Effect of Lemborexant on Daytime Functioning in Adults With Insomnia: Patient-Reported Outcomes From a Phase 3 Clinical Trial.

Insomnia and some insomnia treatments can impact an individual's daytime functioning. Here, we performed post hoc analyses of patient-reported outcomes from a phase 3 clinical trial to assess the impact of lemborexant (LEM), a dual orexin receptor antagonist, on daytime functioning. Adults with insomnia were randomized 1:1:1 to receive placebo, LEM 5 mg (LEM5) or LEM 10 mg (LEM10) for 6 months.

Prevalence and clinical impact of the London classification: a prospective, international, multicenter study from the Lower Gastrointestinal International Consortium (LoGIC).

Introduction: The London classification provides standardization for characterization of disorders of anorectal function, although prevalences and clinical impact of these disorders are unclear.

Methods: An international research consortium was established, including five specialist centers. Prospective data were collected in consecutive adults referred for refractory chronic constipation (CC), fecal incontinence (FI) or coexistent CC/FI over 18 months.

The Evidence Alone Was Not Enough to Change Practice: A Mixed-methods Analysis Using a Standardized Framework to Understand Perceptions of Barriers and Compliance to ERAS Recommendations.

Purpose: Understanding barriers to compliance can aid in mitigation strategies to address them. This study aims to quantitatively and qualitatively assess the relationship between barriers to ERAS recommendations and perceived ability to assure compliance among multidisciplinary team (MDT) members who deliver Enhanced Recovery After Surgery (ERAS) care.

Design: Embedded mixed-methods survey analysis.

Factors associated with failure of humerus nonunion surgery in patients with initial nonoperative management.

Objectives: To describe operative results after humerus nonunion surgery in patients whose initial humerus shaft fracture (OTA/AO code 12) was treated nonoperatively and to identify risk factors of nonunion surgery failure in the same population.

Design: Case series.

Setting: Nine academic level 1 trauma centers.

Racial and Educational Isolation are Associated with Worse Outcomes in Congenital Heart Disease.

Sociodemographic factors influence outcomes in children with congenital heart disease (CHD). We predict an association between measures of social isolation and outcomes in infants with complex CHD. These measures, racial (RI) and educational (EI) isolation range from 0 to 1, with 0 being no isolation and 1 being fully isolated within a specific population.

Do Percutaneously Applied Medial Proximal Tibia Plates Need To Go Beneath the Pes Tendons?

Background: Bicondylar tibial plateau fractures are often associated with significant soft tissue compromise making operative treatment challenging. Dual plating through a two-incision approach following temporary external fixation has been shown to improve complication rates although deep infection rates remain high.The objective was to evaluate early outcomes following a novel technique of percutaneous application of the medial plate superficial to the pes anserinus tendons.

Coronal Malalignment Is Infrequently Present in Patients With Aseptic Tibial Loosening.

Background: Coronal lower extremity malalignment and improper implant position have been described as risk factors for aseptic tibial loosening following primary total knee arthroplasty (TKA). However, several prior studies have shown no association between alignment and implant loosening. Meanwhile, there is increasing interest in kinematic alignment.

Chronic Health Conditions in the Workplace: Work Stressors and Supportive Supervision, Work Design, and Programs.

A large and growing number of workers are managing chronic physical and mental health conditions while working, necessitating attention from both researchers and leaders and practitioners in organizations. Much of the current discourse around research and practice in this area is focused on prevention of chronic disease and rehabilitation of disability to help workers return to work. Less commonly attended to are workplace factors that can support the quality of working life and the longevity of working life for workers with chronic health conditions.

Disparate Use of Diagnostic Modalities for Patients With Limited English Proficiency and Neurologic Disorders.

Background And Objectives: Limited English proficiency (LEP) impairs health access-including outpatient specialty care-and quality care, i.e., inappropriate use of diagnostic tests.

Work-related Fatigue: Relationship between Perceived and Performance Fatigability in Career Firefighters.

Objective: The purpose of this study was to 1) examine the relationship between perceived work-related fatigue and performance fatigability, and 2) assess the impact of percent body fat (%BF) on perceived fatigue constructs in career firefighters.

Methods: Thirty-nine career firefighters completed body composition testing, the Occupational Fatigue Exhaustion Recovery (OFER15) scale assessing three subscales of work-related fatigue (acute fatigue, chronic fatigue, and inter-shift recovery), and maximal leg extensor isometric strength testing prior to and following an isotonic fatiguing protocol.

Results: Performance fatigability was not associated with any of the OFER15 perceived work-related fatigue variables ( P ≥ 0.

The Effect of Pelvic Floor Rehabilitation on Low Anterior Resection Syndrome After Colorectal Cancer Treatment.

Purpose: Low anterior resection (LAR) is the preferred surgical treatment of rectosigmoid or rectal cancers. However, it is often associated with bowel dysfunction, which is termed low anterior resection syndrome (LARS). Daily bowel dysfunction symptoms have a detrimental effect on quality of life (QOL).

An 18-Year Review of Hemoglobinopathy Proficiency Testing: Recommendations From the College of American Pathologists Hematology and Clinical Microscopy Committee.

Context.—: The College of American Pathologists Hematology and Clinical Microscopy Committee implemented a hemoglobinopathy proficiency testing and education program to monitor and assess the performance of participating laboratories.

Objective.

Differences in gut microbial diversity and composition between growth phenotypes of farmed juvenile sandfish, Holothuria scabra.

Background: The observed growth variability of different aquaculture species in captivity hinders its large-scale production. For the sandfish Holothuria scabra, a tropical sea cucumber species, there is a scarcity of information on its intestinal microbiota in relation to host growth, which could provide insights into the processes that affect growth and identify microorganisms with probiotic or biochemical potential that could improve current production strategies. To address this gap, this study used 16 S rRNA amplicon sequencing to characterize differences in gut and fecal microbiota among large and small juveniles reared in floating ocean nurseries.

Partially temporally constrained modeling of speeding crash-injury severities on freeways and non-freeways before, during, and after the stay-at-home order.

Speeding crashes remain high injury severities after the stay-at-home order in California, highlighting a need for further investigation into the fundamental cause of this increment. To systematically explore the temporal impacts of the stay-at-home order on speeding behaviors and the corresponding crash-injury outcomes, this study utilizes California-reported single-vehicle speeding crashes on freeways (access-controlled) and non-freeways (non-access-controlled) before, during, and after the order. Significant injury factors and in-depth heterogeneity across observations are identified by random parameter logit models with heterogeneity in means and variances.

Patient-reported outcome trajectories the first 24 months after surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study.

Objective: Cervical spondylotic myelopathy (CSM) shows varying levels of improvement after surgical treatment. While some patients improve soon after surgery, others may take months to years to show any signs of improvement. The goal of this study was to evaluate postoperative improvement, patient-reported outcomes, and patient satisfaction up to 2 years after surgical treatment for CSM, which will help optimize the current treatment strategies and effectively manage patient expectations.

Variations and Opportunities in Postnatal Management of Hemolytic Disease of the Fetus and Newborn.

Importance: Preventive efforts in pregnancy-related alloimmunization have considerably decreased the prevalence of hemolytic disease of the fetus and newborn (HDFN). International studies are therefore essential to obtain a deeper understanding of the postnatal management and outcomes of HDFN. Taken together with numerous treatment options, large practice variations among centers may exist.

Remote Perioperative Monitoring in Adult Cardiac Surgery: The Impact on 1000 Consecutive Patients.

Background: Our remote patient monitoring (RPM) program for adult cardiac surgery patients aims to remove barriers to access, provide continuity of expert care, and increase their time-at-home. The RPM program integrates novel biosensors, an application for audiovisual visits, messaging, biometric data tracking, patient-reported outcomes, and scheduling with the aim of reducing postoperative length of stay and 30-day readmissions, while simultaneously increasing the rate of patients discharged to home.

Methods: Our institutional database was utilized for this retrospective review of 1000 consecutive RPM patients who underwent coronary artery bypass, valve, and coronary artery bypass + valve, at 3 hospitals from July 2019 through April 2023.

Effect of fatigue on neuromuscular and biomechanical variables after anterior cruciate ligament reconstruction: a systematic review.

Introduction: This systematic review is aimed to evaluate the outcomes of published studies on the topic of fatigue-induced neuromuscular and biomechanical changes after anterior cruciate ligament (ACL) reconstruction.

Evidence Acquisition: The identification of studies involved a search across three databases - PubMed, Scopus, and Sportdiscus - until July 2023. The key terms utilized were fatigue, anterior cruciate ligament, biomechanics, electromyography, and landing.

Outcomes of Older Adults and Frail Patients Receiving Idecabtagene Vicleucel: A CIBMTR Study.

Idecabtagene vicleucel (ide-cel) is an anti-BCMA CAR-T cell therapy approved for patients with relapsed/refractory multiple myeloma (RRMM) after 2 prior lines of therapy. There is limited data on outcomes of CAR T in older adults and frail patients with RRMM. In this study, we utilized data from the Center for International Blood and Marrow Transplantation Registry to describe the safety and efficacy of ide-cel in these clinically important subgroups.

Perception of Residency Program Diversity Is Associated With Vulnerability to Race and Gender Stereotype Threat Among Minority and Female Orthopaedic Trainees.

Introduction: Stereotype threat (ST) is a psychological phenomenon in which perceived fear of confirming negative stereotypes about one's identity group leads to impaired performance. Gender and racial ST has been described in various academic settings. However, it is prevalence in orthopaedic surgery, where women and minorities are underrepresented, has not been examined.

Comparative analysis of EGFR mutations in circulating tumor DNA and primary tumor tissues from lung cancer patients using BEAMing PCR.

In this study, we measured human epidermal growth factor receptor (EGFR) mutations in both tissue and circulating tumor DNA (ctDNA) by using beads, emulsions, amplifications and magnetic polymerase chain reaction (BEAMing PCR). Noninvasive mutation detection by assessing circulating tumor DNA (ctDNA) offers many advantages over tumor biopsy. One hundred non-small cell lung cancer (NSCLC) patients were enrolled, and both preoperative plasma samples and formalin-fixed and paraffin-embedded (FFPE) samples were collected for the study.

Undiagnosed partial ornithine transcarbamylase deficiency presenting as recurrent hyperammonaemic encephalopathy after capecitabine administration.

Capecitabine is a widely used drug for cancer treatment. Capecitabine is a derivative of 5-fluorouracil (5-FU). A known complication of 5-FU is hyperammonaemia which can cause encephalopathy.

Immunophenotyping of Synovial Tissue in Adolescents Undergoing ACL Reconstruction: What Is the Role of Synovial Inflammation in Arthrofibrosis?

Background: Loss of motion and arthrofibrosis after anterior cruciate ligament (ACL) reconstruction (ACLR) can be devastating complications for athletes. The cellular and molecular pathogenesis of arthrofibrosis is poorly understood, limiting prevention and treatment options. Synovial inflammation may contribute to post-ACLR arthrofibrosis.