Outpatient and Inpatient Management of Infants and Children With Eczema Herpeticum Diagnosed in the Emergency Department.

Background: There are no universally established guidelines for when pediatric EH warrants hospitalization or intravenous (IV) acyclovir over oral therapy. To address this lack of consensus, this study aimed to describe outcomes of outpatient oral acyclovir treatment in pediatric EH cases, including rates of disease exacerbation, hospitalizations, and complications.

Methods: We conducted a retrospective cohort review of pediatric patients under age 7 diagnosed with EH who presented to the pediatric emergency department (ED) between January 1, 2008, and December 31, 2022.

Phylogenetic Placement of Aligned Genomes and Metagenomes With Non-Tree-Like Evolutionary Histories.

Phylogenetic placement is the computational task that places a query taxon into a reference phylogeny by analyzing biomolecular sequences or other evolutionary characters. A chief advantage of phylogenetic placement over traditional phylogenetic reconstruction is computational scalability, and the former has many applications in phylogenetics and beyond. Existing phylogenetic placement methods share the common simplifying assumption that a phylogenetic tree suffices for modeling evolutionary history.

The Impact of Species Tree Estimation Error on Cophylogenetic Reconstruction.

Just as a phylogeny encodes the evolutionary relationships among a group of organisms, a cophylogeny represents the coevolutionary relationships among symbiotic partners. Both are primarily reconstructed using computational analysis of biomolecular sequence data. The most widely used cophylogenetic reconstruction methods utilize an important simplifying assumption: species phylogenies for each set of coevolved taxa are required as input and assumed to be correct.

From Human to Mouse and Back: Genetic and Genomic Ta(i)les of Islet Dysfunction in Type 2 Diabetes.

Type 2 diabetes (T2D) is a complex genetic disease with substantial environmental inputs leading to glucose homeostasis defects. Insulin production is central to proper glucose control, and islet cell dysfunction and death lie at the nexus of T2D genetics and pathophysiology. Comprehensive identification of genes and pathways contributing to these processes is essential for mechanistic understanding and therapeutic targeting.

Spin and reporting bias in the use of platelet-rich plasma for the treatment of knee osteoarthritis.

Introduction: Systematic reviews and meta-analyses evaluating platelet-rich plasma (PRP) injections are vulnerable to spin (i.e., misrepresentation of study findings).

Zero-Shot Extraction of Seizure Outcomes from Clinical Notes Using Generative Pretrained Transformers.

Unlabelled: Emerging evidence has shown that pre-trained encoder transformer models can extract information from unstructured clinic note text but require manual annotation for supervised fine-tuning. Large, Generative Pre-trained Transformer (GPT) models may streamline this process. In this study, we explore GPTs in zero- and few-shot learning scenarios to analyze clinical health records.

Dexamethasone has a synergistic effect on liposomal bupivacaine in reducing postoperative pain after total shoulder arthroplasty.

Background: Multimodal approaches to address postoperative pain after total shoulder arthroplasty (TSA) are becoming the standard of care. The combined use of dexamethasone and liposomal bupivacaine (LB) may be an effective method to enhance analgesia. We assess if the addition of dexamethasone to TSA patients receiving LB results in reduced opiate needs and shorter length of stay.

Longitudinal Risk Prediction for Pediatric Glioma with Temporal Deep Learning.

Background: Pediatric glioma recurrence can cause morbidity and mortality; however, recurrence patterns and severity are heterogeneous and challenging to predict with established clinical and genomic markers. As a result, almost all children undergo frequent, long-term, magnetic resonance imaging (MRI) brain surveillance regardless of individual recurrence risk. Longitudinal deep-learning analysis of serial MRI scans may be an effective approach for improving individualized recurrence prediction in gliomas and other cancers, but, thus far, progress has been limited by data availability and current machine-learning approaches.

The Effects of GLP-1 Agonists on Musculoskeletal Health and Orthopedic Care.

Purpose Of Review: The global rise in obesity and type 2 diabetes mellitus (T2DM) presents significant challenges in musculoskeletal care, contributing to increased perioperative complications, impaired bone health, and compromised muscle function. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for glycemic control in T2DM, have demonstrated substantial benefits in weight reduction and metabolic regulation. The purpose of this review is to understand the musculoskeletal biologic and clinical implications of GLP-1RAs.

Increased Incidence of Spin and Reporting Bias on the Use of Hyaluronic Acid for the Treatment of Knee Osteoarthritis: An Evaluation of Systematic Reviews and Meta-Analyses.

Background: The use of hyaluronic acid (HA) for the treatment of knee osteoarthritis holds clinical and financial implications for manufacturers, incentivizing spin, or the misrepresentation of study findings. We sought to identify the incidence of spin in abstracts of systematic reviews and meta-analyses evaluating the efficacy of HA injections used for the treatment of knee osteoarthritis.

Methods: Systematic reviews and meta-analyses reporting on HA for knee osteoarthritis were extracted through a Preferred Reporting Items for Systematic Reviews and Meta-Analyses search of Embase, PubMed, and Cochrane databases.

A Rare First Presentation of Unilateral Fibromuscular Dysplasia Resulting in Renal Infarct.

A rare first presentation of unilateral fibromuscular dysplasia (FMD) in an African American patient in her 60s, with renal infarct, is described, along with imaging. The patient presented with acute-onset right-sided abdominal pain and severe hypertension not responding to multiple antihypertensives. She was found to have renal infarcts on the right side.

Mitochondrial Responses to Conventional and Ultra-high Dose Rate (FLASH) Radiation.

Purpose: Ultra-high dose rate (>40 Gy/s, FLASH) radiation therapy (RT) provides equivalent tumor control while reducing normal tissue toxicity relative to conventional dose rate (CONV) RT. However, the mechanisms underlying the observed FLASH effect are unknown. We hypothesized that the preservation of mitochondrial integrity in nontumorigenic cells by FLASH RT could be a key factor in reducing normal tissue toxicity and improving overall treatment outcomes.

An ultrasensitive method for detection of cell-free RNA.

Sensitive methods for detection of cell-free RNA (cfRNA) could facilitate non-invasive gene expression profiling and monitoring of diseases. Here we describe RARE-seq (random priming and affinity capture of cfRNA fragments for enrichment analysis by sequencing), a method optimized for cfRNA analysis. We demonstrate that platelet contamination can substantially confound cfRNA analyses and develop an approach to overcome it.

Resistive Switching in α-InSe Lateral Field-Effect Transistors.

Ferroelectric semiconducting field-effect transistors (FeS-FETs) based on two-dimensional materials exhibit nonvolatile resistive switching, making them promising candidates for next-generation memory and neuromorphic computing. However, the mechanisms governing resistive switching in α-InSe lateral devices remain unresolved, particularly regarding the relative contributions of channel and contact resistance. In this study, Kelvin probe force microscopy (KPFM) was employed to spatially resolve the gate-poling-dependent contact and channel resistances in α-InSe FeS-FETs, while scanning photocurrent microscopy (SPCM) was used to quantify changes in effective Schottky barrier height at the metal contacts.

Dexamethasone Is Associated With Lower Rates of Pulmonary Complications Following Cemented Femoral Fixation During Primary Total Hip Arthroplasty.

Background: The utilization of cemented femoral fixation during total hip arthroplasty (THA) has increased in recent years. Perioperative corticosteroids have been shown to attenuate the inflammatory cascade associated with cement-induced cardiopulmonary complications. Therefore, the purpose of this study was to determine if dexamethasone (DEX) utilization was associated with decreased perioperative pulmonary complications associated with cemented THA.

Clinical Characteristics of Branchial Cleft Anomalies.

Background And Purpose: Branchial cleft anomalies (BCA) are a group of relatively common congenital pediatric neck masses, which exhibit wide variability in clinical presentation and treatment approaches. This study attempts to fill this gap by evaluating BCA clinical, radiographic, and treatment features in a large cross-sectional cohort.

Materials And Methods: We performed a retrospective cross-sectional study of patients with BCA presenting to a single pediatric quaternary care center between 2017 and 2023.

Hypofractionated Palliative Radiotherapy for Relapsed and Refractory High-Risk Neuroblastoma.

While palliative radiotherapy (RT) is frequently used in the management of relapsed/refractory high-risk neuroblastoma (HR-NBL); outcomes after palliative hypofractionated RT (hypo-RT) remain poorly characterized. : We conducted a multi-institutional retrospective study of 38 patients who were diagnosed with HR-NBL between 1997 and 2021 and received palliative RT. Conventional RT (conv-RT) and hypo-RT were defined as palliative treatment courses using dose ≤2 or >2 Gy per fraction, respectively.

Stacked Cone Constructs for the Treatment of Extensive Tibial Bone Loss in Revision Total Knee Arthroplasty: A Series of 22 Patients.

Background: Highly porous metaphyseal cones have emerged as a promising fixation strategy to address extensive proximal tibial bone loss in the multiply revised knee. Despite a paucity of literature regarding stacked cone constructs, they have gained popularity. This study reports on the early outcomes of stacked tibial cone constructs that are used during revision total knee arthroplasty (TKA).

Mucin 5AC as a Biomarker for Sessile Serrated Lesions: Results From a Systematic Review and Meta-Analysis.

Introduction: Sessile serrated lesions (SSLs) are a class of colon polyps challenging to detect through current screening methods but highly associated with colon cancer. To improve detection, we sought a biomarker sensitive for SSLs. Recent endoscopic and histopathologic studies suggest that SSLs are associated with alterations in intestinal mucin expression, but the frequency with which this occurs is not known.

Role of adjuvant radiotherapy modality on clinical outcomes for early-stage uterine carcinosarcoma.

Background: There are limited data around adjuvant radiotherapy following surgical management for patients with early-stage uterine carcinosarcoma (UCS). We compared outcomes for patients with early-stage UCS who underwent adjuvant chemotherapy (CT) and pelvic external beam radiotherapy (EBRT) vs. CT and vaginal brachytherapy (VBT) vs.

Mitochondrial damage in muscle specific PolG mutant mice activates the integrated stress response and disrupts the mitochondrial folate cycle.

During mitochondrial damage, information is relayed between the mitochondria and nucleus to coordinate precise responses to preserve cellular health. One such pathway is the mitochondrial integrated stress response (mtISR), which is known to be activated by mitochondrial DNA (mtDNA) damage. However, the causal molecular signals responsible for activation of the mtISR remain mostly unknown.

A microfluidic platform for anterior-posterior human endoderm patterning via countervailing morphogen gradients .

Understanding how morphogen gradients spatially pattern tissues is a fundamental question in developmental biology but can be difficult to directly address using conventional approaches. Here, we expose hPSC-derived endoderm cells to countervailing gradients of anteriorizing and posteriorizing signals using a widely available microfluidic device. This approach yielded spatially patterned cultures comprising anterior foregut (precursor to the thyroid, esophagus, and lungs) and mid/hindgut (precursor to the intestines) cells, whose identities were confirmed using single-cell RNA sequencing (scRNA-seq).