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Background: Dissatisfaction with Total Knee Arthroplasty (TKA) surgical outcomes remains between 10–20% and is associated with higher levels of societal costs. Expectations regarding post-surgical outcomes is considered as one of the major factors influencing satisfaction, however, there are no standardised methods for assessing patient's expectations regarding activities to be achieved following surgery. Objectives: The aims of this study were to identify patient expectations relating to activities of importance following TKA and to describe goal fulfillment at 3 months post-TKA. We hypothesised that activity expectation fulfillment would be associated with overall satisfaction with TKA outcomes. Methods: This study comprised secondary data analysis of findings from the SuPeR Knee study. Using conventional content analysis, a classification system of activities specific to our TKA patient cohort was created. At 3 months following TKA, patients rated satisfaction with fulfilling activity goals and pain attenuation. The average level of satisfaction achieved was used as our measure of goal fulfillment. Overall satisfaction of the outcomes of surgery was rated using a 5-point Likert scale and the association between goal fulfillment and overall surgery satisfaction was compared by Spearman's rank correlation. Results: Data were collected from 861 TKA patients. Recreation and sporting pursuits were found to be important activity types (43% of all activities). At 3 months after surgery, less impactful activities were more commonly satisfied (67%), including domestic and vocational activities, low impact hobbies and leisure activities. Goal fulfillment and improvement in knee pain were both significantly positively correlated to, and significant predictors of, overall patient satisfaction (p≤0.001). Conclusions: Our Australian cohort of TKA patients have a range of expectations for undertaking high-impact activities after surgery. However, at 3 months after surgery, higher rates of satisfaction were attained for lower-impact activities. Our findings support the importance of identifying activity expectations for each patient and that fulfillment of these goals contributes to overall satisfaction with the outcomes of TKA. [ABSTRACT FROM AUTHOR]

The Southeast Area Monitoring and Assessment Program (SEAMAP) Bottom Longline (BLL) survey was established to provide a nearshore complement to the offshore National Marine Fisheries Service (NMFS) BLL survey. SEAMAP state partners (i.e., Texas, Louisiana, Mississippi, and Alabama) used identical gear and sampling protocol to NMFS; however, temporal window, sampling universe, sampling frequency, and station selection were determined independently by each state based on available resources and capabilities. Although each state collected high quality data, the lack of a unified design complicated the efforts to combine state partner data to develop an index of abundance for stock assessment purposes. To improve the value of the survey and prioritize the quality and utility of the resultant data, the SEAMAP BLL survey was modified to implement a unified design that included consistency in spatial coverage and sampling frequency, and proportional allocation of sampling effort. Data from the early (2008-2014) and modified (2015-2021) SEAMAP BLL surveys, and from the modified SEAMAP and NMFS surveys were compared to determine the effects of this unified design on data precision. Overall catch composition slightly differed between the early and modified SEAMAP BLL surveys; however, taxa with declined abundance under the modified SEAMAP BLL survey were adequately sampled by the complementary NMFS BLL survey. Size composition was compared for three managed species. The size composition of Atlantic Sharpnose Sharks and Blacktip Sharks differed significantly between the modified SEAMAP BLL survey and the NMFS BLL survey, indicating that the modified survey is indeed providing complementary data. Further, implementing the modified design reduced the coefficient of variation for the indices of abundance for both Blacktip Sharks and Red Drum. The evolution of this survey highlights the benefit of unifying survey designs that build upon existing efforts to enhance the utility of survey data for multiple applications. [ABSTRACT FROM AUTHOR]

Generation of high avidity T cell receptors (TCRs) reactive to tumor-associated antigens (TAA) is impaired by tolerance mechanisms, which is an obstacle to effective T cell therapies for cancer treatment. NY-ESO-1, a human cancer-testis antigen, represents an attractive target for such therapies due to its broad expression in different cancer types and the restricted expression in normal tissues. Utilizing transgenic mice with a diverse human TCR repertoire, we isolated effective TCRs against NY-ESO-1157-165 restricted to HLA-A*02:01. We compared the functions of the murine-derived TCR with human-derived TCRs and an affinity matured TCR, using in vitro co-culture and in vivo adoptive T cell transfer in tumor-bearing mice. Alanine scan, x-scan, LCL assay were employed to address the cross-reactivity of the NY-ESO-1157-165 specific TCRs. We also used human tissue cDNA library and human primary cells to assess the safety of adoptive T cell therapies targeting NY-ESO-1 antigen in the clinic. One of the murine-derived human TCRs, TCR-ESO, exhibited higher functional avidity compared to human-derived NY-ESO-1157-165 specific TCRs. TCR-ESO appeared to have similar efficiency in antigen recognition as an in vitro affinity-matured TCR, TCR 1G4-α95LY, which was applied in clinical trials. TCR-ESO showed little cross-reactivity, in contrast to TCR 1G4-α95LY. Our data indicate that highly effective TCRs against NY-ESO-1 are likely deleted in humans due to tolerance mechanisms, and that the TCR gene loci transgenic mice represent a reliable source to isolate effective and highly-specific TCRs for adoptive T cell therapies. [ABSTRACT FROM AUTHOR]

Ameloblastoma is a rare tumor arising from odontogenic cells that is benign, yet locally aggressive. Metastasizing ameloblastoma (METAM) is an ultra-rare ameloblastoma variant in which both primary and secondary tumors have histological features of benign ameloblastoma. This is a case report of a patient who presented with a jaw mass and subsequent lung metastases, later diagnosed as METAM. Initial treatments, including carboplatin, etoposide, and taxane-based chemotherapy, were ineffective. Molecular profiling revealed mutations including PIK3CA H1047R and BRAF V600E. The patient was enrolled in a tumor-agnostic trial and began treatment with copanlisib, a PI3K inhibitor, which resulted in a partial response and durable disease regression. After 76 cycles, she continues to tolerate therapy well with minimal adverse events. This case highlights the potential of targeted therapies such as copanlisib for treating METAM, providing a promising therapeutic option for patients with PIK3CA mutations. [ABSTRACT FROM AUTHOR]

Romosozumab is a potent treatment for osteoporosis, with significant effects on bone density and fracture prevention. This study evaluated the cardiovascular safety of romosozumab in a real-world cohort of postmenopausal women at high fracture risk. We retrospectively evaluated postmenopausal women who initiated treatment with romosozumab between January 1, 2020, and June 30, 2023. We examined the occurrence of a major adverse cardiovascular event (MACE) across two distinct segments during the treatment period and after its conclusion. After applying inclusion and exclusion criteria, 847 women were followed for a median of 729 days (IQR: 445-1060). The incidence rate of MACE was 24.0 (95% CI 17.7-32.5) per 1000 person-years during the study period. The change in the rate of MACE from 0-90 days and 90-365 days post-treatment initiation was 0.04 and 0.06 events per 1000 days, respectively. The difference in the rate between these intervals was not statistically significant (p  = .09). After 1 yr of treatment, the slope of MACE increased to 0.10, differing significantly from the preceding 12 mo on treatment (p <.001). The incidence of MACE was higher in those with a background of previous cardiovascular disease or diabetes at all timepoints, as expected. The consistency in event rates during treatment suggests that romosozumab is not associated with an increase in MACE in postmenopausal women. This finding challenges reports suggesting an increase in cardiovascular events within the first year of romosozumab treatment. [ABSTRACT FROM AUTHOR]

Purpose: This Hydrocephalus Clinical Research Network (HCRN) study had two aims: (1) to compare the predictive performance of the original ETV Success Score (ETVSS) using logistic regression modeling with other newer machine learning models and (2) to assess whether inclusion of imaging variables improves prediction performance using machine learning models. Methods: We identified children undergoing first-time ETV for hydrocephalus that were enrolled prospectively at HCRN sites between 200 and 2020. The primary outcome was ETV success 6 months after index surgery. The cohort was randomly divided into training (70%) and testing (30%) datasets. The classic ETVSS variables were used for logistic regression and machine learning models. Predictive performance of each model was evaluated on the testing dataset using area under the receiver operating characteristic curve (AUROC). Results: There were 752 patients that underwent first time ETV, of which 185 patients (24.6%) experienced ETV failure within 6 months. For aim 1, using the classic ETVSS variables, machine learning models did not outperform logistic regression with AUROC 0.60 (95% CI: 0.52–0.69) for Naïve Bayes (highest machine learning model performance) and 0.68 (95% CI: 0.60–0.76) for logistic regression. After inclusion of imaging features (aim 2), machine learning model prediction improved but remained no better than the above logistic regression with the highest AUROC of 0.67 (95% CI: 0.59–0.75) attained using Naïve Bayes architecture compared to 0.68 (95% CI: 0.59–0.76) for logistic regression. Conclusions: This contemporary multicenter observational cohort study demonstrated that machine learning modeling strategies did not improve performance of the ETVSS model over logistic regression. [ABSTRACT FROM AUTHOR]

Purpose To identify pharmacy technician career pathways across pharmacy practice settings and opportunities to strengthen and expand these pathways. Methods Interviews were conducted with 17 participants from national pharmacy organizations, community pharmacies, health systems, and academia from March to May 2023. Interview questions were designed to elicit participants' perceptions of factors influencing entry into, recruitment and retention of, and advancement of the pharmacy technician workforce. Interview notes were analyzed using a rapid thematic analysis approach. Results Seven themes were identified, including 3 themes related to entry: (1) healthcare interest and prior exposure facilitate pharmacy technician career discovery; (2) variation in and quantity of entry-level requirements can impede entry into pharmacy technician careers; and (3) proactive promotion of pharmacy technician careers needed. Two themes were related to recruitment and retention: (4) pharmacy technician compensation not aligned with job demands and (5) career ladders or lattices create advancement opportunities. Two themes were related to professional advancement: (6) pharmacy technician advancement limited by weak professional identity and (7) scope-of-practice policies can facilitate pharmacy technician advancement. Conclusion This study highlights the challenges pharmacy technicians face in their careers. Key findings stress cultivating a professional identity for pharmacy technicians, establishing career ladders or lattices, and advocating for policies that facilitate pharmacy technician professional advancement. These efforts are vital for sustaining the pharmacy technician workforce and ensuring quality patient care amidst the changing landscape of the pharmacy profession. [ABSTRACT FROM AUTHOR]

ABSTRACT Viral lower respiratory tract infection (vLRTI) is a leading cause of hospitalization and death in children worldwide. Despite this, no studies have employed proteomics to characterize host immune responses to severe pediatric vLRTI in both the lower airway and systemic circulation. To address this gap, gain insights into vLRTI pathophysiology, and test a novel diagnostic approach, we assayed 1,305 proteins in tracheal aspirate (TA) and plasma from 62 critically ill children using SomaScan. We performed differential expression (DE) and pathway analyses comparing vLRTI (n = 40) to controls with non-infectious acute respiratory failure (n = 22), developed a diagnostic classifier using LASSO regression, and analyzed matched TA and plasma samples. We further investigated the impact of viral load and bacterial coinfection on the proteome. The TA signature of vLRTI was characterized by 200 DE proteins (Padj

The Southeast Area Monitoring and Assessment Program (SEAMAP) Bottom Longline (BLL) survey was established to provide a nearshore complement to the offshore National Marine Fisheries Service (NMFS) BLL survey. SEAMAP state partners (i.e., Texas, Louisiana, Mississippi, and Alabama) used identical gear and sampling protocol to NMFS; however, temporal window, sampling universe, sampling frequency, and station selection were determined independently by each state based on available resources and capabilities. Although each state collected high quality data, the lack of a unified design complicated the efforts to combine state partner data to develop an index of abundance for stock assessment purposes. To improve the value of the survey and prioritize the quality and utility of the resultant data, the SEAMAP BLL survey was modified to implement a unified design that included consistency in spatial coverage and sampling frequency, and proportional allocation of sampling effort. Data from the early (2008-2014) and modified (2015-2021) SEAMAP BLL surveys, and from the modified SEAMAP and NMFS surveys were compared to determine the effects of this unified design on data precision. Overall catch composition slightly differed between the early and modified SEAMAP BLL surveys; however, taxa with declined abundance under the modified SEAMAP BLL survey were adequately sampled by the complementary NMFS BLL survey. Size composition was compared for three managed species. The size composition of Atlantic Sharpnose Sharks and Blacktip Sharks differed significantly between the modified SEAMAP BLL survey and the NMFS BLL survey, indicating that the modified survey is indeed providing complementary data. Further, implementing the modified design reduced the coefficient of variation for the indices of abundance for both Blacktip Sharks and Red Drum. The evolution of this survey highlights the benefit of unifying survey designs that build upon existing efforts to enhance the utility of survey data for multiple applications.

The article emphasizes the importance of integrating sustainable design and engineering principles into education, highlighting the profound impact on environmental and community practices. Topics include incorporating sustainability into daily classroom activities, fostering a mindset shift towards eco-conscious decision-making, and encouraging holistic approaches that connect technological education with broader ecological and social systems.