Outcomes of myofascial flap closure following complex tethered cord release in pediatric patients.

Background: Tethered cord syndrome encompasses a range of neurological deficits resulting from the spinal cord, filum terminale, or nerve roots adhering to the surrounding tissue within the spinal canal. Postoperative complications, such as cerebrospinal fluid leaks or infections, are not uncommon and increase the risk of morbidity and the need for additional surgeries. This study aimed to compare postoperative complications in pediatric patients who received primary wound closure to those who underwent myofascial flap (MFF) closure with plastic surgery following complex tethered cord release (TCR).

Heterogeneity in the management of diabetic ketoacidosis in Australia: a national survey.

Background: Diabetic ketoacidosis (DKA) is a hyperglycaemic emergency, and insulin administration is highly protocolised with either variable- or fixed-rate intravenous infusions. There are limited data supporting superiority of one regimen over another; however, international guidelines recommend fixed-rate infusions.

Aim: To characterise DKA management protocols used in Australian hospitals.

Comparison of specialist ataxia centres with non-specialist services in terms of care access and organisation, health services resource utilisation and costs in Germany using patient-reported data.

Background: The ataxias are rare complex neurological disorders challenging to diagnose and manage. We explored the patient pathways, health care use and costs of individuals attending a specialist ataxia centre (SAC) compared with non-specialist settings in Germany.

Methods: We distributed a survey to people with ataxia to gather information about diagnosis and management of the ataxias, utilisation of health care services, and patients' satisfaction in both SAC and non-specialist settings.

Immunoglobulin superfamily 3 (Igsf3) function is dispensable for brain development.

The Immunoglobulin superfamily (IgSF) is a heterogeneous and conserved family of adhesion proteins crucial during the development of the central nervous system including neuronal migration and synaptogenesis. The Immunoglobulin superfamily member 3 (IGSF3) is expressed in the developing brain and has been suggested to play a role during morphological development of the granule cells neurites in the cerebellum. In addition, a role for IGSF3 in supporting glioma progression has been recently demonstrated.

Toward digitally supported self-assessment of patients with idiopathic inflammatory myopathies.

Background: Manual muscle testing (MMT8), the current gold standard for assessing muscle function in patients with idiopathic inflammatory myopathies (IIM), has notable limitations. This study had three aims (1) to compare MMT8 with inertial sensor-based gait analysis, (2) to evaluate patient-performed functional tests guided by shared decision-making (SDM), and (3) to investigate adherence to electronic patient-reported outcomes (ePROs).

Methods: Gold standard muscle function assessment (MMT8) was performed at baseline (T0) and three months (T1).

Detection of Ocular Surface Squamous Neoplasia Using Artificial Intelligence With Anterior Segment Optical Coherence Tomography.

Purpose: To develop and validate a deep learning (DL) model to differentiate ocular surface squamous neoplasia (OSSN) from pterygium and pinguecula using high-resolution anterior segment optical coherence tomography (AS-OCT).

Design: Retrospective Diagnostic Accuracy Study.

Methods: Setting: Single-center.

Harmonizing population health data into OMOP common data model: a demonstration using COVID-19 sero-surveillance data from Nairobi Urban Health and Demographic Surveillance System.

Background: Observational health data are collected in different formats and structures, making it challenging to analyze with common tools. The Observational Medical Outcome Partnership (OMOP) Common Data Model (CDM) is a standardized data model that can harmonize observational health data.

Objective: This paper demonstrates the use of the OMOP CDM to harmonize COVID-19 sero-surveillance data from the Nairobi Urban Health and Demographic Surveillance System (HDSS).

Using exit surveys to elicit turnover reasons among behavioral health employees for organizational interventions.

Objective: The present study explored turnover reasons via exit surveys for organizational interventions.

Methods: The exit surveys were conducted at a community behavioral health organization for over a year, and the open-ended question responses on turnover reasons were analyzed.

Results: Thirty-five exit surveys were returned (58% response rate).

SHIFTing goals in cystic fibrosis-managing extrapulmonary disease in the era of CFTR modulator therapy; Proceedings of the International Shaping Initiatives and Future Trends (SHIFT) Symposium.

Background: Cystic fibrosis (CF) is a life-shortening multisystem genetic disease. Although progressive pulmonary disease is the predominant cause of morbidity and mortality, improvements in treatment for CF-related lung disease, with associated increase in longevity, have increased the prevalence of extrapulmonary manifestations.

Methods: To discuss these issues, a multidisciplinary meeting of international leaders and experts in the field was convened in November 2021 at the Shaping Initiatives and Future Trends  Symposium with the goal of highlighting shifting management paradigms in CF.

Use of Cardioprotective Adjuncts in Type 1 Diabetes.

Type 1 diabetes is associated with excess cardiovascular risk, even after accounting for traditional cardiovascular risk factors, including glycaemia. Hence, there is an urgent need to document the metabolic abnormalities that contribute to the cardiovascular mortality gap in type 1 diabetes, and to examine whether cardioprotective type 2 diabetes medications prevent premature morbidity and mortality in this population.

Determinants of Liraglutide Treatment Discontinuation in Type 1 Diabetes: A Post Hoc Analysis of ADJUNCT ONE and ADJUNCT TWO Randomized Placebo-Controlled Clinical Studies.

Introduction: Two phase 3 randomized controlled studies (ADJUNCT ONE (Clinicaltrials.gov: NCT01836523), ADJUNCT TWO (Clinicaltrials.gov: NCT02098395)) evaluated liraglutide (1.

Hypoglycaemia following physical exercise in a patient with novel SLC16A1 variant.

Rare defects in the promoter region of SLC16A1, the gene encoding monocarboxylate transporter 1 (MCT-1), result in exercise-induced hyperinsulinism. In this disorder, inappropriate insulin secretion is triggered by anaerobic exercise with consequent hypoglycaemia. We describe the case of a 41-year-old man presenting with a generalised tonic-clonic seizure and severe hypoglycaemia following strenuous exercise.

Intrathecal baclofen pump for severe hypertonia in a patient with juvenile Huntington's disease: illustrative case.

Background: While the symptoms of Huntington's disease (HD) typically first appear around the age of 40 years, 5%-10% of patients experience symptoms before the age of 21 years, in which case it is classified as juvenile Huntington's disease (JHD). JHD poses a unique clinical problem, as affected patients experience rapid deterioration in their quality of life as the motor manifestations of the disease become overwhelming. Medical treatment options for HD are sparse, and the only Food and Drug Administration-approved medication for the treatment of HD is the VMAT-2 inhibitor tetrabenazine.

Integrating longitudinal mental health data into a staging database: harnessing DDI-lifecycle and OMOP vocabularies within the INSPIRE Network Datahub.

Background: Longitudinal studies are essential for understanding the progression of mental health disorders over time, but combining data collected through different methods to assess conditions like depression, anxiety, and psychosis presents significant challenges. This study presents a mapping technique allowing for the conversion of diverse longitudinal data into a standardized staging database, leveraging the Data Documentation Initiative (DDI) Lifecycle and the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) standards to ensure consistency and compatibility across datasets.

Methods: The "INSPIRE" project integrates longitudinal data from African studies into a staging database using metadata documentation standards structured with a snowflake schema.

The Genetics of Chiari 1 Malformation.

Chiari malformation type 1 (CM1) is a structural defect that involves the herniation of the cerebellar tonsils through the foramen magnum, causing mild to severe neurological symptoms. Little is known about the molecular and developmental mechanisms leading to its pathogenesis, prompting current efforts to elucidate genetic drivers. Inherited genetic disorders are reported in 2-3% of CM1 patients; however, CM1, including familial forms, is predominantly non-syndromic.

Hyperglycemia secondary to phosphatidylinositol-3 kinase (PI3K) inhibition.

Summary: Phosphatidylinositol-3 kinase (PI3K) is a critical intracellular pathway that regulates cell growth, metabolism, and survival and has been implicated in most human cancers. Targeting this pathway has been approved as a therapeutic option for breast cancer and lymphoma (e.g.

Photoresponsive Organic Cages─Computationally Inspired Discovery of Azobenzene-Derived Organic Cages.

The incorporation of photoresponsive groups into porous materials is attractive as it offers potential advantages in controlling the pore size and selectivity to guest molecules. A combination of computational modeling and experiment resulted in the synthesis of two azobenzene-derived organic cages based on building blocks identified in a computational screen. Both cages incorporate three azobenzene moieties, and are therefore capable of 3-fold isomerization, using either ditopic or tetratopic aldehydes containing diazene functionality.

Reimagining the N-Of-1 Trial Within Pediatric Neuro-Oncology: A Shifting Paradigm.

The field of neuro-oncology has seen significant advances that have allowed the expansion of the therapeutic armamentarium. Nevertheless, overall outcomes have not improved significantly particularly for high-grade tumors. The relative rarity of these pathologies in the pediatric population limits the capacity to design large-scale, multicenter, randomized clinical trials.

Challenges and Outlooks in Precision Medicine: Expectations Versus Reality.

Recent developments in technology have led to rapid advances in precision medicine, especially due to the rise of next-generation sequencing and molecular profiling. These technological advances have led to rapid advances in research, including increased tumor subtype resolution, new therapeutic agents, and mechanistic insights. Certain therapies have even been approved for molecular biomarkers across histopathological diagnoses; however, translation of research findings to the clinic still faces a number of challenges.

Emergence of Precision Medicine Within Neurological Surgery: Promise and Opportunity.

Within neurosurgery, it has always been important to individualize patient care. In recent years, however, technological advances have brought a new dimension to personalized care as developing methods, including next-generation sequencing, have enabled us to molecularly profile pathologies with increasing scale and resolution. In this review, the authors discuss the history and advances in precision medicine and neurosurgery, focusing both on neuro-oncology, as well as its extension to other neurosurgical subspecialties.

Switching Sides: Regiochemistry and Functionalization Dictate the Photoswitching Properties of Imines.

Photoswitchable imines demonstrate light-dependent dynamic covalent chemistry and can function as molecular ratchets. However, the design of aryliminopyrazoles (AIPs) has been limited to N-pyrazole derivatives with ortho-pyrrolidine motifs. The impact of other functionalization patterns on the photoswitching properties remains unknown.