The Availability of Paternity Leave in US Surgical Residencies: A Study of Program Websites.

Introduction: As family dynamics evolve, an increasing number of male residents are embracing parenthood during their training. Consequently, paternity leave has emerged as a crucial consideration. The aim of this study was to determine the gap in public availability of paternity leave policies in surgical residency programs across the United States.

A detailed spatiotemporal atlas of the white matter tracts for the fetal brain.

This study presents the construction of a comprehensive spatiotemporal atlas of white matter tracts in the fetal brain for every gestational week between 23 and 36 wk using diffusion MRI (dMRI). Our research leverages data collected from fetal MRI scans, capturing the dynamic changes in the brain's architecture and microstructure during this critical period. The atlas includes 60 distinct white matter tracts, including commissural, projection, and association fibers.

Managing Recurrent Carbon Dioxide Embolism During Laparoscopic Hepatectomy With Transesophageal Echocardiography Guidance: A Case Report.

Carbon dioxide gas emboli is a potentially fatal complication that occurs more frequently during laparoscopic hepatectomy compared to other laparoscopic surgeries. The patient featured in this report had massive gas embolism confirmed by intraoperative transesophageal echocardiography (TEE) that were associated with episodes of severe hypoxemia, hemodynamic instability, and right ventricular failure requiring conversion to open hepatectomy. Abrupt abdominal decompression resulted in massive hemorrhage from a previously undetected defect in the middle hepatic vein.

Evaluation of LLMs accuracy and consistency in the registered dietitian exam through prompt engineering and knowledge retrieval.

Large language models (LLMs) are fundamentally transforming human-facing applications in the health and well-being domains: boosting patient engagement, accelerating clinical decision-making, and facilitating medical education. Although state-of-the-art LLMs have shown superior performance in several conversational applications, evaluations within nutrition and diet applications are still insufficient. In this paper, we propose to employ the Registered Dietitian (RD) exam to conduct a standard and comprehensive evaluation of state-of-the-art LLMs, GPT-4o, Claude 3.

Outcomes of Immunotherapy Treatment in Sinonasal Mucosal Melanoma.

Background: Sinonasal mucosal melanoma has poor survival despite multimodality treatment. While the impact of immunotherapy (IT) on metastatic cutaneous melanoma is well-defined, there are relatively little data on sinonasal mucosal melanoma.

Objective: We sought to define immunotherapy outcomes in patients with sinonasal mucosal melanoma.

Anatomic Distal Biceps Tendon Repair With All-Suture Cortical Buttons.

Acute, traumatic distal biceps tendon ruptures are a common injury in the middle-aged athletic male population, with direct anatomic surgical repair being the most effective technique to restore maximal strength. Multiple techniques for distal biceps tendon repair have been described, including single- or dual-incision approaches and tendon fixation with cortical buttons, interference screws, suture anchors, and transosseous sutures. In this Technical Note, we demonstrate an anatomic distal biceps tendon repair technique with a single-incision approach using 2 all-suture cortical buttons.

Arthroscopy-Assisted Core Decompression and Bone Grafting for Avascular Necrosis of the Hip.

Although specific techniques vary, core decompression is generally accepted as the treatment of choice for precollapse avascular necrosis (AVN) of the hip to delay or prevent progression of the disease. This can be combined with hip arthroscopy to allow visual assessment of the femoral head as well as treatment of intra-articular pathologies, which may contribute to pain and joint degeneration. We describe a technique of hip arthroscopy and concurrent core decompression using an expandable reamer and bone grafting for treatment of hip AVN.

Infection with Toxoplasma gondii triggers coagulation at the blood-brain barrier and a reduction in cerebral blood flow.

Background: Immunothrombosis is the process by which the coagulation cascade interacts with the innate immune system to control infection. However, the formation of clots within the brain vasculature can be detrimental to the host. Recent work has demonstrated that Toxoplasma gondii infects and lyses central nervous system (CNS) endothelial cells that form the blood-brain barrier (BBB).

YAP-driven malignant reprogramming of oral epithelial stem cells at single cell resolution.

Tumor initiation represents the first step in tumorigenesis during which normal progenitor cells undergo cell fate transition to cancer. Capturing this process as it occurs in vivo, however, remains elusive. Here we employ spatiotemporally controlled oncogene activation and tumor suppressor inhibition together with multiomics to unveil the processes underlying oral epithelial progenitor cell reprogramming into tumor initiating cells at single cell resolution.

Impact of Locum Tenens Providers on Delivery of Pediatric Surgical Care.

Introduction: We sought to understand the impact of locum tenens surgeons on pediatric surgical care delivery.

Methods: We conducted a cross-sectional survey of Children's Hospital Association pediatric surgical practices. Anonymous electronic surveys were used to investigate locum tenens utilization, primary reason for use, limitations on clinical activities, and variations in practice standards or quality.

Budesonide, Added to PTCy-Based Regimen, for Prevention of Acute GI GVHD After Allogeneic Stem Cell Transplantation.

Oral budesonide exerts local effects with negligible systemic glucocorticoid activity, due to rapid first-pass metabolism, therefore, could potentially be efficacious in preventing gastrointestinal (GI) acute GVHD (aGVHD). We explored the use of budesonide, added to posttransplant cyclophosphamide (PTCy), tacrolimus, and mycophenolate mofetil, for prevention of GI aGVHD after allogeneic hematopoietic stem cell transplantation (AHSCT) in a prospective observational study and treated 80 patients with a median age of 53 years (range 19-74). Results were compared with a publicly available CIBMTR dataset of 646 patients who received PTCy-based GVHD prophylaxis (CIBMTR Study # GV17-02) (control).

Enhanced Killing of Methicillin-Resistant Staphylococcus aureus with Ceftaroline or Vancomycin in Combination with Carbapenems.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with high rates of treatment failure, even when antibiotics showing in vitro susceptibility are used. Early optimization of therapy is crucial to reduce morbidity and mortality. Building on our previous research on carbapenem therapy for methicillin-susceptible S.

Integrating microfluidic and bioprinting technologies: advanced strategies for tissue vascularization.

Tissue engineering offers immense potential for addressing the unmet needs in repairing tissue damage and organ failure. Vascularization, the development of intricate blood vessel networks, is crucial for the survival and functions of engineered tissues. Nevertheless, the persistent challenge of ensuring an ample nutrient supply within implanted tissues remains, primarily due to the inadequate formation of blood vessels.

Bathymetry of the Antarctic continental shelf and ice shelf cavities from circumpolar gravity anomalies and other data.

Bathymetry critically influences the intrusion of warm Circumpolar Deep Water onto the continental shelf and under ice shelf cavities in Antarctica, thereby forcing ice melting, grounding line retreat, and sea level rise. We present a novel and comprehensive bathymetry of Antarctica that includes all ice shelf cavities and previously unmeasured continental shelf areas. The new bathymetry is based on a 3D inversion of a circumpolar compilation of gravity anomalies constrained by measurements from the International Bathymetric Chart of the Southern Ocean, BedMachine Antarctica, and discrete seafloor measurements from seismic and ocean robotic probes.

Sex differences in mitochondrial free-carnitine levels in subjects at-risk and with Alzheimer's disease in two independent study cohorts.

A major challenge in the development of more effective therapeutic strategies for Alzheimer's disease (AD) is the identification of molecular mechanisms linked to specific pathophysiological features of the disease. Importantly AD has a two-fold higher incidence in women than men and a protracted prodromal phase characterized by amnestic mild-cognitive impairment (aMCI) suggesting that biological processes occurring early can initiate vulnerability to AD. Here, we used a sample of 125 subjects from two independent study cohorts to determine the levels in plasma (the most accessible specimen) of two essential mitochondrial markers acetyl-L-carnitine (LAC) and its derivative free-carnitine motivated by a mechanistic model in rodents in which targeting mitochondrial metabolism of LAC leads to the amelioration of cognitive function and boosts epigenetic mechanisms of gene expression.

Static Versus Expandable Cages in Minimally Invasive Lateral Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis.

Study Design: A meta-analysis approach to a systematic review.

Objective: Perform a systematic review to identify all reports directly comparing outcomes of lateral lumbar interbody fusion (LLIF) using static versus expandable interbody cages. Specifically focusing on periprocedural complications, intraoperative morbidity, and fusion outcomes.

Structural Characterization of Encapsulin in Complex with Dye-Decolorizing Peroxide.

(Mtb) is the causative agent of tuberculosis, the world's deadliest infectious disease. Mtb uses a variety of mechanisms to evade the human host's defenses and survive intracellularly. Mtb's oxidative stress response enables Mtb to survive within activated macrophages, an environment with reactive oxygen species and low pH.

Variable Assembly and Procapsid Binding of Bacteriophage P22 Terminase Subunits in Solution.

Concatemeric viral DNA is packaged into bacteriophage P22 procapsids via a headful packaging mechanism mediated by a molecular machine consisting of small (gp3) and large (gp2) terminase subunits. Although a negative stain reconstruction exists for the terminase holoenzyme, it is not clear how this complex binds the dodecameric portal protein located at a 5-fold mismatch vertex. Herein, we describe new assemblies for the holoenzyme.

Electrochemical sensors: Types, applications, and the novel impacts of vibration and fluid flow for microfluidic integration.

Electrochemical sensors are part of a diverse and evolving world of chemical sensors that are impacted by high demand and ongoing technological advancements. Electrochemical sensors offer benefits like cost-efficiency, short response time, ease of use, good limit of detection (LOD) and sensitivity, and ease of miniaturization while providing consistent analytical results. These sensors are employed in various fields-such as healthcare and diagnostics, environmental monitoring, and the food industry-to detect bacteria, viruses, heavy metals, pesticides, and more.

Rhinorrhea Recurrence After Posterior Nasal Nerve Cryoablation: A Multicenter Cohort Study.

Background: Posterior nasal nerve (PNN) cryoablation improves chronic rhinitis (CR) symptoms in 70-80% of cases, including clear thin rhinorrhea (CTR). This study's purpose was to determine time to and degree of CTR recurrence following cryoablation.

Methods: A multicenter retrospective cohort study was conducted on patients who underwent PNN cryoablation to treat CR-related CTR refractory to ipratropium bromide nasal spray (IBNS).

An Expanded Registry of Candidate cis-Regulatory Elements for Studying Transcriptional Regulation.

Mammalian genomes contain millions of regulatory elements that control the complex patterns of gene expression. Previously, The ENCODE consortium mapped biochemical signals across many cell types and tissues and integrated these data to develop a Registry of 0.9 million human and 300 thousand mouse candidate cis-Regulatory Elements (cCREs) annotated with potential functions.

Stool processing methods for Xpert Ultra testing in childhood tuberculosis: A prospective, multi-country accuracy study.

Background: Centrifuge-free processing methods support stool Xpert Ultra testing for childhood tuberculosis (TB), but there are limited data on their accuracy, acceptability and usability.

Methods: We conducted a prospective evaluation of stool Xpert Ultra in India, South Africa, and Uganda with three methods: Stool Processing Kit (SPK), Simple One-Step (SOS), and Optimized Sucrose Flotation (OSF). Children <15 years old with presumptive TB had respiratory specimen testing with Xpert Ultra and culture.