Cleft-Related Revision Procedures: Surgeon Perspectives on Shared Decision-Making and a Decision Aid Prototype.

Objective: Decision-making for elective cleft lip and nose revisions varies widely, from patient-led decisions to more paternalistic approaches. As these procedures incur additional scarring that may impact future interventions, patients should be equipped to participate in these surgical decisions. We thus developed a decision aid based on international standards, and to ensure methodologic rigor, we sought feedback from other surgeons regarding shared decision-making and potential barriers to adopting the decision aid.

Daily executive functioning in adults with pediatric hemispherectomy.

Background And Aims: For young children with intractable epilepsy caused by congenital abnormalities or acquired cortical lesions, pediatric hemispherectomy surgery (pHS) may offer the only path to seizure remediation. Although some sensory and motor outcomes of pHS are highly predictable, the long-term cognitive and functional sequelae of pHS are far more variable. With the aim of identifying potential post-pHS intervention targets, the current study examined daily executive functioning and self-awareness in adults with pHS and broadly intact cognitive outcomes (indicated by average or above performance on intelligence tests).

Challenges and potential solutions to enrollment in a clinical trial of arteriovenous fistula vs arteriovenous graft vascular access strategy.

This article presents the rationale, challenges, and adaptive strategies employed during the initiation and execution of the arteriovenous (AV) access trial-a multicenter randomized controlled trial (RCT) comparing AV fistulas and AV grafts for hemodialysis in older adults with major comorbidities. Motivated by shifts in epidemiologic landscapes and evolving guidelines moving away from a fistula-first approach and to more patient-centric approaches, the objective of this randomized controlled trial was to fill critical knowledge gaps in determining the optimal vascular access for this complex patient population. We outline the challenges encountered in patient recruitment along with measures employed to overcome these obstacles in recruitment.

Metabolic bariatric surgery generates substantial, sustained weight loss and health improvement in a real-world setting.

Background: To determine if the positive outcomes from clinical trials regarding the safety and efficacy of metabolic bariatric surgery are reproducible at a national level.

Methods: A longitudinal registry-based observation study with data collected from all persons undergoing metabolic bariatric surgery in Australia from 28 February 2012-31 December 2021 including data from 122,567 index patients who underwent 134,625 completed bariatric procedures.

Main Outcomes And Measures: Defined adverse outcomes at 90-days (unplanned readmission, intensive care admission and re-operation; death), annual change in weight (percent total body weight loss (TBWL)), diabetes treatment and need for re-operation.

Position statement on the diagnosis and management of acute leukaemia and aggressive lymphomas in pregnancy.

Haematological malignancies affect 12·5 in 100 000 pregnancies. Over the past two decades, the number of haematological malignancies in pregnancy has substantially increased. Life-threatening haematological malignancies in pregnancy, such as acute leukaemia and aggressive lymphomas, pose a unique therapeutic challenge: clinicians must consider both maternal and fetal wellbeing, aiming to deliver optimal curative therapy for the patient and a successful pregnancy outcome.

Attention-based image segmentation and classification model for the preoperative risk stratification of thyroid nodules.

Background: Despite widespread use of standardized classification systems, risk stratification of thyroid nodules is nuanced and often requires diagnostic surgery. Genomic sequencing is available for this dilemma however, costs and access restricts global applicability. Artificial intelligence (AI) has the potential to overcome this issue nevertheless, the need for black-box interpretability is pertinent.

Achieving Chronic Care Equity by Leveraging the Telehealth Ecosystem (ACCTIVATE): A Multilevel Randomized Controlled Trial Protocol.

Background: Racial/ethnic and socioeconomic disparities in diabetes and hypertension outcomes persist in the United States (U.S.), and worsened during the COVID-19 pandemic.

Efficacy of a Multicomponent Physical Activity Intervention for Teachers With or At Risk of Type 2 Diabetes: The Support, Motivation, and Physical Activity Research for Teachers Health Randomized Controlled Trial.

Background: Type 2 diabetes is a major cause of illness and disability and physical activity reduces these risks. The SMART Health study aim was to compare the efficacy of a multicomponent intervention to promote aerobic physical activity and resistance training in schoolteachers at risk of or diagnosed with type 2 diabetes, with and without a technology-based behavior change package.

Methods: We randomized participants (N = 104) into 3 groups: "wait-list" control group, 5 face-to-face visits with a psychologist and exercise specialist (SH group), or 5 face-to-face visits over a 3-month period with a psychologist and exercise specialist, plus a technology-based behavior change package for an additional 6 months (SH+ group).

Controlled Delivery of Paclitaxel via Stable Synthetic Protein Nanoparticles.

Despite decades of intense research, glioma remains a disease for which no adequate clinical treatment exists. Given the ongoing therapeutic failures of conventional treatment approaches, nanomedicine may offer alternative options because it can increase the bioavailability of drugs and alter their pharmacokinetics. Here, a new type of synthetic protein nanoparticles (SPNPs) is reported that allow for effective loading and controlled release of the potent cancer drug, paclitaxel (PTX) - a drug that so far has been unsuccessful in glioma treatment due to hydrophobicity, low solubility, and associated delivery challenges.

Predictors of trigeminal neuropathy in patients receiving Gamma Knife stereotactic radiosurgery for vestibular schwannoma.

Objective: The authors' objective was to validate dosimetric and clinical predictors of the development of trigeminal neuropathy (Tn) in patients treated with stereotactic radiosurgery (SRS) for a diagnosis of vestibular schwannoma (VS).

Methods: In total, 301 patients were treated with SRS for VS at the authors' center between April 2013 and June 2020, with a median prescription dose of 12.5 Gy.

Surface science studies of the coverage dependent adsorption of methyl acetate and methyl propanoate on graphite.

Complex organic molecules (COMs) have been detected in a wide range of astrophysical environments, including the interstellar medium, comets and proto-planetary disks. The icy mantles that form on dust grains in these environments are thought to be the chemical nurseries that allow the formation of many of the COMs that have been identified. As such, the adsorption, thermal processing and desorption of COMs from dust grain surfaces are important in understanding the astrochemical networks as a whole.

An Updated Framework for Modeling White-Tailed Deer () Habitat Quality in Illinois, USA.

White-tailed deer () are a cervid species found mostly in the Americas. Managing white-tailed deer requires understanding their relationship with the environment, which was characterized by Roseberry and Woolf (Wildlife Society Bulletin , 1998, 252) for all counties in Illinois, USA, who incorporated habitat quantity and quality in a deer habitat suitability index. However, this index was based on satellite imagery from 1996 and did not explore the smaller spatial scales used by deer.

Adaptive behavior in primary agenesis of the corpus callosum.

Background And Aims: Primary agenesis of the corpus callosum (ACC) is a congenital neurological disorder characterized by the absence, either partial or complete, of the corpus callosum in individuals who do not have intellectual disability and are otherwise neurologically asymptomatic. While mild to moderate neurocognitive deficits have been observed in individuals with primary ACC using neuropsychological assessments, the impact of this syndrome on adaptive behavior remains insufficiently understood.

Methods: This study used self- and informant-ratings on the Adaptive Behavior Assessment System, Second Edition (ABAS-II) to evaluate adaptive behavior in 35 adults diagnosed with primary ACC.

Nucleoprotein Phase-Separation Affinities Revealed via Atomistic Simulations of Short Peptide and RNA Fragments.

Liquid-liquid phase separation of proteins and nucleic acids into condensate phases is a versatile mechanism for ensuring the compartmentalization of cellular biochemistry. RNA molecules play critical roles in these condensates, particularly in transcriptional regulation and stress responses, exhibiting a wide range of thermodynamic and dynamic behaviors. However, deciphering the molecular grammar that governs the stability and dynamics of protein-RNA condensates remains challenging due to the multicomponent and heterogeneous nature of condensates.

A Core set of patient-reported outcome measures to measure quality of life in obesity treatment research.

The lack of standardization in patient-reported outcome measures (PROMs) has made measurement and comparison of quality of life (QoL) outcomes in research focused on obesity treatment challenging. This study reports on the results of the second and third global multidisciplinary Standardizing Quality of life measures in Obesity Treatment (S.Q.

Scientific evidence for the updated guidelines on indications for metabolic and bariatric surgery (IFSO/ASMBS).

The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.

Nucleoprotein phase-separation affinities revealed via atomistic simulations of short peptide and RNA fragments.

Liquid-liquid phase separation of proteins and nucleic acids into condensate phases is a versatile mechanism for ensuring compartmentalization of cellular biochemistry. RNA molecules play critical roles in these condensates, particularly in transcriptional regulation and stress responses, exhibiting a wide range of thermodynamic and dynamic behaviors. However, deciphering the molecular grammar that governs the stability and dynamics of protein-RNA condensates remains challenging due to the multicomponent and heterogeneous nature of these biomolecular mixtures.

Regional changes of maximum dose insecticide responses in diamondback moth (Lepidoptera: Plutellidae) populations from Georgia and Florida, USA.

Maximum dose bioassays were conducted to assess the efficacy of multiple registered active ingredients for diamondback moth (DBM), Plutella xylostella (L.), control in Georgia and Florida from 2021 to 2023 as a follow-up to an earlier study. Low efficacy (<40% mortality) was recorded for the highest labeled rate of Bacillus thuringiensis var.