Neuroimaging markers of cognitive fatigue in individuals with post-acute sequelae of SARS-CoV-2 infection.

Persistent cognitive fatigue (CF) is the most reported symptom in Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), but little is known about its underlying neural basis. This pilot study examined fMRI brain activation patterns during a fatiguing task in those with and without PASC. We hypothesized that individuals with PASC would show changes in CF-related brain activation within fatigue network.

Cytotoxic response of tumor-infiltrating lymphocytes of head and neck cancer slice cultures under mitochondrial dysfunction.

Background: Head and neck squamous cell carcinomas (HNSCC) are highly heterogeneous tumors. In the harsh tumor microenvironment (TME), metabolic reprogramming and mitochondrial dysfunction may lead to immunosuppressive phenotypes. Aerobic glycolysis is needed for the activation of cytotoxic T-cells and the absence of glucose may hamper the full effector functions of cytotoxic T-cells.

Gender Disparity in Teaching Evaluations of Pediatric Faculty by Residents.

Objectives: Despite their overrepresentation, female physicians continue to have lower rates of promotion compared with male physicians. Teaching evaluations play a role in physician advancement. Few studies have investigated gender disparity in resident evaluations of pediatric faculty.

Thyroid Oncocytic (Hürthle Cell) Nodules With Longitudinal Nuclear Grooves: Clinicopathologic, Immunohistochemical, and Molecular Genetic Study of 15 Cases.

Context.—: Thyroid nodules with longitudinal nuclear grooves have been widely regarded as synonymous with papillary thyroid carcinoma (PTC).

Objective.

Lower FSH With Normal Fertility in Male Mice Lacking Gonadotroph Kisspeptin Receptor.

The kisspeptin receptor, crucial for hypothalamic control of puberty and reproduction, is also present in the pituitary gland. Its role in the pituitary gland is not defined. Kisspeptin signaling the Kiss1r could potentially regulate reproductive function at the level of pituitary gonadotrope.

Coarctation of the Aorta and Anomalous Origin of the Left Coronary from the Opposite Sinus of Valsalva in a 6-Year-Old Male.

Coarctation of the aorta is a form of congenital heart disease requiring surgical intervention. If is often associated with other forms of congenital heart disease. Anomalous origin of the left coronary artery (ALCA) from the opposite sinus of Valsalva is implicated in sudden cardiac death.

Diffuse interstitial pneumonia-like/macrophage activation syndrome-like changes in patients with COVID-19 correlate with length of illness.

Objectives: Assess the pathologic changes in the lungs of COVID-19 decedents and correlate these changes with demographic data, clinical course, therapies, and duration of illness.

Methods: Lungs of 12 consecutive COVID-19 decedents consented for autopsy were evaluated for gross and histopathologic abnormalities. A complete Ghon "en block" dissection was performed on all cases; lung weights and gross characteristics recorded.

High Prevalence of Gram-Negative Rod and Multi-Organism Surgical Site Infections after Pediatric Complex Tethered Spinal Cord Surgery: Preliminary Report from a Single-Center Study.

Background: Surgical site infections (SSIs) are one of the most common complications following pediatric complex tethered spinal cord release. This patient population is similar in some ways to the neuromuscular scoliosis population, in which higher-than-expected rates of gram-negative SSIs have been identified.

Methods: We conducted a single-center retrospective chart review of all patients who underwent complex tethered spinal cord release over a 10-year period between 2007 and 2017.

Replaced right and common hepatic arteries with lienogastric trunk: a rare variant of celiaco-mesenteric anatomy.

We report a rare variant in mesenteric arterial anatomy: replacement of the right hepatic and common hepatic arteries to the SMA in a patient treated for hepatocellular carcinoma. The potential clinical implications of this unusual variation of celiaco-mesenteric anatomy will be discussed.

Virtual Exploration of Safe Entry Zones in the Brainstem: Comprehensive Definition and Analysis of the Operative Approach.

Background: A detailed and accurate understanding of the intrinsic brainstem anatomy and the interrelationship between its internal tracts and nuclei and external landmarks is of paramount importance for safe and effective brainstem surgery. Using anatomical models can be an important step in increasing such understanding. In the present study, we have shown the applicability of our developed virtual 3-dimensional (3D) model in depicting the safe entry zones (SEZs) to the brainstem.

Development of a Mouse Pain Scale Using Sub-second Behavioral Mapping and Statistical Modeling.

Rodents are the main model systems for pain research, but determining their pain state is challenging. To develop an objective method to assess pain sensation in mice, we adopt high-speed videography to capture sub-second behavioral features following hind paw stimulation with both noxious and innocuous stimuli and identify several differentiating parameters indicating the affective and reflexive aspects of nociception. Using statistical modeling and machine learning, we integrate these parameters into a single index and create a "mouse pain scale," which allows us to assess pain sensation in a graded manner for each withdrawal.

Discharge disposition of older patients undergoing trans-catheter aortic valve replacement and its impact on survival.

Background: Patients undergoing transcatheter aortic valve replacement (TAVR) are likely to be discharged to a location other than home. We aimed to assess the association between discharge disposition after TAVR and patient survival at 1 year.

Methods: Patients admitted from home and survived till discharge after TAVR were divided into two groups based on discharge disposition (home discharge vs.

Effects of Auricular Acupressure on Pain Management: A Systematic Review.

Objective: Nearly half of hospitalized patients in the United States have reported experiencing pain even while undergoing treatment for pain. Analgesic use is the most common type of treatment for pain management. Many patients who experience pain seek nonpharmacologic interventions to manage their pain, including forms of complementary or alternative medicine such as auricular acupressure (AA).

Strength in Numbers: A Team-Based Approach to Managing Patients with Hyponatremia.

This virtual patient panel provides learners with real-world application of best practices among various members of the healthcare team in the management of patients with hyponatremia. A patient case is provided, followed by discussion among the team members to provide insight into and context for why particular courses of action were chosen. (Online access: https://courses.

The Effect of Continuous-Flow Left Ventricular Assist Device Duration on Postoperative Outcomes.

Background: This study evaluated the effect of continuous-flow left ventricular assist device (CF-LVAD) duration on postoperative outcomes in heart transplant patients.

Methods: United Network of Organ Sharing heart transplant follow-up data from 2005 to 2015 were obtained. Patients supported by CF-LVADs who subsequently underwent cardiac transplantation were studied.

Impact of Left-Ventricular Assist Device-Related Complications on Posttransplant Graft Survival.

Background: This study describes the impact of continuous-flow left-ventricular-assist device (CF-LVAD)-related complications on postoperative outcomes.

Methods: The United Network for Organ Sharing (UNOS) heart transplant follow-up data from 2005 to 2015 were obtained. CF-LVAD patients who were bridged to transplant were studied.

Non-classical transpeptidases yield insight into new antibacterials.

Bacterial survival requires an intact peptidoglycan layer, a three-dimensional exoskeleton that encapsulates the cytoplasmic membrane. Historically, the final steps of peptidoglycan synthesis are known to be carried out by D,D-transpeptidases, enzymes that are inhibited by the β-lactams, which constitute >50% of all antibacterials in clinical use. Here, we show that the carbapenem subclass of β-lactams are distinctly effective not only because they inhibit D,D-transpeptidases and are poor substrates for β-lactamases, but primarily because they also inhibit non-classical transpeptidases, namely the L,D-transpeptidases, which generate the majority of linkages in the peptidoglycan of mycobacteria.

The immunoendocrinology of systemic lupus erythematosus.

Immunoendocrinology or the study of the effects of sex steroids and sex chromatin on immune diseases was pioneered by Henry G. Kunkel. In the disease lupus (SLE) the prevalence of female disease is high; the sex ratio is 10 females to every male after puberty.

NorLeu-Angiotensin (1-7) [DSC127] as a Therapy for the Healing of Diabetic Foot Ulcers.

Diabetes is a disorder that is well known to delay wound repair resulting in the formation of colonized chronic wounds. Over their lifetime, diabetic patients have a 25% incidence of foot ulcers (DFUs), which contribute to increased risk of morbidity, including osteomyelitis and amputations, and increased burden to the healthcare system. The only active product approved for the treatment of diabetic ulcers, Regranex, is not widely used due to minimal proven efficacy and recent warnings added to the Instructions for Use.

Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period.

Functional neuroimaging studies in mild traumatic brain injury (mTBI) have been largely limited to patients with persistent post-concussive symptoms, utilizing images obtained months to years after the actual head trauma. We sought to distinguish acute and delayed effects of mild traumatic brain injury on working memory functional brain activation patterns < 72 hours after mild traumatic brain injury (mTBI) and again one-week later. We hypothesized that clinical and fMRI measures of working memory would be abnormal in symptomatic mTBI patients assessed < 72 hours after injury, with most patients showing clinical recovery (i.