A review of major reconstructive and gender-affirming surgical techniques in genital surgery and care for the transgender patient population.

The transgender community makes up a significant portion of the American population, yet there is a paucity of data available to surgeons and anesthesiologists. The purpose of this article is to provide information to surgeons, anesthesiologists, and other medical professionals. This narrative review explores the importance of medical information that healthcare professionals should be aware of ahead of gender-affirming surgeries.

Incremental hemodialysis transition in veterans and nonveterans with kidney failure.

Purpose Of Review: Initiation of hemodialysis treatment with a thrice-weekly prescription is currently the standard of care irrespective of patients' residual kidney function (RKF), comorbidities, and preferences.

Recent Findings: Each year ∼12 000 Veterans with advanced kidney disease progress to end-stage kidney disease (ESKD) requiring dialysis and comprise greater than 10% of the US incident ESKD population. Dialysis is costly and is associated with impaired health-related quality of life (HRQOL) and high mortality risk, especially in the first year of treatment.

Frailty integration in medical specialties: Current evidence and suggested strategies from the Clin-STAR frailty interest group.

Frailty is a syndrome that can inform clinical treatments and interventions for older adults. Although implementation of frailty across medical subspecialties has the potential to improve care for the aging population, its uptake has been heterogenous. While frailty assessment is highly integrated into certain medical subspecialties, other subspecialties have only recently begun to consider frailty in the context of patient care.

Frail patients require Longer Fusions for Success following Adult Cervical Deformity Surgery.

Background: Adult cervical deformity (ACD) surgery is more frequently being performed in frail patients. Although surgical outcomes are largely successful, there remains significant risk of poor outcomes. The ideal length of fusion constructs in these patients remains debatable.

Soul Men and Women-what must science do to regain public trust?

To meet the growing deluge of misinformation and distortion of scientific facts, science desperately needs a PR makeover. [Image: see text]

Despite a Multifactorial Etiology, Rates of Distal Junctional Kyphosis After Adult Cervical Deformity Corrective Surgery Can be Dramatically Diminished by Optimizing Age Specific Radiographic Improvement.

Study Design: Retrospective cohort study of a prospectively collected single-center database.

Objective: Distal Junctional Kyphosis (DJK) is one of the most common complications in adult cervical deformity (ACD) correction. The utility of radiographic alignment alone in predicting and minimizing DJK occurrence warrants further study.

Ketogenic Food Ameliorates Activity-Based Anorexia of Adult Female Mice.

Objective: Genome-wide association studies implicate metabo-psychiatric origins for anorexia nervosa (AN). There are two case reports totaling six adult females who experienced complete remission of AN following a treatment comprised of ketogenic diet (targeting metabolism) with ketamine infusions (targeting psychiatric origins), but no study has determined the efficacy of ketogenic diet, alone. We addressed this gap in knowledge, with exploration of potential molecular mechanisms, using an animal model.

Economics and Equity of Large Language Models: Health Care Perspective.

Large language models (LLMs) continue to exhibit noteworthy capabilities across a spectrum of areas, including emerging proficiencies across the health care continuum. Successful LLM implementation and adoption depend on digital readiness, modern infrastructure, a trained workforce, privacy, and an ethical regulatory landscape. These factors can vary significantly across health care ecosystems, dictating the choice of a particular LLM implementation pathway.

Tenofovir and Hepatitis B Virus Transmission During Pregnancy: A Randomized Clinical Trial.

Importance: Standard care for preventing mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in highly viremic mothers consists of maternal antiviral prophylaxis beginning at gestational week 28 combined with an HBV vaccine series and HBV immune globulin (HBIG) at birth. However, HBIG is unavailable in some resource-limited areas.

Objective: To determine whether initiating tenofovir disoproxil fumarate (TDF) at gestational week 16 combined with HBV vaccinations for infants is noninferior to the standard care of TDF at gestational week 28 combined with HBV vaccinations and HBIG for infants in preventing MTCT in mothers with HBV and high levels of viremia.

Guarding against digestive-system cancers: Unveiling the role of Chk2 as a potential therapeutic target.

Digestive-system cancers represent major threats to human health; however, the mechanisms underlying tumorigenesis and radiochemotherapy resistance have remained elusive. Therefore, an urgent need exists for identifying key drivers of digestive system tumorigenesis and novel targeted therapeutics. The checkpoint kinase 2 (Chk2) regulates cell-cycle progression, and Chk2 dysregulation or Chk2 mutations can lead to the development of various cancers, which makes Chk2 an important research topic.

Individual control of input rate improves recall of spoken discourse by adult users of cochlear implants: An exploratory study.

Although cochlear implants (CI) successfully replace the sense of hearing, they do not restore natural hearing. Still, CI users adapt to this novel signal, reaching meaningful levels of speech recognition in clinical tests that focus on repetition of words and short sentences. However, many patients who score above average in clinical speech perception tests complain that everyday speech interactions are both difficult and cognitively draining.

Zoom71 navigation: Does tip orientation matter?

Background: Aspiration thrombectomy is one of the mainstays for stroke interventions. The Zoom 71 (Z71) aspiration catheter is unique with its angled tip. This study describes the orientation of the angled tip as it is navigated around the carotid siphon in relation to trackability.

Treatment of adult spine deformity: A retrospective comparison of bone morphogenic protein and bone marrow aspirate with bone allograft.

Unlabelled: BACKGROUND  : The use of bone morphogenic protein (BMP-2) in adult spine deformity (ASD) surgery remains controversial more than two decades following its approval for clinical application in spine surgery. This study was performed to assess outcomes in patients undergoing ASD surgery with BMP application compared with a combination of bone marrow aspirate, cancellous bone chips and i-Factor.

Methods: This was a retrospective cohort study.

Head and neck cancer mortality in the United States: Regional differences in hospice use and place of death.

Background: With more than 15,000 annual deaths from head and neck cancer (HNC), an important aspect of end-of-life care for these patients is place of death. Recent evidence suggests an increasing preference for home/hospice at end of life; however, it is unclear whether there is variation in home/hospice use based on region or urban status. We described differences in the place of death of HNC patients based on their region and urban status.

Frail patients require instrumentation of a more proximal vertebra for a successful outcome after surgery for adult spine deformity.

Aims: The aim of this study was to investigate the impact of the level of upper instrumented vertebra (UIV) in frail patients undergoing surgery for adult spine deformity (ASD).

Methods: Patients with adult spinal deformity who had undergone T9-to-pelvis fusion were stratified using the ASD-Modified Frailty Index into not frail, frail, and severely frail categories. ASD was defined as at least one of: scoliosis ≥ 20°, sagittal vertical axis (SVA) ≥ 5 cm, or pelvic tilt ≥ 25°.

Implementation of an Optimized Preoperative Checklist for Endoscopic Sinus Surgery Within a Multiinstitutional Resident Education Curriculum.

Background: Preoperative review of computed tomography (CT) imaging assists with endoscopic sinus surgery (ESS) planning, where trainees may benefit from a systematic approach. We have previously developed an optimized preoperative checklist for sinus CT imaging using an iterative modified Delphi method.

Objective: In this study, we assess the utility of an optimized preoperative checklist for residents performing ESS.

Assessment of musical interventions and its effect on blood pressure among United States populations: a systematic review and meta-analysis.

Background: Hypertension (HTN) currently affects over 120 million Americans, in the United States (US). Thus, the implementation of evidence-based interventions (EBI) for blood pressure (BP) reduction is pivotal in minimizing this burden. We sought to evaluate evidence from published literature on the effectiveness of musical interventions for BP reduction within the US.

Embolic Materials' Comparison in Meningeal Artery Embolization for Chronic Subdural Hematomas: Multicenter Propensity Score-Matched Analysis of 1070 Cases.

Background And Objectives: Multiple preferences exist for embolic materials selection in middle meningeal artery embolization (MMAE) for chronic subdural hematoma with limited comparative literature data. Herein, we compare different embolic materials.

Methods: Consecutive patients undergoing MMAE for chronic subdural hematoma at 14 North-American centers (2018-2023) were classified into 3 groups: (a) particles, (b) Onyx, (c) n-butyl cyanoacrylate (n-BCA).

Diversity of ancestral brainstem noradrenergic neurons across species and multiple biological factors.

The brainstem region, locus coeruleus (LC), has been remarkably conserved across vertebrates. Evolution has woven the LC into wide-ranging neural circuits that influence functions as broad as autonomic systems, the stress response, nociception, sleep, and high-level cognition among others. Given this conservation, there is a strong possibility that LC activity is inherently similar across species, and furthermore that age, sex, and brain state influence LC activity similarly across species.