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.

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.

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.

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.

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.

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.

Intracranial aneurysm embolization using Penumbra fill and finish coils: 1-year results of a prospective, real-world, multicenter SURF study.

Background: SURF was a prospective, multicenter, single-arm, observational study with core lab adjudication of radiographic data, assessing embolization of intracranial aneurysms (IAs) using WAVE Extra Soft Coils as part of SMART Coil System.

Methods: Adults undergoing IA embolization with the SMART Coil System (Penumbra, Inc.) comprising 75% of implanted coils and WAVE as the final finishing coil were enrolled at 43 global centers.

Yield of Whole Genome Sequencing for Pathogenic Single Nucleotide Variants in Congenital Heart Disease: A Systematic Review and Meta-Analysis.

Objective: This systematic review and meta-analysis aimed to assess the diagnostic yield of pathogenic or likely pathogenic (P/LP) single nucleotide variants (SNVs) using whole genome sequencing (WGS) in congenital heart disease (CHD).

Methods: A systematic search of three databases (2000-2024) was conducted, and two reviewers independently screened studies and extracted data following PRISMA and MOOSE guidelines. Pooled proportions were calculated using a random-effects model, and study quality was assessed using modified STARD criteria.

Assessing the feasibility, acceptability, and efficacy of a pragmatic pilot and full-scale trial to improve care for older adults with complex care needs: The SPIRE study.

Older adults with complex health and social care needs comprise some 5 % of the United States population but contribute to roughly half of healthcare costs. Patient and caregiver perspectives in qualitative studies emphasize care fragmentation in traditional care delivery models. The need for more streamlined and personalized care for these older adults is acute, particularly in value-based care systems such as Accountable Care Organizations (ACOs).

A multi-method assessment of the vascular surgery program director experience in creating effective training environments.

Objectives: Surgical training has received significant attention in recent years with efforts to improve trainee wellness. Vascular surgery training is subject to unique challenges, and vascular program directors (PDs) are tasked with providing learning environments that produce effective and competent surgeons. The aim of this study is to examine the experience of vascular surgery PDs in promoting effective learning environments for vascular trainees.

Global Outcomes Across 20 Years After Inpatient Rehabilitation for Traumatic Brain Injury.

Objective: To explore and visually display differences in the distribution of the Glasgow Outcome Scale - Extended (GOS-E) over time after traumatic brain injury (TBI), focusing on variations in outcome distributions based on GOS-E at Year 1 postinjury and age at injury.

Setting: Community.

Participants: 14 010 individuals who received inpatient rehabilitation in the TBI Model Systems.

Socioeconomic Status, Voice Disorder Risk, and Voice-Related Handicap Across Childhood.

Importance: Both voice disorders and socioeconomic deprivation can limit quality of life in pediatric populations. However, the association between socioeconomic status (SES), voice disorder prevalence, and voice-related handicap in children and adolescents has not been well understood.

Objective: To examine the association between SES and voice disorder prevalence across childhood, as well as the association between SES and voice-related handicap.

Technical performance assessment of robotic surgery: a systematic scoping review.

Defining performance errors in robotic surgery is critical for the assessment of robotic surgery skill. Our goal was to identify and categorize explicitly defined intraoperative technical errors in robotic surgery, how skill assessment was performed, and how ratings were conducted either manually by experts or via automated ratings. This scoping review included studies involving general, urologic, obstetrics/gynecologic, and thoracic surgery, and general skills as practiced in inanimate, virtual reality, in vivo/ex vivo animal, cadaver, and human operations.

Objective and Subjective Evaluation of Non-Technical Skills and Technical Leadership Skills During Simulated Critical Care Scenarios.

Occupational ApplicationsThe analysis of communication, attention, and cognitive engagement relative to leadership and non-technical skills (NTS) is important for understanding the team dynamic within clinical settings. We found negative correlations between passive communication (receiving information instead of dictating information) and leadership scores, suggesting that passive leadership traits lead to weaker technical leadership performance. Additionally, continuously sharing goals and providing affirmations to patients had positive relationships with leadership scores.

New Asthma Diagnosis Codes or Short-Acting β Agonist Prescriptions After Histoplasmosis Among Patients With Commercial Health Insurance, United States, 2018-2023.

Background: Although several fungal infections have been linked to asthma development, the relationship between histoplasmosis and asthma development has not been fully described.

Objectives: To assess the incidence of new asthma diagnosis codes or short-acting β agonist (SABA) prescription in the year following histoplasmosis diagnosis and identify potentially related factors.

Methods: We used a large health insurance claims database to identify patients with histoplasmosis with and without an asthma diagnosis code or a short-acting β agonist prescription in the year after diagnosis.