Outcomes With Radiation Therapy as Primary Treatment for Unresectable Cutaneous Head and Neck Squamous Cell Carcinoma.

Aims: Unresectable cutaneous squamous cell cancer of the head and neck (HNcSCC) poses treatment challenges in elderly and comorbid patients. Radiation therapy (RT) is often employed for locoregional control. This study aimed to determine progression-free survival (PFS) and overall survival (OS) outcomes achieved with upfront RT in unresectable HNcSCC.

National early warning score 2 plus non-invasive capnography and perfusion index to estimate poor outcomes in emergency departments.

Background: The study of the inclusion of new variables in already existing early warning scores is a growing field. The aim of this work was to determine how capnometry measurements, in the form of end-tidal CO2 (ETCO2) and the perfusion index (PI), could improve the National Early Warning Score (NEWS2).

Methods: A secondary, prospective, multicenter, cohort study was undertaken in adult patients with unselected acute diseases who needed continuous monitoring in the emergency department (ED), involving two tertiary hospitals in Spain from October 1, 2022, to June 30, 2023.

Systematic application of saliency maps to explain the decisions of convolutional neural networks for glaucoma diagnosis based on disc and cup geometry.

This paper systematically evaluates saliency methods as explainability tools for convolutional neural networks trained to diagnose glaucoma using simplified eye fundus images that contain only disc and cup outlines. These simplified images, a methodological novelty, were used to relate features highlighted in the saliency maps to the geometrical clues that experts consider in glaucoma diagnosis. Despite their simplicity, these images retained sufficient information for accurate classification, with balanced accuracies ranging from 0.

A Preliminary Qualitative Exploration of the Lived Experiences of Presenteeism Among Taiwanese Nursing Staff.

Objective: The aim of this study was to explore the lived experiences of presenteeism among Taiwanese nursing staffs.

Background: Presenteeism is a subjective and multifaceted experience, but nurses have rarely been invited to provide their own views of presenteeism.

Methods: A qualitative study based on content analysis was conducted.

Practical Steps Supporting Professional Publications for Leadership and Teams.

Disseminating research or evidence-based practice is not straightforward. As more clinical nurses, executive nurse leaders, nurse scientists, and faculty contribute to new knowledge, there is an increasing need to support the processes to publish and disseminate manuscripts to advance healthcare. Nurse administrators and leaders are key influencers and supporters to bolster expertise and resources to publish.

Intraoperative Anesthetic Care During Emergent/Urgent Craniotomy or Craniectomy for Intracranial Hypertension or Herniation: A Systematic Review.

This systematic review aimed to identify and describe best practice for the intraoperative anesthetic management of patients undergoing emergent/urgent decompressive craniotomy or craniectomy for any indication. The PubMed, Scopus, EMBASE, and Cochrane databases were searched for articles related to urgent/emergent craniotomy/craniectomy for intracranial hypertension or brain herniation. Only articles focusing on intraoperative anesthetic management were included; those investigating surgical or intensive care unit management were excluded.

Oncogenic IDH1 drives robust loss of histone acetylation and increases chromatin heterogeneity.

Malignant gliomas are heterogeneous tumors, mostly incurable, arising in the central nervous system (CNS) driven by genetic, epigenetic, and metabolic aberrations. Mutations in isocitrate dehydrogenase (IDH1/2) enzymes are predominantly found in low-grade gliomas and secondary high-grade gliomas, with IDH1 mutations being more prevalent. Mutant-IDH1/2 confers a gain-of-function activity that favors the conversion of a-ketoglutarate (α-KG) to the oncometabolite 2-hydroxyglutarate (2-HG), resulting in an aberrant hypermethylation phenotype.

A detailed spatiotemporal atlas of the white matter tracts for the fetal brain.

This study presents the construction of a comprehensive spatiotemporal atlas of white matter tracts in the fetal brain for every gestational week between 23 and 36 wk using diffusion MRI (dMRI). Our research leverages data collected from fetal MRI scans, capturing the dynamic changes in the brain's architecture and microstructure during this critical period. The atlas includes 60 distinct white matter tracts, including commissural, projection, and association fibers.

Population encoding of observed and actual somatosensations in the human posterior parietal cortex.

Cognition relies on transforming sensory inputs into a generalizable understanding of the world. Mirror neurons have been proposed to underlie this process, mapping visual representations of others' actions and sensations onto neurons that mediate our own, providing a conduit for understanding. However, this theory has limitations.

infection accelerates postnatal maturation of the intestinal epithelium.

Postnatal establishment of enteric metabolic, host-microbial and immune homeostasis is the result of precisely timed and tightly regulated developmental and adaptive processes. Here, we show that infection with the invasive enteropathogen Typhimurium results in accelerated maturation of the neonatal epithelium with premature appearance of antimicrobial, metabolic, developmental, and regenerative features of the adult tissue. Using conditional Myd88-deficient mice, we identify the critical contribution of immune cell-derived mediators.

Hydroxychloroquine prevents resistance and potentiates the antitumor effect of SHP2 inhibition in NF1-associated malignant peripheral nerve sheath tumors.

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive sarcomas and the primary cause of mortality in patients with neurofibromatosis type 1 (NF1). These malignancies develop within preexisting benign lesions called plexiform neurofibromas (PNs). PNs are solely driven by biallelic loss eliciting RAS pathway activation, and they respond favorably to MEK inhibitor therapy.

Comparing integrative ventilatory and renal acid-base acclimatization in lowlanders and Tibetan highlanders during ascent to 4,300 m.

With over 14 million people living above 3,500 m, the study of acclimatization and adaptation to high altitude in human populations is of increasing importance, where exposure to high altitude (HA) imposes a blood oxygenation and acid-base challenge. A sustained and augmented hypoxic ventilatory response protects oxygenation through ventilatory acclimatization, but elicits hypocapnia and respiratory alkalosis. A subsequent renally mediated compensatory metabolic acidosis corrects pH toward baseline values, with a high degree of interindividual variability.

Palmitoylation-dependent association with Annexin II directs hepatitis E virus ORF3 sorting into vesicles and quasi-enveloped virions.

Historically considered to be nonenveloped, hepatitis E virus (HEV), an important zoonotic pathogen, has recently been discovered to egress from infected cells as quasi-enveloped virions. These quasi-enveloped virions circulating in the blood are resistant to neutralizing antibodies, thereby facilitating the stealthy spread of infection. Despite abundant evidence of the essential role of the HEV-encoded ORF3 protein in quasi-enveloped virus formation, the underlying mechanism remains unclear.

Comparing Virtual Reality-Based and Traditional Physical Objective Structured Clinical Examination (OSCE) Stations for Clinical Competency Assessments: Randomized Controlled Trial.

Background: Objective structured clinical examinations (OSCEs) are a widely recognized and accepted method to assess clinical competencies but are often resource-intensive.

Objective: This study aimed to evaluate the feasibility and effectiveness of a virtual reality (VR)-based station (VRS) compared with a traditional physical station (PHS) in an already established curricular OSCE.

Methods: Fifth-year medical students participated in an OSCE consisting of 10 stations.

Clinical outcomes and cost-utility analysis of GKRS plus TKIs versus TKIs in patients with EGFR-mutant lung adenocarcinoma and brain metastases: a Markov decision model.

Objective: This study focuses on epidermal growth factor receptor-mutated lung adenocarcinoma, known for frequent brain metastasis. It aimed to compare the clinical outcomes and cost-effectiveness of combining Gamma Knife radiosurgery (GKRS) with tyrosine kinase inhibitors (TKIs) (GKRS+TKI group) versus TKIs alone (TKI group) for the treatment of patients with newly diagnosed brain metastasis in this condition.

Methods: Study characteristics of the two groups were matched using inverse probability of treatment weighting (IPTW).

The association between work-life conflict and mental health - A cohort study.

Objective: Mental health problems are increasing worldwide, and research has shown that it can be affected by work-life conflict (WLC). The aim of the present study is to examine the association between WLC and both stress and depressive symptoms in early adulthood.

Methods: A cross-sectional and a 4-year follow-up study was conducted using register data and questionnaire data from The West Jutland Cohort Study (VestLiv), Denmark.

Qwen-2.5 Outperforms Other Large Language Models in the Chinese National Nursing Licensing Examination: Retrospective Cross-Sectional Comparative Study.

Background: Large language models (LLMs) have been proposed as valuable tools in medical education and practice. The Chinese National Nursing Licensing Examination (CNNLE) presents unique challenges for LLMs due to its requirement for both deep domain-specific nursing knowledge and the ability to make complex clinical decisions, which differentiates it from more general medical examinations. However, their potential application in the CNNLE remains unexplored.

In utero progression of cephaloceles: prenatal to postnatal analysis.

Objective: The natural history of cephaloceles is not well understood. The goal of this study was to better understand the natural history of fetal cephaloceles from prenatal diagnosis to the postnatal period.

Methods: Between January 2013 and April 2023, all patients evaluated with a cephalocele at the Center for Fetal Diagnosis and Treatment were identified.

Virtual Reality-Based Psychological Intervention for Young Adults Living With HIV: Protocol for a Randomized Controlled Trial.

Background: Young adults (15-24 years old) living with HIV may experience pressure both from HIV infection and social role change problems, resulting in a series of psychological problems such as depression and anxiety. Effective psychological intervention can improve their mental health and quality of life.

Objective: The study aims to explore the effectiveness of VR-based mental intervention on young adults living with HIV.

Repetitive and extensive focused ultrasound-mediated bilateral frontal blood-brain barrier opening for Alzheimer's disease.

Objective: Focused ultrasound (FUS)-mediated blood-brain barrier (BBB) opening is safe and potentially beneficial in patients with Alzheimer's disease (AD) for the removal of amyloid-beta (Aβ) plaques. However, the optimal BBB opening intervals and number of treatment sessions for clinical improvement remain undefined. Therefore, the aim of this study was to evaluate the safety and benefits of repeated and more extensive BBB opening alone.

Risk factors of short-term poor functional outcomes and long-term durability of ruptured large or giant intracranial aneurysms.

Objective: Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates. In particular, functional outcomes of SAH caused by large or giant (≥ 10 mm) ruptured intracranial aneurysms are worsened by high procedure-related complication rates. However, studies describing the risk factors for poor functional outcomes specific to ruptured large/giant aneurysms are sparse.

Development and Validation of the Digital Sensitivity Scale for Adults: Cross-Sectional Observational Study.

Background: The COVID-19 pandemic has accelerated the digitalization of modern society, extending digital transformation to daily life and psychological evaluation and treatment. However, the development of competencies and literacy in handling digital technology has not kept pace, resulting in a significant disparity among individuals. Existing measurements of digital literacy were developed before widespread information and communications technology device adoption, mainly focusing on one's perceptions of their proficiency and the utility of device operation.