Changes in tobacco use in rural South Africa during the 2020 tobacco sales ban: an analysis of current and previous behaviours using cross-sectional data.

Background: As part of its COVID-19 response, South Africa banned tobacco sales between March and August 2020. We examined self-reported tobacco use before, during and after the ban among a rural South African population with high HIV prevalence.

Methods: Between May 2021 and November 2022, we conducted a telephonic survey on tobacco use among a purposively selected subset of a population-based cohort in rural KwaZulu-Natal.

Differential phagocytosis induces diverse macrophage activation states in malignant gliomas.

Background: Diffuse midline glioma (DMG) and glioblastoma (GBM) are aggressive brain tumors with limited treatment options. Macrophage phagocytosis is a complex, tightly regulated process governed by competing pro-phagocytic and anti-phagocytic signals. CD47-SIRPα signaling inhibits macrophage activity, while radiotherapy (RT) can enhance tumor immunogenicity.

Emerging systemic treatments for asthma and allergic diseases: New tricks, same dog?

Asthma and allergic diseases are heterogeneous conditions driven by complex immunological pathways, with type 2 (T2) inflammation being a key but not exclusive component. Advances in immunology have spurred interest in a breadth of mechanisms and innovative therapeutic strategies, including novel targets, extended dosing intervals, and combined-target therapies. This clinical commentary provides a critical overview of ongoing clinical trials and emerging evidence supporting the use of these therapies in asthma and other allergic conditions.

Developmental auditory deprivation in one ear impairs brainstem binaural processing and reduces spatial hearing acuity.

Early sensory experience can exert lasting perceptual consequences. For example, a brief period of auditory deprivation early in life can lead to persistent spatial hearing deficits. Some forms of hearing loss (i.

Comparative radiation dose analysis in pediatric high-pitch cardiac CTA using photon-counting versus energy-integrating detector CT.

Background: Previous studies have shown improved image quality in pediatric cardiac imaging using photon-counting detector CT (PCDCT). However, these studies did not evaluate image quality and radiation dose when utilizing the full spectral capabilities of PCDCT scanners. The full spectral capability of PCDCT scanners allows the generation of the entire array of mono-energetic reconstructions, virtual non-contrast (VNC) images, and iodine maps, which have potential advantages in evaluating complex congenital heart disease.

Community-based hearing aid fitting model for adults in low-income communities facilitated by community health workers: a feasibility study.

Background: Hearing loss affects more than 1.5 billion people worldwide, yet fewer than 10% of those who could benefit from hearing aids are able to access them. Barriers such as high costs, limited availability, and a critical shortage of trained professionals in low- and middle-income countries contribute to this gap, while emerging models of care-such as task-shifting to community healthcare workers (CHWs) supported by mHealth technologies-show promise in improving access, affordability, and outcomes in underserved communities.

How Is Pulmonary Hypertension Characterised and Treated in Children With Trisomy 21? Observations From the TOPP Registry (Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension).

Pulmonary hypertension is common in children with Trisomy 21, frequently with multifactorial aetiologies. Registry data provide better understanding of disease development, diagnostic workup and treatment patterns in children with Trisomy 21. TOPP (Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension) is a centre-based, comprehensive registry.

Reduction in Dressing Change Burden in Patients With Epidermolysis Bullosa-Impact of Oleogel-S10.

Epidermolysis bullosa (EB) is a severe genetic disorder marked by skin fragility and blistering from minimal trauma. Management relies on frequent and painful dressing changes. The EASE study (NCT03068780), the largest to date in EB, previously demonstrated accelerated wound healing and reduced wound burden for Oleogel-S10 (birch triterpenes) versus control gel.

Identifying Successful Pediatric Outpatient Antimicrobial Stewardship Strategies through Benchmarking: A Multi-Institutional Project.

Background: We evaluated the impact of benchmarking on antibiotic use and identified antibiotic stewardship (AS) strategies affecting pediatric outpatient antibiotic prescribing.

Methods: The Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS)-Outpatient Collaborative shared quarterly benchmarking reports with 22 institutions on antibiotic use metrics (percentage of acute and acute respiratory infection [ARI] encounters with antibiotic prescriptions, and among ARI, rates of amoxicillin and azithromycin use) for emergency departments, urgent care clinics, and primary care clinics. Data on antibiotic duration of ≤7 days were available from a subset of institutions.

Effect of evolocumab on saphenous vein graft patency after coronary artery bypass surgery (NEWTON-CABG CardioLink-5): an international, randomised, double-blind, placebo-controlled trial.

Background: Saphenous vein graft (SVG) failure remains a substantial challenge after coronary artery bypass graft (CABG). LDL cholesterol (LDL-C) is a causal risk factor for atherosclerosis, but its role in SVG failure is not well established. We evaluated whether early initiation of intensive LDL-C lowering with evolocumab could reduce SVG failure.

Feasibility of Pediatric Diagnostic Quality Measurement in All United States Hospitals.

Study Objective: To evaluate the proportion of emergency departments (EDs) with sufficient volumes to measure pediatric misdiagnosis reliably.

Methods: We conducted a cross-sectional study of a nationally representative 20% sample of US EDs within the 2022 Nationwide Emergency Department Sample. We counted the number of child visits (less than 18 years old) at each ED for each of 24 serious pediatric emergency conditions and each ED's total across all conditions.

A narrative review of toxicity after exposure to true morel ( genus) and false morel ( genus) mushroom ingestions.

Introduction: The clinical presentations associated with spp. (true morel) and spp. (false morel) mushroom ingestions are incompletely characterized.

Description of Postoperative Void Patterns After Scheduled Cesarean Delivery Without Use of Routine Intraoperative Urinary Catheterization in a Large-Volume Safety Net Hospital.

Background And Objectives: While urinary catheters are widely utilized during cesarean delivery, little evidence exists to support the practice, and it may be associated with increased risk of urinary tract infections and unnecessary intervention. In this study we aim to describe postoperative voiding patterns and assess the prevalence of complications in patients undergoing scheduled cesarean delivery without an indwelling intraoperative urinary catheter.  Materials and methods: This is a prospective observational cohort of patients undergoing scheduled cesarean delivery at an urban safety-net teaching institution from April 2022 to April 2023.

Circulating TNF-α levels in rheumatoid arthritis: a systematic review and meta-analysis and comparison to TNF-α levels in sepsis.

Background: Tumor necrosis factor-alpha (TNF-α) is implicated in the pathogenesis of autoimmune conditions and sepsis. Although anti-TNF-α therapies have demonstrated clinical efficacy in rheumatoid arthritis (RA), there is no established evidence for benefit in patients with sepsis.

Objectives: We sought to quantify circulating TNF-α in patients with RA and compare results to TNF-α levels in sepsis.

Pathogenic Cardiomyopathy-Associated Gene Variants and Prognosis in Atrial Fibrillation: Results in 18,000 Clinical Trial Participants.

Background: Genetic variants in cardiomyopathy genes are associated with risk of atrial fibrillation (AF), although data on clinical outcomes for AF patients with such variants remain sparse.

Objectives: We aimed to study the prognostic implication of rare cardiomyopathy-associated pathogenic variants (CMP-PLP) in AF patients from large, well-phenotyped clinical trials.

Methods: CMP-PLP carriers were identified using exome sequencing in 5 multinational trials from the Thrombolysis in Myocardial Infarction study group (ENGAGE AF, FOURIER, SAVOR, PEGASUS, and DECLARE), with replication in the EAST-AFNET-4 trial.

Response to biologics along a gradient of T2 involvement in patients with severe asthma: a data-driven biomarker clustering approach.

Background: Asthma with low levels of T2-biomarkers is poorly understood.

Objective: To characterize severe asthma phenotypes and compare pre- to post-biologic change in asthma outcomes along a gradient of T2-involvement.

Methods: This was a registry-based, cohort study including data from 24 countries.

Medical associations' guidance on caring for patients experiencing incarceration in the United States.

The United States has one of the highest incarceration rates in the world. Carceral status can complicate clinical encounters in community and academic settings for an already medically vulnerable population. While it is likely physicians will encounter patients experiencing incarceration in their practice, there are few educational opportunities dedicated to ensuring delivery of healthcare that protects patient dignity, autonomy, and privacy.

Combined inhibition of SHP2 overcomes adaptive resistance to type 1 BRAF inhibitors in BRAF V600E-driven high-grade glioma.

Background: -mutant gliomas can be targeted therapeutically using BRAF-selective inhibitors, yet responses are often transient due to adaptive resistance through reactivation of RAS-ERK signaling. Here, we evaluate the role of SHP2, a central regulator of RAS activity, and SHP2 inhibitors in overcoming resistance to BRAF inhibitors in glioma.

Methods: RNAseq and protein expression in human tissue samples and glioma cell lines were used to identify resistance mechanisms.

Geographic Variations of Intensive Care Unit Admissions with Substance-Related Diagnoses in the United States.

BackgroundSubstance use is an important contributor to morbidity, mortality, and healthcare utilization in the United States. While prior research has explored regional differences in substance use and related hospitalizations, the geographic variation in substance-related ICU admissions remains underexplored. We sought to compare the prevalence of ICU admissions involving substance use across geographic divisions and between urban and rural ICUs in the United States.

Content Validation of the Communication Inventory Disability-Observer Reported (CID-OR).

CDKL5 deficiency disorder is a rare and severe developmental and epileptic encephalopathy that has profound effects on communication. It is essential that communication be measured accurately for upcoming gene therapy trials. The Communication Inventory Disability-Observer Reported (CID-OR) was developed from a framework of communication derived from parent/caregiver interview data (n = 23), in consultation with disability and communication experts, and after reviewing concepts in existing measures.

Severe Cerebral Palsy and Short Stature Predict Absent Baseline IONM Signals in Pediatric Neuromuscular Scoliosis Surgery.

Background: Intraoperative neurophysiological monitoring (IONM) is essential for detecting potential neurological injury during scoliosis surgery, but obtaining recordable baseline signals can be challenging in neuromuscular scoliosis (NMS) patients. Absent baseline IONM signals, characterized by unattainable initial IONM responses despite technical and anesthetic optimization, present significant challenges to intraoperative neurological assessment and surgical risk stratification. This study aims to identify predictive factors for absent baseline IONM signals in pediatric NMS patients and establish a clinically applicable risk prediction model.

Characteristics of Transfusion and Association With Oncologic Outcomes in Hepatoblastoma Resection.

Introduction: Children with hepatoblastoma (HB) and other solid tumors frequently undergo intraoperative blood transfusion (IBT) with unknown impact on oncologic outcomes and scant data to guide transfusion in this population. This study tested the hypothesis that IBT is associated with poorer survival in children with HB.

Methods: A multicenter retrospective observational study of patients aged <18 years with HB who underwent primary tumor resection, including liver transplantation, from 2010 to 2019 was performed at 19 institutions.

Clinical differences in monozygotic twins with Rett syndrome: case report and systematic review.

Background: Rett Syndrome (RTT) is a rare, and severe neurodevelopmental disorder that primarily affects females and is primarily (> 96%) due to pathogenic loss-of-function genetic variants of methyl-CpG-binding protein 2 (MECP2). Despite the rarity of the syndrome, sporadic twin cases have been reported. The descriptions have often focused on the phenotype, emphasizing differences or similarities.