Lifetime Health Effects and Cost-Effectiveness of Tirzepatide and Semaglutide in US Adults.

Importance: Newer antiobesity medications lead to greater weight loss and lower cardiometabolic risks. However, the high costs of these medications have raised policy questions about their value and coverage decisions.

Objective: To compare the cost-effectiveness of 4 antiobesity medications with lifestyle modification vs lifestyle modification alone in the US.

CT Colonography for Colorectal Cancer Prevention and Detection: Integration Into Clinical Practice, From the Special Series on Screening.

CT colonography (CTC) is a CT examination, performed with low dose and typically without IV contrast media, optimized to detect colorectal polyps and cancer. Despite extensive supporting data, CTC has had variable acceptance and use over the past two decades, particularly for a main indication of colorectal cancer screening. CTC is now at an inflection point after the approval in 2025 by CMS for reimbursement of CTC performed for colorectal cancer screening.

Determinants of late metastases in renal cell carcinoma.

The mechanisms underlying metastatic latency in renal cell carcinoma (RCC) remain poorly understood. This study evaluated two large independent cohorts for differences in tumor biology between patients who developed metastases early (≤1 year after nephrectomy) and those with late-onset (>3 years). In the discovery cohort (n = 161), late-metastatic RCC (late-mRCC) was associated with clear cell histology (88.

Impact of Outpatient Palliative Care Services on Resource Utilization and Cost Management in a Capitated Medicare Population.

The integration of palliative care into the U.S. health care system has grown significantly, with outpatient palliative care services (OPCSs) playing an increasingly vital role in managing patients with serious illnesses.

Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine?

Objectives: Anterior spinal fusion (ASF) presents unique challenges, including the proximity of critical anatomic structures. Previous reports have detailed vascular injuries during exposure/approach; however, it is not well-documented whether structural aortic pathology, such as aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors, impacts postoperative outcomes following anterior approach to the spine for spinal fusion.

Materials And Methods: Using the New York State Statewide Planning and Research Cooperative System, thoracolumbar ASF patients with a history of aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors (APath) were identified and matched to patients with no aortic pathologies (No-APath).

Massively parallel assessment of designed protein solution properties using mass spectrometry and peptide barcoding.

Library screening and selection methods can determine the binding activities of individual members of large protein libraries given a physical link between protein and nucleotide sequence, which enables identification of functional molecules by DNA sequencing. However, the solution properties of individual protein molecules cannot be probed using such approaches because they are completely altered by DNA attachment. Mass spectrometry enables parallel evaluation of protein properties amenable to physical fractionation such as solubility and oligomeric state, but current approaches are limited to libraries of 1,000 or fewer proteins.

Rewilding catalyzes maturation of the humoral immune system.

Inbred mice used for biomedical research display an underdeveloped immune system compared with adult humans, which is attributed in part to the artificial laboratory environment. Despite representing a central component of adaptive immunity, the impact of the laboratory environment on the B cell compartment has not been investigated in detail. Here, we performed an in-depth examination of B cells following rewilding, the controlled release of inbred laboratory mice into an outdoor enclosure.

Tethered cord syndrome in a paediatric patient with KBG syndrome.

KBG syndrome is a rare genetic condition caused by mutations, often presenting with distinctive syndromic features, including macrodontia and skeletal anomalies. This case highlights a teenage boy with KBG syndrome presenting with tethered cord syndrome (TCS)-a progressive condition where spinal cord fixation restricts movement-causing motor, sensory and urological symptoms.The patient presented with leg stiffness, gait changes and bowel and bladder symptoms, initially misdiagnosed as catatonia.

Temporal rotation flaps for gender-affirming hairline feminization: Taking the "M" shape out of masculine hairlines.

Background: In transfeminine patients seeking facial gender-affirming surgery, temporal recession of the hairline is a common feature that contributes to a masculine appearance. Standard central hairline advancement lowers the hairline without substantially improving hairline shape. In this article, we describe our technique utilizing bilateral rotational flaps of the temporal hair-bearing scalp to facilitate excision of the area of alopecia and compare outcomes of our technique to central hairline advancement alone.

Solubilization of Membrane Proteins using designed protein WRAPS.

The development of therapies and vaccines targeting integral membrane proteins has been complicated by their extensive hydrophobic surfaces, which can make production and structural characterization difficult. Here we describe a general deep learning-based design approach for solubilizing native membrane proteins while preserving their sequence, fold, and function using genetically encoded protein WRAPs (Water-soluble RFdiffused Amphipathic Proteins) that surround the lipid-interacting hydrophobic surfaces, rendering them stable and water-soluble without the need for detergents. We design WRAPs for both beta-barrel outer membrane and helical multi-pass transmembrane proteins, and show that the solubilized proteins retain the binding and enzymatic functions of the native targets with enhanced stability.

Characterization of Newborn Circumcision Revision and Complication Rates Among Privately Insured Boys in the United States Between 2010 and 2022.

Objective: To investigate national trends in newborn circumcision complication and secondary procedure rates and whether clinician specialty affects these rates.

Methods: The Merative MarketScan Database was queried for claims from 2010 to 2022. CPT 54150 identified newborn circumcisions; CPT 54162, 54163, 54164, 54300, and 54450 identified secondary procedures; ICD-9 and ICD-10 codes identified complications.

Cell Homing Strategies in Regenerative Endodontic Therapy.

Cell homing, a process that leverages the body's natural ability to recruit cells and repair damaged tissues, presents a promising alternative to cell transplantation methods. Central to this approach is the recruitment of endogenous stem/progenitor cells-such as those from the apical papilla, bone marrow, and periapical tissues-facilitated by chemotactic biological cues. Moreover, biomaterial scaffolds embedded with signaling molecules create supportive environments, promoting cell migration, adhesion, and differentiation for the regeneration of the pulp-dentin complex.

Superfluid stiffness of magic-angle twisted bilayer graphene.

The physics of superconductivity in magic-angle twisted bilayer graphene (MATBG) is a topic of keen interest in moiré systems research, and it may provide an insight into the pairing mechanism of other strongly correlated materials such as high-critical-temperature superconductors. Here we use d.c.

Plastic Surgeon Well-being, Mindfulness, and the Art of Letting Go.

As plastic surgeons, we strive to achieve the best possible outcomes for our patients. However, despite being a good surgeon with a sound plan that was thoughtfully crafted and well executed, complications still happen. As a result, surgeons involved in the care of patients who have complications can experience mental and emotional suffering, including feelings of guilt, sadness, anxiety, and stress.

Novel early vertical ridge augmentation technique.

Background/purpose: Multiple augmentation protocols are documented in the literature to rebuild the deficient alveolar ridge after tooth extraction; however, achieving adequate vertical augmentation remains the most challenging goal. This study demonstrated a novel surgical technique of early vertical ridge augmentation for post-dental extraction. This technique offers several biological and technical advantages regarding the timing of the procedure and its relative simplicity compared to other complex techniques.

HDR brachytherapy combined with external beam radiotherapy for unfavorable localized prostate cancer: A single center experience from inception to standard of care.

Purpose: High dose rate (HDR) brachytherapy is increasingly adopted for dose escalation in prostate cancer treatment. We report the clinical efficacy and toxicity of HDR prostate brachytherapy combined with external beam radiotherapy (EBRT) and evaluate the predictability of the biochemical definition of cure of 4-year PSA ≤0.2 ng/mL for failure free survival (FFS).

Regenerative failure of sympathetic axons contributes to deficits in functional recovery after nerve injury.

Renewed scientific interest in sympathetic modulation of muscle and neuromuscular junctions has spurred a flurry of new discoveries with major implications for motor diseases. However, the role sympathetic axons play in the persistent dysfunction that occurs after nerve injuries remains to be explored. Peripheral nerve injuries are common and lead to motor, sensory, and autonomic deficits that result in lifelong disabilities.

A retrospective review of the common childhood illnesses and the indications for antibiotic prescription at community hospital in Malawi.

Background: Childhood remains a vulnerable period and a key determiner for adult health. Various illnesses experienced by children in their early years determine future performance and contribution to society. Acute and chronic infectious diseases, undernutrition, and early childhood non-communicable diseases have greatly been linked to intellectual disability, poor childhood development, increased morbidity, and household and healthcare economic costs.

Identifying Predictors of Extended Intensive Care Unit Stay Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: An Analysis of 101 ACS NSQIP Pediatric Participating Centers.

Background: While prolonged operative time and increased levels fused have been shown to increase the risk of prolonged intensive care unit (ICU) length-of-stay (LOS), studies are limited in guiding decision-making regarding the need for intensive care postoperatively. This is especially the case among the cohort of adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF); associations between comorbidities and ICU LOS are not well-delineated.

Methods: AIS patients who underwent PSF from January 1st, 2016 to December 1st, 2016 at 101 participating centers were identified using the American College of Surgeons (ACS) National Surgical Quality Im-provement Project (NSQIP) Pediatric database.

A highly conserved sRNA downregulates multiple genes, including a σ transcriptional activator, in the virulence mode of .

Bacterial sRNAs together with the RNA chaperone Hfq post-transcriptionally regulate gene expression by affecting ribosome binding or mRNA stability. In the human pathogen , the causative agent of whooping cough, hundreds of sRNAs have been identified, but their roles in biology are mostly unknown. Here we characterize a Hfq-dependent sRNA (S17), whose level is dramatically higher in the virulence (Bvg) mode.

Crosslinked Versus Non-Crosslinked Resorbable Collagen Membranes for Periodontal Regeneration: A Multicenter, Randomized, Double-Blind, Non-Inferiority Clinical Trial.

Aim: This study aimed to evaluate and compare the results of combination therapy involving bone grafting and two different resorbable collagen membranes in 1-, 2- and 3-wall infrabony defects.

Methods: A total of 174 patients with infrabony defects (≥ 7 mm periodontal probing depth) were randomized to receive deproteinized bovine bone mineral (DBBM) with either a native porcine non-crosslinked collagen membrane (N-CM, control, n = 87) or a novel porcine crosslinked collagen membrane (C-CM, test, n = 87). Clinical parameters, including periodontal probing depth (PPD), clinical attachment level (CAL), and gingival recession (GR), were recorded at baseline, 12 weeks, and 24 weeks.