Design Rational for Total Ankle Arthroplasty: An Update.

The design of total ankle arthroplasty (TAA) systems is rapidly evolving as device companies try to keep pace with the expansion of surgical indications and a refinement of techniques for TAA. Even since the publication of the latest "update," published in 2018, three new designs and three updates on preexisting third-generation implants came onto the market. Improvements in third-generation TAA systems include minimal bone resection, retaining ligamentous support, and anatomic balancing.

White Matter Tract Crossing and Bottleneck Regions in the Fetal Brain.

There is a growing interest in using diffusion MRI to study the white matter tracts and structural connectivity of the fetal brain. Recent progress in data acquisition and processing suggests that this imaging modality has a unique role in elucidating the normal and abnormal patterns of neurodevelopment in utero. However, there have been no efforts to quantify the prevalence of crossing tracts and bottleneck regions, important issues that have been investigated for adult brains.

The Fragility of Statistical Findings in Meniscus Repair Literature: A Systematic Review of Randomized Controlled Trials.

Background: Within the realm of orthopedic literature, the determination of statistical significance for outcomes relies on probability analysis and the reporting of P-values. The aim of this study was to employ fragility analysis as a means of evaluating the resilience of randomized controlled trials (RCTs) that assess meniscus surgeries. It was hypothesized that dichotomous outcomes would be statistically fragile and comparable to other orthopedic specialties.

Active Learning Exercises in Synaptic Physiology and Connectivity for the Neuroscience Lecture Hall, Laboratory Course, or Outreach Setting.

It is well-understood that active learning approaches have positive learning outcomes and improve retention. Active learning strategies for the neuroscience laboratory setting have been extensively developed. Fewer active learning approaches are available for the traditional lecture-based setting.

Clonally expanded, targetable, natural killer-like NKG7 T cells seed the aged spinal cord to disrupt myeloid-dependent wound healing.

Spinal cord injury (SCI) increasingly affects aged individuals, where functional impairment and mortality are highest. However, the aging-dependent mechanisms underpinning tissue damage remain elusive. Here, we find that natural killer-like T (NKLT) cells seed the intact aged human and murine spinal cord and multiply further after injury.

Black/White disparities in low birth weight across maternal trajectories of social mobility in South Carolina.

Persistent racial disparities in low birth weight (LBW) in the United States may be better understood through the adoption of a life course perspective that considers differential exposure and vulnerability of Black and White women to socioeconomic position across generations. Using a multigenerational dataset of singleton birth certificates from South Carolina from 1989 to 2020 linked along the maternal line, we constructed intergenerational social mobility trajectories of grandmaternal and maternal education and compared unadjusted and adjusted associations between trajectories and LBW among Black and White women. We found that White women were more likely to be upwardly mobile, and Black women to be downwardly mobile.

"When I talk about it, my eyes light up!" Impacts of a national laboratory internship on community college student success.

Participation in technical/research internships may improve undergraduate graduation rates and persistence in science, technology, engineering, and mathematics (STEM), yet little is known about the benefits of these activities a) for community college students, b) when hosted by national laboratories, and c) beyond the first few years after the internship. We applied Social Cognitive Career Theory (SCCT) to investigate alumni perspectives about how CCI at Lawrence Berkeley National Laboratory (LBNL) impacted their academic/career activities. We learned that alumni had low confidence and expectations of success in STEM as community college students.

Oxygen-Passivated Sulfur Vacancies in Monolayer MoS for Enhanced Piezoelectricity.

Modern-day applications demand onboard electricity generation that can be achieved using piezoelectric phenomena. Reducing the dimensionality of materials is a pathway to enhancing the piezoelectric properties. Transition-metal dichalcogenides have been shown to exhibit high piezoelectricity.

Barriers and Facilitators to Video Telehealth Use in Low-Income Hispanic Patients: A Theory of Planned Behavior Perspective.

Background And Objectives: As telehealth grows in ubiquity, it is important to understand the barriers and facilitators to telehealth utilization in historically marginalized populations. This study utilizes the Theory of Planned Behavior (TPB) to assess correlates of the intention to utilize video consultations among low-income Hispanic patients.

Methods: This cross-sectional observational study included participants (N = 138) recruited from a federally qualified health center affiliated with a large university health system.

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).

Protocol for a multisite randomised controlled trial assessing the effect of the Telehealth for Early Developmental Intervention in babies born very preterm (TEDI-Prem) programme on neurodevelopmental outcomes and parent well-being.

Introduction: Infants born very preterm (VPT, <32 weeks' gestation) are at increased risk for neurodevelopmental impairments including motor, cognitive and behavioural delay. Parents of infants born VPT also have poorer mental health outcomes compared with parents of infants born at term.We have developed an intervention programme called TEDI-Prem (Telehealth for Early Developmental Intervention in babies born very preterm) based on previous research.

Predictive equation derived from 6,497 doubly labelled water measurements enables the detection of erroneous self-reported energy intake.

Nutritional epidemiology aims to link dietary exposures to chronic disease, but the instruments for evaluating dietary intake are inaccurate. One way to identify unreliable data and the sources of errors is to compare estimated intakes with the total energy expenditure (TEE). In this study, we used the International Atomic Energy Agency Doubly Labeled Water Database to derive a predictive equation for TEE using 6,497 measures of TEE in individuals aged 4 to 96 years.

Modulation of Tumor-Associated Macrophages to Overcome Immune Suppression in the Hepatocellular Carcinoma Microenvironment.

Hepatocellular carcinoma (HCC) is a major global health issue characterized by poor prognosis and complex tumor biology. One of the critical components of the HCC tumor microenvironment (TME) is tumor-associated macrophages (TAMs), which play a pivotal role in modulating tumor growth, immune evasion, and metastasis. Macrophages are divided into two major subtypes: pro-inflammatory M1 and anti-inflammatory M2, both of which may exist in TME with altered function and proportion.

Addressing Financial Toxicity From a Global Perspective: How to Advance Shared-Learning to Facilitate Change?

Financial Toxicity is a global issue requiring international efforts, but importantly, where to next?

The Availability of Paternity Leave in US Surgical Residencies: A Study of Program Websites.

Introduction: As family dynamics evolve, an increasing number of male residents are embracing parenthood during their training. Consequently, paternity leave has emerged as a crucial consideration. The aim of this study was to determine the gap in public availability of paternity leave policies in surgical residency programs across the United States.

A detailed spatiotemporal atlas of the white matter tracts for the fetal brain.

This study presents the construction of a comprehensive spatiotemporal atlas of white matter tracts in the fetal brain for every gestational week between 23 and 36 wk using diffusion MRI (dMRI). Our research leverages data collected from fetal MRI scans, capturing the dynamic changes in the brain's architecture and microstructure during this critical period. The atlas includes 60 distinct white matter tracts, including commissural, projection, and association fibers.

Managing Recurrent Carbon Dioxide Embolism During Laparoscopic Hepatectomy With Transesophageal Echocardiography Guidance: A Case Report.

Carbon dioxide gas emboli is a potentially fatal complication that occurs more frequently during laparoscopic hepatectomy compared to other laparoscopic surgeries. The patient featured in this report had massive gas embolism confirmed by intraoperative transesophageal echocardiography (TEE) that were associated with episodes of severe hypoxemia, hemodynamic instability, and right ventricular failure requiring conversion to open hepatectomy. Abrupt abdominal decompression resulted in massive hemorrhage from a previously undetected defect in the middle hepatic vein.

Evaluation of LLMs accuracy and consistency in the registered dietitian exam through prompt engineering and knowledge retrieval.

Large language models (LLMs) are fundamentally transforming human-facing applications in the health and well-being domains: boosting patient engagement, accelerating clinical decision-making, and facilitating medical education. Although state-of-the-art LLMs have shown superior performance in several conversational applications, evaluations within nutrition and diet applications are still insufficient. In this paper, we propose to employ the Registered Dietitian (RD) exam to conduct a standard and comprehensive evaluation of state-of-the-art LLMs, GPT-4o, Claude 3.

Outcomes of Immunotherapy Treatment in Sinonasal Mucosal Melanoma.

Background: Sinonasal mucosal melanoma has poor survival despite multimodality treatment. While the impact of immunotherapy (IT) on metastatic cutaneous melanoma is well-defined, there are relatively little data on sinonasal mucosal melanoma.

Objective: We sought to define immunotherapy outcomes in patients with sinonasal mucosal melanoma.

Anatomic Distal Biceps Tendon Repair With All-Suture Cortical Buttons.

Acute, traumatic distal biceps tendon ruptures are a common injury in the middle-aged athletic male population, with direct anatomic surgical repair being the most effective technique to restore maximal strength. Multiple techniques for distal biceps tendon repair have been described, including single- or dual-incision approaches and tendon fixation with cortical buttons, interference screws, suture anchors, and transosseous sutures. In this Technical Note, we demonstrate an anatomic distal biceps tendon repair technique with a single-incision approach using 2 all-suture cortical buttons.

Arthroscopy-Assisted Core Decompression and Bone Grafting for Avascular Necrosis of the Hip.

Although specific techniques vary, core decompression is generally accepted as the treatment of choice for precollapse avascular necrosis (AVN) of the hip to delay or prevent progression of the disease. This can be combined with hip arthroscopy to allow visual assessment of the femoral head as well as treatment of intra-articular pathologies, which may contribute to pain and joint degeneration. We describe a technique of hip arthroscopy and concurrent core decompression using an expandable reamer and bone grafting for treatment of hip AVN.

Infection with Toxoplasma gondii triggers coagulation at the blood-brain barrier and a reduction in cerebral blood flow.

Background: Immunothrombosis is the process by which the coagulation cascade interacts with the innate immune system to control infection. However, the formation of clots within the brain vasculature can be detrimental to the host. Recent work has demonstrated that Toxoplasma gondii infects and lyses central nervous system (CNS) endothelial cells that form the blood-brain barrier (BBB).