Drone observations reveal white shark (Carcharodon carcharias) dorsal fins are highly flexible and possible investigatory structures.

Drones are becoming increasingly useful in their ability to observe wildlife. They have been especially useful in documenting marine animals such as sharks. Here we present novel aerial drone observations of a previously unknown dorsal-fin behaviour in white sharks (Carcharodon carcharias).

Management of Transvenous Leads in Patients With Iatrogenic Lead Perforation.

Introduction: Iatrogenic lead perforation is a rare but serious complication of cardiac implantable electronic device (CIED) implantation. Evidence on percutaneous management of subacute or delayed cases remains limited.

Methods: We retrospectively reviewed 38 patients treated for iatrogenic lead perforation between January 2012 and October 2024.

Clinical comparison of four commercial MRI phantoms on a 0.35T MR-linac using a standard clinical TRUFI sequence at a single institution.

Purpose: Real‑time magnetic resonance-guided radiation therapy (MRgRT) integrates MRI with a linear accelerator (Linac) for gating and adaptive radiotherapy, which requires robust image‑quality assurance over a large field of view (FOV). Specialized phantoms capable of accommodating this extensive FOV are therefore essential. This study compares the performance of four commercial MRI phantoms on a 0.

Implementation of a midwifery preceptor program in Sierra Leone: a qualitative evaluation using the Consolidated Framework for Implementation Research.

Background: Sierra Leone has the world's third highest incidence of maternal mortality, with 443 deaths per 100,000 live births. Strengthening the country's midwifery workforce is essential to providing adequate maternal healthcare and reducing preventable perinatal mortality. In support of this goal, we developed and implemented a midwifery preceptor program (MPP) to train experienced midwives to effectively mentor new and student midwives.

Integrating medical physics into an EMR-based radiology feedback system for quality improvement.

Introduction: Medical physicists play a critical role in ensuring image quality and patient safety, but their routine evaluations are limited in scope and frequency compared to the breadth of clinical imaging practices. An electronic radiologist feedback system can augment medical physics oversight for quality improvement. This work presents a novel quality feedback system integrated into the Epic electronic medical record (EMR) at a university hospital system, designed to facilitate feedback from radiologists to medical physicists and technologist leaders.

Genomic and clinical epidemiology of SARS-CoV-2 in coastal Kenya: insights into variant circulation, reinfection, and multiple lineage importations during a post-pandemic wave.

Background: Between November 2023 and March 2024, coastal Kenya experienced another wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections detected through our continued genomic surveillance. Herein, we report the clinical and genomic epidemiology of SARS-CoV-2 infections from 179 individuals (a total of 185 positive samples) residing in the Kilifi Health and Demographic Surveillance System (KHDSS) area (~ 900 km).

Methods: We analyzed genetic, clinical, and epidemiological data from SARS-CoV-2 positive cases across pediatric inpatient, health facility outpatient, and homestead community surveillance platforms.

Feasibility of HyperSight CBCT for adaptive radiation therapy: A phantom benchmark study of dose calculation accuracy and delivery verification on the Halcyon.

Purpose: The development of on-board cone-beam computed tomography (CBCT) has led to improved target localization and evaluation of patient anatomical change throughout the course of radiation therapy. HyperSight, a newly developed on-board CBCT platform by Varian, has been shown to improve image quality and HU fidelity relative to conventional CBCT. The purpose of this study is to benchmark the dose calculation accuracy of Varian's HyperSight cone-beam computed tomography (CBCT) on the Halcyon platform relative to fan-beam CT-based dose calculations and to perform end-to-end testing of HyperSight CBCT-only based treatment planning.

The systematic assessment of completeness of public metadata accompanying omics studies in the Gene Expression Omnibus data repository.

Background: Recent advances in high-throughput sequencing technologies have enabled the collection and sharing of a massive amount of omics data, along with its associated metadata-descriptive information that contextualizes the data, including phenotypic traits and experimental design. Enhancing metadata availability is critical to ensure data reusability and reproducibility and to facilitate novel biomedical discoveries through effective data reuse. Yet, incomplete metadata accompanying public omics data may hinder reproducibility and reusability and limit secondary analyses.

Patterns of extreme outlier gene expression suggest an edge of chaos effect in transcriptomic networks.

Background: Most RNA-seq datasets harbor genes with extreme expression levels in some samples. Such extreme outliers are usually treated as technical errors and are removed from the data before further statistical analysis. Here we focus on the patterns of such outlier gene expression to investigate whether they provide insights into the underlying biology.

Acceptability and effectiveness of empathy-based provider training and community-level awareness activities on self-injectable contraceptive use in Niger, Lagos, and Oyo States, Nigeria: a mixed methods program evaluation.

Background: Interventions aimed to increase healthcare provider empathy and capacity to deliver person-centered care have been shown to improve healthcare seeking and outcomes. In the context of self-injectable contraception, empathetic counseling and coaching may be promising approaches for addressing "fear of the needle" among clients interested in using subcutaneous depot medroxyprogesterone (DMPA-SC). In Nigeria, the Delivering Innovation in Self-Care (DISC) project developed and evaluated an empathy-based in-service training and supportive supervision intervention for public sector family (FP) planning providers implemented in conjunction with community-based mobilization.

Pre-employment urine drug screening: examining trends in THC-COOH positivity rates post-legalization of recreational cannabis in California - a retrospective review.

Background: This study examines trends in delta-9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH) positivity rates in pre-employment urine drug screenings at a single university-based hospital occupational medicine clinic from 2017 to 2022, following California's recreational cannabis legalization in 2016, with sales beginning officially on January 1, 2018.

Methods: Retrospective analysis of 21,546 de-identified urine drug screenings from 2017 to 2022 was conducted. Initial screening used instant urine drug immunoassays (50 ng/mL cutoff for THC-COOH), followed by confirmatory gas chromatography-mass spectrometry (15 ng/mL cutoff).

Understanding the differences in occupational injuries due to accidents among native-born and immigrant workers in Sweden: a repeated cross-sectional register-based study.

Background: Immigrants continue to face challenges after entering the labor market and remain overrepresented in '3-D jobs' (dirty, difficult, degrading). This study aims to investigate the differences in occupational injury due to accidents (OIA) among immigrants compared to native-born workers in Sweden, and to examine the role of migrant-specific and work factors in these differences.

Methods: This repeated cross-sectional study used nationwide registers including all gainfully employed individuals in 2004-2020 (average annual sample 4.

Whole genome sequence analysis of low-density lipoprotein cholesterol across 246 K individuals.

Background: Rare genetic variation provided by whole genome sequence datasets has been relatively less explored for its contributions to human traits. Meta-analysis of sequencing data offers advantages by integrating larger sample sizes from diverse cohorts, thereby increasing the likelihood of discovering novel insights into complex traits. Furthermore, emerging methods in genome-wide rare variant association testing further improve power and interpretability.

Cardiometabolic disorders and mild cognitive impairment in White and Black Americans.

Introduction: Mild cognitive impairment (MCI) represents a transitional stage between normal aging and dementia. We investigate associations among cardiovascular and metabolic disorders (hypertension, diabetes mellitus, and hyperlipidemia) and diagnosis (normal; amnestic [aMCI]; and non-amnestic [naMCI]).

Methods: Multinomial logistic regressions of participant data (N = 8737; age = 70.

Long-term oral glucocorticoid use is associated with complications, healthcare resource utilization, and costs among patients with dermatomyositis or polymyositis.

Introduction/objective: Oral glucocorticoids (OGC) are conventionally used as first-line treatment for dermatomyositis (DM) and polymyositis (PM). This study evaluated clinical and economic outcomes associated with long-term (LT) OGC use in DM/PM.

Methods: Adults with ≥ 2 medical claims of DM/PM 30‒365 days apart from January 1, 2016, to December 31, 2022, and ≥ 1 diagnosis code of a physician specialty of interest were selected from the MarketScan Commercial and Medicare Supplemental databases.

Medicolegal landscape of prostate cancer ablative therapy: a national legal database analysis of malpractice claims (1970-2024).

Background: With the advancement of MR-based imaging, prostate cancer ablative therapies have seen increased interest to reduce complications of prostate cancer treatment. Although less invasive, they do carry procedural risks, including rectal injury. To date, the medicolegal aspects of ablative therapy remain underexplored.

Geographic and Policy Factors Influence Telehealth Availability for Substance Use Disorder Treatment.

Telehealth is increasingly a standard and routine clinical option, indicating a changing outlook for SUD treatment from in-person to the more convenient option of telehealth. As populations across geographies increasingly prefer telehealth, more research is warranted that focuses on how where a person lives is associated with telehealth availability. The authors used the Mental Health and Addiction Treatment Tracking Repository (MATTR 2024) to identify telehealth availability among all known licensed SUD treatment facilities in the USA (N = 10,492 facilities).

Mental Health Across the Conception Journey: Trying To Conceive Without Treatment, Considering Treatment, and with Treatment.

Background: While it is well established that trying to conceive while experiencing infertility and undergoing fertility treatment is associated with anxiety, little is known about the mental health toll of trying to conceive without fertility treatment. Minimal contact with the healthcare system while trying to conceive without treatment contributes to low rates of detection and support for this population.

Objective: This research aims to provide formative insights into the prevalence of mental health distress and desire for emotional support among people who are trying to conceive without treatment, and how this compares to people who are considering or using fertility treatment.

Patient-reported outcomes after lobectomy vs. segmentectomy for early-stage non-small cell lung cancer.

Background: Surgical resection is the cornerstone for early-stage non-small cell lung cancer (NSCLC), with lobectomy historically standard. Evolving techniques have spurred debate comparing lobectomy and segmentectomy. This study analyzed early postoperative patient-reported symptoms and functional status in patients with early NSCLC undergoing either procedure.

Risk Trajectories of Type 2 Diabetes-Related Microvascular Complications Across Racial/Ethnic Groups Among Older Adults.

Introduction: Type 2 diabetes mellitus (T2DM) microvascular complications are a major public health issue that disproportionately affects racial/ethnic minorities in the US. We aimed to address the limited understanding of racial/ethnic disparities in the longitudinal natural history of microvascular complications over eight years among older adults with T2DM in the US and Canada.

Methods: From 10,251 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) (2003-2009) trial, we derived 6323 participants.

Specimen extraction techniques utilized in minimally invasive surgery for uterine cancer and an enlarged uterus: a quality assurance study.

This study was conducted to investigate the techniques and complications of enlarged uterine extraction during minimally invasive surgery for uterine malignancy. The electronic medical record was queried for patients with uterine malignancy and enlarged uterus (≥ 250 g) who underwent primary hysterectomy with laparoscopic or robotic approach. Statistical analysis was performed using Fisher's exact test for categorical variables and Kruskal-Wallis test for continuous variables.

Emerging strategies, applications and challenges of targeting NAD in the clinic.

Beyond their classical functions as redox cofactors, recent fundamental and clinical research has expanded our understanding of the diverse roles of nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) in signaling pathways, epigenetic regulation and energy homeostasis. Moreover, NAD and NADP influence numerous diseases as well as the processes of aging, and are emerging as targets for clinical intervention. Here, we summarize safety, bioavailability and efficacy data from NAD-related clinical trials, focusing on aging and neurodegenerative diseases.