Once daily Bromelain-based enzymatic debridement of venous leg ulcers versus gel vehicle (placebo) and non-surgical standard of care: a three-arm multicenter, double blinded, randomized controlled study.

Background: Debridement is considered the first step in treatment of chronic wounds, however, current enzymatic and autolytic debridement agents are slow or ineffective. Previous studies have shown positive initial results with EscharEx® (EX-02 formulation), a Bromelain-based enzymatic debridement agent in development for chronic wounds. The main objective of this study was to assess its efficacy in debriding venous leg ulcers (VLU), compared to gel vehicle (GV) as a placebo control and to non-surgical standard of care (NSSOC).

The Impact of Evolving Endometriosis Guidelines on Diagnosis and Observational Health Studies.

Study Question: Do recent changes in European Society of Human Reproduction and Embryology (ESHRE) clinical guidelines result in more comprehensive diagnosis of women with endometriosis?

Summary Answer: The latest shift in clinical guidelines results in diagnosis of more women with endometriosis but current ESHRE diagnostic criteria do not capture a sizable percentage of women with the disease.

What Is Known Already: Historically, laparoscopy was the gold standard for diagnosing endometriosis, a complex gynecological condition marked by a heterogeneous set of symptoms that vary widely among women. More recently, changes in clinical guidelines have shifted to incorporate imaging-based approaches such as transvaginal sonography and magnetic resonance imaging.

Outcomes for smokers who develop melanoma: a systematic review and meta-analysis.

Background: There is compelling evidence that the incidence of melanoma in cigarette smokers is substantially lower than in non-smokers. However, the risks of both recurrence and death appear to be higher in smokers if melanoma does develop. The magnitude of these increased risks is poorly documented.

Critical Care Management of Acute Venous Thromboembolism: Integrating Pharmacotherapy, Thrombectomy, and Temporary Mechanical Support.

Venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis, carries significant morbidity and mortality risks, and is conventionally managed with anticoagulation. In recent years, notable progress has been made in the therapeutic options available for the acute treatment of VTE. The heterogeneity within pulmonary embolism, spanning a wide spectrum of risks, underscores the critical need for precise risk stratification, particularly in identifying individuals prone to right heart failure and increased mortality.

Corrigendum to "Image-guided superficial radiation therapy has superior 2-year recurrence probability to Mohs micrographic surgery" [Clin. Transl. Radiat. Oncol. 43 (2023) 100678].

[This corrects the article DOI: 10.1016/j.ctro.

Only skull-deep? Headbutting adaptations may not extend to the brain cavity.

High-impact headbutting behavior makes the muskox (Ovibos moschatus) a charismatic species. While many theorize how these headbutting bovids might protect their brain during such encounters, few have investigated their claims anatomically. We investigated the anatomical function of digitiform impressions in the bovid brain cavity and their relationship to headbutting.

Aβ40 Fibril Assembly on Human Cerebral Smooth Muscle Cells Impairs Cell Viability.

Cerebral vascular deposition of the amyloid-β (Aβ) peptide, a condition known as cerebral amyloid angiopathy (CAA), is associated with intracerebral hemorrhaging and contributes to disease progression in Alzheimer's disease (AD) and vascular cognitive impairment and dementia (VCID). Familial mutations at positions 22 and 23 within the Aβ peptide lead to early onset and severe CAA pathology. Here, we evaluate the effects of fibrillar Aβ peptides on the viability of primary-cultured human cerebral smooth muscle (HCSM) cells, which are the major site of amyloid deposition in cerebral blood vessel walls.

Interdisciplinary, Computer-Guided Periodontal and Dental Management of a Novel Hypo- and Microdontia Case Restored With Ultrathin Veneers Fabricated via INKGLUE Technique.

Objectives: This report illustrates the digital interdisciplinary management of a case presenting with diastemata, a retained primary tooth, microdontia, and hypodontia. Esthetic crown lengthening and ultrathin veneers optimized the natural dentition and achieved a stable, minimally-invasive, and esthetically-pleasing outcome.

Clinical Considerations: Reduction guides were digitally-designed and 3D-printed for guided crown lengthening and dental veneer preparation.

Impacts of a puberty and period education intervention among 9- to 12-year-old girls in the New York metropolitan area: a randomized trial.

Objectives: To evaluate the immediate impacts of an illustrated book on puberty and periods for girls in the United States (US).

Methods: We conducted a randomized educational intervention between February-May 2023 among girls ages 9-12 years in after-school programs in the New York metropolitan area (n = 123). Girls were assigned to read a book on puberty and periods or an alternative book on healthy eating.

Parental wellbeing, parenting, and child mental health in families with young children in Arghakhanchi, Nepal.

Background: Children's social-emotional development and mental well-being are critical to adult mental health. However, little is known about the mechanisms or factors that contribute to poor child mental health in low- and middle-income countries. Given the lack of child mental health research to guide interventions or social-emotional learning programs and policy planning, the present study aimed to address these knowledge gaps by examining the psychopathology mechanism involved in the development of childhood mental health problems.

Aberrant splicing in Huntington's disease accompanies disrupted TDP-43 activity and altered m6A RNA modification.

Huntington's disease (HD) is caused by a CAG repeat expansion in the HTT gene, leading to altered gene expression. However, the mechanisms leading to disrupted RNA processing in HD remain unclear. Here we identify TDP-43 and the N6-methyladenosine (m6A) writer protein METTL3 to be upstream regulators of exon skipping in multiple HD systems.

A multiplex method for rapidly identifying viral protease inhibitors.

With current treatments addressing only a fraction of pathogens and new viral threats constantly evolving, there is a critical need to expand our existing therapeutic arsenal. To speed the rate of discovery and better prepare against future threats, we establish a high-throughput platform capable of screening compounds against 40 diverse viral proteases simultaneously. This multiplex approach is enabled by using cellular biosensors of viral protease activity combined with DNA-barcoding technology, as well as several design innovations that increase assay sensitivity and correct for plate-to-plate variation.

Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts.

Purpose: Our goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems.

Methods:  Participants (n = 7,998) were from 37 cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program. Cross-sectional information on demographic factors, parent-report of an ASD diagnosis by clinician, Social Responsiveness Scale (SRS) scores, and Child Behavior Checklist (CBCL) scores were obtained for children aged 2.

Impact of extended-course oral nirmatrelvir/ritonavir in established Long COVID: a case series.

Background: Prior case series suggest that a 5-day course of oral Paxlovid (nirmatrelvir/ritonavir) benefits some people with Long COVID, within and/or outside of the context of an acute reinfection. To the best of our knowledge, there have been no prior case series of people with Long COVID who have attempted longer courses of nirmatrelvir/ritonavir.

Methods: We documented a case series of 13 individuals with Long COVID who initiated extended courses (>5 days; range: 7.

Complete transition from laparoscopic to robotic liver surgery achieves superior outcomes in difficult hepatectomies: a seven-year retrospective study.

Background: Minimally invasive liver surgery (MILS) is superior to open surgery when considering decreased blood loss, fewer complications, shorter hospital stay, and similar or improved oncologic outcomes. However, operative limitations in laparoscopic hepatectomy have curved its applicability and momentum of complex minimally invasive liver surgery. Transitioning to robotic hepatectomy may bridge this complexity gap.

Metabolic rewiring in skin epidermis drives tolerance to oncogenic mutations.

Skin epithelial stem cells correct aberrancies induced by oncogenic mutations. Oncogenes invoke different strategies of epithelial tolerance; while wild-type cells outcompete β-catenin-gain-of-function (βcatGOF) cells, Hras cells outcompete wild-type cells. Here we ask how metabolic states change as wild-type stem cells interface with mutant cells and drive different cell-competition outcomes.

Immunotherapy for advanced-stage squamous cell lung cancer: the state of the art and outstanding questions.

Immune-checkpoint inhibitors (ICIs) have transformed the treatment paradigm for advanced-stage squamous non-small-cell lung cancer (LUSC), a histological subtype associated with inferior outcomes compared with lung adenocarcinoma. However, only a subset of patients derive durable clinical benefit. In the first-line setting, multiple ICI regimens are available, including anti-PD-(L)1 antibodies as monotherapy, in combination with chemotherapy, or with an anti-CTLA4 antibody with or without chemotherapy.

Microbial and chemically induced reductive dechlorination of polychlorinated biphenyls in the environment.

Polychlorinated biphenyls (PCBs) are persistent organic pollutants and are emitted during e-waste activities. Once they enter into the environment, PCBs could pose toxic effects to environmental compartments and public health. Reductive dechlorination offers a sustainable solution to manage the PCBs-contaminated environment.

Label free, capillary-scale blood flow mapping in vivo reveals that low-intensity focused ultrasound evokes persistent dilation in cortical microvasculature.

Non-invasive, low intensity focused ultrasound is an emerging neuromodulation technique that offers the potential for precision, personalized therapy. An increasing body of research has identified mechanosensitive ion channels that can be modulated by FUS and support acute electrical activity in neurons. However, neuromodulatory effects that persist from hours to days have also been reported.

The effects of war-related experiences on mental health symptoms of individuals living in conflict zones: a longitudinal study.

On October 7, 2023, a large-scale attack in southern Israel and the subsequent war resulted in extensive loss of life and injuries, with many individuals experiencing traumatic losses, such as family members or close friends being killed or kidnapped. This study aims to longitudinally examine its effects on mental health, specifically, clinical symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD). We anticipated greater symptom severity among individuals who experienced traumatic loss, were forcibly displaced, or suffered income loss, as well as among women and members of ethnic minorities.