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In children with Chiari type I malformation and syringomyelia, neurosurgical posterior fossa decompression (PFD) provides clinical improvement, but whether duraplasty (incising the dura and placing a dural graft) improves outcomes is unclear. We conducted a multicenter, cluster-randomized, controlled trial of PFD with duraplasty (PFD-D) as compared with PFD alone. Persons 21 years of age or younger with cerebellar tonsillar ectopia of at least 5 mm and a maximum syrinx diameter of 3.0 to 9.9 mm were enrolled at 38 centers. Centers were cluster-randomized: all the participants within each center underwent the same intervention. The primary outcome was surgical complications within 6 months. Secondary outcomes were clinical improvement, syrinx reduction, and repeat decompression at 10 to 24 months and the change in overall health-related quality of life at 6 to 24 months.

We aimed at evaluating the consistency in causal reasoning capabilities of large language models (LLMs) in disease-specific contexts, across the three levels of the causal ladder—associational, interventional, and counterfactual. We aimed at obtaining realistic clinical scenarios involving drug interactions and side effects for Human Immunodeficiency Virus (HIV) antiretroviral therapy (ART).

The objective of this study was to estimate associations of more than minimal prenatal nicotine, alcohol, cannabis, and opioid exposures with gestational age, birth weight, and birth weight for gestational age. Data were drawn from the HEALthy Brain and Child Development (HBCD) Study, a multisite, longitudinal study in the United States. Predefined recruitment thresholds for each substance were assessed using maternal self-report, maternal toxicology results, and newborn substance exposure-related diagnoses. Birth outcomes included gestational age at delivery (weeks), birth weight (grams), and birth weight for gestational age (centiles). Mean differences and risk ratios for the associations between substance exposure and birth outcomes were estimated using multilevel mixed-effect linear regression or multilevel mixed-effect Poisson regression.

Malignant rhabdoid tumor of the kidney (MRTK) is a rare, aggressive tumor seen in young children. The optimal timing of resection for locally advanced tumors is not well-defined. The purpose of this study is to evaluate modern oncologic outcomes and the impact of surgical timing. A multicenter retrospective review was performed by institutions participating in the Pediatric Surgical Oncology Research Collaborative. Children younger than 21 years old with MRTK diagnosed between 2000 and 2022 were included.

To estimate associations of more than minimal prenatal nicotine, alcohol, cannabis, and opioid exposures with gestational age, birth weight, and birth weight for gestational age. Data were drawn from the HEALthy Brain and Child Development (HBCD) Study, a multisite, longitudinal study in the United States. In this initial HBCD Study data release, more than minimal exposure to cannabis and opioids was associated with smaller birth size, adding evidence to an inconsistent literature. Future studies from HBCD can more deeply interrogate timing and dose of each substance and expand to childhood outcomes.

Four experts from the University of Florida Emerging Pathogens Institute gathered to address the 2026 Ebola outbreak, drawing on lessons from previous outbreaks in the Democratic Republic of Congo and examining it at a more microscopic level to understand how it operates.

To examine feasibility, acceptability, satisfaction, and preliminary efficacy of Diabetes Journey (DJ), a randomized controlled clinical trial for 12–17-year-olds with type 1 diabetes (T1D). Our preliminary findings suggest that DJ had high acceptability, feasibility, and satisfaction. Adolescents randomized to DJ showed signals of reduced stress and burnout and improved quality of life at later follow-up, although these findings should be interpreted cautiously given attrition and the optional nature of the final follow-up assessment.

Sepsis-associated acute kidney injury (SAKI) is a heterogeneous condition that lacks disease-modifying treatments, and precision medicine approaches are needed. We previously derived two reproducible pediatric SAKI subphenotypes (pSAKI-1 and pSAKI-2) from readily available clinical data. We aimed to externally validate the prognostic relevance of these subphenotypes, evaluate their molecular signatures, and assess for heterogeneity of treatment effect (HTE) across subphenotypes with sepsis therapies.

Plant-specialized metabolites are essential for plant fitness and human health, with their biosynthesis pathways tightly regulated at multiple levels. However, the translational regulation of their biosynthesis remains poorly understood. Here, we reveal a 5′ untranslated region (5′UTR)–mediated translational mechanism that controls glucosinolate production in Arabidopsis.

Cholera, a climate-associated diarrhea occurs endemically in Dhaka city, Bangladesh, often turning into large epidemics. In 2022, a massive outbreak struck Dhaka city, resulting in a very high number of cholera cases. Although extensive studies have focused on climate and cholera, including genomic evolution of the causative agent, Vibrio cholerae, their association with the case surges remains poorly understood. We analyzed cholera data between 1996 and 2024 from the Diarrheal Disease Surveillance System (DDSS) of icddr,b, and also conducted a follow up genomic analysis of V. cholerae O1 El Tor by including newly sequenced and archived sequence data. Integrated statistical association analysis of cholera cases with the climate and genomic evolutionary factors also reveals a significant association.