Faculty Bibliography

OBJECTIVES/OBJECTIVE:Retained placenta is a potential complication of second-trimester induction of labour. There is limited consensus regarding the use of adjunctive medications to manage the third stage following second-trimester vaginal delivery. This study aimed to evaluate the effects of oxytocin versus misoprostol on third-stage duration and the need for dilation and curettage (D&C) among patients with and without mifepristone pretreatment. STUDY DESIGN/METHODS:We conducted a retrospective cohort study of patients undergoing induction of labour between 14 + 0 and 23 + 6 weeks of gestation for any indication. Data on third-stage uterotonic use and mifepristone pre-treatment were collected. Primary outcomes were third-stage duration and the need for D&C for retained placenta among patients who received a third-stage uterotonic agent. Associations were assessed using adjusted linear and logistic regression models controlling for relevant clinical covariates. RESULTS:Among 181 patients, 85 (47.0%) received a third-stage uterotonic (oxytocin n = 55, 30.4%; misoprostol n = 45, 24.9%) and 101 (55.8%) received mifepristone (median 4.6 h prior to induction). Among patients receiving a third-stage uterotonic, oxytocin use was associated with a 2-hour reduction in placental delivery time and a 74% lower likelihood of D&C compared with misoprostol. Mifepristone pretreatment was not associated with third-stage duration (10 vs 24.5 min, p = 0.43) or D&C rates (12.9% vs 13.8%, p = 0.86). CONCLUSIONS:When third-stage uterotonic intervention is required following second-trimester induction of labour, oxytocin is associated with significantly shorter placental delivery time and lower likelihood of D&C when compared with misoprostol. Mifepristone pretreatment shortly before induction appears to have minimal impact on third-stage outcomes.

With the rapid development in cell therapy and biopharmaceutical production in recent years, safe cryopreservation technologies are required to ensure product quality and safety. Dimethyl sulfoxide (DMSO), which is widely used as a conventional cryoprotectant, raises concerns owing to its cell permeability and consequent cytotoxicity. In this study, we focused on non-cell-permeable zwitterions that exhibit low cytotoxicity. We synthesised 21 zwitterions and systematically evaluated the relation between their molecular structures and cryoprotective effects. Elongation of the cationic side chain or spacer decreases the cryoprotective effects, which are associated with cytotoxicity and freezing of the unfrozen fraction. In contrast, ammonium/sulfonate-type zwitterions exhibited strong cryoprotective effects. This suggests their involvement in the modulation of membrane properties and the suppression of ice crystal formation. Notably, one of the synthesized ammonium/sulfonate-type zwitterions achieved cell recovery comparable with that of a commercial DMSO-containing cryoprotectant for human mesenchymal stem cells. This study deepens understanding of cryoprotective mechanisms based on the molecular design of zwitterions and provides guidelines for safe cellular cryoprotectants.

BACKGROUND/UNASSIGNED:Related to a lack of a perceived fiduciary obligation, the health insurance industry has not historically been supportive of the efforts of providers who treat pain. In the United States and several other nations, the early years of this millennium were marked by a prescription opioid crisis, resulting in abuse, addiction and hundreds of thousands of deaths. OBJECTIVE/UNASSIGNED:The temporal contiguity between payors' withdrawal of support for interdisciplinary pain management and the onset of the prescription opioid crisis has been noted in the literature, as were payors' global instruction to physicians to just prescribe medications. STUDY DESIGN/UNASSIGNED:This is a perspective on health policy. RESULTS/UNASSIGNED:With the explosion of interventional technology and techniques over the past decades, physicians have been able to provide more effective and certainly safer pain management to sufferers of chronic pain. However, over the past several years, payors' willingness to reimburse for previously covered interventional treatments has waned, causing considerable suffering for patients and frustration for clinicians. These payors include the Centers for Medicare and Medicaid Services as well as private insurers. LIMITATIONS/UNASSIGNED:This is a perspective article with limited literature on the topic. CONCLUSION/UNASSIGNED:At present, clinicians are being told to resort to medications, despite a dearth of novel, safe pharmacological agents appropriate for chronic pain management. The availability of restorative, behavioral and alternative medicine approaches is limited in terms of insurance reimbursement. Accordingly, noncoverage of interventional approaches to chronic pain management has the potential to indirectly result in another prescription opioid crisis, which neither our patients nor providers deserve.

Neurons accumulate somatic mutations with age, but how mutation processes vary among neuronal types remains unclear. Characterizing this variability may elucidate the role of genome integrity in brain function and disease and reveal determinants of mutation rates and patterns. Using high-fidelity duplex DNA sequencing, we profiled somatic mutations across the lifespan in human cerebellar Purkinje and granule neurons, which differ markedly in size and physiology. Surprisingly, they exhibited similar substitution rates, including rates of SBS5, the body's predominant mutational signature, whose mechanism is unknown. However, their substitution patterns and insertion/deletion rates and patterns differed, with transcription associated with these differences. In surviving granule neurons from five cerebellar ataxias, we detected only a small disease effect on mutation profiles. Our work indicates that neuronal types can differ in aging-related mutagenesis and that key features distinguishing Purkinje and granule neurons are unlikely, in these neurons, to be major determinants of SBS5 activity.

Treatment de-escalation is increasingly shaping the management of breast cancer, aiming to reduce treatment intensity, minimize toxicity, and improve quality-of-life outcomes without compromising effectiveness and survival. Breast cancer cryoablation, a minimally invasive image-guided percutaneous technique that destroys tumor cells through controlled freezing and thawing, has emerged as an alternative to surgery for select patients with early-stage disease. Support for this approach has grown following recent prospective trials demonstrating its safety and efficacy, US Food and Drug Administration approval of the ProSense Cryoablation System for early-stage low-risk breast cancers in women 70 years of age and older, and inclusion of breast cancer cryoablation in updated American Society of Breast Surgeons treatment guidelines. In this review, we summarize the mechanistic rationale, clinical evidence, and practical considerations for clinical adoption of breast cancer cryoablation in the evolving paradigm of treatment de-escalation.

Children and youth seeking asylum encounter a range of unique experiences and obstacles in their efforts to secure protected immigration status. This study used a consensual qualitative research approach to analyze data that centered lived experience voice gathered from first-person interviews with 12 adults, six men, and six women aged 18-29 years, who entered the United States as minor asylum seekers. Results indicated that they experienced premigratory exposure to violence or harm, psychological distress, financial instability, and obstacles to health care. Participants also reported fear, adversity, and time spent in immigration detention centers as they sought asylum in the United States. Further, they disclosed current mental health concerns, as well as barriers to education, employment, and legal representation. Participants identified a series of effective internal and external supports they leveraged to adaptively respond to systemic challenges, described their aspirations for the future, and provided recommendations for guiding clinicians in service provision. The results of the study can inform psychologists and allied professionals about the impact of exposure to harm that asylum-seeking minors face, this population's resilience, and possible strengths-based strategies for responding to the needs of young people experiencing forced displacement and areas of potential advocacy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Freezing during Pavlovian fear conditioning is the most commonly used indicator of learned fear in rodents. Although freezing and its neural underpinnings have been widely studied, the field has largely ignored other potential indicators of learned fear. Darting, an escape-like conditioned fear response, occurs more frequently in females and is reliably predicted by a distinct behavioral phenotype: heightened shock response and decreased freezing compared to rodents that do not engage in darting. The experiments in this study sought to expand the field's understanding of conditioned fear by investigating the neural correlates of conditioned darting, focusing on the infralimbic cortex (IL) and longitudinal columns of the periaqueductal gray (PAG) due to their known roles in modulating defensive responses, including conditioned freezing. We find that fear conditioning elicits greater neural activity (measured by quantification of cFos expression) in the IL of females compared to males, but that IL activation corresponds to freezing only in Darters. We next used chemogenetic tools to excite or inhibit either the IL alone or IL-PAG projections prior to fear conditioning. IL manipulations in either direction reduced freezing in both males and females, while IL inhibition increased darting and shock response in females only, and the effects of circuit-specific manipulations were minimal. Together, our findings suggest a novel, role for the IL in driving defensive responses during fear conditioning that is not dependent on IL-PAG connectivity.

Environmental pollution, particularly water contamination, continues to be a critical global challenge, thereby necessitating the development of sustainable and high-efficiency catalytic systems for wastewater treatment. In this study, silver nanoparticles (AgNPs) were synthesized via a green chemistry approach and embedded on a biocomposite, cellulose-chitosan aerogel integrated with hydroxyapatite (HCCA) derived from Basa (Pangasius bocourti) fish bones. Notably, the synthesis route is straightforward, eco-friendly, and minimizes the use of hazardous chemicals. Durian shell (DS) extract was utilized as a natural reducing and stabilizing agent, while residual biomass was treated to obtain high-purity cellulose, highlighting the effective valorization of agricultural waste. The resulting HCCA aerogel biocomposite, fabricated through crosslinking and freeze-drying, exhibits high porosity (>97%) and ultralow density (about 0.03 g cm^-3), facilitating uniform dispersion and stabilization of AgNPs. The optimized 1.25Ag@HCCA sample achieved nearly complete conversion (about 99%) of p-nitrophenol (PNP) to p-aminophenol (PAP) within 15 minutes and retained approximately 98% efficiency after seven reuse cycles. Additionally, strong antibacterial activity against Escherichia coli and Salmonella paratyphi was observed. Overall, the Ag@HCCA sample demonstrates high potential as a multifunctional, sustainable material for wastewater treatment and waste valorization in circular economy applications.

INTRODUCTION/BACKGROUND:Gastroschisis is a congenital birth defect with a rising incidence. The herniation of intestines into the amniotic cavity leads to prenatal bowel injury, which contributes to significant postnatal morbidity and mortality. Current management focuses on postnatal interventions, though bowel injury begins in utero. Emerging interest in prenatal therapies aims to mitigate this injury and improve outcomes. However, none of these interventions has been widely adopted in clinical practice, highlighting the need for further research and validation. This protocol aims to outline the procedures to conduct a systematic scoping review of prenatal interventions to improve outcomes for gastroschisis, identifying gaps in the literature to guide future research and inform clinical practice. METHODS:This systematic scoping review will follow the PRISMA-ScR guidelines. We will include studies on prenatal interventions for gastroschisis in both human and animal models. Key databases including MEDLINE, Embase, Scopus, and others will be searched. Gray literature and clinical trial registries will also be reviewed. Studies will be screened, selected, and data extracted in duplicate using predefined criteria. Descriptive analysis will summarize findings, grouped by intervention, with outcomes presented in a narrative synthesis. DISCUSSION/CONCLUSIONS:This scoping review will be the first to systematically examine prenatal interventions for gastroschisis, addressing a growing clinical need due to its rising incidence and associated morbidity. Despite promising experimental approaches, no prenatal therapies are currently standard practice, underscoring the need for further research. This review will identify existing evidence and highlight knowledge gaps. Findings could inform the development of targeted prenatal treatments, improve clinical outcomes, and support the integration of effective interventions into routine care, ultimately reducing morbidity and mortality associated with gastroschisis. SYSTEMATIC REVIEW REGISTRATION/BACKGROUND:The review protocol has been registered within the Open Science Framework database ( https://doi.org/10.17605/OSF.IO/39DSQ ).