Practitioner Summary New masonry workers (apprentices) are assumed to be healthy yet work-related musculoskeletal symptoms (MSS) may be common early in their career. The prevalence of MSS was assessed among apprentices. Approximately 78% of apprentices reported MSS, most in several body regions, comparable to journey-level masons. Abbreviations WMSD work-related musculoskeletal disorders; MSS musculoskeletal symptoms; SAVE SAfety voice for ergonomics; MNQ modified nordic questionnaire; FTE full-time equivalent; SF-12 short from-12v2.Objectives To assess the exposure of surgical personnel to known carcinogens during pediatric tonsillectomy and adenoidectomy (T&A) and compare the efficacy of surgical smoke evacuation systems during T&A. Study design Prospective, case series. Setting Tertiary children's hospital. Subjects and methods The present study assessed operating room workers' exposure to chemical compounds and aerosolized particulates generated during T&A. We also investigated the effect of 3 different smoke-controlling methods smoke-evacuator pencil cautery (SE), cautery with suction held by an assistant (SA), and cautery without suction (NS). Results Thirty cases were included 12 in the SE group, 9 in SA, and 9 in NS. The chemical exposure levels were lower than or similar to baseline background concentrations, with the exception of methylene chloride and acetaldehyde. Within the surgical plume, none of the chemical compounds exceeded the corresponding occupational exposure limit (OEL). The mean particulate number concentration in the breathing zone during tonsillectomy was 508 particles/cm3 for SE compared to 1661 particles/cm3 for SA and 8208 particles/cm3 for NS cases. NS was significantly different compared to the other two methods (P = .0009). Conclusions Although the exposure levels to chemicals were considerably lower than the OELs, continuous exposures to these chemicals could cause adverse health effects to surgical personnel. These findings suggest that the use of a smoke-evacuator pencil cautery or an attentive assistant with handheld suction would reduce exposure levels to the aerosolized particles during routine T&A, compared to the use of cautery without suction.Rationale Epidemiologic studies have identified an associate between iron deficiency (ID) and the use of oral contraceptives (CC) and ischemic stroke (IS). To date, however, the underlying mechanism remains poorly understood. Both ID and CC have been demonstrated to up-regulate the level and iron-binding ability of transferrin, with our recent study showing that this up-regulation can induce hypercoagulability by potentiating FXIIa/thrombin and blocking antithrombin-coagulation proteases interactions. Objective To investigate whether transferrin mediates IS associated with ID or CC and the underlying mechanisms. Methods and ResultsTransferrin levels were assayed in the plasma of IS patients with a history of iron-deficiency anemia (IDA), IDA patients, venous thromboembolism patients using CC, and ID mice, and in the cerebrospinal fluid of some IS patients. Effects of ID and estrogen administration on transferrin expression and coagulability and the underlying mechanisms were studied in vivo and in vitro. High levels of transferrin and transferrin-thrombin/FXIIa complexes were found in patients and ID mice. Both ID and estrogen up-regulated transferrin through hypoxia and estrogen response elements located in the transferrin gene enhancer and promoter regions, respectively. In addition, ID, administration of exogenous transferrin or estrogen, and transferrin overexpression promoted platelet-based thrombin generation and hypercoagulability, and thus aggravated IS.  https://www.selleckchem.com/products/envonalkib.html  In contrast, anti-transferrin antibodies, transferrin knockdown, and peptide inhibitors of transferrin-thrombin/FXIIa interaction exerted anti-IS effects in vivo. Conclusions Our findings revealed that certain factors (i.e., ID and CC) up-regulating transferrin are risk factors of thromboembolic diseases decipher a previously unrecognized mechanistic association among ID, CC and IS and provide a novel strategy for the development of anti-IS medicine by interfering with transferrin-thrombin/FXIIa interactions.Objective To identify the dominant clinical factors associated with increased 1-year charges in treating head and neck cancer. Study design Retrospective review. Setting Single academic institution. Subjects and methods We retrospectively reviewed 1-year charges for 196 consecutive patients with head and neck cancer (HNC) who were treated exclusively at our institution. We analyzed charges by department as well as factors associated with increased charges per multivariable regression. Results The mean age was 59.6 years (SD, 14.9). Most of the population was male (64%), white (70%), and commercially insured (46%). The most common primary sites were the oropharynx (25%; 76%, HPV positive), skin (19%), and thyroid (17%). Eighty-three percent of total charges were due to standard-of-care treatment for HNC surgery ($16 million), radiation therapy ($22 million), or chemotherapy ($11 million). The median total charge per patient was $212,484 (interquartile range, $78,630-$475,823). Multivariable regression demonstrated that the following were associated with increased charges nasopharynx subsite ($250,929 [95% CI, $93,290-$408,569]; effect size in US dollars, P = .002), advanced stage (American Joint Committee on Cancer, seventh edition; $80,331 [$22,726-$137,936], P = .007), therapeutic surgery ($281,893 [$117,371-$446,415], P = .001), chemotherapy ($183,331 [$125,497-$241,165], P less then .001), radiation ($203,397 [$143,454-$263,341], P less then .001), surgical complication requiring return to the operating room ($147,247 [$37,240-$257,254], P = .009), emergency department visits ($89,050 [$23,811-$154,289], P = .008), and admissions ($140,894 [$82,895-$198,893], P less then .001; constant, -$233,927 [-$410,790 to -$57,064]). The top quartile accrued 55% of the total charges. Conclusion Radiation, followed by surgery and chemotherapy, were the most expensive components of HNC care. In this analysis, we identified the dominant clinical factors associated with increased charges.