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1.
Lancet Microbe ; 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38964359

RESUMO

Tuberculosis is a leading cause of death from an infectious agent globally. Infectious subclinical tuberculosis accounts for almost half of all tuberculosis cases in national tuberculosis prevalence surveys, and possibly contributes to transmission and might be associated with morbidity. Modelling studies suggest that new tuberculosis vaccines could have substantial health and economic effects, partly based on the assumptions made regarding subclinical tuberculosis. Evaluating the efficacy of prevention of disease tuberculosis vaccines intended for preventing both clinical and subclinical tuberculosis is a priority. Incorporation of subclinical tuberculosis as a composite endpoint in tuberculosis vaccine trials can help to reduce the sample size and duration of follow-up and to evaluate the efficacy of tuberculosis vaccines in preventing clinical and subclinical tuberculosis. Several design options with various benefits, limitations, and ethical considerations are possible in this regard, which would allow for the generation of the evidence needed to estimate the positive global effects of tuberculosis vaccine trials, in addition to informing policy and vaccination strategies.

2.
Water Environ Res ; 96(7): e11068, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38967114

RESUMO

A life cycle assessment (LCA) study was completed to understand the environmental impacts associated with the land application of wastes produced from rural food-processing operations for final disposal. The system boundaries for the two comprised scenarios included the storage of the produced non-agriculture source material (NASM), transportation to an applicable location, land application of the NASM, and the impacts of the final emissions to the soil and groundwater for a full year. The Tool for the Reduction and Assessment of Chemicals and Other Environmental Impacts (TRACI) v2.1 was selected as the impact assessment method. Furthermore, SimaPro 8.0.4.26 was the LCA model version that was used with all the databases included. Overall, the LCA study showed that the most significant environmental impacts associated with the disposal process resulted from carcinogenic and eutrophication emissions. The component that contributed the most to carcinogenic impacts was found to be from the material required to create the concrete storage tank. Additionally, eutrophication was identified to be a potential significant impact, if proper setback requirements are not followed for the NASM material. Results of the study look to inform stakeholders about the benefits and risks encountered from NASM disposal. PRACTITIONER POINTS: Life cycle assessment was completed on a representative NASM disposal system using land application. Concrete tank used for storage of NASM had the most significant impact in carcinogenic emissions. Eutrophication impacts were the second most significant impact behind carcinogenic emissions.


Assuntos
Manipulação de Alimentos , Manipulação de Alimentos/métodos , Meio Ambiente , Monitoramento Ambiental/métodos
3.
Artigo em Inglês | MEDLINE | ID: mdl-38972781

RESUMO

The presence of membrane-bound organelles with specific functions is one of the main hallmarks of eukaryotic cells. Organelle membranes are composed of specific lipids that govern their function and interorganelle communication. Discoveries in cell biology using imaging and omic technologies have revealed the mechanisms that drive membrane remodeling, organelle contact sites, and metabolite exchange. The interplay between multiple organelles and their interdependence is emerging as the next frontier for discovery using 3D reconstruction of volume electron microscopy (vEM) datasets. We discuss recent findings on the links between organelles that underlie common functions and cellular pathways. Specifically, we focus on the metabolism of ether glycerophospholipids that mediate organelle dynamics and their communication with each other, and the new imaging techniques that are powering these discoveries.

4.
Int J Gynecol Cancer ; 34(7): 1041-1050, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38950925

RESUMO

OBJECTIVE: To identify characteristics associated with long-term progression-free survival (≥2 years) in patients with advanced ovarian cancer treated with niraparib first-line maintenance therapy in the phase III PRIMA/ENGOT-OV26/GOG-3012 study. METHODS: In this post hoc analysis of PRIMA, patients randomized to niraparib were grouped based on investigator-assessed progression-free survival (progressive disease/censoring <2 years or ≥2 years after randomization). Variables assessed for predictive value were Eastern Cooperative Oncology Group performance status, International Federation of Gynecology and Obstetrics (FIGO) stage at diagnosis, clinical response to platinum-based chemotherapy, number of prior chemotherapy cycles, primary tumor location, body mass index, categorical age, debulking surgery type, number of baseline target lesions, number of baseline non-target lesions, BRCA/homologous recombination-deficiency status, residual disease status, and duration from end of chemotherapy to randomization. Logistic regression modeling using backward elimination (significance level=0.15) identified covariates associated with long-term progression-free survival (clinical cut-off date November 17, 2021). RESULTS: Of 487 patients randomized to niraparib, 152 (31%) had progressive disease/censoring ≥2 years after randomization. Multivariable logistic regression modeling using backward elimination identified BRCA1/2 mutation/homologous recombination deficiency status (p<0.0001), FIGO stage (p=0.041), primary tumor location (p=0.095), and number of baseline non-target lesions (p=0.0001) to be associated with long-term progression-free survival. Patients significantly more likely to achieve progression-free survival of ≥2 years in the final model were those with BRCA1- and BRCA2-mutated/homologous recombination-deficient tumors or BRCA wild-type/not determined/homologous recombination-deficient tumors (vs BRCA wild-type/homologous recombination-proficient/not determined tumors), FIGO stage III (vs IV), and 0 or 1 baseline non-target lesions (vs ≥2 baseline non-target lesions). CONCLUSIONS: The hypothesis-generating results of this analysis suggest that BRCA1/2 mutation/homologous recombination-deficiency status, FIGO stage, and number of baseline non-target lesions may predict progression-free survival of ≥2 years in patients with advanced ovarian cancer receiving niraparib first-line maintenance therapy. TRIAL REGISTRATION NUMBER: NCT02655016.


Assuntos
Indazóis , Neoplasias Ovarianas , Piperidinas , Intervalo Livre de Progressão , Humanos , Feminino , Indazóis/uso terapêutico , Indazóis/administração & dosagem , Piperidinas/uso terapêutico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/mortalidade , Pessoa de Meia-Idade , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Adulto , Idoso
5.
World Neurosurg ; 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38992727

RESUMO

OBJECTIVE: This study evaluates the impact of L4-5 minimally invasive surgery (MIS)-TLIF on adjacent-level parameters. METHODS: This is a retrospective study performed on consecutive patients between January 2015-December 2019. The index- and adjacent-level segmental lordosis (SL) and disc angle (DA) were measured. Patient-reported outcomes (PROs) were collected preoperatively and at 3-24 months postoperatively. Factors influencing changes in adjacent-level parameters and the occurrence of adjacent segment degeneration (ASDeg) were assessed. RESULTS: One hundred and seventeen adult patients, averaging 65.5 years of age and slight preponderance of female (56.4%), were analyzed. L4-5 SL decreased at 2 years (p<0.05), but L4-5 DA significantly increased at all timepoints (p<0.05). While L3-4 SL and DA significantly decreased at all timepoints (p<0.05), L5-S1 SL decreased at 3 and 12 months (p<0.05) and L5-S1 DA only significantly decreased at 2 years (p<0.05). All PROs improved significantly (p<0.0001). The ASDeg rate was 19.7% at 2.2 years. Cephalad and caudal ASDeg rates were 12.0% and 10.3%, respectively. Eight patients (6.8%) required adjacent-level reoperations, mainly at L3-4 (6 cases). The use of expandable cage significantly reduced the odds of caudal ASDeg (OR 0.15, p=0.037), but had no significant effect on cephalad ASDeg.. CONCLUSIONS: L4-5 MIS-TLIF had a more consistent effect on L3-4 than L5-S1. Although adjacent-level SL and DA decreased over time, their association with ASDeg appears limited, suggesting a multifactorial etiology. L4-5 MIS-TLIF provides demonstrable clinical benefits with lasting PRO improvements and low adjacent-level reoperations.

6.
J Community Psychol ; 52(6): 774-791, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38968375

RESUMO

Does higher perceived neighborhood social cohesion in adolescence lead to better health and well-being 10-12 years later? We evaluated this question using data from a large, prospective, and nationally representative sample of US adolescents (Add Health; N = 10,963), and an outcome-wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological well-being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes. These results were maintained after robust control for a wide range of potential confounders.


Assuntos
Características de Residência , Humanos , Adolescente , Masculino , Feminino , Estudos Longitudinais , Adulto Jovem , Estados Unidos/epidemiologia , Estudos Prospectivos , Depressão/psicologia , Depressão/epidemiologia , Solidão/psicologia , Saúde Mental , Satisfação Pessoal , Relações Interpessoais , Ideação Suicida , Nível de Saúde , Felicidade , Estresse Psicológico/psicologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-39010849

RESUMO

KEY POINTS: Novel topical therapeutics require extensive pre-clinical testing to assess efficacy and safety. Antibiofilm or immunosuppressant agents can utilize ex vivo models to measure ciliotoxicity. Agents that are found to be effective and non-toxic ex vivo warrant further investigation in vivo.

8.
Diagnostics (Basel) ; 14(13)2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-39001278

RESUMO

INTRODUCTION: In patients with suspected pneumonia who are tested with respiratory culture and multiplex PCR, the potential added benefit of next-generation sequencing technologies is unknown. METHODS: This was a single-center, retrospective study in which residual bronchoalveolar lavage (BAL) specimens were retrieved from hospitalized patients. We compared its research-use-only Respiratory Pathogen Illumina Panel (RPIP) results to culture and BioFire® FilmArray Pneumonia Panel (BioFire® PN) results from critically ill patients. RESULTS: In total, 47 BAL specimens from 47 unique patients were included. All BAL samples were tested with culture and multiplex PCR. In total, 38 of the 47 BALs were consistent with a clinical picture of pneumonia per chart review. Additional testing of the 38 samples with the RPIP identified a new bacterium in 20 patients, a new virus in 4 patients, a new bacterium plus virus in 4 patients, and no additional organisms in 10 patients. In 17 (44.5%) of these patients, the RPIP results could have indicated an antibiotic addition. Compared with cultures, the RPIP had an overall sensitivity of 64% and specificity of 98%, with a 0% sensitivity for fungus and 14% sensitivity for mycobacteria. Compared with BioFire® PN, the RPIP was 70% sensitive and 99% specific, with a 74% sensitivity for bacteria and 33% sensitivity for viruses. The RPIP was 29% more sensitive for HAP/VAP bacterial targets compared with CAP. CONCLUSIONS: Emerging NGS technologies such as the RPIP may have a role in identifying the etiology of pneumonia, even when patients have BAL culture and multiplex PCR results available. Similar to prior studies evaluating RPIP, our study showed this platform lacked sensitivity when compared with cultures, particularly for fungi and mycobacteria. However, the high specificity of the test can be leveraged when clinicians are seeking to rule out certain infections.

9.
Methods Mol Biol ; 2829: 247-255, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38951340

RESUMO

The Baculovirus Expression Vector System (BEVS) is used with cultured insect cells to produce a wide variety of heterologous proteins, which can be secreted into the culture medium during the transient infection process (Smith et al. Mol Cell Biol 12:2156-2165, 1983). When the infection process is complete, centrifugation is often used to separate the desired protein from the spent insect cells. The desired product in the harvested supernatant is contaminated with baculovirus, amino acids, lipids, detergents, oils, lysed cells from the infection process, genomic DNA from the insect cells, and proteases due to the lytic nature of the baculovirus infection process and many other contaminants (Ikonomou et al. Appl Microbiol Biotechnol 62:1-20, 2003). All these contaminants that are present in the centrifuged supernatant with the desired secreted protein make the initial chromatographic capture step critical for effective purification of the desired protein. A purification scheme will be outlined for a slightly acidic secreted protein using cation exchange chromatography (Lundanes et al. Chromatography: basic principles, sample preparations and related methods, 1st edn. Wiley, 2013).


Assuntos
Baculoviridae , Animais , Baculoviridae/genética , Baculoviridae/metabolismo , Cromatografia por Troca Iônica/métodos , Proteínas Recombinantes/isolamento & purificação , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Insetos/citologia , Células Sf9 , Vetores Genéticos/genética , Linhagem Celular , Spodoptera
10.
bioRxiv ; 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38948705

RESUMO

Two protocadherins, Dachsous (Ds) and Fat (Ft), regulate organ growth in Drosophila via the Hippo pathway. Ds and Ft bind heterotypically to regulate the abundance and subcellular localization of a 'core complex' consisting of Dachs, Dlish and Approximated. This complex localizes to the junctional cortex where it promotes growth by repressing the pathway kinase Warts. Ds is believed to promote growth by recruiting and stabilizing the core complex at the junctional cortex, while Ft represses growth by promoting degradation of core complex components. Here, we examine the functions of intracellular domains of Ds and Ft and their relationship to the core complex. While Ds promotes accumulation of the core complex proteins in cortical puncta, it is not required for core complex assembly. Indeed, the core complex assembles maximally in the absence of both Ds and Ft. Furthermore, while Ds promotes growth in the presence of Ft, it represses growth in the absence of Ft by removing the core complex from the junctional cortex. Ft similarly recruits core complex components, however it normally promotes their degradation. Our findings reveal that Ds and Ft constrain tissue growth by repressing the default 'on' state of the core complex.

11.
Mol Ther ; 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38959896

RESUMO

Bispecific antibodies are an important tool for the management and treatment of acute leukemias. As a next step toward clinical translation of engineered plasma cells, we describe approaches for secretion of bispecific antibodies by human plasma cells. We show that human plasma cells expressing either fragment crystallizable domain-deficient anti-CD19 × anti-CD3 (blinatumomab) or anti-CD33 × anti-CD3 bispecific antibodies mediate T cell activation and direct T cell killing of B acute lymphoblastic leukemia or acute myeloid leukemia cell lines in vitro. We demonstrate that knockout of the self-expressed antigen, CD19, boosts anti-CD19-bispecific secretion by plasma cells and prevents self-targeting. Plasma cells secreting anti-CD19-bispecific antibodies elicited in vivo control of acute lymphoblastic leukemia patient-derived xenografts in immunodeficient mice co-engrafted with autologous T cells. In these studies, we found that leukemic control elicited by engineered plasma cells was similar to CD19-targeted chimeric antigen receptor-expressing T cells. Finally, the steady-state concentration of anti-CD19 bispecifics in serum 1 month after cell delivery and tumor eradication was comparable with that observed in patients treated with a steady-state infusion of blinatumomab. These findings support further development of ePCs for use as a durable delivery system for the treatment of acute leukemias, and potentially other cancers.

12.
Heart Lung Circ ; 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38971645

RESUMO

BACKGROUND: Single-lead electrocardiogram (ECG) devices may allow detection and diagnosis of cardiac rhythms. However, data on their accuracy for detecting cardiac arrhythmias beyond atrial fibrillation are limited. We aimed to determine the accuracy of the AliveCor KardiaMobile (AC) (AliveCor Inc, Mountain View, CA, USA) for the diagnosis of arrhythmias against gold standard cardiac electrophysiology study (EPS). METHOD: Patients undergoing clinically indicated EPS underwent simultaneous rhythm recording with an AC, standard 12-lead ECG, and EP catheters for intracardiac electrograms. Rhythms recorded during EPS were classified based on electrogram, 12-lead ECG, and clinical findings. Blinded reviewers provided differential diagnoses for the single-lead AC tracings; a separate reviewer compared diagnoses made between the AC tracings and EPS findings. RESULTS: In 49 patients, 843 cardiac rhythms were captured during 502 AC recordings. Analysis of tracings containing sinus rhythm (n=273) returned an overall accuracy of 92%, with sensitivity and specificity values of 93% and 92%, respectively. Accuracy for tracings per rhythm was atrial fibrillation 91% (n=51); supraventricular tachycardia accuracy was 89% (n=191), ventricular tachycardia 91% (n=198), ventricular fibrillation 98% (n=11), and asystole 100% (n=5). Accuracy for supraventricular ectopy was 93% (n=28) and for premature ventricular complexes was 91% (n=86). Overall accuracy was 94% for solitary rhythms and 93% in tracings from patients with baseline bundle branch block. CONCLUSIONS: When compared against the gold standard EPS diagnosis, the interpretation of arrhythmias recorded by an AliveCor single-lead ECG device had reasonable diagnostic accuracy.

13.
Artigo em Inglês | MEDLINE | ID: mdl-38971976

RESUMO

OBJECTIVE: Endoscopic sinus and skull base surgery has led to significant improvements in patient outcomes, yet may have come at a cost to surgeons' musculoskeletal (MSK) health. We aimed to determine the prevalence and characteristics of work-related MSK disorders (WRMDs) in endoscopic sinus and skull base surgeons; to investigate contributing factors for WRMD in this population; and to evaluate the effectiveness of ergonomic interventions on the severity or prevalence of WRMD in this population. DATA SOURCES: Medline, Embase, CINAHL, Web of Science, and Scopus from inception to April 2, 2024. A bibliographic examination was performed for further papers. REVIEW METHODS: Inclusion criteria included original peer-reviewed papers with work-related MSK outcomes (prevalence, contributing factors, and interventions) relating to endoscopic sinus and/or skull base surgeons in any language. RESULTS: Of 25,772 unique citations, 37 studies met the inclusion criteria. The pooled lifetime, point, and 12-month prevalences of WRMD were 75.9% (95% confidence interval; I2, 67.2%-83.6%, I2 95.6%), 80.8% (77.0%-84.3%, I2 98.0%), and 82.0% (71.8%-90.3%, I2 60.96%) respectively. The neck, lumbar spine, and thoracic spine were the most commonly involved areas. One of 9 studies on contributing factors investigated discomfort as an outcome. The remainder focussed on surrogate outcomes (eg, posture, hand dysfunction). Two of the 13 intervention studies investigated pain or fatigue as an outcome. The remainder targeted posture, muscle activity, or workload. CONCLUSION: WRMDs are highly prevalent in endoscopic sinus and skull base surgeons. Further studies focusing on the direct outcomes of WRMD such as pain are needed.

14.
Emerg Infect Dis ; 30(8): 1571-1579, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39043388

RESUMO

New tuberculosis (TB) drugs with little existing antimicrobial resistance enable a pan-TB treatment regimen, intended for universal use without prior drug-susceptibility testing. However, widespread use of such a regimen could contribute to an increasing prevalence of antimicrobial resistance, potentially rendering the pan-TB regimen ineffective or driving clinically problematic patterns of resistance. We developed a model of multiple sequential TB patient cohorts to compare treatment outcomes between continued use of current standards of care (guided by rifampin-susceptibility testing) and a hypothetical pan-TB approach. A pan-TB regimen that met current target profiles was likely to initially outperform the standard of care; however, a rising prevalence of transmitted resistance to component drugs could make underperformance likely among subsequent cohorts. Although the pan-TB approach led to an increased prevalence of resistance to novel drugs, it was unlikely to cause accumulation of concurrent resistance to novel drugs and current first-line drugs.


Assuntos
Antituberculosos , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis , Humanos , Antituberculosos/uso terapêutico , Antituberculosos/farmacologia , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose/tratamento farmacológico , Tuberculose/microbiologia , Farmacorresistência Bacteriana , Resultado do Tratamento , Rifampina/uso terapêutico , Rifampina/farmacologia
15.
J Am Coll Cardiol ; 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38970597

RESUMO

Rest imaging in hypertrophic cardiomyopathy may underestimate or miss left ventricular outflow tract obstruction, leading to suboptimal management decisions that negatively affect symptomatic patients. The 2024 hypertrophic cardiomyopathy guidelines describe exercise stress testing as an important tool to determine overall exercise tolerance and latent, exercise-provoked left ventricular outflow tract obstruction.

16.
G3 (Bethesda) ; 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39028844

RESUMO

We genotyped a population of 618 diploid potato clones derived from six independent potato-breeding programmes from NW-Europe. The diploids were phenotyped for 23 traits, using standardised protocols and common check varieties, enabling us to derive whole population estimators for most traits. We subsequently performed a Genome-Wide Association Study (GWAS) to identify quantitative trait loci (QTL) for all traits with SNPs and short-read haplotypes derived from read-backed phasing. In this study, we used a marker platform called PotatoMASH (Potato Multi-Allele Scanning Haplotags); a pooled multiplex amplicon sequencing based approach. Through this method, neighbouring SNPs within an amplicon can be combined to generate multi-allelic short-read haplotypes (haplotags) that capture recombination history between the constituent SNPs, and reflect the allelic diversity of a given locus in a different way than single bi-allelic SNPs. We found a total of 37 unique QTL across both marker types. A core of 10 QTL were detected with SNPs as well as with haplotags. Haplotags allowed to detect an additional 14 QTL not found based on the SNP set. Conversely, the bi-allelic SNP set also found 13 QTL not detectable using the haplotag set. We conclude that both marker types should routinely be used in parallel to maximize the QTL detection power. We report 19 novel QTL for nine traits: Skin Smoothness, Sprout Dormancy, Total Tuber Number, Tuber Length, Yield, Chipping Colour, After-cooking Blackening, Cooking Type and Eye depth.

17.
Int J Behav Med ; 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39026119

RESUMO

BACKGROUND: Previous research has shown that screen-based leisure time is related to physical and mental health, relationships, and prosocial behaviors. However, it remains unclear whether screen-based leisure time causally affects wellbeing, as previous studies have relied on cross-sectional data, focused on one type of media use (e.g., social media, video games, or internet), or assessed a narrow set of outcomes. METHOD: We used three waves (2016, 2017, 2019) of national longitudinal data from the New Zealand Attitudes and Values Study to investigate the effects of screen-based leisure time on 24 parameters of wellbeing (n = 11,085). We operationalized screen-based leisure as the sum of time spent browsing the internet, using social media, watching/reading the news, watching videos, and playing video games. We followed the outcome-wide analytic design for observational data by performing a series of multivariable regression models estimating the effect of screen-based leisure time on 24 wellbeing outcomes and assessed potential unmeasured confounding using sensitivity analyses. RESULTS: In our primary analysis with the total sample, total screen-based leisure time was associated with a very modest decrease in body satisfaction and a very modest increase in body mass index. Possible evidence of associations was found with increases in number of hours spent exercising and volunteering each week, as well as decreases in number of average daily hours of sleep, self-control, and subjective health. CONCLUSION: Screen-based leisure time has the potential to affect health and wellbeing. Results are discussed in light of the high prevalence of screen-based leisure time.

18.
Plast Reconstr Surg ; 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39026388

RESUMO

BACKGROUND: Traditional rhinoplasty tip grafts often lead to visibility issues, prompting patients to seek revision surgery. The mastoid fascia tissue graft (MFTG) provides a natural-looking alternative with an acceptable risk of complication. MFTG remains less visible through the skin and helps camouflage and conceal tip irregularities. This study of 193 patients examines MFTG's effectiveness in nasal tip refinement, evaluating revision and infection rates. METHODS: A retrospective analysis of MFTG use for nasal tip aesthetics during open rhinoplasty in the senior author's practice was conducted from January 2019 to June 2022. Inclusion criteria encompassed open rhinoplasty cases using mastoid tissue for tip aesthetics with at least 12 months of follow-up. Among 2003 cases, 193 met these criteria and were evaluated for subsequent revision and infection rates. RESULTS: The average patient age was 34.2 years (175 females, 18 males). Primary rhinoplasties were done on 113 patients, with 80 receiving revision surgeries. Average follow-up was 14.8 months. 6 (3.1%) patients overall needed extended antibiotics, including 1 (0.9%) primary rhinoplasty and 5 (6.3%) secondary rhinoplasty patients. Overall, 6 (3.1%) patients required revision rhinoplasty, comprising of 1 (0.9%) primary and 5 (6.3%) secondary rhinoplasty patients. CONCLUSIONS: MFTG use for nasal tip aesthetics is a safe, convenient, and effective technique in camouflaging and concealing nasal tip contour irregularities in both primary and revision rhinoplasty. Use of MTFG is associated with minimal morbidity.

19.
Learn Health Syst ; 8(3): e10417, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39036530

RESUMO

Introduction: The rapid development of artificial intelligence (AI) in healthcare has exposed the unmet need for growing a multidisciplinary workforce that can collaborate effectively in the learning health systems. Maximizing the synergy among multiple teams is critical for Collaborative AI in Healthcare. Methods: We have developed a series of data, tools, and educational resources for cultivating the next generation of multidisciplinary workforce for Collaborative AI in Healthcare. We built bulk-natural language processing pipelines to extract structured information from clinical notes and stored them in common data models. We developed multimodal AI/machine learning (ML) tools and tutorials to enrich the toolbox of the multidisciplinary workforce to analyze multimodal healthcare data. We have created a fertile ground to cross-pollinate clinicians and AI scientists and train the next generation of AI health workforce to collaborate effectively. Results: Our work has democratized access to unstructured health information, AI/ML tools and resources for healthcare, and collaborative education resources. From 2017 to 2022, this has enabled studies in multiple clinical specialties resulting in 68 peer-reviewed publications. In 2022, our cross-discipline efforts converged and institutionalized into the Center for Collaborative AI in Healthcare. Conclusions: Our Collaborative AI in Healthcare initiatives has created valuable educational and practical resources. They have enabled more clinicians, scientists, and hospital administrators to successfully apply AI methods in their daily research and practice, develop closer collaborations, and advanced the institution-level learning health system.

20.
Plast Reconstr Surg Glob Open ; 12(7): e5997, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39036598

RESUMO

Background: Fresh frozen costal cartilage (FFCC), from the Musculoskeletal Transplant Foundation (MTF), has recently gained popularity for use in revision rhinoplasty or primary rhinoplasty when there is a paucity of autologous cartilage. However, there are currently no guidelines related to the use of intraoperative antibiotic soaking to reduce postoperative infection rates when using MTF FFCC. This study aimed to evaluate the efficacy of intraoperative antibiotic soaks in reducing surgical site infection rate when using MTF FFCC grafts in rhinoplasty. Methods: A retrospective chart review of patients who underwent rhinoplasty with the use of MTF FFCC in the senior author's practice was conducted between May 2017 and June 2022. The inclusion criteria were rhinoplasty cases using MTF FFCC with minimum of 12 months of follow-up. Fisher exact test was conducted to determine significance in rates of postoperative infection for patients who underwent rhinoplasty with the use of MTF FFCC with (1) intraoperative antibiotic solution soak versus (2) no antibiotic solution soak. Results: A total of 310 patients were included and separated into two cohorts, MTF FFCC intraoperative antibiotic solution soak (n = 200) and no antibiotic solution soak (n = 110). There were a total of four (1.3%) cases of infection, all in the antibiotic soak group. There was no statistically significant difference between the rate of infection in the two cohorts (P = 0.301). Conclusion: Our retrospective cohort study demonstrates that soaking MTF FFCC in an antibiotic solution intraoperatively does not reduce postoperative infection rates in rhinoplasty.

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