Articles: cations.
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There remains clinical equipoise regarding the preference for upfront appendectomy or nonoperative management for patients with complicated appendicitis. However, the natural history of the appendix following nonoperative management and pending interval appendectomy in children is not well characterized, and the risk of recurrent appendicitis as a function of time from index admission not known. ⋯ The highest likelihood of recurrent appendicitis or complications following nonoperative management of complicated appendicitis occurs in the first 50 days following index admission. This information will help surgeons during shared decision-making conversations regarding timing of interval appendectomy.
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Monitoring of electrocorticography for the purpose of detecting spreading depolarization (SD) events is becoming increasingly used both for research and clinical applications. Although such monitoring bears many similarities to standard long-term epilepsy monitoring, there are a number of differences that neurosurgeons need to be aware of when initiating such a program. In addition, most of the focus in SD monitoring has been on traumatic and vascular conditions, where invasive monitoring is used commonly, but electrocorticography is not commonly used. ⋯ It is also recognized that this is a rapidly evolving field and that new advances may disrupt these approaches and that there is a diversity of opinion on these topics, even among SD experts. Nonetheless, the general approach to SD monitoring has now been in use for >15 years and is the basis for several active and proposed clinical trials (NCT05337618, NCT04966546), so an understanding from a neurosurgical perspective of the rationale and approach to monitoring is warranted. In this review, we will consider the potential indications for SD monitoring in clinical trials or clinical care, the methodology for recording and interpreting, and finally some potential therapeutic approaches that are being considered in patients with clinically detected SD.
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Beauty judgments are common in daily life, but rarely studied in cognitive neuroscience. Here, in three studies, we searched for the neural mechanisms of musical beauty using a naturalistic free-listening paradigm applied to behavioral and neuroimaging recordings and validated by experts' judgments. In Study 1, 30 adults continuously rated the perceived beauty of three musical pieces using a motion sensor. ⋯ Effective connectivity analysis discovered inhibition of auditory activation and neural communication with the right orbitofrontal cortex for listening to beautiful passages vs. intrinsic activation of auditory cortices and decreased coupling to orbitofrontal cortex for not-beautiful passages. Experts' questionnaires indicated that the beautiful passages were more melodic, calm, sad, slow, tonal, traditional, and simple than the ones rated negatively. In sum, we identified neural and psychological underpinnings of musical beauty, irrespectively of individual taste and listening biography.
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To delineate how identity-based bias exposure evolves with rank and/or context among healthcare workers, and assess their attitudes toward existing DEI education. ⋯ Identity and context strongly influence both clinicians' exposure and ability to respond to bias in the hospital environment, independent of seniority. Existing DEI training fails to account for this nuance, ultimately diminishing its utility to clinicians.