Primary 3-Month Outcomes of a Double-Blind Randomized Prospective Study (The QUEST Study) Assessing Effectiveness and Safety of Novel High-Frequency Electric Nerve Block System for Treatment of Post-Amputation Pain.

Purpose: This multicenter, randomized, double-blinded, active sham-controlled pivotal study was designed to assess the efficacy and safety of high-frequency nerve block treatment for chronic post-amputation and phantom limb pain.

Patients And Methods: QUEST enrolled 180 unilateral lower-limb amputees with severe post-amputation pain, 170 of whom were implanted with the Altius device, were randomized 1:1 to active-sham or treatment groups and reached the primary endpoint. Responders were those subjects who received ≥50% pain relief 30 min after treatment in ≥50% of their self-initiated treatment sessions within the 3-month randomized period.

Mobility Rates After Lower-Limb Amputation for Patients Treated with Physician-Led Collaborative Care Model.

Background: Clinical outcomes after major lower-limb amputation have been historically poor. The current care provided to most amputees is often disorganized and without physician supervision. The primary purpose of this study is to examine rates of postamputation mobility achieved with a prosthesis by patients with chronic limb-threatening ischemia and/or diabetes who required major lower-limb amputation and were treated under an established physician-led collaborative care pathway.

A cytochrome P450 insecticide detoxification mechanism is not conserved across the Megachilidae family of bees.

Recent work has demonstrated that many bee species have specific cytochrome P450 enzymes (P450s) that can efficiently detoxify certain insecticides. The presence of these P450s, belonging or closely related to the CYP9Q subfamily (CYP9Q-related), is generally well conserved across the diversity of bees. However, the alfalfa leafcutter bee, , lacks CYP9Q-related P450s and is 170-2500 times more sensitive to certain insecticides than bee pollinators with these P450s.

Head and Neck Ultrasound Utilization Rates: 2012 to 2019.

Objective: We measured utilization of clinician-performed head and neck ultrasound among otolaryngologists, endocrinologists, and general surgeons, using Medicare Provider Utilization and Payment Data.

Study Design: Retrospective analysis of Medicare billing database.

Setting: University.

A prospective evaluation of neck and shoulder function following treatments of early-stage human papillomavirus-associated oropharynx cancer.

Objectives: To compare post-treatment neck and shoulder function between human papillomavirus-associated oropharynx squamous cell carcinoma (HPV + OPSCC) treatments.

Design: Prospective, repeated-measures study.

Setting: Tertiary care center.

Prospective quality of life outcomes for human papillomavirus associated oropharynx cancer patients after surgery alone.

Purpose: To evaluate changes in patient-reported quality of life (QOL) to inform treatment decisions for human papillomavirus-associated oropharynx squamous cell carcinoma (HPV + OPSCC).

Materials And Methods: Patients with American Joint Committee on Cancer (AJCC) 8th edition cT0-T3 and cN0-N3 HPV + OPSCC treated with transoral robotic surgery to the primary site with neck dissection completed questionnaires prior to surgery and at three-months and one-year post-operatively. Questionnaires included four validated instruments: the University of Washington Quality of Life Questionnaire (UW-QOL), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Head and Neck Module (HN35), and the Neck Dissection Impairment Index (NDII).

A Case of Severe Multisystem Inflammatory Syndrome in Children (MIS-C) Treated with Multiple Biologics.

The COVID-19 virus has impacted global health on a wide scale, affecting humans of all ages and ethnicities. While most have mild upper respiratory viral symptoms, some have died due to severe pneumonia, acute respiratory distress syndrome (ARDS), or coagulopathies to mention a few. It has been postulated that the COVID-19 virus can initiate an autoinflammatory reaction in the body via multiple pathways of cytokine activation.

Management of the parotid for high-risk cutaneous squamous cell carcinoma: A review from the salivary section of the American Head and Neck Society.

Background: Metastases to the parotid nodal basin in patients with high-risk cutaneous squamous cell carcinoma (HRcSCC) impact disease specific survival (DSS) and overall survival (OS).

Methods: A writing group convened by the Salivary Section of the American Head and Neck Society (AHNS) developed contemporary, evidence-based recommendations regarding management of the parotid nodal basin in HRcSCC based on available literature, expert consultation, and collective experience. The statements and recommendations were then submitted and approved by the AHNS Salivary Committee.

Lower Eyelid Ectropion Secondary to Over-the-Counter Treatment of Xanthelasma.

Xanthelasmas are localized accumulations of lipids, mainly cholesterol, that can occur in the epidermis, dermis, and muscle of the eyelids. They are the most common cutaneous presentation of xanthoma and occur most commonly on the upper eyelid near the inner canthus. Despite their benign presence, xanthelasmas can be cosmetically concerning.

Evaluation of Staged TCAR and Cardiac Surgery or Structural Heart Intervention.

Introduction: The optimal treatment strategy for patients with concomitant carotid and cardiac disease remains controversial. Transcarotid artery revascularization stenting with reversed flow protection (TCAR) has achieved results equivalent to carotid endarterectomy (CEA) in high risk patients.

Methods: A retrospective review of all patients at a single center who received staged TCAR prior to cardiac intervention was performed.

Uncaptured rates of postpartum venous thromboembolism: a US national analysis.

Objective: To quantify the proportion of postpartum venous thromboembolism (VTE) readmissions, including those that occur at different hospitals from index admission, and describe risk factors for this outcome.

Design: Retrospective observational study.

Setting: US hospitals included in the Nationwide Readmissions Database.

Elevated neutrophil-lymphocyte ratios in extremely preterm neonates with histologic chorioamnionitis.

Objective: Histologic chorioamnionitis (HCA) is a placental inflammation linked to preterm birth and adverse neonatal outcome. The neutrophil-lymphocyte ratio (NLR) can identify various inflammatory disorders, however its utility in HCA is not clear. Our goal was to examine NLR values and HCA diagnoses in at-risk pregnancies and neonates.

Increased Risk of ACLF and Inpatient Mortality in Hospitalized Patients with Cirrhosis and Hepatic Hydrothorax.

Background: Hepatic hydrothorax (HH) remains a difficult-to-treat complication of cirrhosis.

Aim: To define the mortality, length of stay (LOS), and risk of ACLF in patients admitted with HH.

Methods: We utilized the North American Consortium for the Study of End-stage Liver Disease, a prospective cohort of 2868 non-electively hospitalized patients with cirrhosis from 14 tertiary care hepatology centers in North America.

Primary Melanoma of the Lacrimal Sac Treated With Pembrolizumab.

Primary melanoma of the lacrimal sac is a rare entity, with high mortality and a propensity for recurrence. This report details a patient with widely metastatic melanoma discovered after biopsy of abnormal lacrimal sac tissue during routine dacryocystorhinostomy. The patient subsequently underwent local excision and treatment with pembrolizumab.

Elevated Heart Rate and Survival in Children With Dilated Cardiomyopathy: A Multicenter Study From the Pediatric Cardiomyopathy Registry.

Background In adults with heart failure, elevated heart rate is associated with lower survival. We determined whether an elevated heart rate was associated with an increased risk of death or heart transplant in children with dilated cardiomyopathy. Methods and Results The study is an analysis of the Pediatric Cardiomyopathy Registry and includes baseline data, annual follow-up, and censoring events (transplant or death) in 557 children (51% male, median age 1.

Maternal trauma and fear history predict methylation and gene expression in newborns.

Trauma and related fear exert significant influence on mental and physical health throughout the lifespan and are associated with intergenerational patterns of development, health, and behavior. DNA methylation and gene expression are involved in our developmental adaptations to our experiences and can be influenced by social interventions. Patterns of DNA methylation and expression of a gene involved in neurodevelopment and psychiatric risk () have been linked with childhood trauma.

Enhancing group-based internet obesity treatment: A pilot RCT comparing video and text-based chat.

Objective: Internet delivery of behavioural weight control interventions offers potential for broad geographic reach and accessibility, but weight losses online fall short of those produced with the same programme delivered in-person. This pilot study examined feasibility and preliminary efficacy of a video-based platform for delivering weekly chat as part of a 6-month, 24-session online group behavioural weight control programme compared with the established text-based format, which has produced the best online weight losses to date.

Method: Women with obesity (N = 32) were randomized to either (a) weekly video group chat sessions and provided with a cellular-enabled scale (Video) or (b) Text-based weekly chat sessions and given a digital scale (Text) and followed for 6 months to determine weight loss and treatment engagement.

Expression of α-amylase in without antibiotics-resistant gene and effects of glycosylation on the enzymic thermostability.

Thermostable α-amylases are widely used in industry. The α-amylase from (BLA) with six potential glycosylation sites possessed excellent thermal and pH stability and high activity. Here, it was expressed in .

A Survey of the Complex General Surgical Oncology Fellowship Programs Regarding Applicant Selection and Rank.

Background: There is significant demand for training in Complex General Surgical Oncology (CGSO) fellowships. Previous work has explored objective quantitative metrics of applicants that matriculated to CGSO fellowships; however, ambiguity remains concerning academic benchmarks and qualitative factors that impact matriculation.

Study Design: A web-based survey was sent to each ACGME/SSO-approved CGSO fellowship training program.

Drug-Induced Sleep Endoscopy and Surgical Outcomes: A Multicenter Cohort Study.

Objective: To evaluate the association between findings of blinded reviews of preoperative drug-induced sleep endoscopy (DISE) examinations using the VOTE Classification and obstructive sleep apnea (OSA) surgical outcomes in a large multicenter, international cohort.

Methods: Retrospective, multi-center cohort study of adults without tonsillar hypertrophy who underwent pharyngeal surgery for OSA. The study included only participants without enlarged tonsils.