Modifications to the Geriatric Nutritional Risk Index Predicts Complications after Total Joint Arthroplasty.

Background: Preoperative malnutrition is a known risk factor for postoperative complications following total joint arthroplasty (TJA), however, there is scant literature comparing which nutritional index is best at predicting these outcomes. The purpose of this study was to investigate the utility of the Maastricht Index (MI), Onodera's Prognostic Index (OPNI), the Geriatric Nutritional Risk Index (GNRI), and a novel, modified Geriatric Nutritional Risk Index (mGNRI) in predicting periprosthetic joint infection (PJI), wound complications (WC), readmission, and reoperation rates after TJA.

Methods: A single-center, retrospective cohort study was performed of patients who underwent primary TJA from January 2016 to December 2021.

Pegylated solid lipid nanoparticles for the intranasal delivery of combination antiretroviral therapy composed of Atazanavir and Elvitegravir to treat NeuroAIDS.

Intranasal drug administration offers a promising strategy for delivering combination antiretroviral therapy (cART) directly to the central nervous system to treat NeuroAIDS, leveraging the nose-to-brain route to bypass the blood-brain barrier. However, challenges such as enzymatic degradation in the nasal mucosa, low permeability, and mucociliary clearance within the nasal cavity must first be addressed to make this route feasible. To overcome these barriers, this study developed solid lipid nanoparticles (SLNs) with varying PEGylation levels (0 %, 5 %, 10 %, and 15 % w/w of PEGylated lipid), co-encapsulated with Elvitegravir (EVG) and Atazanavir (ATZ) as an integrase and protease inhibitor, respectively.

Spectral heat flux redistribution upon interfacial transmission.

In nonmetallic crystals, heat is transported by phonons of different frequencies, each contributing differently to the overall heat flux spectrum. In this study, we demonstrate a significant redistribution of heat flux among phonon frequencies when phonons transmit across the interface between dissimilar solids. This redistribution arises from the natural tendency of phononic heat to re-establish the bulk distribution characteristic of the material through which it propagates.

Sternum drop as a kinematic measure of trip recovery performance.

Deficient trip recovery kinematics have been implicated in many trip-induced falls. Three key requisites for successful trip recovery include limiting trunk flexion, maintaining adequate hip height to enable repeated stepping, and completing recovery steps to extend the base of support. The purpose of this study was to evaluate sternum drop as a new measure of trip recovery performance.

Evaluation of Generative Artificial Intelligence Models in Predicting Pediatric Emergency Severity Index Levels.

Objective: Evaluate the accuracy and reliability of various generative artificial intelligence (AI) models (ChatGPT-3.5, ChatGPT-4.0, T5, Llama-2, Mistral-Large, and Claude-3 Opus) in predicting Emergency Severity Index (ESI) levels for pediatric emergency department patients and assess the impact of medically oriented fine-tuning.

A Systematic Literature Review on School-Based Speech-Language Pathology Collaboration Research.

Purpose: School-based teams are called to be collaborative in order to appropriately and effectively serve students. Speech-language pathologists play crucial roles on school-based teams. This systematic review sought to synthesize existing empirical evidence on collaborative perceptions and experiences in research that included school-based speech-language pathologists (SLPs).

Highly Stereo- and Enantioselective Syntheses of δ-Alkyl-Substituted ()-Homoallylic Alcohols.

Highly stereo- and enantioselective synthesis of δ-alkyl-substituted ()-homoallylic alcohols via asymmetric allylation is developed. In the presence of a chiral phosphoric acid catalyst, allylation of aldehydes with α-substituted allylboronates provides δ-alkyl-substituted homoallylic alcohols with excellent ()-selectivities and enantioselectivities.

A qualitative analysis of PA leaders in Kentucky.

Objective: To describe Kentucky's physician associate/assistant (PA) leadership pathway and provide advice for individual leadership trajectories.

Methods: A qualitative study using semistructured interviews and inductive coding methodology to identify themes of PA leaders.

Results: Participants were primarily female (76.

Synthesis, Structure, and Reactivity of Copper(I) Proazaphosphatrane Complexes.

Copper(I) complexes of isobutyl- () and isopropyl-substituted () proazaphosphatranes have been synthesized. Structural and computational studies of a series of monomeric complexes CuX (X = Cl, Br, I) and dimeric [CuCl] provide insight into the transannulation within and steric properties of the proazaphosphatrane ligand. These halide complexes are competent precatalysts in a model borylation reaction, and the silylamido complex CuN(TMS) catalyzes hydrosilylation of benzaldehyde under mild conditions.

Virtual Reality Training to Reduce Workplace Violence in Healthcare.

Violence against nurses and other healthcare workers is a significant and escalating concern, impeding the provision of safe and effective healthcare services. A majority of nurses experience some kind of violence, including physical and nonphysical assaults during their careers. The consequences of workplace violence extend beyond individual trauma, leading to increased burnout, turnover, and significant financial costs for healthcare systems.

EUS-Guided Gastroenterostomy for Benign Gastric Outlet Obstruction: A Systematic Review and Meta-analysis.

Background And Aims: Gastric outlet obstruction (GOO) is a clinical manifestation of mechanical obstruction at the antropyloric region or proximal small bowel. The goal of endoscopic management is to relieve the obstruction so patients can resume per oral intake. Most studies have focused on malignant causes of GOO; yet only a handful have explored outcomes related to benign etiologies.

Impact of COVID-19 Diagnosis on Weight Trajectories of Children in the US National COVID Cohort Collaborative.

The COVID-19 pandemic has exacerbated the obesity epidemic, with both adults and children demonstrating rapid weight gain during the pandemic. However, the impact of having a COVID-19 diagnosis on this trend is not known. Using longitudinal data from January 2019 to June 2023 collected by the US National Institute for Health's National COVID Cohort Collaborative (N3C), children (age 2-18 years) with positive COVID-19 test results { = 11,474, 53% male, mean [standard deviation (SD)] age 5.

Impact of Post-Traumatic Epilepsy on Mental Health and Multidimensional Outcome and Quality of Life: An NIDILRR TBIMS Study.

Traumatic brain injury (TBI) and subsequent post-traumatic epilepsy (PTE) often impair daily activities and mental health (MH), which contribute to long-term TBI-related disability. PTE also affects driving capacity, which impacts functional independence, community participation, and satisfaction with life (SWL). However, studies evaluating the collective impact of PTE on multidimensional outcomes are lacking.

Fluorous-Phase- and Chiral-Axis-Enhanced Fluorescent Sensitivity and Chemoselectivity for Cysteine Recognition.

Highly fluorinated naphthyl aldehyde and binaphthyl aldehyde ()- were designed and synthesized for fluorous-phase-based sensing. Greatly enhanced sensitivity and chemoselectivity in going from to ()- in the fluorescent detection of cysteine has been discovered. This is attributed to the increased structural rigidity of the axially chiral binaphthyl unit in ()- upon reaction with cysteine to form the corresponding thiazolidine product.

Fluoride Exposure and Children's IQ Scores: A Systematic Review and Meta-Analysis.

Importance: Previous meta-analyses suggest that fluoride exposure is adversely associated with children's IQ scores. An individual's total fluoride exposure comes primarily from fluoride in drinking water, food, and beverages.

Objective: To perform a systematic review and meta-analysis of epidemiological studies investigating children's IQ scores and prenatal or postnatal fluoride exposure.

Priority Clinical Actions for Outpatient Management of Nonhospitalized Traumatic Brain Injury.

Outpatient care following nonhospitalized traumatic brain injury (TBI) is variable, and often sparse. The National Academies of Sciences, Engineering, and Medicine's 2022 report on highlighted the need to improve the consistency and quality of TBI care in the community. In response, the present study aimed to identify existing evidence-based guidance and specific clinical actions over the days to months following nonhospitalized TBI that should be prioritized for implementation in primary care.

Use of Supplemental Rod Constructs in Adult Spinal Deformity Surgery: A Review.

Adult spinal deformity comprises a heterogeneous group of disorders that primarily affects older patients and can have a significant negative affect on health-related quality of life. Operative treatment for adult spinal deformity typically entails posterior instrumented fusions that have demonstrated the potential to significantly improve health-related quality of life outcomes. However, until fusion is achieved, the instrumentation providing structural support is subject to repetitive cyclical loading that disproportionately fatigues high-stress areas and can result in instrumentation failure.

The Influence of Parental Social-Emotional Competencies on Intergenerational Child Maltreatment: A Scoping Review.

Child maltreatment is a major public and global health issue with well-documented intergenerational patterns. Social-emotional development, which is detrimentally impacted by child maltreatment, has been associated with parenting behaviors and implicated as a mechanism of intergenerational transmission of child maltreatment. This scoping review sought to synthesize information on the social-emotional skills that contribute to or protect against intergenerational maltreatment.

Human Growth Hormone (GH) use by Athletes with Short Stature without GH Deficiency: Therapeutic Use Exemptions.

Organized sports are governed by specific rules which aim to create or preserve fair play. An unfair advantage can be obtained by the use of specific substances or methods, also referred to as doping. The World Anti-Doping Agency (WADA) leads the international doping-free sport movement and annually publishes the List of Prohibited Substances and Methods (List), that is used by most sport federations and organizations around the world.

Patterns in mortality associated with heart failure and lung cancer among older adults in the United States: An analysis of 20 years.

Background: Despite an established association between heart failure (HF) and lung cancer (LC), there is limited evidence available regarding mortality patterns among the older (≥65 years) population in the United States.

Methods: The mortality data, spanning 1999 to 2019, was surveyed using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database with HF and LC identified as underlying or contributing causes of death. Crude and age-adjusted mortality rates (AAMR) were calculated per 100,000 individuals.