Emperical

Free-living amoebae (FLA) rarely cause human infections but can invoke fatal infections in the central nervous system (CNS). No consensus treatment has been established for FLA infections of the CNS, emphasizing the urgent need to discover or develop safe and effective drugs. Flavonoids, natural compounds from plants and plant-derived products, are known to have antiprotozoan activities against several pathogenic protozoa parasites. The anti-FLA activity of flavonoids has also been proposed, while their antiamoebic activity for FLA needs to be emperically determined...

Preiser's disease, also known as avascular necrosis of the scaphoid, is a rare condition that is incompletely understood in regard to pathophysiology, diagnosis, and management. There have been numerous case reports and case series evaluating a variety of conservative and operative interventions, but optimal treatment has not been well established. We describe the case of a 20-year-old female with stage II Preiser's disease that was managed with a vascularized bone graft from the 1,2 intercompartmental supraretinacular artery, in addition to temporary dorsal wrist-spanning bridge plate fixation...

OBJECTIVES: (1) Generate empirical knowledge of a Musculoskeletal (MSK) Advanced Practice Physiotherapist (APP) Service in Scottish Primary Care; (2) Identify the incidence and baseline time to diagnosis of Axial Spondyloarthropathy (AxSpA); (3) Identify APP Rheumatology referral fulfilment of the NICE 2017 Guidelines and Spondylarthritis Diagnosis Evaluation (SPADE) Tool; (4) Calculate APP Rheumatology referral conversion rates for AxSpA diagnosis and further investigation; (5) Contribute towards the current body of literature for informing analysis of MSK APP services within Scottish Primary Care...

Aggrecan (ACAN) is localized in the intervertebral disc (IVD) in unique compartment-specific patterns where it contributes to the tissue structure and mechanical function together with collagens. The extracellular matrix (ECM) of the IVD undergoes degenerative changes during aging, misuse or trauma, which inevitably alter the biochemical and biomechanical properties of the tissue. A deeper understanding of these processes can be achieved in genetically engineered mouse models, taking into account the multifaceted aspects of IVD development...

BACKGROUND: Despite the high prevalence of rotator cuff (RTC) tears in older adults, there is limited literature evaluating the return to recreational sport after repair. The purpose of this study was (1) to assess the patient-reported outcomes and return to sport rates following rotator cuff repair in patients aged more than 40 years with minimum 2-year follow-up; (2) to compare baseline, preoperative and postoperative outcomes, and level of play following repair of self-reported athletes with nonathletes; and (3) to compare return to sport rates in overhead athletes compared to nonoverhead athletes...

To date, numerous nucleotide, amino acid, and codon substitution models have been developed to estimate the evolutionary history of any sequence/organism in a more comprehensive way. Out of these three, the codon substitution model is the most powerful. These models have been utilized extensively to detect selective pressure on a protein, codon usage bias, ancestral reconstruction and phylogenetic reconstruction. However, due to more computational demanding, in comparison to nucleotide and amino acid substitution models, only a few studies have employed the codon substitution model to understand the heterogeneity of the evolutionary process in a genome-scale analysis...

Introduction Diversion of unused prescription opioids is a common source of opioid sensitization in the community. Educating patients about safe opioid use has been shown to be effective in decreasing opioid use. However, decreasing diversion will also require educating patients on proper opioid disposal. A survey was administered to better understand patients' habits with opioid disposal for opioids prescribed after orthopedic surgery. Methods A cross-sectional survey study of 469 patients who had undergone orthopedic surgery was conducted to learn their preferences and habits regarding the disposal of unused prescription opioids received after orthopedic surgery...

Literature on adverse events (AEs) after outpatient orthopedic surgery is relatively sparse, and efforts to detect, measure, and track AEs after outpatient surgery lag behind those for the inpatient setting. Detection of AEs has traditionally relied on patient safety indicators (from billing data) and self-reporting, but these methods have been shown to have low sensitivity, missing up to 90% of AEs. There is growing recognition that the trigger method, which uses "triggers" as red flags to initiate more detailed chart audits, can serve as a more sensitive alternative to detect AEs...

INTRODUCTION: Bronchoalveolar lavage (BAL) and body cavity fluids (pleural and peritoneal) have a useful role in the detection of infectious diseases, especially when combined with ancillary stains (Grocott methenamine silver, acid-fast bacilli, Fite, and cytomegalovirus). However, empirical ordering of stains and duplicate testing by concurrent microbiology cultures leads to unnecessary wastage of resources. The aim of our study was to optimize the use of resources. MATERIALS AND METHODS: We performed a retrospective review of all BALs and body cavity fluids from 2016 to 2018 to determine the baseline stain order rate, which was then used in conjunction with clinical information to create a reasonable target for 2019...

Plant biomass and yield are largely dictated by the total amount of light intercepted by the plant (daily light integral (DLI)-intensity × photoperiod). It is more economical to supply the desired DLI with a long photoperiod of low-intensity light because it uses fewer light fixtures, reducing capital costs. Furthermore, heat released by the light fixtures under a long photoperiod extended well into the night helps to meet the heating requirement during the night. However, extending the photoperiod beyond a critical length (>17 h) may be detrimental to production and lead to leaf chlorosis and a reduction in leaf growth and plant vigor in greenhouse tomato production...

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies. Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability...

The objective of this study was to investigate the effect of standardized preoperative opioid counseling on postoperative opioid consumption for patients undergoing outpatient lower extremity orthopaedic surgery. Participating patients undergoing elective outpatient lower extremity orthopaedic surgery were randomized to either receive preoperative opioid counseling or not receive counseling (control group). Counseling was delivered via a five-minute pre-recorded standardized video preoperatively. Postoperatively, patients in both groups were queried for their postoperative pain experience, opioid consumption, non-opioid medication consumption, and any adverse effects related to their pain management experience...

Background: Meniscal tears are a common knee injury. Isolated meniscal tears are less common; however, unaddressed tears can be troublesome, particularly for athletes. There is currently a lack of data in the literature on athletes returning to play after isolated meniscal repair. Purpose: To evaluate the return to play rate and time to return to play for athletes with isolated meniscal injuries. Study Design: Systematic review; Level of evidence, 4...

BACKGROUND: Various foods are known to have beneficial effects on health when consumed whole; however, there is a trend towards preparing foods from processed ingredients, and it remains unclear whether the benefits of the whole food are retained. The purpose of this study was therefore to examine whether different processing techniques affect the lowering of cholesterol and the vascular effects of black beans (Phaseolus vulgaris L.). RESULTS: Beans were prepared by overnight soaking and boiling - the standard method - and by micronization, extrusion, or dehulling and boiling, and they were then fine milled...

BACKGROUND: An increasing number of youth baseball athletes are specializing in playing baseball at younger ages. PURPOSE: The purpose of our study was to describe the age and prevalence of single-sport specialization in a cohort of current professional baseball athletes. In addition, we sought to understand the trends surrounding single-sport specialization in professional baseball players raised within and outside the United States (US). STUDY DESIGN: Cross-sectional study; Level of evidence, 3...

OBJECTIVES: The antimicrobial susceptibility pattern of clinical Burkholderia pseudomallei (B. pseudomallei) in Vietnam has not been reported since the first publication in 2008. The present study aimed to determine the antimicrobial susceptibility pattern of B. pseudomallei isolated in a tertiary referral centre in Hanoi from January 2012 to December 2017. METHODS: A total of 312 B. pseudomallei isolates obtained from melioidosis patients admitted to a 2000-bed general hospital were analysed by the Etest method...

Hyperammonemia, in the absence of significant liver dysfunction, is an uncommon but often fatal occurrence following orthotopic lung transplant. Prior reports have provided evidence to support Ureaplasma species as an etiology for this syndrome. This case report describes an individual post-lung transplant, treated emperically with doxycycline along with other measures to lower ammonia levels, at the time hyperammonemia with encephalopathy was recognized. The patient clinically improved. Ureaplasma species were subsequently identified using 16S ribosomal RNA gene PCR/sequencing of pleural fluid, and by culture of bronchoalveolar (BAL) fluid...

In this study, we combine experiments and direct numerical simulations to investigate the effects of the height of transverse ribs at the walls on both global and local flow properties in turbulent Taylor-Couette flow. We create rib roughness by attaching up to 6 axial obstacles to the surfaces of the cylinders over an extensive range of rib heights, up to blockages of 25% of the gap width. In the asymptotic ultimate regime, where the transport is independent of viscosity, we emperically find that the prefactor of the [Formula: see text] scaling (corresponding to the drag coefficient [Formula: see text] being constant) scales with the number of ribs [Formula: see text] and by the rib height [Formula: see text]...

BACKGROUND: Distal ulna fractures at the ulnar neck can be seen in association with distal radius fractures, and multiple techniques have been described to address the ulnar neck component of these injuries. We have found that treatment of ulnar neck fractures can be challenging in terms of anatomy and fracture fixation. We present a new percutaneous fixation technique for ulnar neck fractures commonly seen with distal radius fractures. TECHNIQUE: Fixation of the ulnar neck fracture is performed after fixation of the distal radius fracture...

BACKGROUND: Youth participation in organized sports in the United States is rising, with many athletes focusing on a single sport at an increasingly younger age. PURPOSE: To retrospectively compare single-sport specialization in current high school (HS), collegiate, and professional athletes with regard to the rate and age of specialization, the number of months per year of single-sport training, and the athlete's perception of injury related to specialization. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...