Outpatient Total Knee Arthroplasty Has Become More Frequent Since the Onset of the COVID-19 Pandemic Without an Increase in Early Post-Operative Complications.

Introduction: Outpatient total knee arthroplasty (TKA) has quickly grown in popularity, largely driven by policy shifts and the recent coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to compare 30-day complications between outpatient TKA (oTKA) versus inpatient TKA (iTKA) before and after the COVID-19 pandemic to elucidate the effect of the pandemic on utilization and short-term outcomes.

Methods: Patients who underwent primary TKA between 2008 and 2021 were identified through Current Procedural Terminology codes in a national database.

Sequence variants in HECTD1 result in a variable neurodevelopmental disorder.

Dysregulation of genes encoding the homologous to E6AP C-terminus (HECT) E3 ubiquitin ligases has been linked to cancer and structural birth defects. One member of this family, the HECT-domain-containing protein 1 (HECTD1), mediates developmental pathways, including cell signaling, gene expression, and embryogenesis. Through GeneMatcher, we identified 14 unrelated individuals with 15 different variants in HECTD1 (10 missense, 3 frameshift, 1 nonsense, and 1 splicing variant) with neurodevelopmental disorders (NDDs), including autism, attention-deficit/hyperactivity disorder, and epilepsy.

Extracellular volume expansion drives vertebrate axis elongation.

The vertebrate bauplan is primarily established via the formation of embryonic tissues in a head-to-tail progression. The mechanics of this elongation, which requires the presomitic mesoderm (PSM), remain poorly understood. Here, we find that avian PSM explants can elongate autonomously when physically confined in vitro, producing a pushing force promoting posterior elongation of the embryo.

Development of a predictive model for pediatric intranasal drug delivery with nasal sprays: Leveraging intersubject variability in anatomical dimensions, administration-related parameters, and airway patency.

In this study, we examined the correlation between anatomical dimensions, spray administration parameters, pressure drop across 40 pediatric nasal cavities, and in vitro posterior drug delivery (PDD) using Nasacort ALLERGY 24HR and FLONASE SENSIMIST nasal suspensions sprays, with different nozzle and actuation designs. The importance of each parameter and their interaction in the outcome (PDD) was evaluated. To do so, initially we measured anatomical and administration-related parameters, and the pressure drop of each cavity.

An In-Depth Analysis of the State Laws That License International Medical Graduates Without American Residency Training.

International medical graduates (IMGs) have been integral to the United States (US) healthcare system and have helped tackle physician shortages for over a century. Current data suggest that by 2030, almost half the states will suffer from physician shortage and estimate a deficit of almost 139,000 physician jobs nationally. These numbers raise concern and call for innovative strategies to mitigate the potential problem.

Safety and Efficacy of Fingolimod and Ocrelizumab in Pediatric Patients With Multiple Sclerosis.

Background: Fingolimod and ocrelizumab are approved treatments for adults with multiple sclerosis (MS); however, only fingolimod is approved by the Food and Drug Administration for the treatment of pediatric MS. Currently, there are limited data for the safety and efficacy of ocrelizumab use in children.

Methods: This retrospective cohort study included patients with relapsing-remitting MS who started either ocrelizumab or fingolimod before age 18 years.

A family-based behavioral group obesity randomized control feasibility trial across a clinical trials network: a focus on contact hours.

Objective: This ancillary study's purpose is to describe the relationship between dose of treatment and body mass index (BMI) outcomes in a tele-behavioral health program delivered in the IDeA States Pediatric Clinical Trials Network to children and their families living in rural communities.

Methods: Participants randomized to the intervention were able to receive 26 contact hours (15 hr of group sessions and 11 hr of individual sessions) of material focused on nutrition, physical activity, and behavioral caregiver training delivered via interactive televideo. Dose of the intervention received by child/caregiver dyads (n = 52) from rural areas was measured as contact hours.

New PPARα Agonist A190-Loaded Microemulsion for Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a serious side effect of anticancer agents with limited effective preventive or therapeutic interventions. Although fenofibrate, a peroxisome proliferator-activated receptor-alpha (PPARα) agonist, has demonstrated neuroprotective and analgesic properties, its clinical utility is hindered by low receptor affinity, poor subtype selectivity, and suboptimal bioavailability. A190, a highly selective and potent nonfibrate PPARα agonist, offers a promising alternative but is limited by poor aqueous solubility, resulting in reduced oral bioavailability and therapeutic efficacy.

Program Director Perspectives on DEI Initiatives in the Dermatology Residency Selection Process.

The American Academy of Dermatology (AAD) has maintained a commitment to diversity, equity, and inclusion (DEI) initiatives; however, a recent strike down of affirmative action by the US Supreme Court has caused similar efforts to be called into question. This prompted our investigation into dermatology program director (PD) perceptions of DEI programming and its integration into resident selection. A cross-sectional survey of PDs at US dermatology residency programs was conducted from April 2024 to July 2024 (N=30).

Upper Limit on the Photoproduction Cross Section of the Spin-Exotic π_{1}(1600).

The spin-exotic hybrid meson π_{1}(1600) is predicted to have a large decay rate to the ωππ final state. Using 76.6  pb^{-1} of data collected with the GlueX detector, we measure the cross sections for the reactions γp→ωπ^{+}π^{-}p, γp→ωπ^{0}π^{0}p, and γp→ωπ^{-}π^{0}Δ^{++} in the range E_{γ}=8-10  GeV.

Heavy Neutral Leptons via Axionlike Particles at Neutrino Facilities.

Heavy neutral leptons (HNLs) are often among the hypothetical ingredients behind nonzero neutrino masses. If sufficiently light, they can be produced and detected in fixed-target-like experiments. We show that if the HNLs belong to a richer-but rather generic-dark sector, their production mechanism can deviate dramatically from expectations associated with the standard-model weak interactions.

A Commitment to Gender Equity in Medicine: An American Medical Women's Association Position Paper.

The American Medical Women's Association (AMWA) highlights the ongoing gender inequities in the medical profession, particularly in pay, leadership roles, workplace treatment, and work-life integration. To present evidence of gender disparities in medicine, analyze their root causes, and propose strategies for fostering a more equitable and inclusive environment. Despite progress, women physicians continue to face significant disparities, including lower salaries, underrepresentation in leadership roles, and discrimination.

Laterality and performance in elite male golfers.

Human beings display laterilised behaviour. In sport, including golf, players adopt a right- or left-handed stance. There may be advantages in going against convention in the position of the dominant hand relative to golf stance.

Craniofacial modularity and the evolution of cranial kinesis in the adaptive radiation of Furnariidae (Aves: Passeriformes).

The role of phenotypic modularity in the evolution of skull morphology in birds has been a subject of debate in recent years. Furnariids (ovenbirds and woodcreepers), a spectacular avian adaptive radiation, are distinguished in their cranial morphology as the only passerines with two types of cranial kinesis, constituting a great model to test whether the evolution of novelties linked to kinesis was associated with shifts in patterns of evolutionary modularity and allometry in the avian skull. Our analyses by means of geometric morphometric tools and phylogenetic comparative methods show that the beak and neurocranium of furnariids evolved in a modular fashion and shaped by the cranial kinesis evolution.

Satellite Observations of Atmospheric Ammonia Inequalities Associated with Industrialized Swine Facilities in Eastern North Carolina.

Industrialized swine facilities adversely affect the health and well-being of Eastern North Carolina residents in the U.S. and are an issue of environmental racism.

Refractory Psychosis as a Red Flag for End of Life in Individuals With Dementia With Lewy Bodies: A Case Series and Re-analysis of Prior Qualitative Data.

Objectives: Many individuals with dementia with Lewy bodies (DLB) die of disease-related complications, but predicting the end of life can be challenging. We identified a phenotype associated with approaching end of life.

Methods: We present 4 exemplar cases where individuals with DLB experienced refractory psychosis before death.

Accessing Different Protein Conformer Ensembles with Tunable Capillary Vibrating Sharp-Edge Spray Ionization.

Capillary vibrating sharp-edge spray ionization (cVSSI) has been used to control the droplet charging of nebulized microdroplets and monitor effects on protein ion conformation makeup as determined by mass spectrometry (MS). Here it is observed that the application of voltage results in noticeable differences to the charge state distributions (CSDs) of ubiquitin ions. The data can be described most generally in three distinct voltage regions: Under low-voltage conditions (<+200 V, LV regime), low charge states (2+ to 4+ ions) dominate the mass spectra.

Retropharyngeal effusion secondary to calcific tendinitis of the longus colli muscle: A case report and brief review of the literature.

Calcification or ossification of the longus colli tendon is a rare and often underdiagnosed cause of acute neck pain, typically seen in middle-aged adults, especially women. This condition results from the deposition of calcium hydroxyapatite crystals in the tendon, causing an inflammatory or granulomatous response. Common symptoms include neck pain, painful swallowing, and fever.

Brain receptor dynamics in early and adult life stress: Gateways to maladaptive coping strategies.

Stress plays a significant role in the onset of numerous psychiatric disorders. Depending on individual resilience or stressor's nature, long-term changes to stress in the brain can lead to a wide range of behavioral symptoms, including social withdrawal, feelings of helplessness, and emotional overeating. The brain receptor molecules are key mediators of these processes, translating neuromodulatory signals into neuronal responses or circuit activity changes that ultimately shape behavioral outcomes.

Clustering Sequence Data with Mixture Markov Chains with Covariates Using Multiple Simplex Constrained Optimization Routine (MSiCOR).

Mixture Markov Model (MMM) is a widely used tool to cluster sequences of events coming from a finite state-space. However, the MMM likelihood being multi-modal, the challenge remains in its maximization. Although Expectation-Maximization (EM) algorithm remains one of the most popular ways to estimate the MMM parameters, however, convergence of EM algorithm is not always guaranteed.

Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study.

Background: Sociocultural and behavioral factors have a multifaceted impact on maternal health. In Thailand, cultural influences significantly shape behaviors of diabetes self-management in women. However, the experience of self-managing diabetes in pregnant women with preexisting Type 2 Diabetes Mellitus (T2DM) remains unclear.