Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing.

Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.

Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.

Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.

Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.

Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.

Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.

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.

Guidance for Prescribing Oral Antihypertensive Medications in the Emergency Department.

Purpose Of Review: To review the most current recommendations regarding assessment and treatment of asymptomatic hypertension treatment in the emergency department (ED) and to provide guidance for prescribing oral antihypertensive therapy for ED providers.

Recent Findings: There are varying management strategies for the treatment of asymptomatic hypertension in the ED likely due to a lack of direct guidelines for treatment. There is an increasing body of evidence for the safety of initiating therapy to treat chronic asymptomatic hypertension in the ED.

Improving rupture status prediction for intracranial aneurysms using wall shear stress informatics.

Background: Wall shear stress (WSS) plays a crucial role in the natural history of intracranial aneurysms (IA). However, spatial variations among WSS have rarely been utilized to correlate with IAs' natural history. This study aims to establish the feasibility of using spatial patterns of WSS data to predict IAs' rupture status (i.

Testing the kinetic tradeoff between bicarbonate versus phosphoenolpyruvate affinity and glucose-6 phosphate response of phosphoenolpyruvate carboxylase from two C grasses.

Phosphoenolpyruvate (PEP) carboxylase (PEPC) has an anaplerotic role in central plant metabolism but also initiates the carbon concentrating mechanism during C photosynthesis. The C PEPC has different binding affinities (K) for PEP (K) and HCO (K), and allosteric regulation by glucose-6-phosphate (G6-P) compared to non-photosynthetic isoforms. These differences are linked to specific changes in amino acids within PEPC.

Current Concepts and Clinical Applications in Cartilage Tissue Engineering.

Cartilage injuries are extremely common in the general population, and conventional interventions have failed to produce optimal results. Tissue engineering (TE) technology has been developed to produce neocartilage for use in a variety of cartilage-related conditions. However, progress in the field of cartilage TE has historically been difficult due to the high functional demand and avascular nature of the tissue.

mpactR: an R adaptation of the metabolomics peak analysis computational tool (MPACT) for use in reproducible data analysis pipelines.

mpactR automates pre-processing of liquid chromatography-tandem mass spectrometry (LC-MS/MS) data from microbiological samples to correct mispicked peaks, resolve inter-sample variation in abundance across technical replicates, account for in-source ion fragmentation, and remove background noise to yield high-quality mass spectrometry features. The package is available through CRAN and GitHub.

General Kernel Machine Methods for Multi-Omics Integration and Genome-Wide Association Testing With Related Individuals.

Integrating multi-omics data may help researchers understand the genetic underpinnings of complex traits and diseases. However, the best ways to integrate multi-omics data and use them to address pressing scientific questions remain a challenge. One important and topical problem is how to assess the aggregate effect of multiple genomic data types (e.

Influence of rheumatoid arthritis on peri-implant diseases: A longitudinal retrospective clinical and radiographic evaluation.

Background: To investigate the effect of rheumatoid arthritis (RA) on the incidence of peri-implantitis (PI) and peri-implant mucositis (PIM).

Methods: Radiographic and clinical chart reviews were conducted to measure the probing depth (PD), bleeding on probing, and marginal bone loss (MBL) around the implants to diagnose peri-implant diseases based on the 2017 workshop classification. Values were recorded at the baseline (T0) to the last available chart and radiograph (T1).

Racial and ethnic discrimination and DSM-5 substance use disorders among U.S. adults.

Objective: Racial and ethnic discrimination is a risk factor for substance use among United States adults. However, whether discrimination is associated with substance use disorders (SUDs) overall and by race and ethnicity is less understood.

Methods: We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n=35,355) and defined past-year discrimination as a summary scale (range: 0-4).

Double-vestibular incision subperiosteal tunnel access (double-VISTA) with connective tissue graft for treating multiple gingival recessions: 2-year follow-up.

Background: Gingival recession has a multifactorial etiology, involving various predisposing and precipitating factors. Non-carious cervical lesions (NCCLs) are often associated with gingival recession and pose challenges due to their complex pathodynamics. There is limited evidence regarding tunnel-based procedures combined with connective tissue grafts (CTGs) for treating recession-associated NCCLs.

Exploring itch in hidradenitis suppurativa with lessons from atopic dermatitis and psoriasis.

Itch is a prominent symptom in many cutaneous disorders, including atopic dermatitis (AD), prurigo nodularis, and psoriasis. Itch is also a common but overlooked concern in patients with hidradenitis suppurativa (HS). Currently, the mechanisms underlying itch in HS remain unclear.

Intracellular tenofovir-diphosphate concentrations in HIV pre-exposure prophylaxis users who underwent bariatric surgery.

Objective: To measure concentrations of tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) among individuals taking tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) or tenofovir alafenamide plus emtricitabine (TAF/FTC) who were scheduled to undergo or had already undergone bariatric surgery.

Methods: We enrolled pre-exposure prophylaxis (PrEP) users attending clinics in Toronto or Ottawa who were undergoing or had undergone bariatric surgery. After participants completed a minimum of 7 days of consecutive PrEP dosing, we collected DBS samples immediately before they administered their next daily dose of PrEP.

Serendipitous high-resolution structure of Escherichia coli carbonic anhydrase 2.

X-ray crystallography remains the dominant method of determining the three-dimensional structure of proteins. Nevertheless, this resource-intensive process may be hindered by the unintended crystallization of contaminant proteins from the expression source. Here, the serendipitous discovery of two novel crystal forms and one new, high-resolution structure of carbonic anhydrase 2 (CA2) from Escherichia coli that arose during a crystallization campaign for an unrelated target is reported.

Developing an artificial diet for rearing (Hymenoptera: Figitidae) on spotted-wing drosophila.

(Matsumura) (Diptera: Drosophilidae) is a global invasive pest attacking soft-skinned fruit. The specialist larval parasitoid wasp, (Ihering), was recently approved in Europe and the United States for classical biological control releases against . Rearing methods are essential for supporting innundative releases but current methods using fresh fruit are costly and susceptible to variation in host quality.

Honoring Hartmut Karl Lichtenthaler, innovative pioneer of photosynthesis, on his 90 birthday.

We honor Professor Hartmut Karl Lichtenthaler, a versatile pioneer of photosynthesis research, plant physiology, isoprenoid biochemistry, and stress physiology of plants, for his groundbreaking and creative contributions to plant science. His innovative research on the chemical composition, ultrastructure, and function of chloroplasts and his detection of the major methylerythritol 4-phosphate (MEP) isoprenoid biosynthetic pathway in plants is key to our current understanding of the physiology and biochemistry of photosynthesis systems. His ingenious use of the powerful laser-induced chlorophyll fluorescence imaging has helped us better understand the stress response processes in plant leaves.

Identifying internal and external shoulder rotation using a kirigami-based shoulder patch.

Internal and external rotation of the shoulder is often challenging to quantify in the clinic. Existing technologies, such as motion capture, can be expensive or require significant time to setup, collect data, and process and analyze the data. Other methods may rely on surveys or analog tools, which are subject to interpretation.

Exploring trauma surgeons' views on trauma care in Nigeria: A qualitative study.

Background: In Nigeria, trauma care faces challenges due to high injury and death rates from road traffic accidents and violence. Improvements are underway, but gaps in service availability, training, and coordination persist, necessitating evidence-based interventions.

Purpose: To evaluate trauma care practices in Nigeria, focusing on practitioners' perceptions of training, resources, and care quality to inform policy and practice enhancements.

Targeting menin for precision therapy in high-risk acute myeloid leukemia.

Objective: This mini-review provides an overview of the current evidence for Revumenib, a first-in-class menin inhibitor, in treating AML with KMT2A rearrangements or NPM1 mutations. This therapy represents a promising advancement by selectively disrupting leukemogenic pathways.

Summary: The clinical promise of Revumenib in genetically defined AML highlights its potential role in shaping the future treatment landscape.

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.

Optimizing Surgery for Idiopathic Scoliosis: Does a Dual Approach Help Young Surgeons?

Introduction In idiopathic scoliosis surgery, studies have shown two attending surgeons have better curve correction, pain, and recovery time. There is conflicting evidence on operative time, blood loss, infection rate, and hospital length of stay. Limited literature examines the impact of surgeon experience on the dual approach.

Evaluating One-Week Post-Casting Alignment Checks and Surgical Intervention Rates in Pediatric Type IIA Supracondylar Humeral Fractures.

Background: This study aims to determine the rate of surgical intervention in children with type IIA supracondylar humerus fractures (SCHF) following routine post-casting radiographic assessment. We hypothesized that no cases would convert to operative management following one-week post-casting alignment assessments.

Methods: This single-center retrospective study focused on pediatric patients diagnosed with type IIA SCHF from 2019 to 2022.