKD has remained a puzzle.

International Society of Sports Nutrition Position Stand: Long-Chain Omega-3 Polyunsaturated Fatty Acids.

Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of the literature surrounding the effects of long-chain omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation on exercise performance, recovery, and brain health. This position stand is intended to provide a scientific foundation for athletes, dietitians, trainers, and other practitioners regarding the effects of supplemental ω-3 PUFA in healthy and athletic populations. The following conclusions represent the official position of the ISSN: Athletes may be at a higher risk for ω-3 PUFA insufficiency.

Cell size has pervasive effects on the functional composition and morphology of leaves: a case study in Rhododendron (Ericaceae).

The leaf economics spectrum (LES) characterizes a tradeoff between building a leaf for durability versus for energy capture and gas exchange, with allocation to leaf dry mass per projected surface area (LMA) being a key trait underlying this tradeoff. However, regardless of the biomass supporting the leaf, high rates of gas exchange are typically accomplished by small, densely packed stomata on the leaf surface, which is enabled by smaller genome sizes. Here, we investigate how variation in genome size-cell size allometry interacts with variation in biomass allocation (i.

Local Inflammation Precedes Diaphragm Wasting and Fibrotic Remodelling in a Mouse Model of Pancreatic Cancer.

Background: Cancer cachexia represents a debilitating muscle wasting condition that is highly prevalent in gastrointestinal cancers, including pancreatic ductal adenocarcinoma (PDAC). Cachexia is estimated to contribute to ~30% of cancer-related deaths, with deterioration of respiratory muscles suspected to be a key contributor to cachexia-associated morbidity and mortality. In recent studies, we identified fibrotic remodelling of respiratory accessory muscles as a key feature of human PDAC cachexia.

The Missing Link in Antiamyloid Therapy.

Alzheimer's disease (AD) impacts millions of elderly adults worldwide causing cognitive decline and severe deterioration of activities of daily life. The popular causal hypotheses for several decades include beta-amyloid (Aβ) deposition and tau hyperphosphorylation. AD research and more than 34% of clinical trials in AD are based on these two hypotheses.

Evaluation of a biomarker for amyotrophic lateral sclerosis derived from a hypomethylated DNA signature of human motor neurons.

Amyotrophic lateral sclerosis (ALS) lacks a specific biomarker, but is defined by relatively selective toxicity to motor neurons (MN). As others have highlighted, this offers an opportunity to develop a sensitive and specific biomarker based on detection of DNA released from dying MN within accessible biofluids. Here we have performed whole genome bisulfite sequencing (WGBS) of iPSC-derived MN from neurologically normal individuals.

Effects of injectable trace minerals (Se, Zn, Cu, and Mn) administration on the immune response elicited by primary intranasal modified-live virus vaccination in dairy calves.

The objective was to determine the effects of injectable trace minerals (ITM, containing Se, Cu, Zn & Mn) administered at the time of primary intranasal (IN) modified-live virus (MLV) vaccination of young dairy calves on the serum neutralizing antibody (SNA) titers to Bovine herpes virus 1 (BHV1), Bovine respiratory syncytial virus (BRSV), and Bovine Parainfluenza type 3 virus (BPIV); cytokine expression in peripheral white blood cells, and BHV1-specific IgA titers in nasal secretions following the vaccination. A total of 60 calves (1 month old) were administered an IN MLV vaccine containing BHV1, BRSV, BPIV (Inforce 3) and randomly assigned to one of two experimental groups: ITM (n = 30; Multimin90, containing Se, Cu, Zn, and Mn) or SAL (n = 30; sterile saline). There was a consistent decay in virus-specific SNA titers in both groups.

Diagnostic models to differentiate Takotsubo syndrome from acute coronary syndrome: A systematic review and meta-analysis.

Aims: Differentiation between patients with Takotsubo syndrome and acute coronary syndrome (ACS) remains a challenge. We performed a systematic review to identify and evaluate diagnostic predictive models to distinguish both conditions.

Methods And Results: We performed an electronic search in PubMed, EMBASE, and Scopus until January 2024.

Conceptualizing and Measuring Systemic Racism.

This article provides a guide for rigorous, theory-driven measurement approaches, proposing best practices for the scientific study of systemic racism in health research. We argue that the analytical crux of measuring systemic racism-a complex, interconnected, and dynamic system-lies in operationalizing the collective logics, properties, and mechanisms that undergird racial inequities. Misalignment between measurement tools and these foundational features undermines research validity, as incongruent measures distort findings and obscure systemic racism's true impacts.

Mediation analysis identifies causal factors that lead to increased rates of kidney transplant failure in patients with peripheral vascular disease.

Background: This study aims to identify causal mediators of one-year kidney transplant failure in patients with peripheral vascular disease.

Methods: Standard Transplant Analysis and Research database was queried for adults who underwent kidney transplantation from 1987 to 2021. Multi-organ transplant, prior transplant, and living donor kidneys were excluded.

Modeling, synthesis and cell-based evaluation of pyridine-substituted analogs of CD3254 and fluorinated analogs of CBt-PMN as novel therapeutics.

Six pyridine analogs of (E)-3-(3-(1,2,3,4-tetrahydro-1,1,4,4,6-pentamethylnaphthalen-7-yl)-4-hydroxyphenyl)acrylic acid-or CD3254 (11)-in addition to two novel analogs of 1-(3,5,5,8,8-pentamethyl-5,6,7,8-tetrahydronaphthalen-2-yl)-1H-benzo[d][1,2,3]triazole-5-carboxylic acid (CBt-PMN or 23) were prepared and evaluated for selective retinoid-X-receptor (RXR) agonism alongside bexarotene (1), an FDA-approved drug for cutaneous T-cell lymphoma (CTCL). Treatment with 1 often elicits side-effects by disrupting or provoking other RXR-dependent nuclear receptors and cellular pathways. All analogs were assessed through modeling for their ability to bind RXR and then evaluated in human colon and kidney cells employing an RXR-RXR mammalian-2-hybrid (M2H) system and in an RXRE-controlled transcriptional assay.

How I Treat Higher-Risk MDS.

Myelodysplastic syndromes/neoplasms (MDS) are a widely heterogenous group of myeloid malignancies characterized by morphologic dysplasia, a defective hematopoiesis, and recurrent genetic abnormalities. The original and revised International Prognostic Scoring Systems (IPSS) have been used to risk-stratify patients with MDS to guide treatment strategies. In higher-risk MDS, the therapeutic approach is geared toward delaying leukemic transformation and prolonging survival.

Development of the Lee Symptom Scale-Skin Sclerosis for chronic GVHD-associated sclerosis.

Sclerosis is a highly morbid manifestation of chronic GVHD (cGVHD), associated with distressing symptoms and significant long-term disability. A patient-reported outcome measure (PRO) for cGVHD-associated sclerosis is essential to advance therapeutic trials. We aimed to develop a PRO for adults with cGVHD-associated sclerosis and evaluate and refine its content validity.