Maintaining Professionalism in the Difficult Patient Interaction.

Maintaining professionalism during a difficult patient interaction is paramount to providing excellent patient care, but it can be challenging. As the patient-physician relationship has evolved, patient autonomy has increased and shared decision-making is prioritized. This evolution has led to improved patient support and satisfaction; however, it has added a complexity to the physician-patient interaction.

Surgical Considerations for Osteoporosis, Osteopenia, and Vitamin D Deficiency in Upper Extremity Surgery.

Fragility fractures as a result of osteoporosis, osteopenia, or vitamin D deficiency are some of the most common injuries encountered in orthopedics and require careful consideration when determining the appropriate management and treatment options. A thorough perioperative evaluation can identify causes of low bone mineral density allowing for initiation of appropriate therapy. Surgical treatment of these fractures can be difficult, and techniques should be employed to ensure stable fixation.

The Pitfalls of Difficult Distal Radius Fractures and Provisional Reduction.

Distal radius fractures are some of the most common injuries encountered in orthopedics and require careful consideration when determining the appropriate treatment options. These fractures can be difficult injuries to treat surgically based on a large variability of fracture patterns, bone quality, and anatomy. It is important to understand the potential pitfalls associated with the treatment of difficult distal radius fractures to prevent avoidable complications.

The differential binding and biological efficacy of auxin herbicides.

Background: Auxin herbicides have been used for selective weed control for 75 years and they continue to be amongst the most widely used weed control agents globally. The auxin herbicides fall into five chemical classes, with two herbicides not classified, and in all cases it is anticipated that recognition in the plant starts with binding to the Transport Inhibitor Response 1 (TIR1) family of auxin receptors. There is evidence that some classes of auxins act selectively with certain clades of receptors, although a comprehensive structure-activity relationship has not been available.

A Retrospective Review of Native Septic Arthritis in Patients: Can We Diagnose Based on Laboratory Values?

Introduction The accurate diagnosis of acute septic arthritis is essential to initiating appropriate treatment and minimizing potential cartilage damage. A synovial fluid cell count of 50,000 cells/mm has been used as a diagnostic cutoff for acute septic arthritis, although data supporting this is lacking. The purpose of this study was to assess the efficacy of synovial cell counts to predict septic arthritis in patients with symptomatic native joints.

Septic Arthritis in Immunosuppressed Patients: Do Laboratory Values Help?

Unlabelled: Previous studies have recommended synovial fluid cell count thresholds of 50,000 cells/mm to diagnose septic arthritis; however, data to support this are limited. It is also unknown if this value is valid in immunosuppressed patients.

Methods: We retrospectively reviewed 33 immunosuppressed patients treated at our institution from 2008 to 2018.

Energy Dissipation in the Upper Atmospheres of Trappist-1 Planets.

We present a method to quantify the upper-limit of the energy transmitted from the intense stellar wind to the upper atmospheres of three of the Trappist-1 planets (e, f, and g). We use a formalism that treats the system as two electromagnetic regions, where the efficiency of the energy transmission between one region (the stellar wind at the planetary orbits) to the other (the planetary ionospheres) depends on the relation between the conductances and impedances of the two regions. Since the energy flux of the stellar wind is very high at these planetary orbits, we find that for the case of high transmission efficiency (when the conductances and impedances are close in magnitude), the energy dissipation in the upper planetary atmospheres is also very large.

Understanding the Differential Response of Setaria viridis L. (green foxtail) and Setaria pumila Poir. (yellow foxtail) to Pyroxsulam.

Green foxtail [Setaria viridis (L) Beauv.] and yellow foxtail [Setaria pumila (Poir.) Roem.

Genetic and biochemical evaluation of natural rubber from Eastern Washington prickly lettuce (Lactuca serriola L.).

Alternative sources of natural rubber are of importance due to economic, biological, and political threats that could diminish supplies of this resource. Prickly lettuce (Lactuca serriola L.) synthesizes long-chain natural rubber and was studied to determine underlying genetic and phenotypic characteristics of rubber biosynthesis.

Training Intensity Affects Motor Rehabilitation Efficacy Following Unilateral Ischemic Insult of the Sensorimotor Cortex in C57BL/6 Mice.

Background: Motor rehabilitative training improves behavioral functionality and promotes beneficial neural reorganization following stroke but is often insufficient to normalize function. Rodent studies have relied on skilled reaching tasks to model motor rehabilitation and explore factors contributing to its efficacy. It has been found that greater training intensity (sessions/day) and duration (training days) facilitates motor skill learning in intact animals.

Post-stroke protection from maladaptive effects of learning with the non-paretic forelimb by bimanual home cage experience in C57BL/6 mice.

Behavioral experience, in the form of skilled limb use, has been found to impact the structure and function of the central nervous system, affecting post-stroke behavioral outcome in both adaptive and maladaptive ways. Learning to rely on the less-affected, or non-paretic, body side is common following stroke in both humans and rodent models. In rats, it has been observed that skilled learning with the non-paretic forelimb following ischemic insult leads to impaired or delayed functional recovery of the paretic limb.

Inheritance and physiological basis for 2,4-D resistance in prickly lettuce (Lactuca serriola L.).

Experiments were conducted to determine the inheritance and physiological basis for resistance to the synthetic auxinic herbicide (2,4-dichlorophenoxy)acetic acid (2,4-D) in a prickly lettuce biotype. Inheritance of 2,4-D resistance in prickly lettuce is governed by a single codominant gene. Absorption and translocation were conducted using (14)C-2,4-D applied to 2,4-D-resistant and -susceptible biotypes.

Uptake, translocation and metabolism of aminocyclopyrachlor in prickly lettuce, rush skeletonweed and yellow starthistle.

Background: Aminocyclopyrachlor is a new herbicide proposed to control broadleaf weeds and shrubs in non-crop and rangeland systems. To gain a better understanding of observed field efficacy, the uptake and translocation of foliar-applied aminocyclopyrachlor (DPX-MAT28) and aminocyclopyrachlor methyl ester (DPX-KJM44) were evaluated in two annuals, prickly lettuce (Lactuca serriola L.) and yellow starthistle (Centaurea solstitialis L.