Radical Resection of a Radial Ewing Sarcoma and Ulnar Centralization in a 10-Month-Old Girl: A Case Report.

Case: We outline the management of a 10-month-old girl with an Ewing sarcoma involving the entire radius. The patient was treated with neoadjuvant chemotherapy resulting in almost a complete response. A limb-sparing procedure was performed consisting of a radical resection of the entire radius and centralization of the carpus to the ulna.

Telehealth equity and access communication skills pilot simulation for practicing clinicians.

Objectives: This pilot study evaluated a telehealth training simulation program for practicing clinicians, specifically focused on addressing patient issues of equity and access to healthcare via improving telehealth communication.

Methods: Participants participated in a one-hour simulation experience with two cases. Performance was assessed pre- and post-intervention using a checklist measuring communication domains related to equity and access in telehealth.

Using Theory and Technology to Build an Interprofessional Community of Human Trafficking Educators.

Introduction: Human trafficking, a global health crisis, requires interprofessional responses. Skilled teachers are needed to train health care providers about human trafficking.

Methods: To promote nonhierarchical interprofessional collaborative learning, we applied social cognitive and experiential learning theories within a dialectical constructivist program design to scaffold participants' knowledge and leveraged technology to build and sustain the program's community.

Feasibility of a Multicomponent Digital Fall Prevention Exercise Intervention for At-Risk Older Adults.

Background: Falls are a leading cause of disability, institutionalization and mortality for older adults. More effective strategies to prevent falls are essential and may help at-risk older adults continue to live independently. While exercise programs with in-person supervision reduce fall risk, there are numerous barriers associated with older adults' participation in such programs.

Glucocorticoid facet joint injection for chronic back or neck pain.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The primary objective is to assess the benefits and harms of glucocorticoid facet joint injections in adults with chronic back or neck pain that is presumed to be facet joint-mediated. The secondary objective is to assess whether the effects differ by diagnostic method for facet joint-mediated pain.

Posterior retroperitoneal adrenalectomy for metastatic disease: a multi-site Australian series.

Background: Posterior retroperitoneoscopic adrenalectomy (PRA) for isolated adrenal metastasis is minimally invasive, may prolong survival and improve quality of life. The current evidence base is scant.

Methods: A multi-site retrospective analysis of all cases of PRA for adrenal metastasis between 2011 and 2023, by four high-volume adrenal surgeons was performed.

Trajectories of cold but not mechanical sensitivity correspond with disability trajectories after whiplash injury.

Developmental trajectories for neck disability after whiplash injury have been identified. Their relationship to cold and mechanical sensitivity trajectories is not known. We aimed to (1) identify recovery trajectories of cold and mechanical sensitivity, (2) explore their codevelopment with disability trajectories, (3) identify predictors of sensitivity trajectories, and (4) explore codevelopment of cold and mechanical sensitivity trajectories.

Two-Dimensional Liquid Chromatography Tandem Mass Spectrometry Untangles the Deep Metabolome of Marine Dissolved Organic Matter.

Dissolved organic matter (DOM) is an ultracomplex mixture that plays a central role in global biogeochemical cycles. Despite its importance, DOM remains poorly understood at the molecular level. Over the last decades, significant efforts have been made to decipher the chemical composition of DOM by high-resolution mass spectrometry (HR-MS) and liquid chromatography (LC) coupled with tandem mass spectrometry (MS/MS).

Statistical analysis of feature-based molecular networking results from non-targeted metabolomics data.

Feature-based molecular networking (FBMN) is a popular analysis approach for liquid chromatography-tandem mass spectrometry-based non-targeted metabolomics data. While processing liquid chromatography-tandem mass spectrometry data through FBMN is fairly streamlined, downstream data handling and statistical interrogation are often a key bottleneck. Especially users new to statistical analysis struggle to effectively handle and analyze complex data matrices.

Text mining for disease surveillance in veterinary clinical data: part two, training computers to identify features in clinical text.

In part two of this mini-series, we evaluate the range of machine-learning tools now available for application to veterinary clinical text-mining. These tools will be vital to automate extraction of information from large datasets of veterinary clinical narratives curated by projects such as the Small Animal Veterinary Surveillance Network (SAVSNET) and VetCompass, where volumes of millions of records preclude reading records and the complexities of clinical notes limit usefulness of more "traditional" text-mining approaches. We discuss the application of various machine learning techniques ranging from simple models for identifying words and phrases with similar meanings to expand lexicons for keyword searching, to the use of more complex language models.

Utility of Adrenal Vein Sampling With and Without Ultra-Low Dose ACTH Infusion in the Diagnostic Evaluation of Primary Aldosteronism.

Background: Adrenal vein sampling (AVS), integral to identifying surgically remediable unilateral primary aldosteronism (PA), is technically challenging and subject to fluctuations in cortisol and aldosterone secretion. Intra-procedural adrenocorticotropic hormone (ACTH), conventionally administered as a 250-μg bolus and/or 50 μg per hour infusion, increases cortisol and aldosterone secretion and can improve AVS success, but may cause discordant lateralisation compared to unstimulated AVS.

Aims: To assess if AVS performed with ultra-low dose ACTH infusion causes discordant lateralisation.

A tale of two sisters - delayed diagnosis of genetic hyperinsulinaemic hypoglycaemia.

Summary: Congenital hyperinsulinism is the leading cause of persistent hypoglycaemia in infants and children; however, it is uncommon to be diagnosed in adulthood. We describe the cases of two sisters who presented with hyperinsulinaemic hypoglycaemia aged 47 and 57 years old, who were subsequently diagnosed with compound heterozygous likely pathogenic variants in the ABCC8 gene, a known cause of monogenic congenital hyperinsulinism. We discuss the typical presenting features, investigation findings, and treatment strategies for patients with this condition.

The XENONnT dark matter experiment.

The multi-staged XENON program at INFN Laboratori Nazionali del Gran Sasso aims to detect dark matter with two-phase liquid xenon time projection chambers of increasing size and sensitivity. The XENONnT experiment is the latest detector in the program, planned to be an upgrade of its predecessor XENON1T. It features an active target of 5.

Clinical protocol using calcium and calcitriol after paediatric total thyroidectomy decreases postoperative hypocalcaemia and inpatient blood tests.

Introduction: Postoperative hypocalcaemia is common after thyroidectomy. This study aimed to evaluate whether a standardised post-thyroidectomy protocol using prophylactic calcium and calcitriol reduces hypocalcaemia incidence after total thyroidectomy in children and adolescents.

Methods: A cohort children and adolescents ≤18 years of age undergoing total thyroidectomy between January 2016 and October 2022 in one institution were retrospectively identified and divided into pre-protocol and post-protocol groups.

Explainable text-tabular models for predicting mortality risk in companion animals.

As interest in using machine learning models to support clinical decision-making increases, explainability is an unequivocal priority for clinicians, researchers and regulators to comprehend and trust their results. With many clinical datasets containing a range of modalities, from the free-text of clinician notes to structured tabular data entries, there is a need for frameworks capable of providing comprehensive explanation values across diverse modalities. Here, we present a multimodal masking framework to extend the reach of SHapley Additive exPlanations (SHAP) to text and tabular datasets to identify risk factors for companion animal mortality in first-opinion veterinary electronic health records (EHRs) from across the United Kingdom.

Laparoscopic insulinoma enucleation for an uncinate lesion.

How I do laparoscopic insulinoma enucleation. This article discusses a laparoscopic approach for insulinoma enucleation, an approach which offers all the advantages of a laparoscopic approach and which can also be adapted to other pancreatic lesions requiring enucleation.

Discordant dry eye disease and chronic pain: A systematic review and meta-analysis.

Purpose: To evaluate the relative contributions of objective and subjective indicators of dry eye disease (DED) in individuals with chronic pain conditions compared with controls.

Methods: A systematic review and meta-analysis was conducted of studies that reported the signs and symptoms of DED and/or their prevalence in individuals with chronic pain compared with controls. International Association for the Study of Pain (IASP) International Classification of Diseases (ICD)-11 codes for chronic pain conditions were applied, and outcomes defined as DED signs and symptoms.

Precision medicine within health professions education: Defining a research agenda for emergency medicine using a foresight and strategy technique (FaST) review.

Background: Precision medicine, sometimes referred to as personalized medicine, is rapidly changing the possibilities for how people will engage health care in the near future. As technology to support precision medicine exponentially develops, there is an urgent need to proactively improve our understanding of precision medicine and pose important research questions (RQs) related to its inclusion in the education and training of future emergency physicians.

Methods: A seven-step process was employed to develop a research agenda exploring the intersection of precision and emergency medicine education/training.

Serum Vitamin D and Chronic Musculoskeletal Pain: A Cross-Sectional Study of 349,221 Adults in the UK.

Insufficient and deficient vitamin D may be associated with chronic musculoskeletal pain, but study findings are conflicting, and few account for important confounding factors. This cross-sectional study explored the association between serum vitamin D status and chronic musculoskeletal pain in various body sites, adjusting for a wide range and a number of potential confounding factors. Data collected at the baseline assessments of 349,221 UK Biobank participants between 2006 and 2010 were analyzed.

Maternity care for women from ethnic minority backgrounds in North-West England: A grounded theory study.

Aim: To understand the maternity experiences of women from minority ethnic groups who had given birth in an NHS trust in the North-West of England, and experiences of midwives caring for them.

Background: Women from minority ethnic groups have poorer maternity outcomes compared with other women. Research about maternity experiences of women from minority ethnic groups is limited but suggests that they have poorer experiences.

Coronary artery calcification and high-volume physical activity: role of lower intensity vs. longer duration of exercise.

Aims: While high-volume physical activity (PA) has been linked to elevated coronary artery calcification (CAC), the role of intensity vs. duration of PA has not been investigated. The purpose of the study was to examine the role of intensity vs.

Elucidating Local Structure and Positional Effect of Dopants in Colloidal Transition Metal Dichalcogenide Nanosheets for Catalytic Hydrogenolysis.

Tailoring nanoscale catalysts to targeted applications is a vital component in reducing the carbon footprint of industrial processes; however, understanding and controlling the nanostructure influence on catalysts is challenging. Molybdenum disulfide (MoS), a transition metal dichalcogenide (TMD) material, is a popular example of a nonplatinum-group-metal catalyst with tunable nanoscale properties. Doping with transition metal atoms, such as cobalt, is one method of enhancing its catalytic properties.