Risk prediction tools for pressure injury occurrence: an umbrella review of systematic reviews reporting model development and validation methods.

Background: Pressure injuries (PIs) place a substantial burden on healthcare systems worldwide. Risk stratification of those who are at risk of developing PIs allows preventive interventions to be focused on patients who are at the highest risk. The considerable number of risk assessment scales and prediction models available underscores the need for a thorough evaluation of their development, validation, and clinical utility.

Predictive equation derived from 6,497 doubly labelled water measurements enables the detection of erroneous self-reported energy intake.

Nutritional epidemiology aims to link dietary exposures to chronic disease, but the instruments for evaluating dietary intake are inaccurate. One way to identify unreliable data and the sources of errors is to compare estimated intakes with the total energy expenditure (TEE). In this study, we used the International Atomic Energy Agency Doubly Labeled Water Database to derive a predictive equation for TEE using 6,497 measures of TEE in individuals aged 4 to 96 years.

Specialized pericyte subtypes in the pulmonary capillaries.

Pericytes are essential for capillary stability and homeostasis, with impaired pericyte function linked to diseases like pulmonary arterial hypertension. Investigating pericyte biology has been challenging due to the lack of specific markers, making it difficult to distinguish pericytes from other stromal cells. Using bioinformatic analysis and RNAscope, we identified Higd1b as a unique gene marker for pericytes and subsequently generated a knock-in mouse line, Higd1b-CreERT2, that accurately labels pericytes in the lung and heart.

Accuracy of pathogen diagnostic codes for acute hematogenous musculoskeletal infections in children.

Administrative databases are powerful tools for pediatric research but lack patient-level microbiology results. This study aimed to determine the accuracy of pathogen discharge diagnosis codes for children hospitalized with acute hematogenous musculoskeletal infections (MSKIs). Medical records for 244 children hospitalized with acute hematogenous MSKIs were manually reviewed to determine which bacterial pathogen, if any, was identified for each MSKI based on microbiology results obtained during the hospitalization.

Venous Thromboembolism Occurrence and Association with Gastrointestinal Disorders in Children with Cystic Fibrosis: An Analysis from the TriNetX Research Network Global Multicenter Real-World Dataset.

The purpose of this study is to (1) estimate and compare the prevalence of venous thromboembolism (VTE) in children (age 0 to ≤21) with versus without cystic fibrosis (CF); (2) investigate putative associations between specific gastrointestinal (GI) manifestations and the development of VTE among children with CF. This was a multicenter case-control analysis among patients aged 0 to ≤ 21 years between 2010 and 2020, using the TriNetX Research Network. Data queries included ICD-9/10 (International Classification of Diseases-9th/10th Revision) diagnosis codes.

Tenecteplase for the Treatment of Pediatric Arterial Ischemic Stroke: A Safety Surveillance Report.

Objectives: Intravenous tenecteplase (TNK) is increasingly used to treat adult patients with acute arterial ischemic stroke, but the risk profile of TNK in childhood stroke is unknown. This study aims to prospectively gather safety data regarding TNK administration in children.

Methods: Since December 2023, a monthly email survey was sent to participants recruited from the International Pediatric Stroke Study and Pediatric Neurocritical Care Research Group querying recent experience with TNK in childhood stroke.

Breast Cancer MRI Screening of Patients After Multiplex Gene Panel Testing.

Importance: Enhanced breast cancer screening with magnetic resonance imaging (MRI) is recommended to women with elevated risk of breast cancer, yet uptake of screening remains unclear after genetic testing.

Objective: To evaluate uptake of MRI after genetic results disclosure and counseling.

Design, Setting, And Participants: This multicenter cohort study was conducted at the University of Southern California Norris Cancer Hospital, the Los Angeles General Medical Center, and the Stanford University Cancer Institute.

Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe.

We investigated the association between values and attitudes toward sexual and reproductive health and rights (SRHR) and gender equality, with reproductive agency in Ethiopia, Kenya, and Zimbabwe. Using 2020-21 World Values Survey (WVS) data (n = 3,096), we utilized the SRHR Support Index including five subindices to gauge SRHR attitudes, the WVS Equality Index for gender equality values, and the perceived level of freedom of choice and control over whether, when, and how many children to have as a proxy for reproductive agency. Descriptive statistics, bivariate, and multivariable logistic regressions were used to analyse how values and attitudes differed between respondents of high vs low reproductive agency using the median as cutoff, stratified by country and sex.

Efficacy of Additional Surgical Decompression on Functional Outcome in Pyogenic Spinal Epidural Abscess With No Neurological Deficit.

Objective: The aim of this study was to investigate the efficacy of additional surgical decompression with antibiotics to treat pyogenic spinal epidural abscess (SEA) with no neurological deficits.

Methods: We retrospectively reviewed the data of patients diagnosed with spontaneous pyogenic SEA in the thoracolumbosacral area who presented with sciatica and no motor deficits in the lower extremities. The treatment took place in a single tertiary hospital.

Developing a Research Center for Artificial Intelligence in Medicine.

Artificial intelligence (AI) and machine learning (ML) are driving innovation in biosciences and are already affecting key elements of medical scholarship and clinical care. Many schools of medicine are capitalizing on the promise of these new technologies by establishing academic units to catalyze and grow research and innovation in AI/ML. At Stanford University, we have developed a successful model for an AI/ML research center with support from academic leaders, clinical departments, extramural grants, and industry partners.

Effect of elexacaftor-tezacaftor-ivacaftor on liver transient elastography, fibrosis indices and blood tests in children with cystic fibrosis.

Background: Elexacaftor-tezacaftor-ivacaftor (ETI) has significantly improved the clinical course of people with cystic fibrosis (pwCF) and eligible CFTR variants. In this study, we prospectively evaluated liver elastography, liver fibrosis indices and liver tests in children with CF aged 6-12 years started on ETI therapy.

Methods: Body mass index, sweat test, percent predicted forced expiratory volume in one second, serum markers of liver injury or portal hypertension, liver fibrosis indices, controlled attenuation parameter and liver stiffness were assessed before starting ETI and three and twelve months post-ETI, according to new international guidelines.

Personalized theta-burst stimulation enhances social skills in young minimally verbal children with autism: a double-blind randomized controlled trial.

Background: Minimally verbal children with autism are understudied and lack effective treatment options. Personalized continuous theta-burst stimulation (cTBS) targeting the amygdala and its circuitry may be a potential therapeutic approach for this population.

Methods: In a double-blind randomized controlled trial, minimally verbal children with autism (ages 2-8 years) received 4 weeks of cTBS.

Prevalence and impact of parental co-morbid anxiety and depression during the first 2 years postpartum in China.

Background: Parental postpartum co-morbid anxiety and depression negatively impact personal well-being, family dynamics, and child developmental outcomes. This study investigates the prevalence of co-morbid anxiety and depression in both mothers and fathers during the first 2 years postpartum in China, and to explore its associations with parental family support, maternal health-related quality of life (HRQoL), and child development.

Methods: This cross-sectional study was conducted in China, involving families with children aged 0-2 years who participated in community child health care.

Efficacy, safety, and target engagement of dazukibart, an IFNβ specific monoclonal antibody, in adults with dermatomyositis: a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial.

Background: Dermatomyositis is a chronic autoimmune disease with distinctive cutaneous eruptions and muscle weakness, and the pathophysiology is characterised by type I interferon (IFN) dysregulation. This study aims to assess the efficacy, safety, and target engagement of dazukibart, a potent, selective, humanised IgG1 neutralising monoclonal antibody directed against IFNβ, in adults with moderate-to-severe dermatomyositis.

Methods: This multicentre, double-blind, randomised, placebo-controlled, phase 2 trial was conducted at 25 university-based hospitals and outpatient sites in Germany, Hungary, Poland, Spain, and the USA.

Suture Anchor Fixation of the Pediatric Posteromedial and Posterolateral Menisco-Tibial Ligament Complex Matches or Exceeds Native Tissue Strength: A Cadaveric Study.

Objectives: To compare the biomechanical strength and stiffness of the native posteromedial and posterolateral meniscotibial ligament complex (MTLC) to suture anchor repair of the MTLC.

Methods: Biomechanical testing was performed on 24 fresh-frozen pediatric human knees. Four conditions were tested: native posteromedial MTLC (n=14), native posterolateral MTLC (n=14), posteromedial MTLC repair (n=5), and posterolateral MTLC repair (n=5).

Clinical Outcomes With Immune Checkpoint Inhibitors in Patients With FGFR2/3, MTAP or ERBB2 Genomic Alterations in Advanced Urothelial Carcinoma.

Background: FGFR2/3, MTAP and ERBB2 genomic alterations have treatment targets in advanced urothelial carcinoma (aUC). These alterations may affect tumor microenvironment and outcomes with immune checkpoint inhibitors (ICIs) in aUC.

Patients And Methods: We identified patients with available genomic data in our multi-institution cohort of patients with aUC treated with ICI.

Injectable Estradiol Use in Transgender and Gender-Diverse Individuals in the U.S.: A Multicenter Retrospective Study.

Context: Guidelines for use of injectable estradiol esters (valerate [EV] and cypionate [EC]) among transgender and gender diverse (TGD) individuals designated male at birth vary considerably, with many providers noting supraphysiologic serum estradiol concentrations based on current dosing recommendations.

Objectives: 1. Determine dose of injectable estradiol (subcutaneous [SC] and intramuscular [IM]) needed to reach guideline-recommended estradiol concentrations for TGD adults using EC/EV.

Rehabilitation Progress in Patients Following Surgery for Acute Stanford Type A Aortic Dissection Extending Beyond the Ascending Aorta.

The objective of this study was to assess the course of rehabilitation of patients hospitalized in the cardiac rehabilitation unit after surgery for acute Stanford type A aortic dissection, extending beyond the ascending aorta, and comparing these findings with those for patients who, after the same type of surgery, had no remaining dissection. The aim was to develop an optimal cardiac rehabilitation model for this patient population, given the lack of clear guidelines. Additionally, the study aimed to evaluate their one-year survival.

Surgical Technique and Perioperative Outcomes of the "Sapienza" Urology Residency Program's Trocar Placement Configuration During Robotic-Assisted Radical Prostatectomy (RARP): A Retrospective, Single-Centre Observational Study Comparing Experienced Attendings vs. Post-Graduate Year I-III Residents as Bedside Assistants.

: Robot-assisted radical prostatectomy (RARP) for the treatment of prostate cancer (PCa) has been standardized over the last 20 years. At our institution, only n = 3 rob arms are used for RARP. In addition, n = 2, 12 mm lap trocars are placed for the bedside assistant symmetrically at the midclavicular lines, which allows for direct pelvic triangulation and greater involvement of the assisting surgeon.

Automated Detection and Differentiation of Stanford Type A and Type B Aortic Dissections in CTA Scans Using Deep Learning.

Background/objectives: To develop and validate a model system using deep learning algorithms for the automatic detection of type A aortic dissection (AD), and differentiate it from normal and type B AD patients.

Methods: In this retrospective study, a deep learning model is developed, based on aortic computed tomography angiography (CTA) scans of 498 patients using training, validation and test sets of 398, 50 and 50 patients, respectively. An independent test set of 316 patients is used to validate and evaluate its performance.

Host-microbe multiomic profiling identifies distinct COVID-19 immune dysregulation in solid organ transplant recipients.

Coronavirus disease 2019 (COVID-19) poses significant risks for solid organ transplant recipients, who have atypical but poorly characterized immune responses to infection. We aim to understand the host immunologic and microbial features of COVID-19 in transplant recipients by leveraging a prospective multicenter cohort of 86 transplant recipients age- and sex-matched with 172 non-transplant controls. We find that transplant recipients have higher nasal SARS-CoV-2 viral abundance and impaired viral clearance, and lower anti-spike IgG levels.