Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.

Outcomes and complications of vertebral body tethering by patient gender.

Purpose: Non-fusion surgical options for pediatric scoliosis management such as vertebral body tethering (VBT) offer an alternative to spinal fusion. With this study, we aim to evaluate the postoperative outcomes in boys versus girls who have undergone VBT. Our hypothesis is that girls and boys will have similar outcomes by 2-year follow-up.

Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.

Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.

Explaining cognitive function in multiple sclerosis through networks of grey and white matter features: a joint independent component analysis.

Cognitive impairment (CI) in multiple sclerosis (MS) is only partially explained by whole-brain volume measures, but independent component analysis (ICA) can extract regional patterns of damage in grey matter (GM) or white matter (WM) that have proven more closely associated with CI. Pathology in GM and WM occurs in parallel, and so patterns can span both. This study assessed whether joint-ICA of GM and WM features better explained cognitive function compared to single-tissue ICA.

Clinical and imaging spectrum of non-congenital dominant ACTN2 myopathy.

Background: Alpha-actinin-2, a protein with high expression in cardiac and skeletal muscle, is located in the Z-disc and plays a key role in sarcomere stability. Mutations in ACTN2 have been associated with both hypertrophic and dilated cardiomyopathy and, more recently, with skeletal myopathy.

Methods: Genetic, clinical, and muscle imaging data were collected from 37 patients with an autosomal dominant ACTN2 myopathy belonging to 11 families from Spain and Belgium.

Green Synthesis of Eosin-Y Coated Silver Nanoparticles for Sensitive and Selective Fluorometric Detection of L-Dopa.

This study is to produce biogenic silver nanoparticles (AgNPs) by utilizing aqueous extracts derived from Turnera Sublata (TS) leaves under visible light. Subsequently, these nanoparticles are coated with eosin-yellow (EY) to enhance sensitivity and selectivity in L-3,4-dihydroxyphenylalanine (L-dopa) detection. This method encompasses the deposition of metal onto the Ag NPs, resulting in the formation of EY-AgNPs.

Patient perceptions of osteoporosis management: a qualitative pilot study by a patient advisory group.

Unlabelled: The management of osteoporosis even after a fracture is declining. Our pilot study in patients with osteoporosis confirms a large ignorance of the disease and major fears and uncertainties about the treatments. Complete and sustained medical information seems essential to counteract the contradictory information, which are exclusively negative.

Mutations disrupting the kinase domain of IKKα lead to immunodeficiency and immune dysregulation in humans.

IKKα, encoded by CHUK, is crucial in the non-canonical NF-κB pathway and part of the IKK complex activating the canonical pathway alongside IKKβ. The absence of IKKα causes fetal encasement syndrome in humans, fatal in utero, while an impaired IKKα-NIK interaction was reported in a single patient and causes combined immunodeficiency. Here, we describe compound heterozygous variants in the kinase domain of IKKα in a female patient with hypogammaglobulinemia, recurrent lung infections, and Hay-Wells syndrome-like features.

Cenobamate as add-on treatment for SCN8A developmental and epileptic encephalopathy.

Objectives: Developmental and epileptic encephalopathies (DEEs) caused by pathogenic variants in SCN8A are associated with difficult-to-treat and early-onset seizures, developmental delay/intellectual disability, impaired quality of life, and increased risk of early mortality. High doses of sodium channel blockers are typically used to treat SCN8A-DEE caused by gain-of-function (GoF) variants. However, seizures are often drug resistant, and only a few patients achieve seizure freedom.

Critical Issues in the Management of CRMS/CFSPID Children: A National Real-World Survey.

Background: Notwithstanding guidance from the European Cystic Fibrosis (CF) Society (ECFS) neonatal screening (NBS) working group, significant variation persists in the evaluation and management of Cystic Fibrosis Screen Positive, Inconclusive Diagnosis (CFSPID) subjects, leaving many aspects of care under debate. This study reports the results of a national survey investigating management and treatment approaches of pre-school CFSPIDs in Italy.

Methods: In February 2024, a comprehensive questionnaire was distributed to all Italian CF centers.

Systematic Molecular Influenza A/B Screening Upon Hospital Admission in Belgium, January-April 2022: Positivity Ratios and Viral Loads According to Symptomatology, Age, and Vaccination Status.

Three hospitals implemented molecular point-of-care tests (POCTs) to screen patients for SARS-CoV-2 infection upon admission during the 2021/2022 influenza season, which in Belgium lasted from January to April 2022. The samples were simultaneously tested for influenza A/B. Influenza positivity at admission was examined in relation to patient characteristics and symptomatology.

Relationship of Angle Kappa with Ocular Parameters using Swept-Source Ocular Coherence Tomography in Cataract Surgery Patients.

Purpose: To assess the relationship between angle kappa (apparent chord mu) and ocular parameters in cataract patients.

Methods: In this cross-sectional study, the data on apparent chord mu, age, axial length, anterior chamber depth, anterior and posterior mean keratometry, mean total keratometry, white-to-white, central corneal thickness and lens thickness were collected for consecutive cataract patients. Correlation (Pearson) between chord mu and the other ocular parameters was calculated.

Effect of Fibrates on Lipoprotein-associated Phospholipase A2 Mass and Activity: A Systematic Review and Meta-analysis of Controlled Clinical Trials.

Background: In vascular tissue, macrophages and inflammatory cells produce the enzyme lipoprotein- associated phospholipase A2 (Lp-PLA2). Treatment with fibrates decreases Lp-PLA2 levels in individuals with obesity and metabolic syndrome; however, these findings have not been fully clarified.

Objective: The goal of this study was to investigate the possible effects of fibrate therapy on Lp-PLA2 mass and activity through a meta-analysis of clinical trials.

Intraprosthetic Dislocation Following Dual Mobility Total Hip Arthroplasty: A Retrieval Analysis Study.

Background: Dual mobility (DM) implants in total hip arthroplasty provide excellent range of motion with low dislocation rates. A complication of this design is intraprosthetic dislocation (IPD), where the polyethylene (PE) liner dissociates from the femoral head. In older designs, IPD occurred due to a small head size and late PE wear with head-capture-mechanism failure.

Ultrasonic emulsification and aspiration for coral reef atherosclerosis as a novel alternative to transaortic endarterectomy and thoracic aorta-based bypass grafting.

Transaortic endarterectomy (TE) is an effective and durable method of restoring patency in the aorta afflicted with atherosclerotic disease, which most commonly affects the infrarenal aorta and common iliac artery. When the suprarenal aorta is involved, the disease is usually confined to the orifices of the visceral vessels without obstruction of the aortic lumen. In rare cases, dense, calcified, exophytic, and amorphous lesions causing severe luminal obstruction, termed coral reef atherosclerosis (CRA) of the suprarenal aorta, may occur.

Evaluating the Diagnostic Accuracy and Challenges of the Two-Week Wait Referral Pathway for Skin Cancers in Primary Care.

Skin cancers are among the most common cancers in the Western world, with incidence rates increasing significantly over time. Skin cancer survival rates are highly dependent upon early identification. In the United Kingdom (UK), initial assessment of skin lesions is carried out via general practitioners (GPs) who identify and refer suspected cases under the two-week pathway in compliance with the National Institute for Health and Care Excellence (NICE) guidelines.

Utilities Associated with the Treatment of Growth Hormone Deficiency (GHD): A Time Trade-off (TTO) Study in the UK and Canada.

Purpose: Growth hormone deficiency (GHD) causes decreased growth rate in children, resulting in short stature in childhood and adulthood. Daily subcutaneous injections with growth hormone (GH) have been standard treatment. Newer weekly GH formulations now exist.

Cost-effectiveness of follow-up algorithms for chronic thromboembolic pulmonary hypertension in pulmonary embolism survivors.

Introduction: Achieving an early diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in pulmonary embolism (PE) survivors results in better quality of life and survival. Importantly, dedicated follow-up strategies to achieve an earlier CTEPH diagnosis involve costs that were not explicitly incorporated in the models assessing their cost-effectiveness. We performed an economic evaluation of 11 distinct PE follow-up algorithms to determine which should be preferred.

Update to: self-help cognitive behavioural therapy for anxiety in pulmonary hypertension.

https://bit.ly/3YLHIHm.

Environmental impact of commonly used anaesthetic agents: systematic literature review with narrative synthesis.

Background: Increasing awareness of the potential environmental impact of volatile anaesthetic agents has stimulated increased use of total i.v. anaesthesia.

Establishing the UHB doctor wellbeing group as a model for sustainable change in improving resident doctor wellbeing.

Significant wellbeing concerns have been reported nationally among resident doctors. A peer-led survey at University Hospitals Birmingham NHS Foundation Trust revealed high burnout risk and dissatisfaction. The Doctor Wellbeing Group (DWG) was established to address these multifaceted concerns by supporting resident doctors to run quality improvement projects to improve working conditions, with consultant supervision and regular reports to stakeholders.

Novel ionic liquid-infused PVA-based anion exchange membranes boosting bioelectricity yield from microbial fuel cells.

The goal of this research is to develop and characterize low-cost NHI doped polyvinyl alcohol (PVA)-4-ethyl-4-methylmorpholiniumbromide (ionic liquid) anion exchange membranes (AEM) and its application for membrane cathode assembly. Physical characterization like FTIR, POM, and XRD notified the functional groups, basic structure, and amorphosity of the produced membrane, and it was employed in single-chambered microbial fuel cells (sMFCs) as a separator. The membranes in terms of oxygen diffusion, proton conductivity, and ion exchange capabilities were evaluated.

Iron management and exercise training in individuals with chronic kidney disease: lived experiences.

Background: Non-anaemic iron deficiency is highly prevalent in people living with chronic kidney disease (CKD) but is underdiagnosed and undertreated, especially in earlier stages of CKD. A multicentre trial assessing the effect of intravenous iron supplementation in iron-deficiency but not anaemic people with CKD included a qualitative sub-study that aimed to explore the patient experience and psychosocial impact of living with CKD and iron deficiency, and the experience of the therapeutic intervention (intravenous iron and exercise).

Methods: Semi-structured interviews were conducted with 23 trial participants blinded to treatment.