The Psu protein of phage satellite P4 inhibits transcription termination factor ρ by forced hyper-oligomerization.

Many bacteriophages modulate host transcription to favor expression of their own genomes. Phage satellite P4 polarity suppression protein, Psu, a building block of the viral capsid, inhibits hexameric transcription termination factor, ρ, by presently unknown mechanisms. Our cryogenic electron microscopy structures of ρ-Psu complexes show that Psu dimers clamp two inactive, open ρ rings and promote their expansion to higher-oligomeric states.

Neoadjuvant or concurrent atezolizumab with chemoradiation for locally advanced cervical cancer: a randomized phase I trial.

Combined immune checkpoint blockade (ICB) and chemoradiation (CRT) is approved in patients with locally advanced cervical cancer (LACC) but optimal sequencing of CRT and ICB is unknown. NRG-GY017 (NCT03738228) was a randomized phase I trial of atezolizumab (anti-PD-L1) neoadjuvant and concurrent with CRT (Arm A) vs. concurrent with CRT (Arm B) in patients with high-risk node-positive LACC.

Impact of Preoperative Glucagon-Like Peptide-1 Receptor Agonist on Outcomes Following Major Surgery.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly being used for the management of diabetes mellitus and obesity. We sought to define the impact of preoperative GLP-1RA use on outcomes following major surgical procedures.

Methods: Patients who underwent a major surgical procedure between 2013 and 2021 were identified using the IBM MarketScan database.

Concomitant antihistamine administration is associated with improved survival outcomes in patients with locally advanced or metastatic urothelial carcinoma treated with atezolizumab. Analysis of individual participant data from IMvigor210 and IMvigor211.

Objectives: Survival outcomes of patients with metastatic urothelial carcinoma (mUC) are still suboptimal and strategies to enhance response to immune-oncology (IO) compounds are under scrutiny. In preclinical studies, it has been demonstrated that antihistamines may reverse macrophage immunosuppression, reactivate T cell cytotoxicity, and enhance the immunotherapy response. We aimed to evaluate the role of concomitant antihistamines administration on oncological outcomes among patients with mUC.

Mechanical and optical properties of additively manufactured denture base resin in different colors modified with antimicrobial substances: An in vitro study.

Statement Of Problem: Acrylic denture base resins are subject to colonization by oral and nonoral bacteria, contributing to the onset of denture stomatitis. However, how the addition of antimicrobial substances affects the mechanical and optical properties of additively manufactured denture base resin remains unclear.

Purpose: The purpose of this in vitro study was to investigate the surface roughness, color stainability, and flexural strength of antimicrobial-modified, additively manufactured polymethyl methacrylate (PMMA) denture base resin in tooth and gingiva colors.

Circle of Willis Variants and Their Association with Outcome after Successful Revascularization of Anterior Large Vessel Occlusion.

Background And Purpose: Leptomeningeal collaterals have been associated with better outcomes in large-vessel stroke, but little is known about how the Circle of Willis (CoW) collaterals affect stroke outcomes. We aimed to determine the relationship between three anatomically distinct CoW subtypes and 90-day outcomes in acute ischemic stroke patients after successful revascularization via endovascular thrombectomy (EVT).

Materials And Methods: We performed a retrospective analysis of patients treated with successful EVT for large-vessel occlusion at a comprehensive stroke center between May 2016 and November 2023.

Phase Level Assessment of Ergonomic Intervention Effectiveness in Reducing Knee Musculoskeletal Disorder Risks During Residential Roof Shingle Installation.

Background: This study aimed to assess how knee savers (KSs) and knee pads (KPs) alleviate risks of knee musculoskeletal disorders (MSDs) among roofers during various phases of shingle installation. These phases encompass (1) reaching for shingles, (2) placing shingles, (3) grabbing a nail gun, (4) moving to the first nailing position, (5) nailing shingles, (6) replacing the nail gun, and (7) returning to an upright position.

Methods: In a laboratory setting, nine male participants simulated the shingle installation task on a slope-adjustable roof platform (0°, 15°, and 30° slopes) under four intervention conditions: no intervention (NO); with KPs only (KP); with KSs only (KS); and with both KPs and KSs (BO).

Evaluation of COVID-19 Diagnosis Codes for Identification of SARS-CoV-2 Infections in a Nursing Home Cohort, 2022-2023.

Objectives: This study aimed to evaluate the utility of electronic health record (EHR) diagnosis codes for monitoring SARS-CoV-2 infections among nursing home residents.

Design: A retrospective cohort study design was used to analyze data collected from nursing homes operating under the tradename Signature Healthcare between January 2022 and June 2023.

Setting And Participants: Data from 31,136 nursing home residents across 76 facilities in Kentucky, Tennessee, Indiana, Ohio, North Carolina, Georgia, Alabama, and Virginia were included.

Hydrology and water quality evaluation for potential HABs under future climate scenarios.

Harmful algal blooms (HABs) are increasingly a global concern and the issue of all fifty states in the U.S as it poses a threat to human health and aquatic ecosystem. This study aimed to investigate the relationship of HABs with streamflow and water quality parameters and assess the hydrology-based potential future HABs in the Ohio River Basin at Ironton (ORBI) using the Soil and Water Assessment Tool (SWAT).

The impact of non-tobacco e-cigarette flavoring on e-cigarette uptake, cigarette smoking reduction, and cessation: A secondary analysis of a nationwide clinical trial.

Introduction: The impact of e-cigarette flavoring on e-cigarette uptake and switching to e-cigarettes among adults who smoke is critical to e-cigarette regulation in the United Sates. The purpose of this secondary analysis was to assess the impact of e-cigarette flavoring choice on e-cigarette uptake and changes in cigarette smoking in a large nationwide trial of e-cigarette provision in the United States.

Methods: A free four-week supply of e-cigarettes was provided with minimal instructions to use to adults who smoke (N = 427).

Evaluation of objective methods for analyzing ipsilateral motor evoked potentials in stroke survivors with chronic upper extremity motor impairment.

Ipsilateral motor evoked potentials (iMEPs) are believed to represent cortically evoked excitability of uncrossed brainstem-mediated pathways. In the event of extensive injury to (crossed) corticospinal pathways, which can occur following a stroke, uncrossed ipsilateral pathways may serve as an alternate resource to support the recovery of the paretic limb. However, iMEPs, even in neurally intact people, can be small, infrequent, and noisy, so discerning them in stroke survivors is very challenging.

Long-term performance and stability of implanted neural interfaces in individuals with lower limb loss.

Objective: High-density nerve cuffs have been successfully utilized to restore somatosensation in individuals with lower-limb loss by interfacing directly with the peripheral nervous system. Elicited sensations via these devices have improved various functional outcomes, including standing balance, walking symmetry, and navigating complex terrains. Deploying neural interfaces in the lower limbs of individuals with limb loss presents unique challenges, particularly due to repetitive muscle contractions and the natural range of motion in the knee and hip joints for transtibial and transfemoral amputees, respectively.

Right Ventricular Injury Definition and Management in Veno-Venous Extracorporeal Membrane Oxygenation.

Right ventricular injury (RVI) in respiratory failure receiving veno-venous extracorporeal membrane oxygenation (VV ECMO) is associated with significant mortality. A scoping review is necessary to map the current literature and guide future research regarding the definition and management of RVI in patients receiving VV ECMO. We searched for relevant publications on RVI in patients receiving VV ECMO in Medline, EMBASE, and Web of Science.

Factors affecting the direct red cell effect on thrombosis: Hematocrit dilution and injury patterns.

Background: Red blood cell (RBC) aggregation can be initiated by calcium and tissue factor, which may independently contribute to microvascular and macrovascular thrombosis after injury and transfusion. Previous studies have demonstrated that increased blood storage duration may contribute to thrombotic events. The aims of this study were to first determine the effect of blood product components, age, and hematocrit (HCT) on the aggregability of RBCs, followed by measurement of RBC aggregability in two specific injury models including traumatic brain injury (TBI) and hemorrhagic shock.

Evaluation of an Orientation Program for Adjunct Clinical Instructors in Nursing.

Part-time clinical nurse instructors teach students in many nursing schools in the United States. They are often unprepared for this role and require instruction in teaching methods. We developed and evaluated an online orientation program to provide the knowledge and skills necessary for nurses to become confident clinical instructors.

Successful Long-Term Management of NF1 Congenital Tibial Dysplasia with Prophylactic Bypass Graft and Bracing: A Case Report.

Case: An 8-year-old girl with NF1 and congenital tibial dysplasia with significant bilateral tibial bowing underwent McFarland procedures. Now age 22 with 14-year follow-up indicating sustained correction and healing of her bilateral limb deformities.

Conclusion: This case illustrates the McFarland procedure provided adequate corrective treatment of this deformity and remains a success at long-term follow-up.

Deloyers Technique for Restoration of Bowel Continuity Following Extended Left Hemicolectomy: A Comprehensive Analysis of 97 Cases and Literature Review.

Background: Deloyers technique addresses challenges in restoring bowel continuity following extended left hemicolectomies. Despite being first described in 1958, the technique remains underutilized, with limited data on long-term outcomes.

Objective: To evaluate the indications, surgical and functional outcomes of Deloyers technique and review existing literature.

Synthesis and Characterization of Poly(ethylene furanoate)/Poly(ε-caprolactone) Block Copolymers.

Biobased poly(ethylene furanoate) (PEF)/poly(ε-caprolactone) (PCL) block copolymers have been synthesized using ring opening polymerization (ROP) of ε-caprolactone (ε-CL) in the presence of PEF in different mass ratios. An increase in intrinsic viscosity is observed for the block copolymers with higher ε-CL content due to the extension of their macromolecular chain. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MS) was employed to understand the composition and structure of the produced block copolymers.

The association of financial resources and loneliness among older adults during a state of emergency.

This study focuses on the initial wave of the COVID-19 pandemic in Spring 2020 in the United States to assess how liquidity constraints were related to loneliness among older adults. Data are from the COVID Impact Survey, which was used to collect data in April, May and June 2020 across the U.S.

A Qualitative Assessment of Barriers, Facilitators, and Outcomes in a Simulation-Based Collaborative Quality Improvement Program: The ImPACTS Project.

Objectives: ImPACTS (Improving Acute Care Through Simulation) is a collaborative simulation-based program partnering pediatric specialty centers ("hubs") with general emergency departments (GEDs) to improve pediatric acute care. Objective measurements of ImPACTS, such as evaluating Pediatric Readiness Score (PRS) and simulation-based outcome improvements, have been reported previously. Barriers to and facilitators of program involvement and the downstream effects of the program have not been previously described.

Creating custom GPTs for faculty development: An example using the Johari Window and Crucial Conversation frameworks for providing feedback to struggling students.

Feedback plays a crucial role in the growth and development of trainees, particularly when addressing areas needing improvement. However, faculty members often struggle to deliver constructive feedback, particularly when discussing underperformance. A key obstacle is the lack of comfort many faculty experience in providing feedback that fosters growth.

Carbohydrate Ingestion Eliminates Hypoglycemia & Improves Endurance Exercise Performance in Triathletes Adapted to Very Low & High Carbohydrate Isocaloric Diets.

Very-low-carbohydrate diets (LCHF; <50g/day) have been debated for their potential to lower pre-exercise muscle and liver glycogen stores and metabolic efficiency, risking premature fatigue. It is also hypothesized that carbohydrate ingestion during prolonged exercise delays fatigue by increasing carbohydrate oxidation, thereby sparing muscle glycogen. Leveraging a randomized crossover design, we evaluated performance during strenuous time-to-exhaustion (70%⩒O) tests in trained triathletes following 6-week high-carbohydrate (HCLF, 380g/day) or very-low-carbohydrate (LCHF, 40g/day) diets to determine (i) if adoption of the LCHF diet impairs time-to-exhaustion performance, (ii) whether carbohydrate ingestion (10g/hour) 6-12x lower than current CHO fuelling recommendations during low glycogen availability (>15-hour pre-exercise overnight fast and/or LCHF diet) improves time-to-exhaustion by preventing exercise-induced hypoglycemia (EIH; <3.

Approaches, barriers, and facilitators in statewide initiative to combat opioid overdose: A narrative review of Ohio's Experiences During the HEALing Communities Study.

Objectives: Opioid-associated fatal and non-fatal overdose rates continue to rise. Prehospital overdose education and naloxone distribution (OEND) programs are attractive harm-reduction strategies, as patients who are not transported by EMS after receiving naloxone have limited access to other interventions. This narrative summary describes our experiences with prehospital implementation of evidence-based OEND practices across Ohio as part of the HEALing Communities Study (HCS).