Impact of ERAS Protocol with Multimodal Anesthesia on Perioperative Outcomes after Open AAA Repair.

Objective: Enhanced Recovery After Surgery (ERAS) clinical pathways have demonstrated improved perioperative outcomes after major surgery. However, its adoption within vascular surgery has been limited. In this study, we examined the impact of an ERAS protocol with multimodal anesthesia on open abdominal aortic aneurysm (AAA) repair by comparing early outcomes before and after its implementation.

Current Trends in Remote and Flexible Work Options in Radiology and Perception of Impact on Radiologist Well-being.

Objective: This study aims to assess the current trends in remote and flexible work models in radiology, evaluate their perceived impact on radiologists' well-being, and explore the importance of these options in shaping employment decisions.

Methods: A voluntary, anonymous survey was sent to 981 members of the Association of Academic Radiologists (AAR) in April 2024. Descriptive statistics were used to analyze demographics and trends in remote and flexible work participation.

Evaluation of the use of intraosseous access on adult patients presenting to the emergency department in urban South Africa.

Background: Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access.

Trends and variations in admissions for cannabis use disorder among pregnant women in United States.

Objectives: Cannabis use disorder (CUD) among pregnant women is increasing, yet limited information exists on admissions for treatment in this population. This study examined trends in CUD admissions among pregnant women in publicly funded U.S.

Toward the validation of crowdsourced experiments for lightness perception.

Crowdsource platforms have been used to study a range of perceptual stimuli such as the graphical perception of scatterplots and various aspects of human color perception. Given the lack of control over a crowdsourced participant's experimental setup, there are valid concerns on the use of crowdsourcing for color studies as the perception of the stimuli is highly dependent on the stimulus presentation. Here, we propose that the error due to a crowdsourced experimental design can be effectively averaged out because the crowdsourced experiment can be accommodated by the Thurstonian model as the convolution of two normal distributions, one that is perceptual in nature and one that captures the error due to variability in stimulus presentation.

Laparoscopic-Assisted Enterolithotomy for Recurrent Gallstone Ileus: A Case Report.

Gallstone ileus is the mechanical obstruction of the bowel due to gallstone impaction. It forms when a fistula is created between the gallbladder and the gastrointestinal tract, which can result in small bowel obstruction. Its surgical management ranges from enterolithotomy, cholecystectomy, and fistula closure performed together (one-stage) or performed separately (two-stage), while some patients undergo simple enterolithotomy.

Experimental and computational investigations of RNA duplexes containing N7-regioisomers of adenosine and LNA-adenosine.

Although glycosidic bonds in purines typically involve the N9 position, the chemical synthesis of adenosine produces N7-ribofuranosyladenine (7A) as a kinetically favorable ribosylation product. Similarly, in the synthesis of LNA-adenosine (AL), a minor product, N7-LNA-adenosine (7AL), is observed. While extensive research has focused on investigating the properties of N9-regioisomers of adenosine, 7A has been largely overlooked and considered as a side-product.

Plasmapheresis for extracorporeal membrane oxygenation (ECMO)-induced hemolysis in infants.

Background: Intravascular hemolysis is a known complication of extracorporeal membrane oxygenation (ECMO). Characterized by elevated plasma-free hemoglobin (PFH), intravascular hemolysis is associated with cytotoxic effects leading to renal replacement therapy (RRT), longer ECMO runs, and mortality. Therapeutic plasma exchange (TPE) in tandem with ECMO was described as a therapy for various pathologic conditions, but there are no Extracorporeal Life Support Organization (ELSO) guidelines for the treatment of ECMO-induced hemolysis.

Return to Swimming After Shoulder Arthroplasty.

Background: Swimming is one of the most common sporting activities in the United States, and often popular among shoulder arthroplasty patients. While return to sport has become a popular topic recently, the literature focused on swimming is limited. The purpose of this study is to report the rate of return to swim after primary shoulder arthroplasty and evaluate changes in performance after surgery.

Stable isotope tempestology of tropical cyclones across the North Atlantic and Eastern Pacific Ocean basins.

Tropical cyclones (TCs) are one of the major natural hazards to island and coastal communities and ecosystems. However, isotopic compositions of TC-derived precipitation (P) in surface water (SW) and groundwater (GW) reservoirs are still lacking. We tested the three main assumptions of the isotope storm "spike" hypothesis (sudden spikes in isotopic ratios).

PHARMACOKINETICS OF METRONIDAZOLE IN GREEN (), LOGGERHEAD (), AND KEMP'S RIDLEY () SEA TURTLES AFTER SINGLE ORAL AND INTRAVENOUS DOSES.

Currently there are few antibacterial dosage regimens established to be safe and effective for sea turtles. Pharmacokinetic evaluation of antibiotics is an essential step in establishing accurate dosage guidelines for a particular species. Metronidazole is an antibiotic that is effective against anaerobic bacteria and some protozoa.

Identifiability investigation of within-host models of acute virus infection.

Uncertainty in parameter estimates from fitting within-host models to empirical data limits the model's ability to uncover mechanisms of infection, disease progression, and to guide pharmaceutical interventions. Understanding the effect of model structure and data availability on model predictions is important for informing model development and experimental design. To address sources of uncertainty in parameter estimation, we used four mathematical models of influenza A infection with increased degrees of biological realism.

Soil microbiome interventions for carbon sequestration and climate mitigation.

Mitigating climate change in soil ecosystems involves complex plant and microbial processes regulating carbon pools and flows. Here, we advocate for the use of soil microbiome interventions to help increase soil carbon stocks and curb greenhouse gas emissions from managed soils. Direct interventions include the introduction of microbial strains, consortia, phage, and soil transplants, whereas indirect interventions include managing soil conditions or additives to modulate community composition or its activities.

Evaluating the Performance of ChatGPT 3.5 and 4.0 on StatPearls Oculoplastic Surgery Text- and Image-Based Exam Questions.

Introduction: The emergence of large language models (LLMs) has led to significant interest in their potential use as medical assistive tools. Prior investigations have analyzed the overall comparative performance of LLM versions within different ophthalmology subspecialties. However, limited investigations have characterized LLM performance on image-based questions, a recent advance in LLM capabilities.

Ultrastructural Analysis Reveals Mitochondrial Placement Independent of Synapse Placement in Fine Caliber C. elegans Neurons.

Neurons rely on mitochondria for an efficient supply of ATP and other metabolites. However, while neurons are highly elongated, mitochondria are discrete and limited in number. Due to the slow rates of metabolite diffusion over long distances, it follows that neurons would benefit from an ability to control the distribution of mitochondria to sites of high metabolic activity such as synapses.

The Frontiers of Smart Healthcare Systems.

Artificial Intelligence (AI) is poised to revolutionize numerous aspects of human life, with healthcare among the most critical fields set to benefit from this transformation. Medicine remains one of the most challenging, expensive, and impactful sectors, with challenges such as information retrieval, data organization, diagnostic accuracy, and cost reduction. AI is uniquely suited to address these challenges, ultimately improving the quality of life and reducing healthcare costs for patients worldwide.

Tampa difficulty score: a scoring system for difficulty of robotic pancreaticoduodenectomy.

Robotic platforms are increasingly utilized in surgery, offering unique technical advantages, though there is a scarcity of difficulty scoring systems (DSS) for these procedures. DSS aids in understanding operative complexities and enhancing preoperative planning. With IRB approval, data were collected on 200 consecutive adult patients who underwent robotic pancreaticoduodenectomy at a high-volume institution from 2019 to 2022.

Abnormalities in gut virome signatures linked with cognitive impairment in older adults.

Multiple emerging lines of evidence indicate that the microbiome contributes to aging and cognitive health. However, the roles of distinct microbial components, such as viruses (virome) and their interactions with bacteria (bacteriome), as well as their metabolic pathways (metabolome) in relation to aging and cognitive function, remain poorly understood. Here, we present proof-of-concept results from a pilot study using datasets ( = 176) from the Microbiome in Aging Gut and Brain (MiaGB) consortium, demonstrating that the human virome signature significantly differs across the aging continuum (60s vs.

Financial Toxicity and Unemployment in Patients with Major Lower Limb Amputation are High.

Background: Major limb amputation can place a significant financial burden on patients and their families because of costs of care and loss of income, encapsulated by the concept of financial toxicity. We sought to measure and understand factors associated with financial toxicity among patients undergoing major lower limb amputation for diabetic foot ulcers or peripheral arterial disease.

Methods: We identified patients in an institutional database who received lower limb amputations and excluded patients who underwent amputation due to known trauma or cancer.

Needle Guide Friction Reduction Utilizing Contact Surface Structure.

Prostate cancer ranks as the second most common cause of cancer-related mortality among males. A template guided core biopsy procedure is an essential component of prostate cancer diagnosis. Various factors influence the quality of the histological sample that is produced from the biopsy, including tissue fragmentation, needle insertion speed, needle deflection, and sheath cutting speed.

Probing the origins of subjective confidence in source memory decisions in young and older adults: A sequential sampling account.

Subjective confidence is an important factor in our decision making, but how confidence arises is a matter of debate. A number of computational models have been proposed that integrate confidence into sequential sampling models of decision making, in which evidence accumulates across time to a threshold. An influential example of this approach is the relative balance of evidence hypothesis, in which confidence is determined by the amount of evidence for the choice that was made compared to the evidence for all possible choices.