A Critical Appraisal of the Application of Frailty and Sarcopenia in the Spinal Oncology Population.

Study Design: Systematic review and clinimetric analysis.

Objectives: Frailty and sarcopenia predict worse surgical outcomes among spinal degenerative and deformity-related populations; this association is less clear in the context of spinal oncology. Here, we sought to identify frailty and sarcopenia tools applied in spinal oncology and appraise their clinimetric properties.

What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?

Study Design: Systematic review.

Objective: In patients with extradural metastatic spine disease, we sought to systematically review the outcomes and complications of patients with intermediate Spinal Instability Neoplastic Score (SINS) lesions undergoing radiation therapy, percutaneous interventions, minimally invasive surgeries, or open spinal surgeries.

Methods: Following PRISMA guidelines for systematic reviews, MEDLINE, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews and the Cochrane Center Register of Controlled Trials were queried for studies that reported on SINS intermediate patients who underwent: 1) radiotherapy, 2) percutaneous intervention, 3) minimally invasive, or 4) open surgery.

Lumpectomy Patients are at Highest Risk for Opioid Overprescription: A Comparison Between Practice Patterns and OPEN National Guidelines.

Background: Nearly 25% of opioid-related deaths are from prescribed opioids, and the exacerbation of the opioid epidemic by the coronavirus disease 2019 (COVID-19) pandemic underscores the urgent need to address superfluous prescribing. Therefore, we sought to align local opioid prescribing practices with national guidelines in postoperative non-metastatic breast cancer patients.

Methods: A single-institution analysis included non-metastatic breast surgery patients treated between April 2020 and July 2021.

Examining the effect of direct-from-blood bacterial testing on antibiotic administration and clinical outcomes: a protocol and statistical analysis plan for a pragmatic randomised trial.

Introduction: Patients with suspected bacterial infection frequently receive empiric, broad-spectrum antibiotics prior to pathogen identification due to the time required for bacteria to grow in culture. Direct-from-blood diagnostics identifying the presence or absence of bacteria and/or resistance genes from whole blood samples within hours of collection could enable earlier antibiotic optimisation for patients suspected to have bacterial infections. However, few randomised trials have evaluated the effect of using direct-from-blood bacterial testing on antibiotic administration and clinical outcomes.

Use of continuous glucose monitoring and point-of-care glucose testing in hospitalized patients with diabetes mellitus in non-intensive care unit settings: A systematic review and meta-analysis of randomized controlled trials.

The benefits of using continuous glucose monitoring (CGM) in hospitalized patients with diabetes remain uncertain. Point-of-care (POC) glucose testing is the standard of care in this setting. We compared the effect of adding CGM to POC testing versus POC testing alone on glycemic outcomes in this population.

State of the Art in Left Atrial Appendage Occlusion.

Left atrial appendage occlusion (LAAO) has become an important therapeutic target for stroke prevention in patients with nonvalvular atrial fibrillation. Over the past 2 decades, several advancements in LAAO devices (percutaneous and surgical) have been made for stroke prevention and arrhythmia therapy. However, there are several unanswered questions regarding optimal patient selection, the preferred LAAO approach and device, the management of periprocedural and postprocedural complications, including pericardial effusion, device-related thrombus, and device leaks.

Recent Orthopedic Trauma Volume in the United States Military Health System.

Introduction: As illustrated by the "Walker Dip," there is growing concern regarding the lack of combat casualty care during peacetime. Surgical volume and case complexity are paramount for training and skill sustainment. We sought to quantify the recent orthopedic trauma surgical case load of all military orthopedic surgeons across the Military Health System (MHS).

Long-term neurobehavioral and neuroimaging outcomes in athletes with prior concussion(s) and head impact exposure.

The long-term health of former athletes with a history of multiple concussions and/or repetitive head impact (RHI) exposure has been of growing interest among the public. The true proportion of dementia cases attributable to neurotrauma and the neurobehavioral profile/sequelae of multiple concussion and RHI exposure among athletes has been difficult to determine. Across three exposure paradigms (i.

Association of Enhanced Recovery After Surgery (ERAS) with textbook outcomes among patients undergoing surgery for rectal cancer.

Background: Surgical resection is the cornerstone of rectal cancer treatment but can be associated with adverse short-term postoperative outcomes. We sought to assess the factors associated with achievement of optimal outcomes among patients undergoing surgery for rectal cancer.

Methods: In this multicenter retrospective cohort study, the US Rectal Cancer Consortium database was used to identify patients who underwent surgery for nonmetastatic rectal cancer between 2007 and 2018.

Validating the Fluctuating Mental Status Evaluation in Neurocritically Ill Patients With Acute Stroke.

Objectives: Neurocritically ill patients are at high risk for developing delirium, which can worsen the long-term outcomes of this vulnerable population. However, existing delirium assessment tools do not account for neurologic deficits that often interfere with conventional testing and are therefore unreliable in neurocritically ill patients. We aimed to determine the accuracy and predictive validity of the Fluctuating Mental Status Evaluation (FMSE), a novel delirium screening tool developed specifically for neurocritically ill patients.

The coronavirus nsp14 exoribonuclease interface with the cofactor nsp10 is essential for efficient virus replication and enzymatic activity.

Coronaviruses (CoVs) encode non-structural proteins (nsp's) 1-16, which assemble to form replication-transcription complexes that function in viral RNA synthesis. All CoVs encode a proofreading 3'-5' exoribonuclease in non-structural protein 14 (nsp14-ExoN) that mediates proofreading and high-fidelity replication and is critical for other roles in replication and pathogenesis. The enzymatic activity of nsp14-ExoN is enhanced in the presence of the cofactor nsp10.

Evaluation of piperacillin-tazobactam disks using contemporary Enterobacterales isolates suggests the need for disk potency optimization.

Unlabelled: Piperacillin-tazobactam (TZP) is a commonly used broad-spectrum agent. OXA-1 β-lactamases drive global Enterobacterales TZP resistance and raise MICs to the clinical breakpoints (8/4-16/4 µg/mL), making susceptibility testing challenging. Two TZP disks are used globally.

Sternal Reconstruction for Refractory Pectus Excavatum From Facioscapulohumeral Muscular Dystrophy.

A 44-year-old man with a history of facioscapulohumeral muscular dystrophy and pectus excavatum presented with multiyear history of progressive, severe respiratory dysfunction, pain, recurrent respiratory infection, and chest wall deformity. With bioprosthetic engineers, the surgical team customized a 3-dimensional printed model of a sternal implant interacting with the patient's anatomy. After approval from the Food and Drug Administration, the customized sternal plates were created and implanted in a sternal reconstruction operation.

Expert advice from ResearchMatch volunteers: Recruitment Innovation Center use cases and innovation.

Involving participants in the design of clinical trials should improve the overall success of a study. For this to occur, streamlined mechanisms are needed to connect the populations potentially impacted by a given study or health topic with research teams in order to inform trial design in a meaningful and timely manner. To address this need, we developed an innovative mechanism called the "ResearchMatch Expert Advice Tool" that quickly obtains volunteer perspectives from populations with specific health conditions or lived experiences using the national recruitment registry, ResearchMatch.

The Population-Based Incidence and Prevalence of Catatonia.

Objective: Catatonia is a neuropsychiatric disorder that is associated with a range of medical and psychiatric illnesses. Although many single-center studies have been conducted, uncertainty over the population-based incidence and prevalence of the disorder remains. This study reports on the incidence and prevalence rates of catatonia extrapolated from two large epidemiologic studies in the United Kingdom and United States.

Chronic cigarette smoke exposure masks pathological features of Helicobacter pylori infection while promoting tumor initiation.

Gastric cancer is the fifth most common cancer and the fifth leading cause of cancer deaths worldwide. Chronic infection by the bacterium Helicobacter pylori is the most prominent gastric cancer risk factor, but only 1-3% of infected individuals will develop gastric cancer. Cigarette smoking is another independent gastric cancer risk factor, and H.

A socioecological model of neighborhood disorder, religious attendance, and sleep efficiency.

Objectives: Drawing on the socioecological model of sleep health, we formally examine the association between neighborhood disorder and sleep efficiency. While most studies focus on direct associations with neighborhood context, we also consider whether the relationship between religious attendance and sleep efficiency varies as a function of neighborhood disorder.

Design: We use ordinary least squares regression to model cross-sectional survey data.

Effectiveness of shared decision making strategies for stroke prevention among patients with atrial fibrillation: cluster randomized controlled trial.

Objective: To evaluate the effectiveness of multiple decision aid strategies in promoting high quality shared decision making for prevention of stroke in patients with non-valvular atrial fibrillation.

Design: Cluster randomized controlled trial.

Setting: Six academic medical centers in the United States.

Dysregulation of Airway and Systemic Interferon Responses Promote Asthma Exacerbations in Urban Children.

Background: Determining why some upper respiratory illnesses provoke asthma exacerbations remains an unmet need.

Objective: To identify transcriptome-wide gene expression changes associated with colds that progress to exacerbation.

Methods: 208 urban children (6-17 years) with exacerbation-prone asthma were prospectively monitored for up to two cold illnesses.

The pathobiology of neurovascular aging.

As global life expectancy increases, age-related brain diseases such as stroke and dementia have become leading causes of death and disability. The aging of the neurovasculature is a critical determinant of brain aging and disease risk. Neurovascular cells are particularly vulnerable to aging, which induces significant structural and functional changes in arterial, venous, and lymphatic vessels.