Critical Assessment of the Recommended Alert Limit Curves for Occupational Heat Exposure.

Background: Occupational heat stress recommendations aim to achieve thermal equilibrium and keep core temperature (T) below 38.0°C. We assessed the recommended alert limit curves when: (1) work-rest ratios are adjusted based on wet-bulb globe temperature (WBGT) at a fixed rate of metabolic heat production (H) and (2) H is adjusted based on WBGT at a fixed work-rest ratio.

Safety of artificial intelligence-assisted optical diagnosis for leaving colorectal polyps in situ during colonoscopy (PRACTICE): a non-inferiority, randomised controlled trial.

Background: Guidelines recommend leaving in situ rectosigmoid polyps diagnosed during colonoscopy that are 5 mm or smaller if the endoscopist optically predicts them to be non-neoplastic. However, no randomised controlled trial has been done to examine the efficacy and safety of this strategy.

Methods: This open-label, multicentre, non-inferiority, randomised controlled trial enrolled adults age 18 years or older undergoing colonoscopy for screening, surveillance, or clinical indications across four Italian centres.

Incidence of long COVID among U.S. children and adults during the omicron era - Tracking Post-COVID Conditions (Track-PCC) network, 2022-2023.

Background: Long COVID, or Post-COVID Conditions (PCC), refers to new and persisting sequelae occurring in the months following an acute SARS-CoV-2 infection. Although previous studies have reported estimates of PCC incidence, few have examined trends during the Omicron variant period or have included geographically distinct regions for the same time periods.

Methods: Track PCC is a surveillance network, leveraging electronic health records and public health data to monitor incidence over time across five diverse geographic sites in the U.

Multiple maternal occupational exposures during pregnancy and intrauterine growth: analysis of the French Longitudinal Study of Children - ELFE cohort, using data-driven approaches.

Objective: To use data-driven approaches to investigate maternal multi-occupational exposures during pregnancy and their effects on intrauterine growth.

Methods: Maternal occupational exposure to 47 factors during pregnancy was evaluated with job-exposure matrices in the French ELFE cohort. The outcomes of interest were birthweight (BW), small for gestational age (SGA) and head circumference (HC).

Fractures are Highly Correlated with Bone Density and Inversely Correlated with Bone Turnover Markers in Autosomal Dominant Osteopetrosis.

Autosomal Dominant Osteopetrosis (ADO) is a rare, osteosclerotic disorder usually caused by missense variants in the CLCN7 gene, resulting in impaired osteoclastic bone resorption. Penetrance is incomplete and disease severity varies widely, even among relatives within the same family. Although ADO can cause visual loss, osteonecrosis, osteomyelitis, and bone marrow failure, the most common complication of ADO is fracture.

Impact of Population Pharmacogenomics on Cisplatin-Induced Neurotoxicities in Testicular Cancer Survivors.

Background: Cisplatin is a commonly used chemotherapeutic across numerous cancer types that can cause neurotoxicities in patients, including peripheral sensory neuropathy, tinnitus, hearing loss, and vertigo.

Objective: We aimed to evaluate, for the first time, how genetic ancestry impacts cisplatin-induced neurotoxicities and if disparities are related to population differences in allele frequency.

Methods: In a cohort of cisplatin-treated testicular cancer survivors, relationships between genetic ancestry and neurotoxicities, medications, and lifestyle factors were assessed using logistic regression and Kruskal-Wallis tests and multiple pairwise comparisons using the Wilcoxon rank-sum test (Benjamini-Hochberg adjustment).

Differential impacts of advanced age and sex in age-related trace fear memory impairment in rats.

While cognitive function remains stable for majority of the lifespan, many functions sharply decline in later life. Women have higher rates of neurodegenerative diseases that involve memory loss, including Alzheimer's disease. This sex disparity may be due to longer life expectancies when compared to men; women outlive men by roughly 5 years globally.

POU6F1 promote lumbar motor circuit reorganization following spinal cord injury.

Spinal cord injury (SCI) causes irreversible motor deficits due to disrupted lumbar circuitry. However, transcriptional mechanisms in distal lumbar circuits are poorly understood. We identify POU6F1 as a critical transcriptional regulator in spinal lumbar segment (SLS, L3-L5) motor circuit regeneration.

HIV-related mortality time trends among children and young adolescents on antiretroviral therapy by age, treatment duration, and region: a systematic review and meta-regression analysis.

Background: Past cohort studies have examined mortality among children and young adolescents (aged 0-14 years) who have received antiretroviral therapy (ART), but no systematic reviews have been undertaken to synthesise these findings. Our study aims to provide the most comprehensive global estimates of paediatric mortality among children and adolescents receiving ART.

Methods: For this systematic review and meta-regression analysis, we searched PubMed and Embase from Jan 1, 1990 to July 31, 2024 for studies reporting mortality among children and young adolescents living with HIV who were on ART.

A digital workflow for full-arch implant fixed prosthesis: Clinical application of a 3D-printed polychromatic flangeless trial denture, anatomic bone reduction guide, and intraoral scanning for definitive prosthesis fabrication.

This clinical report presents a comprehensive digital workflow for rehabilitating a patient with maxillary terminal dentition using a full-arch, implant-supported fixed dental prosthesis (FP-1). It highlights the integration of a 3D-printed polychromatic flangeless trial denture and a customized anatomic bone reduction template, enabling prosthetically driven implant planning and optimal bone architecture modification. The workflow incorporated fully guided implant surgery using sequential templates and immediate loading with a closed-mouth pickup system.

Social Connections Over the Life Course: Appreciating Distinct Dimensions of Social Connections.

Despite growing attention to the social isolation crisis in the U.S., it remains unclear whether Americans experience a decline in social connection with age.

Music in Healing: Leveraging Classical Music to Promote Medical Humanism Concepts Among First-Year Medical Students.

The arts and humanities have recently been recognized as valuable tools in medical education. Despite this, there are few programs that leverage music, and even fewer that leverage classical music, to teach medical humanities concepts. Here, we designed a two-hour session in conjunction with a live classical string quartet to discuss themes related to identity, interprofessional education, active listening, and empathy.

Reducing post-cesarean sepsis: Current best practice in prevention and treatment.

Cesarean section is the most common surgical procedure performed worldwide. It is associated with good perinatal and maternal outcomes when indicated. The rising global cesarean birth rate has coincided with an increase in post-cesarean sepsis - specifically site infections, which have an incidence of 7% worldwide.

Associations between ureteral stent indwelling time, patient characteristics, and stent pain from an international prospective registry.

Objectives: Previous studies have shown conflicting results concerning the optimal duration of ureteral stenting after endourologic treatment of stone disease, its effect on patient comfort, and the necessity for emergent, unscheduled care. This study assessed the impact of stent duration, sex, and other patient-associated factors on reported pain scores using a large, international prospective registry.

Methods: A prospective observational patient registry on ureteral stents from 10 institutions in 4 countries (United States, Canada, France, and Japan) from 2020-2023 was assessed.

Establishing best practices guidelines for collaborative research in global surgery: developing a Delphi survey.

Background: Collaborative research in global surgery has resulted in the rapid development of the field via knowledge creation and dissemination, research capacity building, and direct improvements in the delivery of clinical care. Yet the establishment and maintenance of trans-boundary collaborations carries significant risk to health systems, clinicians, patients, and researchers, particularly if such collaborations are not developed thoughtfully and with appropriate guardrails. In recent years, there has been significant growth in the literature on the pervasiveness and impact of neocolonialism on global health research.

Updating the genomic and clinicopathologic features of thoracic SMARCA4-deficient undifferentiated tumor: a mini-series including a long-term survivor.

Introduction: Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-dUT) is a recently described type of lung cancer, presenting as a bulky mass variably involving the mediastinum and the lung in patients with smoking history, and exhibits adverse prognosis. The essential diagnostic immunomorphologic features and typical genomic findings have been described. However, there is a continuing need to catalogue the spectrum of genomic changes underlying the disease, the heterogeneity of antigen expression in order to avoid diagnostic pitfalls, and any variability in patient outcomes.

Beyond the COVID-19 Pandemic: Budget Impact Analysis of Remote Healthcare Delivery for Hypertension and Diabetes Mellitus Management in Thailand.

Purpose: The COVID-19 pandemic disrupted healthcare services globally, necessitating innovative care delivery models for non-communicable diseases. Remote healthcare pathways, including telehealth with pharmacy at home (PAH) and deferred care (DC), emerged as potential solutions for managing stable hypertension (HT) and diabetes mellitus (DM) patients. This study aims to estimate the budget impact of implementing PAH and DC compared to usual care (UC) for HT and DM patients in Thai tertiary care hospitals from the government perspective.

Pharmacogenomics of buprenorphine - a narrative review.

Buprenorphine, a semi-synthetic opioid, is used to treat Opioid Use Disorder (OUD) and as an analgesic. Buprenorphine's benefits over other opioids include longer duration of action, lower abuse potential, and a ceiling effect to serious adverse effects such as respiratory depression. This is a literature review of gene variants affecting the pharmacokinetics and pharmacodynamics of buprenorphine from databases, such as PubMed.

Perceptions of the Benefits and Risks of Novel Therapies for Type 1 Diabetes: A Qualitative Study.

Introduction: Novel therapies, including disease-modifying and cell replacement therapies, may preserve or replace beta cells in people with type 1 diabetes. This study sought to understand how people living with type 1 diabetes or caring for someone with type 1 diabetes perceive the benefits and risks of novel therapies.

Methods: Semistructured qualitative interviews were conducted with 26 participants in the United States: four adolescents and 12 adults with type 1 diabetes, and 10 caregivers of children with type 1 diabetes.