Campbell University

While opioids are commonly prescribed for postoperative pain management, their use is recommended with caution in pediatric populations. In adult populations, patient sex has been identified as a predictor for increased opioid use, and understanding sex-related differences in postoperative pain is important for optimizing analgesia safety in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. A single-institution retrospective cohort study was conducted on patients < 18 years who underwent corrective surgery for adolescent idiopathic scoliosis (AIS). Variables included patient demographics and socioeconomic factors. Primary outcomes were patient-reported pain scores on a 0–10 scale during the index hospitalization. Secondary outcomes included total inpatient opioid consumption (converted to morphine milligram equivalents), discharge opioid prescriptions, and rates of opioid refills. In total, 266 patients were analyzed, including 188 (71

Chitosan is a promising coagulant for bacteria, viruses and turbidity in water, but needs identification of optimal dose-polymer combinations. This research tested chitosans to identify dose range and characteristics that provide highest simultaneous reduction of bacteria, viruses, and turbidity, and possible coagulation mechanisms, including charge neutralization, sweep coagulation, and electrostatic patch. Three molecular weights (MW) and degrees of deacetylation (DD) were tested at doses 1, 3, 10 and 30 mg/L using jar tests in water containing clays, E. coli, and bacteriophage MS2. Turbidity removal was 93-99% at 1 and 3 mg/L, with no significant difference between MW. MW, DD and dose significantly affected viral and bacterial reduction. Across doses, MW 100,000 Da had highest mean log10 MS2 (3.5) and E. coli (3.5) reductions. The 100,000 Da/10 mg combination had the highest mean log10 E. coli (4.5) and MS2 (3.5) reductions simultaneously. Overall, 100,000 Da/3 mg and 1,000,000 Da/3 mg maximize reduction of turbidity and MS2, but not E. coli. 100,000 Da/10 mg maximized E. coli reduction and gave MS2 reductions similar to 100,000 Da/3 mg, but turbidity reduction was lower. Chitosan reduced turbidity, bacteria, and viruses in water, influenced by MW, DD, and dose. Data suggests that there is no single dose/MW/DD combination that produced significantly higher reductions of all three contaminants simultaneously but good removal of all three can be achieved with 100,000 Da at 3 or 10 mg/L. Chitosans can be effective coagulant-flocculants in water at reasonably achievable doses using polymer characteristics that are commercially available.

Paired box (PAX) genes encode a family of nine transcription factors that function as master regulators of embryogenesis, organogenesis, and lineage specification. Their tightly regulated spatial and temporal expression is essential for the development of multiple organ systems, including the central nervous system, eyes, kidneys, immune system, musculoskeletal system, and endocrine organs. Germline mutations of PAX genes result in a broad and often pleiotropic spectrum of human disease, reflecting the developmental programs governed by each family member. Pathogenic variants in PAX genes underlie diverse congenital disorders such as aniridia (PAX6), renal coloboma syndrome (PAX2), otofaciocervical syndrome with immunodeficiency (PAX1), Waardenburg syndrome (PAX3), maturity-onset diabetes of the young (PAX4), and tooth agenesis (PAX9). These conditions frequently demonstrate variable expressivity, incomplete penetrance, and overlapping phenotypes, which make it challenging to be clinically recognized. Beyond embryogenesis and embryologic development, emerging evidence indicates that several PAX proteins remain active in postnatal tissue maintenance, adult stem cell regulation, immune function, and regenerative responses (particularly PAX7 in skeletal muscle satellite cells and PAX5 in B-cell homeostasis), further expanding their clinical relevance. This review provides a synopsis of the major, clinically relevant, germline PAX gene mutations, emphasizing genotype–phenotype correlations, developmental mechanisms, and disease classification across the organ systems. By integrating molecular genetics with human pathology, we highlight the diagnostic implications of PAX genes as central determinants of congenital disease and provide a framework for understanding how alterations in the developmental transcriptional networks translate into human pathology.

BACKGROUND:Backyard, or hobby, poultry ownership is increasingly popular in the United States, driven, in part, by a desire for food security and personal connection with animals. However, backyard poultry ownership can impose public health and biosecurity risks. Backyard poultry-associated Salmonella outbreaks are on the rise. Qualitative studies are needed to obtain updated information on husbandry and biosecurity practices, motivations for ownership, and engagement with available resources. This knowledge can inform contemporary interventions that reduce zoonotic disease risks in backyard poultry settings. OBJECTIVES:To qualitatively assess practices, management, and resource preferences of backyard poultry owners in central North Carolina, a large commercial poultry-producing state, regarding flock management and health and resource preferences. METHODS:During January 2024 to June 2024, we conducted focus groups and individual interviews with 18 North Carolina backyard poultry owners recruited through an online interest group. Discussion topics included flock purpose, management, health, and biosecurity and owners' knowledge base and resource preferences regarding flock management and health. We analysed transcripts using thematic analysis. RESULTS:Participants reported owning small mixed-breed flocks, primarily for egg production and companionship, and maintaining basic biosecurity measures (e.g., handwashing, yard boots). Among the major themes identified, participants considered their poultry as pets, though flocks were managed with a focus on overall herd health. Participants reported independence in treating poultry health conditions at home without veterinary specialist guidance. Online communities of backyard poultry owners and homesteaders were the preferred sources of information and advice. CONCLUSION:A public health approach that frames biosecurity in backyard poultry settings around the pet-owner mindset warrants further exploration as a strategic communication tactic. The potential impact of this approach on educational outcomes, however, remains to be established. Additional resources are needed to successfully bridge the veterinary care gap that exists for some backyard flocks. Future research should investigate cost-effective, owner-friendly interventions related to these efforts.

Surgical treatment for ASD is complex and associated with significant perioperative risks. Despite advancements in surgical techniques and perioperative care, complications remain common. This study aims to develop a predictive model of 30-day mortality in patients undergoing surgery for ASD using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2014 to 2022. Patients included were aged ≥ 18 years undergoing ASD surgeries were included. Major complications were defined as deep surgical site infection (SSI), organ space SSI, wound dehiscence, prolonged ventilation ≥ 48 h, pulmonary embolism, cerebrovascular accident, renal failure, myocardial infarction, cardiac arrest, bleeding requiring transfusion, sepsis, septic shock, pneumonia, and unplanned reintubation. The primary outcome of interest was 30-day mortality. Categorical variables were analyzed using the Pearson χ2 test, and continuous variables were analyzed using the Mann–Whitney U test. The study cohort included 2471 adults. The overall mortality rate within 30 days of 0.5