Type A Aortic Dissection Following Abdominal Solid Organ Transplantation: Population-Level Outcomes in the United States.

Background: This study aims to analyze the patient characteristics, clinical outcomes, and contemporary trends concerning type A aortic dissection (TAAD) in previous recipients of abdominal solid organ transplantation (ASOT) in the United States.

Methods: The National Inpatient Sample was queried to identify all patients aged ≥18 with TAAD and a history of ASOT (TAAD-ASOT) between 2002 and 2015Q3 using ICD-9 diagnosis and procedure codes. Baseline characteristics and in-hospital outcomes were compared between TAAD-ASOT patients and TAAD patients without a history of ASOT (TAAD-non-ASOT).

Connecting Underrepresented Medical Students to Resources and Role Models in Orthopaedic Surgery: A Virtual Diversity, Equity, Inclusion, and Accessibility Summit.

Introduction: Limited access to resources and stereotypes about orthopaedic surgeons may contribute to the low percentage of women and people of underrepresented in medicine (URiM) backgrounds in orthopaedic surgery. Several organizations have created resources to address these barriers, but medical students are unlikely to be exposed to the initiatives through traditional curricula. The purpose of this study was to (1) evaluate the ability of a 1-day virtual Diversity, Equity, Inclusion, and Accessibility (DEIA) summit to effectively reach URiM medical students, (2) increase medical students' knowledge of DEIA resources, and (3) augment the perception of diverse backgrounds in orthopaedic surgery.

Ophthalmology Examinations in Children With Skull Fractures and Underlying Focal Hemorrhage.

Objectives: To assess the frequency and yield of retinal examination in children below 2 years old undergoing abuse evaluations in the setting of skull fracture(s) and small underlying intracranial hemorrhage.

Methods: This cross-sectional study used CAPNET, a multicenter child physical abuse network, to identify children below 2 years with a skull fracture(s) and intracranial injury limited to an underlying small focal intracranial hemorrhage undergoing subspeciality child abuse evaluations. Our outcomes of interest were (1) the performance of a retinal examination, (2) the identification of retinal hemorrhages, and (3) associations of clinical factors and CAPNET site with the performance of retinal examinations.

Early Readmissions of Necrotizing Pancreatitis in the US: Where Do We Stand?

Background: Necrotizing pancreatitis (NP), a severe form of pancreatitis characterized by necrosis of pancreatic tissue, is associated with a significant health care burden worldwide. In this study, we assess early readmissions of NP in the US.

Methods: The National Readmission Database from 2016 to 2020 was utilized to identify all index and 30-day readmissions of NP in the US.

Awake Prone Positioning in Adults With COVID-19: An Individual Participant Data Meta-Analysis.

Importance: The impact of awake prone positioning (APP) on clinical outcomes in patients with COVID-19 and acute hypoxemic respiratory failure (AHRF) remains uncertain.

Objective: To assess the association of APP with improved clinical outcomes among patients with COVID-19 and AHRF, and to identify potential effect modifiers.

Data Sources: PubMed, Embase, the Cochrane Library, and ClinicalTrials.

Evaluation of Institutional Prophylactic Open Fracture Antibiotic Guidelines on Infection Development.

Background: Open fracture wounds are associated with a high risk of infection, though the outcomes are dependent on the fracture location, prophylactic antibiotics utilized, and time to antibiotic intervention. Although several institutions have provided guidelines for appropriate prophylaxis in open fractures, there is currently no consensus on antibiotic selection and duration. Reducing inappropriate prophylactic antibiotic use for open bone fractures is a potential stewardship opportunity within pharmacy departments.

Network Localization of Pediatric Lesion-Induced Dystonia.

Objective: Dystonia is a movement disorder defined by involuntary muscle contractions leading to abnormal postures or twisting and repetitive movements. Classically dystonia has been thought of as a disorder of the basal ganglia, but newer results in idiopathic dystonia and lesion-induced dystonia in adults point to broader motor network dysfunction spanning the basal ganglia, cerebellum, premotor cortex, sensorimotor, and frontoparietal regions. It is unclear whether a similar network is shared between different etiologies of pediatric lesion-induced dystonia.

Perceived barriers to neurodevelopmental follow-up among cardiac neurodevelopmental outcome collaborative institutional and affiliated members.

Objective: Neurodevelopmental follow-up programmes for children with CHD help identify neurodevelopmental impairments and support the delivery of recommended interventions. The Cardiac Neurodevelopmental Outcome Collaborative, Diversity, Equity, and Inclusion Special Interest Group surveyed members to assess perceived patient barriers to neurodevelopmental follow-up, previous diversity and inclusion education, and confidence in caring for historically marginalised populations.

Methods: A link to a Redcap online survey was emailed to Cardiac Neurodevelopmental Outcome Collaborative members on 23 April 2022, with 4 weeks given to complete.

Genome-wide profiling of highly similar paralogous genes using HiFi sequencing.

Variant calling is hindered in segmental duplications by sequence homology. We developed Paraphase, a HiFi-based informatics method that resolves highly similar genes by phasing all haplotypes of paralogous genes together. We applied Paraphase to 160 long (>10 kb) segmental duplication regions across the human genome with high (>99%) sequence similarity, encoding 316 genes.

Trends in Respiratory Pathogen Testing at US Children's Hospitals.

Importance: Respiratory pathogen testing has been a common deimplementation focus. The COVID-19 pandemic brought new considerations for respiratory testing; recent trends in testing rates are not well understood.

Objective: To measure trends in respiratory testing among encounters for acute respiratory infections among children and adolescents (aged <18 years) from 2016 to 2023, assess the association of COVID-19 with these trends, and describe associated cost trends.

Diagnosis and Treatment of Hypophosphatasia.

Hypophosphatasia (HPP) is a rare inherited metabolic disorder characterized by deficient activity of tissue-nonspecific alkaline phosphatase (TNAP) caused by variants in the ALPL gene. Disease manifestations encompass skeletal hypomineralization with rickets and lung hypoplasia, vitamin B6-dependent seizures, craniosynostosis, and premature loss of deciduous teeth. The clinical presentation can comprise failure to thrive with muscular hypotonia, delayed motor development, and gait disturbances later in childhood.

Development of a pharmacodynamic biomarker of opioid antagonism in adolescents with eating disorders: Study protocol for the naltrexone neuroimaging randomized controlled trial (NN-RCT).

Eating disorders (ED) affect 5 % of youth, are associated with reward system alterations, and lead to substantial morbidity. Naltrexone, an opioid antagonist, is used to treat ED behaviors such as binge eating and purging. However, not all patients respond, and the optimal dose is unknown.

Developing and implementing Pediatric Nephrology Milestones 2.0 as an efficient tool for trainee evaluation and just-in-time feedback.

In 2013, the Accreditation Council for Graduate Medical Education (ACGME) implemented Milestones 1.0 as a tool to assess trainee progress towards readiness for independent practice. Critiques of Milestones 1.

Efficacy and safety of bromocriptine in peripartum cardiomyopathy: A systematic review and meta-analysis.

Background: Peripartum cardiomyopathy (PPCM) is a rare but potentially serious pregnancy complication. The use of bromocriptine in addition to standard treatment has been recommended; however, the evidence supporting its efficacy remains limited.

Methods: A systematic search was conducted across 4 databases including PubMed, Embase, Web of Science, and Cochrane CENTRAL, from inception to September 13, 2024, without language restrictions.

Teletherapy Ethics.

This manuscript focuses on regret as a significant moral experience in surgical professionalization. It distinguishes between constructive regret, which encourages self-reflection and growth, and destructive regret, which can lead to emotional withdrawal and impaired decision-making. This article also offers recommendations for how both colleagues and organizations should respond to each type of regret, especially regret over poor outcomes, to nourish professional formation.

Stage, Cut, Investigate, Regret, Heal.

This manuscript focuses on regret as a significant moral experience in surgical professionalization. It distinguishes between constructive regret, which encourages self-reflection and growth, and destructive regret, which can lead to emotional withdrawal and impaired decision-making. This article also offers recommendations for how both colleagues and organizations should respond to each type of regret, especially regret over poor outcomes, to nourish professional formation.

County-level association between modifiable health behaviors and premature mortality in the United States.

Objective: Unhealthy lifestyle habits are associated with increased morbidity and mortality. This study aims to examine the county-level association of physical inactivity, insufficient sleep, and current smoking, three elements of the American Heart Association's Life's Essential 8, with premature mortality.

Methods: Premature country-level age-adjusted death rate (AADR) in 2018-2020 were obtained from National Center for Health Statistics Mortality Files.

The Effect of Thrombolysis of Deep Vein Thrombosis on Late Symptoms of Post-Pulmonary Embolism Syndrome.

In the ATTRACT trial, 691 patients were randomized to receive, or not receive, pharmacomechanical catheter-directed thrombolysis (PCDT) to treat acute proximal deep vein thrombosis (DVT). Serious adverse events and suspected PE (collectively, "late symptom events", LSEs) were reported. An independent physician, blinded to treatment allocation, categorized LSEs occurring 1-24 months post-randomization by whether they could relate to post-PE syndrome.

Time to Bystander CPR and Survival for Witnessed Out-of-Hospital Cardiac Arrest.

Background: Cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) is associated with higher survival. The association between time to bystander CPR at different time thresholds, compared with those with no bystander CPR, is less clear.

Methods: Within the Cardiac Arrest Registry to Enhance Survival, we identified 194,807 witnessed OHCAs during 2013-2023.

Interim Estimates of 2024-2025 Seasonal Influenza Vaccine Effectiveness - Four Vaccine Effectiveness Networks, United States, October 2024-February 2025.

Annual influenza vaccination is recommended for all persons aged ≥6 months in the United States. Interim influenza vaccine effectiveness (VE) was calculated among patients with acute respiratory illness-associated outpatient visits and hospitalizations from four VE networks during the 2024-25 influenza season (October 2024-February 2025). Among children and adolescents aged <18 years, VE against any influenza was 32%, 59%, and 60% in the outpatient setting in three networks, and against influenza-associated hospitalization was 63% and 78% in two networks.

Erratum to 'Cost differences between autologous and nonautologous cranioplasty implants: A propensity score-matched value driven outcomes analysis' [World Neurosurgery: X (22C) (2024) (100358)].

[This corrects the article DOI: 10.1016/j.wnsx.

Truly Attending: Cultivating Attention, Presence and Self-Awareness Through Narrative Medicine Workshops.

Narrative Medicine is an international discipline at the intersection of humanities, the arts, clinical practice and healthcare justice. This discipline aims to deepen skills of self-awareness, presence, attention and creative capacities and evokes our capacity to attend to the emotional undercurrents of narrative stories both in spoken and written form. Through group discussion and human connection of sharing stories/writing and creative exchange, we expand justice, equity, attention to self and others, and how we interact with our complex healthcare system.

Evaluating the Appropriate Use Criteria for Coronary Revascularization in Stable Ischemic Heart Disease Using Randomized Data From the ISCHEMIA Trial.

Background: The appropriate use criteria for revascularization of stable ischemic heart disease have not been evaluated using randomized data. Using data from the randomized ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches; July 2012 to January 2018, 37 countries), the health status benefits of an invasive strategy over a conservative one were examined within appropriate use criteria scenarios.

Methods: Among 1833 participants mapped to 36 appropriate use criteria scenarios, symptom status was assessed using the Seattle Angina Questionnaire-7 at 1 year for each scenario and for each of the 6 patient characteristics used to define the scenarios.