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Objective: The purpose of this study was to evaluate whether a new anticoagulation management program resulted in better monitoring of warfarin, increased warfarin patient education prior to discharge, and fewer bleeding complications associated with warfarin.Methods: A retrospective chart review was conducted of all patients who were inpatients and received warfarin from April 1, 2008 to July 31, 2008 (control group) and from April 1, 2009 to July 31, 2009 (after implementation of the new anticoagulation program). The frequency of warfarin-related laboratory orders that included international normalized ratios (INRs), complete blood counts (CBCs), and documented patient education by pharmacy, nursing, and dietary services were determined before and after program implementation. Also, data was collected to determine frequencies of bleeding complications associated with warfarin.Results: There were 112 patients in the pre- and 115 patients in the post-program group. After implementation of the inpatient warfarin management program, obtaining baseline INRs increased from 74% to 90% (p=0.001). Orders for baseline CBCs increased from 85% to 94% (p=0.026). Obtaining CBCs every 3 days increased from 54% to 74%, (p

Objectives We conducted a mortality study of members of the United Food and Commercial Workers International Union who worked in poultry slaughtering/processing plants, and controls. Excess deaths from cancer at 11 different cancer sites including lung cancer were observed in the poultry workers. The study described here is a pilot case-cohort study of lung cancer nested within the cohort to examine if it is possible, in a larger study to be conducted later, to identify specific potentially carcinogenic occupational exposures in poultry workers. Methods Subjects or the next of kin of deceased subjects were interviewed by phone. Logistic regression ORs and Cox proportional HRs were estimated. Results Elevated risks for poultry exposure were recorded for subjects who (1) killed chickens at work (OR 4.2, 95% CI 1.2 to 14.7; HR 1.8, 95% CI 1.0 to 3.3) and (2) ever had direct contact with chicken blood at work (OR 1.9, 95% CI 1.0 to 3.8; HR 1.3, 95% CI 0.9 to 2.0). These activities are associated with high exposure to oncogenic viruses. Conclusion These results may have important public health implications, since the general population is also exposed to these viruses. Elevated risks were observed for non-poultry-related occupational exposures such as working in a stockyard, working in a chemical plant, use of chemicals to kill moulds, and working in plants where plastic products were manufactured. These preliminary findings indicate that full scale epidemiological studies of adequate statistical power are needed to examine the role of occupational exposures in cancer occurrence in poultry workers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Providers need a reliable way to identify patients with chronic kidney disease (CKD) at the highest risk of progression to end-stage renal disease so they can intervene to slow progression and refer patients to nephrology for comanagement. We developed a risk score to predict the 5-year risk of renal replacement therapy (RRT) in patients with stage 3 or 4 CKD. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Participants were members of a health maintenance organization and met Kidney Disease Outcomes Quality Initiative criteria for stage 3 or 4 CKD during 1999 or 2000: two estimated glomerular filtration rate values of 15 to 59 mL/min/1.73 m(2). PREDICTOR: Characteristics collected during routine clinical practice. OUTCOMES & MEASUREMENTS: We ascertained the onset of RRT (dialysis or kidney transplantation) using the health maintenance organization databases. Cox regression predicted patient risk of RRT and generated a risk scoring system. RESULTS: 9,782 patients experienced a 3.3% five-year progression to RRT (95% confidence interval, 2.9 to 3.7). Using 6 characteristics (age, sex, estimated glomerular filtration rate, diabetes, anemia, and hypertension), the risk score discriminated the highest risk patients effectively: 19.0% of patients in the highest risk quintile experienced progression, and 0.2% of patients in the lowest risk quintile experienced progression. The c statistic also showed effective discrimination: 0.89 on a scale of 0.5 to 1.0. Predicted and observed risks agreed within 1.0%--effective calibration. We present a range of predicted risk cutoff values from 1% to 20% and their test properties for decision makers' consideration. LIMITATIONS: Characteristics were measured without a protocol. CONCLUSIONS: The risk score can help providers identify patients with CKD at the highest risk of progression to improve referral to nephrology for comanagement. A separate risk score for mortality also is needed. Copyright © 2008 National Kidney Foundation, Inc. [ABSTRACT FROM AUTHOR]

Aims: We assessed whether a novel programme to evaluate/communicate predicted coronary heart disease (CHD) risk could lower patients' predicted Framingham CHD risk vs. usual care.Methods: The Risk Evaluation and Communication Health Outcomes and Utilization Trial was a prospective, controlled, cluster-randomised trial in nine European countries, among patients at moderate cardiovascular risk. Following baseline assessments, physicians in the intervention group calculated patients' predicted CHD risk and were instructed to advise patients according to a risk evaluation/communication programme. Usual care physicians did not calculate patients' risk and provided usual care only. The primary end-point was Framingham 10-year CHD risk at 6 months with intervention vs. usual care.Results: Of 1103 patients across 100 sites, 524 patients receiving intervention, and 461 receiving usual care, were analysed for efficacy. After 6 months, mean predicted risks were 12.5% with intervention, and 13.7% with usual care [odds ratio = 0.896; p = 0.001, adjusted for risk at baseline (17.2% intervention; 16.9% usual care) and other covariates]. The proportion of patients achieving both blood pressure and low-density lipoprotein cholesterol targets was significantly higher with intervention (25.4%) than usual care (14.1%; p < 0.001), and 29.3% of smokers in the intervention group quit smoking vs. 21.4% of those receiving usual care (p = 0.04).Conclusions: A physician-implemented CHD risk evaluation/communication programme improved patients' modifiable risk factor profile, and lowered predicted CHD risk compared with usual care. By combining this strategy with more intensive treatment to reduce residual modifiable risk, we believe that substantial improvements in cardiovascular disease prevention could be achieved in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Current research efforts have mainly concentrated on evaluating the role of substances present in animal food in the aetiology of chronic diseases in humans, with relatively little attention given to evaluating the role of transmissible agents that are also present. Meat workers are exposed to a variety of transmissible agents present in food animals and their products. This study investigates mortality from non-malignant diseases in workers with these exposures.Methods: A cohort mortality study was conducted between 1949 and 1989, of 8520 meat workers in a union in Baltimore, Maryland, who worked in manufacturing plants where animals were killed or processed, and who had high exposures to transmissible agents. Mortality in meat workers was compared with that in a control group of 6081 workers in the same union, and also with the US general population. Risk was estimated by proportional mortality and standardised mortality ratios (SMRs) and relative SMR.Results: A clear excess of mortality from septicaemia, subarachnoid haemorrhage, chronic nephritis, acute and subacute endocarditis, functional diseases of the heart, and decreased risk of mortality from pre-cerebral, cerebral artery stenosis were observed in meat workers when compared to the control group or to the US general population.Conclusions: The authors hypothesise that zoonotic transmissible agents present in food animals and their products may be responsible for the occurrence of some cases of circulatory, neurological and other diseases in meat workers, and possibly in the general population exposed to these agents. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prognostic risk scores can help clinicians intervene on higher risk patients and counsel them. Our objective is to identify characteristics that predict the rate of progression to renal replacement therapy (RRT) and evaluate how those characteristics predict mortality and a composite end point (RRT and mortality). STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: We conducted the study at Kaiser Permanente Northwest, a health maintenance organization. We followed up members with an estimated glomerular filtration rate (eGFR) that indicated chronic kidney disease (2 eGFRs < 60 mL/min/1.73 m(2) [<1.0 mL/s/1.73 m(2)] at least 90 days apart). PREDICTORS: We measured baseline clinical characteristics between January 1997 and June 2000 by using electronic medical records and patients' histories of hospitalization. OUTCOMES & MEASUREMENTS: We calculated adjusted hazard ratios and concordance statistics for progression to RRT, mortality, and the composite by using Cox regression. RESULTS: Patients (n = 6,541) were followed up for up to 5 years. We observed 1.6 progressions to RRT/100 person-years and 11.4 deaths/100 person-years. The 6 characteristics of age, sex, eGFR, diabetes, hypertension, and anemia predicted RRT effectively (c statistic, 0.91). However, hypertension and age predicted in the opposite direction for mortality and its composite end point. The c statistic decreased: mortality (0.70), mortality and RRT (0.71). LIMITATIONS: Characteristics were measured without a protocol; extensive missing data prevented the evaluation of known risk factors (eg, proteinuria). CONCLUSIONS: Predicting RRT effectively requires a separate risk score. Predicting the composite end point would favor characteristics that predict mortality because it is 7 times as common as RRT. Copyright © 2007 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To report a non-cancer mortality update in supermarket meat workers. METHODS:: Mortality of 10,383 supermarket meat workers was compared with that of a control group of non-meat workers and the US population from 1949 to 1989. RESULTS:: Compared with both controls, male supermarket meat workers had an elevated relative risk for diabetes. There is also a suggestion of an increase in deaths from ischemic heart disease, other diseases of the kidney and ureter, alcoholism, and subarachnoid hemorrhage. Women had elevated relative risks for chronic bronchitis and ischemic heart disease, and possibly alcoholism. Numbers were too small to interpret the apparent increase in deaths from intracranial and intraspinal abcesses and acute nephritis in men and peritonitis in women. CONCLUSIONS:: The role of occupational exposure to transmissible agents and exposure to fumes from the wrapping machine warrants further investigation. [ABSTRACT FROM AUTHOR]

This study reviewed the alternate assessment results (N = 1,404) from 1 state that uses a portfolio system. It addressed 3 main questions: (a) the extent to which assessment content was linked to the state's general curricular standards, (b) the types of tasks that operationalized the general curricular standards, and (c) the correlation of the completeness of the portfolio with student performance. Although we found connections to the general curriculum on paper, the actual tasks used to represent the standards raised concerns about the strength of those connections. Additionally, we noted serious concerns with construct underrepresentation. Finally, practical issues with portfolio assembly may be contributing to poor student performance. We present implications for practice in the context of federal regulations such as No Child Left Behind and the Individuals With Disabilities Education Act, as well as existing research on alternate assessment practices. [ABSTRACT FROM AUTHOR]

Background: Healthy chickens or turkeys and their eggs destined for human consumption are commonly infected with viruses which cause cancer in these animals. Some of the viruses can infect and transform human cells in vitro, and human sera show serological evidence of infection with these viruses. It is not known whether the viruses cause cancer in humans.Methods: We conducted a mortality study of a subcohort of 2639 workers in poultry slaughtering plants who have one of the highest human exposures to these viruses, and 6081 unexposed workers from non-meat companies (controls). All were members of a local meatcutters' union in Baltimore.Results: Statistically significant increased risks were observed for cancer of the oesophagus, liver cancer, tumours of the haemopoietic lymphatic system, and motor vehicle accidents, in the group of poultry workers as a whole or in particular race/sex subgroups. The results for other causes of death showed consistently elevated risks in most race/sex subgroups, but these were not statistically significant.Conclusion: The cohort is young, and because the number of deaths is small, the results though suggestive of increased risks for some causes, are inconclusive. However they indicate that this cohort is of interest, and that further follow-up might reveal a much clearer and consistent picture. [ABSTRACT FROM AUTHOR]

We conducted a retrospective cohort study of Kaiser Permanente Northwest patients 18 years and older who were vaccinated with the COVID-19 bivalent vaccine between September 1, 2022 and March 1, 2023. We replicated the Vaccine Safety Datalink (VSD) rapid cycle analysis protocol to identify cases of ischemic stroke or transient ischemic attack (TIA) in the 21 days following vaccination using ICD-10-CM diagnosis codes in the primary position. The incidence of ischemic stroke or TIA was 34.3 per 100,000 (95 % CI, 17.7-59.9) in patients 65 years or older who received the bivalent Pfizer vaccine. Although a safety signal was detected in this study, further investigation is warranted to validate an association between COVID-19 vaccination and risk of ischemic stroke. Replication of the VSD case definition confirmed the exceptionally high positive predictive value in identifying ischemic stroke or TIA within 21 days of Pfizer bivalent vaccination in individuals 65 years and older. Two physician adjudication with chart review and confirmation of ischemic stroke cases allowed accurate absolute incidence estimates of stroke per 100,000 vaccine recipients and is helpful in calculation of net benefit for policy recommendations and shared decision-making., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Katie Sharff reports a relationship with Sanofi that includes: employment. Katie Sharff, first author, became an employee of Sanofi on 4/1/2024. The original brief report was submitted in February 2024 while she was still a full-time employee at Kaiser Permanente. The data collection and analysis were completed while Katie Sharff was an employee at Kaiser Permanente. No additional data was collected to address the reviewer comments. Katie Sharff is now employed at Sanofi as a medical director for vaccines which could be interpreted as a conflict of interest. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Scleromyxedema is a rare skin mucinosis often associated with systemic involvement and monoclonal gammopathy (MG). No formal recommendation for management with therapeutic plasma exchange (TPE) has been published due to rarity. This paper reports a 42-year-old male with progressive scleromyxedema. The patient was treated with glucocorticoids, immunosuppressants, and intravenous immunoglobulin (IVIG) therapy, but the disease progressed. Ultimately, the patient was referred for TPE, which resulted in decreased skin stiffness, improved extremity range of motion, and decreased visibility of papules on the hands. The patient's debilitating dysphagia gradually improved. A review of the literature focusing on clinical response identified five cases of scleromyxedema patients treated with TPE. Three of the five cases reported significant improvement in cutaneous symptoms and range of motion for at least 12 months. Overall, we propose that TPE should be considered an effective supportive treatment for symptomatic relief in severe or refractory scleromyxedema., (© 2024 The Author(s). Journal of Clinical Apheresis published by Wiley Periodicals LLC.)

Smk1 is a MAPK homolog in the yeast Saccharomyces cerevisiae that controls the postmeiotic program of spore wall assembly. During this program, haploid cells are surrounded by a layer of mannan and then a layer of glucan. These inner layers of the spore wall resemble the vegetative cell wall. Next, the outer layers consisting of chitin/chitosan and then dityrosine are assembled. The outer layers are spore-specific and provide protection against environmental stressors. Smk1 is required for the proper assembly of spore walls. However, the protective properties of the outer layers have limited our understanding of how Smk1 controls this morphogenetic program. Mutants lacking the chitin deacetylases, Cda1 and Cda2, form spores that lack the outer layers of the spore wall. In this study, cda1,2∆ cells were used to demonstrate that Smk1 promotes deposition of the glucan layer of the spore wall through the partially redundant glucan synthases Gsc2 and Fks3. Although Gsc2 is localized to sites of spore wall assembly in the wild type, it is mislocalized in the mother cell cytoplasm in the smk1∆ mutant. These findings suggest that Smk1 controls assembly of the spore wall by regulating the localization of Gsc2 during sporogenesis., (© 2024 The Author(s). Yeast published by John Wiley & Sons Ltd.)

When placed in an ionic surfactant gradient, charged colloids will undergo diffusiophoresis at a velocity, u DP = M DP ∇ ln  S , where M DP is the diffusiophoretic mobility and S is the surfactant concentration. The diffusiophoretic mobility depends in part on the charges and diffusivities of the surfactants and their counterions. Since micellization decreases surfactant diffusivity and alters charge distributions in a surfactant solution, M DP of charged colloids in ionic surfactant gradients may differ significantly when surfactant concentrations are above or below the critical micelle concentration (CMC). The role of micelles in driving diffusiophoresis is unclear, and a previously published model that accounts for micellization suggests the possibility of a change in the sign of M DP above the CMC [Warren, P. B.; . Soft Matter 2019, 15, 278-288]. In the current study, microfluidic channels were used to measure the transport of negatively charged polystyrene colloids in sodium dodecyl sulfate (SDS) surfactant gradients established at SDS concentrations that are either fully above or fully below the CMC. Interpretation of diffusiophoresis was aided by measurements of the colloid electrophoretic mobility as a function of SDS concentration. A numerical transport model incorporating the prior diffusiophoretic mobility model for ionic surfactant gradients was implemented to elucidate signatures of positive and negative diffusiophoretic mobilities and compare with experiments. The theoretically predicted sign of the diffusiophoretic mobility below the CMC was determined to be particularly sensitive to uncertainty in colloid and surfactant properties, while above the CMC, the mobility was consistently predicted to be positive in the SDS concentration range considered in the experiments conducted here. In contrast, experiments only showed signatures of a negative diffusiophoretic mobility for these negatively charged colloids with no change of sign. Colloid diffusiophoretic transport measured in micellar solutions was more extensive than that below the CMC with the same ∇ ln  S .

Objectives: Fecal immunochemical testing (FIT) is an effective screening tool for colorectal cancer. If an FIT is abnormal, a follow-up colonoscopy is necessary to remove polyps or find cancers. We sought to develop a usable risk prediction model to identify patients unlikely to complete a colonoscopy following an abnormal FIT test., Methods: We recalibrated and then redeveloped a prediction model in federally qualified health centers (FQHCs), using a retrospective cohort of patients aged 50-75 with an abnormal FIT test and clinical data. Logistic and Cox regressions were used to recalibrate and then redevelop the model., Results: The initial risk model used data from eight FQHCs (26 clinics) including 1723 patients. When we applied the model to a single large FQHC (34 clinics, 884 eligible patients), the model did not recalibrate successfully (c-statistic dropped more than 0.05, from 0.66 to 0.61). The model was redeveloped in the same FQHC in a cohort of 1401 patients with a c-statistic of 0.65., Conclusions: The original model developed in a group of FQHCs did not adequately recalibrate in the single large FQHC. Health system, patient characteristics or data differences may have led to the inability to recalibrate the model. However, the redeveloped model provides an adequate model for the single FQHC., Competing Interests: Declaration of conflicting interestsSince 2020, Dr. Coronado has served as a scientific advisor for Exact Sciences and Dr. Coronado and Dr. Mummadi have been funded through a contract with Guardant Health and the Kaiser Permanente Center for Health Research.

Introduction: Despite mounting evidence that the inclusion of race and ethnicity in clinical prediction models may contribute to health disparities, existing critical appraisal tools do not directly address such equity considerations., Objective: This study developed a critical appraisal tool extension to assess algorithmic bias in clinical prediction models., Methods: A modified e-Delphi approach was utilized to develop and obtain expert consensus on a set of racial and ethnic equity-based signaling questions for appraisal of risk of bias in clinical prediction models. Through a series of virtual meetings, initial pilot application, and an online survey, individuals with expertise in clinical prediction model development, systematic review methodology, and health equity developed and refined this tool., Results: Consensus was reached for ten equity-based signaling questions, which led to the development of the Critical Appraisal for Racial and Ethnic Equity in Clinical Prediction Models (CARE-CPM) extension. This extension is intended for use along with existing critical appraisal tools for clinical prediction models., Conclusion: CARE-CPM provides a valuable risk-of-bias assessment tool extension for clinical prediction models to identify potential algorithmic bias and health equity concerns. Further research is needed to test usability, interrater reliability, and application to decision-makers., Competing Interests: No competing financial interests exist., (© Shazia M. Siddique et al., 2023; Published by Mary Ann Liebert, Inc.)

Promotion of colorectal cancer (CRC) screening can be expensive and unnecessary for many patients. The use of predictive analytics promises to help health systems target the right services to the right patients at the right time while improving population health. Multilevel data at the interpersonal, organizational, community, and policy levels, is rarely considered in clinical decision making but may be used to improve CRC screening risk prediction. We compared the effectiveness of a CRC screening risk prediction model that uses multilevel data with a more conventional model that uses only individual patient data. We used a retrospective cohort to ascertain the one-year occurrence of CRC screening. The cohort was determined from a Health Maintenance Organization, in Oregon. Eligible patients were 50-75 years old, health plan members for at least one year before their birthday in 2018 and were due for screening. We created a risk model using logistic regression first with data available in the electronic health record (EHR), and then added multilevel data. In a cohort of 59,249 patients, 36.1% completed CRC screening. The individual level model included 14 demographic, clinical and encounter based characteristics, had a bootstrap-corrected C-statistic of 0.722 and sufficient calibration. The multilevel model added 9 variables from clinical setting and community characteristics, and the bootstrap-corrected C-statistic remained the same with continued sufficient calibration. The predictive power of the CRC screening model did not improve after adding multilevel data. Our findings suggest that multilevel data added no improvement to the prediction of the likelihood of CRC screening., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

To guide the rational design of personal care formulations, we formulate a molecular thermodynamic model that predicts coacervation from cationic polymers and mixed micelles containing neutral and anionic surfactants and added salt. These coacervates, which form as a result of dilution of conditioning shampoos during use, deposit conditioning agents and other actives to the scalp or skin and also provide lubrication benefits. Our model accounts for mixing entropy, hydrophobic interactions of polycation with water, free energies of bindings of oppositely charged groups to micelles and polycations, and electrostatic interactions that capture connectivity of charged groups on the polycation chain and the micelle. The model outputs are the compositions of surfactants, polycation, salt, and water in the coacervate and in its coexisting dilute phase, along with the binding fractions and coacervate volume fraction. We study the effects of overall composition (of surfactant, polycation, and added salt), charge fractions on micelles and polycations, and binding free energies on the phase diagram of coacervates. Then, we perform coacervation experiments for three systems: sodium dodecyl sulfate (SDS)-JR30M, sodium methyl cocoyl taurate (Taurate)-JR30M, and sodium lauryl alaninate (Alaninate)-JR30M, where JR30M is a cationic derivative of hydroxyethylcellulose (cat-HEC), and rationalize their coacervation data using our model. For comparison with experiment, we also develop a parametrization scheme to obtain the requisite binding energies and Flory-Huggins χ parameter. We find that our model predictions agree reasonably well with the experimental data, and that the sulfate-free surfactants of Taurate and Alaninate display much larger 2-phase regions compared to SDS with JR30M.

The incidence of cardiac adverse events following JYNNEOS vaccination for prevention of mpox is unknown, however the Advisory Committee on Immunization Practices states that people with underlying cardiac risk factors should be counseled about the theoretical risk for myopericarditis following vaccination. We conducted a retrospective cohort study of 2,126 patients who were vaccinated with at least 1 dose of JYNNEOS vaccine and searched the Kaiser Permanente Northwest databases, including the electronic health record, to evaluate for cardiac adverse events of special interest (AESI). After physician adjudication, there were 10 confirmed cardiac AESI for an incidence of 3.1 per 1000 doses (exact 95% CI, 1.5 to 5.7), however none of these events could be directly attributed to vaccination. This retrospective cohort study of JYNNEOS vaccination for prevention of mpox identified 10 cardiac events that all had alternative explanations; and no hospitalizations or serious adverse outcomes were attributed to vaccination., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Efficient and accurate word reading ability is critical for later reading success. As such, it is important to understand the component skills that underlie strong word reading ability. Although a growing research base points to the importance of phonological processing, morphological processing and orthographic processing for accurate and fluent word reading in Arabic, there are few studies that examine all three areas at one time to better understand their role in word reading. Additionally, it remains unclear whether the contribution of the various processes might differ across the early years when children are learning to read. 1,098 pupils in grades 1-3 participated in this study and took tests for phonological processing, morphological processing, orthographic processing, and word reading accuracy and fluency. According to the findings of regression analyses, the relative contribution of these underlying processes differed according to the method used to test word reading and the student's grade level. Regarding accuracy, several subscales of phonological processing and two measures of orthographic processing accounted for significant differences in word reading accuracy for first graders. For second grade students, nonword repetition, elision, and all three measures of orthographic processing accounted for variance. In third grade, elision and memory for digits, word creation and morpheme identification, and letter/sound identification and orthographic fluency were significant predictors of word reading accuracy. In terms of fluency, two subscales of phonological processing, two measures of orthographic processing, and two measures of morphological processing explained significant differences in word reading fluency for first graders. For second grade students, nonword repetition, elision, RAN-digits, isolation, segmenting and all the measures of orthographic processing and word creation explained unique variance in word reading fluency. In third grade, elision, RAN-letters, RAN-digits and phoneme isolation, all measures of orthographic processing and morphological processing, explained variance in word reading fluency. Implications and future directions in research are discussed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hassanein, Johnson, Ibrahim and Alshaboul.)

Background: Dandruff is a pervasive chronic condition which negatively impacts quality of life. Effective treatment requires efficient delivery of scalp benefit agents that control commensal scalp Malassezia levels. Delivery of benefit agents from shampoos requires balancing many technical parameters to achieve the desired outcome without sacrificing secondary parameters, such as cosmetic attributes., Aim: To develop formulation technologies that increase the shampoo delivery efficiency of the scalp benefit agent piroctone olamine (PO). Increased delivery should result in increased anti-dandruff efficacy., Methods: Micellar Stability and Association parameters were quantified via dynamic surface tension and nuclear magnetic resonance (NMR) diffusion parameters, respectively. PO delivery has been assessed in vivo both on the scalp surface and follicular infindibula using extraction procedures and analytical analysis. Clinical anti-dandruff efficacy was assessed for an advanced delivery technology prototype in comparison to standard delivery technology., Results: Shampoo prototypes have been developed that increase the delivery efficiency of PO. Both surfactant and polymer coacervate-based approaches have been developed. Decreased micellar stability results in weaker association between PO and micelles, resulting in more efficient PO retention on the scalp surface and delivery to the infundibula. Increased charge density of cationic polymers optimizes coacervation enabling improved PO delivery as well. Increased PO delivery has been shown clinically to result in higher anti-dandruff efficacy as measured by both visible flakes and underlying biomarkers., Conclusion: Increased efficiency PO delivery shampoos have been developed by optimization of both surfactant and coacervate parameters. The increased deposition efficiency results in significantly more products with significantly greater anti-dandruff efficacy., (© 2023 Society of Cosmetic Scientists and Societe Francaise de Cosmetologie.)

Evolutionary biologists have grown increasingly interested in laterality, a phenomenon where bilaterally symmetrical organisms show a side bias in some trait. Lateralized behavior is particularly interesting because it is not necessarily tied to morphological asymmetry. What causes lateralized behavior remains largely unknown, although previous research in fishes suggest that fish might favor one eye over another to view potential food sources, mates, and to assess predation risk. Here we test the hypothesis that a history of predation risk predicts lateralized behavior in the livebearing fish Brachyrhaphis rhabdophora. To do this, we used a detour assay to test for eye bias when a focal fish approached various stimuli (predator, potential mate, novel object, and empty tank control). Contrary to our predictions, we found no differences in lateralized behavior between fish from populations that co-occurred with fish predators relative to those that do not co-occur with predators. In fact, we found no evidence for behavioral lateralization at all in response to any of the stimuli. We explore several possible explanations for why lateralized behavior is absent in this species, especially considering a large body of work in other livebearing fishes that shows that lateralized behavior does occur., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Callaway et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Xenophallus umbratilis is a freshwater livebearing fish that exhibits unique antisymmetry in the male gonopodium, which terminates in either a dextral or sinistral twist. This asymmetry in the gonopodium suggests that males might exhibit side-biased behavior when interacting with females to mate. We conducted two assays to assess the laterality of male and female mating interactions based on gonopodial morphology. We observed lateralized mating behavior in one test where males with sinistral gonopodial morphology interacted with a single female. However, we did not find lateralized mating behavior in males with dextral gonopodial morphology. We also examined male and female positioning in trials that placed a single female with five males, all with the same morphology. These trials also showed no evidence of lateralized body positioning., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Nielsen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The COVID-19 pandemic, which started in March of 2020, and its associated surges have had an immense impact on the ability of medical staff to perform their daily activities. Thus, we sought to direct patients who had gram-positive Acute Bacterial Skin and Skin Structure Infections (ABSSSI) to our Outpatient Department/Wound Care Center for treatment. We met the challenge of the pandemic by shifting care in the treatment of ABSSSI using a new antibiotic delivery system. We examined the use and cost-effectiveness of Dalbavancin, a unique long-acting lipoglycopeptide antibiotic that is used in the treatment of acute bacterial skin and skin structure infections, during the COVID-19 pandemic. A total of 631 patients were treated in the Outpatient Department/Wound Care Center, with re-evaluation at the Wound Care Center on Day 3 post-infusion. The primary test of cure or major improvement was based on a 4- to 6-week re-assessment by the Wound Care Center Faculty (i.e., Podiatric, Vascular, Plastics, and Infectious Diseases). Treatment effectiveness was determined by examining documentation at follow-up. We also looked at the number of Outpatient Department treatments at the Wound Care Center for the periods 2018-2019 and 2020-2021. The shift of patients from the Emergency Department/Inpatient Department to the Outpatient Department/Wound Care Center was made possible by the use of the novel, streamlined, safe, Food and Drug Administration (FDA)-approved, well-tolerated antibiotic Dalbavancin. Dalbavancin is not prescribed for gram-negative infections, or for random prescribing, contamination, colonization, or prophylaxis. Dalbavancin has a low infusion reaction, low toxicity, long half-life, and low incidence of adverse reactions. Use of this medication was helpful for decreasing the inpatient burden in our facility.