Retroperitoneal Teratoma in a Newborn: A Case Report and Diagnostic Insights.

Retroperitoneal teratomas are rare neoplasms in neonates, presenting with nonspecific symptoms and variable clinical features, making diagnosis challenging. Radiological investigations, particularly fetal ultrasound and contrast-enhanced computed tomography, play a critical role in their detection. Differential diagnoses include neuroblastoma, adrenal hemorrhage, and congenital cystic lesions, which share overlapping clinical and imaging features.

Identification of a Subpopulation of Astrocyte Progenitor Cells in the Neonatal Subventricular Zone: Evidence that Migration is Regulated by Glutamate Signaling.

In mice engineered to express enhanced green fluorescent protein (eGFP) under the control of the entire glutamate transporter 1 (GLT1) gene, eGFP is found in all 'adult' cortical astrocytes. However, when 8.3 kilobases of the human GLT1/EAAT2 promoter is used to control expression of tdTomato (tdT), tdT is only found in a subpopulation of these eGFP-expressing astrocytes.

Towards a Provider Builder Maturity Model to Empower Clinicians to Actively Participate in Electronic Health Record Design.

Background: Engagement of clinicians who understand clinical workflows and technology constraints can accelerate the development and implementation of better electronic health record (EHR) designs that improve quality and reduce burnout. Provider builder programs can accelerate clinical informatics education for a broader coalition of clinical specialties.

Objective: In this State of the Art / Best Practice paper, we aim to (1) propose a provider builder maturity model informed by the experience of three institutions using a single EHR vendor (Epic Systems©) and (2) describe the program elements and relationships necessary to advance along this model to yield organizational benefits.

Association of Residential Greenness and Sleep Duration in Adults: A Prospective Cohort Study in China.

Background: Exposure to residential greenness has been linked with improved sleep duration; however, longitudinal evidence is limited, and the potential mediating effect of ambient fine particulate matter (PM) has yet to be assessed.

Methods: We obtained data for 19,567 participants across seven counties in a prospective cohort in Ningbo, China. Greenness was estimated using Normalized Difference Vegetation Index (NDVI) within 250-m, 500-m and 1000-m buffer zones, while yearly average PM concentrations were measured using validated land-use regression models, both based on individual residential addresses.

A Qualitative Assessment of Barriers, Facilitators, and Outcomes in a Simulation-Based Collaborative Quality Improvement Program: The ImPACTS Project.

Objectives: ImPACTS (Improving Acute Care Through Simulation) is a collaborative simulation-based program partnering pediatric specialty centers ("hubs") with general emergency departments (GEDs) to improve pediatric acute care. Objective measurements of ImPACTS, such as evaluating Pediatric Readiness Score (PRS) and simulation-based outcome improvements, have been reported previously. Barriers to and facilitators of program involvement and the downstream effects of the program have not been previously described.

Biomarkers.

Background: Studying brain reserve - the brain's resilience to age-related changes or damage - is crucial for understanding protective mechanisms against cognitive decline. The cerebellum may be a key region in brain reserve, but it has been historically understudied. This investigation delves into this critical area within the largest aging multi-cohort to date.

Protracted Tuberculosis Outbreak in a Pasifika Diaspora in Western Sydney, Australia: The Importance of Community Engagement.

A prolonged tuberculosis outbreak, linked by whole-genome sequencing, occurred in a Pasifika extended family over 10 years (2013-2022) in Sydney, Australia. Despite Australia's low tuberculosis incidence, social and cultural complexities, and coronavirus disease 2019 (COVID-19) disruptions exacerbated transmission. Control required culturally sensitive, family-centered care and robust health system engagement.

Biomarkers.

Background: The hippocampus is a key site of atrophy in Alzheimer's disease (AD) and MRI derived estimates of hippocampal volume have been shown to be a robust biomarker of AD-related neurodegeneration. However, its application at the individual level is limited by the lack of reference standards from large normative datasets that can be applied across a wide range of settings. We aimed to investigate the utility of hippocampal volume centile scores adjusted for age, sex and total intracranial volume (TIV) derived from a normative data from 101,457 participants across the life course, as a biomarker of neurodegeneration in AD.

Developing Topics.

Background: Recent genome-wide association studies (GWAS) of Alzheimer's disease (AD) have identified approximately 70 genetic loci linked to the disorder. The pivotal challenge in the post-GWAS era is dissecting the underlying causal variants and effector genes, a crucial step for effective therapeutic development. Most of these variants reside in non-coding regions of the genome, suggesting their regulatory role in distal gene expression.

Relapsed childhood T-cell acute lymphoblastic leukemia and lymphoblastic lymphoma.

While outcomes for pediatric acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) have improved dramatically in recent decades, relapsed and refractory disease remain a significant therapeutic challenge. This is particularly true for patients with T-cell ALL and LBL, where survival for patients with relapsed/refractory disease remains dismal. Recent efforts to comprehensively profile the genomics of T-ALL/LBL to improve understanding of disease biology have enhanced our ability to identify high-risk patients at diagnosis who are more likely to relapse and have also identified novel targets for precision medicines.

Provision of continuous renal replacement therapy in children in intensive care in Australia and New Zealand.

Objectives: The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand.

Design: retrospective, binational registry-based cohort study and electronic survey of clinical practice.

Setting: ICUs that contribute to the Australian and New Zealand Paediatric Intensive Care Registry and a survey conducted in November 2021 including ICUs accredited for paediatric intensive care training that provide CRRT for children were part of this study.

Removal of a circumferentially torn stuck balloon from a calcified right ventricle to pulmonary artery conduit.

We report a case of right ventricle to pulmonary artery conduit angioplasty in which a valvuloplasty balloon ruptured circumferentially and was retained within the conduit. A high-pressure balloon was used to relieve the obstruction and free the ruptured balloon. The procedure was further complicated when the distal part of the balloon broke away from the proximal part during an attempt to retrieve it back into the femoral sheath.

Phenotypic Expansion: Fetus With Cole-Carpenter Type 2 Presenting With Novel Neonatal Lethal Skeletal Dysplasia.

We report a 28-year-old G2P0 at 24 weeks 5 days who presented for evaluation secondary to suspected skeletal dysplasia in her fetus. Fetal ultrasound imaging demonstrated foreshortened long bones by 9-10 weeks, multiple bowing deformities and fractures, 11 foreshortened paired ribs with fractures, decreased skull mineralization, frontal bossing, enlarged cavum septum pellucidi, and severe fetal growth restriction (< 2%). Findings were concerning for life limiting condition with thoracic circumference < 2.

A lifespan-generalizable skull-stripping model for magnetic resonance images that leverages prior knowledge from brain atlases.

In magnetic resonance imaging of the brain, an imaging-preprocessing step removes the skull and other non-brain tissue from the images. But methods for such a skull-stripping process often struggle with large data heterogeneity across medical sites and with dynamic changes in tissue contrast across lifespans. Here we report a skull-stripping model for magnetic resonance images that generalizes across lifespans by leveraging personalized priors from brain atlases.

Transradial cerebral angiography in the neonate and infant: a case series.

Background: We aim to share our experience of transradial access (TRA) for cerebral angiography and intervention in five patients ranging from 6 days to 7 months of age.

Methods: In this institutional review board-approved, retrospective case series, we reviewed all patients who underwent TRA for cerebral angiography with and without intervention. We describe three techniques for radial artery cannulation, namely: (1) bareback; (2) with a micropuncture sheath; and (3) with an intravenous catheter.

Genetic Test Utilization and Cost among Families of Children Evaluated for Genetic Conditions: An Analysis of USA Commercial Claims Data.

Introduction: Healthcare payers in the USA increasingly cover genetic testing, including exome sequencing (ES), for pediatric indications. Analysis of claims data enables understanding of utilization and costs in real-world settings. The objective of this study was to describe genetic test utilization, diagnostic outcomes, and costs for children who received ES as well as for those who received less comprehensive forms of genetic testing, along with their families.

Predicting Blood Loss in Aneurysmal Bone Cyst Surgery.

Background: Preoperative estimation of intraoperative blood loss is essential for its management and literature is lacking with respect to factors influencing blood loss in aneurysmal bone cysts (ABC) surgery. The purpose of this study is to identify risk factors and predictors for blood loss in ABC surgery.

Methods: An IRB-approved retrospective review was performed from 2011 to 2021 at a pediatric tertiary care center.

Tgfβ signaling stimulates glycolysis to promote the genesis of synovial joint interzone in developing mouse embryonic limbs.

The initial interzone cells for synovial joints originate from chondrocytes, but such critical transition is minimally understood. With single-cell RNA sequencing (scRNA-seq) of murine embryonic knee joint primordia, we discovered that heightened expression of glycolysis genes characterized developing interzone cells when compared to flanking chondrocytes. Conditional deletion of the glucose transporters and/or , in either the incipient pre-skeletal mesenchyme with or in chondrocytes with , disrupted interzone formation dose-dependently.

Microdissection of Distinct Morphological Regions Within Uveal Melanomas Identifies Novel Drug Targets.

: Uveal melanomas (UMs) are rare but often deadly malignancies that urgently require viable treatment options. UMs often exhibit tumour heterogeneity, with macroscopic and microscopic differences in morphology between different regions of the same tumour. However, to date, the clinical significance of this and how it may help guide personalised therapy have not been realised.

Surgeons' views on hypospadias care journey: A qualitative study.

Background: Three major parties are involved in the hypospadias treatment journey - the patient, their parents/carers, and the surgeon. There is a strong trend towards involving all three, where possible, in deriving evidence around the care pathways. Currently, there are little data available on surgeons' perspectives of distal hypospadias care.

Current trends in intraoperative neurophysiological monitoring among Asia-Pacific countries: an Asia-Pacific Spine Society survey.

Study Design: A prospective web-based survey.

Purpose: Although intraoperative neurophysiological monitoring (IONM) is critical in spine surgery, its usage is largely based on the surgeon's discretion, and studies on its usage trends in Asia-Pacific countries are lacking. This study aimed to examine current trends in IONM usage in Asia-Pacific countries.

Choledochal Cyst in Children Under Six Months: Is Da Vinci Robot-Assisted Surgery More Advantageous?

Surgery for choledochal cysts (CDC) in children younger than 6 months is relatively rare. We report our experience and compare the results between Da Vinci robot-assisted hepaticojejunostomy (RAHJ) and laparoscopic-assisted hepaticojejunostomy (LAHJ) in children younger than 6 months to treat CDC. A retrospective study was conducted on all children under 6 months of age who underwent RAHJ or LAHJ at the Children's Hospital, Zhejiang University School of Medicine, from July 2018 to November 2023.

CK2-dependent SK channel dysfunction as contributor to neuronal hyperexcitability in Alzheimer's disease.

Neuronal hyperexcitability in the cortex and hippocampus represents an early event in Alzheimer's disease (AD). In a recent study, Blankenship and colleagues reported that in a mouse of AD, ventral tegmental area (VTA) dopamine neurons are also hyperexcitable, and this hyperexcitability is due to casein kinase 2 (CK2)-dependent SK channel dysfunction, adding new insights into the underlying mechanisms of aberrant neuronal properties in AD.