Cushing's Disease Clinical Phenotype and Tumor Behavior Vary with Age: Diagnostic and Perioperative Implications.

Context: Little is known about presenting clinical characteristics, tumor biology, and surgical morbidity of Cushing's disease (CD) with aging.

Objective: Using a large multi-institutional dataset, we assessed diagnostic and prognostic significance of age in CD through differences in presentation, laboratory results, tumor characteristics, and postoperative outcomes.

Design: Data from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) were reviewed for patients with CD treated with transsphenoidal tumor resection at 11 centers between 2003 and 2023.

Hazardous exposures and engineering controls in the landscaping services industry.

Landscapers are exposed to noise, carbon monoxide (CO), respirable dust, and respirable crystalline silica (RCS) generated from the tools they use. Although engineering controls are available to reduce these exposures, no previous study has evaluated chronic exposures to landscapers in different work settings and compared exposures from landscaping tools with and without engineering controls. This field study of workers in the landscaping services industry documented the occupational exposures of 80 participants at 11 varied worksites to noise, CO, respirable dust, and RCS using personal breathing zone sampling.

Sexual Harassment in Academic Anesthesiology: A Survey of Prevalence, Sources, Impact, and Recommendations.

Background: A report by the American Association of Medical Colleges (AAMC) showed that academic anesthesiology has the highest prevalence of sexual harassment among specialties for both men and women. We aimed to explore the prevalence, sources, and impact of sexual harassment on anesthesiologists in academic centers in the United States and Canada. We also sought recommendations for its mitigation.

Multi-Institutional Study of Multimodal Analgesia Practice, Pain Trajectories, and Recovery Trends After Spine Fusion for Idiopathic Scoliosis.

Background: Posterior spinal fusion (PSF) surgery for correction of idiopathic scoliosis is associated with chronic postsurgical pain (CPSP). In this multicenter study, we describe perioperative multimodal analgesic (MMA) management and characterize postoperative pain, disability, and quality of life over 12 months after PSF in adolescents and young adults.

Methods: Subjects (8-25 years) undergoing PSF were recruited at 6 sites in the United States between 2016 and 2023.

Artifacts at Cardiac MRI: Imaging Appearances and Solutions.

Cardiac MRI (CMR) is an important imaging modality in the evaluation of cardiovascular diseases. CMR image acquisition is technically challenging, which in some circumstances is associated with artifacts, both general as well as sequence specific. Recognizing imaging artifacts, understanding their causes, and applying effective approaches for artifact mitigation are critical for successful CMR.

Disconnects between provider network directories and patient preferences.

Objectives: The question of what providers one has access to under their insurance coverage is crucial for patients in managed care. This study sought to examine information displayed in online provider directories and whether this information matched consumer preferences.

Study Design: A national survey (N = 4007) paired with an analysis of online provider network directories.

Physicians-in-training and advanced practice providers perceptions in managing perioperative obstructive sleep apnea: a multi-institutional survey.

Study Objectives: Physicians-in-training (residents, fellows) and Advanced Practice Providers (APPs) receive limited education on sleep disorders, including obstructive sleep apnea (OSA). They often assess patients first. We aimed to understand their views on OSA and screening for OSA in the perioperative period.

A multicenter performance evaluation of cefiderocol MIC results: ComASP in comparison to CLSI broth microdilution.

Unlabelled: The performance of the Liofilchem Compact Antimicrobial Susceptibility Panel (ComASP) Cefiderocol was evaluated in a multicenter study. Enterobacterales, , and clinical isolates and challenge isolates were tested by three and one sites, respectively. Minimum inhibitory concentration (MIC) testing was performed by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution and ComASP, which included two reading endpoints (CLSI read; MIC is the first well in which reduction of growth is <1 mm or light haze/faint turbidity] and ComASP [ComASP read; MIC is the first well at which 100% inhibition of growth occurs]).

Flaring of Protruding Coronary Stents Before Transcatheter Aortic Valve Replacement to Minimize Interaction-A Feasibility Study.

Background: Protruding coronary artery stents can adversely affect transcatheter aortic valve replacement (TAVR) procedure. Current evidence on the topic is limited.

Aims: We aim to study the clinical feasibility and safety of flaring of protruding coronary artery stents before TAVR to reduce interaction with transcatheter heart valves.

Transitioning From Nusinersen to Risdiplam for Spinal Muscular Atrophy in Clinical Practice: A Single-Center Experience.

Background: Nusinersen and risdiplam are U.S. Food and Drug Administration (FDA)-approved treatments for spinal muscular atrophy (SMA).

Psychosocial information sharing to improve equity in kidney transplant evaluation.

Purpose Of Review: Increasing transplant access overall and particularly among historically underserved and marginalized patient groups is a shared goal nationwide. Patient challenges with psychosocial factors, such as social support and health literacy, are recognized as among the top reasons patients may not be referred, evaluated, or waitlisted, key steps along the pathway to transplantation. Yet referring providers' (e.

Metastasis-directed therapy in oligometastatic and oligoprogressive renal cell carcinoma.

Purpose Of Review: This review addresses the evolving role of metastasis-directed therapy (MDT) in the management of oligometastatic and oligoprogressive renal cell carcinoma (RCC). With advances in both surgical techniques and stereotactic ablative radiotherapy (SABR), it is timely to explore how MDT can improve patient outcomes in these distinct disease states. The review highlights the potential of MDT to delay systemic therapy and improve quality of life while noting the lack of randomized clinical trial data guiding its use.

C-H Activation and Sequential Addition to Dienes and Imines: Synthesis of Amines with -Quaternary Centers and Mechanistic Studies on the Complex Interplay Between the Catalyst and Three Reactants.

A Rh(III)-catalyzed sequential C-H bond addition to dienes and in situ formed aldimines was developed, allowing for the preparation of otherwise challenging to access amines with quaternary centers at the -position. A broad range of dienes were effective inputs and installed a variety of aryl and alkyl substituents at the quaternary carbon site. Aryl and alkyl sulfonamide and carbamate nitrogen substituents were incorporated by using different formaldimine precursors.

Morpho-physiological and transcriptomic responses of field pennycress to waterlogging.

Field pennycress () is a new biofuel winter annual crop with extreme cold hardiness and a short life cycle, enabling off-season integration into corn and soybean rotations across the U.S. Midwest.

First Report of sp. Causing Downy Mildew of Stock () in Ohio.

, commonly known as stock, is a flowering plant species in the Brassicaceae popularly used as a cut flower due to its fragrant, long-lasting blooms. In September 2023, stock 'Iron White' plants displaying symptoms and signs of downy mildew were observed within a high tunnel in a cut flower farm in Franklin Co., OH.

Contemporary Microbiological Challenges in Pediatric Dentistry.

Knowledge of microbiology-related issues in dentistry is fundamental to clinical practice and patient care. The purpose of this literature review is to comprehensively describe the roles microbes play in pediatric dental practice, with a special focus on eight continuing and emerging microbiological issues related to waterline safety, dental material contamination, effects of oral bacteria on systemic health, antibiotic resistance, continuing COVID-19 findings and risks associated with animal-assisted therapies. Key points are highlighted on each topic, with current reports demonstrating microbial impacts on human health and clinical settings.

Microfluidic Thread-Based Analytical Platform for Reaction Screening Enabled by In Situ Thread Spray Mass Spectrometry.

This study describes a microfluidic thread-based analytical device (μTAD) capable of in situ mass spectrometric analysis for continuous flow reaction monitoring. Organic reaction screening is foundational to drug discovery. Microfluidic devices are of special interest here because they provide continuous reaction monitoring with advantages such as the use of smaller reagent volumes and short analysis times.