AI-based analysis of fetal growth restriction in a prospective obstetric cohort quantifies compound risks for perinatal morbidity and mortality and identifies previously unrecognized high risk clinical scenarios.

Background: Fetal growth restriction (FGR) is a leading risk factor for stillbirth, yet the diagnosis of FGR confers considerable prognostic uncertainty, as most infants with FGR do not experience any morbidity. Our objective was to use data from a large, deeply phenotyped observational obstetric cohort to develop a probabilistic graphical model (PGM), a type of "explainable artificial intelligence (AI)", as a potential framework to better understand how interrelated variables contribute to perinatal morbidity risk in FGR.

Methods: Using data from 9,558 pregnancies delivered at ≥ 20 weeks with available outcome data, we derived and validated a PGM using randomly selected sub-cohorts of 80% (n = 7645) and 20% (n = 1,912), respectively, to discriminate cases of FGR resulting in composite perinatal morbidity from those that did not.

Increased serum GM-CSF at diagnosis of biliary atresia is associated with improved biliary drainage.

Background: The immune heterogeneity of biliary atresia (BA) presents a challenge for development of prognostic biomarkers. This study aimed to identify early immune signatures associated with biliary drainage after Kasai Portoenterostomy (KPE).

Methods: Serum samples, liver slides, and clinical data were obtained from patients enrolled in the NIDDK-supported Childhood Liver Disease Research Network.

Fabrication of heteroatom-doped graphene-porous organic polymer hybrid materials via femtosecond laser writing and their application in VOCs sensing.

Graphene, a two-dimensional material featuring densely packed sp-hybridized carbon atoms arranged in a honeycomb lattice, has revolutionized material science. Laser-induced graphene (LIG) represents a breakthrough method for producing graphene from both commercial and natural precursors via direct laser writing, offering advantages such as simplicity, efficiency, and cost-effectiveness. This study demonstrates a novel approach to synthesize a composite material exclusively from a porous organic polymer (POP) by direct femtosecond laser writing on a compressed imide-linked porous organic polymer substrate.

Posterior urethral valves: Examining the relationship of socioeconomic factors in disease presentation and progression.

Introduction: A significant portion of posterior urethral valve patients continue to progress to end stage renal disease despite improvements in medical care. Socioeconomic status has been connected to various healthcare outcomes but has not been evaluated in relation to longitudinal outcomes of posterior urethral valves.

Objective: To evaluate the effect of socioeconomic status on the progression to renal failure among patients with posterior urethral valves.

Using augmented reality to deliver cue exposure treatment for smoking cessation: App usability findings and protocol for a randomized controlled trial.

Background: Augmented Reality (AR) is a rapidly developing technology with potential utility for treating addictive behaviors, including tobacco smoking. AR inserts digital images into a natural real-time scene as viewed on a smartphone or other video devices. With respect to smoking cessation, AR can place virtual smoking cues (i.

Non-atherosclerotic coronary causes of myocardial infarction in women.

Ischemic heart disease is the most common cardiovascular cause of death in women worldwide. Obstructive coronary atherosclerosis is the primary cause of myocardial infarction (MI), however, non-atherosclerotic mechanisms of MI, such as spontaneous coronary artery dissection, vasospasm, microvascular dysfunction, embolization, inflammation, coronary anomalies, infectious and infiltrative causes are increasingly being recognized. Emerging data suggest that women are two to five times more likely to have an MI in the absence of coronary atherosclerosis compared to men, but they continue to remain underdiagnosed and undertreated, partly due to underdiagnosis and limited understanding of these mechanisms.

Without Known Cause: Contextualizing the Body.

The author describes her personal experience with a cardiac diagnosis to demonstrate how wellness disparities are often rooted in historical constructions of "ideal" physical presentation that are both racialized and gendered. Her experiential analysis contends that failure to contextualize patients and divorce them from these historically problematic constructions is used to justify their profound disability and death.

Outpatient Total Knee Arthroplasty Has Become More Frequent Since the Onset of the COVID-19 Pandemic Without an Increase in Early Post-Operative Complications.

Introduction: Outpatient total knee arthroplasty (TKA) has quickly grown in popularity, largely driven by policy shifts and the recent coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to compare 30-day complications between outpatient TKA (oTKA) versus inpatient TKA (iTKA) before and after the COVID-19 pandemic to elucidate the effect of the pandemic on utilization and short-term outcomes.

Methods: Patients who underwent primary TKA between 2008 and 2021 were identified through Current Procedural Terminology codes in a national database.

Sequence variants in HECTD1 result in a variable neurodevelopmental disorder.

Dysregulation of genes encoding the homologous to E6AP C-terminus (HECT) E3 ubiquitin ligases has been linked to cancer and structural birth defects. One member of this family, the HECT-domain-containing protein 1 (HECTD1), mediates developmental pathways, including cell signaling, gene expression, and embryogenesis. Through GeneMatcher, we identified 14 unrelated individuals with 15 different variants in HECTD1 (10 missense, 3 frameshift, 1 nonsense, and 1 splicing variant) with neurodevelopmental disorders (NDDs), including autism, attention-deficit/hyperactivity disorder, and epilepsy.

Extracellular volume expansion drives vertebrate axis elongation.

The vertebrate bauplan is primarily established via the formation of embryonic tissues in a head-to-tail progression. The mechanics of this elongation, which requires the presomitic mesoderm (PSM), remain poorly understood. Here, we find that avian PSM explants can elongate autonomously when physically confined in vitro, producing a pushing force promoting posterior elongation of the embryo.

Development of a predictive model for pediatric intranasal drug delivery with nasal sprays: Leveraging intersubject variability in anatomical dimensions, administration-related parameters, and airway patency.

In this study, we examined the correlation between anatomical dimensions, spray administration parameters, pressure drop across 40 pediatric nasal cavities, and in vitro posterior drug delivery (PDD) using Nasacort ALLERGY 24HR and FLONASE SENSIMIST nasal suspensions sprays, with different nozzle and actuation designs. The importance of each parameter and their interaction in the outcome (PDD) was evaluated. To do so, initially we measured anatomical and administration-related parameters, and the pressure drop of each cavity.

An In-Depth Analysis of the State Laws That License International Medical Graduates Without American Residency Training.

International medical graduates (IMGs) have been integral to the United States (US) healthcare system and have helped tackle physician shortages for over a century. Current data suggest that by 2030, almost half the states will suffer from physician shortage and estimate a deficit of almost 139,000 physician jobs nationally. These numbers raise concern and call for innovative strategies to mitigate the potential problem.

Safety and Efficacy of Fingolimod and Ocrelizumab in Pediatric Patients With Multiple Sclerosis.

Background: Fingolimod and ocrelizumab are approved treatments for adults with multiple sclerosis (MS); however, only fingolimod is approved by the Food and Drug Administration for the treatment of pediatric MS. Currently, there are limited data for the safety and efficacy of ocrelizumab use in children.

Methods: This retrospective cohort study included patients with relapsing-remitting MS who started either ocrelizumab or fingolimod before age 18 years.

A family-based behavioral group obesity randomized control feasibility trial across a clinical trials network: a focus on contact hours.

Objective: This ancillary study's purpose is to describe the relationship between dose of treatment and body mass index (BMI) outcomes in a tele-behavioral health program delivered in the IDeA States Pediatric Clinical Trials Network to children and their families living in rural communities.

Methods: Participants randomized to the intervention were able to receive 26 contact hours (15 hr of group sessions and 11 hr of individual sessions) of material focused on nutrition, physical activity, and behavioral caregiver training delivered via interactive televideo. Dose of the intervention received by child/caregiver dyads (n = 52) from rural areas was measured as contact hours.

New PPARα Agonist A190-Loaded Microemulsion for Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a serious side effect of anticancer agents with limited effective preventive or therapeutic interventions. Although fenofibrate, a peroxisome proliferator-activated receptor-alpha (PPARα) agonist, has demonstrated neuroprotective and analgesic properties, its clinical utility is hindered by low receptor affinity, poor subtype selectivity, and suboptimal bioavailability. A190, a highly selective and potent nonfibrate PPARα agonist, offers a promising alternative but is limited by poor aqueous solubility, resulting in reduced oral bioavailability and therapeutic efficacy.

Program Director Perspectives on DEI Initiatives in the Dermatology Residency Selection Process.

The American Academy of Dermatology (AAD) has maintained a commitment to diversity, equity, and inclusion (DEI) initiatives; however, a recent strike down of affirmative action by the US Supreme Court has caused similar efforts to be called into question. This prompted our investigation into dermatology program director (PD) perceptions of DEI programming and its integration into resident selection. A cross-sectional survey of PDs at US dermatology residency programs was conducted from April 2024 to July 2024 (N=30).

Upper Limit on the Photoproduction Cross Section of the Spin-Exotic π_{1}(1600).

The spin-exotic hybrid meson π_{1}(1600) is predicted to have a large decay rate to the ωππ final state. Using 76.6  pb^{-1} of data collected with the GlueX detector, we measure the cross sections for the reactions γp→ωπ^{+}π^{-}p, γp→ωπ^{0}π^{0}p, and γp→ωπ^{-}π^{0}Δ^{++} in the range E_{γ}=8-10  GeV.

Heavy Neutral Leptons via Axionlike Particles at Neutrino Facilities.

Heavy neutral leptons (HNLs) are often among the hypothetical ingredients behind nonzero neutrino masses. If sufficiently light, they can be produced and detected in fixed-target-like experiments. We show that if the HNLs belong to a richer-but rather generic-dark sector, their production mechanism can deviate dramatically from expectations associated with the standard-model weak interactions.

A Commitment to Gender Equity in Medicine: An American Medical Women's Association Position Paper.

The American Medical Women's Association (AMWA) highlights the ongoing gender inequities in the medical profession, particularly in pay, leadership roles, workplace treatment, and work-life integration. To present evidence of gender disparities in medicine, analyze their root causes, and propose strategies for fostering a more equitable and inclusive environment. Despite progress, women physicians continue to face significant disparities, including lower salaries, underrepresentation in leadership roles, and discrimination.

Laterality and performance in elite male golfers.

Human beings display laterilised behaviour. In sport, including golf, players adopt a right- or left-handed stance. There may be advantages in going against convention in the position of the dominant hand relative to golf stance.

Craniofacial modularity and the evolution of cranial kinesis in the adaptive radiation of Furnariidae (Aves: Passeriformes).

The role of phenotypic modularity in the evolution of skull morphology in birds has been a subject of debate in recent years. Furnariids (ovenbirds and woodcreepers), a spectacular avian adaptive radiation, are distinguished in their cranial morphology as the only passerines with two types of cranial kinesis, constituting a great model to test whether the evolution of novelties linked to kinesis was associated with shifts in patterns of evolutionary modularity and allometry in the avian skull. Our analyses by means of geometric morphometric tools and phylogenetic comparative methods show that the beak and neurocranium of furnariids evolved in a modular fashion and shaped by the cranial kinesis evolution.