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Background: Perioperative atrial fibrillation (AF) and myocardial injury after noncardiac surgery (MINS) are common complications after noncardiac surgery. Inflammation has been implicated in the pathogenesis of both disorders. The COP-AF trial tests the hypothesis that colchicine reduces the incidence of perioperative AF and MINS in patients undergoing major noncardiac thoracic surgery. Design: The 'COlchicine for the Prevention of Perioperative Atrial Fibrillation' (COP-AF) trial is an international, blinded, randomized trial that compares colchicine to placebo in patients aged at least 55 years and undergoing major noncardiac thoracic surgery with general anesthesia. Exclusion criteria include a history of AF and a contraindication to colchicine (e.g., severe renal dysfunction). Oral colchicine at a dose of 0.5 mg or matching placebo is given within 4 hours before surgery. Thereafter, patients receive colchicine 0.5 mg or placebo twice daily for a total of 10 days. The two independent co-primary outcomes are clinically important perioperative AF (including atrial flutter) and MINS during 14 days of follow-up. The main safety outcomes are sepsis or infection and non-infectious diarrhea. We aim to enroll 3,200 patients from approximately 40 sites across 11 countries to have at least 80% power for the independent evaluation of the two co-primary outcomes. Summary: COP-AF is a large randomized and blinded trial designed to determine whether colchicine reduces the risk of perioperative AF or MINS in patients who have major noncardiac thoracic surgery. Population Health Research Institute

The climate system responds to changes in the amount of atmospheric greenhouse gases or aerosols through rapid processes, triggered within hours and days, and through slower processes, where the full response may only be seen after centuries. In this paper, we aim to elucidate the mechanisms operating on time scales of hours to years to better understand the response of key climate quantities such as energy fluxes, temperature, and precipitation after a sudden increase in either carbon dioxide (CO2), black carbon (BC), or sulfate (SO4) aerosols. The results are based on idealized simulations from six global climate models. We find that the effect of changing ocean temperatures kicks in after a couple of months. Rapid precipitation reductions start occurring instantly and are established after just a few days. For BC, they constitute most of the equilibrium response. For CO2 and SO4, the magnitude of the precipitation response gradually increases as surface warming/cooling evolves, and for CO2, the sign of the response changes from negative to positive after 2 years. Rapid cloud adjustments are typically established within the first 24 h, and while the magnitude of cloud feedbacks for CO2 and SO4 increases over time, the geographical pattern of the equilibrium cloud change is present already after the first year. While there are model differences, our work underscores the overall similarity of the major time-varying processes and responses simulated by current global models and hence the robustness of key features of simulated responses to historical and future anthropogenic forcing. Significance Statement How does the climate system respond to a change in the amount of atmospheric greenhouse gases or aerosols? Some processes are rapid, responding within hours and days. Others are slow, and the full response to a forcing of the climate may only be seen after centuries. In this paper, we use six global climate models to investigate the time scales of climate responses to carbon dioxide, black carbon, and sulfate, focusing on key climate quantities, such as temperature, precipitation, and clouds. While there are ample model differences, our work underscores the overall similarity of the major time-varying processes and responses simulated by current global models and hence the robustness of key features of simulated responses to historical and future anthropogenic forcing.

To describe the use of psychotropic medications among older hospitalized patients. This was a descriptive study using baseline data from the first 308 older patients in a function focused care intervention study. Age, gender, race, comorbidities, admitting diagnosis, and medications (antidepressants, antianxiety medications, anticonvulsants, dementia drugs, antipsychotics, sedative-hypnotics, and opioids) were obtained at baseline and discharge. To compare change over time, generalized estimating equations were used. Participants were mostly female (63%) and White (69%) and were 83.1 years old on average. Antidepressant, antianxiety, anticonvulsant, dementia medication, sedative-hypnotic, and opioid use remained essentially unchanged between admission and discharge. Antipsychotic medication use increased significantly from 16% to 21% at discharge. There was persistent use of psychotropic medication among hospitalized older adults living with dementia and little evidence of deprescribing. There was some indication of changes made during hospitalization that may be appropriate, even without a focused deprescribing initiative.

This study sought to investigate the relationship between multiple preoperative characteristics of pain (maximum pain severity location, the presence of pain in certain locations, the highest level of pain, and the number of pain locations) and psychological outcome measures as reported by patients. Fifty-four hips (50 patients) that underwent periacetabular osteotomy to treat acetabular dysplasia between February 2017 and July 2020 were reviewed using the Depression, Anxiety, and Stress Scale-21 (DASS21), Hospital Anxiety and Depression Scale (HADS), and Pain Catastrophizing Scale (PCS), radiographic analysis, and questionnaires concerning pain severity/location. Twenty-six hips had their worst pain in the groin, whereas 28 hips had greater or equal levels of pain at another location. There was no significant difference between these two locations on any of the postoperative psychological outcomes (HADS, P =.53; DASS21, P =.85; PCS, P =.97). Additionally, there was not a significant relationship between pain in any location other than the groin and any postoperative psychological outcomes ( P ≥.08). Finally, the highest level of preoperative pain and the number of locations of pain demonstrated no significant relationship with postoperative psychological outcomes (maximum severity: HADS, P =.28; DASS21, P =.49; PCS, P =.57; number of pain locations: HADS, P =.47; DASS21, P =.60; PCS, P =.35). Variance in preoperative pain location, severity, and number of pain locations seemingly does not result in any significant effect on postoperative psychological outcomes. Thus, a large range of patients with acetabular dysplasia may experience similar, favorable psychological outcomes from treatment with periacetabular osteotomy notwithstanding the characteristics of preoperative pain. [ Orthopedics . 202x;4x(x):xx–xx.]

Maureen George,1 Carlos A Camargo Jr,2 Autumn Burnette,3 Yuning Chen,4 Ajinkya Pawar,4 Cliona Molony,4 Melissa Auclair,4 Michael A Wells,4 Thomas J Ferro4 1Office of Research and Scholarship, Columbia University School of Nursing, New York, NY, USA; 2Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 3Division of Allergy and Immunology, Howard University Hospital, Howard University College of Medicine, Washington, DC, USA; 4Sanofi, Cambridge, MA, USACorrespondence: Maureen George, Office of Research and Scholarship, Columbia University School of Nursing, New York, NY, 10032, USA, Tel +1 212-305-1175, Email mg3656@cumc.columbia.eduPurpose: The identification of risk factors associated with uncontrolled moderate-to-severe asthma is important to improve asthma outcomes. Aim of this study was to identify risk factors for uncontrolled asthma in United States cohort using electronic health record (EHR)-derived data.Patients and Methods: In this retrospective real-world study, de-identified data of adolescent and adult patients (≥ 12 years old) with moderate-to-severe asthma, based on asthma medications within 12 months prior to asthma-related visit (index date), were extracted from the Optum® Humedica EHR. The baseline period was 12 months prior to the index date. Uncontrolled asthma was defined as ≥ 2 outpatient oral corticosteroid bursts for asthma or ≥ 2 emergency department visits or ≥ 1 inpatient visit for asthma. A Cox proportional hazard model was applied.Results: There were 402,403 patients in the EHR between January 1, 2012, and December 31, 2018, who met the inclusion criteria and were analyzed. African American (AA) race (hazard ratio [HR]: 2.08), Medicaid insurance (HR: 1.71), Hispanic ethnicity (HR: 1.34), age of 12 to < 18 years (HR 1.20), body mass index of ≥ 35 kg/m2 (HR: 1.20), and female sex (HR 1.19) were identified as risk factors associated with uncontrolled asthma (P < 0.001). Comorbidities characterized by type 2 inflammation, including a blood eosinophil count of ≥ 300 cells/μL (as compared with eosinophil < 150 cells/μL; HR: 1.40, P < 0.001) and food allergy (HR: 1.31), were associated with a significantly higher risk of uncontrolled asthma; pneumonia was also a comorbidity associated with an increased risk (HR: 1.35) of uncontrolled asthma. Conversely, allergic rhinitis (HR: 0.84) was associated with a significantly lower risk of uncontrolled asthma.Conclusion: This large study demonstrates multiple risk factors for uncontrolled asthma. Of note, AA and Hispanic individuals with Medicaid insurance are at a significantly higher risk of uncontrolled asthma versus their White, non-Hispanic counterparts with commercial insurance.Keywords: asthma, underserved, uncontrolled, Medicaid

Skeletal muscle energy production is influenced by both lean body mass and adipose tissue but the effect of their distribution on energy metabolism is unclear. This study examined variations in quadriceps muscle energy metabolism in healthy adults with varied relative amounts of lean and adipose tissue. Results suggest increased adiposity is associated with reduced muscle energetic efficiency with more reliance on glycolysis, and when accompanied with reduced lean mass, is associated with reduced maximum oxidative capacity.

Integrated behavioral health can improve primary care and mental health outcomes. Access to behavioral health and primary care services in Texas is in crisis because of high uninsurance rates, regulatory restrictions, and lack of workforce. To address gaps in access to care, a partnership formed among a large local mental health authority in central Texas, a federally designated rural health clinic, and the Texas A&M University School of Nursing to create an interprofessional team-based health care delivery model led by nurse practitioners in rural and medically underserved areas of central Texas. Academic–practice partners identified 5 clinics for an integrated behavioral health care delivery model. From July 1, 2020, through December 31, 2021, a total of 3183 patient visits were completed. Patients were predominantly female (n = 1719, 54%) and Hispanic (n = 1750, 55%); 1050 (33%) were living at or below the federal poverty level; and 1400 (44%) were uninsured. The purpose of this case study was to describe the first year of implementation of the integrated health care delivery model, barriers to implementation, challenges to sustainability, and successes. We analyzed data from multiple sources, including meeting minutes and agendas, grant reports, direct observations of clinic flow, and interviews with clinic staff, and identified common qualitative themes (eg, challenges to integration, sustainability of integration, outcome successes). Results revealed implementation challenges with the electronic health record, service integration, low staffing levels during a global pandemic, and effective communication. We also examined 2 patient cases to illustrate the success of integrated behavioral health and highlighted lessons learned from the implementation process, including the need for a robust electronic health record and organizational flexibility.

Adrienne Malik,1 Olga Dewald,2 John Gallien,3 Mark Favot,3 Adam Kasten,5 Brian Reed,6 Robert Wells,5 Robert R Ehrman4 1Department of Emergency Medicine, University of Kansas Medical Center, Kansas City, MO, 66160, USA; 2Department of Emergency Medicine, Sparrow Hospital, Lansing, MI, 48912, USA; 3Department of Emergency Medicine, DMC Detroit Receiving Hospital, Detroit, MI, 48201, USA; 4Department of Emergency Medicine, DMC Sinai Grace Hospital, Detroit, MI, 48235, USA; 5Department of Emergency Medicine, DMC Harper Hospital, Detroit, MI, 48201, USA; 6Department of Emergency Medicine, Wayne State University, Detroit, MI, 48201, USACorrespondence: Adrienne Malik, Department of Emergency Medicine, University of Kansas Medical Center, 4000 Cambridge St, Kansas City, MO, 66160, USA, Email amalik3@kumc.edu; adriennemalikmd@gmail.comBackground: Patients with difficult peripheral intravenous (IV) access are common in emergency departments (EDs). Ultrasound-guided peripheral intravenous catheters (USIVs) are frequently used in this population; however, information regarding the effect of patient and IV characteristics on the dwell time (DT) and survival probability (SP) of USIVs is limited.Objective: Our study aimed to evaluate for associations between patient or IV characteristics and the DT and SP of USIVs.Methods: Retrospective analysis was performed on a database from an ED nurse (RN) USIV training program at an urban, academic hospital. Patients over 18 years with an USIV placed during the study period were included. Subject demographics, history, IV characteristics, insertion, and removal times were collected. Data were analyzed using descriptive statistics and univariable and multivariable Cox regression. USIV survival times for variates of interest were estimated using Kaplan–Meier curves for three censoring points.Results: The final analysis cohort was 388 patients. Mean age was 56.6 years, 66.5% were female, mean BMI was 29.9 kg/m2, and 42.5% were obese (BMI ≥ 30). Median DT was 40.3 hours in admitted patients (N=340). SP for USIVs at 96 hours was 87.8%. A total of 21 of 340 (6.2%) USIVs failed. USIV location conferred a difference on DT in obese patients when dichotomized into upper arm versus antecubital fossa and forearm together (38.6 hours vs 44.6 hours, p=0.03). No factors were associated with a difference in USIV SP.Conclusion: Median USIV DT of 40.3 hours for admitted patients was higher than in previous studies. Only 7% of USIVs in our study failed. Overall, catheters survived longer than expected.Keywords: ultrasound, peripheral IV, retrospective, emergency medicine, vascular access

The Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), supported by the Society of Thoracic Surgeons, provides detailed information on pediatric patients supported with ventricular assist devices (VADs).From September 19, 2012, to December 31, 2021, there were 1,355 devices in 1,109 patients (19 years) from 42 North American Hospitals.Cardiomyopathy was the most common underlying etiology (58%), followed by congenital heart disease (CHD) (26%) and myocarditis (9%). Regarding device type, implantable continuous (IC) VADs were most common at 40%, followed by paracorporeal pulsatile (PP) (28%), and paracorporeal continuous (PC) (27%). Baseline demographics differed, with the PC cohort being younger, smaller, more complex (ie. CHD), and sicker at implant (P.0001). At six months post-VAD implantation, a favorable outcome (transplant, recovery, or alive on device) was achieved in 84% of patients, which was greatest among those on IC VADs (92%) and least for PC VADs (69%). Adverse events (AEs) were not uncommon, with non-gastrointestinal bleeding (incidence of 14%) and neurological dysfunction (11% [Stroke 4%]), within 2 weeks post implant being the most prevalent. Stroke and bleeding had negative impacts on overall survival (p=0.002 and p0.001, respectively).This Sixth Pedimacs Report demonstrates the continued evolution of the pediatric field. The complexity of cardiac physiologies and anatomical constraint mandates the need for multiple types of devices utilized (PC, PP, IC). Detailed analyses of each device type in this report provide valuable information to further advance the care of this challenging and vulnerable population.

In recent years, IoT adoption has been higher, and this causes lots of security concerns. One of the fundamental security concerns in IoT adoption is the question, “Are you who you say you are?” Thus, authentication forms the gateway for a secure communication system with IoT. So far, the human voice is one of the most natural, non-intrusive, and convenient behavioural biometric factors compared to other biometric authentication methods. Despite the non-intrusive characteristics of voice as a biometric authentication factor when accessing IoT technologies, there is a concern of a general societal trust and distrust with IoT technology and the risk of theft of users' data and imitation. This study derived a realistic trust evaluation model that incorporates privacy, reliability, security, usability, safety, and availability factors into a trust vector for a flexible measurement of trust in the user accessing IoT technologies.

Objective. (1) Examine QoL of caregivers of patients with brain tumours compared to population norms and other cancer caregiver groups, (2) appraise the content of quantitative QoL outcome measures utilised, and (3) assess to what extent QoL measures used in research align with caregivers’ priorities. Methods. Systematic literature search of studies including caregivers of brain tumour patients using self-completed assessments of QoL. Extracted data from included studies included quantitative QoL outcome data, QoL outcome measures utilised, and the included QoL domains. The impact of brain tumour patient caregiving was assessed by summarising included data comparing brain tumour caregivers to other cancer caregivers and normative population data. QoL measures utilised by the studies and their domains were extracted, coded, and analysed by themes. The rates of investigation by theme were then compared to existing data on caregiver-own preference in relation to QoL. Results. 49 studies, including 57 outcome measures, incorporating a combined 124 QoL domains. Brain tumour caregivers reported lower QoL outcomes than population norms but similar to other cancer caregiver groups. Thematic analysis of QoL domains generated 7 themes: caregiving burden and adaptation, existential and self, family and social support, finances, information needs, physical symptoms and functioning, and psychological symptoms and wellbeing. The most investigated themes were physical and psychological symptoms, the most important for caregivers themselves were family and social support. Conclusions. Caregiving for brain tumour patients is shown to negatively affect QoL, particularly mental health, burden, and social life. Existing QoL research in caregivers of brain tumour patients predominantly utilises generic QoL measures designed for use in patients and draws a medicalised view of QoL priorities. The few studies using caregiver-specific QoL measures demonstrated closer alignment to caregiver preferences such as family and social support.

Purpose This paper aims to develop a deeper understanding of what (un)sustainable food behaviours and values are transmitted across generations, to what extent this transference happens and the sustainability challenges resulting from this for individuals and households. Design/methodology/approach A total of 25 semi-structured in-depth interviews are analysed regarding the value of inherited food, family food rituals, habits and traditions, aspects of food production and understanding of sustainability. Findings Intergenerational transferences are significant in shaping (un)sustainable consumption throughout life, and those passed-on behaviours and values offer opportunities for lifelong sustainable change and food consumption reappraisal in daily life, beyond early years parenting and across diverse households. Research limitations/implications Participants were limited to British families, although the sample drew on multiple ethnic heritages. Future research could study collectivist versus more individualistic cultural influence; explore intergenerational transference of other diverse households, such as multigeneration or in rural and urban locations, or whether sustainable crossover derived from familial socialisation continues into behaviours and values beyond food. Practical implications The findings show the importance of families and intergenerational transference to the embedding of sustainable consumption behaviours. Mundane family life is a critical source of sustainable learning, and marketers should prioritise understanding of the context and relationships that drive sustainable consumer choices. Opportunities for intentional and unintentional sustainable learning exist throughout life, and marketers and policymakers can both disrupt unsustainable and encourage sustainable behaviours with appropriate interventions, such as nostalgic or well-being communications. The paper sheds light on flexible sustainable identities and how ambivalence or accelerated lives can deflect how policy messages are received, preventing sustainable choices. Originality/value The findings provide greater understanding about the mechanisms responsible for the sustainable transformation of consumption habits, suggesting intergenerational transferences are significant in shaping (un)sustainable food consumption throughout life. The study shows secondary socialisation can play a critical role in the modification of early behaviour patterns of food socialisation. The authors found individuals replicate food behaviours and values from childhood, but through a process of lifelong learning, can break formative habits, particularly with reverse socialisation influences that prioritise sustainable behaviours.

IntroductionVisually normal areas of the lung with high attenuation on computed tomography (CT) imaging, termed CT lung injury, may represent injured but not yet remodelled lung parenchyma. This prospective cohort study examined if CT lung injury is associated with future interstitial features on CT and restrictive spirometry abnormality among participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study.MethodsCARDIA is a population-based cohort study. CT scans obtained at two time points were assessed objectively for amount of lung tissue characterised as CT lung injury and interstitial features. Restrictive spirometry was defined as having a forced vital capacity (FVC) 70%.ResultsAmong 2213 participants, the median percentage of lung tissue characterised as CT lung injury at a mean age of 40 years was 3.4% (interquartile range 0.8–18.0%). After adjustment for covariates, a 10% higher amount of CT lung injury at mean age 40 years was associated with a 4.37% (95% CI 3.99–4.74%) higher amount of lung tissue characterised as interstitial features at mean age 50 years. Compared to those with the lowest quartile of CT lung injury at mean age 40 years, there were higher odds of incident restrictive spirometry at mean age 55 years in quartile 2 (OR 2.05, 95% CI 1.20–3.48), quartile 3 (OR 2.80, 95% CI 1.66–4.72) and quartile 4 (OR 3.77, 95% CI 2.24–6.33).ConclusionsCT lung injury is an early objective measure that indicates risk of future lung impairment.

Purpose Values are critical to how individuals make decisions and cope, yet the values of heart failure (HF) patients and their family caregivers (FCGs) remain understudied. We sought to report the state of the science on how values are discussed, reflected upon, and acted on by patients with HF, their FCGs, or both related to health-related decision making and coping. Method A scoping review was conducted of empirical studies using the following keywords: “heart failure,” “values,” “decision-making,” and “coping.” PubMed, PsycINFO, and Scopus were searched from inception to June 2022 in English. Included articles reported values as a key finding (outcome/theme) in their abstract. Results Of 448 articles screened for eligibility, 16 met the inclusion criteria. Twelve articles reported findings addressing patient values, 3 addressed patient and FCG values, and 1 addressed FCG values. Values were reported to influence patient self-care behaviors and left ventricular assist device (LVAD) implantation decisions, although their prioritization varied across time and contexts. When prioritized values conflicted with recommended self-care activities, some patients modified their approach to achieving the value. Others modified or abandoned tasks in favor of the value and accompanying goals. Low motivation and alignment between unhealthy behaviors and values often led to nonadherent decisions. Five of 8 articles focusing on cardiac devices reported patient survival as the most prioritized value during implantation decisions. FCG values were rarely reported or evaluated separately from patient values. Patients leveraged several coping strategies, although the processes through which values affected coping was not described. Conclusions Prioritized values influenced HF-related decisions, including self-care and LVAD implantation. While several articles reported on coping and values, none described processes through which values affect coping, which highlights a research gap. Highlights Family caregiver values were rarely reported or evaluated separately from patient values, highlighting a gap in the literature.

Pelvic tilt is thought to be a compensatory mechanism in hip pathology, specifically in patients with femoroacetabular impingement syndrome (FAIS) and hip dysplasia. This study investigated the relationship between preoperative pelvic tilt and postoperative outcomes in patients undergoing hip preservation surgery for FAIS or hip dysplasia. We reviewed a prospective hip preservation database for demographic, radiographic, and outcome data for 89 patients who underwent hip preservation surgery with a primary diagnosis of FAIS or dysplasia from 2016 to 2020. Pelvic tilt was assessed on the standing anteroposterior radiograph with the pubic symphysis to sacroiliac joint (PS-SI) distance measurement. The International Hip Outcome Tool 12 (iHOT-12), Hip Outcome Score, Harris Hip Score, UCLA activity score, and European Quality of Life–Visual Analog Scale were used to assess hip function and pain preoperatively and postoperatively. The mean pelvic tilt (PS-SI distance) was 86.4±18.3 mm for the FAIS group and 96.2±15.1 mm for the dysplasia group. The statistical analysis demonstrated a positive relationship between pelvic tilt and change in iHOT-12 score ( r s =0.262, P =.019) for all 89 patients with hip pathology and, separately, a trend toward significance for the 42 patients with FAIS ( r s =0.330, P =.056). No other significant relationships were observed. The improvement in iHOT-12 score was greater for patients with more anterior tilt and less for patients with posterior pelvic tilt, regardless of underlying hip etiology. These results provide intriguing insights into an initial investigation on pelvic tilt in patients undergoing hip preservation surgery. Further investigation is necessary to assess pelvic tilt preoperatively and postoperatively, spinal parameters, and longer-term outcomes. [ Orthopedics . 202x;4x(x):xx–xx.]

Recurrence remains a significant clinical barrier to improving breast cancer patient outcomes. The RON receptor is a predictor of metastatic progression and recurrence in breast cancers of all subtypes. RON directed therapies are in development, but pre-clinical data directly testing the impact of RON inhibition on metastatic progression/recurrence are lacking, and mechanisms to exert this function remain unclear. Herein, we modeled breast cancer recurrence using implantation of RON-overexpressing murine breast cancer cells. Recurrent growth was examined after tumor resection via in vivo imaging and ex vivo culture of circulating tumor cells from whole blood samples from tumor bearing mice. In vitro functional assessment of was performed using mammosphere formation assays. Transcriptomic pathway enrichment identified glycolysis and cholesterol biosynthesis pathways, transcription factor targets, and signaling pathways enriched in RON-overexpressing breast cancer cells. BMS777607, a RON inhibitor, abrogated CTC colony formation tumor cells and tumor recurrence. RON promoted mammosphere formation through upregulated cholesterol production that utilizes glycolysis-derived substrates. In mouse models with RON overexpression, statin-mediated inhibition of cholesterol biosynthesis impeded metastatic progression and recurrence but does not affect the primary tumor. RON upregulates glycolysis and cholesterol biosynthesis gene expression by two pathways: MAPK-dependent c-Myc expression and β-catenin-dependent SREBP2 expression.

Intimate partner violence (IPV) represents a significant public health concern. Adverse childhood experiences (ACEs) represent one risk factor for IPV, however, the results of existing research on the association between ACEs and IPV demonstrate mixed findings. The present research sought to meta-analytically examine the association between ACEs and (a) IPV perpetration and (b) IPV victimization. Moderator analyses were conducted to determine factors that may impact the association between ACEs and IPV involvement. Electronic searches were conducted in MEDLINE, Embase, and PsycINFO in August of 2021. One-hundred and twenty-three records were screened for inclusion. All studies included a measure of ACEs and IPV victimization or perpetration. Among the 27 studies and 41 samples included in the meta-analysis, 65,330 participants were included. The results of the meta-analyses demonstrated that ACEs were positively associated with IPV perpetration and victimization. Significant methodological and measurement moderators further inform our understanding of ACEs and IPV involvement. The present meta-analyses demonstrates that trauma-informed approaches to IPV screening, prevention, and intervention may be useful, given that individuals who are involved with IPV may be more likely to possess a history of ACEs exposure.

Factors influencing the clinical outcomes after periacetabular osteotomy (PAO) have not been well explored. This study evaluated the influence of symptom duration in developmental dysplasia of the hip on short-term patient-reported outcomes after PAO. A retrospective review of prospectively collected data identified PAOs performed on 139 patients. Sixty-five patients were then stratified into two groups based on preoperative symptom duration: 2 years or less (n=22) vs more than 2 years (n=43). We compared the results of hip-specific patient-reported outcome surveys collected preoperatively and postoperatively. When comparing the two groups, we found no significant differences in clinical outcome scores except for the UCLA Activity Scale. The shorter duration group achieved improvement 6 months postoperatively on the visual analog scale average pain score (from 4.5 to 2.167; P =.0017), International Hip Outcome Tool-12 (from 42.95 to 59.19; P =.0176), and Harris Hip Score (from 53.88 to 69.88; P =.049). The longer duration group also achieved postoperative improvement across multiple surveys. Nevertheless, a multivariate analysis controlling for age, sex, and body mass index and found that symptom duration did not independently affect the change in clinical outcomes. Although PAO leads to improvements in functional status and pain, preoperative symptom duration does not significantly affect these clinical outcomes. [ Orthopedics . 202x;4x(x):xx–xx.]

Mitochondrial function and metabolic homeostasis are integral to cardiovascular function and influence how vascular cells respond to stress. However, little is known regarding how mitochondrial redox control mechanisms and metabolic regulation interact in the developing lungs. Here we show that human Obg-like ATPase-1 (OLA1) couples redox signals to the metabolic response pathway by activating metabolic gene transcription in the nucleus. We observed that OLA1 phosphorylation at Ser232/Tyr236 triggers its translocation from the cytoplasm/mitochondria into the nucleus. Subsequent phosphorylation of OLA1 at Thr325 effectively changes its biochemical function from ATPase to GTPase, promoting the expression of genes involved in the mitochondrial bioenergetic function. This process is regulated by extracellular-regulated kinases (ERK1/2), which were restrained by protein phosphatases 1A (PP1A) when stress abated. Knockdowns of ERK1 or OLA1 mutated to a phosphoresistant T325A mutant blocked its nuclear translocation, compromised the expression of nuclear-encoded mitochondrial genes, and as a consequence, led to cellular energy depletion. Moreover, the lungs of OLA1 knockout mice have fewer numbers of mitochondria, lower cellular ATP levels, and higher lactate levels. The ensuing mitochondrial metabolic dysfunction resulted in abnormal behaviors of pulmonary vascular cells and significant vascular remodeling. Our findings demonstrate that OLA1 is an important component of the mitochondrial retrograde communication pathways that couple stress signals with metabolic genes in the nucleus. Thus, phosphorylation-dependent nuclear OLA1 localization that governs cellular energy metabolism is critical to cardiovascular function.

Background: Computed tomography (CT) findings of acute and chronic ischemia are associated with subsequent stroke risk in patients with transient ischemic attack. We sought to validate these associations in a large prospective cohort of patients with transient ischemic attack or minor stroke. Methods: This prospective cohort study enrolled emergency department patients from 13 hospitals with transient ischemic attack who had CT imaging. Primary outcome was stroke within 90 days. Secondary outcomes were stroke within 2 or 7 days. CT findings were abstracted from radiology reports and classified for the presence of acute ischemia, chronic ischemia, or microangiopathy. Multivariable logistic regression was used to test associations with primary and secondary end points. Results: From 8670 prospectively enrolled patients between May 2010 and May 2017, 8382 had a CT within 24 hours. From this total population, 4547 (54%) patients had evidence of acute ischemia, chronic ischemia, or microangiopathy on CT, of whom 175 had a subsequent stroke within 90 days (3.8% subsequent stroke rate; adjusted odds ratio [aOR], 2.33 [95% CI, 1.62–3.36]). This was in comparison to those with CT imaging without ischemia. Findings associated with an increased risk of stroke at 90 days were isolated acute ischemia (6.0%; aOR, 2.42 [95% CI, 1.03–5.66]), acute ischemia with microangiopathy (10.7%; aOR, 3.34 [95% CI, 1.57–7.14]), chronic ischemia with microangiopathy (5.2%; aOR, 1.83 [95% CI, 1.34–2.50]), and acute ischemia with chronic ischemia and microangiopathy (10.9%; aOR, 3.49 [95% CI, 1.54–7.91]). Acute ischemia with chronic ischemia and microangiopathy were most strongly associated with subsequent stroke within 2 days (aOR, 4.36 [95% CI, 1.31–14.54]) and 7 days (aOR, 4.50 [95% CI, 1.73–11.69]). Conclusions: In patients with transient ischemic attack or minor stroke, CT evidence of acute ischemia with chronic ischemia or microangiopathy significantly increases the risk of subsequent stroke within 90 days of index visit. The combination of all 3 findings results in the greatest early risk.

Current economic conditions demonstrate the need for disease-resistant, highly productive pecan (Carya illinoinensis) cultivars for the southeastern United States that can generate high yield potential and can be produced at a reduced cost to enhance grower profit margins. The objectives of this study were to evaluate the performance of the pecan cultivars Lakota, McMillan, and Excel in the humid growing region of the Coastal Plain of Georgia, USA, in the absence of fungicides. In addition, recognizing the excessive nut production of ‘Lakota’, we evaluated the response of ‘Lakota’ to mechanical fruit thinning. Four trees each of ‘Lakota’, ‘McMillan’, and ‘Excel’ were selected randomly for sampling. Trees within this orchard block receive no fungicide applications. Pecan scab (Venturia effusa) was not observed on any cultivar evaluated throughout the study. Powdery mildew (Microsphaera alni) was observed on all cultivars, but was significantly greater on ‘McMillan’ in 2020 and 2022 as a result of drier conditions in those years. Based on current data, all three pecan cultivars evaluated during this study are suitable for commercial production; however, ‘Lakota’ and ‘Excel’ performed best under these conditions in terms of nut yield. There was no consistent difference in nut weight among cultivars. ‘Lakota’ has the greatest potential in terms of percent kernel, averaging 58% kernel compared with 49% and 52%, respectively, for ‘Excel’ and ‘McMillan’. However, in years of excessive cropping, percent kernel of ‘Lakota’ is reduced significantly. Mechanical fruit thinning increased the following year’s production of ‘Lakota’ by 82% over nonthinned trees.