Prenatal Care of Parents Who Continued Pregnancies With Down Syndrome, 2003-2022.

Parents of children with Down syndrome have historically reported poor experiences receiving a prenatal diagnosis. In a 2003 survey, mothers reported that their physicians pitied them, emphasized negative aspects of Down syndrome, and encouraged them to terminate the pregnancy. This study assesses whether parents' perceptions have since improved.

Proposed resources required for a comprehensive program for CCT CHD imaging.

Background: Cardiac Computed Tomography (CCT) is increasingly used for evaluation of congenital heart disease (CHD) in patients of all ages. Pediatric and adult congenital heart disease (ACHD) surgical programs require high quality CCT imaging as part of the multimodality imaging support expected of comprehensive care centers. Despite these expectations, there are no benchmarks or defined programmatic elements specific to the performance of CCT in patients with CHD.

Assessment and treatment considerations for patients with colorectal liver metastases: AHPBA consensus guideline and update for surgeons.

Background: Colorectal cancer most commonly metastasizes to the liver. While various treatment strategies have been developed, surgical management of these patients has vital implications on the prognosis and survival of this group of patients. There remains a need for a consensus guideline regarding the surgical evaluation and management of patients with colorectal liver metastases (CRLM).

ExerGeneDB: A physical exercise-regulated differential gene expression database.

Background: Exercise induces molecular changes that involve multiple organs and tissues. Moreover, these changes are modulated by various exercise parameters-such as intensity, frequency, mode, and duration-as well as by clinical features like gender, age, and body mass index (BMI), each eliciting distinct biological effects. To assist exercise researchers in understanding these changes from a comprehensive perspective that includes multiple organs, diverse exercise regimens, and a range of clinical features, we developed Exercise Regulated Genes Database (ExerGeneDB), a database of exercise-regulated differential genes.

Skeletal muscle adiposity, coronary microvascular dysfunction, and adverse cardiovascular outcomes.

Background And Aims: Skeletal muscle (SM) fat infiltration, or intermuscular adipose tissue (IMAT), reflects muscle quality and is associated with inflammation, a key determinant in cardiometabolic disease. Coronary flow reserve (CFR), a marker of coronary microvascular dysfunction (CMD), is independently associated with body mass index (BMI), inflammation and risk of heart failure, myocardial infarction, and death. The relationship between SM quality, CMD, and cardiovascular outcomes is not known.

Preventing unrestricted and unmonitored AI experimentation in healthcare through transparency and accountability.

The integration of large language models (LLMs) into electronic health records offers potential benefits but raises significant ethical, legal, and operational concerns, including unconsented data use, lack of governance, and AI-related malpractice accountability. Sycophancy, feedback loop bias, and data reuse risk amplifying errors without proper oversight. To safeguard patients, especially the vulnerable, clinicians must advocate for patient-centered education, ethical practices, and robust oversight to prevent harm.

Integrated Phase I Pharmacokinetics and Pharmacodynamics of Epinephrine Administered via Sublingual Film, Autoinjector, or Manual Injection.

Background: Epinephrine is the first-line treatment for anaphylaxis and is administered via intramuscular (IM) or subcutaneous (SC) injection. AQST-109, a sublingual film containing a prodrug of epinephrine, is in development as an alternative delivery method for the treatment of severe allergic reactions including anaphylaxis.

Objective: To compare the pharmacokinetics (PK) and pharmacodynamics (PD) of epinephrine following administration of AQST-109 to epinephrine delivered by manual IM injection and epinephrine autoinjectors (EAIs).

Consistent direction despite wavering policy: reductions in resident physician extended duration shifts over 20 years.

We examined data from 17,498 physicians-in-training who reported on 92,662 months of work over a 20 year study interval that included three major revisions to work hour limits. Extended duration shifts (≥24 hours; EDS) are much less common than they used to be. On average, first-year resident physicians (PGY1s) currently work a total of 4 EDS per year and 3 EDS per month during months in which any EDS are worked.

Neonatal cost savings in hypertensive disorders of pregnancy: Economic evaluation of the sFlt-1/PlGF test with real world implementation of biomarkers.

Background: Preeclampsia is a key cause of prematurity in the U.S. and incurs significant healthcare costs.

A Targeted Feedback Framework to Move the Needle on Operative Feedback.

Objective: Actionable and impactful feedback remains a perpetual challenge in medical education despite extensive efforts to improve the feedback process. A feedback framework was adapted from a validated model and tailored to a single residency program. The purpose of this study was to evaluate the impact of the new feedback framework on the quantity and quality of perioperative feedback amongst surgical residents.

Structuring Palliative Care Education for Medical Students: Impact of a Novel Framework and Pocket Card.

Introduction: Palliative care (PC) education is not uniformly provided across U.S. medical schools.

Assessment and Reporting of Extraintestinal Manifestations and Fatigue in Phase 3 Inflammatory Bowel Disease Clinical Trials.

Background: Extraintestinal Manifestations (EIMs) of Inflammatory Bowel Disease (IBD) are frequently experienced by patients and may lead to severe symptoms and fatigue. However, the reporting patterns of these outcomes in IBD randomized controlled trials (RCTs) is not clear.

Methods: We searched placebo controlled phase 3 RCTs of advanced therapies in IBD and assessed the frequency and means of reporting EIM and fatigue data in these studies.

Bridging Therapies-Ex Vivo Liver Xenoperfusion and the Role of Machine Perfusion: An Update.

Advancements in xenotransplantation intersecting with modern machine perfusion technology offer promising solutions to patients with liver failure providing a valuable bridge to transplantation and extending graft viability beyond current limitations. Patients facing acute or acute chronic liver failure, post-hepatectomy liver failure, or fulminant hepatic failure often require urgent liver transplants which are severely limited by organ shortage, emphasizing the importance of effective bridging approaches. Machine perfusion is now increasingly used to test and use genetically engineered porcine livers in translational studies, addressing the limitations and costs of non-human primate models.

Oxytocin levels in response to CRH administration in hypopituitarism and hypothalamic damage: a randomized, crossover, placebo-controlled trial.

Increasing evidence supports the presence of oxytocin deficiency (OXT-D) in patients with hypopituitarism and hypothalamic damage (HHD), that might be associated with neuropsychological deficits and sexual dysfunction, leading to worse quality of life (QoL). Therefore, identifying a provocative test to diagnose an OXT-D will be important. Corticotropin-releasing hormone (CRH) is a candidate for such a test as it increases oxytocin secretion in animal models.