Sound waves of progress: advancing endoscopic ultrasound in pediatric gastroenterology.

Introduction: A substantial body of research validates the application of endoscopic ultrasound in adults in the management of biliary and pancreatic conditions. There is limited data regarding its impact on children, although its use has steadily increased over the years. This study aims to assess long-term data on indications, efficacy and safety of endoscopic ultrasound in pediatric patients.

Footshock stress enhances morphine-induced reward but attenuates aversion in behavior and neural mechanisms.

The impact of stress on the behaviors and neural substrates underlying opioid use disorder (OUD) remains unclear. To investigate this, we employed a footshock treatment before the pre- and post-conditioning procedures for conditioned taste aversion (CTA) and conditioned place preference (CPP) with morphine injections. In the experiment, all rats were subjected to 10-second footshock (3 mA) or no footshock treatments.

Stem Cell-Derived Corneal Epithelium: Engineering Barrier Function for Ocular Surface Repair.

The cornea, the transparent anterior window of the eye, critically refracts light and protects intraocular structures. Corneal pathologies, including trauma, infection, chemical injury, metabolic diseases, genetic conditions, and age-related degeneration, can lead to significant visual impairment. While penetrating keratoplasty or full-thickness corneal transplantation remains a standard and effective intervention for severe corneal dysfunction, limitations in donor tissue availability and the risk of immunogenic graft rejection necessitate alternative therapeutic strategies.

nf-UnO pipeline: A metagenomic co-assembly pipeline for novel pathogen detection from mNGS outbreak sets.

Summary: nf-UnO is a pipeline implemented in Nextflow to identify novel pathogens from metagenomic shotgun sequencing of epidemiologically related foodborne outbreak specimens. nf-UnO uses MIDAS2, metagenomic co-assembly, multiple binning programs, and read mapping to metagenomically assembled genomes to detect potential etiological agents found in common across outbreak specimens.

Availability And Implementation: https://github.

Diagnostic utility of an automated fundus-OCT camera in the emergency department: a retrospective review.

Background: Posterior segment pathology can be challenging to diagnose and may lead to irreversible vision loss. Ocular imaging modalities are limited in the emergency department (ED) where many posterior segment emergencies present. Automated fundus-OCT cameras are emerging as a rapid, user-friendly and cost-effective tool in the ED.

A Cost-Effectiveness Analysis of Rivaroxaban Compared to Warfarin for the Management of Venous Thromboembolism in Western Kenya.

Background And Objective: Access to direct oral anticoagulants (DOACs) in sub-Saharan Africa is limited due to prohibitive upfront costs, making warfarin the standard of care for many patients, especially those relying on public-sector healthcare. This study evaluated the cost-effectiveness of using the DOAC, rivaroxaban, compared to warfarin for treating venous thromboembolism (VTE), a cardiovascular disorder caused by blood clots in the veins, in western Kenya.

Methods: We developed a discrete-time individual state-transition Markov model to simulate a VTE patient's quality-adjusted life-years (QALYs) and annual treatment costs under a rivaroxaban or warfarin therapy strategy.

Understanding the risks of abdominal aortic endograft explantation with early outcomes from two decades of experience.

Objective: Endovascular aneurysm repair (EVAR) currently comprises more than two-thirds of all abdominal aortic aneurysm repairs in the United States. However, data show that patients are at higher risk for late mortality after EVAR compared with open repair. As the number of aging EVARs grow, so, too, does the number requiring explant.

Simulation Models for Bladder Cancer: A Scoping Review.

Objectives: The study identifies and summarizes information from manuscripts using simulation models for Bladder Cancer (BCA) research.

Methods: We conducted and presented results of a systematic literature search of Medline, Web of Science, and Google scholar, following the PRISMA guidelines for scoping reviews. We summarized extracted key components of the methodology, data sources, and software used for the development of simulation models and classify eligible articles in terms of the study objectives and conclusions.

Analysis of Anxiety Disorders and Post-Traumatic Stress Disorders for Screening Anxiolytic Drugs and Linking Preclinical and Clinical Research.

How to determine suitable animal models of anxiety disorders and post-traumatic stress disorders (PTSD) for screening anxiolytic drugs and linking preclinical and clinical research is a crucial issue. This review paper provides background knowledge and critical determination to the animal models for discussing this issue. Moreover, this article analyzes the characteristics, properties, advantages, and disadvantages of various animal models of anxiety disorders and PTSD.

Case Report: Contralateral Progression of a Vestibular Schwannoma After Resection in a Patient with Neurofibromatosis Type 2.

Background And Importance: Bilateral vestibular schwannomas (VS) are a distinctive feature of neurofibromatosis type 2 (NF2) that result in a serious reduction in the quality of life for patients. The growth rates of these schwannomas are variable, and the early detection of increased growth is fundamental for improving outcomes.

Clinical Presentation: A 17-year-old man with NF2 and bilateral VS presented with complete right facial paralysis and sudden right hearing loss less than 1 month after resection of a left VS.

Effect of emergency department opioid prescribing on health outcomes.

Background: The relation between emergency department opioid prescribing and subsequent harm is complex and poorly studied. We sought to quantify adverse outcomes, incremental risk, and rates of prolonged opioid use among emergency department patients receiving an opioid prescription and propensity-matched controls.

Methods: We used administrative data to sample all Alberta emergency department visits over 10 years, excluding patients with cancer, palliative care, or concurrent opioid use.

NMDA-induced lesions of the nucleus accumbens core increase the innately rewarding saccharin solution intake and methamphetamine-induced conditioned place preference but not conditioned taste aversion in rats.

The role of the nucleus accumbens (NAc) core in determining the valence of innately rewarding saccharin solution intake, methamphetamine (MAMPH)-induced conditioned taste aversion (CTA), and conditioned place preference (CPP) reward remains unclear. The present study utilized the "pre- and post-association" experimental paradigm (2010) to test whether the rewarding and aversive properties of MAMPH can be modulated by an N-methyl-D-aspartic acid (NMDA) lesion in the NAc core. Moreover, it tested how an NAc core NMDA lesion affected the innate reward of saccharin solution intake.

Understanding Barriers to Hepatitis C Antiviral Treatment in Low-Middle-Income Countries.

: Direct-acting antiviral agents (DAAs) have significantly reduced Hepatitis C Virus (HCV) transmission and improved health outcomes since their FDA approval in 2011. Despite these advances, over 70 million people remain untreated globally, with a disproportionately high burden in low- and middle-income countries (LMICs). : Through a structured search of open access informational sources and an informal peer-reviewed literature review, HCV treatment barriers were identified, compiled, and analyzed.

Alterations in Striatal Architecture and Biochemical Markers' Levels During Postnatal Development in the Rat Model of an Attention Deficit/Hyperactivity Disorder (ADHD).

Attention deficit/hyperactivity disorder (ADHD) is defined as a neurodevelopmental condition. The precise underlying mechanisms remain incompletely elucidated. A body of research suggests disruptions in both the cellular architecture and neuronal function within the brain regions of individuals with ADHD, coupled with disturbances in the biochemical parameters.

The Impact of the COVID-19 Public Health Crisis on the Surgical Management of Abdominal Aortic Aneurysm Rupture.

Background: The COVID-19 epidemic introduced significant systems- and disease-based uncertainty into Abdominal Aortic Aneurysm (AAA) rupture management. The goal of this work was to evaluate whether short-term AAA rupture outcomes during COVID-19 were comparable to pre-COVID era outcomes and to explore the impact of COVID status and COVID era health-care systems restrictions on AAA rupture outcomes.

Methods: The Vascular Quality Initiative database was queried for all ruptured AAAs that underwent intervention from January 1, 2019, to August 31, 2022.

A Case of MIRAGE Syndrome with Mutation and Refractory Infantile Diarrhea: Endoscopic Biopsy Evaluation via Light and Electron Microscopy.

An infant with intrauterine growth restriction, suspected of having MIRAGE syndrome based on prenatal ultrasound, presented with genital ambiguity, adrenal insufficiency, intractable diarrhea from birth, and a pathogenic mutation (). Endoscopic biopsies of the duodenum revealed complex light and electron microscopic abnormalities. Hypoplastic villi without signs of enteritis suggests a disorder of mucosal growth with reduced absorptive surface area contributes to intractable diarrhea.

Dysregulation of neuropilin-2 expression in inhibitory neurons impairs hippocampal circuit development and enhances risk for autism-related behaviors and seizures.

Dysregulation of development, migration, and function of interneurons, collectively termed interneuronopathies, have been proposed as a shared mechanism for autism spectrum disorders (ASDs) and childhood epilepsy. Neuropilin-2 (Nrp2), a candidate ASD gene, is a critical regulator of interneuron migration from the median ganglionic eminence (MGE) to the pallium, including the hippocampus. While clinical studies have identified Nrp2 polymorphisms in patients with ASD, whether selective dysregulation of Nrp2-dependent interneuron migration contributes to pathogenesis of ASD and enhances the risk for seizures has not been evaluated.

Deletion of Fgfr2 in Ductal Basal Epithelium With Tamoxifen Induces Obstructive Meibomian Gland Dysfunction.

Purpose: Fibroblast growth factor receptor 2 (Fgfr2) is crucial for the homeostasis of meibomian gland (MG). However, the role of Fgfr2 in MG ductal epithelial progenitors remains to be delineated. Herein, we created a new transgenic mouse model with conditional deletion of Fgfr2 from MG ductal progenitors and investigated the cell-specific role in the pathogenesis of obstructive meibomian gland dysfunction.

A Cricopharyngeal Bar as an Underrecognized Finding in an Adolescent with Eosinophilic Esophagitis.

A 16-year-old Caucasian male with previously diagnosed eosinophilic esophagitis (EoE) 4 years before his initial visit to an allergist-immunologist, scheduled due to severe dysphagia and recurrent food impaction. He had been off EoE therapy for 1 year. After resuming inhaled fluticasone and a proton pump inhibitor (PPI), esophagogastroduodenoscopy (EGD) was immediately scheduled.

Over-the-scope clip for closure of persistent gastrocutaneous fistula after gastrostomy tube removal: a multicenter pediatric experience.

Background: Percutaneous endoscopic gastrostomy is commonly used for enteral nutritional access, but gastrocutaneous fistulae (GCF) may persist after tube removal, posing clinical challenges. The use of endoscopic closure devices, including over-the-scope clips (OTSC), has shown promise in managing non-healing fistulae, although data in the pediatric population are limited.

Methods: A retrospective multicenter study analyzed pediatric patients who underwent GCF closure following gastrostomy tube removal.

Navigating Neurologic Illness: Skills in Neuropalliative Care for Persons Hospitalized with Neurologic Disease.

Persons hospitalized for neurologic illness face multidimensional care needs. They can benefit from a palliative care approach that focuses on quality of life for persons with serious illness. We describe neurology provider "skills" to help meet these palliative needs: assessing the patient as a whole; facilitating conversations with patients to connect prognosis to care preferences; navigating neurologic illness to prepare patients and care partners for the future; providing high-quality end-of-life care to promote peace in death; and addressing disparities in care delivery.