Cranial osteology and neuroanatomy of the late Permian reptile and implications for early reptile evolution.

Millerettidae are a group of superficially lizard-like Permian stem reptiles originally hypothesized as relevant to the ancestry of the reptile crown group, and particularly to lepidosaurs and archosaurs. Since the advent of cladistics, millerettids have typically been considered to be more distant relatives of crown reptiles as the earliest-diverging parareptiles and therefore outside of 'Eureptilia'. Despite this cladistic consensus, some conspicuous features of millerettid anatomy invite reconsideration of their relationships.

Efficacy of iron replacement in pulmonary hypertension: A systematic review.

The systematic review summarizes the current evidence on the efficacy and safety of iron replacement in patients with pulmonary hypertension (PH). A systematic literature search was conducted in electronic databases like PubMed, Scopus, Web of Science, and Embase up to April 2024. Eligible studies investigating iron replacement therapy in pulmonary hypertension patients were included in the review.

Identifying Growth Hormone Deficiency in Brain-Injured Patients: The Quality of Life Scale-99.

Traumatic brain injury (TBI) is frequently associated with hypopituitarism. The hypothalamic-pituitary axis appears to be susceptible to the same forces that cause injury to the parenchyma of the brain. Following even a mild TBI (mTBI), patients may suffer transient or permanent decreases in anterior pituitary hormones, including somatotropin (growth hormone [GH]), gonadotropins (luteinizing hormone and follicle-stimulating hormone), thyrotropin, and adrenocorticotropic hormone, with the most frequent long-term deficiency being GH deficiency (GHD).

OSAIRIS: Lessons Learned From the Hospital-Based Implementation and Evaluation of an Open-Source Deep-Learning Model for Radiotherapy Image Segmentation.

Several studies report the benefits and accuracy of using autosegmentation for organ at risk (OAR) outlining in radiotherapy treatment planning. Typically, evaluations focus on accuracy metrics, and other parameters such as perceived utility and safety are routinely ignored. Here, we report our finding from the implementation and clinical evaluation of OSAIRIS, an open-source AI model for radiotherapy image segmentation that was carried out as part of its development into a medical device.

Reconstructive Management of a Severe Mentosternal Contracture in a Resource-Limited Setting: A Case Report from Ghana, West Africa.

This case report describes the surgical management of a severe mentosternal contracture in a 49-year-old woman in Ghana, West Africa, secondary to an acid burn injury. With limited resources, the treatment involved scar excision and full-thickness skin grafting in a single operation performed solely under local anesthetic infiltration, with no use of oral, inhaled, or parenteral anesthetic or sedating agents. As we were unable to find any documented cases performed under only local anesthesia, this case highlights a simplified reconstructive and anesthetic approach to managing complex, disabling burn contractures in low-income countries, particularly where advanced reconstructive options and monitored anesthesia care are not readily available.

Outcomes Following Vascular and Endovascular Procedures Performed During the First COVID-19 Pandemic Wave.

Objective: The first COVID-19 pandemic wave was a period of reduced surgical activity and redistribution of resources to only those with late stage or critical presentations. This Vascular and Endovascular Research Network COVID-19 Vascular Service (COVER) study aimed to describe the six-month outcomes of patients who underwent open surgery and or endovascular interventions for major vascular conditions during this period.

Methods: In this international, multicentre, prospective, observational study, centres recruited consecutive patients undergoing vascular procedures over a 12-week period.

Breaking Barriers: Ensuring Gender Neutral Care on Short Term Surgical Missions.

Introduction: Gender discrimination is prevalent worldwide in medical and surgical care. In the setting of short-term surgical missions (STSMs) conducted to address the global burden of surgical disease, patient selection raises ethical considerations regarding equitable distribution of limited clinical resources. The goal of this study was to examine if equitable distribution of operative care between male and female patients occurs in STSMs.

Unveiling the Lasting Impact: A 15-Year Follow-Up of Short-Term Surgical Mission Experiences.

Introduction: Resident interest in global surgery has increased over recent years. Incorporating short-term surgical missions (STSMs) into training improves Accreditation Council for Graduate Medical Education (ACGME) competencies and aids in understanding of global health infrastructure. We aim to investigate the impact of STSM participation during residency on the desire for participation after residency, and barriers in doing so.

Simultaneous implementation of unrelated tumour sites on the MR Linac: A review of the commissioning process from a radiographer perspective and lessons learned.

Introduction: This work reports on a systematic approach to select MRI sequences, quantify inter-observer image registration variation and determine patient positioning for the clinical implementation of MR-guided adaptive radiotherapy (MRgRT) in patients with oropharyngeal (H&N) and lung cancer.

Methods: A total of 30 participants (N=10 H&N and N=10 lung cancer patients and N=10 healthy participants) were scanned on the Elekta Unity Magnetic Resonance Linear Accelerator (MRL). Participant experience questionnaires were used to determine the most appropriate positioning device for lung treatments and tolerability of H&N immobilization devices within the confined MR Linac environment.

Association of vitamin D status and vitamin D receptor polymorphism in diabetic foot ulcer patients: A prospective observational study in a South-Indian tertiary healthcare facility.

Objective of the study was to find the association of vitamin D receptor (VDR) polymorphisms (Fokl, Taql and Apal) with vitamin D levels in diabetic foot ulcer (DFU) patients in South India. In this case-control study, plasma vitamin D levels and VDR genotype frequencies of 70 cases (DFU patients) were compared with 70 diabetic (diabetes mellitus [DM] [non-DFU]) patients and 70 apparently healthy controls (HC) from South India. Plasma vitamin D levels were measured using the ELISA technique, and genotyping of VDR polymorphisms was carried out using real-time polymerase chain reaction.

Jurassic fossil juvenile reveals prolonged life history in early mammals.

Living mammal groups exhibit rapid juvenile growth with a cessation of growth in adulthood. Understanding the emergence of this pattern in the earliest mammaliaforms (mammals and their closest extinct relatives) is hindered by a paucity of fossils representing juvenile individuals. We report exceptionally complete juvenile and adult specimens of the Middle Jurassic docodontan Krusatodon, providing anatomical data and insights into the life history of early diverging mammaliaforms.

Improved Accuracy/Completeness of EHR Race/Ethnicity Data: A Requisite Step to Address Disparities in Care.

Accurate and complete racial/ethnic data in the electronic health record are a requisite step to addressing disparities in neurologic care, and at local, regional, and national levels. The current data pertaining to the patients' race and ethnicity contained in the electronic health record are inadequate. This article outlines recommendations at the individual practice and electronic health record vendor level to improve documentation of race and ethnicity.

Impact of a contouring atlas on radiographer inter-observer variation in male pelvis radiotherapy.

Purpose/objective: To determine the impact of a MR-based contouring atlas for male pelvis radiotherapy delineation on inter-observer variation to support radiographer led real-time magnetic resonance image guided adaptive radiotherapy (MRgART).

Material/methods: Eight RTTs contoured 25 MR images in the Monaco treatment planning system (Monaco 5.40.

The effect of abatacept on T-cell activation is not long-lived .

Abatacept, a co-stimulatory blocker comprising the extracellular portion of human CTLA-4 linked to the Fc region of IgG1, is approved for the treatment of rheumatoid arthritis. By impairing the interaction between CD28 on T cells and CD80/CD86 on APCs, its mechanisms of action include the suppression of follicular T helper cells (preventing the breach of self-tolerance in B cells), inhibition of cell cycle progression holding T cells in a state described as 'induced naïve' and reduction in DC conditioning. However, less is known about how long these inhibitory effects might last, which is a critical question for therapeutic use in patients.

SCALE-UP II: protocol for a pragmatic randomised trial examining population health management interventions to increase the uptake of at-home COVID-19 testing in community health centres.

Introduction: SCALE-UP II aims to investigate the effectiveness of population health management interventions using text messaging (TM), chatbots and patient navigation (PN) in increasing the uptake of at-home COVID-19 testing among patients in historically marginalised communities, specifically, those receiving care at community health centres (CHCs).

Methods And Analysis: The trial is a multisite, randomised pragmatic clinical trial. Eligible patients are >18 years old with a primary care visit in the last 3 years at one of the participating CHCs.

Examining patterns suggestive of acquisition during functional analyses: A consecutive controlled series of 116 cases.

The functional analysis approach described by Iwata et al. (1982/1994) has been used widely to determine the variables evoking and maintaining challenging behavior. However, one potential concern with conducting functional analyses is that repeated exposure to contingencies may induce a novel functional relation.

Geometric distortion caused by metallic femoral head prosthesis in prostate cancer imaging on an MR Linac: in-vivo measurements of spatial deformation.

Objectives: Metallic implants cause artefacts and distortion on MRI. To ensure accurate dose delivery and plan adaptation on an MR Linac, there is a need to evaluate distortion caused.

Methods: Participants were imaged on an MR Linac (Elekta Unity, Elekta AB Stockholm).

Macroevolutionary drivers of morphological disparity in the avian quadrate.

In birds, the quadrate connects the mandible and skull, and plays an important role in cranial kinesis. Avian quadrate morphology may therefore be assumed to have been influenced by selective pressures related to feeding ecology, yet large-scale variation in quadrate morphology and its potential relationship with ecology have never been quantitatively investigated. Here, we used geometric morphometrics and phylogenetic comparative methods to quantify morphological variation of the quadrate and its relationship with key ecological features across a wide phylogenetic sample.

Radiological outcomes following surgical fixation with wires versus moulded cast for patients with a dorsally displaced fracture of the distal radius: a radiographic analysis from the DRAFFT2 trial.

Aims: The primary aim of this study was to report the radiological outcomes of patients with a dorsally displaced distal radius fracture who were randomized to a moulded cast or surgical fixation with wires following manipulation and closed reduction of their fracture. The secondary aim was to correlate radiological outcomes with patient-reported outcome measures (PROMs) in the year following injury.

Methods: Participants were recruited as part of DRAFFT2, a UK multicentre clinical trial.