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Surgical Management of Unilateral Cleft Lip
No full textUnilateral cleft lip is a common congenital defect of the head and neck, which ranges from incomplete to complete forms, with or without cleft palate. Early intervention is crucial to address feeding difficulties and unwanted sequalae. Advanced ultrasonography enables prenatal diagnosis and coordinated planning with multidisciplinary cleft repair teams. Postnatal care includes feeding strategies, growth monitoring, and early interventions like nasoalveolar molding. In this article, surgical techniques, such as Millard, modified Millard or Mohler, and Fisher, are highlighted. Emphasis is placed on functional and aesthetic outcomes, supported by thorough postoperative care and follow-up to ensure optimal recovery
SPACE: Spatially variable gene clustering adjusting for cell type effect for improved spatial domain detection
No full textRecent advances in spatial transcriptomics (ST) have significantly deepened our understanding of biology. A primary focus in ST analysis is to identify spatially variable genes (SVGs) which are crucial for downstream tasks like spatial domain detection. Spatial domains reflect underlying tissue architecture and distinct biological processes. Traditional methods often use a set number of top SVGs for this purpose, and embedding these SVGs simultaneously can confound unrelated spatial signals, dilute weaker patterns, leading to obscured latent structure. Instead, grouping SVGs and getting low-dimensional embedding within each group preserves specific patterns, reduces signal mixing, and enhances the detection of diverse structures. Furthermore, classifying SVGs is akin to identifying cell-type marker genes, offering valuable biological insights. The challenge lies in accurately categorizing SVGs into relevant clusters, aggravated by the absence of prior knowledge regarding the number and spatial gene patterns. Here, we propose SPACE, a framework that classifies SVGs based on their spatial patterns by adjusting for shared cell-type confounding effects, to improve spatial domain detection. This method does not require prior knowledge of gene cluster numbers, spatial patterns, or cell type information. Both simulation and real data analyses demonstrate that SPACE is an efficient and promising tool for ST analysis
Red light photodynamic therapy with 10% aminolevulinic acid gel showed efficacy for treatment of superficial basal cell carcinoma in a randomized, vehicle controlled, double-blind, multicenter phase III study
No full textBACKGROUND: Surgical procedures remain the gold standard for treating basal cell carcinoma (BCC), although commonly associated with cosmetic defects. The demand for noninvasive alternatives remains high.
OBJECTIVE: To determine efficacy and safety of red light photodynamic therapy (PDT) with 10% 5-aminolevulinic acid (ALA) gel vs vehicle for treatment of superficial BCC.
METHODS: This randomized, double-blind, vehicle-controlled, pivotal phase III study was conducted at 21 centers in the US. Eligible participants had ≥1 naïve superficial BCC and received 1-2 PDT cycles (2 PDTs each cycle) followed by clinical and histological assessment 12 weeks after start of the last PDT cycle.
RESULTS: Of 187 randomized participants, 145 received PDT with 10% ALA gel and 42 with vehicle. Histological clearance was 75.9% with 10% ALA gel vs 19.0% with vehicle (P \u3c .0001). Clinical clearance was 83.4% with 10% ALA gel vs 21.4% with vehicle (P \u3c .0001). A total of 88.1% of participants treated with 10% ALA gel rated the esthetic outcome as very good or good. No previously unknown adverse events occurred.
LIMITATIONS: Few participants with lesions on face/scalp; to date, a 60-month follow-up is still ongoing.
CONCLUSION: 10% ALA gel showed significantly higher clearance rates than vehicle with unproblematic safety and positive esthetic outcome
Self-Perceived Hearing Outcomes With Radiation and Cisplatin or Radiation and Cetuximab for Patients With Human Papilloma Virus (HPV)-Positive Oropharyngeal Cancer-Results From NRG Oncology RTOG 1016
No full textPURPOSE: RTOG 1016 was a noninferiority phase 3 trial comparing the efficacy of radiation with either cisplatin (RT + Cis) or cetuximab (RT + Cetux) for patients with Humman Papillomavirus (HPV)+ oropharyngeal cancer (OPC). Perceived hearing handicap was included as a patient-reported outcome (PRO) secondary endpoint. The primary hypothesis was that perceived hearing handicap would be greater for patients receiving RT + Cis compared with RT + Cetux.
METHODS AND MATERIALS: Perceived hearing handicap was measured at baseline, end of treatment, and 3, 6, and 12 months posttreatment using the Hearing Handicap Inventory for Adults Screening Version (HHIA-S), a 10-item self-assessment questionnaire designed to measure patients\u27 reactions to their hearing loss. Mixed ordinal logistic models were used to determine the treatment effect on HHIA-S scores and handicap categories (2-sided α = 0.05).
RESULTS: The PRO substudy included 375 eligible patients. No significant differences in patient/tumor characteristics were found between patients who participated in the HHIA-S study versus those excluded. For total HHIA-S scores and social and emotional subscales, RT + Cetux had significantly lower (ie, better) scores from end of treatment. Change score from baseline to end of treatment for RT + Cis (4.32; 95% confidence interval [CI], 2.57-6.07]) was greater than RT + Cetux (0.08; 95% CI, -1.15 to 1.31). For hearing handicap category, RT + Cis had a significantly higher percentage of mild/moderate and severe cases at the end of treatment (32%) compared with RT + Cetux (20%) (P \u3c .0001). Adjusted conditional odds of higher self-perceived hearing handicap category for RT + Cis compared with RT + Cetux was 3.73 (95% CI, 2.10-6.62).
CONCLUSION: Patients have significantly worse self-perceived hearing handicap after receiving RT + Cis treatment than with RT + Cetux. This was consistent across time through 1 year posttreatment. These findings inform hearing-related outcomes for patients with HPV-associated OPC and indicate the need for ototoxicity monitoring with RT + Cis treatment
Target volume delineation of the neck for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas
No full textThe Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, the Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology collaboratively developed evidence-based guidelines and a comprehensive contouring atlas for neck target volume delineation in nasopharyngeal carcinoma. These guidelines address five key challenges in modern radiotherapy practice: margin design of clinical target volume; nodal target volume delineation after induction chemotherapy; delineation of equivocal nodes evident on imaging; low-risk clinical target volume delineation based on regional stepwise extension patterns; and modifications for anatomical boundaries of lymphatic areas. Developed through a rigorous systematic review and expert appraisal process by a panel of 50 international, multidisciplinary members from 17 countries and regions, these guidelines incorporate the latest advances in nasopharyngeal carcinoma diagnosis and treatment. They reflect contemporary therapeutic concepts and elaborate on current practice variations. These guidelines aim to standardise global practice, substantially improving consistency and reducing variability in nasopharyngeal carcinoma radiotherapy target delineation
Peritoneal Dialysis -Associated Fibrosis: Emerging Mechanisms and Therapeutic Opportunities
No full textPeritoneal Dialysis (PD) requires a healthy and functional peritoneal membrane for adequate ultrafiltration and fluid balance, making it a vital treatment for patients with end-stage renal disease (ESRD). The spectrum of PD-associated peritoneal fibrosis encompasses a diverse range of collective mechanisms: peritoneal fibrogenesis, epithelial to mesenchymal transition (EMT), peritonitis, angiogenesis, sub-mesothelial immune cells infiltration, and collagen deposition in the sub-mesothelial compact zone of the membrane that accompany deteriorating membrane function. In this narrative review, we summarize the repertoire of current knowledge about the structure, function, and pathophysiology of the peritoneal membrane, focusing on biomolecular mechanisms and signalling pathways that potentiate the development and progression of peritoneal fibrosis. The article suggests future directions that could enhance our comprehension of the relationship between peritoneal membrane dysfunction and its fibrosis to elucidate the promising targets for therapeutic interventions. A thorough understanding of early events in pathophysiology closely associated with the inflammatory events in peritoneal fibrosis is the logical starting point for identifying new targets rather than concentrating on more downstream effects. Biomarkers are essential for monitoring the progression of peritoneal fibrosis and evaluating the effectiveness of therapeutic interventions. Biomarkers are evolving in concert with new targets and novel agents, and biomarker outcomes offer a means of monitoring the peritoneal membrane\u27s health. Recent approaches to reducing the etiologies of peritoneal membrane dysfunction, the impact of fibroblast switch, and peritoneal membrane events perturbing fibroblast function are explored and suggest using unique, effective therapeutic strategies to target peritoneal fibrosis and associated complications
Factors associated with colorectal cancer screening among U.S. adults: A cross-sectional study using NHIS 2023 data
No full textIntroduction: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the USA. Although early detection via screening significantly reduces morbidity and mortality, national uptake rates remain suboptimal, particularly among underserved populations. Understanding the multifaceted factors influencing CRC screening adherence is essential for guiding targeted public health interventions.
Objective: This study used a nationally representative sample to identify demographic, socioeconomic, and behavioral factors associated with CRC screening adherence among U.S. adults aged 45-75 years.
Methods: A cross-sectional analysis was conducted using the 2023 national health interview survey (NHIS) data. Adults aged 45-75 years who reported CRC screening history were included. The primary outcome was up-to-date screening per U.S. Preventive Services Task Force guidelines. Independent variables were guided by Andersen and Davidson’s behavioral model of health services use and included demographic characteristics, socioeconomic status, and healthcare access. Multivariable logistic regression analyses were conducted using weighted survey procedures.
Results: The study showed that 68.2% of the adults were up-to-date with CRC screening. Screening rates increased with age and education and were higher among individuals with health insurance and a regular source of care. Compared to non-Hispanic whites, minority groups, particularly Hispanic, non-Hispanic Black, and non-Hispanic Other, exhibited lower screening rates. Access to care, including insurance coverage and a usual care provider, emerged as the strongest predictors of adherence. Individuals who lacked U.S. citizenship, insurance, or faced transportation and cost-related barriers were significantly less likely to be screened.
Conclusion: Disparities in CRC screening persist, especially among younger adults, racial/ethnic minorities, and the socioeconomically disadvantaged. Expanding insurance coverage and strengthening provider engagement are key drivers to improve screening uptake
Let’s Talk About it: Utilizing a Code Blue Debrief for Inpatient Resuscitation Events
No full texthttps://scholarlycommons.henryford.com/nursresconf2025/1022/thumbnail.jp
Scrub Club: No Dues, Just News
No full texthttps://scholarlycommons.henryford.com/nursresconf2025/1029/thumbnail.jp
Advancing Nursing Research Through Implementation Science and Health Equity
No full texthttps://scholarlycommons.henryford.com/nursresconf2025/1049/thumbnail.jp