Use of the Posterior Auricular Artery for Indirect Bypass in Moyamoya: A Pediatric Case Series.

Introduction: Encephaloduroarteriosynangiosis (EDAS) for moyamoya is predominantly performed using a branch of the superficial temporal artery (STA) as the donor artery. At times, other branches of the external carotid artery are better suited for EDAS than is the STA. There is little information in the literature concerning using the posterior auricular artery (PAA) for EDAS in the pediatric age-group.

Adverse Events Related to Tirzepatide.

Context: Tirzepatide is a dual glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 receptor agonist (GLP-1 RA) approved by the US Food and Drug Administration in May 2022 for patients with type 2 diabetes mellitus (T2DM).

Objective: We aimed to determine the rates of individual adverse events (AEs) related to 3 studied doses of tirzepatide.

Methods: We performed a systematic review with meta-analysis including 5 databases (PubMed, Embase, CINAHL, Scopus, and Web of Science) for all clinical trials reporting AEs related to tirzepatide.

Common Issues in Prenatal Care: Antepartum Fetal Surveillance.

Patients at increased risk of stillbirth should be assessed with antepartum fetal surveillance (AFS) tests at regular intervals. In general, AFS should begin at the gestational age at which delivery would be considered. Most surveillance tests are performed weekly, but more frequent testing should be considered for patients with high-risk conditions.

Common Issues in Prenatal Care: Fetal Growth Restriction.

Fetal growth restriction (FGR) is defined as an ultrasound (US)-determined estimated fetal weight or abdominal circumference less than the 10th percentile according to a population level reference curve. FGR affects up to 10% of pregnancies. Fetuses with FGR are at increased risk of intrauterine mortality and, postnatally, neonatal intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress, hypoglycemia, and suboptimal neurologic, behavioral, and cognitive development.

Common Issues in Prenatal Care: Gestational Diabetes.

Two screening approaches are used to detect gestational diabetes, the 1-step and 2-step methods. The 1-step method is diagnostic and consists of a 75-g, 2-hour oral glucose tolerance test (OGTT). The 2-step method consists of a 50-g, 1-hour glucose challenge test, followed by a 100-g, 3-hr OGTT if initial test results are positive.

Common Issues in Prenatal Care: First Trimester Bleeding.

Vaginal bleeding in the first trimester is a common concern during pregnancy. The amount of bleeding and associated symptoms, such as nausea and vomiting, can be of prognostic value. Timely evaluation with vital signs, physical examination, laboratory tests (eg, Rh factor, hemoglobin and possibly progesterone levels), and pelvic ultrasound (US) can distinguish among viable pregnancy, nonviable pregnancy, intrauterine pregnancy (IUP) of uncertain viability, and pregnancy of unknown location.

Quantitative Ultrasound Biomarkers to Assess Nonalcoholic Fatty Liver Disease.

Purpose: To assess diagnostic performance of quantitative ultrasound (QUS) biomarkers in assessing hepatic steatosis.

Methods: We prospectively recruited 125 participants (mean age 54 years) who underwent liver QUS, magnetic resonance imaging (MRI), and laboratory tests within 30 days in this IRB approved study. Based on MRI-proton density fat fraction (MRI-PDFF) and MRE, we divided 125 participants into normal liver, nonalcoholic fatty liver (NAFL) and liver fibrosis (≥F1) groups.

A cross-sectional analysis of harms reporting in systematic reviews evaluating laminectomy.

Background Context: Laminectomy is a common vertebral decompression procedure that has multiple potential adverse events which are not always reported in SRs.

Purpose: To evaluate the completeness of harms reporting in systematic reviews (SRs) on laminectomy.

Study Design: Cross-sectional analysis.

A Mixed Methods Investigation on the Relationship Between Perceived Self-Regard, Self-Efficacy, and Commitment to Serve Among Military Medical Students.

Introduction: Routinely faced with potentially traumatizing situations, resilience is critical for military physicians. However, related studies are limited in scope. The current study distinctively combines hyper-realistic immersion training for military medical students with emotional intelligence and hardiness measures.

Common Paths in Medical Education: An Updated Look at the Training of Allopathic, Osteopathic, and Naturopathic Physicians.

Context: Allopathic, osteopathic, and naturopathic medical education all prepare students to practice medicine yet diverge in certain respects. Despite the significant changes that have occurred in the education of each discipline, a more recent comparison and analysis of these three pathways hasn't been published.

Objective: The review intended to examine the five segments of the educational process common to all three pathways: admissions, preclinical education, clinical education, graduate medical education, and continuing medical education.

Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES).

Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care.

Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established.

Dilated coronary arteries in a 2-month-old with RIT1-associated Noonan syndrome: a case report.

Noonan Syndrome is caused by variants in a variety of genes found in the RAS/MAPK pathway. As more causative genes for Noonan Syndrome have been identified, more phenotype variability has been found, particularly congenital heart defects. Here, we report a case of dilated coronary arteries in a pediatric patient with a RIT1 variant to add to the body of literature around this rare presentation of Noonan Syndrome.

Models of Classroom Assessment for Course-Based Research Experiences.

Course-based research pedagogy involves positioning students as contributors to authentic research projects as part of an engaging educational experience that promotes their learning and persistence in science. To develop a model for assessing and grading students engaged in this type of learning experience, the assessment aims and practices of a community of experienced course-based research instructors were collected and analyzed. This approach defines four aims of course-based research assessment - 1) Assessing Laboratory Work and Scientific Thinking; 2) Evaluating Mastery of Concepts, Quantitative Thinking and Skills; 3) Appraising Forms of Scientific Communication; and 4) Metacognition of Learning - along with a set of practices for each aim.

The Most Common Rehabilitation Protocol After Matrix-Assisted Autologous Chondrocyte Implantation Is Immediate Partial Weight-Bearing and Continuous Passive Motion.

Purpose: To perform a systematic review of postoperative rehabilitation protocols for third-generation autologous chondrocyte implantation (ACI) of the knee joint.

Methods: A systematic review was performed by searching PubMed, Cochrane Library, and EMBASE to locate randomized controlled trials that described a rehabilitation protocol following third-generation ACI of the knee joint. The search terms used were: "autologous" AND "chondrocyte" AND "randomized".

In-person radiologist to review the trauma panscan: a high-fidelity simulation training program for radiology trainees at an academic level 1 trauma center.

Background: Radiology trainees were uncomfortable going to the CT scanner to review trauma panscans and interacting with trauma surgeons.

Objective: This study aims to determine if radiology residents can be trained to accurately identify injuries requiring immediate surgical attention at the CT scanner.

Methods: A high-fidelity simulation model was created to provide an immersive training experience.

COVID-19 and mental health: A systematic review of international medical student surveys.

Background: The medical school curriculum has imposed psychological stressors on students worldwide, some of which may induce feelings of increased depression and anxiety. Meanwhile, the COVID-19 pandemic has exacerbated the feelings of stress, depression, and anxiety that a portion of medical students experience in their daily life. The aim of this systematic review is to gather concrete data from medical schools around the globe, and further evaluate how the COVID-19 pandemic has impacted medical students' mental health.

Percutaneous bone adhesive application for Jones fracture "at-risk" of nonunion or delayed union: a hypothesis.

Background: Bone adhesives have been on the forefront of orthopedic surgery research for decades due to the potential benefit they may have in fracture management. Current publications and research being conducted on bone adhesive could be applied to our current hypothesis for the benefit of a novel minimally invasive treatment option for a select cohort of fractures, Jones fractures. The select fracture's gold standard of treatment would be nonoperative, but with risk of complications including nonunion and delayed union.

Genome Editing and Fatty Liver.

Fatty liver disease is characterized as nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD). Fatty liver disease is one of the most common causes of chronic liver disease worldwide among adults and children. It is characterized by excessive fat accumulation in the liver cells.