Identifying the greatest surgeon-perceived barriers and challenges in performing corneal transplantation in India.

Objective: There is currently no systematic method of assessing limitations in performing corneal transplantation. The purpose of the study was to identify the limitations of performing corneal transplantation in India.

Design: Cross-sectional survey study.

Paraneoplastic Autoimmune Hemolytic Anemia Secondary to a Gastric Duplication Cyst in a 15-Month-Old Girl: A Case Report and Review of the Literature.

Gastric duplication is a rare congenital disorder of the alimentary tract, and anemia is a rare presenting clinical sign of gastric duplication cysts (GDC). There are two reported cases of autoimmune hemolytic anemia as a paraneoplastic presentation of gastric duplication in the adult population, but there have not yet been any reported cases of this in childhood. We report the first case in the pediatric patient population: the case of GDC presenting as autoimmune hemolytic anemia in a 15-month-old girl.

Diabetes Centers' Participation in the T1D Exchange Quality Improvement Collaborative Advances Health Equity and Clinical Outcomes.

As the learning health network known as the T1D Exchange Quality Improvement Collaborative (T1DX-QI) has expanded on a significant scale to provide care for more than 120,000 people since its inception in 2016, assessing the quality improvement (QI) culture and monitoring clinical outcome improvements of participating centers has become vital to understanding the network's progress and success. Centers participating in the T1DX-QI complete regular QI culture self-assessments to quantify four evidence-based areas of culture: QI team structure, QI foundation, QI capacity, and QI success. This study builds on a previous baseline analysis to demonstrate self-reported improvements in T1DX-QI centers' QI culture from 2021 to 2022 and summarizes QI successes experienced by participating centers.

Invasive Fungal Diseases in Patients with Multiple Myeloma: Experience at a Large, Urban Referral Center.

Background: Although infections are a leading cause of morbidity and mortality among patients with multiple myeloma (MM), the epidemiology of invasive fungal disease (IFD) is less well characterized in this population than in other hematologic malignancies.

Methods: We conducted a nested 3:1 case-control study of IFD at a large MM referral center to identify risk factors for IFD in this population.

Results: In a cohort of 2960 patients, we identified 32 episodes of IFD among 31 patients between 01/2011 and 06/2019.

Substrate stiffness dictates unique doxorubicin-induced senescence-associated secretory phenotypes and transcriptomic signatures in human pulmonary fibroblasts.

Cells are subjected to dynamic mechanical environments which impart forces and induce cellular responses. In age-related conditions like pulmonary fibrosis, there is both an increase in tissue stiffness and an accumulation of senescent cells. While senescent cells produce a senescence-associated secretory phenotype (SASP), the impact of physical stimuli on both cellular senescence and the SASP is not well understood.

Metabolic syndrome and its effect on immune cells in apical periodontitis- a narrative review.

Objectives: Apical periodontitis (AP) is an inflammatory immune response in periapical tissues caused by microbial infections. Failure of root canal treatment or delayed healing is often due to intracanal or extra-radicular bacteria. However, beyond microbial factors, the patient's systemic health can significantly influence the progression and healing of AP.

Endocrinologists' Acceptability and Implementation of Hemoglobin A1c Targets among Adults with Type 1 Diabetes.

Aims: Attainment of the A1C target of ≤7.0% is consistently low among those living with type 1 diabetes (T1D). We evaluated endocrinologists' acceptability and implementation of A1C targets.

Impact of pedicle screw accuracy on clinical outcomes after 1- or 2-level minimally invasive transforaminal lumbar interbody fusion.

Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy.

Robotic-Assistance in Total Hip Arthroplasty Is Associated With Decreased Dislocation Rates.

Background: As the use of robotics in total hip arthroplasty (THA) continues to gain popularity, differences in clinical outcomes when compared to manual techniques have remained unclear. This study aimed to compare postoperative complications between patients undergoing robotic-assisted techniques and manual THA for primary osteoarthritis at 90 days, 1 year, and 2 years.

Methods: Using an all-payer national database, we identified 405,048 patients who underwent either robotic-assisted or manual THA for primary osteoarthritis.

Hemangioma of the Mitral Valve and Aortomitral Curtain in an Adolescent.

A hemangioma of the mitral valve and aortomitral curtain was incidentally discovered in an adolescent. The lesion was surgically excised, and the mitral valve was reconstructed with complete preservation of valvular function. Pertinent principles of multimodality imaging-based diagnosis and nuances of operative management of this rare, vascular tumor are discussed.

Multimodality Approach to a Neonate With a Pericardial Mass and a Hemorrhagic Pericardial Effusion.

A 7-week-old infant with a 1-week history of a SARS-CoV2 respiratory infection presented with tachypnea. Cardiomegaly was noted on chest roentgenogram. Echocardiogram showed a large pericardial effusion, with tamponade physiology and a large pericardial mass.

Canadian Stroke Best Practice Recommendations: Vascular cognitive impairment, 7th edition practice guidelines update, 2024.

The Canadian Stroke Best Practice Recommendations (CSPR) 7th edition includes this new module on the diagnosis and management of vascular cognitive impairment (VCI) with or without neurodegenerative disease. An expert writing group and people with VCI lived experience (PWLE) reviewed current evidence. Existing recommendations were reviewed and revised, and new recommendations added.

Postnatal management of preterm infants with congenital diaphragmatic hernia.

Introduction: Congenital diaphragmatic hernia (CDH) in the preterm population is increasingly common in the current era of fetal endoluminal tracheal occlusion (FETO) therapy. There remains a lack of clinical guidance for clinicians and surgeons regarding optimal management strategies for such infants. We aimed to describe our experience in managing preterm CDH in a single quaternary neonatal intensive care unit (NICU).

Longitudinal association of statin treatment with insulin sensitivity and beta-cell function in the PROMISE cohort.

Context: Statin treatment lowers low-density lipoprotein (LDL) cholesterol thereby reducing cardiovascular risk. Meta-analyses of clinical trials report a higher risk of new-onset type 2 diabetes with statins. Current clinical evidence regarding effects of statins on insulin sensitivity and beta-cell function is limited.

Using a Theoretical Model to Assess the Impact of Vascular Risk Factors on Autoregulation in the Retina.

Purpose: Vascular impairments, including reduced capillary density (CD), impaired autoregulation capacity (Reg), and elevated intraocular pressure (IOP), have been identified as significant contributors to glaucomatous disease. This study implemented a theoretical model to quantify the impact of these impairments on retinal blood flow and oxygenation as intraluminal pressure (Pa) is varied.

Methods: A theoretical model of the retinal vasculature was used to simulate reductions in CD by 10% (early glaucoma) and 30% to 50% (advanced glaucoma), a range in autoregulation capacity from 0% (totally impaired) to 100% (totally functional), and normal (15 mm Hg) and elevated (25 mm Hg) levels of IOP.

The association between physician sex and patient outcomes: a systematic review and meta-analysis.

Background: Some prior studies have found that patients treated by female physicians may experience better outcomes, as well as lower healthcare costs than those treated by male physicians. Physician-patient sex concordance may also contribute to better patient outcomes. However, other studies have not identified a significant difference.

What does cancer screening have to do with tomato growing?

Cancer screening is considered to be a major strategy for combatting cancer. The United States Preventive Services Task Force (USPSTF) recommends screening for five cancers, but the strength of evidence about the effectiveness of screening is limited. To gain insights into the efficacy of early detection requires prospective, blinded, placebo-controlled clinical trials with decades of follow-up and inclusion of millions of participants.

Cardiac Critical Care of the Cardio-Obstetric Patient.

Cardiovascular disease (CVD) is the leading cause of pregnancy-related mortality in the United States, with an incidence that has increased from 7.2 to 32.9 fatalities per 100,000 live births in the last 3 decades.

Development and Validation of a Novel Model to Discriminate Idiosyncratic Drug-Induced Liver Injury and Autoimmune Hepatitis.

Background And Aim: Discriminating between idiosyncratic drug-induced liver injury (DILI) and autoimmune hepatitis (AIH) is critical yet challenging. We aim to develop and validate a machine learning (ML)-based model to aid in this differentiation.

Methods: This multicenter cohort study utilised a development set from Beijing Friendship Hospital, with retrospective and prospective validation sets from 10 tertiary hospitals across various regions of China spanning January 2009 to May 2023.

Global Disparities in Outcomes of Pregnant Individuals With Rheumatic Heart Disease: A Scoping Review.

Background: Rheumatic heart disease (RHD) remains as 1 of the major contributors to indirect pregnancy-related mortality and morbidity worldwide and disproportionately affects marginalized populations.

Objectives: In this scoping review, the authors sought to explore the socioeconomic, cultural, and health care access-related causes of global disparities in outcomes of pregnancy among individuals with RHD.

Methods: We performed a literature search of all studies published between January 1, 1990, and January 1, 2022, that investigated causes for disparate outcomes in pregnant individuals with RHD.

Does Intravenous Tranexamic Acid Reduce Blood Loss at the Time of Total Colpocleisis? A Randomized Double-Blind Placebo-Controlled Trial.

Objective: To determine the efficacy of intravenous (IV) tranexamic acid (TXA) in reducing blood loss and blood transfusion among women undergoing total colpocleisis.

Design: Double-blind, randomized, placebo-controlled trial.

Setting: Tertiary academic urogynecology practice.

Optimizing Stem Cell Expansion: The Role of Substrate Stiffness in Enhancing Dental Pulp Stem Cell Quiescence and Regeneration.

Introduction: Quiescent stem cells exhibit unique self-renewal and engraftment abilities vital for regenerative therapies, but these diminish during ex vivo culture. This study investigates how substrate stiffness regulates the balance between dental pulp stem cell (DPSC) quiescence, activation, and senescence and explores the role of extracellular matrix stiffness in modulating DPSC fate via the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway.

Methods: Polydimethylsiloxane substrates with varying stiffness in 2D (2 kPa, 50 kPa) and 3D (50 kPa) were fabricated.

Outcomes and complications of vertebral body tethering by patient gender.

Purpose: Non-fusion surgical options for pediatric scoliosis management such as vertebral body tethering (VBT) offer an alternative to spinal fusion. With this study, we aim to evaluate the postoperative outcomes in boys versus girls who have undergone VBT. Our hypothesis is that girls and boys will have similar outcomes by 2-year follow-up.