Publications

PURPOSE: This study explored the 2-year impacts of the Family Engagement in Research (FER) Course on researchers' and family members' engagement in neurodevelopmental disability and child health research.

MATERIALS AND METHODS: A qualitative study was conducted with graduates from the first six cohorts of the FER Course. Data were collected through semi-structured interviews and focus groups two years after taking the course. Thematic analysis was used to analyze qualitative data from transcripts.

RESULTS: Twenty-six learners (family members and researchers) participated in the 2-year follow-up interview or focus group. The majority (85%) reported increased involvement in FER since they completed the course, which included (i) engaging in research and (ii) advocating and championing FER. Learners reported how the course supported their research engagement, which included: (i) feeling confident and empowered; (ii) acquiring new knowledge and skills; (iii) embracing new perspectives; and (iv) growing a network for FER.

CONCLUSIONS: The FER Course is a training initiative that enables and sustains research engagement over time. Training for both researchers and family members is essential for building capacity in FER in neurodevelopmental disability and child health research.

Twice-daily dosing of Dolutegravir is approved for adults with HIV and integrase strand transfer inhibitor resistance, but not for children. Population pharmacokinetic modeling and simulations identified a weight-tiered twice-daily dose for children, predicted to yield dolutegravir exposures within the therapeutic window and provide similar efficacy and safety as seen in adults with HIV-1 and first-generation integrase strand transfer inhibitor resistance.

Two-dimensional (2D) transition metal dichalcogenides exhibit strong excitonic responses, direct bandgaps, and remarkable nonlinear optical properties, making them highly attractive for integrated photonic, optoelectronic, and quantum applications. Here, we present a large-area freestanding membrane photonic platform that achieves exceptional enhancement of light-matter interactions in monolayer WSe2 via quasi-bound states in the continuum (quasi-BICs). The freestanding architecture effectively suppresses radiative losses and supports high-Q optical resonances, leading to enhanced light-matter interactions. This results in significant photoluminescence emission and second-harmonic generation (SHG) enhancement factors of 1158 and 378, respectively, with spatial uniformity sustained across a 450 × 450 µm2 area. This uniform SHG enhancement further enables polarization-resolved mapping of crystal orientation and grain boundaries, offering a practical method for large-area structural characterization of 2D materials. Moreover, femtosecond-pumped SHG spectra reveal multiple narrowband peaks originating from distinct quasi-BIC modes-providing direct spectral evidence of resonantly enhanced nonlinear coupling. The combined attributes of strong optical enhancement, spectral selectivity, and wafer-scale compatibility establish this platform as a scalable interface for 2D semiconductor integration in next-generation optoelectronic, nonlinear, and quantum photonic technologies.

BACKGROUND: Clinical use of cardiovascular magnetic resonance (CMR), reference tool for cardiac function and myocardial tissue assessment, is frequently limited by long acquisition times. This study aimed to compare conventional "standard protocol" (ASSET bSSFP cine plus 2D single-segment PSIR LGE) with novel "fast protocol" incorporating deep-learning reconstruction (Sonic DL bSSFP cine and 2D multisegment PSIR LGE with AIR Recon DL), focusing on image quality, functional measurements, myocardial characterisation, and overall scan duration.

METHODS AND RESULTS: One-hundred consecutive patients with known or suspected myocardial disease underwent both protocols. Participants were predominantly male (78%), mean age 52 ± 16 years, mean BMI 25.0 ± 4.3 kg/m2. Clinical indications included arrhythmias (26%), hypertrophic cardiomyopathy (19%), and coronary artery disease (13%). Cine image quality was comparable between ASSET bSSFP and Sonic DL bSSFP (Likert score 4.59 vs 4.56, p = 0.682), with no differences in ventricular size, function, or left ventricle mass. However, Sonic DL cine markedly shortened acquisition time for long-axis and short-axis stacks (38 vs 61 s and 125 vs 227 s respectively, both p < 0.001). Similarly, 2D-MS PS LGE preserved diagnostic quality (Likert score 4.60 vs 4.51) while reducing acquisition time for long-axis and short-axis stacks (25 vs 77 s and 78 vs 302 s respectively, both p < 0.001). The "fast" protocol reduced total scan time by nearly 60%, enabling comprehensive CMR completion in under 10 min.

CONCLUSIONS: A deep learning-based "fast" CMR protocol significantly reduces scan time without compromising volumetric accuracy or image quality, resulting a feasible option for routine clinical practice.

BACKGROUND: While varices and variceal bleeds are well-known and feared complications of advanced cirrhosis and portal hypertension, omental variceal bleed are a rare sequala even in patients with known esophageal or gastric varices. While rare, omental varices pose a risk for hemoperitoneum if ruptured, which is a life-threatening complication with high mortality rates despite surgical intervention.

CASE SUMMARY: This report reviews the case of a patient 36-year-old female with alcohol related cirrhosis decompensated by ascites, but no history of varices admitted for hemorrhagic shock from spontaneous rupture of omental varices requiring emergency surgery. She underwent the first documented successful orthotopic liver transplantation the same admission.

CONCLUSION: This case report and literature review stresses the importance of early consideration and identification of intraabdominal variceal sources in cirrhotic patients with refractory shock.

This article interprets the "Expert consensus on the management of neonatal parenteral nutrition (2025)", focusing on precise control of parenteral nutrition fluid volume, key considerations for the stability of compounded nutrient solutions, scientific determination of amino acid dosing, and rational recommendations for intravenous lipid emulsion. The aim is to offer authoritative and clear guidance for frontline clinicians, and facilitate the widespread dissemination and effective implementation of the consensus, thereby strengthening the standardization of neonatal parenteral nutrition management and improving short- and long-term outcomes in neonates.

PURPOSE: To evaluate safety, hypertrophy, and kinetic growth rate (KGR) of future liver remnant following yttrium-90 radiation lobectomy (RL-90Y) in liver cancer using resin microspheres.

MATERIALS AND METHODS: This was a retrospective, single-center study. Patients with primary liver cancer who underwent RL-90Y transarterial radioembolization (TARE) from November 2015 to December 2022 were reviewed. Twenty-eight patients (68% with HCC and 36% with iCCA) were included. The right lobe was treated in 18 of 28 patients (64%). Single-compartment dosimetry model was used. Total liver parenchymal volume (TLPV), treated parenchymal volume, and future liver remnant volume (FLRV) were recorded at baseline and after treatment at 0-4 months (T1) and >4 months (T2). Hypertrophy, FLRV/TLPV ratio, and KGR were calculated. Treatment response was categorized by modified Response Evaluation Criteria in Solid Tumors (RECIST) for hepatocellular carcinoma (HCC) and RECIST for intrahepatic cholangiocarcinoma (iCCA). Primary outcomes included safety profile, hypertrophy, and KGR. Secondary outcomes included disease response and proportion of patients bridged to surgery.

RESULTS: The hypertrophy and KGR at T1 were 16% (interquartile range [IQR], 4%-28%) and 1.5% per week (IQR, 0.6%-2.3%) with increase in FLRV (P < .001) and FLRV/TLPV ratio (P < .001). KGR was higher at T1 than at T2 (1.3% vs 0.6%, P = .034). Treatment response (n = 27) was complete, partial, stable, and progressive in 53%, 24%, 6%, and 18% for HCC and 0%, 20%, 50%, and 30% for iCCA. Seven patients (25%) were bridged to resection at 2.5 months (IQR, 1.9-4.7 months). No differences were noted in atrophy, hypertrophy, and KGR at both time points (T1 and T2) when stratified on type of cancer, cirrhosis, portal vein thrombosis, or prescribed tumor dose.

CONCLUSIONS: RL-90Y TARE using single-compartment dosimetry with resin microspheres can safely be performed in patients with primary liver cancer with KGR of 1.5% per week.

BACKGROUND: EUS and MRCP are considered equivalent for pancreatic cancer screening. ASGE guidelines suggest that the choice between these modalities should be based upon patient preferences, however, there is limited data to help guide clinicians.

METHODS: All consecutive patients undergoing pancreatic cancer screening who had undergone both EUS and MRCP between 2021 and 2024 were identified. We also selected a comparison cohort of patients undergoing pancreatic cyst surveillance. A survey to elicit patient preferences and experience regarding physical discomfort, anxiety, dread, convenience, reassurance and cancer worry was administered to both groups.

RESULTS: Of 150 pancreatic cancer screening patients approached, 74 % agreed to participate. We compared mean response scores between EUS and MRCP and found patients favored EUS: less claustrophobia(p = 0.001), less dread(p = 0.02), more reassurance(p = 0.01), and more likely to recommend to family(p = 0.059). While 41.4 % reported no overall preference, 33.3 % preferred EUS and 25.2 % MRCP. Of 70/150(47 %) pancreatic cyst surveillance patients who responded, no difference in anxiety, dread or reassurance was noted between EUS and MRCP, but patients reported more claustrophobia with MRCP(p = 0.001). However, patients were more likely to recommend MRCP to family(p = 0.055). While 36.8 % reported no overall preference, 44.1 % preferred MRCP and 19.1 % EUS. Higher levels of cancer worry were reported by screening than cyst surveillance patients, but both groups reported that this rarely interfered with daily activities.

CONCLUSIONS: Almost 60 % of patients prefer one screening modality over the other, with a trend towards screening patients favoring EUS and cyst surveillance patients MRCP. These findings support a patient-centered individualized approach to pancreatic cancer screening.

BACKGROUND: Lymphatic anatomy has primarily been described in cadaveric dissections. Mapping of the upper extremity superficial lymphatic system with indocyanine green (ICG) lymphography provides functional insights and detail to major anatomic variations.

METHODS: Healthy female volunteers underwent lymphatic mapping of the upper extremities with ICG lymphography. ICG was injected in six standard sites in the hand/wrist and upper arm. Major anatomic variations of four main forearm pathways and connectivity to four upper arm pathways were described.

RESULTS: 90 arms of 45 volunteers were included. The posterior radial channel predominantly courses in the dorsal forearm (98%). The posterior ulnar forearm pathway courses in the dorsal forearm in the majority of arms (70%). The anterior radial and anterior ulnar forearm channels exclusively course in the volar forearm (100%). The posterior radial pathway connects to the bicipital (80%), lateral (48%), medial (9%), and tricipital (7%) upper am pathways. The posterior ulnar pathway connects to the lateral (54%), tricipital (51%), medial (21%), and bicipital (14%) upper arm pathways. The anterior radial pathway connects to the medial (50%) and bicipital (60%) pathways. The anterior ulnar pathway connects to the medial (54%) and bicipital (59%) pathways.

CONCLUSIONS: Upper extremity lymphatic drainage to the lateral and tricipital pathways is enabled exclusively by the dorsal forearm channels suggesting their importance in BCRL risk. Variations of upper extremity lymphatic anatomy are relevant to the risk, prevention, and treatment of breast cancer-related lymphedema risk and warrant further study.