Non-Sedated Intrauterine Device Experiences Among Transgender and Cisgender Adolescents and Young Adults in the Outpatient Setting.

Study Objectives: This study compares the demographic characteristics and experiences of three different groups of adolescent and young adults (AYAs) seeking non-sedated intrauterine device (IUD) insertion in the outpatient setting: (1) cisgender individuals, (2) transgender and gender diverse (TGD) individuals receiving gender-affirming testosterone therapy, and (3) TGD individuals not receiving gender-affirming testosterone therapy.

Methods: This retrospective cohort study included AYAs age 13 to 21 years seeking IUD insertion. Data were obtained from the electronic health record via a pre-existing, multi-institutional shared quality improvement (QI) collaborative.

Accelerated Patient-specific Non-Cartesian MRI Reconstruction using Implicit Neural Representations.

Purpose: Accelerating MR acquisition is essential for image guided therapeutic applications. Compressed sensing (CS) has been developed to minimize image artifacts in accelerated scans, but the required iterative reconstruction is computationally complex and difficult to generalize. Convolutional neural networks (CNNs)/Transformers-based deep learning (DL) methods emerged as a faster alternative but face challenges in modeling continuous k-space, a problem amplified with non-Cartesian sampling commonly used in accelerated acquisition.

Treatment and Referral of Youth with Opioid Addiction in the Pediatric Emergency Department: A Pilot Study.

Background: Fatal opioid overdoses have increased among adolescents. Emergency Departments (EDs) are critical access points for connecting adults with opioid use disorder (OUD) to medication-assisted treatment (MAT). Whether this is feasible in pediatric patients is unknown.

Multicellular tumor-stromal interactions recapitulate aspects of therapeutic response and human oncogenic signaling in a 3D disease model for H3K27M-altered DIPG.

It has become evident from decades of clinical trials that multimodal therapeutic approaches with focus on cell intrinsic and microenvironmental cues are needed to improve understanding and treat the rare, inoperable, and ultimately fatal diffuse intrinsic pontine glioma (DIPG), now categorized as a diffuse midline glioma. In this study we report the development and characterization of an in vitro system utilizing 3D Tumor Tissue Analogs (TTA), designed to replicate the intricate DIPG microenvironment. The innate ability of fluorescently labeled human brain endothelial cells, microglia, and patient-derived DIPG cell lines to self-assemble has been exploited to generate multicellular 3D TTAs that mimic tissue-like microstructures, enabling an in- depth exploration of the spatio-temporal dynamics between neoplastic and stromal cells.

Atypical complications and co-morbidities of type 1 diabetes in young adults.

Aims: Our review aimed to determine the prevalence of - and factors associated with - hearing loss, oral and olfactory disease, frozen shoulder, trigger finger, and hair loss in young adults with type 1 diabetes. These conditions were selected based on research team interests, existing literature, and group discussion.

Methods: We conducted a quantitative narrative review using a systematic process to identify cohort and cross-sectional studies involving young adults with type 1 diabetes (mean age 18-30 years).

Dexmedetomidine's effect on neonatal sedation, pain, respiratory status and cardiovascular system.

Objective: To describe the effects of dexmedetomidine on sedation, pain, respiratory status, and hemodynamics in neonates.

Methods: A retrospective study of 206 infants in a level IV NICU (2016-2021) receiving continuous dexmedetomidine infusion. Pain/sedation scores, BP, vasopressor and inotrope score (VIS), and concomitant sedatives/analgesics (CSA) were recorded before and every 3-4 h for 24 h.

Surgical management patterns for spontaneous pneumothorax in adolescents and young adults.

Background: Management of primary spontaneous pneumothorax varies widely. We aimed to assess national trends in PSP management in the last decade.

Methods: We conducted a 10-year retrospective analysis of the MarketScan claims database to identify adolescents and young adults (aged 10-24 years) diagnosed with primary spontaneous pneumothorax (2012-2021).

Prenatal Nitrogen Oxide (NO) and Its Potential Impact on Infant Metabolism during the First Month of Life: Evidence from Two Distinct Cohorts─The Atlanta African American Maternal-Child Cohort and the Southern California Mother's Milk Study.

Exposure to traffic-related air pollution (TRAP) during pregnancy has been linked with adverse health outcomes, yet the biological mechanisms remain poorly understood. High-resolution metabolomics offers a promising approach to examine how TRAP influences infant health. However, few studies have focused on Black and Latino populations, who are disproportionately exposed to TRAP.

4D-MRI at 0.55T for internal target volume delineation in liver radiation therapy planning.

Background: Low-field MRI provides superior soft-tissue contrast compared to CT while costing significantly less than high-field MRI, which makes it a more accessible option for MRI-guided radiation therapy planning. Four-dimensional MRI (4D-MRI) is a technique that has been increasingly adopted clinically for internal target volume (ITV) delineation in free-breathing liver radiotherapy planning, and it requires high spatial resolution and accurate respiratory phase differentiation to enable precise dose planning. The feasibility of 4D-MRI at low-field strength, specifically at 0.

Pediatric Spine Frailty Index Predicts Morbidity and Mortality Following Spinal Deformity Surgery.

Background: The purpose of this study was to develop a frailty index for pediatric patients undergoing posterior spinal fusion for deformity correction.

Methods: The National Surgical Quality Improvement Program (NSQIP) Pediatric database was used. Patients <18 years of age who had undergone posterior spinal fusion for the treatment of spinal deformity were included.

2D Speckle Tracking Strain Echocardiography in Multisystem Inflammatory Syndrome in Children: A Multicenter Analysis From the MUSIC Study.

Background: 2D-speckle tracking echocardiography may help detect subclinical ventricular dysfunction, but data in multisystem inflammatory syndrome in children (MIS-C) are scarce. We investigated left ventricular (LV) strain parameters in MIS-C and their association with outcomes.

Methods: We performed an ambi-directional, 32-center cohort study on hospitalized MIS-C patients (March 2020-November 2021) with at least 1 echocardiogram read by the Core Lab.

Microstructural alterations of the corpus callosum in affective and non-affective early psychosis: A diffusion magnetic resonance imaging study.

Background: Early psychosis (EP) is associated with a disrupted integrity of the white matter microstructure of a variety of brain regions, especially the corpus callosum (CC). In this study, we used diffusion-weighted magnetic resonance imaging data of patients with EP and employed diffusion tensor imaging (DTI), free water-corrected diffusion, and neurite orientation dispersion and density imaging (NODDI) to comprehensively assess the white matter microstructure.

Methods: 106 patients with EP (84 non-affective and 22 affective) and 51 healthy controls (HCs) were included from the Human Connectome Project in the Early Psychosis dataset.

Adipocytes Impair Mitoxantrone Cytotoxicity Against Acute Lymphoblastic Leukemia.

Introduction: Obesity contributes to poorer clinical outcomes in patients with acute lymphoblastic leukemia. We have shown that adipocytes cause anthracycline resistance by absorbing and metabolizing them into less-active alcohol metabolites.

Methods: We hypothesized that mitoxantrone, which has a similar cytotoxic mechanism to anthracyclines but is metabolized through different pathways, might overcome this adipocyte-mediated chemoresistance.

HLA-B*15:01-positive severe COVID-19 patients lack CD8 T cell pools with highly expanded public clonotypes.

Understanding host factors driving asymptomatic versus severe disease outcomes is of key importance if we are to control emerging and re-emerging viral infections. HLA-B*15:01 has been associated with asymptomatic SARS-CoV-2 infection in nonhospitalized individuals of European ancestry, with protective immunity attributed to preexisting cross-reactive CD8 T-cells directed against HLA-B*15:01-restricted Spike-derived S peptide (B15/SCD8 T-cells). However, fundamental questions remained on the abundance and clonotypic nature of CD8 T-cell responses in HLA-B*15:01-positive patients who succumbed to life-threatening COVID-19.

"Listening Neglect": A Mixed-Methods Study of How Families Feel Unheard in Hospitals.

Background/objectives: Listening is essential for communication and is a key driver of patient safety. We aimed to gain a rich understanding of how hospitalized patients and families feel unheard to develop actionable interventions.

Methods: This mixed-methods study examined data from family safety interviews administered to hospitalized patients and families on pediatric inpatient units of 8 US hospitals.

Trio exome sequencing of an optic nerve hypoplasia cohort reveals evidence for polygenic architecture.

Background: Optic nerve hypoplasia (ONH), the leading congenital cause of permanent blindness, is characterized by a retinal ganglion cell (RGC) deficit at birth and frequently associated neurologic and endocrine abnormalities. Multifactorial developmental events are hypothesized to underlie ONH; however, environmental influences are unclear, and genetic causes are under-investigated.

Methods: To identify monogenic, disease-causing variants among ONH patients, exomes from 34 ONH subjects and their parents were sequenced and rare variants identified.

Conservative Concussion Management in Youth Athletes Can Avoid Increased Injury Rates After Return to Sport: Initial Evidence.

Objective: To evaluate whether injury rates are elevated after return to sport after concussion clearance in youth athletes and examine differences between concussed athletes who sustain injury after return to play and those who remain uninjured.

Design: Prospective cohort study.

Setting: Large metropolitan hospital.

Rationale for the use of fetal ventriculosubgaleal shunts for the treatment of aqueduct stenosis.

Fetal hydrocephalus causes irreversible neural injury , yet no prenatal therapy currently exists. Postnatal treatments such as ventriculoperitoneal shunts and endoscopic third ventriculostomy with choroid plexus cauterization cannot reverse pre-existing brain injury. We propose that the ventriculosubgaleal shunt (VSGS), widely used as a temporizing measure in severely premature neonates, may offer a feasible and ethically justifiable approach for treatment.

Matrix metalloproteinase inhibitor-loaded extracellular matrix macromolecules enhance cartilage regeneration and inhibit degeneration in osteoarthritis.

Background: Osteoarthritis (OA) is a prevalent joint disorder, characterized by cartilage degradation driven by matrix metalloproteinases (MMPs) and dysregulated extracellular matrix (ECM) turnover. Biological macromolecules, such as ECM-derived scaffolds, offer therapeutic potential by mimicking native cartilage composition, yet their rapid enzymatic breakdown hampers regenerative potential. We hypothesized that embedding an MMP inhibitor within ECM could mitigate MMP-driven breakdown, thereby halting OA progression, while stabilizing ECM structure and boosting chondrogenesis.

Conceptualizing Pathways to Depression and Anxiety in Autistic Youth Using the Cognitive and Behavioral Model of Low Self-Esteem.

Autistic youth are more likely to experience both anxiety and depression than their nonautistic peers, yet treatment options are extremely limited. Clinicians working with this population lack a robust evidence base of psychological models within which to formulate and treat these enduring internalizing disorders in autistic youth. Negative self-esteem is a robust risk factor-and treatment target-for internalizing disorders in nonautistic youth that remains largely understudied in autistic youth.

Free vs. Local Tissue Transfer and Reconstruction in Pediatric Head and Neck Cancer Patients: A Comparable Complication Outcome Review.

: Reconstructive outcomes following head and neck (H&N) cancer resection in pediatric patients remain understudied, particularly regarding the comparative efficacy of free versus local tissue transfer. : A retrospective review was conducted on pediatric patients undergoing malignant H&N tumor resection at a tertiary center from 2007 to 2024. Patients were stratified by reconstruction type (free vs.

Sex-Associated Disparities in Industry Payments to US Authors in High-Impact Rheumatology Journals: Correlation with Author Impact.

Objective: The aim of this study was to assess sex-associated disparities in the frequency and magnitude of industry payments to US physician authors in high-impact rheumatology journals and their correlation with author impact.

Methods: US authors of publications in four high-impact rheumatology journals were vetted on Open Payments Database (OPD) for industry payments. The h-index (an accepted metric of author impact), physician type, and dollar amounts for each OPD category were recorded.

Plasma and neurostructural biomarkers in the clinical-biological characterization of early stages of the Alzheimer's disease continuum: findings from the Compostela Aging Study.

Recent technical advances in peripheral blood analysis have enabled precise quantification of Alzheimer´s Disease (AD) biomarkers in the early stages of the AD continuum, in an economical, non-invasive and safe manner. The main objective of this study was to contribute to the clinical-biological characterization of the initial stages of cognitive impairment by measurement of blood and neurostructural AD biomarkers in groups of participants classified according to their cognitive clinical phenotype. Plasma concentrations of p-tau217, p-tau181, total tau, neurofilament light chain and amyloid-β 42/40 ratio biomarkers were measured along with APOE gene variants, hippocampal volume and cortical thickness of the AD signature regions.