Navigating Limited Resources-Outpatient Pediatric Cholecystectomies at Rural Hospitals.

Background: Rural facilities that provide pediatric surgical services are a critical resource to local communities. Our aim was to characterize differences in outpatient pediatric cholecystectomy outcomes performed at rural and urban hospitals with the hypothesis that rural hospitals would have similar outcomes.

Methods: The Nationwide Ambulatory Surgery Sample (NASS), which contains ambulatory surgery encounters at hospital-owned facilities, was used to perform a retrospective cohort analysis of pediatric patients age 18-years and younger who had a cholecystectomy (n = 15,449) between 2016 and 2018.

Rigorous Analysis of Multimodal HDX-MS Spectra.

An inherent strength of hydrogen/deuterium exchange coupled to mass spectrometry (HDX-MS) is its ability to detect the presence of multiple conformational states of a protein, which often manifest as multimodal isotopic envelopes. However, the statistical considerations for accurate analysis of multimodal spectra have yet to be established. Here we outline an unrestrained binomial distribution fitting approach with the corresponding statistical tests to accurately detect and, when possible, deconvolute isotopic distributions that contain multiple subpopulations.

The Prevalence of Septo-Optic Dysplasia in Neonates with Absent Cavum Septi Pellucidi Identified During Routine Prenatal Imaging.

Objective: To determine the prevalence of septo-optic-dysplasia (SOD) in patients with prenatally identified absent cavum septi pellucidi (CSP), agenesis of the corpus callosum (ACC) or dysgenesis of the corpus callosum (DCC).

Study Design: This retrospective chart review investigated neonates prenatally diagnosed with an absent CSP, ACC, or DCC who were admitted to a single quaternary academic medical center in the Pacific Northwest between 2016-2023. This prenatal diagnosis prompted a routine and protocolized postnatal workup for SOD including laboratory evaluation, imaging, and specialty consultation.

The use of premedication for intubating very low birth weight infants in the neonatal intensive care unit: Results of a national survey.

Objective: To explore barriers and perspectives of premedication use for non-emergent intubations of very low birth weight (VLBW) infants (less than 1,500 g).

Study Design: A cross-sectional, online survey was distributed from January to April 2023 to members of the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine. Data was analyzed using descriptive statistics and chi-square tests.

Early prenatal but not postnatal glucocorticoid exposure is associated with enhanced HPA axis activity into adulthood in a wild primate.

The hypothalamic-pituitary-adrenal (HPA) axis plays a dual role in the biology of developmental plasticity in mammals, including humans-HPA axis activity not only provides the input for, but is also a target of, offspring developmental plasticity. To investigate the understudied effects of exposure timing, this study quantified maternal HPA axis activity during each half of gestation as well as during early lactation and assessed its effect on offspring HPA axis activity in a cross-sectional sample of infant, juvenile and adult Assamese macaques (). To add ecological validity to experimental studies under laboratory conditions, macaques were studied in the wild.

Dating the origin of a viral domestication event in parasitoid wasps attacking Diptera.

Over the course of evolution, hymenopteran parasitoids have developed a close relationship with heritable viruses, sometimes integrating viral genes into their chromosomes. For example, in parasitoids belonging to the genus, 13 viral genes from the family have been domesticated to deliver immunosuppressive factors to host immune cells, thereby protecting parasitoid offspring from the host immune response. The present study aims to comprehensively characterize this domestication event in terms of the viral genes involved, the wasp diversity affected by this event and its chronology.

Thirty-day stroke/mortality of carotid revascularization in asymptomatic patients with newly diagnosed and/or decompensated heart failure exceeds the Society for Vascular Society guideline risks.

Background: According to the latest Society for Vascular Surgery (SVS) guidelines, carotid revascularization for asymptomatic individuals should be offered if the perioperative stroke/death rate does not exceed 3%. Heart failure (HF) has been associated with reduced survival rates following carotid revascularization, which may significantly impact the risk-benefit decision of treating asymptomatic patients with HF. This study aimed to evaluate the 30-day postoperative risks in asymptomatic patients with newly diagnosed and/or decompensated HF undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS).

Closed-loop modulation of remote hippocampal representations with neurofeedback.

Humans can remember specific remote events without acting on them and influence which memories are retrieved based on internal goals. However, animal models typically present sensory cues to trigger memory retrieval and then assess retrieval based on action. Thus, it is difficult to determine whether measured neural activity patterns relate to the cue(s), the memory, or the behavior.

Training of Administrative Chief Residents: Report of The Association of Program Directors in Surgery Chief Resident Workshop.

Objective: Surgical administrative chief residents (ACRs) play essential roles in residency training programs, including resident advocates, conflict negotiators, and scheduling managers. Despite their varied and important jobs, surgical ACRs receive very little training or introduction to the role.

Design: We describe here the creation and implementation of an Administrative Chief Resident Workshop developed for the Association of Program Directors in Surgery (APDS) to familiarize chief residents with their roles in scheduling and conflict negotiation.

Making Waves: Formulation components used in agriculture may serve as important precursors for nitrogenous disinfection byproducts.

N-Nitrosamines, many of which are carcinogenic, mutagenic, and teratogenic, are disinfection byproducts (DBPs) formed from the reaction of chloramine with nitrogenous organic compounds during water disinfection. The identification of major nitrosamine precursors is important to understand and prevent nitrosamine formation. In this analysis, we propose that efforts to identify nitrosamine precursors must look beyond conventionally evaluated active agent chemicals to consider inert or inactive chemicals as potentially relevant precursors.

Innovations in intestinal organoid technology featuring an open apical surface.

Since the development of the three-dimensional (3D) "mini-gut" culture system, adult stem cell-derived organoid technology has rapidly advanced, providing in vitro models that replicate key cellular, molecular, and physiological properties of multiple organs. The 3D intestinal organoid system has resolved many long-standing challenges associated with immortalized or cancer cell cultures, offering unparalleled capabilities for modeling gastrointestinal development and diseases. However, significant limitations remain, including restricted accessibility to the epithelial apical surface for studying host-microbe interactions, interruptions in modeling chronic gastrointestinal diseases due to frequent passaging and dissociation, and the absence of mechanical cues such as peristalsis and luminal flow, which are critical for organ development and function.

Benefits of longitudinally linked national records of child maltreatment report and foster care.

Background: The Report and Placement Integrated Data System (RAPIDS) integrates two U.S. national data systems-NCANDS' child maltreatment report (CMR) records and AFCARS' foster care (FC) records-into a single longitudinal dataset spanning 2006-2021.

A Systematic Review and Meta-Analysis of Surgical Approaches for Venous Thoracic Outlet Syndrome.

Introduction: There is currently no consensus on the optimal surgical approach for the treatment of venous thoracic outlet syndrome (vTOS). Surgical exposures for vTOS decompression include infraclavicular (IC), supraclavicular (SC), paraclavicular (PC), and transaxillary (AX) approaches. The purpose of this study is to provide a comprehensive review of the outcomes and major complications of these four surgical techniques.

Audible tremor: Analysis of the validity of audible information in assessing tremor severity.

Introduction: Assessing the severity of kinetic tremor is important in clinical and research settings. Archimedes spirals are often used to assess tremor severity. Rating tremor from spirals has been based solely on visual information.

A Systematic Approach to Prioritise Diagnostically Useful Findings for Inclusion in Electronic Health Records as Discrete Data to Improve Clinical Artificial Intelligence Tools and Genomic Research.

Aims: The recent widespread use of electronic health records (EHRs) has opened the possibility for innumerable artificial intelligence (AI) tools to aid in genomics, phenomics, and other research, as well as disease prevention, diagnosis, and therapy. Unfortunately, much of the data contained in EHRs are not optimally structured for even the most sophisticated AI approaches. There are very few published efforts investigating methods for recording discrete data in EHRs that would not slow current clinical workflows or ways to prioritise patient characteristics worth recording.

Navigating vaccine confidence: A mixed methods study investigating healthcare providers' perspectives across four non-EU European regions.

Background: Vaccine confidence remains a global public health challenge, especially highlighted during the COVID-19 pandemic. Public trust in vaccines is crucial, with healthcare providers (HCPs) playing a pivotal role in navigating this sensitive topic. This requires an understanding of HCPs' perceptions of vaccines.

Navigating payment and policy barriers to gender-affirming care for transmasculine individuals: A qualitative study and policy assessment.

Over the past decade, access to and insurance coverage for gender-affirming medical and surgical treatment for transgender (trans) individuals in the U.S. has improved.

Not all uterine carcinosarcomas are created equal: Survival outcomes according to molecular characterization of uterine carcinosarcoma.

Objectives: To assess if ProMisE classifier molecular subtypes are associated with differing survival outcomes in uterine carcinosarcoma (UCS) and compare these outcomes to endometrioid endometrial cancer (EEC) tumors.

Methods: There were 2235 UCS and 6469 EEC tumors using next-generation sequencing of DNA, whole exome sequencing, and RNA. Microsatellite instability (MSI) was tested by IHC and NGS.

Chronic inflammation in a radium dial painter cohort: elevated neutrophil to lymphocyte ratio and radiation-induced hearing loss.

The radium dial painters (RDP) are a well-described group of predominantly young women who incidentally ingested 226Ra and 228Ra as they painted luminescent watch dials in the first part of the twentieth century. In 1974 pathologist Dr. William D.

Letetresgene Autoleucel in Advanced/Metastatic Myxoid/Round Cell Liposarcoma.

Purpose: The cancer/testis antigen New York esophageal squamous cell carcinoma 1 (NY-ESO-1) is a promising target in myxoid/round cell liposarcoma (MRCLS).

Methods: In this pilot study, we assessed the adoptive T-cell therapy NY-ESO-1cT letetresgene autoleucel (lete-cel) in patients with human leukocyte antigen (HLA)-A*02:01-, HLA-A*02:05-, and/or HLA-A*02:06-positive advanced/metastatic NY-ESO-1-expressing MRCLS. Patients underwent a reduced-dose (cohort 1) or standard-dose (cohort 2) lymphodepletion regimen (LDR).

Multi-Institutional Analysis of Surgery for Lichen Sclerosus Induced Penile Urethral Stricture: Establishing Single-Stage Urethroplasty as a Primary Treatment Option.

Introduction: Ideal treatment of lichen sclerosus (LS) induced penile urethral strictures (PUS) remains elusive. The objective of this study is to compare multi-institutional outcomes of single-stage urethroplasty (SSU) with oral mucosal graft (OMG), staged urethroplasty and perineal urethrostomy (PU) for treatment of LS induced PUS.

Methods: Multi-institutional analysis was performed at 9 centers on males undergoing SSU, staged urethroplasty or PU for LS induced PUS.

Bypassing senescence.

A metabolic switch enables hepatocytes in damaged livers to escape senescence and form tumors.

Quantum Dot Erythropoietin Bioconjugates Enhance EPO-Receptor Clustering on Transfected Human Embryonic Kidney Cells.

Erythropoietin (EPO)-induced cellular signaling through the EPO receptor (EPOR) is a fundamental pathway for the modulation of cellular behavior and activity. In our previous work, we showed in primary human astrocytes that the multivalent display of EPO on the surface of semiconductor quantum dots (QDs) mediates augmented JAK/STAT signaling, a concomitant 1.8-fold increase in the expression of aquaporin-4 (AQPN-4) channel proteins, and a 2-fold increase in the AQPN-4-mediated water transport activity.