Climate change and variability influence temperature and rainfall, which impact vector abundance and the dynamics of vector-borne disease transmission. Climate change is projected to increase the frequency and intensity of extreme climate events. Mosquito-borne diseases, such as dengue fever, are primarily transmitted by Aedes aegypti mosquitoes. Freshwater availability and temperature affect dengue vector populations via a variety of biological processes and thus influence the ability of mosquitoes to effectively transmit disease. However, the effect of droughts, floods, heat waves, and cold waves is not well understood. Using vector, climate, and dengue disease data collected between 2013 and 2019 in Kenya, this retrospective cohort study aims to elucidate the impact of extreme rainfall and temperature on mosquito abundance and the risk of arboviral infections. To define extreme periods of rainfall and land surface temperature (LST), we calculated monthly anomalies as deviations from long-term means (1983–2019 for rainfall, 2000–2019 for LST) across four study locations in Kenya. We classified extreme climate events as the upper and lower 10% of these calculated LST or rainfall deviations. Monthly Ae. aegypti abundance was recorded in Kenya using four trapping methods. Blood samples were also collected from children with febrile illness presenting to four field sites and tested for dengue virus using an IgG enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). We found that mosquito eggs and adults were significantly more abundant one month following an abnormally wet month. The relationship between mosquito abundance and dengue risk follows a non-linear association. Our findings suggest that early warnings and targeted interventions during periods of abnormal rainfall and temperature, especially flooding, can potentially contribute to reductions in risk of viral transmission.

Background: Rates of cartilage degeneration in asymptomatic elite basketball players are significantly higher compared with the general population due to excessive loads on the knee. Compositional quantitative magnetic resonance imaging (qMRI) techniques can identify local biochemical changes of macromolecules observed in cartilage degeneration. Purpose/Hypothesis: The purpose of this study was to utilize multiparametric qMRI to (1) quantify how T_1ρ and T₂ relaxation times differ based on the presence of anatomic abnormalities and (2) correlate T_1ρ and T₂ with self-reported functional deficits. It was hypothesized that prolonged relaxation times will be associated with knees with MRI-graded abnormalities and knees belonging to basketball players with greater self-reported functional deficits. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 75 knees from National Collegiate Athletic Association Division I basketball players (40 female, 35 male) were included in this multicenter study. All players completed the Knee injury and Osteoarthritis Outcome Score (KOOS) and had bilateral knee MRI scans taken. T_1ρ and T₂ were calculated on a voxel-by-voxel basis. The cartilage surfaces were segmented into 6 compartments: lateral femoral condyle, lateral tibia, medial femoral condyle, medial tibia (MT), patella (PAT), and trochlea (TRO). Lesions from the MRI scans were graded for imaging abnormalities, and statistical parametric mapping was performed to study cross-sectional differences based on MRI scan grading of anatomic knee abnormalities. Pearson partial correlations between relaxation times and KOOS subscore values were computed, obtaining r value statistical parametric mappings and P value clusters. Results: Knees without patellar tendinosis displayed significantly higher T_1ρ in the PAT compared with those with patellar tendinosis (average percentage difference, 10.4%; P = .02). Significant prolongation of T_1ρ was observed in the MT, TRO, and PAT of knees without compared with those with quadriceps tendinosis (average percentage difference, 12.7%, 13.3%, and 13.4%, respectively; P ≤ .05). A weak correlation was found between the KOOS-Symptoms subscale values and T_1ρ/T₂. Conclusion: Certain tissues that bear the brunt of impact developed tendinosis but spared cartilage degeneration. Whereas participants reported minimal functional deficits, their high-impact activities resulted in structural damage that may lead to osteoarthritis after their collegiate careers.

Introduction: Pediatric orthopaedic surgeries for complex hip and spine conditions, particularly in children with cerebral palsy, are associated with high complication rates. Malnutrition, common in this population, contributes to poor wound healing, infections, and prolonged recovery. Despite its impact, definitions and assessments of malnutrition remain inconsistent. Posterior spinal fusion and hip reconstruction carry complication rates over 50%. While interest in nutritional optimization is growing, no standardized approach exists, especially in pediatric orthopaedic populations. The purpose of this study was to evaluate the existing literature on perioperative nutritional assessment and optimization of pediatric patients undergoing complex hip and spine surgery. Methods: We conducted a PRISMA-compliant systematic review of MEDLINE, Embase, and Cochrane databases in April 2025. Inclusion criteria were studies on patients 21 years or younger undergoing hip or spine surgery that reported perioperative nutritional status or interventions alongside clinical outcomes. Eligible study designs included RCTs, cohort studies, and case series (>10 patients). Data were independently extracted and study quality assessed using the Newcastle-Ottawa Scale (NOS). Results: Out of 371 studies, 23 met the inclusion criteria. Eighteen were retrospective cohorts, 1 prospective cohort, 2 cross-sectional, and 2 case-control studies. Fifteen were high quality (NOS ≥7). Thirteen studies (57%) examined laboratory-based markers; 10 (43%) assessed nutritional interventions or classifications. Common outcomes included wound complications (48%), respiratory complications (26%), LOS/readmissions (26%), and patient-reported outcomes (17%). Laboratory findings were inconsistent, though transferrin 10% weight loss. Enhanced recovery after surgery (ERAS) protocols improved LOS, pain, and IL-6 levels, while routine nutrition assessments showed no clear benefit. Conclusion: While isolated laboratory values are inconsistent predictors, underweight status and weight loss are more reliable indicators of risk. ERAS protocols incorporating nutritional strategies may improve outcomes, although more pediatric-focused data are needed. The lack of standardized malnutrition definitions across studies limits comparability. Future research should establish uniform nutritional screening practices and evaluate specific interventions in high-risk pediatric orthopaedic populations. Despite limitations in study heterogeneity and small sample sizes, this review supports integrating structured perioperative nutrition into care pathways.

To review applications to a single urology residency program to determine application characteristics predictive of 1) successful match into urology residency and 2) pursuit of fellowship training and/or academic practice after completion of residency. Our principal variables of interest were gender bias as assessed in letters of recommendation (LOR), personal statements (PS), Medical Student Performance Evaluation (MSPE), race, and gender. Applications submitted to our urology residency program in the 2014 cycle were reviewed. Twenty-three variables were analyzed, including applicant demographics, application materials, and gender bias. Deidentified text from LOR, PS, and MSPE was evaluated for gender bias using an open-source gender bias calculator. A sub-analysis of applicants who matched at a top 25 urology program was performed. Logistic regression analysis was performed to identify applicant variables associated with 1) match success and 2) fellowship training or academic employment as of September 2021. 222 completed applications were analyzed. First-authorship of a published manuscript was significantly associated with greater odds of matching. Female gender and top 25 medical school attendance were both significant predictors of matching at a top 25 urology program. The number of first-author publications was associated with completion of fellowship training or current employment in an academic position. First author publications are the most important pre-interview determinant of match success and subsequent pursuit of academic practice/fellowship training. Certain applicant characteristics are associated with matching at highly ranked programs. Gender bias in application materials (including LOR) does not appear to exert a significant influence on match and early career outcomes.