Tramadol as a fentanyl adulterant: Prevalence and management in a ToxIC Fentalog study prospective cohort.

Background: Tramadol is an adulterant of illicit opioids. As it is a serotonin-norepinephrine reuptake inhibitor as well as a μ-opioid agonist, tramadol adulteration may worsen overdose signs and symptoms or affect the amount of naloxone patients receive.

Methods: This is a multicenter, prospective cohort of adult patients with suspected opioid overdoses who presented to one of eight United States emergency departments and were included in the Toxicology Investigators Consortium's Fentalog Study.

Changes in Medication Complexity and Post-Hospitalization Outcomes in Older Adults Hospitalized for Heart Failure.

Introduction: Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.

Will the Real Immunogens Please Stand Up: Exploiting the Immunogenic Potential of Cryptococcal Cell Antigens in Fungal Vaccine Development.

is an opportunistic fungal pathogen that is a continuous global health concern, especially for immunocompromised populations. The World Health Organization recognized as one of four critical fungal pathogens, thus emphasizing the need for increased research efforts and clinical resource expansion. Currently, there are no fungal vaccines available for clinical use.

The Contribution of the Limbus and Collagen Fibrils to Corneal Biomechanical Properties: Estimation of the Low-Strain In Vivo Elastic Modulus and Tissue Strain.

We have compared the biomechanical properties of human and porcine corneas using vibrational optical coherence tomography (VOCT). The elastic modulus of the cornea has been previously reported in the literature to vary from about several kPa to more than several GPa based on the results of different techniques. In addition, the formation of corneal cones near the central cornea in keratoconus has been observed in the clinic.

Vulnerability in Colorectal Cancer: Adjusted Gross Income and Geography as Factors in Determining Overall Survival in Colorectal Cancer: A Single-Center Study Across a Broad Income Inequality in an American Context.

: Regional differences in socioeconomic status (SES) are well known, and we believe that the use of geocoding (zip code) can facilitate the introduction of targeted interventions for underserved populations. This is a single-center, retrospective analysis of data extracted from the cancer registry at the Capital Health Cancer Center in Pennington, N. The Capital Health Cancer Center in central New Jersey primarily serves two counties, catering to a diverse patient population from a wide range of socioeconomic backgrounds.

Geometric variations in nucleosomal DNA dictate higher-order chromatin structure and enhancer-promoter communication.

The dynamic organization of chromatin plays an essential role in the regulation of genetic activity, interconverting between open and compact forms at the global level. The mechanisms underlying these large-scale changes remain a topic of widespread interest. The simulations of nucleosome-decorated DNA reported herein reveal profound effects of the nucleosome itself on overall chromatin properties.

Topological functional network analysis of cortical blood flow in hyperacute ischemic rats.

Acute cerebral ischemia alters brain network connectivity, leading to notable increases in both anatomical and functional connectivity while observing a reduction in metabolic connectivity. However, alterations of the cerebral blood flow (CBF) based functional connectivity remain unclear. We collected continuous CBF images using laser speckle contrast imaging (LSCI) technology to monitor ischemic occlusion-reperfusion progression through occlusion of the left carotid artery.

Low pH Means More Female Offspring: A Multigenerational Plasticity in the Sex Ratio of Marine Bivalves.

Global changes can profoundly affect the sex determination and reproductive output of marine organisms, disrupting the population structure and ecosystems. High COdriven low pH in the context of ocean acidification (OA) has been shown to severely affect various calcifiers, but less is known about the extent to which low pH influences sex determination and reproduction of marine organisms, particularly mollusks. This study is the first to report a biased sex ratio over multiple generations toward females, driven by exposure to high CO-induced low pH environments, using the ecologically and economically important Portuguese oyster () as a model.

The Wittmann-Price Theory of Emancipated Decision-Making in Women's Health Care: An Analysis Based on McEwen.

The use of theories in nursing reflects the discipline's progression toward autonomy and delineates its scope, directly guiding practice, research, education, and administration. This paper analyzes and evaluates the theoretical model for nursing care of women involved in health care decisions-The Wittmann-Price Theory of Emancipated Decision-Making in Women's Health Care-based on McEwen's systematic theory 3-phase evaluation method. Developed through a rigorous process, this theory centers on the concept of emancipation and its associated subconcepts crucial to decision-making in women's health.

Transcutaneous Electrical Nerve Stimulation for Prevention and Treatment of Post-Herpetic Neuralgia: A Narrative Review.

The present investigation evaluated transcutaneous electrical nerve stimulation (TENS) for the non-pharmacological treatment of post-herpetic neuralgia (PHN). PHN is the most common complication of the Herpes Zoster virus, affecting one in every five patients with shingles, and presents as intense neuropathic pain that can persist for 90 days or longer after the initial onset of symptoms. Current pharmacological treatment options are mainly limited to symptom management, including oral medications such as tricyclic antidepressants and gabapentinoid preparations, as well as topical options such as lidocaine or capsaicin.

Antiracist activism for immigrant rights and healthy coping: Initial evidence for a community-based framework.

Racist and xenophobic policies in the United States (e.g., family separations and lack of access to protected immigration statuses for undocumented immigrants) have historically excluded immigrants of color from accessing full civil rights, thus contributing to widening racial inequities in the US.

Wastewater-based estimation of temporal variation in shedding amount of influenza A virus and clinically identified cases using the PRESENS model.

Wastewater-based estimation of infectious disease prevalence in real-time assists public health authorities in developing effective responses to current outbreaks. However, wastewater-based estimation for IAV remains poorly demonstrated, partially because of a lack of knowledge about temporal variation in shedding amount of an IAV-infected person. In this study, we applied two mathematical models to previously collected wastewater and clinical data from four U.

Global prevalence, resistance rates, and underlying resistance mechanisms of clinical Mycoplasma and Ureaplasma species.

Mycoplasmas are significant pathogens in human health, implicated in a range of clinical conditions from respiratory infections to urogenital disorders. Their resistance to commonly used antibiotics poses a substantial challenge to treatment and control. This study aims to provide a comprehensive overview of the global distribution of clinical mycoplasmas, elucidate their resistance to various antibiotics, and identify the genetic and molecular mechanisms underlying their resistance.

A Queen City Legacy: 45 Years of Research in Pregnant Women with Insulin-Dependent Diabetes Mellitus, The Diabetes in Pregnancy Program Project Grant.

The Diabetes in Pregnancy Program Project Grant (PPG) was a 15-year program focused on enhancing the care for women with insulin-dependent diabetes mellitus (IDDM) during pregnancy and improving the well-being of their offspring. Launched in July 1978 at the University of Cincinnati, the PPG pursued a multifaceted research agenda encompassing basic science, animal and placental studies, and maternal and neonatal clinical trials to understand the physiological and pathophysiological aspects of IDDM during pregnancy. A total of 402 singleton pregnancies in 259 women with IDDM were enrolled prior to 10 weeks gestation over the 15-year period.

Ursolic Acid as a Protective Agent Against UVB-Induced Metabolic and Epigenetic Alterations in Human Skin Keratinocytes: An Omics-Based Study.

This study aimed to assess how ursolic acid (UA) can protect human skin keratinocytes from damage caused by ultraviolet B (UVB) radiation. Utilizing an omics-based approach, we characterized the features of photodamage and investigated the potential of UA to reverse HaCaT cell subpopulation injury caused by UVB radiation. The most significant changes in metabolite levels after UA treatment were in pathways associated with phosphatidylcholine biosynthesis, arginine and proline metabolism.

Identifying a Genetic Link Between Lung Function and Psoriasis.

Introduction: The common genetic underpinnings of psoriasis and pulmonary comorbidities have yet to be explored.

Material And Methods: In this cross-sectional study, we investigated the single-nucleotide polymorphisms (SNPs) associated with psoriasis and their relationship with pulmonary function using data from the UK Biobank (UKBB) and the Vanderbilt University Medical Center Biobank (BioVU).

Results: Out of the 63 psoriasis-associated SNPs identified in previous genome-wide association studies within the European population, we successfully identified 53 SNPs, including proxy SNPs in UKBB database.

Characterizing the Relationships Amongst Psychological Safety, the Learning Environment, and Well-Being in Surgical Faculty and Trainees.

Objective: Learning environments affect the well-being of surgical faculty and trainees. Psychological safety (PS) has been linked with learning behaviors and aspects of well-being within medicine; however, given the unique challenges inherent to the surgical learning environment, there is a need to more closely examine these concepts for surgical faculty and trainees. The objective of this study is to examine the relationships between learning environment and PS, as well as PS and well-being with surgery.

Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

Reddit Perspectives on Tonsillectomy Procedure: Sentiment and Thematic Analysis.

Introduction: Every year, 530,000 tonsillectomies are performed in the United States. Many patients use social media for medical advice and support. This study investigates Reddit perspectives to identify the current needs of tonsillectomy patients.

Early detection and progression of insulin resistance revealed by impaired organismal anti-inflammatory heat shock response during ex vivo whole-blood heat-challenge.

Chronic inflammatory diseases, e.g., obesity, cardiovascular disease, and type 2 diabetes, progressively suppress the anti-inflammatory heat shock response (HSR) by impairing the synthesis of key components, perpetuating inflammation.

Extracting interpretable signatures of whole-brain dynamics through systematic comparison.

The brain's complex distributed dynamics are typically quantified using a limited set of manually selected statistical properties, leaving the possibility that alternative dynamical properties may outperform those reported for a given application. Here, we address this limitation by systematically comparing diverse, interpretable features of both intra-regional activity and inter-regional functional coupling from resting-state functional magnetic resonance imaging (rs-fMRI) data, demonstrating our method using case-control comparisons of four neuropsychiatric disorders. Our findings generally support the use of linear time-series analysis techniques for rs-fMRI case-control analyses, while also identifying new ways to quantify informative dynamical fMRI structures.