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INTRODUCTION: The relative citation ratio (RCR), a novel bibliometric tool supported by the National Institute of Health, provides a standardized approach to evaluate research productivity and impact across different fields. This study aims to evaluate RCR of fellowship-trained foot and ankle orthopaedic surgeons to analyze the influence of various surgeon demographics. METHODS: Fellow names listed on the American Orthopaedic Foot and Ankle Society website were extracted from the year 2008 to 2009 to the year 2022 to 2023...

Canonically, the complement system is known for its rapid response to remove microbes in the bloodstream. However, relatively little is known about a functioning complement system on intestinal mucosal surfaces. Herein, we report the local synthesis of complement component 3 (C3) in the gut, primarily by stromal cells. C3 is expressed upon commensal colonization and is regulated by the composition of the microbiota in healthy humans and mice, leading to an individual host's specific luminal C3 levels. The absence of membrane attack complex (MAC) components in the gut ensures that C3 deposition does not result in the lysis of commensals...

COVID-19 made explicit the need for rethinking the way in which we conduct testing for epidemic emergencies. During the COVID-19 pandemic, the dependence on centralized lab facilities and resource-intensive methodologies (e.g., RT-qPCR methods) greatly limited the deployment of widespread testing efforts in many developed and underdeveloped countries. Here, we illustrate the development of a simple and portable diagnostic kit that enables self-diagnosis of COVID-19 at home from saliva samples. We describe the development of a do-it-yourself (DIY) incubator for Eppendorf tubes that can be used to conduct SARS-CoV-2 detection with competitive sensitivity and selectivity from saliva at home...

Emphysematous osteomyelitis (EO) is an uncommon fatal condition with high morbidity and mortality. Simultaneous involvement of the axial and appendicular skeleton with multifocal disease is even rarer, with only a few cases being reported in the literature. We present a case of multifocal emphysematous osteomyelitis in a 56-year-old woman with concurrent emphysematous pyelonephritis complicated by psoas and epidural abscesses. The causative organism in our patient was Escherichia coli. Emergency radiologists should be aware of this condition and differentiate it from other benign entities that can present with intraosseous gas...

In drinking water chloramination, monochloramine autodecomposition occurs in the presence of excess free ammonia through dichloramine, the decay of which was implicated in N -nitrosodimethylamine (NDMA) formation by (i) dichloramine hydrolysis to nitroxyl which reacts with itself to nitrous oxide (N2 O), (ii) nitroxyl reaction with dissolved oxygen (DO) to peroxynitrite or mono/dichloramine to nitrogen gas (N2 ), and (iii) peroxynitrite reaction with total dimethylamine (TOTDMA) to NDMA or decomposition to nitrite/nitrate...

BACKGROUND: In patients with new-onset heart failure (HF), coronary artery disease (CAD) testing remains underutilized. Whether widespread CAD testing in patients with new-onset HF leads to improved outcomes remains to be determined. OBJECTIVE: We sought to examine whether CAD testing, and its timing, among patients hospitalized with new-onset HF with reduced ejection fraction (HFrEF), is associated with improved outcomes. DESIGN: Retrospective cohort study...

Background: Understanding interventions preceding death in children with immunocompromised conditions is important to ensure a peaceful and dignified perideath experience. The aim of this study was to describe the number of interventions performed in the pediatric intensive care unit (PICU) within the 48 hours before death in this population. Methods: This was a single-center, retrospective cohort study of all children with an underlying oncologic, hematologic, or immunologic diagnosis admitted to the PICU for at least 72 hours between 2014 and 2021...

This observational study was conducted to evaluate the effect of transition cow health on pregnancy per artificial insemination (P/AI) and pregnancy loss (PL) in cows submitted to a Double-Ovsynch protocol (DO) for first service. Lactating Holstein cows (n = 15,041) from one commercial dairy farm in northern Germany between January 2015 to December 2021 were enrolled into a modified Double-Ovsynch protocol (GnRH, 7 d later PGF2α , 3 d later GnRH, 7 d later GnRH, 7 d later PGF2α , 24 h later PGF2α , 32 h later GnRH, and 16 to 18 h later timed artificial insemination) for first service at 72 ± 3 d in milk...

BACKGROUND: The sagittal imbalance (SI) of spine triggers compensatory mechanisms (CMs) of lower extremity (LE) to restore trunk balance. These CMs can cause long-period stress on the femur and may possibly alter the femoral morphology. This cross-sectional observational study aimed to answer the following questions: (a) Do SI subjects exhibit greater femoral bowing compared to subjects with sagittal balance? (b) Are there associations between femoral bowing and CMs of LE in SI subjects? METHODS: Subjects who underwent biplanar full body radiographs with the EOS imaging system between January 2016 and September 2021 were recruited...

OBJECTIVE: Natural language processing (NLP) of clinical notes in electronic medical records is increasingly used to extract otherwise sparsely available patient characteristics, to assess their association with relevant health outcomes. Manual data curation is resource intensive and NLP methods make these studies more feasible. However, the methodology of using NLP methods reliably in clinical research is understudied. The objective of this study is to investigate how NLP models could be used to extract study variables (specifically: exposures) to reliably conduct exposure-outcome association studies...

Resorcinolic lipids are described as potential examples of selective chemotherapeutic adjuvants that can enhance the effects of cyclophosphamide ( CYC ) while promoting cell death without causing DNA damage. Therefore, the current study attempted to describe how the resorcinolic lipid methyl 3,5-dimethoxy-2-octanoylbenzoate ( AMS35BB ) interacted with DNA (DNA docking) and how this compound affected genetic toxicology models and other biological characteristics when combined with CYC . We observed that AMS35BB , used alone (7...

INTRODUCTION: The values and attitudes of healthcare professionals influence their handling of "do-not-attempt-resuscitation" (DNAR) orders, as does that of the families they interact with. The aim of this study was to describe attitudes, perceptions, and practices among community-based medical practitioners towards discussing cardiopulmonary resuscitation and DNAR orders with patients and their relatives, and to investigate if the COVID-19 pandemic affected their practice in having these discussions...

Cetaceans are well known for their unique behavioral habits, such as calls and tactics. The possibility that these are acquired through social learning continues to be explored. This study investigates the ability of a young beluga whale to imitate novel behaviors. Using a do-as-other-does paradigm, the subject observed the performance of a conspecific demonstrator involving familiar and novel behaviors. The subject: (1) learned a specific 'copy' command; (2) copied 100% of the demonstrator's familiar behaviors and accurately reproduced two out of three novel actions; (3) achieved full matches on the first trial for a subset of familiar behaviors; and (4) demonstrated proficiency in coping with each familiar behavior as well as the two novel behaviors...

Molecular chameleons possess a flexibility that allows them to dynamically shield or expose polar functionalities in response to the properties of the environment. Although the concept of molecular chameleons was introduced already in 1970, interest in them has grown considerably since the 2010s, when drug discovery has focused to an increased extent on new chemical modalities. Such modalities include cyclic peptides, macrocycles and proteolysis-targeting chimeras, all of which reside in a chemical space far from that of traditional small-molecule drugs...

The outer membrane vesicles (OMVs) secreted by some Gram-negative bacteria contain RNA cargo, which can be introduced into target cells, affecting their cellular processes. To test whether the antimicrobial OMVs secreted by predatory myxobacteria might contain cargo RNA with a role in prey killing, we purified OMVs and cells from four different strains of Myxococcus spp. for RNA-seq transcriptome sequencing. Myxobacterial OMVs contained distinct sets of RNA molecules. The abundance of major cellular transcripts correlated strongly with their abundance in OMVs, suggesting non-specific packaging into OMVs...

Large scale high-energy density science facilities continue to grow in scale and complexity worldwide. The increase in driver capabilities, including pulsed-power and lasers, continue to push the boundaries of temperature, pressure, and densities, opening up new physics regimes. X-ray imaging is one of the many diagnostic techniques that are used to probe states of matter in these extreme conditions. Improved fabrication and polishing methods have provided improved x-ray microscope performance, while improving detector and x-ray sources now enable pico-second imaging with few micron resolutions...

Elevated lipoprotein(a) [Lp(a)] is independently associated with cardiovascular disease (CVD). In a recent long-term follow-up study involving children with familial hypercholesterolemia, Lp(a) levels contributed significantly to early atherosclerosis, as measured by carotid intima-media thickness (cIMT). To determine if this holds true for children without FH, we conducted a 20-year follow-up study, examining 88 unaffected siblings (mean age: 12.9 years) of children with FH. No significant association was found between Lp(a) and cIMT during follow-up (ß-adjusted [95% CI] = 0...

BACKGROUND: Casting is routinely used in orthopaedics. Preventing a wet cast is crucial for maintaining structural integrity and reducing unwanted complications like unnecessary skin irritation/ulceration, bacterial overgrowth, and unnecessary emergency department visits. Using experimental models, studies have tested various contemporary methods to prevent a wet cast. One such study found that in comparison the most effective and cost-conscious approach was to use a Do-It-Yourself cast cover using a double-bag technique sealed with tape...

PURPOSE: This study aims to understand what is known about the high performing or exceptional learner in medical education. There is a rich literature about learners in difficulty, yet little is known about those performing at the high end, also known as exceptional learners. METHODS: A qualitative study was undertaken whereby 15 faculty members at the University of Toronto were interviewed to explore their experiences with these learners. RESULTS: Based on the findings, we developed a framework to categorize characteristics of exceptional learners by differentiating them as either 'Being' (a pre-existing attribute or set of values that the learner possesses from the start of training) or 'Doing' (demonstrable characteristics that can be observed or measured)...

AIM: To compare out-of-hospital cardiac arrest (OHCA) characteristics and outcomes between people aged ≥ 65 years who arrested in a residential aged care facility (RACF) versus a private residence in Perth, Australia. METHODS: We undertook a retrospective cohort study of OHCA cases attended by emergency medical services (EMS) in Perth, January 2018-December 2021. OHCA patient and event characteristics and survival outcomes were compared via univariate analysis...