Germ cell tumors in children.

Pediatric germ cell tumors represent a rare but biologically diverse group of neoplasms arising from pluripotent primordial germ cells. The 2022 edition of the WHO Classification of Pediatric Tumors introduced the first organ independent classification of germ cell tumors, reflecting advances in molecular biology, histopathology, and clinical practice. This review highlights the key changes, including the refined distinctions between the different subtypes.

Resting State Functional Connectivity of the Default Mode Network During Opioid Use and Cessation in Treatment-Seeking Persons.

Resting-state functional connectivity analyses have been used to examine synchrony in neural networks in substance use disorders (SUDs), with the default mode network (DMN) one of the most studied. Prior research has generally found less DMN synchrony during use and greater synchrony during cessation, although little research has utilized this method with opioid use. This study examined resting brain activity in treatment-seeking persons who use opioids at two points-when using opioids and when opioid-free-to determine whether the DMN exhibits different levels of connectivity during opioid use and cessation and whether differences in connectivity predict subsequent relapse.

Orderly Regulation of Macrophages and Fibroblasts by Axl in Bleomycin-Induced Pulmonary Fibrosis in Mice.

Pulmonary fibrosis is a pathological manifestation that occurs upon lung injury and subsequence aberrant repair with poor prognosis. However, current treatment is limited and does not distinguish different disease stages. Here, we aimed to study the differential functions of Axl, a receptor tyrosine kinase expressing on both macrophages and fibroblasts, in the whole course of pulmonary fibrosis.

Wound Healing After Vaginal Delivery, Episiotomy, and Cesarean Section Delivery Among Women With IBD: Results From the PIANO Registry.

Background: Women with inflammatory bowel disease (IBD) face complexities of disease management during pregnancy and childbirth. Apprehension regarding vaginal delivery in pregnant individuals with IBD persists due to concern for perianal disease and perineal trauma. The incidence of poor wound healing after obstetric anal sphincter injury is approximately 4% in the general population.

I love you no matter what: Negative relationship quality and daily encounters in the parent-child tie and their implications for daily mood across the lifespan.

Parent-child relationship quality has critical implications for parental emotional well-being across the lifespan. The present study assessed how relationship quality is related to daily encounters between parents and children, how those encounters are linked with parents' mood, and how these associations vary by age. Participants (N = 129, ages 33-91) reported baseline relationship quality with a total of 337 children (ages 1-69).

Benefits and burdens of daily sacrifices and commitment in same- and different-gender couples: Explorations of proximity and direction of effects.

Research and theory document links between sacrifices and commitment in couples, yet the direction of effects remains unclear. Whereas interdependence theorists suggest that sacrifices help couples to build commitment, other scholars have suggested that being committed leads partners to sacrifice for each other. Nearly all research in this area has focused on men and women in different-gender relationships with each other.

Large language models for the mental health community: framework for translating code to care.

Large language models (LLMs) offer promising applications in mental health care to address gaps in treatment and research. By leveraging clinical notes and transcripts as data, LLMs could improve diagnostics, monitoring, prevention, and treatment of mental health conditions. However, several challenges persist, including technical costs, literacy gaps, risk of biases, and inequalities in data representation.

Biosecurity and Biocontainment for Ruminant Respiratory Disease.

Respiratory disease in cattle and small ruminants is caused by various factors, including inadequate biosecurity and biocontainment. Biosecurity and biocontainment depend on good husbandry. Testing on arrival and quarantining for 42 to 56 days could improve biosecurity.

Working memory needs pointers.

Cognitive neuroscience has converged on a definition of working memory (WM) as a capacity-limited system that maintains highly accessible representations via stimulus-specific neural patterns. We argue that this standard definition may be incomplete. We highlight the fundamental need to recognize specific instances or tokens and to bind those tokens to the surrounding context.

A National Assessment of Pediatric Surgical Critical Care Fellowship Structure: Defining the Training Experience.

Background: Pediatric Surgical Critical Care (PSCC) is a unique specialty incorporating fundamental principles of surgical, neonatal, and pediatric critical care. This study aims to characterize the current landscape of PSCC training to identify opportunities for educational standardization and improvement.

Methods: An anonymous electronic survey-based assessment was distributed to the program directors (PDs) of all current ACGME-accredited PSCC fellowships (n = 14).

Reimagining Male Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia Treatment: A New Approach to First-line Interventional Therapy.

Benign prostatic hyperplasia is a prevalent condition leading to male lower urinary tract symptoms (mLUTS), particularly in aging populations. Current management strategies-spanning watchful waiting, pharmaceutical therapy, and surgical interventions such as transurethral resection of the prostate-face significant limitations, including side effects, low adherence, and patient hesitancy toward invasive treatments. First-line interventional therapy (FIT) emerges as a novel paradigm bridging the gap between medications and surgery.

Preoperative Assessment of the Nasal Valve.

Nasal obstruction is often a multifactorial problem, attributable to physiologic and anatomic processes. Nasal valve compromise may be static or dynamic in nature. Successful diagnostic evaluation rests on a comprehensive history and physical examination.

Artificial Intelligence, Machine Learning and Big Data in Radiation Oncology.

This review explores the applications of artificial intelligence and machine learning (AI/ML) in radiation oncology, focusing on computer vision (CV) and natural language processing (NLP) techniques. We examined CV-based AI/ML in digital pathology and radiomics, highlighting the prospective clinical studies demonstrating their utility. We also reviewed NLP-based AI/ML applications in clinical documentation analysis, knowledge assessment, and quality assurance.

Continuous vital sign monitoring of patients recovering from surgery on general wards: a narrative review.

Most postoperative deaths occur on general wards, often linked to complications associated with untreated changes in vital signs. Monitoring in these units is typically intermittent checks each shift or maximally every 4-6 h, which misses prolonged periods of subtle changes in physiology that can herald a critical downstream event. Continuous monitoring of vital signs is therefore intuitively necessary for patient safety.

TEMPORARY REMOVAL: Targeting the kappa opioid receptor for analgesia and antitumour effects.

The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.

Stress responses induced by perturbation of the ubiquitin-proteasome system.

The ubiquitin-proteasome system is key for proteostasis and its disruption can induce several cellular adaptations. Here, we summarize the range of cellular responses that are induced by perturbation of distinct components of the ubiquitin-proteasome system, and how proteasome stress in a tissue can induce systemic responses in distant tissues.

The Digital Full-Arch Solution Plus Photogrammetry for Guided Patient Success in All-On-X Cases.

This article highlights the critical role of digital technologies, particularly photogrammetry, in full-arch dental implant practices. By replacing traditional analog methods, digital tools enhance the precision of implant placement and prosthetic design, leading to better functional and esthetic outcomes. The seamless integration of photogrammetry with a computer-aided design /computer-aided manufacturing system not only streamlines the workflow but also improves patient satisfaction by reducing treatment times and increasing comfort.

Stackable Guides: Digital Workflows for Full Arch Dental Implant Rehabilitation.

Computer-guided full-arch dental rehabilitation, which is highly technique-sensitive, benefits from advancements in 3-dimensional-printed guides and open-source software. Critical pre-surgical planning includes patient selection, health history evaluations, and detailed imaging like cone beam computed tomography scans. Various surgical guides-freehand, static, dynamic, stackable, and interchangeable-are used based on case complexity, with stackable guides improving workflow efficiency.

Chapter 13.0. FFR, iFR, CFR, and IMR: Results from clinical trials.

In this review article, we provide an overview of the definition and application of fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), coronary flow reserve (CFR), and index of microvascular resistance (IMR) in the diagnosis, prognosis, and management of coronary microvascular dysfunction. We discuss their respective limitations as it relates to microvascular dysfunction. In each section, we review the most recent evidence supporting their use in microvascular and epicardial coronary artery disease.

Barriers to accessing mental health resources as perceived by surgical compared to medical trainees.

Introduction: Despite myriad wellness programs, training demands restrict resident access. This study aimed to evaluate barriers to accessing mental health resources(MHR) and determine if differences exist between medical(MT) and surgical trainees(ST).

Methods: A cross-sectional survey was performed in one health system assessing awareness of and barriers to accessing MHR.

Partially observable Markov models inferred using statistical tests reveal context-dependent syllable transitions in Bengalese finch songs.

Generative models have diverse applications, including language processing and birdsong analysis. In this study, we demonstrate how a statistical test, designed to prevent overgeneralization in sequence generation, can be used to infer minimal models for the syllable sequences in Bengalese finch songs. We focus on the partially observable Markov model (POMM), which consists of states and the probabilistic transitions between them.

Retrieval of an ethanol-conditioned taste aversion promotes GABAergic plasticity in the anterior insular cortex.

Blunted sensitivity to ethanol's aversive effects can increase motivation to consume ethanol; yet, the neurobiological circuits responsible for encoding these aversive properties are not fully understood. Plasticity in cells projecting from the anterior insular cortex (aIC) to the basolateral amygdala (BLA) is critical for taste aversion learning and retrieval, suggesting this circuit's potential involvement in modulating the aversive properties of ethanol. Here, we tested the hypothesis that GABAergic currents onto aIC-BLA projections would be facilitated as a consequence of retrieval of an ethanol-conditioned taste aversion (CTA).