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Persistent chemicals in particulate matter (PM) near a hazardous waste thermal treatment facility
No full textColfax, an overburdened community in central Louisiana, hosts the last commercially-operated open-burn/open-detonation (OB/OD) hazardous waste thermal treatment facility in the United States. Until December 2023 when their permit disallowed OB/OD, the facility processed military waste, fireworks, propellants, soils excavated from Superfund sites, and other hazardous materials. This community-engaged study measured ambient fine particulate matter (PM2.5), environmentally persistent free radicals (EPFRs), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), and metals using two high-volume PM2.5 samplers deployed 1.2 mi and 9.0 mi from the facility from April, 2022 through February, 2023. Elevated PM2.5 concentrations were recorded at both sites during spring and summer 2022. EPFR concentrations increased during fall and winter, coinciding with increases in PCDD/F but in contrast to PM2.5. Similarities between the 1.2 mi and 9.0 mi sites for both PM2.5 and EPFRs suggest a common emission source influencing concentrations at both sites. Regularized linear regression analyses indicated that EPFRs were significant predictors of PM2.5 at both sites, with a markedly stronger effect at the 9.0 mi site than at 1.2 mi. Among the metals, Zn was consistently the strongest and most significant predictor of EPFRs and PM2.5 across both sites and seasons, supported by both moderately high Pearson correlations and Elastic Net coefficients. Through this study, we aim to provide crucial information on exposure risks from an OB/OD facility with the goal of empowering exposed community members for mitigating their risks
Evaluating the impact of Medicaid expansion on outcomes for patients with gastric cancer in Louisiana
No full text2025 ASCO Annual Meeting I, May 30-June 3, 2025, Chicago, I
Enhancing Uveal Melanoma Staging: A Volume-Based System for Improved Prognostication
No full textAssociation for Research in Vision and Ophthalmology Annual Meeting, ARVO 2025, May 4-8, 2025, Salt Lake City, U
A Leg Up: Evaluating Ultramassive Transfusion after Extremity Vascular Injury
No full textINTRODUCTION: Extremity vascular injuries (EVI) are rare, life-threatening injuries that may require ultra-massive transfusion (UMT), defined as transfusion of ≥ 20 units of red cell products in 24 hours. This study aimed to evaluate outcomes of patients with EVI who required UMT and to determine which variables are associated with survival. METHODS: A retrospective, multicenter analysis from eleven high-volume trauma centers was conducted of trauma patients who received UMT from 2016-2024. Demographic, clinical, and outcome data were obtained and compared between patients with/without an EVI with subgroup analysis based on mortality. RESULTS: 1,155 patients received UMT and 194 (16.8%) had an EVI. The majority (62.4%) of these injuries were penetrating, and those with an EVI had a lower Injury Severity Score (ISS) (30 vs. 34, p \u3c 0.01), underwent fewer resuscitative thoracotomies (19.1 vs. 24.9%, p=0.02), and fewer exploratory laparotomies (61.3 vs. 82.7%, p \u3c 0.01). Of all EVI patients, 79 patients (40.7%) had an isolated EVI. More than half of patients with an EVI survived compared to only a third without an EVI (50.5 vs. 33.3%, p \u3c 0.01). There was no difference in the transfusion of blood products. Among EVI patients, survivors had a lower ISS (27 vs. 33, p \u3c 0.01), higher initial heart rate (111 vs. 87 beats per minute, p \u3c 0.01), higher Glasgow Coma Scale score (10 vs. 7, p\u3c 0.01), higher initial platelet count (169 vs. 140 103/mcL, p = 0.02), lower lactate (8.2 vs. 12.5 mmol/L, p \u3c 0.01), and smaller base deficit (11.5 vs. 16.1 mmol/L, p \u3c 0.01). CONCLUSION: In patients who require UMT, EVI is associated with a higher rate of survival compared to those without EVI
Nevus Sebaceous of Jadassohn With Secondary Cystic Papillary Hidradenoma
No full textNevus sebaceous of Jadassohn (NS) is a congenital cutaneous hamartoma that typically presents at birth as a plaque on the face, scalp, or neck. While NS is associated with a risk of neoplastic transformation, the majority of secondary tumors are benign, with the most common being trichoblastomas and syringocystadenomas. In this report, we present a rare case of a 63-year-old male with a right parietal scalp NS with a secondary cystic papillary hidradenoma (HP), which is a benign tumor that almost exclusively occurs in the perineal region. Histopathologic examination was consistent with NS, revealing hyperkeratosis, parakeratosis, increased sebaceous glands, ectopic apocrine glands, and anomalous duct sweat gland hyperplasia. The lesion also demonstrated characteristics of HP, a neoplasm that has not been well-documented in association with NS. This case expands understanding of neoplasms that arise within NS and highlights histologic characteristics that differentiate HP from other neoplasms
Cardiovascular Characterization of a Mouse Model of Dual Chronic + Binge Alcohol and Nicotine Vape Use
No full textComparison of the Oral Presentation of Quinine, Water and Ethanol under a Multiple Schedule with Food
No full textEconomic value of intra-articular knee OA therapies: a U.S. perspective
No full textAIMS: This study compared the six-month medical/pharmacy costs and healthcare resource utilization (HCRU) for knee OA patients undergoing intra-articular therapy with different classes of hyaluronic acid (HA) (by molecular weight) or corticosteroid (ICS). MATERIALS AND METHODS: Patients across high molecular weight (HMW) HA, medium molecular weight (MMW) HA, low molecular weight (LMW) HA, and ICS therapy groups were matched from a U.S. claims database (Optum\u27s de-identified Clinformatics Data Mart Database), with a final size of 6,234 patients per group. Adjusted six-month medical/prescription costs per patient per month (PPPM), and HCRU rates and costs, were determined. Secondary endpoints included complication rates and adjusted costs, new prescription analgesic use, and adjunctive/supplemental intra-articular treatment. RESULTS: Mean adjusted PPPM medical costs were highest for LMW HA (469.35) and MMW HA (240.26; p \u3c .001). Office visit, arthrocentesis, and subsequent ICS/arthrocentesis rates and corresponding costs, as well as costs for any complications, decreased from LMW HA to MMW HA to HMW HA. The ICS group had greater arthrocentesis, subsequent ICS/arthrocentesis, and office visit costs versus MMW and HMW HA groups. The ICS group had higher rates of new prescription analgesic use (15.8% versus 11.7%-12.2%) and adjunctive ICS (21.8% vs. 9.4%-11.1%) and HA (14.1% versus 1.6%-5.3%) treatment than the HA groups. HMW HA had the lowest rates of adjunctive non-index HA treatment. LIMITATIONS: Claims data contains limited clinical data and relied on the accuracy of coding of diagnoses and procedures. CONCLUSIONS: Among HA products, HMW HA may provide greater short-term clinical and economic benefits. Additionally, intra-articular HA therapy may provide improved short-term clinical and economic results over ICS, in terms of lower rates of adjunctive intra-articular treatments, HCRU, and new prescription analgesic use. Complication rates were low reflecting the safety profiles of HA and ICS
Impact of Living in a Food Desert on Complications After Fracture Surgery
No full textBackground: Food deserts-communities with limited access to healthy food-have been linked with poor surgical outcomes; however, their impact on orthopaedic trauma outcomes remains unknown. The aims of this study were to determine the prevalence of food desert residency among orthopaedic trauma patients and to investigate the impact of food desert residency on the rate of unplanned reoperation with use of a large, high-quality, prospectively collected dataset with adjudicated outcomes. We hypothesized that orthopaedic trauma patients would reside in food deserts at a higher rate than the general U.S. population and that living in a food desert would be independently associated with an increased rate of unplanned reoperation. Methods: We included all patients from the Aqueous-PREP and PREPARE trials who had documented ZIP codes. The primary outcome was unplanned reoperation within 1 year, and the secondary outcomes included the reasons for reoperation. Residing in a food desert was the independent variable and was defined by the United States Department of Agriculture (USDA). Census tracts were converted to ZIP codes in order to assign food access for an individual s residence with use of the USDA Food Access Research Atlas. Results: Of the 2,607 patients included, 1,453 (55.7%) lived in a ZIP code containing a food desert compared with 49% of the U.S. population. Patients residing in a food desert were 42% female, 26.6% non-White, and 64% employed prior to injury, whereas patients not residing in a food desert were 41% female, 15% non-White, and 63% employed prior to injury, all of which was collected via patient self-report. Multivariable analysis demonstrated that living in a food desert was independently associated with 40% higher odds of unplanned reoperation (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.06 to 1.85; p = 0.019). This was driven by reoperation for delayed union or nonunion (OR, 1.75; 95% CI, 1.19 to 2.57; p = 0.004) and reoperation for a wound-healing complication (OR, 1.60; 95% CI, 1.01 to 2.54; p = 0.044). Conclusions: This study found a strong association between residing in a ZIP code containing a food desert and an increased rate of unplanned reoperation, which was primarily driven by delayed union or nonunion and wound-healing complications. Addressing nutritional deficiencies in this populationmay help to effectively triage the use of health-care resources. Further research should focus on clarifying specific deficiencies and assessing the effectiveness of targeted interventions
Senescent and Exhausted CD8+ T-cells Do Not Predict Worse Pulmonary Function at Baseline in People With Human Immunodeficiency Virus (HIV)
No full textAmerican Thoracic Society International Conference, ATS 2025, May 16 - 21, 2025, San Francisco, C