Surgical Opioid Stewardship: From the Epidemic Through the Pandemic and Beyond.

Background: In response to the opioid epidemic, prescribing guidelines and statewide surgical opioid management programs were initiated in 2018-19. This analysis aims to document the sustainability of a regional opioid stewardship consortium through the pandemic and beyond.

Study Design: From September 2019 through August 2023, 15 NSQIP hospitals in two states gathered opioid-specific variables on patients undergoing 12 procedures.

Lyme neuroborreliosis in Japan: Borrelia burgdorferi sensu lato as a cause of meningitis of previously undetermined etiology in hospitalized patients outside of the island of Hokkaido, 2010-2021.

Background And Purpose: Clinical manifestations of Lyme borreliosis (LB), caused by Borrelia burgdorferi sensu lato (Bbsl), include erythema migrans, Lyme neuroborreliosis (LNB), carditis, and arthritis. LB is a notifiable disease in Japan with <30 surveillance-reported LB cases annually, predominately from Hokkaido Prefecture. However, LB, including LNB, may be under-diagnosed in Japan since diagnostic tests are not readily available.

Clinical criteria for limbic-predominant age-related TDP-43 encephalopathy.

Limbic predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is highly prevalent in late life and a common co-pathology with Alzheimer's disease neuropathologic change (ADNC). LATE-NC is a slowly progressive, amnestic clinical syndrome. Alternatively, when present with ADNC, LATE-NC is associated with a more rapid course.

Imidazolium-Based Ionic Liquid Exhibiting Dual Hydrophilic and Oleophobic Properties without Polar End Groups.

Simultaneously hydrophilic and oleophobic surfaces offer substantial advantages for applications such as antifogging, self-cleaning, and oil-water separation. It remains challenging to engineer such surfaces without requiring polar functional groups. This study introduces HFIL, a novel ionic liquid (IL) coating that achieves simultaneous hydrophilic and oleophobic properties via a one-step dip-coating process without relying on polar functional groups.

Longitudinal Outcomes in Noonan Syndrome.

Purpose: Noonan syndrome and related disorders (NS) are multisystemic conditions affecting approximately 1:1000 individuals. Previous natural history studies were conducted prior to widespread comprehensive genetic testing. This study provides updated longitudinal natural history data in participants with molecularly confirmed NS.

Decoding brain structure to stage Alzheimer's disease pathology in Down syndrome.

Introduction: Alzheimer's disease (AD) in Down syndrome (DS) is associated with changes in brain structure. It is unknown if thickness and volumetric changes can identify AD stages and if they are similar to other genetic forms of AD.

Methods: Magnetic resonance imaging scans were collected for 178 DS adults (106 nonclinical, 45 preclinical, and 27 symptomatic).

Determinants of Racial and Ethnic Differences in Maternal Cardiovascular Health in Early Pregnancy.

Background: Suboptimal cardiovascular health (CVH) in pregnancy is associated with adverse maternal and offspring outcomes. To guide public health efforts to reduce disparities in maternal CVH, we determined the contribution of individual- and neighborhood-level factors to racial and ethnic differences in early pregnancy CVH.

Methods: We included nulliparous individuals with singleton pregnancies who self-identified as Hispanic, non-Hispanic Black (NHB), or non-Hispanic White (NHW) and participated in the nuMoM2b cohort study (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be).

Striving for excellence in a little red dot: Exploring the evolution of oral and maxillofacial surgery training and practice in Singapore.

Oral and maxillofacial surgery (OMS) is a field that straddles knowledge and clinical experience from both medical and dental specialties. In the small island nation of Singapore, the rapidly and constantly changing needs of its diverse and aging population, as well as changes in the mindsets of both students and educators have led to many developments in the local OMS program. Tied to the only dental school in the country, the curriculum of the training program has kept up with the changes in the demographics and attitudes of the local patient pool, which comprises a multicultural population with both traditional and modern mindsets.

Enhancing the Travel Experience for People with Visual Impairments through Multimodal Interaction: NaviGPT, A Real-Time AI-Driven Mobile Navigation System.

Assistive technologies for people with visual impairments (PVI) have made significant advancements, particularly with the integration of artificial intelligence (AI) and real-time sensor technologies. However, current solutions often require PVI to switch between multiple apps and tools for tasks like image recognition, navigation, and obstacle detection, which can hinder a seamless and efficient user experience. In this paper, we present NaviGPT, a high-fidelity prototype that integrates LiDAR-based obstacle detection, vibration feedback, and large language model (LLM) responses to provide a comprehensive and real-time navigation aid for PVI.

Effect of Sex and Age on Knee Strength in Young Athletes: A Systematic Review and Meta-analysis.

The purpose was to summarize the studies examining knee strength in young athletes and provide valuable insights into the magnitude of changes in knee flexion and extension strength during the transition from pre-puberty to puberty among male and female athletes. The literature search was conducted through Cochrane Library, Embase, PubMed, Web of Science. Cohen's effect size (ES) and 95% confidence intervals (CIs) were computed using a random effects model.

A Randomized Trial of Cardiac Catheterization With Fasting Versus Liberal Oral Intake: The CALORI Trial.

Background: Routine preprocedural fasting before cardiac catheterization remains common practice, despite a lack of robust evidence to support this practice. We investigated the impact of a liberal nonfasting strategy vs a standardized nil per os (NPO) regimen prior to cardiac catheterization.

Methods: Adult inpatients undergoing elective or urgent cardiac catheterization were randomized (1:1 ratio) to either NPO past midnight or ad libitum intake of liquids and solids (without dietary constraints) until immediately prior to the procedure.

The potential for glacial flour to impact soil fertility, crop yield and nutrition in mountain regions.

Novel sustainable agricultural strategies that enhance soil nutrients and human nutrition are crucial for meeting global food production needs. Here, we evaluate the potential of "glacial flour," a naturally crushed rock produced by glaciers known to be rich in nutrients (P, K, and micronutrients) needed for plant growth. Our proof-of-concept study, investigated soybean ( var.

A Streamlined High-Throughput LC-MS Assay for Quantifying Peptide Degradation in Cell Culture.

Peptides are widely used in biomaterials due to their ease of synthesis, ability to signal cells, and modify the properties of biomaterials. A key benefit of using peptides is that they are natural substrates for cell-secreted enzymes, which creates the possibility of utilizing cell-secreted enzymes for tuning cell-material interactions. However, these enzymes can also induce unwanted degradation of bioactive peptides in biomaterials, or in peptide therapies.

Tomato Defenses Under Stress: The Impact of Salinity on Direct Defenses Against Insect Herbivores.

Abiotic stressors, such as salt stress, can reduce crop productivity, and when combined with biotic pressures, such as insect herbivory, can exacerbate yield losses. However, salinity-induced changes to plant quality and defenses can in turn affect insect herbivores feeding on plants. This study investigates how salinity stress in tomato plants (Solanum Lycopersicum cv.

Trends and disparities in age, sex, ethnoracial background, and urbanization status in adult mortality due to thoracic aortic aneurysm: a retrospective nationwide study in the United States.

Introduction: Thoracic aortic aneurysms (TAA) are a significant health concern, with the true prevalence likely underestimated due to undiagnosed cases. Outcomes in TAA are influenced by factors like age, sex, and comorbidities such as hypertension. This study examines mortality trends and disparities associated with TAA in US adults.

Cross-sectional evaluation of medical reversals among National Institute of Health guideline practices implemented during the COVID-19 pandemic: how often did experts err in a time of crisis?

Objective: The COVID-19 pandemic required the rapid and often widespread implementation of medical practices without robust data. Many of these practices have since been tested in large, randomised trials and were found to be in error. We sought to identify incorrect recommendations, or reversals, among National Institute of Health COVID-19 guidelines and Food and Drug Administration (FDA) approvals and authorisations.

Protocol for a multi-domain scoping review to identify measures of decision-making ability in an ageing population.

Introduction: Deficits in decision-making (DM) can lead to adverse outcomes across multiple domains such as financial management and medical care. By hindering such DM abilities, cognitive impairment (CI) often affects quality of life. Routine screening for CI, however, does not include systematic and comprehensive assessment of DM ability.

Feasibility and acceptability of multiple methods of recording injecting drug use episode data among people who inject drugs in Melbourne, Australia: a pilot evaluation study protocol.

Introduction: Opioid overdose and blood-borne virus transmission are key health risks for people who inject drugs. Existing study methods that record data on injecting drug risks mostly rely on retrospective self-reporting that, while valid, are limited to being broad and subject to recall bias. The In-The-Moment-Expanded (ITM-Ex) study will evaluate the feasibility and acceptability of multiple novel data collection methods to capture in situ drug injecting data.

Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic - the multicentre, multimethod PotPrev Study.

Purpose: In the setting of an established childhood pneumococcal vaccination programme with immediate initiation and treatment of antiretroviral therapy (ART) for people living with HIV (PLWH), the risk of adult pneumococcal community-acquired pneumonia (CAP) is not recently described. We aimed to investigate CAP incidence, recurrence, mortality, risk factors and microbiology before and during the COVID-19 pandemic.

Participants: Adults aged ≥18 years were enrolled in three South African provinces from March 2019 to October 2021, with a brief halt during the initial COVID-19 lockdown.

Multicentre study conducted across centres in the USA, Europe and Australia to assess the safety and effectiveness of a bilateral hypoglossal nerve stimulation system for the treatment of obstructive sleep apnoea in adults: a protocol for a pivotal, multicentre, open-label, single-arm study.

Introduction: Obstructive sleep apnoea (OSA) is characterised by blood oxygen desaturations and sleep disruptions manifesting undesirable consequences. Existing treatments including oral appliances, positive airway pressure (PAP) therapy and surgically altering the anatomy of the pharynx have drawbacks including poor long-term adherence or often involving irreversible, invasive procedures. Bilateral hypoglossal nerve stimulation (HNS) is a new treatment for managing OSA, and this study is intended to determine whether an HNS system is a safe and effective treatment option for adults with OSA.

The MyLungHealth study protocol: a pragmatic patient-randomised controlled trial to evaluate a patient-centred, electronic health record-integrated intervention to enhance lung cancer screening in primary care.

Introduction: Early lung cancer screening (LCS) through low-dose CT (LDCT) is crucial but underused due to various barriers, including incomplete or inaccurate patient smoking data in the electronic health record and limited time for shared decision-making. The objective of this trial is to investigate a patient-centred intervention, MyLungHealth, delivered through the patient portal. The intervention is designed to improve LCS rates through increased identification of eligible patients and informed decision-making.