Penile Reconstruction in Aphallia: Modification of the De Castro Technique With Large Tissue Expander.

Aphallia is an exceedingly rare congenital malformation. The condition is the result of a sporadic anatomic anomaly during fetal development in a 46, XY male patient with otherwise normal functioning testes and male sexual hormone metabolism. Neophallus reconstruction using the De Castro phalloplasty technique is currently the most accepted treatment modality for this condition.

Minimally Invasive Surgery Deserts: Is There a Role for Robotic Assisted Surgery?

Despite evidence indicating patient and hospital benefits of minimally invasive surgery (MIS) over open surgery, there is still access barriers to MIS. Availability of training and associated learning curve, health literacy, and hospital characteristics (location, size) have been identified as the primary barriers to the adoption of MIS. Robotic assisted surgery could help to overcome some of these barriers and increase access to MIS through easier tele-mentoring and potential for remote access.

Transdisciplinary perspectives for health systems science.

Health systems science uses systems thinking as part of a transdisciplinary approach that transcends traditional disciplinary boundaries. It integrates and synthesizes knowledge from multiple disciplines to address real-world problems in healthcare with pragmatic solutions. This editorial defines health systems from the perspectives of systems thinking, science, and engineering, discusses their current challenges and opportunities, and envisions how health systems science as a field can advance the continuous learning and improvement of health systems.

Carbonless DNA.

Carbonless DNA was designed by replacing all carbon atoms in the standard DNA building blocks with boron and nitrogen, ensuring isoelectronicity. Electronic structure quantum chemistry methods (DFT(ωB97XD)/aug-cc-pVDZ) were employed to study both the individual building blocks and the larger carbon-free DNA fragments. The reliability of the results was validated by comparing selected structures and binding energies using more accurate methods such as MP2, CCSD, and SAPT2+3(CCD)δ.

Beyond the baseline: Quantification of two Phosphatidylethanol (PEth) homologues in Whole Blood by LC-MS/MS and Retrospective Data Analysis from a National Reference Laboratory.

Unlabelled: Background - Alcohol is the most abused substance in Western society, resulting in major economic losses and negative health consequences. Therefore, there is a need for a selective and robust detection method for alcohol consumption in various clinical and forensic settings. This study aimed to validate a mass spectrometry method for quantifying phosphatidylethanol (PEth) and perform retrospective data analysis from the patient population of a national reference laboratory.

Nanomechanical Characterization of an Antiferromagnetic Topological Insulator.

The antiferromagnetic topological insulator MnBiTe (MBT) exhibits an ideal platform for investigating unique topological and magnetic properties. While the transport characteristics of magnetic phase transitions in the MBT materials have been extensively studied, the understanding of their mechanical properties and magneto-mechanical coupling remains limited. Here, we utilize nanoelectromechanical systems to probe the intrinsic magnetism in MBT thin flakes through magnetostrictive coupling.

A registry-based approach for estimating county-level race disparities in breast cancer mortality: an analysis in Georgia.

Despite similar incidence rates, nationwide breast cancer mortality is 40% higher among non-Hispanic Black (NHB) than non-Hispanic White (NHW) women. The racial disparity persists even among women with early-stage disease, prognostically favorable subtypes, and indicators of high socioeconomic status and is not evenly distributed throughout the US. Understanding geographic differences may provide additional insight into the drivers of the disparity.

Associations of fire smoke and other pollutants with incident rheumatoid arthritis and rheumatoid arthritis-associated interstitial lung disease.

Objective: Determine whether pollutants such as fire smoke-related particulate matter smaller than 2.5 microns (PM) are associated with incident rheumatoid arthritis (RA) and RA-associated interstitial lung disease (RA-ILD).

Methods: This case-control study used Veterans Affairs data 10/1/2009-12/31/2018.

Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics.

Objective: To identify patient and provider factors associated with lower rates of follow-up for positive depression screens in outpatient settings.

Design: Retrospective cohort study with electronic health record analysis investigating factors associated with follow-up care for patients with moderate-to-severe depressive symptoms. Patient and provider variables were associated with rates of follow-up for positive depression screens.

First-in-human phase I trial of the bispecific CD47 inhibitor and CD40 agonist Fc-fusion protein, SL-172154 in patients with platinum-resistant ovarian cancer.

Background: SL-172154 is a hexameric fusion protein adjoining the extracellular domain of SIRPα to the extracellular domain of CD40L via an inert IgG-derived Fc domain. In preclinical studies, a murine equivalent SIRPα-Fc-CD40L fusion protein provided superior antitumor immunity in comparison to CD47- and CD40-targeted antibodies. A first-in-human phase I trial of SL-172154 was conducted in patients with platinum-resistant ovarian cancer.

An 18-Year Review of Hemoglobinopathy Proficiency Testing: Recommendations From the College of American Pathologists Hematology and Clinical Microscopy Committee.

Context.—: The College of American Pathologists Hematology and Clinical Microscopy Committee implemented a hemoglobinopathy proficiency testing and education program to monitor and assess the performance of participating laboratories.

Objective.

Doing Less Later: Seniorization of General Surgery Resident Operative Experience in the Entrustable Professional Activities at Veterans Affairs Hospitals.

Objective: Identify changes in general surgery resident autonomy and resident postgraduate year (PGY) level in Entrustable Professional Activity (EPA) cases over time.

Design: Retrospective cohort study.

Setting: United States Veterans Affairs (VA) hospital system, 2004 to 2020.

Association of Palliative Care Timing with End-of-Life Quality in Children with Heart Disease.

Context: Children with heart disease are at risk for early mortality and parents often perceive suffering at end-of-life (EOL). Involvement of pediatric palliative care (PPC) is a proposed quality measure at the EOL in children with cancer, and early PPC involvement is associated with other quality measures. The impact of early PPC involvement on EOL quality is unknown in children with heart disease.

Human α10 nicotinic acetylcholine receptor subunits assemble to form functional receptors.

Nicotinic acetylcholine receptors (nAChRs) are pentameric ligand-gated ion channels. In mammals, there are 16 individual nAChR subunits allowing for numerous possible heteromeric compositions. nAChRs assembled from α7 or α9 subunits will form as homopentamers.

Clinical Outcomes With Immune Checkpoint Inhibitors in Patients With FGFR2/3, MTAP or ERBB2 Genomic Alterations in Advanced Urothelial Carcinoma.

Background: FGFR2/3, MTAP and ERBB2 genomic alterations have treatment targets in advanced urothelial carcinoma (aUC). These alterations may affect tumor microenvironment and outcomes with immune checkpoint inhibitors (ICIs) in aUC.

Patients And Methods: We identified patients with available genomic data in our multi-institution cohort of patients with aUC treated with ICI.

Synthetic rational design of live-attenuated Zika viruses based on a computational model.

Many viruses of the Flaviviridae family, including the Zika virus (ZIKV), are human pathogens of significant public health concerns. Despite extensive research, there are currently no approved vaccines available for ZIKV and specifically no live-attenuated Zika vaccine. In this current study, we suggest a novel computational algorithm for generating live-attenuated vaccines via the introduction of silent mutation into regions that undergo selection for strong or weak local RNA folding or into regions that exhibit medium levels of sequence conservation.

"Listening to understand," exploring postpartum women's perceptions of their social networks and social support in relation to their health behaviors and weight: A qualitative exploratory study.

Background: Postpartum is a critical period to interrupt weight gain across the lifespan, decrease weight-related risk in future pregnancies, promote healthy behaviors that are often adopted during pregnancy, and improve long-term health. Because the postpartum period is marked by unique challenges to a person's ability to prioritize healthy behaviors, a multi-level/domain approach to intervention beyond the individual-level factors of diet and activity is needed.

Objectives: The purpose of this study was to understand postpartum people's perceptions about the relationship between their social networks and support, and their health behaviors and weight.

Injectable Estradiol Use in Transgender and Gender-Diverse Individuals in the U.S.: A Multicenter Retrospective Study.

Context: Guidelines for use of injectable estradiol esters (valerate [EV] and cypionate [EC]) among transgender and gender diverse (TGD) individuals designated male at birth vary considerably, with many providers noting supraphysiologic serum estradiol concentrations based on current dosing recommendations.

Objectives: 1. Determine dose of injectable estradiol (subcutaneous [SC] and intramuscular [IM]) needed to reach guideline-recommended estradiol concentrations for TGD adults using EC/EV.

Aggressive Digital Papillary Adenocarcinoma: A Meta-Analysis of the Presentation, Treatment, and Outcomes of a Rare Hand Tumor.

Background: Aggressive digital papillary adenocarcinoma (ADPA) is a rare skin adnexal tumor with a predilection for the hand. The presentation, treatment, and outcomes of ADPA remain poorly defined due to the scarcity of reports and low-level evidence of published findings.

Methods: We performed a meta-analysis following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines with the intent to provide hand surgeons a better understanding of the diagnosis and treatment of the disease.