Titanium clips and ligamentum flavum-epidural fat patch graft for midline lumbar durotomy closure in pediatric neurosurgery.

Objective: CSF leaks are a significant source of patient morbidity following intradural spine surgeries. Watertight dural closure is crucial during these procedures to minimize the risk of a CSF leak. This study reports postoperative outcomes and changes in patient management after switching to penetrating titanium clips for dural closure in a large cohort of pediatric patients receiving a tethered cord release (TCR) or a selective dorsal rhizotomy (SDR).

Glutathione, Vitamin C, and Cysteine Use in Autistic Children With Disruptive Behavior: A Double-Blind, Placebo-Controlled Crossover Pilot Study.

Objective: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication differences and restricted interests. One proposed biologic mechanism underlying ASD is oxidative stress, leading to the clinical use of glutathione based on anecdotal reports of improved behavior in autistic children. In this pilot study, we tested this observation using a randomized clinical trial format to collect preliminary data on glutathione safety and efficacy.

Patient-Reported Outcomes in Robotic-Assisted vs Manual Cementless Total Knee Arthroplasty.

Background: Robotic-assisted total knee arthroplasty (RA-TKA) was introduced to provide surgeons with virtual preoperative planning and intraoperative information to achieve the desired surgical goals in an effort to improve patient outcomes. The purpose of this study was to compare clinical outcomes and patient-reported outcome measures following primary TKA using RA-TKA vs manual instrumentation.

Methods: This was a retrospective cohort review study comparing 393 primary RA-TKAs vs 312 manual TKAs at a minimum 2-year follow-up.

Frequency and reasons that parents decline genetic testing for critically ill neonates.

Purpose: Current literature reports strong support among parents for genetic testing for ill neonates; yet, some parents decline this testing for unknown reasons. We aimed to document the proportion of parents who decline, describe their clinical and demographic characteristics, and categorize their rationales.

Methods: We reviewed medical records to collect and compare clinical and demographic information for patients whose parents consented to and declined recommended genetic testing.

Risk Profile and Prognostic Implications of Premature Advanced Coronary Atherosclerotic Disease Among Young to Early Middle-aged Adults: The Coronary Artery Calcium Consortium.

Introduction: Premature advanced subclinical coronary atherosclerosis among young adults is an under-recognized and unique disease phenotype that has not been well characterized.

Methods: We used data from 44,047 participants with no prior CVD history (59.8% male) from the Coronary Artery Calcium (CAC) Consortium.

The impact of aging on neutrophil functions and the contribution to periodontitis.

The increasing aging population and aging-associated diseases have become a global issue for decades. People over 65 show an increased prevalence and greater severity of periodontitis, which poses threats to overall health. Studies have demonstrated a significant association between aging and the dysfunction of neutrophils, critical cells in the early stages of periodontitis, and their crosstalk with macrophages and T and B lymphocytes to establish the periodontal lesion.

Improved healthcare utilization and economic outcomes of chronic subdural hematoma treatment with middle meningeal artery embolization compared to conventional surgical drainage.

Background: Middle meningeal artery embolization (MMAE) emerges as an alternative to conventional surgical drainage (CSD) for chronic subdural hematomas (cSDH). Several studies have suggested that MMAE improves the cost efficacy of cSDH treatment. However, further comprehensive analyses of the outcomes and healthcare costs of MMAE are necessary.

New Perspectives on Antimicrobial Agents: Omadacycline for community-acquired pneumonia, skin and soft tissue infections, and nontuberculous mycobacteria (focus on ).

Omadacycline is a novel antimicrobial belonging to the tetracycline class. It has the ability to evade both efflux and ribosomal methylation types of resistance and therefore has an expanded spectrum compared to other tetracycline agents. Omadacycline is active against a number of multidrug-resistant bacteria, including macrolide and doxycycline-resistant methicillin-resistant (MRSA), vancomycin-resistant Enterococcus, and several enteric gram-negative bacilli.

Distance and Orientation Dependence of Triplet-Triplet Energy Transfer Couplings Based on Nonorthogonal Multireference Wave Functions.

Triplet-triplet energy transfer (TEnT) is of particular interest in various photochemical, photobiological, and energy science processes. It involves the exchange of spin and energy of electrons between two molecular fragments. Here, quasi-diabatic self-consistent field solutions were used to obtain the diabatic states involved in TEnT.

Scoping review of robotics technology in spinal surgery with highlights of the Annual Seattle Science Foundation Course.

Background: Robotic assistance has become increasingly prevalent in spinal surgery in recent years, emerging as a tool to increase accuracy and precision and lower complication rates and radiation exposure. The 7 and 8 Annual Seattle Science Foundation (SSF) Robotics Courses showcased presentations and demonstrations from some of the field's most experiences leaders on latest topics in robotics and spinal surgery, including cutting-edge preoperative planning technologies, augmented reality (AR) in the operating room, cervical fusion with transpedicular screws, and neuro-oncologic management. We provide a scoping review of the use of robotics technology in spinal surgery featuring highlights from the 7 and 8 Annual SSF Robotics Courses.

Incidence and Progression of Diastolic Dysfunction in People With HIV in Tanzania: A Comparative Cohort.

Background: People living with HIV (PLWH) have a higher prevalence of diastolic dysfunction and left ventricular hypertrophy (LVH) in cross-sectional studies. Longitudinal data are lacking, especially from Africa.

Objectives: The aim was to examine: 1) the incidence of diastolic dysfunction in PLWH compared to community controls in Tanzania; 2) the progression of diastolic function and LVH in PLWH after antiretroviral therapy initiation; and 3) traditional, endemic, and HIV-specific risk factors for diastolic function and LVH.

Sociodemographic disparities in everyday discrimination among a national sample of adults in the United States, 2023.

Objective: Discrimination is a social determinant contributing to health inequities in the United States (US). This study investigated the prevalence of, and sociodemographic disparities in, perceived everyday discrimination among a national sample of US adults.

Methods: We used data from the 2023 National Health Interview Survey ( = 27,538) and estimated the prevalence of three perceived everyday discrimination outcomes (1) any discrimination, (2) unique components of the discrimination experience, and (3) the Everyday Discrimination Scale (EDS) (range: 0-20) overall and by age, sex assigned at birth, race and ethnicity, sexual orientation, educational attainment, income-to-poverty ratio, and urban-rural status.

A Prospective Study of a Custom-Made Eco-Friendly Thyroid Shield: A Breakthrough in Radiation Protection.

Background The thyroid gland is the most susceptible organ to radiation during the exposure of teeth because the thyroid area appears to be within the primary beam, and the dose levels are relatively high even after using collimation. This study aims to develop an eco-friendly thyroid shield by reusing lead foils from intra-oral periapical radiographic films and evaluate its effectiveness in intraoral radiography. Methods A total of 16 patients undergoing endodontic procedures who gave written consent to participate in the study were included and divided into four categories: anterior, canine, premolar, and molar.

Silicon Nanotube Anode on Copper Foils for Li-Ion Batteries.

We report a silicon anode for lithium-ion batteries consisting of a layer of 100% nanotubes directly bonded to copper foil. The process involved silicon deposition on a sacrificial zinc oxide nanorod film and removal of zinc oxide to produce a nanotube film directly on thin copper foils. The thickness of resulting films ranged from 9 to 20 μm with Si nanotubes having diameters of 200-400 nm and lengths of 2-10 μm.

Abnormality detection in nailfold capillary images using deep learning with EfficientNet and cascade transfer learning.

Nailfold Capillaroscopy (NFC) is a simple, non-invasive diagnostic tool used to detect microvascular changes in nailfold. Chronic pathological changes associated with a wide range of systemic diseases, such as diabetes, cardiovascular disorders, and rheumatological conditions like systemic sclerosis, can manifest as observable microvascular changes in the terminal capillaries of nailfolds. The current gold standard relies on experts performing manual evaluations, which is an exhaustive time-intensive, and subjective process.

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Background: Pediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI.

Methods: We analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 U.

Creating an Extremely Long-lasting Neuroischemic Wound Model.

In wound study and dressing development, a lack of a suitable animal model that can recapitulate the complex pathophysiology of human chronic wounds has been a major hurdle. Chronic wounds are defined as wounds that heal with a significant delay, usually over a period >2-3 months, but no current animal wound model has such a longischemia. After a longexploration, our group has developed an animal wound model with ischemia and nerve damage lasting for at least 6 months.

Enhancing the Use of 5-Aminolevulinic Acid in Fluorescence-guided Surgery for High-grade Glioma: An Expert Nurse Practitioner Opinion-based Approach.

Purpose: This report details the recommendations of a Nursing Best Practice Working Group, which aims to advance best practice in the use of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in patients with high-grade glioma (HGG).

Design: Quality Improvement Project.

Methods: These recommendations were gathered during a meeting of a Nursing Best Practice Working Group comprising expert nurses and practice administrators from five US centers of excellence in the management of HGG.

Enhancing the Travel Experience for People with Visual Impairments through Multimodal Interaction: NaviGPT, A Real-Time AI-Driven Mobile Navigation System.

Assistive technologies for people with visual impairments (PVI) have made significant advancements, particularly with the integration of artificial intelligence (AI) and real-time sensor technologies. However, current solutions often require PVI to switch between multiple apps and tools for tasks like image recognition, navigation, and obstacle detection, which can hinder a seamless and efficient user experience. In this paper, we present NaviGPT, a high-fidelity prototype that integrates LiDAR-based obstacle detection, vibration feedback, and large language model (LLM) responses to provide a comprehensive and real-time navigation aid for PVI.

Wilson disease in the USA: epidemiology and real-world patient characteristics based on a retrospective observational health claims study.

Objectives: To describe the epidemiology, patient characteristics and comorbidities in patients with Wilson disease (WD) in the USA.

Design: Retrospective, population-based study.

Setting: The study used the US Komodo claims database containing records regarding medical claims for over 120 million individuals.

Mepolizumab real-world effectiveness in severe asthma with an eosinophilic phenotype and overlapping severe allergic asthma.

Background: Some patients with severe asthma have overlapping allergic and eosinophilic phenotypes and may be eligible for anti-eosinophilic or anti-IgE biologics.

Objective: This post hoc sub-analysis assessed real-world mepolizumab effectiveness in patients with overlapping allergic and eosinophilic phenotypes, using 1-year data from the international, prospective REALITI-A study.

Methods: The clinically significant asthma exacerbation (CSE) rate was assessed 1 year prior to (pre-treatment) and following (follow-up) mepolizumab treatment, stratified by baseline total IgE levels (tIgE; <60, 60-<190, 190-<550, and ≥550 kU/L), atopic status (yes/no/unknown), prior omalizumab use (yes/no), geographic baseline omalizumab eligibility (eligible/non-eligible), and baseline tIgE level and blood eosinophil count (BEC) threshold combinations (<81 or ≥81 kU/L and <300 or ≥300 cells/µL).

Cigar, Pipe, and Smokeless Tobacco Use and Cardiovascular Outcomes From Cross Cohort Collaboration.

Importance: Cardiovascular health outcomes associated with noncigarette tobacco products (cigar, pipe, and smokeless tobacco) remain unclear, yet such data are required for evidence-based regulation.

Objective: To investigate the association of noncigarette tobacco products with cardiovascular health outcomes.

Design, Setting, And Participants: This cohort study was conducted within the Cross Cohort Collaboration Tobacco Working Group by harmonizing tobacco-related data and conducting a pooled analysis from 15 US-based prospective cohorts with data on the use of at least 1 noncigarette tobacco product ranging between 1948 and 2015.

Let's talk about class: A peer-to-peer social class workshop for psychotherapy trainees.

There is a growing consensus that effective psychotherapists and counselors require antioppressive, social-justice-oriented, culturally and structurally responsive training (e.g., Neville et al.