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Since the emergence of the highly pathogenic avian influenza (HPAI) A(H5N1) virus (A/chicken/ Scotland/59) in Scotland, UK, several outbreaks of H5Nx viruses have been reported in poultry worldwide (1). In [...]

Noninvasive transabdominal fetal pulse oximetry can provide clinicians critical assessment of fetal health and potentially contribute to improved management of childbirth. Conventional pulse oximetry through continuous wave (CW) light has challenges measuring the signals from deep tissue and separating the weak fetal signal from the strong maternal signal. Here, we propose a new approach for transabdominal fetal pulse oximetry through interferometric near-infrared spectroscopy (iNIRS). This approach provides pathlengths of photons traversing the tissue, which facilitates the extraction of fetal signals by rejecting the very strong maternal signal from superficial layers. We use a multimode fiber combined with a mode-field converter at the detection arm to boost the signal of iNIRS. Together, we can detect signals from deep tissue (>∼1.6 cm in sheep abdomen and in human forearm) at merely 1.1 cm distance from the source. Using a pregnant sheep model, we experimentally measured and extracted the fetal heartbeat signals originating from deep tissue. This validated a key step towards transabdominal fetal pulse oximetry through iNIRS and set a foundation for further development of this method to measure the fetal oxygen saturation.

IntroductionCongenital diaphragmatic hernia (CDH) repair is an area of active research. Large defects requiring patches have a hernia recurrence rate of up to 50%. We designed a biodegradable polyurethane (PU)-based elastic patch that matches the mechanical properties of native diaphragm muscle. We compared the PU patch to a non-biodegradable Gore-Tex™ (polytetrafluoroethylene) patch.MethodsThe biodegradable polyurethane was synthesized from polycaprolactone, hexadiisocyanate and putrescine, and then processed into fibrous PU patches by electrospinning. Rats underwent 4 mm diaphragmatic hernia (DH) creation via laparotomy followed by immediate repair with Gore-Tex™ (n = 6) or PU (n = 6) patches. Six rats underwent sham laparotomy without DH creation/repair. Diaphragm function was evaluated by fluoroscopy at 1 and 4 weeks. At 4 weeks, animals underwent gross inspection for recurrence and histologic evaluation for inflammatory reaction to the patch materials.ResultsThere were no hernia recurrences in either cohort. Gore-Tex™ had limited diaphragm rise compared to sham at 4 weeks (1.3 mm vs 2.9 mm, p = 0.003), but no difference was found between PU and sham (1.7 mm vs 2.9 mm, p = 0.09). There were no differences between PU and Gore-Tex™ at any time point. Both patches formed an inflammatory capsule, with similar thicknesses between cohorts on the abdominal (Gore-Tex™ 0.07 mm vs. PU 0.13 mm, p = 0.39) and thoracic (Gore-Tex™ 0.3 mm vs. PU 0.6 mm, p = 0.09) sides.ConclusionThe biodegradable PU patch allowed for similar diaphragmatic excursion compared to control animals. There were similar inflammatory responses to both patches. Further work is needed to evaluate long-term functional outcomes and further optimize the properties of the novel PU patch in vitro and in vivo.Level of evidenceLevel II, Prospective Comparative Study.

As a measure of cytotoxic potency, half-maximal inhibitory concentration (IC50) is the concentration at which a drug exerts half of its maximal inhibitory effect against target cells. It can be determined by various methods that require applying additional reagents or lysing the cells. Here, we describe a label-free Sobel-edge-based method, which we name SIC50, for the evaluation of IC50. SIC50 classifies preprocessed phase-contrast images with a state-of-the-art vision transformer and allows for the continuous assessment of IC50 in a faster and more cost-efficient manner. We have validated this method using four drugs and 1,536-well plates and also built a web application. We anticipate that this method will assist in the high-throughput screening of chemical libraries (e.g., small-molecule drugs, small interfering RNA [siRNA], and microRNA and drug discovery).

An Amyand's hernia is an unusual diagnosis in children and even rarer in neonates. Perforation of the appendix inside the hernia sac is also extremely unusual. The diagnosis of an Amyand's hernia is difficult as presenting symptoms can also be attributed to an isolated inguinal hernia, noncommunicating hydrocele, or testicular torsion. We present a case of an Amyand's hernia with perforated appendix and scrotal abscess in a premature newborn.

IntroductionOptimal management of pediatric perforated appendicitis remains a topic of active investigation. Our institutional clinical practice guidelines (CPGs) were modified to discontinue antibiotics on discharge for patients with normal white blood cell count (WBC) without left shift. We hypothesized that patients would receive fewer antibiotics without increased complications.MethodsPatients

CDH is a congenital defect in the diaphragm causing herniation of abdominal contents and impaired lung growth. PTFE is a synthetic polymer that is the current standard of care for patch repair of CDH. Limitations: stiff, not biodegradable, no growth with the child leading to reherniation and repeated intervention. Polyurethane (PU) is a novel material that is elastic, biodegradable, and biocompatible, allowing for optimized lung mechanics and tissue integration.

Lymphatic malformations are fluid-filled congenital defects of lymphatic channels occurring in 1 in 6000 to 16,000 patients. There are various types, and they often exist in conjunction with other congenital anomalies and vascular malformations. Great strides have been made in understanding these malformations in recent years. This review summarize known molecular and embryological precursors for lymphangiogenesis. Gene mutations and dysregulations implicated in pathogenesis of lymphatic malformations are discussed. Finally, we touch on current and developing therapies with special attention on targeted biotherapeutics.

Spina bifida is the most common congenital defect of the central nervous system which can portend lifelong disability to those afflicted. While the complete underpinnings of this disease are yet to be fully understood, there have been great advances in the genetic and molecular underpinnings of this disease. Moreover, the treatment for spina bifida has made great advancements, from surgical closure of the defect after birth to the now state-of-the-art intrauterine repair. This review will touch upon the genetics, embryology, and pathophysiology and conclude with a discussion on current therapy, as well as the first FDA-approved clinical trial utilizing stem cells as treatment for spina bifida.

Background: Given the crucial role of integrating acupuncture treatment into primary care for managing chronic diseases, this study endeavors to identify the utilization of acupuncture among chronic disease patients seeking primary care services in Korea. Additionally, it aims to evaluate their knowledge level and perceptions related to acupuncture use. Methods: A descriptive cross-sectional study was conducted among chronic disease patients attending a primary care clinic in Korea. A self-reported questionnaire comprising 37 items was employed to evaluate the utilization of acupuncture treatment. These items covered socio-demographic information, respondents' health status, levels of acupuncture knowledge, and patterns of acupuncture use. Using the SPSS Statistics 26.0 Network Version program, descriptive statistics, a chi-square test, and a logistic regression analysis were performed to identify factors associated with acupuncture treatment. Results: Out of 370 respondents, 44.3% reported utilizing acupuncture treatment. The most popular reason for the utilization of acupuncture was to enhance the effectiveness of the current treatment. The patients with musculoskeletal disease had the highest utilization rate of 53.2%. The main source of information for acupuncture use was family and friends. The average score for the level of knowledge on acupuncture treatment among the respondents was 65.4%, and the knowledge level of the acupuncture group was high. Potential predictors of acupuncture use included musculoskeletal disease, and intention to recommend acupuncture. Conclusion: This study highlights the widespread acceptance of acupuncture use among patients with chronic diseases in primary healthcare context. Integration of acupuncture into primary care emerges as a viable avenue for effective chronic disease management, and fostering a comprehensive and holistic approach to healthcare. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]